steroids >7.5 mg >3 months, increased risk of steroid induced OP - correct answer ✔✔Tx:
postmenopausal woman
all men age >70
10 yr FRAX >20%
1st risedronate
Alendronate
opportunistic infection that can happen after transplant? - correct answer ✔✔BK virus ( happens when
the patient is TOO immunosupressed), its a increase in creatinine
this leads to PTH mediated excretion of phosph in the tubules
Tx for ABPA - correct answer ✔✔itraconzole and steroids
Drugs that cause eosinophilic pneumonia - correct answer ✔✔sulfa, ampicillin, azithromycin, phenytoin
,rocky mountain spotted fever rash: - correct answer ✔✔Petechial, starts in ankles and wrist and spreads
centripetally (including palms and soles)
Lyme Disease can sometimes be coinfected with - correct answer ✔✔Anaplasmosis (caustive agent for
HGA-human granulocytis Anaplasmosis)- this will have high fevers and cytopenias, which is atypical for
Lyme Disease
they are both transmitted by Ioxodes Scapularis Tick
Ixodes Tick can trasnmit - correct answer ✔✔Lyme Disease
cyclophosphamide effect in the bladder - correct answer ✔✔causes a chemical cysitis and can lead to
bladder carcinoma
H pylori therapy
1st-
after how long do you check for resolution, and in whom do you check for resolution?
2nd line therapy - correct answer ✔✔1st: PAC(PPI, amoxo and Clarythro)- if allergic to PCN then switch
to metronidazole
-in people with persistent symptoms after 4 weeks recheck. (being on a PPI will decrease sensitivity of
testing)
2nd Line (PPI, bismuth, metro, tetracycline)
Recurrent Apthous Stomatitis - correct answer ✔✔can be a/w Lupus
Crohns
,Celiac Disease
HIV
Diagnosis of PCOS - correct answer ✔✔Rotterdam criteria
2/3 should be positive
1. androgen excess
2. ovulatory dysfunction
3. polycystic ovaria
PCOS Tx.
-1st line for menstrual abnormalities and hirsutism/acne
-1st line for infertility
-what is beneficial for metabolic abnormalities? - correct answer ✔✔1st: OCP
1st infertility: clomiphene
metabolic tx: metformin
how does estrogen work in PCOS - correct answer ✔✔Estrogen component of OCPS will increase SHBG
and this will decrease the amount of free testosterone, and it will also suppress LH
in patients that are highly educated, the MMSE positivity goes from 24/30 to - correct answer ✔✔9 or
more years of education: 29/30
5-8 years of education: 26/30
when is spironolactone added to treatment of PCOS? - correct answer ✔✔if there is an inadequate
response (cosmetic) after 6 month therapy of OCP's
HCM s athletes heart - correct answer ✔✔HCM, LV wall thickness >15, asymmetric, t wave inversions
and Q waves seen on EKG, abnormal LV diastolic function
Athletes heart LV thickness <12, symmetric, bradycardia seen in athletes due to increased vagal tone
induced by exercise conditioning
, major risk factors for aneurysmal expansion and rupture (AAA) - correct answer ✔✔large 5.5
expansion of >0.5 cm in 6 months
expansion of >1.0 cm in 1 year
active cigarette smoking
RF a/w AAA development - correct answer ✔✔Age >60
male
smoker
white
atherscleoris
family history of AAA
how can rhinitis medicamentosa be prevented ?
tx? - correct answer ✔✔limiting over the counter nasal sprays(decongestants) use to less than 5 days
tx: stop spray, and intranasal fluticasone for a few days , some patients need oral steroids
when is nasal saline lavages effective? - correct answer ✔✔when patient has chronic rhino-sinusitis,
which is more than 12 weeks of sinus congestion refractory to medical therapy
acute stress disorder vs PTSD - correct answer ✔✔30 day or more is PTSD
before 30 days is acute stress disorder
what is a inflammatory bowel disease that is common in middle aged women?
what can cause this immune response? - correct answer ✔✔Microscopic Colitis
meds (NSAIDS, PPI) and smoking
What will biopsy show in microscopic colitis?
what are the two types? - correct answer ✔✔mononuclear lymphocytic infiltrates
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