The etiology and workup for a 36yo F with BP 160/90 and K 3.0
What is primary hyperaldosteronism.
Evaluate with serum aldosterone/renin ratio (high aldosterone, low renin)
26-year-old male with coccidioidomycosis (valley fever) develops a rash on the extensor surfaces of his lower legs consisting of painful, subcutaneous, nonulcerated, erythematous nodules
Erythema nodosum
Associated w coccidioidomycosis, strep, and TB
management of sundowning in dementia
NONPHARMACOLOGIC!
Sensory stimulation, touch, music.
Last resort is meds
prophylactic antibiotics for dental treatment in patient with prosthetic joint
none!
Unless hx of joint infection or immunocompromised.
Give Amoxicillin for pts with prosthetic heart valves or surgical correction of congenital anomalies
needs 2 of the following: oligomenorrhea, hyperandrogenism, and the presence of polycystic ovaries on ultrasonography.
medication to prevent ischemic stroke in 56yo M w Afib and CHADS2VASC 3
Apixaban 5mg BID (for CHADSVASC >2)
conditions associated with Hidradenitis suppurativa
obesity, diabetes, Crohn’s disease, arthritis and spondyloarthropathy, metabolic syndrome, polycystic ovary syndrome, pyoderma gangrenosum, and trisomy 21.
Contraindication to triptans
Triptans vasoconstrict - so...coronary artery disease, cerebrovascular disease, or peripheral vascular disease; patients with uncontrolled or multiple cardiovascular risk factors; and patients with certain high-risk migraine syndromes, including basilar and hemiplegic migraines.
And Suicidality
treatment regimen for Gonorrhea positive, chlamydia negative in young man >130kg
1g IM Ceftriaxone (would give 500mg if <130kg)
For Chlamydia: Doxy 100mg x10d, or Azithro 1g PO x1
management of 15yo with painful, heavy menses
primary dysmenorrhea: maximum strength NSAIDs, +/- combined OCPs
at what age should we start BP checks in children
3yrs old!
very pruritic, recurrent, grouped papules, vesicles, and erosions on knees and elbows, biopsy confirmed dermatitis herpetiformis is associated with what condition and labs values?
celiac disease/gluten sensitivity;
elevated IgA tissue transglutaminase (tTG) antibodies, which is the serology of choice for diagnosing celiac disease.
Tx: gluten free diet + dapsone
12yo
antihypertensives most likely to cause hyperkalemia
ACE inhib or ARB! (-pril, -sartan).
EC: thiazides can cause HYPOkalemia
Etiology of this lesion: 28yo F w a 2.5-cm pruritic, erythematous, oval macule on her left thigh.
She started sulfamethoxazole/trimethoprim (Bactrim) for UTI 2 days ago. Her UTI symptoms have improved. She reports that she was called earlier this morning and told that her infection was caused by Escherichia coli. The patient reports a similar lesion in the same area a year ago at the time of her last UTI.
fixed drug eruption (FDE), which is an immunologic reaction that recurs upon re-exposure to the offending drug (usually Sulfonamides and anticonvulsants)
risk factors for IPV (intimate partner violence)
young age, unplanned pregnancy, belief in strict gender roles, having few friends, low income
recommended treatment of hypertension in a patient with stage 3 chronic kidney disease and proteinuria?
either an ACE inhibitor or an angiotensin receptor blocker (ARB) AND thiazide diuretic or calcium channel blocker
treatment for 40yo F w several pruritic, thickened, scaly areas on her lower back, knees, and elbows that bleed when she tries to remove the scale
Psoriasis with Auspitz sign (bleeding when removing scales). Treat with topical steroids like clobetasol
Etiology symptoms:
Patient on Prozac gets a cold and takes over the counter cold medicine, then promptly has agitation, diaphoresis, hyperthermia, inducible clonus, agitation, and diaphoresis, as well as hyperthermia.
Serotonin syndrome, can be precipitated by dextromethorphan when on SSRI