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Uworld Gaby > Step3 CCS > Flashcards

Step3 CCS Flashcards

1
Q

Nephrotic Sd. Criteria

A
  1. Generalized edema
  2. Protein <2
  3. Uprot/Ucreat= >2 or 24hrs Urine >50mg/kg
  4. Hypercholotesrolemia >200
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2
Q

Lab/Orders workup for for nephrotic sd.

A

CBC, CMP, Liver panel, PT/PTT, UA, albumin, lipid panel, complement 3 and 4

Wards
IV
vitals 4hr
I/O
Albumin
Lasix
Low Na diet
CMP am

Prednisone
Repeat albumin and Lasix

Discharge with steroid treatment for 4-6 weeks
Follow up in 3-5 days

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3
Q

Workup for hypertensive crisis

A 
Emergency orders before the exam
IV access
Oxygen
Pulse oximetry
Cardiac monitor
BP monitor

CBC, CMP, EKG, CT, Chest Xray, UA

If no Stroke

IV arterial line
Nitroprusside

Transfer to ICU
NPO
Complete bed rest
Monitor Urine I/O

Check BP every 30 min until norma

Final orders:
Lipid profile
Counseling

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4
Q

Orders for neonatal sepsis

A

Order:
Pulse oximetry
Physical exam

Order: 
CBC, CMP, CRP, UA culture, Blood culture, CSF analysis and culture, chest x-ray
IV access, dextrose, saline
Vitals q4
Oxygen if <94
Next: 
Admit to floor
Continuous cardiac monitoring
Ampicillin
Cefotaxime
Saline+dextrose
NPO if tachypnea >60
I/O
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5
Q

Kid with sudden shortness of breath aproach

A

Emergency orders
IV access
Pulse oximetry
Oxygen

Exam

Neck and Chest x-ray
CBC

Bronchoscopy

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6
Q

EMERGENCY ORDERS

A 
Pulse oxymetry
Oxygen therapy
Fingerstick glucose
EKG
Cardiac monitor
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7
Q

Approach to a patient with active TB

A

CBC, Creat, BUN UA, Chest Xray, sputum gram, and AFB, ESR, EKG

AFB positive for Bacilli

Admit to ward
LFTs
Uric acid (pyrazinamide increases uric acid)
Ophthalmology consult (before ethambutol)

Initiate treatment
Isoniazid (6m)
Piridoxine(6m)
Rifampin (6m)
Ethambutol (2m)
Pirzainamide (2m)

Continue treatment until 3 consecutive negative AFB
Routinely check LFTs
X-ray after 1 month

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8
Q

Approach to Irritable bowel sd (no alarm symptoms)

A

Complete physical
CBC, BMP, Stool test (parasite, blood, 72hr fat, cells), ESR

Send patient home

All tests are normal (obviously)

Lactose-free diet
Loperamide
Biofeedback
Relaxation
Counsel
Reassurance
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9
Q

Order and treatment for Alzheimer Dementia

A

CBC, BMP, LFT, UA, TSH, Vit. B12
Brain MRI

Donepezil
Vitamin E
SSRI if depressed
Olanzapine if paranoid

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10
Q

Management of invasive SCC of the throat

A

Chemo + Radio

It may help make an inoperable case, operable

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11
Q

Indication of removal of an IUD in a patient with cervicitis or PID

A

When there is no response to treatment

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12
Q

What condition is poxvirus responsible for?

A

Molluscum contagiosum

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13
Q

Eczema herpeticum

A

Herpes simplex infection associated with eczema

Painful, herpes rash over the skin (not lips) +/- fever, lymphadenopathies

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14
Q

Organs that you evaluate for in patients with neurofibromatosis

A

Type 1: optic glioma

Type 2: acoustic neuroma

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15
Q

Immune Reconstitution Inflammatory Syndrome

A

Inflammatory response after the patient is initiated with anti-HIV medication, especially common on patients treated for TB at the same time

Occurs several weeks after treatment initiation and present as paradoxical worsening of the infection

NO treatment is needed, systemic steroids can be added if symptoms are too bothersome

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16
Q

Test in patients with presbycusis to decrease speech discrimination ability

A

Create background noise or distracting environment

17
Q

Length of treatment of depression

A

6 months for first-timers

1-3 years for repeating episodes or indefinitely

18
Q

Important orders in patients with hypertensive crisis

A

Nitroprusside

Arterial line

19
Q

Orders for a patient with Pelvic inflammatory disease

A 
CBC
BMP
UA and culture
Vaginal everything
HIV
VDRL
Pap-smear
If the patient cant tolerate oral:
Ward
Antibiotics (doxy+ ceftriaxone)
NPO
Bed rest

Send patient home if improvement

If ambulatory: ceftriaxone IM (one dose) + doxy

Do not wait for results to start antibiotics

20
Q

ACUTE CORONARY SD

A

EMERGENCY ORDERS
IV, saline, O2 sat, cardiac monitor, ekg, nitrate, aspirin

FOCUSED PHYSICAL EXAM

ORDERS
Cardiac enzymes
Chest Xray
Echocardiogram
CBC, BMP, LFTs
PT/PTT
MEDICATION
Aspirin
Metoprolol
Heparin
Statin
Eptifibatide (if catheterization)

Rember: consult cardiology
cath lab

Uworld Gaby (77 decks)

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