Form 14 Review By System

What is the initial treatment for patients with hypertension if there are no secondary causes identified?

Start them with a diuretic or anti-hypertensive medication.

What causes hypertension in renal artery stenosis?

Increased angiotensin II (ATII)

What are the classic signs of pericardial tamponade?

JVD, hypotension, and decreased heart sounds.

In a patient with coronary artery disease (CAD) who had stent placement and is asymptomatic, what should be done for surveillance of disease?

Nothing needs to be done in terms of surveillance.

What does a low INR indicate in a patient with acute limb ischemia?

It means anticoagulation isn’t sufficient, so an additional anticoagulant should be added.

What does a markedly scaphoid abdomen in an infant with respiratory distress indicate?

It indicates a high risk of death from pulmonary hypoplasia due to congenital diaphragmatic hernia.

What causes hypoxemia in P. jirovecii pneumonia?

Decreased diffusion capacity.

How is alpha-1 antitrypsin deficiency best confirmed?

With a genetic test.

What is the most likely diagnosis for shortness of breath after a transfusion with bilateral infiltrates?

Transfusion-related acute lung injury (TRALI).

If a VQ scan confirms a pulmonary embolism (PE), what further action is necessary?

Nothing else needs to be done; the PE is already confirmed.

What condition can occur in conjunction with eczema, especially in infants?

Asthma.

Between ventilation and home oxygen, if a patient has hypoxemia and cor pulmonale?

The preferred management involves addressing the underlying hypoxemia with home oxygen therapy.

Any acute onset shortness of breath in a kid should have what considered?

Foreign body obstruction; Just because there’s no decreased right sided breath sounds in the setting of foreign body obstruction doesn’t mean the condition is ruled out

What is the course of Hep A?

Hepatitis A typically has a self-limiting course with symptoms lasting from a few weeks to several months, and it is acquired primarily through the fecal-oral route.

What is the course of annular pancreas that is asymptomatic?

An annular pancreas that is asymptomatic typically does not require treatment and may not present any symptoms or complications.

With intermittent dysphagia and sensation of food getting stuck in the chest, what is that indicative of?

Esophageal spasm

Between percutaneous drainage and ex-lap, what is the better of the two if the patient is stable?

Percutaneous drainage is the better option if the patient is stable, as it is less invasive and carries fewer risks compared to exploratory laparotomy (ex-lap).

What should we be thinking about when there is iron deficiency anemia in the elderly?

We should consider possible causes such as gastrointestinal bleeding, malabsorption, or dietary deficiency. Evaluation for malignancy is also crucial in this population.

In treating H.pylori, what are the options for antibiotic therapy?

Options for H. pylori treatment include a combination of clarithromycin, amoxicillin, and proton pump inhibitors, or alternative regimens like bismuth subsalicylate, metronidazole, and tetracycline.

In vitamin D deficiency from malabsorption, what will be elevated?

Parathyroid hormone (PTH) levels will be elevated, as the body compensates for low calcium levels associated with vitamin D deficiency.

How is tinea cruris transmitted?

Tinea cruris is primarily transmitted through direct skin-to-skin contact or indirectly via contaminated clothing, towels, or surfaces.

What shoulder injury does seizure cause?

Seizures can lead to a shoulder dislocation, particularly a posterior dislocation, due to intense muscle contractions during the seizure.

What features are seen with myotonic dystrophy?

Wasting of distal muscles and fish-like mouth with high arched palate

If a confirmed meniscal injury is getting worse, what should be considered?

Surgical intervention may be needed.

What is craniosynostosis and how does it appear?

Craniosynostosis is a condition where one or more sutures in a baby's skull close prematurely, leading to an abnormal head shape. It may result in developmental delays and increased intracranial pressure.

What kind of infection can diabetic foot ulcers lead to?

Diabetic foot ulcers can lead to serious infections such as osteomyelitis, cellulitis, and even gangrene, potentially requiring hospitalization and surgical intervention.

What is used to decrease recurrence of MS?

Something like glatiramer

In the elderly, how are they at increased risk for subdural hematoma?

Elderly individuals are at increased risk for subdural hematoma due to age-related changes in the brain, including brain atrophy which can stretch and damage veins, making them more susceptible to tearing from minor head trauma.

If someone has neurological instability after deep sea diving, what is the next best step in management?

The next best step is to administer high-flow oxygen and begin hyperbaric oxygen therapy, especially if decompression sickness is suspected.

What are features of glaucoma?

Features of glaucoma include increased intraocular pressure, increased cup:disc ratio, visual field loss, and optic nerve damage.

How long does it take to recover from Bell’s palsy?

Recovery from Bell's palsy typically takes several weeks to a few months, with most patients experiencing significant improvement within three to six months.

What is the management for isolated tinnitus with no other features?

The management for isolated tinnitus typically involves reassurance, as it is often benign, and recommending sound therapy or tinnitus retraining therapy if symptoms persist.

If a patient requests an unnecessary treatment despite showing understanding,

physicians are not allowed to provide that treatment

When a surgeon chooses the treatment for the patient,

there’s no matching going on, because factors exist that had the surgeon choose one procedure over the other

What is the best treatment for dry eyes in Sjogren’s syndrome?

Pilocarpine, a muscarinic agonist.

What is the most common complication of chronic lymphocytic leukemia (CLL)?

Infection due to the immunocompromised state.

What should be the next step in investigating the cause of hematuria?

Microscopic examination of urine sediment.

What is the next confirmatory test for a positive pregnancy test?

Transvaginal ultrasound (TVUS).

What should be done for a patient with recurrent bacterial infections and suspected common variable immunodeficiency (CVID)?

Check for immunoglobulin (Ig) levels.

What should be reported to local authorities regarding gunshot wounds?

They should be reported to law enforcement.

What defines uncomplicated grief compared to Major Depressive Disorder (MDD)?

Uncomplicated grief includes sadness and fatigue but no anhedonia or loss of functioning.

What is the management for a firm, rubbery breast mass?

It should be investigated as possible breast cancer.

What should be done if late decelerations persist for an hour during monitoring?

An emergency C-section needs to be performed.

What is the associated risk with smoking and oral contraceptive pills in women under 35?

Smoking is not a contraindication to OCP in this age group.

If a patient is understanding and declining treatment options, it’s best to make sure you,

explain the potential benefits and risks associated with each choice clearly

To suspect anorexia, pay attention to

BMI and preoccupation with body weight

Lithium is much more effective in

decreasing suicide risk than SSRI

Gender dysphoria increases the risk of developing

MDD

Rates are dependent on

population and are not standardized based on race

Stimulant medications for ADHD will benefit patients even into

adulthood and may improve executive functioning.

It’s normal to have hyperglycemia following surgery, but dexamethasone can cause

prolonged hyperglycemia due to its effects on glucose metabolism.

the sores of Coxsackie virus will be

inside the mouth, and on the hands and feet, which can lead to discomfort and difficulty eating.

Necrotizing fasciitis doesn’t always have to be blackened skin; there will be

exquisite tenderness and warmth

Thrombocytosis following splenectomy is treated with

medications such as aspirin or by addressing the underlying cause of increased platelet production.

The most common complication for CLL is

infections due to immunosuppression.

If allergic to penicillin, the treatment for PTA is usually

clindamycin or macrolides.

HIV with any cell count increases the risk for

Toxoplasmosis and other opportunistic infections

In cornual pregnancy, the gestational sac extends into

the myometrium and grows in the corner of the uterus.

With any case of abnormal uterine bleeding, you want to make sure you rule out

endometrial cancer

Any firm and rubbery mass should be investigated as

a potential malignancy.

What kind of fetal malformation can hyperglycemia cause?

Congenital heart defects and neural tube defects.

Breast mass in puberty is

typically benign and related to hormonal changes during adolescence.

STIs must be reported to the

appropriate health authorities.

Lichen sclerosis is a

chronic inflammatory skin condition affecting the genital and anal areas.

Hypertension increases the risk for

oligohydramnios

If someone is coming in with an existing positive pregnancy test,

TVUS is the next confirmatory test

Inadequate weight gain, history of procedures are among some of the risk factors for

preterm labor

Vulvovaginitis will have discharge with

epithelial cells and few leukocytes

Someone clearly symptomatic for ovarian masses needs to have the mass

removed

Remember that gonorrhea and chlamydia are tied at the hip; a gonorrhea infection can likely lead to

chlamydia co-infection