Pedia + sever dehydration + fluid type?
RL
High electrolye
Fever >5d+ conjunctivitis + lymphadenopathy + strawberry tongue + dx?
Kawasaki
Sx of meningitis + low glucose + high protein + polymorph cell + type of infection?
Bacterial
1st line tx of anal fissure:
Conservative (sitz bath, diet, topical analgesia & vasodilator, stool softner) —> >8wks —> rule out ibd & start surgical
Pregnant + SLE + IUGR + expected amniotic fluid status?
Oligohydraminos
65 yr + smoker + screening test?
AAA.
Screening between 65-74
34 wks pregnant + mild placenta abruption + bleeding stopped + nxt?
Discharge home and f/u as high risk pregnancy w/US.
“34-36+6 you have two option, if severe then admit to the hospital & consider delivery, if mild then go expectant”
K/c of primary hyperparathyroidism + did surgery to remove glands + then came w/signs of hyperparathyroidism again, cause?
Missed adenoma.
“<6m this is missed, >6m is a new adrnoma”
34wk + PPROM + no contractions/cervical dilation, nxt?
Antibiotics.
She’s already 34 & lung has matured, no need for steroids. Instead give heR GBS prophylaxis
Breastfeeding + hot, tender, <5cm mass in breast, mx?
Choose between aspiration or incision and drainage.
- aspiration: small and intact overlying skin
- i&d: large w/nectotic skin.
Breast abscess is a complication of mastitis, so you consider AB therapy.
Vaccine:
- steroid <2wks:
- steroid >2wks:
- chemotherapy:
- biologics:
- PRBC:
- FFP:
- all vaccine
- live defer 1m
- live 3m
- live 6m
- live 6m
- live 7m.
HIV + toxoplasmosis, mx?
Pyrimethamine & Sulfadiazine
“Toxoplasmosis is caused by cat, she says purrrr - the cat in tweety is sylvester”
Baby laugh + stranger anxiety, age?
Baby start laughing at 4m, but develop stranger anxiety at 6m. Baby is 6m old
High LH+FSH + inability to conceive + amenorrhea for 6m
Premature ovarian failure
Differentiate between sirs, sepsis, severe sepsis, and septic shock:
- SIRS: 2 of 4 criteria
- Sepsis: 2 of 4 + suspected infection
- sever: 2 of 4 + organ dysfunction
- shock: sepsis + hypotension + vasopressor need to keep MAP>65 + lactate>2 despite fluid.
Criteria:
Temperature: > 38°C or < 36°C
Heart rate: > 90/min
Respiratory rate: > 20/min or PaCO2 < 32 mm Hg
White blood cell count: > 12,000/mm3, < 4000/mm3, and/or > 10% band cells
Warm extremity in shock is a sign of
Disterbutive shock (anaphylactic, septic, neurogenic)
Male + gynecomastia tanner 5 + nxt?
Endocrine& thyroid test
3rd degree burn +1% gentalia, nxt?
Admit to burn unit.
Major burn: areas (face, genetala, feet, hand) - 10% full thickness - 25% partial
1st Investigation for midline swelling in the neck
TSH
Pedunculate leison in colonscopy + 1.3cm tubular adenoma, screening?
After 3 years.
This is advanced adenoma (> or eq to10)
Vitamin b12 absorbed where?
Terminal ileum along with bile salt
Vascular leison in pedia cheeks l
Hemangioma
Pt with asthma + Test after which FEV1 reduced by >20, diagnostic test?
Methacoline challenge test.
If spirometry is in the choices go for it
Most significant RF for breast Ca
Non modifiable risk factors like gender (female) & age
