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27 Cards in this Set
- Front
- Back
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TTP
S/S Tx |
Neuro changes, thrombocytopeina, ARF, Hemolytic anemia(reticulocytosis w/ helmet cells & schistocytes).
Plasmaphoresis |
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Lice
Tx |
Remember lice does not mean you are poor.
Decontaminate bedshhets and use Permethrin cream(lindane is neurotoxic). |
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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. |
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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 |
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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 |
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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 |
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Effect of anticoagulant meds on Coagulation studies
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All increase the following:
Heparin: PTT -May cause thrombocytopenia & thrombosis so monitor platelets also Warfarin: PT Enaxaparin(LMWH): Factor Xa |
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Drug induced thrombocytopenia
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Heparin
Alcohol Sulfa drugs & Quinidine(Both cause SJS) |
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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 |
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Kapsosi Sarcoma
Culprit S/S Tx |
HHV-8
Malignant Black lesions seen in AIDS patients HAART |
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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 |
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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. |
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Sodium Bicarb uses
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TCA overdose
Severe Hyperkalema |
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Drugs to give in COMA
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"DONT"
Dextrose(thiamine first) Oxygen Naloxone Thiamine |
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Cytochrome P-450 inducers
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Queen(quinidine)
barb(barbituates) takes Phen-Phen(Phenytoin) & refuses(rifampin) Greasy(griseofulvin) Carbs(Carbamazepine) |
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Cytochrome P-450 inhibitors
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Cimentidine
Ketoconazole |
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OCP's Benefits and Risks
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Benefits:
Lower endometrial & ovarian Cx Lower Ovarian cysts Lower Benign breast disease Lower dysmen/mennhorrhagia Risks: HTN,Liver disease |
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Asthma & Nasal polyps
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Do not give aspirin
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Origins of alkaline phosphatase elevations
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Bone disease
Liver(pancreas cx/stones) -5 nucleosidase or GGT elevation means obstruction in the duct Placenta |
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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.
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#1 cause of sensorineural hearing loss in adults? children?
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Adult: Presbyacusis
Kid: meningitis |
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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. |
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Celecoxib/Rofecoxib
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Cox II inhibitors good for any arthritis condition where there are chances of GI bleeds from NSAIDS/ASA.
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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 |
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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 |
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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 |
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Trichomonas
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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 |
