Can you name 7 findings that alone would trigger head CT in children with a
minor head injury? - ANSWER-1. GCS less then 15 at 2 hours post injury
2. Suspected open or depressed skull fracture
3. Worsening headache
4. Irritability
5. Signs of basal skull fracture
6. Large, boggy hematoma
7. Dangerous mechanism (fall from a bike with no helmet, MVA, fall from
height greater than or equal to 3 feet)
8. ≥ 4 episodes of vomiting (an "episode" being separated from another
"episode" by 15 minutes in time, i.e. child vomits a bit....15 minutes later
spends 2 minutes vomiting = 2 episodes).
Women at increased risk of breast cancer that do not fall into regular
screening guidelines - ANSWER-Personal history of breast cancer
,Family history of breast cancer
Women who are carriers of BRCA1 or BRCA2 gene mutations, or have a first-
degree relative with these
Women with chest radiation BEFORE age 30 or WITHIN the last 8 years
Differences in Migraines in Children and Adolescence - ANSWER-Often more
bilateral
Occipital headaches are rare in children and should be cause for diagnostic
caution
Red Flags on history associated with higher risk headaches in Children` -
ANSWER-1. Headache awakens child from sleep
2. Sudden, severe headache (thunderclap)
3. Associated neuro symptoms
4. Worsened by recumbent position or cough, micturition/defecation or
straining
5. Absence of aura
6. Chronic, progressive headache pattern
7. Occipital headache
8. Recurrent localized
,Red flags on clinical exam of paediatric headache - ANSWER-Abnormal neuro
exam
Papilledema or retinal haemorrhages
Growth abnormalities
Nuchal rigidity
Fever
Signs of trauma
Cranial bruits
Skin lesions (related to neurocutaneous syndromes)
Age less than 3 years
Risk factors such as sickle cell, immunodeficiency or history of malignancy
Absence of family history of migraine
Diabetes meds with vascular benefit - ANSWER-Empagliflozin (Jardiance)
Canagliflozin (Invokana) - Twofold increased risk of amputations, increased
risk of fractures
Liraglutide (Victoza, Saxenda) - Increased risk of pancreatitis
Medications approved for weight loss - ANSWER-Orlistat
, Liraglutide (Saxenda)
Contrave (Naltrexone and Bupropion)
GLP-1 receptor agonists CI - ANSWER-Can increase gallbladder disease.
CI in family/personal history of medullary thyroid cancer or MEN2
Requires subcut injection
Mgmt of GERD - ANSWER-Smoking cessation, avoid trigger foods, weight
loss, HTRAs
Who gets endoscopy with GERD? - ANSWER-1. Patients with alarm features
2. Who fail to respond to PPI therapy
3. With chronic GERD and at least three other risk factors for barrett's: male
>/= 50, Caucasion, central obesity, Smokers, history of BE
Women who require more intensive screening for breast cancer but do not
meet criteria for medical genetics - ANSWER-1. Women with one or two first
degree relatives with invasive breast Ca (but not meeting criteria for med
gen)
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