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14 Cards in this Set
- Front
- Back
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old man with back pain, anemia, renal dysfunction, and elevated ESR. reason for constipation?
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typical of multiple myeloma
hypercalcemia seen in about 30% of pts, with sx including constipation!, polyuria!, and confusion! |
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preventing gout
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low purine diet, avoiding drugs such as diuretics and pyrazinamide. avoid alcohol!
treatment of acute attack with NSAIDs, colchicine or steroids |
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Contact lens associated infectious keratitis
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likely to be gran neg organisms but can also be due to gram positive organisms as well as certain fungi and amoebas.
MEDICAL EMERGENCY and can lead to corneal perforation, scarring, and permanent vision loss if not addressed promptly. most pts require topical broad-spectrum antibiotics. |
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opioid intoxication
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miosis, depressed mental status, decreased respiratory rate, decreased bowel sounds, hypotension, adn badycardia.
of these, decreased RR is the best predictor of intoxication and is also a frequent cause of mortality |
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mgmt of conjunctivitis
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bacterial: erythro, polymixin-trimethoprim, azithro, preferred agent in contact lens: fluoroquinolone
viral: warm or cold compresses, antihistamine/decongestant drops allergic: OTC antihistamine/decongestant drops, mast cell stabilizer/antihistamine drops for frequent episodes |
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anserine vs prepatellar bursitis
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anserine: p/w sharply localized pain over the anteromedial part of the tibial plateau just below the joint line of the knee. valgus stress test fails to reproduce the pain, thereby ruling out damage to the MCL, and radiographs are classically nl
prepatellar bursitis p/w pain and swelling directly over the patella. examination shows cystic swelling over the patella with variable signs of inflammation. most common cause is trauma. |
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diabetic autonomic neuropathy
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can affect the genitourinary tract to cause a neurogenic bladder with urinary retention and distended bladder.
pts can then develop overflow incontinence (dribbling, poor urinary stream) with a high post-void residual volume |
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cellulitis mgmt
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when systemic sign so ftoxicity high grade fever with rigors and chills, malaise, fatigue, and confusion) are present, IV nafcillin or cefazolin is the preferred tx.
In areas with high prevalence of MRSA vanc can be used as a first line agent. chronic fungal foot infection can serve as a nidus for bacterial cellulitis and it should be eradicated in pts with recurrent cellulitis |
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paget disease of bone
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characterized by increased bone remodeling and abnl osteoid formation.
pts may be asymptomatic or p/w headaches, deafness, neuropathy, or bone/back pain. lab data show elevated alkphos but nl ca, phos, and other liver enzymes |
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hypopituitarism with a mild to moderate increase in prolactin
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suggests nonfunctioning (gonadotroph) adenoma)
pts with a nonfunctioning adenoma may develop symptomatic hypogonadism or hypothyroidism but are frequently asymptomatic until the adenoma becomes very large and begins to cause a mass effect on surrounding tissues. Primary treatment modality is transphenoidal surgery qid 8918 |
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advanced vs delayed sleep phase syndrome
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advanced: circadian rhythm disorder and is characterized by an inability to stay awake in the evening (usually after 7PM), making social functioning difficult. these pts frequently complain of early-morning insomnia bc of their early bedtime
delayed sleeph phase syndrome: inability to fall asleep at "normal" bedtimes such as 10PM- midnight. These pts often cannot fall asleep until 4-5AM, but their sleep is nl if they are allowed to sleep until late morning. They present with complaints of insomnia and excesive daytime sleepiness. Accurate history and/or sleep diary essential to dx |
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hemodynamically unstable pts who have an equivocal or inconclusive FASt exam
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DPL can accurately determine presence of active intraperitoneal hemorrhage and subsequent ned for emergency laparotomy
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increased intracranial pressure features
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papilledema and p/w transient vision loss lasting a few seconds with changes in head position. It requires urgent diagnostic evaluation (eg ophthalmologic exam, neuroimaging and/or LP) as persistent papilledema can lead to vision loss
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TCA overdose
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CNS depression, hypotension, hyperthermia, and anticholinergic effects.
QRS complex is the most appropriate indicator of severity of intoxication. sodium bicarb shortens the qrs interval in tca overdose, decreasing the likelihood of arrhythmia |
