ABFM ITE 2018

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pt who had recently been on CRUISE SHIP NOW HAS productive COUGH- sometime bloody HA MUSCLE ACHE LEGIONELLA PNEUMONIA DIAG= URINE LEGIONELLA ANTIGEN WHAT increases the risk of developme ... ntal dysplasia of the hip in infants BREECH PRESENTATION - REGARDLESS OF DELIVERY BEING C/S OR NSVD 00:02 01:13 CARPET LAYER PT HAS LEFT KNEE SWELLING, MINIMAL TTP NO ERYTHEMA, WARMTH NO TRAUMA DIAGNOSE TXQ PRE-PATELLAR BURSITIS = TX= REST ICE COMPRESSION equiv of olecrenon aseptic bursitis what is ABSOLUTE CONTRAINDICATION TO USE OF TPA/FIBRINOLYTIC THERAPY RECENT ISCHEMIC STROKE IN 3 MONTHS OTHERS: ANY HISTORY OF INTRACRANIAL HEMMORHAGE IF SUSPECT ACUTE Acute intracranial hemorrhage Persistent elevated blood pressure (systolic >185 mm Hg or diastolic >110 mm Hg Symptoms of subarachnoid hemorrhage ANY SORTS OF CONCERNS FOR BLEEDS Use of anticoagulant drug Aortic dissection PT HAS SUDDEN LEFT HEARING LOSS NO TRAUMA NO PAIN, NO BLEEDING, DRAINAIGE, , FEVER EAR EXAM COMPLETELY NORMAL DIAGNOSE TX IDIOPATHIC sudden sensorineural hearing loss = (SSNHL) TX= PREDNISONE= ORAL PT TWISTED ANKLE Able to bear weight but with significant pain. She reports pain across her right midfoot .An examination reveals edema over the lateral malleolus and diffuse tenderness, but she does not have any pain OVER posterior distal lateral and medial malleoli SHOULD U DO XRAY OR NOT? NO XRAY ALTHOUGH LATERAL MALLEOLUS TTP, DISTAL PART OF LATERAL/MEDIAL MELLEOLUS IS NOT TTP OR PAINFUL AND ALTHOUGH PT HAS PAIN, SHE IS ABLE TO BEAR WEIGHT (4 STEPS) = CONSERVATIVE MANAGEMENT D) Lace-up ankle support, ice, compression, and clinical follow-up ACCORDING TO OTTAWA ANKLE RULES WHEN SHOULD U DO ANKLE XRAY VS FOOT XRAY DO BOTH ANKLE AND FOOT XRAY IF = COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS ==== ANKLE XRAY = COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS + PAIN OVER "DISTAL MOST" PART OF LATERAL/MEDIAL MELLEOLUS --back of medial/lateral melloli ===== FOOT XRAY = PAIN/TTP OVER MIDFOOT REGION = OVER 2 REGIONS: NAVICULAR BONE AND/OR BASE OF 5TH MTP JOINT + COMPLETE INABILITY (not just pain) TO BEAR WEIGHT (4 STEPS Which one of the following factors would increase the risk of atrial fibrillation in thispatient? A) Alcohol use B) Treatment with lisinopril (Prinivil, Zestril) C) Treatment with pioglitazone (Actos) D) Use of a continuous positive airway pressure (CPAP) device E) Physical stress3 ALCHOL USE best way to assess the patient's response to oral iron? RETICULOCYTE COUNT IN JUST 1-2 WEEKS PT WITH CHRONIC URTICARIA ON LORATADINE= CLARITIN STILL HAS HIVES TX? ADD ON H1 BLOCKER = RANITIDINE/CIMETIDINE First- and second-generation H1 antihistamine receptor antagonists are generally considered first-linetreatment for chronic urticaria PT WHOSE BRO HAS ACTIVE TB HIS PPD TEST= 8MM NO SX, PE NORMAL CXR NORMAL SHOULD U TREAT THIS KID IF SO WITH WHAT YES TX DUE TO CLOSE CONTACT TO ACTIVE TB PT AND >5MM INDURATION TX FOR LATENT TX = INH FOR 9 MONTHS TB TEST POSITIVE IF >5MM FOR WHICH POPULATION An induration of 5 or more millimeters is considered positive in -HIV-infected persons -A recent contact of a person with ACTIVE TB disease -Persons with fibrotic changes on chest radiograph consistent with prior TB -Patients with organ transplants -Persons who are immunosuppressed 00:03 01:13 [Show More]

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