This patient with moderate COPD and moderate nonpulmonary arterial hypertension
pulmonary hypertension is hypoxic and meets the criteria for use of supplemental oxygen
(SOR A). Sildenafil and nifedipine are utilized in pulmonary arterial hypertension, but
evidence is lacking for their use in pulmonary hypertension associated with chronic lung
disease and/or hypoxemia. Low-dose prednisone may be a future option.
The American Academy of Asthma, Allergy, and Immunology recommends that asthma not
be diagnosed
or treated without spirometry. Once the diagnosis is confirmed, treatment should
commence with a
short-acting $-agonist as needed, followed by stepwise treatment based on the severity of
asthma.
The preferred anticoagulant for venous thrombosis during pregnancy is low molecular
weight heparin. Unfractionated heparin requires more monitoring and may increase the risk
of heparin-induced thrombocytopenia. Warfarin should not be used during pregnancy but
may be used in women who are breastfeeding (SOR B
Lichen sclerosus is a chronic, progressive, inflammatory skin condition found in the
anogenital region. It is characterized by intense vulvar itching. The treatment of choice is
high-potency topical corticosteroids. Testosterone has been found to be no more effective
than petrolatum. Fluorouracil is an antineoplastic agent most frequently used to treat
actinic skin changes or superficial basal cell carcinomas.
,Definition 2 of 90
prednisone
This patient has signs and symptoms of painful subacute thyroiditis, including a painful thyroid
gland, hyperthyroidism, and an elevated erythrocyte sedimentation rate. It is unclear whether
there is a viral etiology to this self-limited disorder. Thyroid function returns to normal in most
patients after several weeks, and may be followed by a temporary hypothyroid state. Treatment is
symptomatic. Although NSAIDs can be helpful for mild pain, high-dose glucocorticoids provide
quicker relief for the more severe symptoms.
Levothyroxine is not indicated in this hyperthyroid state. Neither thyroidectomy nor antibiotics is
indicated for this problem.
testing for septic arthritis
treatment for painful subacute thyroiditis:
how to use corticosteroids to manage COPD
adenosine terminate supraventricular arrythmias
Definition 3 of 90
Lichen sclerosus is a chronic, progressive, inflammatory skin condition found in the anogenital
region. It is characterized by intense vulvar itching. The treatment of choice is high-potency
topical corticosteroids. Testosterone has been found to be no more effective than petrolatum.
Fluorouracil is an antineoplastic agent most frequently used to treat actinic skin changes or
superficial basal cell carcinomas.
lichen sclerosus tx
proctalgia fugax
vasopressin
psoriasis associations
,Definition 4 of 90
Fingernails and toenails are often overlooked as clues to systemic illness. Like hair shafts, they
document a history of the body during the past several months. The symmetric depression across
the nail plate growing toward the distal edge of the nail shown here represents significant trauma
to the body some weeks ago. These classic lines are called Beau's lines. No treatment is required.
The other options listed involve the nails, but cause different and characteristic types of nail
changes.
beaus lines
ridges
splinter hemorrhages
diverticulosis
, Term 5 of 90
OTC cough meds dont use children under?
2
Systemic corticosteroid therapy reduces the hospital length of stay in patients with acute
COPD
exacerbations (SOR A). Oral therapy has been shown to be as effective as the intravenous
route in patients
who can tolerate oral intake (SOR B). A randomized, controlled trial has demonstrated that
5-day courses
of systemic corticosteroid therapy are at least as effective as 14-day courses (SOR A).
Inhaled
corticosteroids are beneficial in some COPD patients but nebulizers generally do not offer
significant
advantages over metered-dose inhalers in most patients.
ONLY NEED ORAL PREDNISONE FOR 5 DAYS
Surgery for rotator cuff tears is most beneficial in young, active patients. In cases of acute,
traumatic, complete rotator cuff tears, repair is recommended in less than 6 weeks, as
muscle atrophy is associated with reduced surgical benefit (SOR B). Advanced age and
limited strength are also associated with reduced surgical benefit.
In addition to an appropriate diet and exercise regimen, pharmacologic therapy should be
initiated in pregnant women with gestational diabetes mellitus whose fasting plasma
glucose levels remain above 100 mg/dL despite diet and exercise. There is strong evidence
that such treatment to maintain fasting plasma glucose levels below 95 mg/dL and 1-hour
postprandial levels below 140 mg/dL results in improved fetal well-being and neonatal
outcomes. While oral therapy with metformin or glyburide is considered safe and possibly
effective, insulin therapy is the best option for the pharmacologic treatment of gestational
diabetes. Thiazolidinediones such as pioglitazone have not been shown to be effective or
safe in pregnancy.
The use of long-acting basal insulin analogues, such as glargine and detemir, has not been
sufficiently evaluated in pregnancy. Sliding-scale coverage with ultra-short-acting insulin
or insulin analogues, such as lispro and aspart, is generally not required in most women
with gestational diabetes. While it may be effective, it involves four daily glucose checks
and injections.
Most patients are successfully treated with a twice-daily combination of an intermediate-
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