Test 25 Flashcards
Hyperthyroidism
Management of retrosternal goiter with compressive sx is surgical.
Polycystic ovary dx
Patients with polycystic ovary syndrome typically have irregular menses, androgen excess, and polycystic ovaries on US. The unopposed estrogen excess caused by anovulation results in an increased risk for endometrial hyperplasia or cancer. The endometrium can be protected by use of a progestin-containing intrauterine device, which simultaneously provides contraception.
Anticoagulants
It is recommended that the warfarin dose be reduced by 25-50% to compensate for the increase in serum concentration of warfarin after initiating amiodarone therapy.
Tuberculosis
Health care providers with positive tuberculosis screening should receive chest x-ray and sx review to determine if they have latent or active dx. Those with no sx or chest x-ray abnormalities (infiltrate, cavitation) are considered to have latent tuberculosis infection and should be offered tx with isoniazid daily for 9 months (longer because monotherapy).
NSAIDs
Recognize the manifestations of analgesic-induced nephropathy. Analgesic-inducted nephropathy can present with florid nephrotic range proteinuria. MM-induced proteinuria is usually not detected by urine analysis. Drug-induced lupus often does cause renal failure. Uncontrolled HTN can cause a progressive decline in glomerular filtration and chronic renal failure, but usually takes several years.
Methotrexate toxicity
Trimethoprim, methotrexate, and phenytoin, can interfere with folate metabolism and result in folic acid deficiency anemia.
Post concussion syndrome
TBI of any severity can lead to (a few hours to days later) post concussive syndrome, which is characterized by headache, confusion, amnesia, difficulty in concentrating or with multitasking, vertigo, mood alteration, sleep disturbance, and anxiety. These sx typically resolve with sx tx within a few weeks to months following TBI; however, some patients may have persistent sx lasting greater than or equal to 6 months.
