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99 Cards in this Set
- Front
- Back
Post-prandial fullness, hypoglycemia, sweating, dizziness, constipation in a DM patient. Diagnosis? Treatment? |
Gastroparesis (DM)
Rx = Metoclopramide, Erythromycin |
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Drugs that lead to hypercalcemia
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Thiazides
Lithium |
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Calcium greater than 12 or symptoms Rx
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NSS IV 3-6 l in 24 h
Furosemide if necessary |
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Hypocalcemia post op removal of parathyroid adenoma Dx?
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Hungry bones syndrome
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Disease causing increased vitamin D levels?
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Sarcoidosis
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Confirmatory test for Dx of Familial hypocalciuric hypercalcemia?
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Low 24 h urine calcium
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Confirmatory test for Chronic thyroiditis (Hashimoto)
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Antimicrosomal Antibodies
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Drugs that lead to hypothyroidism
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Lithium
ASA |
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Large nodule (cold) in multinodular goiter (hot) NEXT BEST STEP?
if follicular elements NEXT BEST STEP? |
Large nodule (cold) in multinodular goiter (hot) = FNA
if follicular elements = excision |
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Graves disease Rx
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Bring the patient to euthyroid state, then: radioactive iodine, steroids for
ophtalmopathy |
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Test for Thyroiditis
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low 24 h radioactive iodine uptake
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Graves disease Dx
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increased thyroid, "hot", proptosis, positive TSH Ig
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Nitroblue tetrazolium test
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chronic granulomatous disease; tests phagocyte function,
oxidative burst |
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Cellular deficiency disease
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fatal infections after receiving live viral vaccines (MMR varicella)
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Ab deficiency disease symptoms and causes
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recurrent abscesses, lymphadenitis, periodontal infections, Gram negatives, catalase positives
e.g. CGD, Chédiak-Higashi |
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Increased ALP during pregnancy
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Can be a normal finding or stones...
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How to Dx Meconium ileus
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Barium enema
There are often many gas-filled bowel loops, but without air-fluid levels. Air-fluid levels are thought not to occur because the meconium does not provide a good air-fluid interface. |
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Cystic fibrosis tests
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sweat test, nasal potential testing
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Can a heptatis B mother breast feed?
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YES! Hepatitis B mothers can breast feed!
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Graves in pregnancy Rx
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Propylthiouracil
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Clue cells
Dx? Rx? Counseling? |
DX = bacterial vaginosis
Rx = metronidazole Counsel not to drink alcohol because of disulfiram-like reaction |
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Pruritic urticarial papules and plaques of pregnancy. Which trimester?
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Third trimester = Pruritic urticarial papules and plaques of pregnancy
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Risk Factors for Ectopic Pregnancy?
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Age, PID, salpingitis, more than 3 pregnancies
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Pyloric stenosis
Dx? Risk Factors? |
Non-bilious emesis, midepigastric olive:
Dx = USG RF = erythromycin use |
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Rx of symptomatic biliary stones during pregnancy
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laparoscopic cholecystectomy
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N. gonorrhea
Histology & Rx |
Gram negative diplococci;
Rx = ceftriaxone + azithromycin (to cover Chlamydia, which generally is there too) Notify publc health authorities |
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Trichomonas vaginalis
Histology |
motile flagellated microorganisms in vaginal wet mount
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Low grade squamous intraepithelial lesion (cervix)
Grade? Treatment? |
CIN I; Rx = rescreen in 4-6 months
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Abnormal vaginal bleeding in woman older than 35 yo next step
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Office endometrial pipelle biopsy
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Menorrhagais, anovulatory bleeding - next step
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order a TSH!
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Group B strep prophylaxis
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penicillin or ampicillin to mother during active labor, CBC and blood culture on the newborn
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Bleeding in pregnancy tests to order:
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Blood type
Rh Atypical antibodies |
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Bilious vomiting in infant
And what to do with no peritoneal signs? |
Malrotation with volvulus
If no peritoneal signs: flexible sigmoidoscopy is diagnostic and treatment at the same time |
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High grade intraepithelial lesion (cervix) management
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colposcopy + endocervical curetage
+ biopsy |
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Following a molar pregnancy
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1) contraceptives for 1 year
2) monitor beta HCG, if it goes up, it could be choriocarcinoma |
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Tuboovarian abscess Rx
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IV antibiotics
surgery only if necessary - it's one of the few cases of abscess that are cured without incision |
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Prostate cancer Dx
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USG guided needle biopsy with 6-12 specimens
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Metastatic prostate cancer Rx
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GnRh agonists (flutamide), orchiectomy + chem
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Staging for testicular cancer and treatment
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Serum LDH, AFP, beta HCG
CT chest/abd/pelvis Rx = radical inguinal orchiectomy + spermatic cord ligation |
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Most common sites of melanoma
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Trunk for Men
Legs for Women |
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Basophilic palisiding cells, pearl appearance, upper 1/3 of the face
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Basal cell ca
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Moh's micrographic surgery
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for squamous cell ca (lower 1/3 of the face), makes 1-2 mm
margins |
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Most common causes of encephalitis in adults, diagnostic findings and treatment
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HSV;
meningeal signs + focal neurological signs, temporal lobe changes on CT Rx = IV Acyclovir 14-21 days |
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Listeria monocytogenes meningitis Rx
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Ampicillin; NB, elderly
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Chronic sinusitis definition, diagnosis, and rx
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Longer than 3 months
Clinical Dx, but if something is going to be ordered = CT sinus Rx = amoxicillin +/- clavulanate +/-clindamycin for 21 days, nasal steroid sprays, endoscopic surgery if necessary |
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Otitis media, ac. sinusitis Rx
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TMP/SMX
or Amoxicillin +/- clavulanate |
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Chronic carriers of group A strep Rx
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Clindamycin
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Smoker with pneumonia, diarrhea, increased LDH
Diagnosis? What to order? Treatment? |
Diagnosis: Legionella
Dx = Urine Ag Rx = Doxycycline |
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Cystic fibrosis pneumonia Rx and Most Common Cause
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IV ceftazidime + IV levofloxacine = IV aminoglycoside;
MCC = Pseudomonas |
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PCP pneumonia Dx & Rx?
When do you add prednisone |
Dx = silver stain of sputum, bronchial lavage
Rx = IV TMP/SMX or inhaled pentamidine Add prednisone if: PaO2 less than 70 orA-a gradient more than 35 |
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TB Rx
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RIPE for 8 w., then INH + rifampin for 16 w. more
Add vit. B6 for INH |
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Lab value to monitory in TB patients given Pyrazinamide
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Uric Acid
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What do TB patients on Ethambutol need?
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Order ophtalmologic evaluation
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Latent TB Rx
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nine months of INH (+ B6)
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TB + HIV, how to modify drugs?
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use Rifabutin instead of Rifampin because of possible drug interaction
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Ac. prostatitis Rx
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TMP/SMX or fluoroquinolone for 14 d
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Chronic prostatitis Rx
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Fluoroquinolone 1 m. or TMP/SMX 3 m.
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Primary/secondary syphilis Rx
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Penicillin G 2.4 million U IM; if disease present for more than 1 year = three doses with 1 w. intervals; notify health department
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Neurosyphilis Rx
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Penicillin G IV for 14 days
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DM Dx =
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1))) random glucose test >200 + symptoms
2))) Twice fasting glucose > 126 3))) 75g GTT > 200 at 2 h. 4))) 50g GTT > 146 at 2 h |
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Annual influenza vaccine recommendation:
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Patients older than 50 yo, healthcare workers
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Do OCP decrease risk for gonococcal PID?
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YES! OCP decrease risk for gonococcal PID!
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Osteoporosis Rx
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With drugs, not only calciumm is indicated when = T-score < 1.5 OR < 2.5 + RF
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Elderly + fall, what do you need to do?
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do a home safety evaluation
avoid narcotics |
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Woman sexually active, younger than 25 yo or with RF screen for?
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Screen for Chlamydia
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how many readings for HTN Dx =
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3 separate readings
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Post exposure TB prophylaxis
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2 drugs chosen according to bug susceptibility
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Smallpox Rx
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Cidofovir
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Anthrax Rx and prophylaxis
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Ciprofloxacin (adults)
Penicillin (children) |
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Pneumococcal vaccine
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Q5 y for >50 yo with chronic disease
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Td vaccine
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q10 y or once at age 50 yo
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Woman with relative with breast ca recommendation
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Mammogram 10 y before the affected person age + self breast examination
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Men with relative with prostate cancer recommendations
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annual PSA + DRE after 40 yo
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Autism suspicion must order which test?
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hearing test
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Gingko biloba + warfarin
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increased risk of bleeding
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1 yo vaccines
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Hib
MMR Varicella PCV |
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ERCP complications
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Acute pancreatitis
Infected pancreatic pseudocyst formation Cholangitis Perforation |
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Disrupted/transected urethra suspicion next step
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retrograde urethrogram;
blood at meatus + high riding prostate |
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Leaking CSF (ears)
-Diagnoses -Contraindications |
cribiform fracture
blind nasogastric or nasal intubations are contraindicated! |
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Radial head fracture (outstretched hand, Cole's fracture) Rx
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sling 2-3 days, early exercises
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New onset serous discharge, means?
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Wound dehiscence
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How do you take CXR in pneumothorax
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Take CXR at maximal expiration
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Compartment syndrome suspicion confirmation and treatment?
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measure compartment pressures
emergent fasciotomy if confirmed |
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What is CI in In burn patients
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Succinylcholine due to the risk of hyperkalemia
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Diuretic given to sulfa alergic patients
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Etacrinic acid
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Increased ICP first steps in management
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Intubation + hyperventilation
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Anterior spinal arterial occlusion symptoms
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Decreased motor function, decreased sensation, decreased pinprick, preserved proprioception
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Painful Chancroid unilateral lymphadenopathy and lesion with
purulent base Rx? |
Haemophilus ducreyi
Rx = ceftriaxone, azithromycin |
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PSA > 4 next step
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Prostate Biopsy
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Metastatic prostate ca Rx
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Leuprolide
Goserelin Bilateral orchiectomy |
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Hydrocele how to dx and rx?
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Dx with USG
no Rx required |
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Tumors that increase HCG?
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seminomas and nonseminomas
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Tumors that increase AFP?
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Embryonal, Yolk sac elements (nonseminomas)
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HTN + BPH Rx
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Terazosin, Doxazosin
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Epididimoorchitis Rx =
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Doxycycline 100 mg PO bid for 10 d + ceftriaxone 250 mg IM
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Amytriptiline S.E.
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constipation, ac. glaucoma, urinary retention, dry mouth, paralytic
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Methanol toxicity
Effects Orders RX |
Effects: vision changes
Order: ABG, electrolytes, osmolality Rx = IV ethanol, dyalisis |
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Testicular torsion Rx and treatments S.E
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Ketorolac
S.E. = gastric ulceration, GI bleeding |
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Thioridazine S. E.
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prolonged QT
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