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ismailalmokyad's version from 2017-10-16 06:15


Question Answer
what test is good to diagnose latent TBInterferon-gamma release assay (for vaccinated) and tuberculin skin test. both can diagnose latent TB but not the active one.
what is the test that diagnose active TB.sputum smear, should obtain 3 samples, 8 hours apart, and at least one sample early in the morning. culture which is gold stander should be preformed at the same time as it is the gold standard
who to know if active TB pt is infectious or not 3 negative smears ar considered noninfectious of TB.
what is the features of lewy body dementia?fluctuating cognition, visual hallucinations, parkinsonism features, vivid dreams, sever neuroleptic sensitivity(haloperidol), pet or spect showing low dopamine transporter uptake in basal ganglia, repeated falls, syncope or near, sever autonomic dysfunction, hallucinations or delusions, depression, dementia appears before parkinsonism symptoms.
How to diagnose lewy body dementia ?dementia plus 2 out of 3 core clinical features: cognitive fluctuations, visual hallucinations and parkinsonism.
parkinson vs lewy body dementia ?parkinson disease has tremor and parkinson symptoms starts early and dementia starts late, the opposite with LBD and tremor is rare with LBD.
frontotemporal dementia ?presents earlier usually 50s, starts as personality changes before cognitive dysfuction. typically will present with disinhibition, personality changes, extreme agitation and urinary incontinence.
What is the classic triad of NPH?dementia, urinary incontinence, and abnormal gait.
How to dx NPHHead CT.
What Lewy BD medication can exacerbate visual hallucination?dopamin agonist > levodopa
What is the features of pineal gland tumor?parinaud's syndrome, which is loss of pupillary reaction, vertical gaze paralysis, loss of potokinetic nystagmus and ataxia. headache is a prominent feature due to obstructive hydrocephalus. some pineal tumors are germinomas and secret HCG which can cause precocious puberty in prepubertal males.
wt is the most common associated diesease with craniopharyngiomas?Diabetes insipidus and deficiency of one or more anterior pituitary hormones
wt is foster kennedy syndrome ?optic atrophy on the side of frontal lobe tumor and papilledema on the contralateral side.
wt is the use of inferior petrosal sinus sampling?used to differentiate the sours of ACTH production(pituitary vs ectopic)
how to prevent bone loss 2/2 chronic prednisone use ?treat with calcium and vit D.
how does glucocorticoids cause low bone massmultiple mechanisms. decrease calcium absorption, increase renal calcium wasting and direct anti-anabolic effect on bone. also they suppress the release of gonadotropin releasing hormone form hypothalamus leading to central hypogonadism with aggravate bone loss.
how to treat glucocorticoid induced osteoprosis alendronate or risedronate, treatment could be warranted if bone mineral density studies reveal a t score of <-1.5 that continues to rapidly deteriorate.
who is candidate for lung cancer screening ?smoker >30 years who currently smoker or quite within the past 15 years. start at age 55 to 80. stop screen after 15 years of smoking free or age 80. screen with CT
how does quit smoking affect risk of cancer?cancer risk increase 10 to 30 fold than non-smokers, if quit >15 year risk decrease by 80-90%. however lung cancer risk remains elevated by 10-80% in former smokers
Wt is bronchiolitis and how to treat itit is infection occur in kids in the winter caused by RSV, pt typically have nasal congestion, rhinorrhea, corse breath sound, whezzing with or without crackles. also may be increase work of breath, nasal flaring, and grunting.
who should be admit because of brochiolitis RSVpt with resp destress, apnea, hypoxia or dehydration should be hospitalized on contact droplet precautions.
how to ttt bronchiolitis RSVsupportive only
who should get palivizumab as prevention of RSVinfant with the following preterm birth<29, chronic lung disease of prematurity, hemodynamically significant congenital heart disease.
when to do antigen testing of nasal or pulmonary secretion or nucleic acid amplification testing to detect rsv infectionin infant who is in prophylaxis with palivizumab to detect breathrough rsv which provid active immunity and protection and palivizuman can be discontinued
wt is the long term complication of rsvrecurrent wheezing in 30%