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1
Q

What antibodies do you test for for sjogrens syndrome?

A

ANTI-SSA
ANTI-SSB
ANA
RF

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2
Q

What are the manifestations of sjogrens?

A

-keratoconjunctivitis sicca
-dry mouth ->difficulty talking, swallowing, eating, etc.

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3
Q

which glands could be biopsied to confirm sjogrens?

A

salivary glands

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4
Q

what is the name of the ocular test for moisture?

A

Schirmer test

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5
Q

What is an abnormal schirmer test result?

A

<5mm of moisture after placing the sterile strip under the lower eyelid for 5 minutes

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6
Q

what is the name of the muscarinic antagonist that can be used in sjogrens?

A

pilocarpine (oral dosing)

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7
Q

CI to pilocarpine use

A

angle-closure glaucoma and asthma

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8
Q

how do you manage xerostomia in sjogrens?

A

-advise daily antibacterial mouthwashes/fluoride use
-OTC salivary drops
-sugar free gum/losenges
-oral pilocarpine

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9
Q

what is the typical treatment for ovarian cancer?

A

Surgical tumor cytoreduction (debulking surgery) followed by a combination of
platinum and nonplatinum (taxane-based) chemotherapy

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10
Q

What is the prognosis of stage I ovarian ca?

A

90% at 5 years

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11
Q

What is the prognosis of stage IV ovarian cancer?

A

<10% at 5 years

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12
Q

interstitial cystitis aka

A

painful bladder syndrome

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13
Q

Differentials for interstitial cystitis

A

-STI
-pelvic floor pathology
-bladder tumour
-overactive bladder
-endometriosis
-prostatitis

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14
Q

which food/drinks should be avoided in interstitial cystitis?

A

-caffeine
-alcohol
-spicy foods
-vit C

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15
Q

what are the non-pharmacologic management options of interstitial cystitis?

A

-heating pads
-avoiding triggers
-bladder training
-psychosocial support/stress management

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16
Q

what are the pharmacological treatment options for interstitial cystitis?

A

-amitryptyline
-pentosan polysulfate sodium
-hydroxyzine (antihistamine)
-gabapentin
-amitryptilline

17
Q

how does pentosan polysulfate sodium work?

A

it coats the deficient inner lining of the bladder and prevents mast cells from degranulating

18
Q

what is the most common comorbid disorder with OCD?

A

MDD

19
Q

where are the most common sites of statin myopathy?

A

thighs and calves

20
Q

what are the patient related risk factors for statin myopathy?

A

age >80
female
concurrent hypothyroidism
alcohol use
low BMI
Hx of myopathy on other lipid lowering agents
multisystem disease

21
Q

what are medication related risk factors for statin myopathy?

A

high dose statin therapy
interactions with other drugs (amiodarone, fibrates, verapimil, antifungals)

22
Q

how long do statin myopathy symptoms last following cessation of the statin?

A

avg 2.3 months

23
Q

what are the two most common stroke mimics?

A

-hypoglycemia
-seizure

24
Q

which statins have the lowest risk for myopathy?

A

rosuvastatin
pravastatin
fluvastatin

25
Q

what finding in a cerebropspinal tap confirms subarachnoid hemorhage?

A

bilirubin
(red blood cells could be present from a traumatic tap, but they would not have been broken down into bilirubin)

26
Q

what is the most specific sign in asthma?

A

wheezing

27
Q

Diagnostic criteria for asthma in children under 5

A
  1. History compatible with asthma
  2. Evidence of airflow obstruction on exam WITH reversibility
  3. No other more likely diagnosis
28
Q

Diagnostic criteria for children 6+ for asthma

A

FEV1/FVC <0.8 AND increased FEV1 at least 12% with bronchodilator

29
Q

Diagnostic criteria for asthma in adults

A

FEV1/FVC <0.8 AND increased FEV1 at least 12% (OR greater than 200mL) with bronchodilator

30
Q

what medication should patients with asthma considering avoiding?

A

NSAIDS (10-20% are sensitive)

31
Q

What are the pharm managment strategies by step for asthma?

A

Step 1: SABA PRN
Step 2: Add low dose ICS
Step 3: Medium dose ICS
Step 4. Specialist-> LRTA, LABas

32
Q

Indications for referral to a specialist for asthma management (list 3)

A

-History of ICU admission
-Poor asthma control despite medium ICS (persistent symptoms or hospitilization or necessity for course of oral steroids)
-Atypical symptoms or unclear diagnosis

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