Misc
Are Omega-3 Fatty Acids safe in pregnancy and are they effective in reducing the risk of preterm birth
Yes and Yes
- reduce birth <37wks and <34wks
- increase risk of prolonged gestation >42
- Number needed to harm 102
What are approved medications for Anorexia Nervosa?
There are no FDA approved medications for anorexia. Olanzapine or SSRIs may be used as off-label.
According to the USPSTF for women of average risk, mammography is recommended starting at age _ with a frequency of _.
Define Arrest of Labor in Latent stage
You should not Dx arrested labor in latent stage
Protracted labor:
Nulliparous >20hrs
Mutliparous >14hrs
Describe 2 phases of swallowing
Esophageal- passes upper esophageal sphincter and enters esophageal body, propelled by peristalsis through midthoracic and distal esophagus and into stomach through fully relaxes lower esophageal sphincter
yes, at 1yr more effective then other quit tools
Name at least 1 criteria that define a Moderate degree of malnutrition.
1. Percent of Median BMI 70-79%
2. BMI Z-score -2 to -2.9
3. % Weight loss >15% pre-illness weight loss
What is the approximate lifetime risk of develping invasive breast cancer?
A) 5-10%
B)10-15%
C)15-20%
D)20-25%
B)12.8% or 1 in 8
Name 3 possible Dx for young active adults with anterior hip pain
- Femoroacetabula impingement
- labral tear
- femoral neck stress Fx
Define Arrest of labor for active stage
>/= 6cm dilation, membrane rupture and either
> 4hrs w/o cervical change with adequate CTXs
or
> 6hrs w/o cervical change w/o adequate CTXs
Name 5 causes of oropharyneal dysphagia
- Stoke
- Parkinsons
- Alzheimers and other dementias
- ALS
- MS
- Myasthenia gravis
- Dermatomyositis/polymyositis
- Antipsychotic meds
- structural causes (CA/masses, zenker diverticulum, head/neck radiation)
- poor dentition/dentures
- dry mouth
-
In treatment-resistant depression, this medication when added on to SSRIs was effective in controlling symptoms.
Quetiapine
Amylase
When should breast cancer screening be discontinued?
What is the most common cause of lateral hip pain and its 2 underlying etiologies
Greater Trochanteric Pain Syndrome
- Bursitis
- Gluteus Medius Tendonopathy
Typically woman 40-6-
Define protracted labor in second stage
epidural:
Nulliparous- >/= 4hrs
Multiparous >/= 3hrs
w/o epidural
Nulliparous- >/= 3hrs
Multiparous >/= 2hrs
What are the 3 most common causes of esophageal dysphagia?
GERD
Functional esophageal d/o (IBS, functional dyspepsia)
eosinophilic esophagitis
Describe 3 phases of severe dengue
Febrile
Critical- starts 72hrs after fever, increased vascular permeability, fever, hemorrhagic manifestations, and marked thrombocytopenia
What is the first line treatment for anorexia nervosa or bulimia nervosa with grade A evidence?
Family-based therapy
When might ultrasonography be considered in addition to mammography for screening?
In women with moderate risk and dense breasts (not high risk such as BRCA)
Describe the long-stride walking test and what it is testing for.
94% sensitivity and 85% specificity
After 3+ hrs in second stage how many woman will delivery spontaneously?
only 1/4
Describe at least 3 characteristics that differentiate between oropharyngeal and esophageal dysphasia
- Feeling that food is stuck, almost always esophageal
- Coughing, choking, or nasopharyngeal regurg, consistent with oropharngeal
- Liquids and solids > esophageal
- Liquids only > oropharyngeal
- Solids only > esophageal mechanical obstruction (intrinsic or extrinsic)
What is the new drug Vascepa (isosapent ethyl) indicated for, does it work, 2 adverse effects, and cost?
- CVD pts on max statin therapy with persistent elevated TGs
- yes effective at reduces risk of ischemic events
- A-fib (including hospitalizations) and bleeding
- $130/mo vs $40/mo for fish oil
Name 3 ways to prevent arrested labor
- do not admit in latent labor
- labor support (Doula)
- proper active management of labor (using cervical ripening, augmenting as indicated)
What are the first 2 tests of choice for esophageal dysphagia
EGD followed barium swallow
Need Bx to dx eosinophilic esophagitis