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free Qbank and study notes
Hi guys,
Let us pool the study notes we developped for step 3 for the benefit of others. Here is my 2 cents UGI bleeding in HIV is either related to Kaposi?s or Lymphoma. LGI bleeding is usu. CMV, or HSV, or bacteria. Kaposis is usu characterized by purplish lesions (macules, papules, tumors etc.) most commonly on face, LN, lungs and GI tract. Basal cell Ca is characterized as a papule w/ central ulcerations and a "pearly" border. Squamous cell ca is characterized by an indurated and hyperkeratotic plaque w/ crusting and ulceration. Actinic keratosis may undergo malignant transformation? charact as macules or papules, hyperkeratotic, adherent scale with a "cutaneous horn". A keratoacanthoma is a rapidly growing nodule w/ keratinous debris in middle and is related to squamous cell ca. seborrheic keratoses usu has a waxy "stuck on" appearance. In peds? set hot water heaters to less than 130 F Always think of fungal infxn w/ immunocompromised pts?. In pts? in DKA, if you lower the blood glc level to quickly you will get cerebral edema. In pregnancy you will see increased elevated Alk phos secreted by the placenta, so just reassure pts and there is no need for a work-up. Abd wound dehiscence typically occurs 7-10d post-op; look for new onset serous d/c. tx is to re-do the laparotomy. For chlamydia positive females, tx them and their partners; pt?s w/ gonorrhea need tx for both chlamydia and gonorrhea. classic EKG for PE? S wave in I, Q wave and T wave inversion in III, or ST-T wave changes in V1-4. In family thryroid ca, think of medullary thyroid Ca. Acute glaucoma (elevation of intraocular pressure) often presents w/ abd pain, n/v and is an emergency which can lead to blindness. Dx it by measuring intraocular pressure and possibly give acetazolamide, topical BB, mannitol or pilocarpine. cocaine is contraindicated during breastfeeding. SE?s of testosterone tx (for erectile dysfxn) are increase in PSA, erythrocytosis and exacerbation of sleep apnea. Skin necrosis will happen in a pt w/ deficiency of protein C and who is started on Coumadin without heparin at the same time. u/s of molar pregnancy? "Snowstorm" pattern. The content of the uterus are hydropic villi and are grapelike in appearance. They are at risk for choriocarcinoma, thus monitor their BhCG for one year afterwards, therefore they can?t get pregnant and thus need to be on OCPs. A pt w/ an LDL >160 and >2 risk factors should be started on drug tx as well as diet/exercise. Prinzmetal?s angina is a variant angina charact by coronary vasospasm that causes reversible ST elevation. Tx is CCB and nitrates. "Nursemaids elbow"(sublaxation of radial head)? tx is supination of the forearm w/ the elbow flexed. Do not do a percutaneous needle bx of a suspected renal cell Ca, just do a nephrectomy. You can seed the tumor. Esophageal rupture is a complication of EGD. The first step is to get an esophagram w/ a water soluble agent. A thoracotomy is the tx. Screening w/ mammograms and annual clinical breast exams should begin at 40yo. In woman w/ FmHx (1st degree), screening w/ annual mammograms should begin 10 years b/f the age of the youngest affected pt. pt post-op an ortho procedure needs to be on warfarin or LMWHep post op for 6wks to 6 months. A modified radical mastoidectomy spares the tympanic membrane (a bad case of cholesteatoma). Do a direct coombs test to test for blood incompatability of mother and fetus when you get hyperbilirubinemia in an infant soon after being born. When the level of unconjugated bili reaches >20 worry about kernicturus (deposit in the basal ganglia). A woman should get mammograms yearly. In treating DKA, pt?s can get cerebral edema if the glc level drops to rapidly which presents as acute change in MS, vomiting and HA. Give mannitol and dexamethasone. If this doesn?t work, hyperventilate pt. A CT scan makes the dx. In a pt who had a subarachnoid bleed and who got treated but then declines in MS, think of a vasospasm (blood in csf is an irritant) and give nimodipine (no other CCB works). Ulcerating granulomatous lesions of the upper and lower resp tract is the hallmarks for Wegener?s granulomatosis as are cavitating lesions. An IVP is performed to est the presence or absence of both kidneys, to define renal outlines and cortical borders, and to outline the collecting system and ureters. A retrograde urethrogram is used for pts suspected of having a urethral injury. They typically have blood at the meatus, high-riding prostate, perineal hematoma, pelvic fx, A varicocele is the most common cause of male factor infertility. [b]Add your notes below[/b]
Let us pool the study notes we developped for step 3 for the benefit of others. Here is my 2 cents UGI bleeding in HIV is either related to Kaposi?s or Lymphoma. LGI bleeding is usu. CMV, or HSV, or bacteria. Kaposis is usu characterized by purplish lesions (macules, papules, tumors etc.) most commonly on face, LN, lungs and GI tract. Basal cell Ca is characterized as a papule w/ central ulcerations and a "pearly" border. Squamous cell ca is characterized by an indurated and hyperkeratotic plaque w/ crusting and ulceration. Actinic keratosis may undergo malignant transformation? charact as macules or papules, hyperkeratotic, adherent scale with a "cutaneous horn". A keratoacanthoma is a rapidly growing nodule w/ keratinous debris in middle and is related to squamous cell ca. seborrheic keratoses usu has a waxy "stuck on" appearance. In peds? set hot water heaters to less than 130 F Always think of fungal infxn w/ immunocompromised pts?. In pts? in DKA, if you lower the blood glc level to quickly you will get cerebral edema. In pregnancy you will see increased elevated Alk phos secreted by the placenta, so just reassure pts and there is no need for a work-up. Abd wound dehiscence typically occurs 7-10d post-op; look for new onset serous d/c. tx is to re-do the laparotomy. For chlamydia positive females, tx them and their partners; pt?s w/ gonorrhea need tx for both chlamydia and gonorrhea. classic EKG for PE? S wave in I, Q wave and T wave inversion in III, or ST-T wave changes in V1-4. In family thryroid ca, think of medullary thyroid Ca. Acute glaucoma (elevation of intraocular pressure) often presents w/ abd pain, n/v and is an emergency which can lead to blindness. Dx it by measuring intraocular pressure and possibly give acetazolamide, topical BB, mannitol or pilocarpine. cocaine is contraindicated during breastfeeding. SE?s of testosterone tx (for erectile dysfxn) are increase in PSA, erythrocytosis and exacerbation of sleep apnea. Skin necrosis will happen in a pt w/ deficiency of protein C and who is started on Coumadin without heparin at the same time. u/s of molar pregnancy? "Snowstorm" pattern. The content of the uterus are hydropic villi and are grapelike in appearance. They are at risk for choriocarcinoma, thus monitor their BhCG for one year afterwards, therefore they can?t get pregnant and thus need to be on OCPs. A pt w/ an LDL >160 and >2 risk factors should be started on drug tx as well as diet/exercise. Prinzmetal?s angina is a variant angina charact by coronary vasospasm that causes reversible ST elevation. Tx is CCB and nitrates. "Nursemaids elbow"(sublaxation of radial head)? tx is supination of the forearm w/ the elbow flexed. Do not do a percutaneous needle bx of a suspected renal cell Ca, just do a nephrectomy. You can seed the tumor. Esophageal rupture is a complication of EGD. The first step is to get an esophagram w/ a water soluble agent. A thoracotomy is the tx. Screening w/ mammograms and annual clinical breast exams should begin at 40yo. In woman w/ FmHx (1st degree), screening w/ annual mammograms should begin 10 years b/f the age of the youngest affected pt. pt post-op an ortho procedure needs to be on warfarin or LMWHep post op for 6wks to 6 months. A modified radical mastoidectomy spares the tympanic membrane (a bad case of cholesteatoma). Do a direct coombs test to test for blood incompatability of mother and fetus when you get hyperbilirubinemia in an infant soon after being born. When the level of unconjugated bili reaches >20 worry about kernicturus (deposit in the basal ganglia). A woman should get mammograms yearly. In treating DKA, pt?s can get cerebral edema if the glc level drops to rapidly which presents as acute change in MS, vomiting and HA. Give mannitol and dexamethasone. If this doesn?t work, hyperventilate pt. A CT scan makes the dx. In a pt who had a subarachnoid bleed and who got treated but then declines in MS, think of a vasospasm (blood in csf is an irritant) and give nimodipine (no other CCB works). Ulcerating granulomatous lesions of the upper and lower resp tract is the hallmarks for Wegener?s granulomatosis as are cavitating lesions. An IVP is performed to est the presence or absence of both kidneys, to define renal outlines and cortical borders, and to outline the collecting system and ureters. A retrograde urethrogram is used for pts suspected of having a urethral injury. They typically have blood at the meatus, high-riding prostate, perineal hematoma, pelvic fx, A varicocele is the most common cause of male factor infertility. [b]Add your notes below[/b]
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