Test 40 - Created Aug 6 Flashcards
what is considered threatened limb in acute limb ischemia and what to do about it
severe pain, delayed cap refill, no arterial Doppler signals, sensory/motor deficits
tx = heparin and emergency surgical revascularization
net clinical benefit
clinical usefulness of a med; measure of its possible benefit minus its possible harm.
If a question asks this, look for the answer that has both a benefit and a harm of the med. Also, make sure they’re statistically significant!
what’s the purpose of “intention-to-treat” approach
preserve randomization and to avoid the effects of crossover and dropout
apathetic thyrotoxicosis in elderly patient
lethargy, confusion, depression
next step in newly discovered hypercalcemia
PTH level
cancers with hypercalcemia
Squamous cell, renal, bladder, breast, ovarian, multiple myeloma, lymphoma
when fibrates prescribed
triglycerides > 1000
when statins are indicated
established ASCVD, LDL >190, age >40 with DM + high 10 yr ASCVD risk, 7.5-10% 10 yr ASCVD risk
when looking at lipid profile, which numbers do you pay attention to when thinking about statin therapy?
LDL
what causes a diverticular bleed
arterial erosion due to colonic mucosal outcropping
ways to diagnose diverticular bleed
colonoscopy or tagged RBC scan
ways to treat diverticular bleed
IV volume replacement, endoscopic therapy, angiographic embolization, colonic resection
what to do if patient in pain, having dyspnea, and already been giving morphine
if patient is dying and “comfort care” only, give more morphine to make patient more comfortable
labs done at initial prenatal visit
Rh(D) type and Ab, CBC, STDs, rubella, varicella, pap, urine Cx, urine protein
labs done at 24-28 wks GA
CBC, Ab screen if Rh(D) neg, GTT
labs done at 36-38 wks GA
GBS culture
reasons why pt with h/o cholecystectomy may have acute cholangitis
biliary stricture, malignant biliary obstruction, or post-cholecystectomy migration of a biliary clip; GB is removed but biliary duct remains, hence why cholangitis can happen!
tx of pediatric sepsis in < 1 month old
amp + gent
or
amp + cefotaxime
why is ceftriaxone bad in a hyperbili baby
it can displace albumin-bound bilirubin and worsen hyperbili
what 2 drugs can cause hyperbilirubinemia
ceftriaxone and sulfonamides
when is tx needed for salmonella
kid < 1 yo and immunocompromised people
what to do when a pt declines a recommended service based on inaccurate or incomplete info
provide a balanced assessment of the intervention including benefits, risks, and limitations; improves the decision-making
what uterine anomaly is most commonly associated with recurrent pregnancy loss and how do you fix it?
uterine septum; hysteroscopic resection (surgery)
next step if maternal serum AFP elevated
repeat AFP to double-check value and then do obstetric U/S for detailed anatomic survey
positive antibodies for antiphospholipid-antibody syndrome
lupus anticoagulant, anticardiolipin Ab, and anti-beta-2 glycoprotein Ab
tx of hepatic adenoma
Asx and < 5 cm: stop OCPs
SXS or > 5 cm: surgery with serial imaging and AFP levels
best choice of anti-HTN drug for pt on Lithium
CCB (-dipine) or loop diuretic
what do to if statin was discontinued due to CK level >10x normal after extensive exercise
repeat CK level and restart statin if level has normalized (statin can make muscle injury worse)
who has worse prognosis with PSGN
adults with h/o CKD, metabolic syndrome, or DM
tx of hyperthyroidism in pregnancy
maintain a mild hyperthyroid state with PTU in 1st tri and methimazole in 2nd/3rd tri; overtreatment can cause fetal hypothyroid and goiter
