Test 25,26,27 - Created July 23 Flashcards
problem with hypertransfusion regimen
iron overload and organ damage; happens commonly in kids with bad anemia
tx of urge incontinence
tolterodine, oxybutynin, solifenacin
staff gets a needlestick injury, what to do if pt refuses HIV testing
start staff member on HIV prophylaxis
signs of aspirin toxicity
tachycardia, tachypnea, hyperthermia, dizzy, N/V; also shows respiratory alkalosis and AG metabolic acidosis
tx of aspirin toxicity
Na bicarb, glucose, activated charcoal (w/in 2h); dialysis if really bad
what increases risks for pyloric stenosis
macrolides in first 2 wks of life, first born boy, formula feeding
celiac disease presentation
large volume, foul smelling, excess gas, wt loss, microcytic anemia; increases osmotic gap
celiac disease pathology
villous atrophy with increased extraepithelial lymphocytes; crypt hyperplasia
tx of celiac disease
gluten free diet; replace nutritional deficiencies; DEXA scans; pneumococcal vaccine; dapsone for dermatitis herpetiformis
risk associated with central venous access for TPN
Candida endophthlamitis, esp. if in ICU or has neutropenia
Candida endophthlamitis presentation
fever, eye pain, decreased vision; fundoscopy shows focal, white, glistening, mound-like lesions that leads to vitreous haze
tx of Candida endophthlamitis
vitrectomy and systemic Amp B (plus antifungal injected into eye)
teen presents with hunchback. when is tx necessary?
back brace with chronic pain. surgery of angle of convexity is >60*
when U/A and urine culture is needed to evaluate UTI in adult female
if possible pregnancy, pyelonephritis, or vaginal infection
empiric tx of uncomplicated UTI in female
TMP-SMX x3 days or nitrofurantoin x5 days
when to do colonoscopy in pt who is high risk for colon cancer
at age 40 or 10 yrs before age of dx in 1st degree relative (whichever comes first); repeat q3-5 yrs
mgt of UTI in pregnant pt
cephalexin, amoxi-clav, fosfomycin, nitrofurantoin
tx of pyelonephritis in pregnant pt
IVF and Abx until afebrile 48h; oral Abx 10-14d; daily suppressive Abx until 6w postpartum
tx of bipolar patients with severe mania
lithium (or valproate) plus antipsychotic
smoking cessation at an older age: benefits
mortality risk will drop below that of current smokers within next 5 years. decreased risk of cardiac events, osteoporosis (w/in 10 yrs), and decline in lung function.
what to do with pt who has bilateral nipple d/c and negative PE, labs, and imaging
reassure and observe
moa for organophosphate toxicity
inhibition of acetylcholinesterase
tx of organophosphate toxicity
IVF, decontaminate, atropine (inhibit ACh) plus pralidoxime (reactivate enzyme)
overall risk with antipsychotic use in dementia patients
increased mortality risk; short-term benefits may outweigh long-term risks; use as last resort and low dose
organ systems that may get damaged by diphtheria
heart, kidneys, neuro
tx of PCP intoxication
mild - low stim environment
bad - lorazepam
presentation of PCP intoxication
tachycardia, HTN, ataxia, bizarre behavior, nystagmus, possible hallucinations
presentation of coarctation of aorta (later in child’s life)
claudication, arm HTN, leg htn, weak/delayed distal pulses; possibly continuous murmur
management of pressure (decubitus) ulcers
- full-thickness wounds (III, IV) -> debride devitalized or necrotic tissues
- shallow ulcers (I, II) -> use dressings to maintain moist, wound environment
presentation of Vitamin D deficiency in pt with h/o gastric bypass surgery
LBP, low P, high alk phos, osteomalacia, 2* hyperPTH; need 2000-3000 IU/day
presentation of appendicitis in pregnant woman
can look similar to pyelonephritis: fever and R sided abd. and flank pain; do abdominal U/S
possible complication of untreated appendicitis
pylephlebitis (infected portal vein thrombosis)
