Medications
This bisphosphonate medication works by inhibiting osteoclast activity, thereby reducing bone resorption. It must be taken with water on an empty stomach, and the patient must remain upright for 30 minutes after administration to reduce the risk of esophageal irritation.
What is Fosamax, and what are the important administration instructions for this medication?
A patient presents with a positive tuberculosis (TB) skin test, but no active symptoms. Imaging reveals a Ghon focus in the lung parenchyma. Based on the pathophysiology of Mycobacterium tuberculosis infection, what is the current state of the infection in this patient?
Latent TB, where the body's immune response has contained the bacteria within granulomas, leading to a dormant state.
In latent TB, Mycobacterium tuberculosis remains encapsulated within tubercles, and it may reactivate if the host's immune system becomes compromised, leading to "opportunistic reactivation."
This condition occurs when bone resorption outpaces bone formation, leading to decreased bone mineral density and increased fracture risk. Common causes include low calcium or vitamin D intake, endocrine dysfunction, medications like glucocorticoids, and low physical activity. It can be diagnosed using DXA or TBS.
What is osteoporosis?
This progressive neurodegenerative disease primarily affects motor function, leading to tremors, bradykinesia, and muscle rigidity. It is caused by a loss of dopamine-producing neurons in the brain.
What is Parkinson’s disease?
This is a phenomenon that often precedes a seizure, particularly in partial seizures, and can involve sensory changes like a strange smell, visual disturbance, or a feeling of déjà vu. It indicates that a seizure is about to occur.
What is Aura?
This first-line medication for tuberculosis (TB) is known for its ability to cause orange-colored urine, tears, and sweat. It works by inhibiting bacterial RNA synthesis but can also interact with warfarin, oral contraceptives, and several other drugs.
What is Rifampin?
This condition involves the formation of a blood clot, typically in the deep veins of the lower extremities, and is a major risk factor for pulmonary embolism. Common risk factors include immobility, recent surgery, advanced age, and hypercoagulability.
What is deep vein thrombosis (DVT)?
This non-inflammatory joint disorder is characterized by pain that worsens with excessive use and movement, stiffness relieved by activity, and the development of Heberden's and Bouchard's nodes. While inflammation occurs as part of the degeneration, it is not the primary cause. Management strategies include weight control, acetaminophen for pain, and physical therapy.
What is osteoarthritis?
This condition involves progressive memory loss, confusion, and difficulty with daily activities. It is associated with the accumulation of beta-amyloid plaques and tau tangles in the brain.
What is Alzheimer’s disease?
The initial treatment for a patient experiencing a seizure involves ensuring safety, protecting the head, and preventing aspiration. After the seizure stops, this medication is commonly used to stabilize the patient and prevent further seizure activity.
What is lorazepam (Ativan) or diazepam (Valium)?
This antiepileptic drug requires regular monitoring of plasma levels due to its narrow therapeutic index. At toxic levels, it can cause gingival hyperplasia, ataxia, and nystagmus.
What is Phenytoin, and why must its plasma levels be monitored?
This condition results from hypervolemia and can be caused by either cardiogenic mechanisms like left-sided heart failure, or noncardiogenic causes such as acute lung injury or ARDS. It is characterized by sudden onset of dyspnea, pink frothy sputum, and adventitious lung sounds like crackles.
What is acute pulmonary edema?
This systemic autoimmune disease causes joint inflammation and synovitis, leading to systemic symptoms like fever, fatigue, and weight loss. Common joint deformities include ulnar drift, swan neck deformity, and boutonniere deformity. Management focuses on joint rest during flare-ups and medications to control inflammation.
What is rheumatoid arthritis?
This condition is most commonly triggered by noxious stimuli such as a full bladder, bowel impaction, or skin irritation. It causes a rapid, dangerous increase in blood pressure and other symptoms like severe headache, sweating, and flushing. Immediate treatment involves addressing the underlying cause and managing blood pressure.
What are the common triggers, clinical manifestations, and initial treatments for autonomic dysreflexia?
This type of shock occurs when there is a loss of circulating blood volume due to severe blood loss, dehydration, or fluid shifts. It leads to decreased perfusion and oxygenation of tissues, resulting in tachycardia, hypotension, and decreased urine output.
What is hypovolemic shock?
This medication, a recombinant parathyroid hormone (PTH), is used for osteoporosis treatment and works by stimulating bone formation. It is typically reserved for patients at high risk of fractures due to its cost and potential osteosarcoma risk.
What is Forteo, and how does it work in the treatment of osteoporosis?
This respiratory infection can be caused by viral, bacterial, or atypical pathogens, and is classified as community-acquired (CAP), hospital-acquired (HAP), or ventilator-associated (VAP). It involves the inflammatory response in the lung parenchyma, leading to exudative fluid accumulation in the alveoli, which results in consolidation.
What is pneumonia?
This class of medications, such as Methotrexate, suppress inflammation and modulate the immune system in conditions like rheumatoid arthritis. However, these drugs can cause side effects like hypertension, hyperglycemia, GI ulceration, and liver damage.
What are glucocorticoids and disease-modifying antirheumatic drugs (DMARDs)?
This acute autoimmune disorder is often triggered by an infection, such as a viral or bacterial illness, and leads to rapidly progressing symmetric muscle weakness, beginning in the lower extremities and ascending upwards. It involves demyelination of peripheral nerves and can lead to respiratory failure if severe. Management focuses on supportive care and immunotherapy.
What is Guillain-Barré Syndrome?
This type of shock occurs when the heart is unable to pump blood effectively, often due to a severe myocardial infarction. It presents with symptoms like hypotension, tachycardia, pulmonary edema, and signs of poor perfusion such as cool, clammy skin.
What is cardiogenic shock?
This biologic drug works by inhibiting tumor necrosis factor (TNF), a cytokine involved in the inflammatory process of rheumatoid arthritis and other autoimmune diseases. It can increase the risk of infections and should be avoided in patients with active TB.
What is Enbrel (etanercept), and what is its mechanism of action?
A 55-year-old patient presents with sudden onset of shortness of breath, pleuritic chest pain, and tachypnea. A CT pulmonary angiography reveals a blockage in the pulmonary artery caused by a thromboembolism. What is the most appropriate initial treatment for this patient?
Immediate administration of oxygen and intravenous heparin.
In the setting of a pulmonary thromboembolism, the immediate treatment focuses on stabilizing the patient with oxygen support, while anticoagulation (commonly with IV heparin) is essential to prevent further clot formation. Other treatments, such as thrombolytics or surgical interventions (e.g., embolectomy), may be considered depending on the severity, but the initial management typically involves oxygen and anticoagulation therapy.
The chronic stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:
Tophaceous gout is the third and chronic stage of the disease. It is characterized by a progressive inability to excrete uric acid, which expands the urate pool. This causes urate crystal deposits (tophi) to appear in cartilage, synovial membranes, tendons, and soft tissue. The characteristic crystalline deposits are not associated with monarticular or complicated gout. Asymptomatic hyperuricemia would not lead to crystalline deposits.
These are the pathological findings in Alzheimer's disease.
Amyloid plaques and Neurofibrillary tangles
Amyloid plaques cause neuronal death by promoting neuroinflammation, and neurofibrillary tangles impair the axonal transport system, leading to cellular dysfunction.
This form of shock involves a loss of vascular tone, causing blood to pool in peripheral vessels. Common causes include sepsis, severe allergic reactions, and spinal cord injury. Key symptoms include hypotension, warm skin, and low systemic vascular resistance (SVR).
What is distributive shock?