UW 5 Flashcards
Pt returns from developing country w/sx’s of malabsorption
Giardiasis
Empiric tx w/Metronidazole
Maintenance tx of pts with Bipolar Disorder
- Post first episode - at least 1 year from time of remission
- Pts w/2+ episodes = long term/lifetime tx, esp with FHx
- Pts w/hx of 3+ relapses = lifetime
Single episode of major depression tx
Antidepressant for 6 months
Monitor pt’s response
Complicated Diverticulitis and Tx
Diverticulitis + Abscess, perforation, obstruction, or fistula formation
- Fluid < 3cm = IV Abx and observation
- Surgery if sx’s worsen
- Fluid > 3cm = CT-guided drainage
- if not controlled by 5th day - surgery for drainage and debridement
Dx for leprosy
Skin Bx shows acid fast bacilli
What do blood cultures show in leprosy?
Nothing. they are negative
Asian patient, insensate, hypopigmented patch of skin
Leprosoy = affects peripheral nerves and skin
Fetal Hydantoin syndrome
Anticonvulsant exposure - phenytoin, carbamezapine Small body size Microcephaly Digital/Nail hypoplasia Midfacial hypoplasia Hirsutism Cleft palate and lip Rib abnormalites
Fetal Alcohol Syndrome
Midfacial hypoplasia Microcephaly Stunted growth CNS - hyperactivity, MR, learning disability NO cleft palate/excess hair
Electrolyte derangements in loops?
HypoKalemia
HypoMaGnesemia
Cardiac patient develops v tach - what to consider
- Assess stability
2. Measure serum electrolytes
Missed Abortion
Fetal loss with retained POC
Closed cervix
IU fetal death < 20 wks
Presentation of missed abortion
Minimal sx’s
Light vaginal bleeding
Decreased preg s’s - nausea, breast tenderness
Management of missed abortion
- Asses fetal heart tones
- Pelvic exam for cervix and vaginal bleeding
- Dx w TV US
Tx for Missed abortion
Hemodynamically unstable, heavy bleeding: D&C
Hemodynamically stable, mild bleeding: expectant management, PGs or D&C
Presentation of placental abruption
Sudden onset bleeding
Abd Pain
Hypertonic/tender uterus
US of placental abruption
Retroplacental hemorrhage
Presentation of uterine rupture
Sudden onset bleeding Constant abd pain Cessation of CTX Palpable fetal parts Fetal deterioration
Uterine Atony
Postpartum complication
MCC of painless hemorrhage post delivery
Poor uterine tone
Manifestations of hyperestrogenism in Cirrhosis
Gynecomastia Palmer Erythema Spider angiomas Testicular atrophy Decreased body hair - males
Manifestations of portal HTN in Cirrhosis
Caput medusae
Esophageal varices
Hemorrhoids
Pt presents with double vision, jaw pain after eating and change in voice after talking for long period of time? Best next test?
Myasthenia Gravis
CT of chest - check for thymoma
First line tx for specific phobia
Behavioral thearpy
Systemic desensitization
Neonate with delayed passage of meconium
- Hirschsprung
2. Meconium ileus
Meconium ileus: level of obstruction and meconium consistency
Ileum
Inspissated
Free air above liver
Intestinal perforation
Emergency surgery
What dz is ass’d with meconium ileus
Cystic Fibrosis
Hirschsrpung: level of obstruction and meconium consistency
Rectosigmoid
Normal
Complications seen with CF
Opacification of all sinuses
Recurrent sinopulmonary infxn
Bronchiecstasis
Sensorineural hearing loss from frequent aminoglycoside tx
Dz ass’d with hirschsrung
Down’s
Hypothyroidism
SIADH
Hypotonic
Hyponatremia
Euvolemia
Plasma and urine osmolality with SIADH
Low plasma osmolality < 280
High urine osmolality > 100-150
NSAIDs impact on ADH
Potentiates action of ADH, causing SIADH
WHy is pain decreased with eating in duodenal ulcer?
Pain worse on empty stomach b/c of unopposed acidic fluid emptying into duodenum
Best long-term sx relief for duodenal ulcer
H.Pylori eradication
Ascertainment bias is a type of what kind of bias?
Selection bias
Types of Bias occur with inappropriate selection or poor retention of subjects
Ascertainment/Sampling bias
Nonresponsive bias
Berkson bias - hospital based subjects only
Prevalance/Neyman bias - diseased pts die early/recover
Attrition bias
What is reporting bias
Subject is reluctant to report exposure due to stigma about exposure - sexual behavior, drug use
Eye lesion seen w NF Type I
Optic glioma - slowly progressive unilateral visual loss, dyschromatopsia, esophthalmos
MC glomerular dz in Hodgkins
Minimal Change Dz
MC glomerular dz in solid cancers
Membranous
Lung, colon, prostate, breasts
Glomerular dz ass’d with Hep B and Hep C
Membranoproliferative
Glomerular dz ass’d with NSAIDs
Minimal change
Who gets a Pneumococcal polysaccharide vaccine (PPSV)
All adults >65 = 1X Adults < 65 w: Chronic lung dz Chronic Cardiovascular dz DM Chronic liver dz Smoker Alcoholic Cochlear implant CSF leak Immunocompromised Asplenia
Diabetic pts get what vaccines
Influenza
Td booster or TdaP
Pneumococcal
When is tetanus-diptheira toxoid booster given?
Every 10 yrs after 18
Do Adults get TdaP?
Yes. 1x for all adults
What is pilonidal dz?
Acute pain and swelling of midline sacrococcygeal skin and subcutaneous tissue = infxn of pilonidal cyst
Perianal Abscess
Anal pain
Tender, erythematous bulge at anal verge
Where is coccyx in relation to anus
At least 5 cm above anus
Presentation of suppurative hidradenitis
Multiple painful nodules and pustules of axilla and groin
Presentation of Kawasaki dz
Fever >5 days and - BL nonexudative conjunctivitis - Mucositis - injected lips, pharynx, strawberry tongue - Erythematous polymorphous rash - Extremity changes - Cervical LA, one > 1.5 cm Irritability
Tx for Kawasaki
ASA
IVIG
Baseline Echo, repeat in 6-8 wks
Fever and Rash in peds DDX
Scarlet fever
Kawasaki
Tx for acute bacterial rhinosinusitis
Amoxicillin-Clavulanic acid
Seborrheic dermatitis
Chronic, inflammatory papulosquamous dz
Transparent to yellow papules
scaling plaques
MC areas affected in seborrheic dermatitis
Eyebrows
Nasolabial folds
Bases of eyelashes
Paranasal skin
Infants with scaly scalp that improves with baby shampoo
Seborrheic dermatitis
also called cradle cap
Atopic dermatitis
Recurrent, pruritic, eczematous eruption
Flexural and extensor surfaces affected
Scaling red papules
What is ass’d with pseudogout?
Chondrocalcinosis
PTs w dysphagia w/liquids and solids at onset
Motility disorder
Dx test for motility disorder
- Barium swallow
2. Manometry
Which pancreatic cancer is ass’d with steatorrhea
Pancreatic head tumors
