Test 23 - Created July 22 Flashcards
timing of echo in kids with Kawasaki disease
time of dx, 2 wks after tx, 6 wks after tx
important fact about IVIg
delay all live vaccines for 11 months after administration
prognosis of Kawasaki
risk of future cardiac events are NOT increased if baseline echo normal
common cause of balanitis and what to do next
if thick, white d/c present, think Candid; check blood glucose for DM especially if nocturnal enuresis is present
tests to do if you suspect Duchenne’s muscular dystrophy
CK first; genetics to confirm
leading cause of death in young women with SLE and why
cardiovascular events due to premature coronary atherosclerosis and coronary artery disease
mgt of cocaine induced MI
- oxygen, ASA, diazepam, nitroglycerin
- CCBs for persistent CP
- phentolamine for persistent HTN
- PCI if ST elevation continues despite tx #1
- alteplase if PCI isn’t available
initial drug of choice for RA once joint destruction found on xray and NSAIDs already started
methotrexate
examples of DMARDs to use in tx of RA
MTX, hydroxychloroquine, sulfasalazine, leflunomide, azathioprine
tx of cyanide toxicity
stop nitroprusside and give sodium thiosulfate
when to suspect cyanide toxicity
renal failure, prolonged nitroprusside use, unexplained metabolic acidosis, AMS, seizures, flush, arrhythmias, tachypnea
complications of untreated hyperthyroidism
arrhythmia, CMP, osteoporosis
hyperthyroidism in a child
may look like ADHD but also may have wt loss, goiter, lid lag, tachycardia, tremor, hyperreflexia, and warm/sweaty skin
tx of insomnia
CBT first; then zolpidem
what to do if you suspect Guillain-Barre and pt having significant respiratory sxs
check vital capacity at bedside; LP can wait
when supracondylar fractures occur
fall on outstretched hand
when to suspect occult, nondisplaced fracture at elbow
elbow pain/swelling, limited ROM; fat-pad displacement on Xray; tx = splint
next step when pt is suspected of having ankylosing spondylitis
xray of sacroiliac joint
what can be used to monitor disease progression in patients with ankylosing spondylitis
radiographs (L and C spine; pelvis) and ESR
MC extraarticular manifestations of ankylosing spondylitis
acute ant. unveitis, AR, apical pulmonary fibrosis, IgA nephropathy, restrictive lung dz
what can help with disease course of ankylosing spondylitis
regular aerobic exercise
prognosis of ankylosing spondylitis
no disabilities and no increased overall mortality
prophylaxis that is indicated for pt hospitalized for variceal bleed
antibiotics for SBP; ceftriaxone -> TMP-SMX or FQN
when to suspect scoliosis in young teen
thoracic or lumbar prominence on forward bend test
when is xray indicated if (+) forward bend test
spinal rotation 7* or more
tx of scoliosis based on Cobb angle
< 10: observe
10-39: observe or back brace
40*+: surgical eval
what to do with pt who has painless vaginal bleed and >20 wks
TVUS to rule out previa
