Test 50 - Created Aug 13 Flashcards
imaging for spinal stenosis
MRI (look for encroaching osteophytes, hypertrophy of ligamentum flavum, protrusion of disks -> narrowing of spinal canal)
mgt of incidentaloma in adrenal gland
get labs: electrolytes, dexamethasone suppression test; 24hr urine catecholamine, metanephrine, VMA; 17 ketosteroid
remove if big, functional, or cancer
what majorly determines survival in patients with primary CNS lymphoma
the degree of immunosuppression (CD4 count)
Dupuytren contracture risk factors
age >50, male, Fhx, Northern European, DM!!
presentation of immune reconstitution inflammatory syndrome
advanced HIV pt started on HAART -> wks later -> recurrent fever, cough, worsened pulmonary infiltrate (for ex); common in patients with initially low CD4 and high viral loads; more common in TB + HIV patients
mgt of immune reconstitution inflammatory syndrome
no alteration in antiretroviral (or antiTB) tx; may need symptomatic tx w/ NSAIDs or steroids
issue with basal cell carcinoma near eye and tx
can invade the orbit; no metastases; needs surgery
power of a study
determining there is a difference in tx effectiveness when one truly exists (correctly rejecting a false H0); power = 1 - B
type I error
determining there is a difference in treatment effectiveness when one truly does NOT exist (incorrectly rejecting a true H0); = a
type II error
determining there is NO difference in tx effectiveness when one truly exists (incorrectly failing to reject a false H0); = B
preferred antiarrhythmic therapy in patients with a. fib with no dz, LVH, CAD w/o HF, HF, or refractory
no dz - flecainide, propafenone LVH - amiodarone CAD w/o HF - sotalol HF - amiodarone refractory - ablation
how long to continue antidepressant in pt w/ single episode of MDD
6 mo. after acute response
needs to be 1-3 yrs if recurrent, chronic episodes, S.I., or Fhx
emergency contraception
within 5d: Cu IUD or ulipristal
within 3d: levonorgestrel (plan B) or OCPs
contraindications to copper IUD
acute pelvic infection (including cervicitis), severe uterine cavity distortion, Wilson’s, complicated organ transplant failure
post-exposure prophylaxis with sexual assault victim
chla - azithro gono - CTX trich - metro (unless neg wet mount HIV - tenofovir/emtri/ralte; up to 72h after Hep.B - vaccines (unless UTD) Syphilis - none; monitor w/ testing
mgt of retrosternal goiter with compressive sxs
surgery (radioactive radioiodine ablation can lead to some enlargement of thyroid, possibly making sxs worse)
when selection bias occurs
when sample is unrepresentative of target population and may lead to incorrect measures of association
sensitivity definition
probability of an individual testing (+) given the presence of disease
specificity definition
probability of an individual testing (-) given the absence of disease
positive predictive value
probability that an individual who tests (+) actually has the disease
negative predictive value
probability that an individual who tests (-) actually does NOT have the disease
starting age for colonoscopy
avg risk: 45
1* relative w/ cancer or high risk polyp: 40 or 10 yrs prior to age of dx in family member
UC pt: 8-10 yrs after dx
