SCREENING
When do you screen for AAA
One time age 65-76 who have ever smoked?
vertical nystagmus
central
hair loss, brittle hair
Biotin, protein, B12, folate
Patient with DM on hemodialysis: history of painful diabetic foot infection, treatment with Zosyn, repeated narcotic pain medicine injections, during treatment develops new seizures. Which is the most likely narcotic to do this?
meperidine
Healthy patient who wears contact lenses presents with:
-acutely painful eye, redness, tearing, admitted to reusing contact lens storage solution, wearing the lenses months at a time, using tap water to clean, fungal smears:Hyphae
Acanthamoeba keratoconjunctivitis
Polydipsia, polyuria, persistent thirst, nonresponsive to ADH
Nephrogenic diabetes insipidus
When do you start screening for diabetes (normal risk asymptomatic patients)
Age >45, HTN, PCOS,
Fatigability
peripheral
coiled corkscrew hair
vitamins A and C
Known asthmatic with h/o major depression presents with: intractable vomiting, abdominal pain, tremulousness, sinus tachycardia, hypokalemia, normal kidney function, liver function and coags.
theophylline toxicity
young patient who swims frequently presents in the summertime with: sore throat, mildly inflamed conjunctiva, mild purulent ocular discharge and pain, anterior cervical lymphadenopathy
Adenovirus
Chronic diarrhea, bloating, weight loss, abdominal pain, pruritic papulovesicular rash on the extensor surfaces. What is required to make a definitive diagnosis?
Small-bowel biopsy or presence of dermatitis herpetiformis
What age to start giving Herpes Zoster vaccine in an immunocompetent patient? (Grade 1A or 2A recommendations)
Age> or = to 60
nystagmus lasting 6 hours
central (usually on a test less than 1 min is peripheral)
acro-orificial dermatitis (erythematous, vesiculobullous, and pustular)
zinc
Patient with bipolar disorder presents with: nausea, vomiting, diarrhea, confusion, ataxia, tremors, myoclonic jerks
lithium toxicity
otherwise healthy patient presents with: acute unilateral eye pain, redness-maximal at the limbus, numbing of the cornea, decreased visual acuity, Fluorescein dye: Dendritic lesions
herpes keratitis
Serology if suspicious of celiac disease?
IgA anti tTG or IgA anti endomysial antibody
What is the age range for screening for Hep C?
1945-1965 (74 to 84)
Type of vertigo that is severe, lasts several days, nausea and vomiting, no hearing loss
Vestibular neuronitis
ophthalmoplegia and foot drop
thiamine
patient with history of migraines, on prophylaxis presents with : somnolence, confusion, hallucinations and seizures, flushing, hypotension, mydriasis, widening of QRS, PR and QT prolongation, HAGMA
TCA overdose
Previously healthy patient presents with: acute unilateral eye pain, photophobia, redness maximal at the limbus, poorly reactive pupil, Fluorescin dye shows no foreign body or keratitis, pain in Achilles tendon
Anterior uveitits (iritis)
Treatment for brown recluse spider bite
Dapsone
When do you screen for HIV?
all adult once between the ages of 15-65
vertigo and hearing loss with a history of straining or standing
perilymphatic fistula
Skin pigmentation, cracking and crusting, glossitis
Niacin
Middle aged patient with HTN, CHF, OA takes Ramipril, Lasix, spironolactone, digoxin and chronic use of naproxen presents with several weeks of : weakness, fatigue, nausea, vomiting, intermittent abdominal pain, disorientation, changes in color vision
dig toxicity
large floater or several floaters in the field of vision that may or may not improve with time, intermittent short (<1 second) flashes of light in the same eye, eventual loss of vision
retinal detachment
Three common causes nephrogenic diabetes insipidus
Lithium toxicity, demeclocycline, hypercalcemia, hypokalemia