UW 6 Flashcards
Post-exposure prophylaxis for animal bites (rabies)
Unvaccinated bitten by animal that could have rabies - PEP with active and passive immunization
Exposure to healthy appearing animals - observe animal 10 days w/out PEP
Screening for children 0-5
Vision exam to id strabismus, amblyopia, refractive errors
Rotavirus - when
B/t 2-8 months
1st dose: 6-14 wks
Do not initiate for > 15 wks
Final dose not given after 8 months
Presentation of androgen secreting neoplasm of ovary or adrenal
Rapid development of androgenic sx’s w virilization - excess muscle development, clitoral enlargement
Screening test for androgen screening neoplasm
Testosterone and DHEAS
Risk factors for RDS
Prematurity Male sex Perinatal asphyxia Maternal DM C-section w/out labor
CXR of RDS
Diffuse reticulogranular pattern (ground glass opacities)
Air bronchograms
Achalasia workup
CXR - widened mediastinum
Barium Swallow - bird’s beak
Manometry - confirm Dx
Endoscopy to r/o esophageal cancer
Tx for achalasia
Pneumatic dilatation
Surgical myotomy
What can mimic achalasia and what is workup to differentiate?
Esophageal cancer at Esophageal - gastric Jnc
R/O with endoscopy
CML presentation
Leukocytosis Anemia Increased mature granulocytes Fatigue, malaise, low grade fever, anorexia, bone pains, night sweats Phil chromosome
What are mature granulocytes
Segmented neutrophils
Band forms
LAP score in CML
LOW
LAP score in Leukomoid Rxn
High
Absence of measurable EPO in urine
Polycythemia vera
When do adults receive td booster?
Every 10 years
1x Tdap booster
MCC of secondary clubbing
Lung malignancies
Cystic Fibrosis
R to Left shunt
How does Cerebellar hemorrhage present
Evolves over a few hours
Acute occipital HA, repetitive vomiting, gait ataxia, 6th CN palsy, conjugate deviation
Tx for cerebellar hemorrhage
Immediate evacuation of hematoma
How does PCA occlusion present?
Ipsilateral sensory face, 9th, 10th CNs
Contralateral sensory loss of limbs
Limb ataxia
What does PCA supply
Midbrain Basal nuclei Thalamus Mesial inferior temporal lobe Occipital and occipitoparietal cortices
What is vestibular neuonitis
Acute onset of vertigo and nystagmus w/out any other neuro deficit
What is Meniere dz? Presentation?
Labrinthine dysfnc
Increased pressure of endolymph
Recurrent vertigo,tinnitus, hearing problems
Vomiting NOT common
MOA of metoclopromide and prochlorperazine
Dopamine antagonists
Hepatic Encephalopathy management
1. Supportive - IVF, electrolytes Esp K 2. Nutrition 3. Tx precipitating cause 4. Lower serum ammonia
Tx of patient with hepatic encephalopathy and hypokalemia
K replacement
Hypokalemia increases renal ammonia production
How to lower serum ammonia
Lactulose orally or enema if cannot take oral
Rifaximin oral -If no improvement in 48 hours w/lactulose
Heme manifestations of SLE?
Anemia
Leukopenia
Thrombocytopenia
Antiphospholipid syndrome
SLE + panctyopenia
Concurrent peripheral immune mediated destruction of all 3 cell lines
Do bone marrow BX
Drugs Ass’d with drug induced pancreatitis
Anti-seizure - Valproic Acid Diuretics - Furesomide, thiazides IBD - sulfsalazine, 5-ASA Immunosuppressive - Azathioprine HIV meds - Didanosine, pentamidine Abx - metronidazole, tetracycline
Rheumatoid arthritis + hepatomegaly + proteinuria
Amyloidosis - deposits revealed under polarized light
Crescent formation on light microscopy
Rapid Progressive GN
Granular deposits seen on immunofluorescence
Immune complex GN - lupus nephritis or poststreptococcoal
Major cause of morbidity and moratlity in SAH
Cerebral infarction
Rebleeding w/in first 24 hrs
Vasospasm days 3-10
Prevent vasospasm in SAH with
Nimodipine
MCC Brain abscess after neurosurgery, penetrating trauma
Staph aureus
MCC brain abscess w sinusitis
Viridans strep
Head and neck anaerobes
Tx for brain abscess
Prolonged Abx - 4-8 wks
Aspiration/drainage when possible
What are ankylosing spondylitis pts for 2+ decades at risk for?
Vertebral Fx
- decreased bone mineral density
- minimal trauma
Spinal root compression pain
Dermatomal distribution
Sensory loss
Paresthesias
Muscle weakness
Candida esophagitis presentation
Oral thrush
odynophagia - mild to moderate
Viral esophagitis
Severe odynophagia
HSV - circular, ovoid vesicular ulcerated lesions
CMV - large, linear ulcers
Pill esophagitis presentation Meds that cause
Acute odynophagia Meds: Potassium Chloride Tetracyclines Bisphosphonates NSAIDs
TX for Cryptococcal meningoencephalitis
Induction: 2 wks IV Ampho B + flucytosine
then
Consolidation: 8 wks Fluconazole
Maintenance: tx for 1 year
If HIV + start antiretroviarls at least 2-8 wks after completing induction tx
What is the tx for cerebral toxoplasmosis
Sulfadiazine-pyrimethamine
When is thymoma visualized on CXR
Children < 3yoa
Sail sign - triangular shape, scalloped border, uniform density
Electron microscopy shows alternating areas of thinned and thickened capillary loops w GBM splitting
Alport’s syndrome
Tx for stress incontinence
- Kegel exercises
2. Urethropexy
Tx for urge incontinence
Oxybutynin
Urge incontinence = detrusor hyperactivity
Overflow incontinence Tx
Bethanechol
Alpha blockers
