-
post-test probability
= post-test odds / (post-test odds +1)
post-test odds = pretest odds x positive likelihood ratio
-
abdominal US screen
one-time screen for abdominal aortic aneurism is recommended for men ages 65 to 79 years
-
influenza prevention in immunosuppressed
- oseltamivir
- active against influenza A and B
-
inactivated vs live influenza vaccine
inactivated is recommended for patients with chronic medical conditions
-
midsystolic murmur in elderly patient
right sternal border
Aortic sclerosis is present in approximately 25% of persons between the ages of 65 and 74 years and in 48% of persons older than 84 years.
-
PSA
in patients with no symptoms of prostate disease, PSA testing has positive predictive value of only 30%
-
Orlistat
- Lipase inhibitor that increases fecal fat loss
- tx of patients to aid in weight loss
- efficacy: 2.8kg at 12 months
-
Depression
weight loss
- Depression accounts for 9 to 15% of all cases of involuntary weight loss
- most common psychiatric cause
-
Most common cause of irregular menstrual bleeding
- polycystic ovary syndrome
- early onset: key part of history (usually within 1 year)
- evidence of androgen excess
- ovulatory dysfunction
-
Abx for inflammatory acne
tetracyclines
-
comedone acne
- blackheads/whiteheads
- tx: topical retinoids
-
Apthous ulcers
- paiful lesions that are localized, shallow, round, often with whitish appearance
- cause: unknown
-
Becet's disease
- connective tissue disease characterized by recurrent oral and genital ulcers
- systemic manifestations
-
atopic dermatitis
- ezcema
- allergic disorder
- 1. involvement of skin creases
- 2. history of asthma or hay fever
- 3. history of dry skin during the past year
- 4. onset in a child <2yo
- 5. Visible dermatitis of skin flexures
-
poison ivy
topical corticosteroids cannot be used on the face, neck, intertrigenous areas
-
painful, erythematous nodules on anterior surface of legs
- erythema noduosum
- causes: IBS, fungal or streptococcal infections, lymphomas, medications...
-
Erythema plus arthritis or periarthritis -->
suspicion for acute sarcoidosis
-
Herepes zoster
Tx: famciclovir
-
Itching at night, papules, excoriations
- scabies
- sarcoptes scarbieli var hominis
- most commonly in school chilgren, nusring-home residents, institutionalized patients
- transmission: close physical contact
-
tinea versicolor
- area of hypopigmentation
- hyperpigmented form
- large, blunt hyphae and thick-walled budding spores in spaghetti and meatballs
- Tx: topical ketoconazole cream or shampoo
-
coarctation of the aorta
associated with bicuspid aortic valve
-
NSAIDs in elderly patients
can raise blood pressures considerably
-
CKD progression
- hypertension
- diabetes mellitus
- proteinuria
- cigarette smoking
-
dissecting aortic aneurysm
- hypertension
- back pain
- diastolic murmur
-
hemophilia A
deficiency of factor VIII
-
Hemophilia B
Factor IX deficiency
-
ABO mismatch transfusion
- rapid hemolysis
- fever
- flank pain
- dark urine
- DIC
-
HIV kidney damage
- most common: collapsing focal and segmental glomerulosclerosis
- "HIV-related nephropathy"
- Presentation: proteinuria
-
primary hyperaldosteronism
- Conn's syndrome
- hypertension
- hypokalemia
- metabolic alkalosis
- mild hypernatremia
- suppressed plasma renin activity
- elevated plasma aldosterone levels
-
glucagonoma
clinical features
- Necrolytic migratory erythema: papules/plaques on face, perineum, extremities
- Diabetes mellitus: mild hyperglycemia easily controlled with oral agents
- Gastointestinal symptoms: diarrhea, anorexia, abdominal pain, occasional constipation
- Other findings: weight loss, neuropsychiatric, associated with venous thrombosis
-
Glucagonoma
diagnosis
- hyperglycemia with elevated glucagon >500pg/mL
- NOrmocytic, normochromic anemia (ACD)
- Abdominal imaging (CT or MRI) to localize tumor
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