Initial evaluation of chronic diarrhea
microscopic stool exam for leucocytes, parasites, ova, and occult blood
If patient develops rapid myelopathy (paresthesias, flaccid paralysis), what is best next step in management if they have bladder/bowel dysfunction? if they do not have bladder dysfx?
- w/ bladder/bowel dysfx or sensory deficit, then MRI. Otherwise, it is GBS– nerve conduction study
- If MRI is normal and gadolinum enhancement is absent, then lumbar puncture.
Treatment for nonfunctioning pituitary adenoma (increased alpha subunits, low gonadotropin levels)? For prolactinomas (prolactin >200)?
- trans-sphenoidal surgery
- prolactinomas: cabergoline (dopaminergic meds)
Treatment of dumping syndrome (complication of gastrectomy, causes n/v, abdominal pain, diarrhea, neurovegetative sx like dizziness, sweating etc)
high protein diet, smaller more frequent meals
multiple brain metastasis treatment
whole brain radiation
Salmonella treatment
- supportive- fluids and electrolytes
Plantar warts, usually due to HPV, treatment options
- topical salicylic acid for at least 2-3 weeks
Surgical management options for renal cell carcinoma
- if stage 1 (confined within renal capsule), then partial nephrectomy
- if stage 2 (beyond renal capsule but not beyond Gerota’s fascia), then radial nephrectomy
- if metastatic, then chemo/immunotherapy
Complications of multiple myeloma
- hypercalcemia
- renal insufficiency
- infections (PNA, UTI)
- hyperviscosity syndrome
- lytic bone lesions- need skeletal survey, bisphosphonates for prevention
- thrombosis
How does esophageal dysmotility present in scleroderma
- absent peristalsis in lower two thirds of esophagus
- decreased LES tone (as opposed to achalasia, which has increased LES tone)
Indications for ICU admission in diabetic ketoacidosis
- pH <7.1
- bicarb < 5
- AMS
Management of nonsuicidal self injury (scratching, superficial cuts)
- screen for suicidal ideation
- comprehensive psych eval but no need to be admitted
Post partum thyroiditis vs Graves disease lab values for TSH, thyroglobulin, anti-TPO, RAIU, T4
- both low TSH
- post partum: high thyroglobulin–> occurs when thyroid gland destroyed
- low RAIU vs high RAIU in graves
- may have increased anti TPO in post partum
Clinical features of MCL tear
- pain with valgus stress test
- instability with lateral movement
- effusion uncommon
When does type II error (beta) occur?
when study is too small
power= 1-beta
- when a study fails to reject a null hypothesis that is false
acute asthma exacerbation management
- o2
- short acting beta agonist (albuterol)
- systemic steroids, NOT inhaled steroids (this is more for long term ppx)
Treatment of metoclopramide induced acute dystonia
- diphenhydramine IV- anticholinergic
Initial evaluation of tuberous sclerosis (hypopigmented lesions/ashleaf spots, CNS lesions, seizures, autism, behavior problems, rhabdomyoma)
- skin examination
- MRI of brain for hamartomas
- EEG if seizures are present (seizures most predominant cause of death)
Risk factors and screening for iron deficiency anemia in children <2
- exclusive breastfeeding after 6 months
- lead exposure
- prematurity
- low iron diet, exposure to milk before age 1
- screening test: CBC when 9-12months old
What test should women with elevated AFP receive? (AFP measurements occur 16-20 weeks)
Ultrasound
Clinical features of Chagas disease (leading cause of dilated cardiomyopathy in Central and South America)
- Left ventricular apical aneurysm
- embolic complications
- arrhythmias
Kava kava side effect (used for anxiety)
hepatic injury
Side effect of licorice (used for stomach ulcers, bronchiolitis/viral infection)
hypertension, hypokalemia
Prevention for acute rheumatic fever (usually after untreated streptococcal meningitis; joints, cardiac issue, nodules, erythema marginatum, syndemham chorea)
IM penicillin for group A strep until adulthood
