1. Brain abscess: fever, HA, +/- focal deficits, seizure. Subacute course (weeks) vs stroke which is more acute.
2. Recurrent chalazion should be biopsied b/c of risk of underlying carcinoma (of meibomian gland) or basal cell carcinoma. If it turns out to be benign, can treat with steroid injectison or incision & curettage
3. Schizophrenia
- Minimizing conflict at home decreases risk of relapse
- Family interventions warranted for those with psychotic episodes and a disruptive home environment.
4. Cystinuria
- Defective dibasic amino acid transport at brush border (cystine, lysine, arginine, ornithine) of renal tubular and intestinal epithelial cells.
- Cystine is poorly soluble in water - hence forms hexagonal crystals (radioopaque)
- +urine cyanide nitroprusside test.
5. Anemia of chronic disease from ESRD + epo => may lead to depletion of iron stores and a subsequent iron deficiency anemia
6. Hyperemesis gravidarum:
- 1% of pregnancies
- Severe persistent vomiting, lab derangements (hypoK, ketonuria), and >5% of loss of pre-pregnancy weight.
- Risk factors: greater placental mass - ie multiple fetuses, molar pregnancy - will have higher b-hCG levels at 10-12 weeks when B-hCG levels peak for all pregnant women
- Treat with hydration, ginger, vitamin B6
7. When to operate for SBO:
- Unstable patient
- Signs of strangulation (acidosis, lactate, fever, septic vitals, leukocytosis)
- Failure to improve with conservative measures (bowel rest - NG, pain ctrl, fluids, correct metabolic derangements)
8. Pediatric skin conditions:
- Seborrheic dermatitis: "cradle cap" papular, scaly erythematous rash affecting eyebrows, nasolabial folds, scalp - treat with moisturizers, antifungals, topical steroids
- Atopic dermatitis: recurrent, pruritic, eczematous rash on flexor/extensor surfaces - scaling red papules
- Tinea capitis: patchy, fine white adherent scales, with accompanying adenopathy. Does not typically involve eyebrows/paranasal area like seb derm.
9. Hashimotos => thyroid lymphoma -
- risk 60x higher)
- presents as rapidly enlarging thyroid in someone with hashimotos.
- may have compressive sx - dysphagia, voice changes.
- pseudocystic sign on u/s
- rad iodine uptake lower.
- need core needle biopsy for diagnosis
10. Side effects of epo:
- worsening HTN in 30% of patients. 20-50% of people getting IV epo will have >10mmHg rise in diastolic BP; less common with SubQ admin. Unknown mechanism. Treat with fluid removal (dialysis), beta-blockers and vasodilators, prevent by slowly increasing hematocrit
- HA - 15%
- Flu like sx - 5%, responsive to antiinflammatory drugs
- Red cell aplasia - rare
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