Exam (elaborations)
ABFM ITE 2017
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ABFM ITE 2017 ABFM ITE 2017 ABFM ITE 2017
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ABFM ITE 20173 Year old child speaks 100 words
no hearing concerns
does this kid need intervention? what kind? - YES
3 YR SHOULD SPEAK ABOUT 300 WORDS
REFER TO
SPEECH LANGUAGE
EARLY DEVELOPMENT INTERVENTION PROGRAM
28 YR PT HAS
ATHRALGIA IN SEVERAL JOINTS
+
RASH ON ARMS
TOW BUG - PARVOVIRUS B19==>fifth disease
-
IN ADULTS CAUSE RASH + ARTHRITIS
===
Rem- gonorhea also causes:
rash, joint pain, can also cause
pharyngitis (oral sex)
kid has
CERVICAL LYMPHADENOPATHY
+
FEVER
,TX? - ANTIBIOTICS TO COVER
STREP PYOGEN
MSSA
===
WRONG ANS
=
FNA
=
DO THIS IF LN
=
PRESENT FOR >1 MONTH
PT COMES IN WITH KNEE PAIN
STATES HAS BEEN TX FOR GOUT FLARES IN PAST
KNEE EXAM
=
SWELLING
NO ERYTHEMA
KNEE XRAY- SWELLING
URIC ACID LEVEL= NORMAL
TX? - DO NOT JUMP TO TX
FIRST MAKE SURE THIS IS DUE TO GOUT
=
EVALUATION OF FLUID FROM KNEE JOINT AND LOOK FOR GOUT SPECIFIC CRYSTALS
,===
REM- TX OF ACUTE GOUT WHEN THERE IS RENAL IMPAIRMENT
=
PREDNISONE
B/C BOTH COLCHICINE AND NSAID ARE CONTRAINDICATED IF RENAL DAMAGE PRESENT
2 PATIENTS WITH H.PYLORI GASTRITIS SX
NEITHER HAVE WARNING SX
WHAT FACTOR DETERMINES IF REASONABLE TO TX FOR H.PYLORI
WITHOUT DOING
EGD - AGE
IF PT <55 YEARS
AND HAS GERD LIKE SX WITHOUT WARNING SX
=
OK TO NOT DO EGD AND JUST TX FOR
H.PYLORI
WHAT TIME RELATED CONSIDERATION SHOULD DOC KEEP IN MIND
BEFORE TX STEMI PT WITH
FIBRINOLYSIS=tPA
if PCI HOSPITAL IS MORE THAN 120 MIN-2 HOURS
AWAY - OK TO TX STEMI WITH FIBRINOLYSIS=tPA
AS LONG AS
SX STARTED <12 HOURS AGO
, AND
PCI HOSPITAL IS >120 MINS AWAY
===
PCI= ALWAYS PREFERRED REPERFUSION THERAPY HOWEVER IF
>120 MINS TO PCI HOSPITAL
=
CONSIDER REPERFUSION VIA tPA
AS LONG AS
SX STARTED <12 HOURS AGO
===
REMEMBER=
FIBRINOLYSIS ONLY TO TX
STEMI (never for NSTEMI)
What are absolute contraindicationS
TO FIBRINOLYSIS THERAPAY FOR
STEMI - H/O OF INTRACRANIAL HEMORRHAGE
=
ANY-CAN BE ISCHEMIC OR HEMORRHAGIC
ACTIVE BLEEDING
H/O ISCHEMIC STROKE IN LAST 3 MONTHS
PROCALCITONIN IS A BIOMARKER FOR WHAT - BACTERIAL INFN
3 THINGS TO TEST BEFORE PT IS GIVEN
TUVADA=emtricitabine+tenofovir
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