child with head lice
rx'd with shampoo permethrin
still has nits in her
can she go to school?
yes
as long as continue home remedy, nit combing and
... [Show More] repeat permethrin shampoo in 6 days
is diverticular bleeding painful?
no
- abdominal pains
00:34
01:13
BP recommendation for >65
150/90
young boy
left hip pain
afebrile
ESR normal
WBC normal
Radiograph knee and hip normal
dx?
rx?
transient synovitis
rx: nsaids
rx for SVTs but short-term and llong term
CCB eg verapamil, diltiazem
16 yo
fatigue
on OCPs
low bleed on periods
normal TSH
normal Hct
normal RBC count
MCV <80
what lab test next?
Hgb electrophoresis
- check beta thalassemia
Signs of ALS
- mainly motor sx
asymmetrical weakness in legs, feet, ankles
slurred speech
trouble swallowing
SOB
wt loss
mcc urge incontinence in elderly
detrusor instability
what diabetes medications are good for prevention of developing DM in pre-diabetes pt
metformin
"alpha-glucosidase inhibitors (acarbose)
orlistat
thiazolidinediones
most specific sign of peritonsillar abscess
difficulty opening mouth
rx management for concussion
physical and cognitive rest
- avoid physical activity that exacerbate sx
- avoid activities that require
concentration or attention, such as schoolwork and electronics use.
lung cancer screening recommendation
ANNUAL
low-dose noncontrast CT
Asymptomatic adults 55-80 yo who have a 30-pack-year smoking history and currently smoke or have quit smoking within the past 15 years.
non-medical indicated (elective) induction of labor or C-section deliveries should be scheduled at what GA?
39wks 0 d
drug to prevent seizure in alcohol withdrawal
benzos
initial rx allergic rhinitis
intranasal steroids
most effective medication to prevent relapse in alcohol abuse
naltrexone
do not use acamprosate if renal disease
which SSRI should be prevented in elderly
paroxetine
- anticholinergic effects
screen for autism at what age in kids?
18 - 24months
bacterial vaginosis has vagina pH ?
>4.5
29 yo woman
30weeks gestation
received Tdap 3 years ago
what vaccine should she receive?
Tdap again
27 -36 weeks gestation, regardless of when they last received it
rx for acute gout
pt has HTN and CKD
prednisone
note: nsaids, colchicine and steroids can be used for acute gout...but prednisone is best in CKD
mcc med-induced adverse drug events in US
anti-coags
most common risk factor for uncomplicated cystitis
Frequent sexual intercourse
others:
- spermicide use
- previous UTI
- new sex partner
- fam hx UTI in first degree female relative
first line rx primary dysmenorrhea
nsaids
surveillance for barett's esophagus without dyspasia
endoscopy q 3 years
best initial rx for keloid
intralesional corticosteroid injections.
rx osteoporosis if 10yr risk of major osteoporotic fracture > ___ %
20%
pt with osteopenia (T <2.5)
risk of fracture <20%
what meds do you start on
calcium and vit d supplements
test for meniscus tears
thessaly test
This patient has low energy, menstrual irregularities, and a history of stress fractures, BMI <18...is consistent with ______ dx?
what test does she need?
the female athlete triad.
She is at risk for altered bone density and needs a bone mineral density test.
pt with exercise induced asthma
pt can prevent this by?
albuterol 10-15min before exercise
does ankylosing spondylitis improve with exercise and activity?
yes
also note:
- pain worse in evening
- stiffness worse in morning
pt wwith ASCVD risk >7.5% should be started on?
moderate-or-high intensity statin
note:
- fibrates don't have effect on CVD and are not part of recommendation guidelines
what pneumococcal vaccine should 65yo receive
PCV13 now and PPSV23 in 1 year
mcc hearing loss in newborn
genetics
A 32-year-old female at 12 weeks gestation presents with an itchy vulvar lesion, which you
diagnose as external genital warts. Which one of the following would be accurate advice
regarding treatment?
- The recurrence rate is low with treatment
- Cryotherapy is the most effective treatment
- Treatment should be based on patient preference
- Treatment is effective in preventing congenital transmission
Treatment of genital warts should be based on patient preference and cost. There is no treatment that is more effective than others, and the recurrence rate for any treatment is relatively high.
pt took extra pill prescribed by psychiatrist
PMH: depression
normal RR, HR
diaphoretic
resting symmetrical tremor
4+ reflexes
dx?
derotonin syndrome
pt SOB
d-dimer is positive
what test to order next?
CT angiography of chest
pt experience increase in floaters but not light flashes or loss of vision
dark spot in the periphery of her right eye
retinal detachment
rx COPD exacerbations
Prednisone, 40 mg daily for 5 days
pt vs ptt
Prothrombin Time (PT)
Partial Thromboplastin Time (PTT)
employees with >50 employees need to have what for nursing mothers?
reasonable unpaid break time to express milk
pt with episodic pains in rectum
happening for years
occur 3-6weeks
sharp, cramp-like pain
last 1-15min
no GI sx
PE normal
dx?
proctalgia fugax
lesion in forearm
looks like actinic keratosis
horn-like projection
cutaenous horn
note:
keratoacanthoma- most commonly on the face, grows very rapidly, and often is more nodular with a central pit.
pt with allergy (hives) with eggs
can they get inactivated flu vaccine
yes
give it
The Timed Up and Go test is used to evaluate geriatric patients for?
risk of falling
test:
ask the patient to rise from a chair, walk 10 feet, turn, return to the chair, and sit down.
pt with acute salpingitis (PID)
rx?
hospitalization + antibiotics
pt with rash in belt region
went walking in woods recently
cause?
mite larvae - chggers [Show Less]