Cushing
Symptoms of Cushing Syndrome
Yup - all those
How long is the implant good for before it should be removed?
3 years
define support
to give assistant to or help
Ice or heating pads? Why and why not to both?
Ice can cause vasoconstriction - causing worsening of the pain crisis, heat does the opposite
What population is body lice usually seen? Head lice?
Body lice - homeless
Head lice - school children and caregivers
exogenous administration of glucocorticoids
Number one contraindication for ENG implant
Pregnancy or suspected pregnancy
marriage between two unrelated individuals
Preventing VOE at home
- avoiding pain triggers
- pursuing physical activity
- adequate sleep
- health heart diet
- having a good support system
How do you diagnose lice?
Identification of lice, eggs, or nits. Head lice are about the size of a sesame see and can move quickly. Eggs are glued to hair, which can help differentiate them from dandruff or dirt.
The gold standard cortisol measurement is taken how and when?
What is the best birth control to suggest to your patient? What factors matter?
It depends on their situation and what they need - non-hormonal and long term? hormonal and short term? double protection?
define facial plethora
Fullness, swelling, redness
What is MME and how is it used
1 Morphine milligram equivalent
Used for comparing potency of different opioids with morphine to help with prescribing or step down to oral
How long can it take for symptoms, ie itching, to start after infection of lice?
up to 4-6 weeks after infestation due to sensitization and sensitivity developing.
- 24hr Urinary Free Cortisol level
- Midnight Salivary Cortisol level
- Low Dose (1mg) Dexamethasone Suppression test
Most effective types of family planning methods
IUD, Implant (nexplanon), permanent sterilization (famale ie tubal and male ie vasectomy)
define Cognitive bias
tendency of the human brain to simplify information processing through a filter of personal experience and preferences
Treatment in the ER and goal time to treat
- ideally door-to-analgesia time of <60 minutes
- Step up pain control from home attempt
- Hypotonic IV fluids at Maint, unless dehydrated
- other forms of pain control - distraction, heating pads, NSAIDS
- ask if they have an individual plan with their doctor, believe them if they say "x" worked best last time
how long can head lice live off the body? Body lice?
Head lice - 2 days
Body lice 5-7 days
Signs/Symptoms to help differentiate CS from obesity in office
- HTN
- Back pain with tenderness over the spine (vertebral compression fractures from osteoporosis)
- Headaches
Which birth control methods are the safest for use in patients with sickle cell?
Progestin only methods - POP, DMPA, implant, and hormonal IUD are considered safest.
However, using a birth control with estrogen is considered lower risk then a pregnancy.
define Jarisch-Herxheimer reaction?
Release of endotoxin like antigens during bacterial lysis after starting penicillin for the treatment of primary and secondary syphilis. Symptoms include fever, HTN, hyperventilation. headache, flushing and vomiting.
Treat symptoms but continue treatment.
What does Hydroxyurea do and who is it recommended for (disease/age)?
chemo agent that increased Hb F and reduces sickle HB polymerization.
Recommended for all children >9mo with Hb SS or S/Beta Thal
How do you treat head lice and who do you treat?
Permethrin 1% lotion or shampoo, leave on clean hair for 10 min then wash out. fine tooth comb for eggs. repeat in 7-10 days. (bugs may be resistant)
Must be done for all contacts who have symptoms and anyone who shares a bed, regardless of symptoms.
also must treat/wash bedding, clothes, stuffed animals.