Untitled Deck Flashcards
What test is obtained in patients with clinical suspicion for primary hyperaldosteronism?
A plasma aldosterone concentration/plasma renin activity ratio is obtained.
What test is used to screen for pheochromocytoma?
Plasma fractionated metanephrines are obtained.
What are the symptoms of pheochromocytoma?
Symptoms include episodic palpitations, headaches, and tachycardia.
When should a urine albumin-creatinine ratio test be done?
It should be done if UA is suspicious for glomerulonephritis.
What is Type 1 amiodarone-induced thyrotoxicosis (AIT)?
Type 1 AIT occurs in patients with Graves disease or thyroid nodules and is typically treated with methimazole.
What is Type 2 amiodarone-induced thyrotoxicosis (AIT)?
Type 2 AIT is more common and occurs in patients without underlying thyroid disease; it is usually self-limiting but may require glucocorticoids.
How does thyroid ultrasonography with Doppler studies help in diagnosing AIT?
Increased vascularity suggests Type 1 AIT, while decreased vascularity suggests Type 2 AIT.
What antibodies are present in Hashimoto hypothyroidism?
TPO antibodies are present but not used for testing unless diagnosis is unclear.
What method aids in the evaluation of thyrotoxicosis?
Thyroid scintigraphy with radioactive uptake differentiates hyperthyroidism from destructive thyroiditis.
What is a characteristic presentation of lichen planus?
Lichen planus presents with pruritic purple papules that are often flat topped and polygonal.
Where do papules from lichen planus typically erupt?
Papules characteristically erupt on the low back, volar wrists, elbows, knees, and ankles.
What are the positive prognostic factors for patients undergoing mastectomy?
Longer disease-free intervals, fewer than three pulmonary nodules, absence of extra thoracic and lymph node metastases, and response to immunotherapy or targeted therapy.
What is the recommended treatment for unresectable melanoma?
Immunotherapy and targeted therapy are preferred over chemotherapy.
What should be done to avoid thromboembolic events in patients with established cardiovascular disease and lower gastrointestinal bleeding?
Aspirin for secondary prophylaxis should not be discontinued; if it is, it should be restarted as soon as possible following hemostasis.
What medications have Level A evidence for the pharmacologic prevention of episodic migraine?
Three β-blockers (propranolol, timolol, metoprolol), two antiseizure drugs (valproate, topiramate), and candesartan, as well as four monoclonal antibodies (erenumab, fremanezumab, eptinezumab, galcanezumab).
What is the difference between episodic and chronic migraines?
Episodic migraines occur less than 15 days monthly, while chronic migraines occur on at least 15 days per month.
What should be done for patients taking warfarin with a supratherapeutic INR less than 10 and no signs of bleeding?
Warfarin should be withheld until the INR returns to the therapeutic range.
What is recommended for INR elevation greater than 10 without bleeding?
Vitamin K is recommended in addition to withholding warfarin.
What is preferred for warfarin reversal in life-threatening bleeding?
Warfarin is withheld, and vitamin K and prothrombin complex concentrate are administered.
What are the types of prothrombin complex concentrate?
3-factor (containing factors II, IX, and X) or 4-factor (containing factors II, VII, IX, and X), with 4-factor PCC preferred for more predictable warfarin reversal.
