what kind of antibody does the polyvalent pneumococal and heptavalent pneumococcal vaccine produce ?
what population gets what?
- polyvalent--t cell independent
- adults get poly valent
- heptavalent--t cell dependent
- kids get heptavalent
what vaccines should hiv pts get?
- strep pneumo
- hep b
- hep a
how often is lipid screening?
- every 5 years
- from 21 to 65 , after 30 every 2-3 years
when do u suspect hit?
platelts drop by at least 50%
most feared complication of hit?
intubation in asthma exacerbation?
- cant maintain pao2
- respiratory muscle failure
- cant speak bc of breathing
- altered mental status
presentation of androgen insensitivity?
- normal appearing female
- short vagina
- no uterus
- no ovaries, no fallopian tubes
- testicles in the labia majora
- high testosterone, lh and estrogen
ocp for lactating woman?
- progestin only
aica and pica supplies what part of the brain?
occlusion of pica causes?
- loss of pain and temp or ipsi face
- loss of pain and temp or contra body
- cerebellar defects
2 caues for romberg sign?
interruption of dorsal columns or vertibular apparatus
most common site of an aneurysm in circle of willis?
- anterior communicating
- posterior communicating
lesion of what produces poor repetition?
what artery perfuses wernickes. brocas and arcuate fasiculus?
- cerebellar vermis
- left parietal
most common cause of meningitis from 1 month to 60 years?
- strep neumo
- h. influenza
how old is child to give steroids for meningitis?
when do u give steroids prior to or after antibiotics?
rx for fungal meningitis/
cause of encephalitis causing a rash?
what animals have rabies?
- not rats
muscle weakness + encephalitis?
difference between meningitis vs encephalitis?
encephalitis-- mental status change
what headaches are associated with menstrual cycles?
migraine with aura, cant give what contraceptive?
head made worse by eating tyramine containging foods?
jaw muscle pain when chewing headache?
periorbital pain with ptosis and miosis headache?
bilateral frontal or occipital pressure?
lacrimation and rhinorrhea?
elevated esr headache?
worst headache of my life?
headache + extraocular muscle palsies?
cavernous sinus thrombosis
sciniillating scotomas prior to headache?
responsive to 100% oxygen?
trauma to the heachage and it wont go away?
vomiting preceding headache or headache during sleep or right after awakening?
most srious complication of pseudotumor cerebri?
what can cause pseudotumor cerebri?
- steroid withdrawal
fasiculations and spastic paralysis?
impaired prioprioception + pupils do not react to light?
bilateral loss of pain and temp below the lesion and hand weakness?
bilatearl loss of vibration sense and spastic paralysis of legs then arms?
vit b 12 def
carotid endartectomy indications?
- 50-69% in men
- asymptomatic 80%
anticoagulant for first tia?
tia and cad?
tia while on aspirin?
- aggrenox or clopidogrel
- pure motor
- pure sensory
- ataxic hemiparesis
- sensory motor stroke
- dysarthia clumsy hand syndrome
- absent cortical signs**
what meds must be started withing 2 days of an ischemic stroke?
parenchymal hemorrhages require the use of what to prevent seizures?
what 2 coniditions are associated with berry anerusm?
if sah is suspected and ct is negative, next step?
which hematoma in the brain, u can perform an lp?
normal pressure hydrocephalus occurs secondary to waht?
pathologies in the subarachnoid space--meningitis, sah
in terms of regions of brain involved, what is the difference between simple partial and complex partial?
simple partial--focal region of the cortex
complex partial--focal region of temporal lobe
3 cycle per second spike and wave?
second drug of choice for absence seizures?
which febrile seizures have increased risk of epilepsy?
anticonvulsants causing low folate?
spastic cp is caused by what?
while dyskinetic cp is caused by what?
- pyramidal tract lesions
- extrapyramidal tract lesions
what drugs cause depression?>
- antipsychotics, metoclopromide, prochlorathiazine
- stimulant withdrawal, antihistamines, etoh,benzo
what antibiotics can cause serotonin sydnrome?
difference between serotonin syndrome and nms?
nms--lead pipe rigidity
serotonin withdrawal is the worst with?
withdrawal + neuropathic pain?
how long does hypomania have to last?
- flight of ideas
- taking risks
episodes of mania in 10 years?
doc for rapid cyclers in bipolar?
valproate or carbamezapine
if an adjustement disorder lasts more than 6 months, what is it called?
chronic adjustement disorder
drug for benzo or etoh withdrawal?
stage fright is what kind of phobia?
difference between greif vs adjustement disorder?
- grief--still functional
- adjustement disorder--not functional
- seborheic dermatitis
- selenium sulfide
what can be used to rescue a sudden akinetic episode in parkinsons?
rx for als?
riluzole--decreased glumatate excitatory toxicity
rx for huntingtons?
- dopamine antagonists
symptoms of als?
asymmetric limb weakness
most accurate way to tell alzheimers from multiinfarct vascular dementia?
injury to the afferent optic nerve causing inability to constrict the affected eye, this is called?
marcus gunn pupil
symptoms of complex regional pain syndrome?
rewiring of nerve fibers is aberrant--sympathetics rewiring--you get sweating and hypersensitivity
benzos and etoh increase what stage and decrease what stage of sleep?
- increase stage 2
- decrease 3 and 4
night terror and sleep walking occur during what stage?
3 and 4
depressed patients have more of what stage of sleep?
elderly have less of what stage?
rem and get quicker to rem
rem and takes longer to reach rem
what effect does benzo have on osa?
rx for narcolepsy?
narcolpesy + cataplexy?
sleep aid used for long term?
what clue points to syncope vs seizure as for reason for passing out?
- syncope--light headedness or dizziness
causes of syncope?
- situational--micturition, defacation,
- carotid sinus hypersensitivity
can leg jerking be part of syncope?
what is the reaction of the eyes if the cerebrum is damaged and water is poured into the rt ear?
brain stem damage and the water is poured into the rt ear?
normal reaction of nystagmus
eyes look towards the rt ear, no nystagmus
eyes do not move
rx for calcium phosphate stones?
rx for cysteine and struvite stones?
uveitis is caused by what?
- ciliary bodies
different between anterior uveitis and posterior uveitis?
red eye that has preauricular lymph nodes?
red eye with dryness?
red eye with colored halos or shallow anterior chamber?
acute angle closure glaucoma
red eye with corneal ulceration
red eye with collagen vascular disease or hla-b27 disease?
difference between chalazion and hordeolum?
rx for each?
- chalazian is infection of internal sebaceous (whole eyelid swelling) and hordeolum is infection of the external sebaceous glands(eyelid margin swelling)
- anterior blepharitis-- eye lid infection + dandruff(lid margin + dandrfuff)
- chalazion--sx or steroids
- hordeolum--warm compress and then abx
most effective rx for glaucoma?
most common cause of bilateral vision loss?
cherry red spot in fovea?
- retinal artery occlusion
- nieman picks
- tay sachs
rx for retinal artery occlusion?
problems driving at night?
most common cause for bullous myringitis?
symptoms of mastoidis?
- displaced external ear, erythema behind the ear
difference between vestibular neuritis and labirynthitis?
vestibular neuritis--vertigo, no hearing loss
labiryntitis--vertigo, hearing loss
what two entities have vertigo, hearing loss, tinninute?
rx for menieres?
salt restiriction and diuretics
- vestibular neurocetomy
most common cause of conductive hearing loss?
causes of vertigo?
- vestibular neuritis
most common cause of sensineuronal hearing loss
3 causes of hearing loss and vertigo?
ramsay hunt synrome?
herpes zoster oticus
rx for pagets/.
rx for alcohol withdrawal?
alcohol addiction rx?
rx for benzo and alcohol withdrawal?
- switch from carb to fat resulting in
- CArdiovascular collapse
whivh one is treated better with antidepressants, anorexia or bulimia?
rx for hypochondriasis?
frequent doctor visits
how can pain disorder be diagnosed?
when opiods fail to relieve the pain
most common causes of delirium?
rx for elderly agitation?
alternative to stimulants for adhd?
- alpha 2 agonists
what neurological disorder is contraindiated with stimulants in adhd?
what side effect does atomoxetine have for adhd/
increased suicide risk
rx for tourettes?
antipsychotics and tetrabenazine
physical signs and symptoms of pregnancy but not really pregnant?