If patient is asymptomatic with actinomyces on pap smear and she has copper IUD, how do you manage?
observe, no abx needed as actinomyces is part of normal flora
Rapidly progressive weakness of b/l lower extremities followed by URI, with sensory loss and urinary retention. Ddx?
transverse myelitis
Types of diabetes screening test, and when to repeat these tests?
- A1C: >6.5
- random glucose >200
- oral glucose tolerance test- >200 (most sensitive test)
- fasting blood glucose >126
- if pt is asymptomatic with abnormal test, repeat same test on same day. If 2 tests are concordant, then no need to repeat
Lab values for thalassemia
low MCV
normal RDW (elevated in iron deficiency anemia)
high ferritin for increased RBC turnover (low in iron deficiency anemia)
normal RBCs
Features of sarcoidosis
- common in Af. Am
- b/l hilar adenopathy
- anterior and posterior uveitis
- hepatomegaly, splenomegaly
- arthritis, migratory polyarthralgia
- central diabetes, hypercalcemia (tx: responds to steroids)
- erythema nodosum
Clinical features, management and treatment of spinal epidural abscess
- fever, focal spinal tenderness, neurological dysfunction
- MRI, blood cx, inflammatory markers, CT guided aspiration and culture, abx
- Tx: emergency surgical decompression and drainage abscess
Treatment of group A streptopharyngitis
penicillin or amoxicillin
Treatment of skin abscess
- I& D
- abx needed if systemic signs are present or if size is >5cm, immunocompromised, multiple abscesses
most frequent complication of TURP
retrograde ejaculation
Features of neurosyphilis (usually has prodrome several days before)
early neurosyphilis: meningitis, ocular (posterior uveitis, decreased visual acuity), otosyphilis
late neurosyphilis: general paresis (dementia), tabes dorsalis
Treatment of latent TB infection
- isoniazid and rifapentine weekly for 3 months
- isoniazid monotherapy for 6-9 months
- rifampin for 4 months
- isoniazid and rifampin for 4 months
asymptomatic pulmonary sarcoidosis with erythema nodosum, treatment?
none needed, high rates of spontaneous recovery
pseudohypoparathyroidism lab values
low calcium, high phosphorus high PTH (PTH increases calcium levels and lowers phosphate levels normally)
c.diff treatment
- mild to moderate: oral metronidazole
- severe (WBC >15000, creatinine >1.5x baseline, serum albumin <2.5): oral vanc, IV metronidazole
- toxic megacolon, severe ileus: subtotal colectomy, diverting loop ileostomy with colonic lavage
Treatment of lyme arthritis and primary diagnostic test
- doxycycline or amoxicillin if <8 yo
- enzyme linked immunosorbent assay, followed by confirmatory western blot
low T3, normal T4 and TSH. Ddx and treatment
- euthyroid sick syndrome/ low T 3 syndrome
- it is often present with other severe acute illnesses, treatment not recommended until baseline health returns
How often do HIV patients on/about to start HAART need HIV and CD4 counts checked?
3-4 months
RA-like sx with small joint involvement and weakly positive RF with less than six weeks of sx, with prior URI. Ddx and treatment
- viral arthritis- parvovirus infection
- self limited, symptomatic management
First test to differentiate between insulinoma and oral hypoglycemic agent use?
- hypoglycemic drug assay
Best treatment for borderline personality disorder
dialectical behavior therapy
Interpersonal therapy is effective for which psych disorder?
depression
diagnostic test for pheochromocytoma (headaches, diaphoresis, and tachycardia), and follow up tests when positive
- 24 hour urine collection for metanephrine and catacholamine
- CT or MRI of abdomen; if negative or has large tumor or extraadrenal disease, then MIBG scan
Diagnostic test for chronic lymphocytic leukemia
- flow cytometry
- severe lymphocytosis and smudge cells
- LN & BM biopsy not generally needed
rotator cuff tendonitis presents with what kind of shoulder pain? anterior vs posterior vs lateral
lateral
- anterior: biceps tendonitis, acromioclavicular or glenohumeral joint OA
- posterior: referred pain
