Evidence Rating
Level of Evidence: can reassure otherwise health younger than 70 year old with acute cough, normal vitals and normal chest exam that CAP is highly unlikely
C
Up to what age should a Down's syndrome patient have an Individuals Family Service Plan?
3 years old
Recommended referral to consider between age 3-4?
Sleep study to rule out OSA
Acute bronchitis duration, patients should be counseled it could last...
2 to 3 weeks
Level of Evidence: Delayed abx prescription decreased abx use without affecting patient satisfaction.
A
Name 5 Common Physical Characteristics with Down's Syndrome
Arched Palate
Brachycepahly
Ear abnormalities
Epicanthal Folds
Michrocephaly
Macroglossia
Upward slant to eyes
Widened gap between first and second toes
After age 1 month, what do all patients need to be recommended in their diet?
Adequate iron intake as patients with Downs are more likely to have iron deficiency and macrocytosis
What treatments for Tpe 2 DM have improve outcomes in older adults?
GLP1 and SGLT2 have improved patient outcomes in older adults with differing effects on cardiovascular and renal outcomes (Level 1a evidence)
Level of Evidence: SNRI, such as duloxetine and TCA can be used to treat chronic pelvic pain.
B
What is the most common medical problem for patients with Down's Syndrome?
60-80% have vision and eye disease
50-79% have OSA
50-70% get otitis media
What vaccines are HIGHLY recommended for all Down's patients due to high risk of hospitalization early in life?
RSV
FLU
Prevnar
High flow nasal cannula in treatment of bronchiolitis does what for outcomes compared to low flow oxygen?
A. Reduces hospital stay
B. No effect on treatment escalation
C. Increased the risk for adverse outcomes
Reduces hospital stay
Level of Evidence: NSAIDS and gabapentin can be considered in the treatment of chronic pelvic pain
Recommended blood tests from 1 month to 1 year?
TSH at 6 and 12 months
CBC/diff AND either ferritin/CRP OR iron/TIBC
What tests are recommended in a patient with Down's syndrome at ALL annual visits?
Hearing, TSH, CBC
What is a risk factor for progression of Barrett esophagus to esophageal adenocarcinoma or high-grade dysplasia?
Increasing length of Barrett Esophagus (1 point per cm)
Level of Evidence: Pacifiers can reduce pain associated with common medical procedures
A
How often should an individualized family plan for Downs patients be re-evaluated for current needs?
every 6 months
What test has the lowest false positive rate of all Down's screening antepartum?
Cell-free DNA
What medication is an effective treatment for adults with severe postpartum depression with a strength of recommendation level A?
Zuranolone (GABA A receptor modulator)