step3
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| picks dz characteristics | irritability, hyperoral, disinihibitio
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| lewy body characteristics | like PD but visual halluc
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| what controls language | dominant temporal
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| tx for CINII, III, mod and high grade dysplasia (HSIL) on PAP | ablation or LEEP, LEEP if high grade
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| tx ASCUS | do HPV, if + do colposcopy
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| tx CIN 1 | repeat pap in 6 and 12mos or repeat HPV 12mo, if positive will need colposcopy
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| tx high grade dysplasia on pap (HSIL) | LEEP, don't get HPV
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| focal deficits in HIV, tx | PML, HAART will help
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| PCP tx | Bactrim IV, add steroid if PaO2<70
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| what are in MELD | bili, INR, creatinine
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| cut offs for lead intoxication and tx | >70 hospitalize IV dimercaprol + EDTA, 45-70 IV EDTA or oral DMSA, 10-45: DMSA or d penicillamine
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| ITP characteristcis and tx | isolated decrs plts due to plt Abs 2/2 infxn, tx=steroids +/- IVIG if plts <30-50…splenectomy is last resort
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| TTP characteristcis and tx | total plts and RBC decrsd 2/2 hemolysis, tx=plasmaphoresis NOT PLTS
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| HUS/TTP characteristcis and tx | both have F, hematuria, microangiopathic hemolytic anemia w schisto, AMS, decrsd plts, BUT if CNS then its TTP
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| HUS most commonly occurs after, tx | hemorrhagiv Ecoli diarrhea, tx=supportive
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| HSP characteristics, tx | abd pain s/p URI, palpable purpura, arhtralgias, tx=supportive
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| characteristics thalassemia | microcytic anemia, nml Fe, nml RDW, target cells
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| Fe studies of Fe defic anemia | low ferritin, high TIBC, incrsd RDW
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| what causes febrile transfusion reactions | Abs in pt's plasma to donor WBC
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| how tell if ascites is 2/2 portal HTN | SAAG >1.1 (serum albumin - ascites albumin)
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| anti histone | Rx induced Lupus
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| Abs for SLE | antismith very specific, not very sensitive, dsDNA and complement show activity of dz
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| anti centromere | CREST of scleroderma
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| anti-mitoch | primary biliary cirrhosis (elevated AlkP no AST/ALT elevation)
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| anti Ro/SSA | sjorgens
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| anti sm mscl | autoimmune hep
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| tx SLE | steroids, add hydroxychloroquine if skin/joint
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| tx SLE nephritis | cyclophosphamide
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| elevated alkP in middle aged woman | think sarcoid or primary biliary cirrhosis
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| elevated ALT/AST in someone no risk factors for hepatitis/liver dz and nml bilis, alkP | autoimmune hep, check ANA and anti sm mscl
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| cANCA, dz and tx? | wegeners w bloody sinusitis, GN w hematuria
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| pANCA, dz and tx | churg strauss asthma pt w eos, palpable purpura, tx= steroids
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| goodpasteur presents w | ANCA negative, GN, lung hemoptysis, tx=plasmaphoresis
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| addisons | hypoNa, hyperK, acidosis from aldosterone defic and hyperpigment
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| pernicious anemia characteristics | b12 defic w high MCV, look for anti intrinsic factor
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| celiac characteristics | anti-endomysial and anti tissue transglutaminase Ab, see villus blunting
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| gout crystals | negative birefringent
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| tx hyperthyroid in preg | PTU 1st trimester (risk liver failure but not as teratogenic), then methimazole
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| painless thyroid swelling, high T4, low TSH, low RAIU…dx? Tx? | subacute lymphocytic thyroiditis or postpartum, give BB for symptoms, no need PTU bc synthesis already decrsd
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| hashimotos is at risk for what? What should you measure | thyroid lymphoma, measure anti thyroid peroxidase indicates Hashimoto
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| vit D defic has what lab values | low phos and high PTH (as PTH tries to get to work)
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| what does vit D do for Ca++ and phos | increases both
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| what labs hypoPTH | high phos and low PTH
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| lab values familial hypocalciuric hyperCa | mildly elevated serum Ca, low U_Ca, nml PTH, vitD…no tx
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| tx herpes zoster | oral acyclovir and can give steroids to accelerate healing time
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| tx post herpetic neuralgia | TCA (desmipramine, amitryptyline), topical capsaicin, gabapentin
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| will ikelihood ratios change w prevalence | no, calculated from sensitivity and specificity
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| will positive and negative predictive values change w prevalence | yes, bc PPV is % positive test w dz divided by total positive test, so more prevalent the higher the PPV
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| what's the diff bw odds ratio and relative risk | odds ratio is case control study, compares cases to controls; relative risk is cohort study where look at risk of dz in exposed grp v not exposed
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| asthmas cut offs | intermittent <2x/wk day and <2x/mo night; mild persistent, mod persistent daily, >1x/wk night, severe persistent
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| asthma tx by category | intermittent short acting bronchodil, mild persistent low dose inh steroid, mod high dose steroid and long acting, severe persist add oral steroid
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| what's apnea test for brain death | vent off 10-20min until PCO2 50-60
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| what 2 rashes on preg women abd and tx | PUPP=pruritic, herpes gestation has vesicles, both topical steroid (ie triamcinolone)
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| tx postpartum hemorrhage | fundal massage and oxytocin, if that doesn't work methylergonovine
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| stage I labor | latent phase (effacement): reg cxns until cervical dilation 3-4cm; active (dilation): ends at 10cm
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| stage I labor cut off for time | latent: <20h or <14h multipara, tx rest or sedation not oxytocin; <1.2 or 1.5 tx=oxytocin
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| stage II labor | stage II (descent): cardinal mvmt ends w delivery
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| stage II labor cutoffs and tx | <2hr or <1hr + 1hr epidural, tx oxytocin if cxns inadequate, coaching for pushing. If head not engaged c/s otherwise vacuum or forceps
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| stage III labor and cutoff | expulsion of placenta, <30min
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| puberty delay in males | no testicular nelargement 14yo and female no 2ry sex characteristics 14yo
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| screening DM | >45 q3 fasting glu
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| screening chol | >20 q5
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| mammo screen | 50-75 q2
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| pelvic screening | 20-40q3, annually >40
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| pap screen | 21-65 q2 can do q3 if nmlsx3
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| dexa screen | >65
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| Spneu vaccine | >65, DM, pul dz, CAD, liver ESRD
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Created by:
ehstephns
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