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ismailalmokyad's version from 2018-01-11 17:23

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Question Answer
1-what is the mc cause of inherited thrombosisfactor V leiden account for 40-50%.
what are common causes of heredity thrombophilia1-prothrombin gene mutation,
2-hyperhomocysteinemia,
3-protein C, protein S
4-antithrombin III deficiency
2-how to test blood for compatibility before blood transfusionfirst ABO and RH type, then do prestransfusion antibody screening if negative then safley transnsfuse, if positive then further investigation to identity of antibody.

this most likely is an issue found in patients required multiple blood transfusions as sickle cell and MDS.
3-wt is ttt of DVT/PE->3 months of an oral factor Xa inhibitor (eg, rivaroxaban) if no cancer.

-LMWH more efficacious than factor Xa inhibitors if there is cancer .
4-what is the risk of using menopausal hormone therapy(MHT)?Increase rates of
1-Stroke
2-Breast cancer
3-thromboembolism (VTE)
5-how to manage female developed DVT while on menopausal hormonal therapy for menopausal symptoms ?stop it and start SSRI (escitalopram) or SNRI (venafaxine)
6-what is hepatic adenomaBenign epithelial liver tumor Primarily young women on oral contraception
7-what is c/p of hepatic adenomaOften asymptomatic (incidentally found), but may be episodic abdominal pain Liver function testing usually normal
8-how to dx hepatic adenomaCT scan with contrast Well demarcated with peripheral enhancement
9-how to treat hepatic adenoma1-Asymptomatic & <5 cm
-stop oral contraception and follow

2-Symptomatic or >5 cm
– surgical resection
10-wt is Complications of hepatic adenomaMalignant transformation (~10%) Rupture & hemorrhage
11-how to follow patient dx with hepatic adenomaAs malignant transformation can rarely occur
1-serial imaging
2-alpha-fetoprotein levels
12-what is Echinococcusparasitic infection, causes hepatic cysts. asymptomatic for years after infection.

CT reveals cyst with fluid, peripheral calcification, and septation.
13-what is mc bacteria infection after human bites1-Eikenella corrodens
2-alpha hemolytic strep (viridans)
3-staph A
14-how to manage human bite1-local wound care
2-no primary closure except face
3-Oral amoxicillin/clavulanate (or ampicillin-sulbactam if intravenous therapy is indicated)
4-consider tetanus booster
15-what is the treatment of empyema1-mpyemas also require drainage
2--Beta-lactam plus beta-lactamase inhibitor (eg, piperacillin-tazobactam) or
3-Carbapenem (eg, imipenem).
16-what is best test to dx chronic pancreatitis? and what are the findings?magnetic resonance cholangiopancreatography (MRCP). Pancreatic calcifications are the hallmark of CP. Pancreatic enlargement, ductal dilation, and pseudocysts may also be seen.
17-what are causes of chronic pancreatitis1-alcohol
2-CF
3-ductal obstructions (stone and malignancy)
4-autoimmune.
18-wt is c/p of chronic pancreatitis1-chronic epigastric pain with free intervals
2-malabsorption (wight loss)
3-DM.
19-what are labs and imaging finding in chronic pancreatitis1-normal amylas/lipase
-ct scan or better MRCP can show calssifications and dilatation of duct, and enlarged pancreace.
20-wt is the treatment of chronic pancreatitis?1-pain management
2-alcohol and smoking cessation
3-frequent small meals
4-fat soluble vit supplement
5-pancreatic enzyme supplement if low fecal elastase-1
21-how to treat pain in chronic pancreatitis1-life style modification, and small frequent meals
2-if no improvement try TCA or NSAIDS.
3-if no improved try opioids
4-if not improved then
-celiac nerve block
-ductal decompression therapy
-extracorporeal shock wav lithotripsy
-surgical resection.
22-complications of donor nephrectomyincreased risk of gestational complications include:
1-fetal loss
2-preeclampsia
3-gestational diabetes
4-gestational hypertension.
23-what is c/p of chronic lymphocytic leukemia1-median age at diagnosis is 70, mainly asymptomatic.
2-LAD (cervical, supraclavicular, and axillary).
3-HSM.
4-Mild thrombocytopenia and anemia.
24-how to dx CLL1-sever lymphocytosis and smudge cells.
2-Peripheral blood flow cytometry, to confirms the presence of circulating clonal B-lymphocytes
3-Lymph node & bone marrow biopsy not generally needed. It is a B cell not T-cell disease.
25-prognosis of CLLmedian survival 10 years.
Worse prognosis if
1-multiple chain LAD.
2-HSM.
3-Anemia and thrombocytopenia.
26-complication of CLL.1-infection.
2-Autoimm hemolytic anemia.
3-malignancies (richter transformation)
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