Newborn Respiratory Distress
Some signs of increased work of breathing (at least 3)
grunting, nasal flaring, cyanosis, retractions, respiratory rate greater than 60 breaths/min [tachypnea]
Definition of resistant HTN
BP above goal despite use of 3 agents
Bonus for goal and what 3 agents should be used
Major risk factor for compression fracture
osteoporosis/osteopenia
Target BP for secondary stroke prevention
130/80
Mechanism behind metabolic dysfunction in HIV infection
Chronic inflammation and immune activation from HIV itself as well as drug related side effects
Antepartum risk factors for RDS: name 3
Intrapartum risk factors: name at least 1
Ante: maternal preeclampsia or eclampsia, multiple gestation, pre- or postterm pregnancy, oligohydramnios or polyhydramnios, fetal hydrops, fetal growth restriction, fetal macrosomia and significant fetal malformations
Intra: emergency cesarean delivery, vacuum- or forceps-assisted delivery, or chorioamnionitis
4th line drug for resistant HTN
MRA
Xray AP, L views
Vertebral height loss of 20% compared to normal portion of vertebra
Diets that can help with stroke preventionn
DASH, mediterranean
Moderate intensity-statin therapy is recommended for what 10 year ASCVD risk level in patients with HIV on ART?
What drug is preferred?
5-20%, NNT 82
Pitavastatin
Diffuse symmetrical reticulogranular appearance, air bronchogram, whiteout appearance can all be seen in this condition
Respiratory Distress Syndrome
Common causes of elevated BP that should be excluded before diagnosing resistant HTN
medication non adherence, white coat hypertension, inaccurate BP measurement technique
Conservative management consists of:
It should be pursued for this long:
Pain relief, rehab, bracing, nerve root blocks, facet join inj
4-10 weeks
Name three types of ischemic stroke
Cardioembolic, lacunar, embolic, cryptogenic, larger artery atherosclerosis, other (malignancy, vasculitis, etc), covert
Treatment of HIV associated peripheral neuropathy
Gabapentin, capsaicin
This is the next step if HR <100 BPM
PPV, pulse ox, cardiac monitoring
Causes of secondary hypertension: name at least 4
OSA, hyperaldosteronism, RAS, CKD, thyroid disease, Aortic coarctation, pheochromocytoma, cushing disease
Classes of medications that can be used for pain relief (2)
analgesic, anti-osteoporotic meds (bisphosphonates, calcitonin, teriparatide)
Elements of AHA Association's Life's Essential 8 for mitigating stroke risk
4 items for full credit. Double for all 8.
BP, cholesterol, blood glucose, diet, weight, exercise, tobacco cessation, optimizing sleep
Antithrombotic therapy
Five Ps of sexual history
partners, practices, protection from STIs, past history of STIs, pregnancy intention
Elements of sepsis workup
Blood/csf cx, cxr, cbc, crp, blood glc, blood gases
Common side effect of MRA class drugs and an agent that has lower risk of this issue
Sexual dysfunction or gynecomastia
Name two surgical treatment options for vertebral compression fractures and describe them
Kyphoplasty: ballon inflated in vertebral body then cement is injected into the cavity
Treatment for noncardioembolic minor stroke NIHSS <3 or high risk TIA
DAPT for 21-90 days, then single antiplt
Effects of HIV on gut
Cancer risks: kaposi sarcoma, NHL
Non cancer: weakened intestinal barrier due to depletion of CD4-T cells, microbial translocation ->chronic inflammation, gut dysbiosis->risk of liver disease, CV disease, neurocognitive issues.
Medication SE: nausea, diarrhea, vomiting