Set 9 Flashcards
Tx DVT/PE?
heparin bridge to warfarin. if 1st event, 6mo. If recurrent, lifelong anticoagulation
FSH, LH, FSH/LH expected in premature ovarian failure? confirmatory criteria?
- dec FSH and LH
- FSH:LH ratio >1 b/c FSH is cleared from circ slower.
Dx = FSH very elevated in woman 3 mos of amenorrhea - confirms dx
SE of dihydropyrodine CCBs
peripheral edema (especially amlodipine)
When do you get a CT in head fall? what about admission/neuro checks?
no LOC or neuro findings –> no CT, send home
If vomiting, HA or LOC –> CT, if neg send home
if severe HA, prolonged LOC or seizures, admit
Abnormal bleeding in patient with CKD due to? Tx?
platelet dysfunction, tx = DDAVP (release stores of factor 8/vWF)
3rd trimester bleeding with uterine tenderness and increased tone, contractions. Ddx?
Placental Abruption* = a/w pain, dark red bleeding
placenta previa = NO pain, bright red bleeding
HIV patient with PCP, when do you add steroids to the tx?
when PaO2 35
smelly discharge and vaginal pH of 5.5, ddx and differentiate?
trichomonas vaginITIS = gray-green frothy d/c with INFLAMMATION PRURITIS, dysuria/dyspareunia
bacterial vaginOSIS = NO inflammation or pruritis
normal vaginal pH
3.5-4.5
secondary amenorrhea + galactorrhea. next tests?
pregnancy test, THEN TSH (hypothyroidism can elevate PRL level).
also, FSH to r/o ovarian failure, PRL for hyperprolactinemia.
2 complications (NOT PE findings) of nephrotic syndromes?
hypercoagulability and dyslipidemia (leads to atherosclerosis and strokes/MI!)
Fever, dysphagia, odynophagia and drooling in an alcoholic? MCC?
Ludwig Angina = progressive b/l cellulitis of the submandibular + sublingual sapces 2/2 tooth infxn. MCC strep or anaerobes
MCC mucolpurulent cervicitis
Chlamydia trachomatis
Feared consequence of whiplash injury
central cord syndrome. damage to central portion of ant SC - central parts of CST +/- decussating fibers of lat STT.
- weakness more pronounced in upper ext b/c motor fibers for arms are nearer to the central part of the CST. +/- loss of pain and temp (STT )
(similar to syringomyelia - expansion of central canal -> fibers of STT are affected first. cape-like loss of pain/temp)
18yo girl w/ primary amenorrhea, normal breasts and pubic hair, blind vagina and no uterus, 2 ovaries, 46 XX?
Mullerian agenesis
CI succinylcholine
hyperkalemia –> depolarizing NM blocker can cause further K+ release –> arrhythmias
SE acyclovir
renal tubule obstruction 2/2 crystalluria (poorly soluble drug in urine)
TSH and T4 levels in pregnancy, MoA?
TSH and free T4 normal, increased total T4 –> due to increased E2 causing increased TBG and stimulation of TSH receptors by BhCG
chromosome findings in Kallmann Syndrome
46 XX (GnRH deficiency, anosmia)
Tactile fremitus incr/decr in: PNA, Pleural E, COPD, pneumo
increased only in PNEUMONIA b/c fluid is INSIDE the lungs –> sound transmits faster.
all others have fluid outside the lungs, therefore decreased tactile fremitus)
Tx clavicular fx
middle 3rd–> check neuroarterial injury, if OK then brace and rest, no reduction
Distal 3rd –> may require ORIF
what is plan B, how long afterwards can you take it, efficacy?
levonorgestrel, up to 120hrs, 7/8 won’t get preggers
What is pseudocyesis?
false pregnancy –> woman displays psychophysical signs of pregnancy w/o actual pregnancy. NORMAL endometrial stripe on US and negative pregnancy test in the OFFICE (regardless of home test result)
Tx duodenal hematoma 2/2 blunt trauma
NGTD and parenteral nutrition, resolves in 1-2wks
