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