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13 Cards in this Set
- Front
- Back
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ID. TB (DX) |
Sputum smear (3x q8-24hr) best test = culture; other tests include: 1) skin test (for non-BCG pt; cost effective and specific); 2) interferon-gamma release assay or Quant gold (highly specific in 16-24 hours ok for BCG pt; can't determine latent/active); 3) sputum Smear (determine active/latent; tx progress - 3 negative smears considered nonfx; PPV for 3 samples range as high as 90% BUT low sensitivity for ruling out TB); 4) sputum cx (gold standard); nucleic acid amplification (high specificity/sensitivity than smear; can differentiate other TB; +in pt who are treated) |
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PEDs. Child development |
- childhood development:
-2yr: 50+words, 2-3 word phases, 2 step commands |
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Endo. Different thyriod tests (reverse T3, thyroglobulin level) |
reverse T3: done to distinguish euothyroid sick syndrome from central hypothyroidism
thyroglobulin level: useful in FU of differentiated thyorid cancer and suspected factitious thyrotoxicosis
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ID. beta lactams |
not neurotoxic but associated with increased risk of seizures! (PCN, cephalosporins, monobactams, carbapenemes, fluoroquinolones) |
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pulm. asthma |
associated with cough induced by expiration |
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ID. Actinomyces (IUD) |
normal colonization can occur; observe unless pt having symptoms then remove device and tx |
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CARD. MI complications |
1. LV aneursym (occurs late; result in HF, arrhythmias, arterial embolization) 2. Papillary rupture (2-7 days after MI; acute HD instabiity with pulm EDEMA) 3. Desslers (autoimmune syndrome occuring weeks-monhs after MI with infx symptoms and pericardial rub; TX NSAIDS first corticosteroids) 4. Acute pericarditis (1-4 days after MI, positional pain, rub with EKG (diffuse STE and PR depression); TX with ASA, high dose) |
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ID. VZV (risk of exposure and vaccine indication) |
VZV vaccine (contraindication, intol to neomycin/gelatin/preg/immuno def); only rash is contagious; Give vaccine for pt's who will get transplantation; if immunocomp exposed then VariZIG (Ig, give w/n 10 days of exposure) |
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Ortho. Hand injury. |
scaphoid fx (fall on outstretched hand or forced dorsiflexion >95 degrees with tenderness at snuffbox (radial dorsum) and Xrays may be negative if compressed or minimally displaced - may take 2 weeks for fx to show FU with MRI or repeat xray in 7-10 days or bone scan in 3-5 days; complications: nonunion and avascular necrosis d/t blood compromise - therefore prox fx worse px and requires longer immobilization until radiologic confirmation of union; use thumb cast and then rigid wrist protection for 2 mo, can go to work, full mobility afterwards )
- Colles fx: (fall on outstretched hand but dorsally angulated/displaced distal radius; associated with visible angulation prox to wrist joint (dinner fork deformity); complication - carpal tunnel d/t multiple reductions or splinted in extreme wrist flexion
- hamate fx: (fall on outstretched hand at hook of hamate containing ulner artery/nerve; pain at hypothenar eminence and ulnar aspect of the wrist
- Radial styloid fx (hutchinson/chauffeur fx): direct blow to the styloid while falling on outstretched hand with ulnar dev and supination; dislocation of radial styloid +lunate/scaphoid |
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ID. ampicillin associated maculopapular rash (mono) |
vasculitis rash via immune-mediated complexes |
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CARD/ID: chagas disase |
via trypanosoma cruzi; 3 phases, 1) acute: gen symptoms (f/c) 2) resolution of symptoms 3) chronic chagas CM and GI disease: leading cause of dilated CM in latin america. *LV apical aneurysm - pathognomonic of chagas CM |
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GI. SX. uncomplicated GB disease |
colic: ppx cholecystectomy vs ursodeoxycholic acid for non-sx candidate; *gb with atypical symptoms: empiric urosdiol followed by cholecystectomy eval other causes if no imporvement; *typical biliary colic w/o gallstones: HIDA (eval functional gb disorder) and cholecystectomy in pt with low GB ejection - acute cholecystitis: IV antbx and immediate cholecystectomy
- choledocho: ERCP and then elective cholecystectomy, |
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ID. UTI |
predisposting factors: brevty of urethra, proximity of urethra from rectum/vagina, decreased urethral resistance during pregnancy and after menopause; (recurrent - different organism; relapse: same organism causing infx w/n 2 weeks of completion of tx; if after 2 weeks, it is defined as recurrent as well)
- ppx antiobtic indicated if >=2 infx in 6 month and used for 6-12 mo; check UA/cx before starting therapy. If UTi is only w/ intercourse, single dose after cooitus is effective; other methods include voiding after intercourse, drinking a lot of water |
