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27 Cards in this Set

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TTP
S/S
Tx
Neuro changes, thrombocytopeina, ARF, Hemolytic anemia(reticulocytosis w/ helmet cells & schistocytes).

Plasmaphoresis
Lice
Tx
Remember lice does not mean you are poor.

Decontaminate bedshhets and use Permethrin cream(lindane is neurotoxic).
AFP
High=
Low=
High(b/c leaks)=Defects(neural tube & GI wall or baby older than thought.

Low:Trisomies 13 & 18 or baby younger than thought.
Villous sampling vs Amniocentesis
Use
When to use
Risks
Both used to detect chromosomal abnormalities

1)Villou Sampling:9-12 weeks
-Used in inherited chromosomal conditions to dx in 1st trimester so abortion can occur in 1st trimester if +ve. More dangerous

Amniocentesis: 16 weeks
-Safer & used to further evaluate triple screen results in trisomies

21: High Hcg,Low AFP,Low Estriol

13: All low
Viral Pericarditis
Culprits
S/S
EKG
ECHO
Tx
Coxsachiae or Echo virus

Pleuritic CP (pain w/ inspiration, sharp, relieved by sitting forward) seen post URI w/ friction rub(scratchy noise heard in sys & diastole)

EKG: Diffuse ST elevation in ALL LEADS w/ PR depression(MI has ST depression)

ECHO: Pericardial Effusion

Tx: NSAID
Endocarditis
Types
S/S
Tx
Normal valve or IV drugs:
-Staph

Damaged valve(ie RF as kid): Strep Viridans

Prosthetic:
<2 mo=staph
>2mo=Strep

Fever w/ Murmur & signs of embolic disease(splinter hemmhorrhages under fingernails, Oslers painful finger tip Nodes,Roth white spots on IRIS)

Aminoglycoside +ceph/gen 3 pen

**Give prophylaxis before surgery(intubation,dental) of ampicillin
Effect of anticoagulant meds on Coagulation studies
All increase the following:
Heparin: PTT
-May cause thrombocytopenia & thrombosis so monitor platelets also

Warfarin: PT

Enaxaparin(LMWH): Factor Xa
Drug induced thrombocytopenia
Heparin
Alcohol
Sulfa drugs & Quinidine(Both cause SJS)
Psoriasis
RF
SS
Tx
White, 20-30, family Hx

Well demarcated silvery plaques on Extensor surfaces of Knees-Elbows-Scalp

May have RF -ve arthritis.

UV light, steroids, anthralin, tar
Kapsosi Sarcoma
Culprit
S/S
Tx
HHV-8

Malignant Black lesions seen in AIDS patients

HAART
Pittyriasis Rosea
SS
Tx
Get a single oval lesion (Herald patch) on the chest or back. 1 week later you get many itchy ones on the back in a "christmas tree" pattern.

Reassurance, it will go away
Shingles
culprit
SS
Tx
Herpes Zoster Virus

Seen in elderly or Immunocompromised

Painful vessicular skin infection that follows one dermatome in distribution and does not cross the midline.

Tx: Acyclovir if immunosuppressed but famicyclovir in immunocompetent.
Sodium Bicarb uses
TCA overdose
Severe Hyperkalema
Drugs to give in COMA
"DONT"
Dextrose(thiamine first)
Oxygen
Naloxone
Thiamine
Cytochrome P-450 inducers
Queen(quinidine)
barb(barbituates)
takes Phen-Phen(Phenytoin)
& refuses(rifampin) Greasy(griseofulvin)
Carbs(Carbamazepine)
Cytochrome P-450 inhibitors
Cimentidine
Ketoconazole
OCP's Benefits and Risks
Benefits:
Lower endometrial & ovarian Cx
Lower Ovarian cysts
Lower Benign breast disease
Lower dysmen/mennhorrhagia

Risks: HTN,Liver disease
Asthma & Nasal polyps
Do not give aspirin
Origins of alkaline phosphatase elevations
Bone disease

Liver(pancreas cx/stones)
-5 nucleosidase or GGT elevation means obstruction in the duct

Placenta
Perforated PUD
SS
DDX
Tx
Pain radiating to the back(ddx: pancreatitis,AAA) w/ coffee ground emesis & free air under the diaphram in alcoholic or patient w/ PUD.
#1 cause of sensorineural hearing loss in adults? children?
Adult: Presbyacusis
Kid: meningitis
Hyperkalemia when to treat?
Hypokalemia how to treat?
3.5-5.0 Normal range
-Treat if EKG changes or symptoms. If asymptomatic think of Hemolysis of the specimen.

Supplement Mg if hypokalemia does not respond to tx.
Celecoxib/Rofecoxib
Cox II inhibitors good for any arthritis condition where there are chances of GI bleeds from NSAIDS/ASA.
Aortoilliac Occlusive Disease
SS
Tx
Leriche Syndrome: Buttock Atrophy, Impotence, & pain with ambulation. DP pulses usually absent and hair on leg is absent and skin pale & shiny

Modify Risk Factors
cushing reflex
SS
Tx
Seen after head injury and means high ICP and you must lower it immediately:

-High BP
-Low RR,Pulse

Lower ICP by:
1) Elevate Bed(reverse trendelemburg)
2) Forced Hyperventilation
3) Mannitol & Furosemide
Cholangitis
SS
Dx
Tx
Gallstone symptoms(RUQ pain) w/ Charcot triad of(fever-chills-Jaundice)

Dx: Blood Cx & U/S of biliary tree. If negative do ERCP to R/O cholydocolithiasis.

Tx: Get blood cultures and then start BS-Antibiotics & fluid
Trichomonas
STD. Green D/C that itches and flagellate tear shaped organism on plate. Cervix will be red and inflamed and may even bleed.

Tx: Metronidazole