Bugging out
19-year-old college student presents with fever, severe fatigue, sore throat, and posterior cervical lymphadenopathy. Exam reveals tonsillar exudates, palatal petechiae, and splenomegaly
TREATMENT?
Supportive
avoid contact sports
When to give T dap in pregnancy
27-36 weeks
Afiat took a course of doxycycline for obtaining Lyme disease out of thin air.
What should she invest in, since this med has a side effect she should look out for?
teeth whitening strips
24-year-old woman presents with sudden unilateral pelvic pain, nausea, and adnexal tenderness. Pregnancy test is negative.
next best step
doppler ultrasound
32-year-old man with Schizophrenia presents with fever, severe muscle rigidity, confusion, and diaphoresis several days after starting a new antipsychotic medication. Labs reveal markedly elevated creatine kinase levels.
diagnosis?
NMS
serotonin syndrome- hyperreflexia, clonus
32year old man with advanced HIV presents with fever, weight loss, nonproductive cough, and fatigue. Recently returned from Columbus, Ohio. Exam shows hepatosplenomegaly and oral ulcers. Labs reveal pancytopenia and elevated LDH.
DIAGNOSIS?
HISTOPLASMOSIS
A pregnant 26-year-old woman is found to be nonimmune to rubella during prenatal screening. What is the appropriate management regarding vaccination?
MMR post partum...
not pregnancy
NAME 3 DISEASE PROCESSES THAT CAN BE CREATED BY LITHIUM
- hypothyroidism
- nephrogenic diabetes insipidus
- ebsteins anomaly
- hypercalcemia
- tremor
3-year-old presents with drooling, tripod positioning, and inspiratory stridor. What is the next best step?
SECURE airway
True or False:
A chronic alcoholic patient is brought to the ED with confusion, ataxia, and ophthalmoplegia. Immediate IV dextrose administration should take priority over vitamin supplementation to prevent neurologic deterioration.
FALSE
THIAMINE BEFORE GLUCOSE
25-year-old man presents with recurrent episodes of chills followed by high fever and drenching sweats that occur every 48 hours. He recently returned from a trip to Nigeria.
Labs will show what....(2)
thrombocytopenia
hemolytic anemia
leukopenia
16-year-old male presents for a routine physical. Review of records shows he received a single HPV vaccine dose at age 14 but never returned for follow-up. What is the appropriate recommendation today?
1 dose today
71-year-old man with a history of atrial fibrillation presents with progressive shortness of breath and new blue-gray discoloration of the face after several months of therapy with a medication he takes to maintain normal heart rhythm. Exam reveals diffuse bilateral crackles.
NAME THAT MED
amiodarone
4-year-old boy presents with nighttime cough and intermittent wheezing during exercise. Physical exam is normal today.
next best step
spirometry
3 RISK factors for avascular necrosis
steroids
alcohol
sickle cell
FUNGAL MENINGITIS CSF
__ WBCS
__GLUCOSE
__ PROTEIN
•↑ WBCs (lymphocytes)
•decreased glucose
•↑ protein
A healthy infant received the first Hepatitis B Vaccine dose at birth and the second dose at 1 month of age. At what age is the third routine dose administered?
6-18 months
62-year-old man with type 2 diabetes presents with severe epigastric pain radiating to the back and elevated lipase levels shortly after starting a new diabetes medication. The med was started after liraglutide did not work for him.
what's the class of the med he took?
DPP4 inhibitors
(sitagliptin, linagliptin)
36-year-old woman presents with episodic headaches, palpitations, and diaphoresis. Blood pressure is 212/118 mmHg. CT abdomen reveals an adrenal mass. What is the next best step before surgery?
alpha blockade
74-year-old man presents with chronic hip pain and increasing hat size over the past several years. Labs reveal isolated elevation in alkaline phosphatase. Imaging demonstrates thickened cortical bone with disorganized remodeling. Which additional finding is most commonly associated with this condition?
hearing loss
Pagets
43-year-old man with advanced HIV presents with fever, night sweats, chronic diarrhea, fatigue, and weight loss. Labs show anemia, and exam reveals hepatosplenomegaly. Chest imaging demonstrates upper lobe infiltrates. CD4 count is 32 cells/μL. Acid-fast staining is positive, but TB test is negative.
Treatment?
•clarithromycin + ethambutol + a rifamycin
(rifabutin or rifampin)
THIS IS MAC
A healthy 4-month-old infant presents for a routine well-child visit. Which vaccines are routinely administered at this age?
24-year-old man with a history of generalized tonic-clonic seizures presents with progressive gum enlargement noted during a dental visit
WHAT MED
phenytoin
A 22-year-old woman presents with fatigue and hematuria 2 weeks after a sore throat. Blood pressure is elevated. Urinalysis shows RBC casts. What is the next best step in diagnosis?
antistreptolysin O titers
What is goodpasture syndrome
autoimmune disease characterized by antibodies against the glomerular and alveolar basement membranes, causing pulmonary hemorrhage (hemoptysis) and rapidly progressive glomerulonephritis (hematuria/RBC casts)