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CC July 2016 SUMMARY Part 2

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echoecho's version from 2016-10-11 13:11

Section

CC JULY 2016 Part 2:
Question Answer
30) DRUG-INDUCED URINARY RETENTION =
The complex innervation of the lower urinary tract that controls micturition is influenced by a variety of medications with what properties? 1) anticholinergic OR 2) sympathomimetic properties
True or false? When medications that can cause urinary retention are given in combination, they are more likely to cause urinary retention than monotherapy?true
31) von WILLEBRAND DISEASE =
What is the most common hereditary bleeding disorder world-wide?von Willebrand's disease
VWD presents as a spectrum of disease, list this spectrum?1) partial deficiency of VWF (VWF: Ag) protein (type 1) 2) altered VWF function with ristocetin cofactor activity (VWF:RCo)(type2) 3) complete deficiency of VWF protein (type 3) 4) inability of VWF protein to serve as the carrier protein to maintain normal FVIII survival
What medication is the initial prophylactic choice for VWD type 1?desmopressin (DDAVP)
32) PREVENTION OF RECURRENT RENAL STONES =
Stone analysis is key to evaluation and management decision for urolithiasis, true or false?true
What are the first-line therapies for urolithiasis?1) dietary measures 2) alkalinization
What medication can have a greater citraturic effect than potassium bicarbonate?potassium citrate
33) PRURITUS IN END-STAGE RENAL DISEASE =
What is a common complication of renal failure and it's etiology is not completely understood?pruiritus
What is the first-line topical therapy?topical emollients
What medication has been shown to be effective in controlling pruritus and has a limited side-effect profile?gabapentin (Neurontin)
34) ELBOW FRACTURES =
Elbow fractures are most likely associated with a what type of fall in both children and adults?fall on an outstretched arm
ROM in extension of the affected arm less than the unaffected side is an important clue to significant elbow injury and suggests the need for what imaging study and evaluation?1) x-ray 2) orthopedic evaluation
What fractures have a greater risk of vascular or neurologic complications?supracondylar fractures
35) POSTSTREPTOCOCCAL GLOMERULONEPHRITIS (PSGN) =
PSGN is classically seen in children ____ to ____ years of age and generally is self-limited; in developed countries older adults with comorbidities are more commonly affected and have higher mortality rates?2; 12
Treating what infections does NOT reduce risk for PSGN?streptococcal
What does medical therapy for PSGN focus on?on limiting the deleterious effects of the renal injury, particularly high blood pressure and edema
36) IMAGING FOR SUSPECTED NEPHROLITHIASIS =
What type of stone characteristics are more likely to pass spontaneously?1) smaller 2) more distal in location
What is the imaging modality of choice for nephrolithiasis?LDCT (low-dose, computed tomography)
What imaging modality is the preferred choice in pregnant women and others in whom radiation exposure is a concern (children)?ultrasound
37) RADIATION EXPOSURE IN PREGNANCY =
Risk associated with radiation exposure depend NOT only on the radiation _____ per procedure but also on the _____ ______?doses; gestational age
What protects the baby from direct exposure, but indirect scatter still occurs from radiation that strikes maternal tissue and radiates in all directions?shielding
Exposure to a cumulative radiation dose of < ____ rads during pregnancy has not been shown to affect pregnancy outcomes when compared to background radiation exposure of < ____ rads?5; 0.1
38) HIGH ANKLE STRAIN =
The mechanism of injury is usually _____ loading to an externally rotated and dorsiflexed foot?axial
Pain is located where?above the ankle joint anteriorly and lateral to the midline
What 2 tests can help with the dx?1) squeeze test 2) dorsiflexion-external rotation test
Treatment depends on what?severity of injury and if there is instability, surgical management is needed
39) DIABETIC KETOACIDOSIS =
Does degree of hyperglycemia determine the severity of DKA?no
Severity depends on what?intensity of acid-base imbalance (pH and bicarbonate levels) and mental status
In hemodynamically stable patients without respiratory compromis, what analysis is recommended as an alternative to arterial blood gas analysis?venous blood gas analysis
Point-of-care testing for urine _________ has equally high sensitivity and higher specificity for ketoacidosis compared to measuring urine ketones?beta-hydroxybutyrate
Rectifying calculated fluid deficits using ________ infusion is key to resuscitation?crystalloid
Infusion of ______ insulin is recommended in moderate / severe DKA?regular
What is an alternative of infusion of regular insulin is an alternative in stable patients with mild/moderate DKA?subcutaneous insulin (regular, insulin analogues)
40) MULTIPLE MYELOMA =
Define MM?a plasma cell dyscrasia with significant morbidity and mortality associated with anemia, osteolytic bone lesions and fracture, fatigue and renal dysfunction
Dx is based on what?SPEP indentifying immunoglobulins (mostly commonly IgG)
There is evidence of a familial disposition. List causes?1) specific chromosomal deletions 2) translocations 3) hyperploidy influence risk and treatment options
Treatment is?complex, involving combination therapy with immune-modulating drugs and steroids and often culminanting in autologous stem cell transplantation
41) CARDIOMYOPATHY =
Define cardiomyopathy?is a group of disorders of cardiac muscle function resulting in cardiovascular decompensation and most commonly presenting as CHF
Etiology is often genetic, however, it may be induced by what?1 ) inflammation 2) immun e disorders 3) nutritional or toxic injury 4) infiltration of cardiac muscle by metabolic byproducts
Treatment is directed at?the symptoms of cardiovascular dysfunction and, if possible, at the underlying etiologic disorder
Most types have a poor prognosis and a limited 5-year survival rate despite of _________ therapy. What intervention is considered in refractory cases?1) pharmacologic 2) surgical intervention (cardiac transplantation)
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