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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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