Tinea
Name the different types of superficial tinea infections (at least 3/5)
capitis, corporis, cruris, pedis, unguium (onychomycosis)
Diagnostic tool of choice for uterine fibroids
Multiple nails vs single nail affected
Most common presentation for SCFE
Knee/distal thigh pain in 23% of pts
Limping can occur as well
Name 2 sx, 3 signs of HFpEF
Signs: elevated JVP, HJR, lateral displacement of apical impulse, s3; less specific: ascites, cachexia, murmur, hepatomegaly, decreased extremity perfusion, edema, pleural effusion, weight gain, weight loss
Symptoms: ankle edema, dyspnea, fatigue, orthopnea, pnd, reduced exercise toleranceTrue or False: combo products such as lotrisone are a good option in instances of diagnostic uncertainty
bonus: name the components of lotrisone
No: they can result in skin atrophy, systemic adverse effects
Clotrimazole, betamethasone
Initial therapy for heavy or AUB?
Oral contraceptive, levonorgestrel IUD
NSAIDs/tranexamic acid can be used
Important elements of Hx when evaluating nail abnormalities? name 3
Diet, duration of sx, fhx, hobbies: infx/toxic exposure, medical hx, medications, nail care habits, affected nails, occupation: infx/toxic/traumatic exposure
Diagnostic evaluation should include what type of radiography
Hip: AP, Frog-leg lateral views
The cutoffs for
- normal EF
- HFpEF
- HFrEF
- HFmrEF
- normal EF: >50
- HFpEF: same
- HFrEF: <40
-HFmrEF: 40-50
Oral recommended: terbinafine 250 mg daily for 6-12 weeks
Can use topical efinaconazole, topical ciclopirox, topical tavabarole for mild/moderate cases
Jublia is wildly expensive
Name four factors that increase or decrease risk for fibroids
Decrease: increased parity, late menarche, depo use, COC use.
Possible decrease: high fruit/veggie intake
Increase: age > 40, black, early menarche <10, increased time since last birth, FHx, nulliparity, obesity, premenopausal
May increase: food additives, htn, vitamin D deficiency
Name and define two shape abnormalities of nails
Clubbing: nails enlarge and curve: usually due to cardiopulmonary, hepatic, or GI d/o
Koilonychia: spoon nail: concave, central depression/lateral elevation. Vascular changes, enzyme abnormalities. Can be familial. Can be normal in absence of other findings in children. IDA, toxins, trauma.
Findings on imaging for SCFE? Name 1 of 3 key findings
Steel sign: blurring of femoral metaphysis due to overlap of metaphysis/slipped epiphysis
Widened physis: widening of clear growth plate
The drug that reduces mortality for HFpEF
SGLT-2 inhibitors
mortality benefit in ef >40
Findings that best rule in dermatomycosis name all 3 for full credit
maceration, concentric rings, central clearing
Risk factors that would raise suspicion for cancer: name 2
Radiation exposure, li fraumeni or other genetic syndrome, post menopausal, previous tamoxifen use
Name 3 nail changes that can occur with psoriasis
Nail pitting, leukonychia, brittle nails, Beau lines, trachyonychia, oil drops, salmon-colored patches, and splinter hemorrhages
>1/2 pts with psoriasis will have nail involvement. tx with steroid injection to nail fold, topical steroids, vit D analogues, systemic therapy can be used if there are other sx
What type of SCFE is associated with osteonecrosis and when should surgery be performed?
Unstable. w/in 24h or after 72h
Other medicines that can help with HFpEF (3)
Tinea corporis, cruris, pedis treatment principles
Usually topicals such as ketoconazole, terbinafine
Oral if extensive disease, lack of response to topical treatment, immunocompromise, hair follicle involvementPALM-COEIN name all elements
DDx for AUB
Structural causes: polyps, adenomyosis, leiomyoma, malignancy/hyperplasia
Nonstructural causes: coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not yet classified
Two part question: Characteristics of patient that should prompt addnl workup; list the workup
Age: <10 or >16
Height or weight <10th percentile
Endocrine w/u: TSH, PTH, CMP, Vit D, GH
Non pharmacologic measures that can help with HFpEF
aerobic activity, cardiac rehab, low Na diet