Misc

Question 1

Travel Immunizations Algorithm

Answer 1

1) Routine: childhood

Question 2

Volume status

Answer 2

• Visible JVP
• sometimes, dry mucous membranes
• if they have axilla sweat they are almost always not dry
• HR + BP
  
  • -> in Peds, can estimate with vitals
  • -> 1st inc HR, then dec BP
• Edema
• Notnreally cap refill (vascular confounders)

Question 3

Hypertension

Answer 3

N = =160 OR >=100

Ddx

• Sleep apnea
• Drugs, steroids
• CKD
• 1° aldosteronism
• Renovascular disease
• Cushing’s
• Pheochromocytoma
• Coarctation of aorta
• Thyroid/ parathyroid issue

Dx

• 3 separate readings over >= 1 wk w doc
• Home measurements for 1-2 days

Tx
- Thiazide, B-blocker, ACE-I, ARB, aldosterone antagonist, CCB

Question 4

Orthostatic Hypotension

Answer 4

30: 20: 10
- Inc pulse by 30, dec systolic by 20, dec diastolic by 10
- Indicates ____

If heart rate doesn’t increase, indicates _____

Question 5

Clubbing

Answer 5

-