Step3 45 Flashcards
Adults vs. Infant botulism
Adults: toxin. Treat with equine serum heptavalent antitoxin. Canned food, aged seafood
Infant: bacteria. Treat with IVIG. Honey and dust in farms
Symmetric descending FLACID paralysis in adults
Constipation could be the only initiating symptom in children. Considerer if bulbar palsy, constipation, hypotonia
Avoid antibiotics, especially aminoglycosides. They cause the bacteria to lyse and worsen the situation
Statistical methods
ANOVA
Chi-Square
T-test
Fisher test
ANOVA:
Compares the mean value of a continuous variable (number value) difference between multiple groups >2
Chi-Square and Fishers Test:
compares 2 categorical variables (not continuous). Fisher is the same but with smaller samples. Eg. treatment response (success/failure) compared with sex (male/female)
T-test:
2 paired means. Eg. Blood pressure (before and after treatment) in the same patient
Gestational diabetes
Screening:
Target glycemic state
Postpartum management
Screening: 2nd trimester 24-28 weeks Step1: 1hr 50mg: glucose challenge Step2: 3hr 100mg: glucose test Fasting: >95 or 105 1hr: >180 or >190 2hr: >155 or >165 3hr: >140 or >145
Target:
Fasting <95
1hr: <140
2hr: <120
Postpartum management:
Stop insulin
Check fasting glucose at 48-72hr
Glucose tolerance test at 6-12 weeks postpartum with 75grms
Types of pulmonary hypertension and best pharmacological treatment
- Idiopathic
Endothelin receptor antagonist: bosentan, ambrisentan
5-alpha reductase: sildenafil
Prostacyclin pathway agonist: epoprostenol, treprostinil
Type 2: Secondary to left heart disease
ACE/ARA, CCB
Type 3: Due to pulmonary disease
Adenosine:
Muscarinic agonist: Ipratropium in COPD
Unhealthy alcohol use
Women
>3 drinks on any day
>4 drinks in one sitting
>7 drinks per week
Men
>4 drinks on any day
>5 drinks in one sitting
>14 drinks per week
Diabetic neuropathy
TCAs: amitriptiline, nortriptiline
SNRI: duloxetine, venlafaxine
Gabapentin
