1,2 STEP
_______ (what and for how long) helps reduce recurrence of Ankle Sprains
Bracing or tape for 12 months.
Neutropenia is defined as Neutrophil count of ______ in patients > 1 YO and ______ in infants.
<1500 per microL, < 1000 per microL
Corticosteroids are recommended between _____ and _______ weeks GA to promote ________ if anticipating pre-term delivery.
24 and 34 Weeks GA, Fetal Lung Maturation
USPTF low dose CT Lung cancer screening guidelines:
50 – 80 YO with at least 20 pack year smoking hx and have smoked in the past 15 years.
______ is tolerated by patients with a calcaneal stress reaction, and not so much by those with true calcaneal stress fracture. _______ is the preferred test for definitive diagnosis of calcaneal stress fractures.
Single-leg hop, MRI
Acronym for Initial and Subsequent Management of Ankle Sprains + Full description
PEACE and LOVE:
Protection – unload or resist movement
Elevation
Avoid NSAIDs / Ice to allow for inflammation – important in healing
Compression
Education on recovery expectations
Load – Resume activity, allow loading without pain exacerbation
Optimism – Expectations
Vascularization – Resume pain free cardio to increase blood flow to injured structures
Exercise – Restore mobility, strength and proprioception with active rehab exercises.
Besides tachycardia and hypotension, name 3 other findings that would prompt evaluation for Neutropenia
Fever, Hepatosplenomegaly, Respiratory distress, LDN, Oropharyngeal lesions – aphthous ulcers, gingivitis, poor dentition, Skin changes – Eczema, Rash, Albinism, Cutaneous vasculitis
Neonatal survival rates for vasa previa diagnosed during the antenatal period is _____ as compared to ______ when not diagnosed until membrane rupture.
97% vs 28%
A 65 YO mother with moderate - severe dementia who needs oversight and help with ADLs, BMI 22 is brought by her daughter for her hospital discharge follow-up. She had been hospitalized for a heart failure exacerbation. She asks if you can order a mammogram for her mother. Your response:
Routine screening is not recommended as life expectancy is probably < 10 years and she is not in good health.
Corticosteroid injections provide temporary relief of retrocalcaneal bursitis, but are associated with _________ usually within 6 months.
Achilles Tendon Rupture
Ankle radiography only is indicated only if patient has ______
Pain in Malleolar region + Bone tenderness at posterior edge or tip of either malleoli or if unable to bear weight for 4 steps immediately after injury, in ED or OP setting
A little Ugandan boy named Mukisa is brought to clinic by his mother for review of several CBCs. He is not on any medications and appears content with life. He has always had a Neutrophil count ranging between 1.0 – 1.2 cells per uL. What further work-up should be done to determine the cause and why ?
None – Benign Ethnic Neutropenia is chronic mild neutropenia in African, Caribbean, Middle Eastern, and West Indian Descent individuals
A 40 YO G5P4 presents after she fell forward a flight of stairs after her son left a banana peel on the floor. She reports mild abdominal and back pain. She has no vaginal bleeding, pain has improved without intervention since she left her house. ______ would indicate possible placental abruption even if she is not bleeding, and you would monitor her for _____ (duration).
Uterine hyperactivity, Fetal distress. Monitor for 4 hours.
American Urological Association recommends routine PSA screening in men 50 – 69 YO annually. True or False
False – recommendation is 2-4 years after shared decision making.
Windlass test is ___________ (description), and is highly specific and sensitive for ______ (Condition)
Passive extension of the great toe of foot affected by plantar fasciitis. Can be performed in both supine and weight bearing positions (more specific and sensitive when weight bearing)
True or False: Posterior Leg Splints or Walking boots are recommended for > 10 days after sprains.
False - Could result in muscular degeneration. Use protective ankle braces, preferably lace-up ankle and stirrup braces over elastic bandages or tape, as they offer more stability.
You’re asked to admit a patient who has a malignancy, he is not sure what it is, as he was diagnosed a month ago. He was started on chemotherapy 8 days ago and has not felt like himself since. Today he did develop severe chills, had a tactile fever and worsening weakness. You are unable to locate his records at this time. His temperature is 102.4 F. CBC shows pancytopenia and ANC of 3 cells per microL. You start him on either one of these 3 antibiotic regimens.
Meropenem, or Vanc and Zosyn, or Cefepime
________ test is utilized in late pregnancy bleeding to determine dose of Rhogam given to ______ by quantifying fetal RBCs in maternal circulation.
Kleihauer-Betke test, Rh – mothers
1/3 Prognostic Tools for Cancer Decision making in older adults:
_________ disease is most common in __________ (population) and is confirmed by single-leg stance test or by pain elicited on compression of the medial and lateral sides of the heel bone.
Calcaneal Apophysitis (Sever disease), children (skeletally immature)
Dr. Martin is participating in a friendly game of Pickleball. She is hungry to return a serve and runs forward towards teammate Dr. Poondla’s half of the court. They collide, with him unfortunately jamming his foot on top of hers. Diagnostic accuracy of the severity of her sustained sprain on P/E would best be established _______ days post-injury. This is because ____.
4-7 days. Initial swelling and pain interferes with reliability of clinical tests
Neutropenic patients with recurrent severe infections may benefit from _____ with goal ANC ______
Granulocyte Colony Stimulating Factor titrated to a level that prevents symptoms
You’re following an expectant patient confirmed to have Placenta Previa on US. If placenta is >= ______ from cervical os, vaginal delivery can be pursued.
2 cm
Cervical cancer screening is recommended to stop at age 65 if _______
They have had 3 consecutive negative Cytology results, or 2 negative consecutive cotesting results within 10 years, with the most recent result within the past 5 years.
Risk factors for a condition with Pes Planus and too many toes seen when viewing the foot from the posterior aspect of an affected ankle.
R/F for Posterior Tibial Dysfunction include; Excessive foot pronation, obesity, HTN, DM, Steroid use.