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ismailalmokyad's version from 2018-01-07 10:19

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Question Answer
1-what cause cat scratch disease, c/p, dx, and treatment?1-caused by bartonella henselae.
2-cp: papule at scratch/bite site, regional LAD (1-2 weeks after injery), +/- fever
3-Dx: clinical =/-serology
4-TT: azithromycin.
2-what is the most common allergens that may trigger asthma1-house dust mite allergens (responsible for 60-90% of cases)
2-cat allergens
3-dog allergens
4-cockroach allergens.
3-what is breakthrough seizure ?seizure that occurred despite previously successful antiepileptic therapy.
4-what is the most common cause subtherapuetic antiseizure level?subtherapeutic drug levels 2/2:
-altered drug metabolism (eg, phenytoin)
-increasing patient weight
-nonadherence to the therapeutic regimen.
5-what is first step in working up breakthrough seizure ?measure level of medication.
6-wt is carbamazepine s/e1-fulminant hepatic failure lead to
-hyperammonemia
-vomiting
-asterxia
-hepatic encephalopathy
-seizure.

so when a patient treated with this medication for seizure and present with breakthrough seizure look for vomiting or asterixis and measure level of carbamazepine
7-how to save amputated part of the body for replantation?sterile gauze, moistened with saline and placed in a sealed, sterile plastic bag. bag then should be placed in a container filled with ice and saline or sterile water
8-what is the c/p of atopic dermatitis ?Intense pruritus
-Infants: Red crusted lesions involving extensor surfaces & face
-Children & adults: Flexural eczema & lichenification.
-usually appear early in life and associated with asthma and seasonal or perennial allergies.
9-wt is Laboratory findings in atopic dermatitis ?1-High serum IgE levels
2-Eosinophilia
3-Increased leukocyte phosphodiesterase
10-what is the treatment of atopic dermatitis ?first do all the following:
1-avoid trigger factors
2-oral antihistamines
3-emollients for skin hydration
4-avoid hot or cold environment.

-if all failed then low potency (hydrocortisone) if continue or symptom sever then high-potency triamcinolone or betamethasone.
-if in face, eyelids or felxural area (steroid contraindicated) the use tacrolimus.
-if very severe then ultraviolet phototherapy or systemic immunosuppressants.
11-what is aortic dissection risk factors?-Hypertension (most common)
-Marfan syndrome
-Cocaine use
12-what is arotic dissection Clinical features1-Severe, sharp, tearing chest or back pain
2->20 mm Hg variation in systolic blood pressure between arms
13-what is aortic dissection Complications (involved structure)1-Stroke (carotid arteries)
2-Acute aortic regurgitation (aortic valves)
3-Horner syndrome (superior cervical sympathetic ganglion)
4-Acute myocardial ischemia/infarction (coronary artery)
5-Pericardial effusion/cardiac tamponade (pericardial cavity)
6-Hemothorax (pleural cavity)
7-Lower-extremity weakness or ischemia (spinal or common iliac arteries)
8-Abdominal pain (mesenteric artery)
14-what is the dx imaging for aortic dissection ?CT angiography
15-what is classic presentation of superior vena cava syndrome (SVCS) ?begins with dyspnea, persistent cough, facial fullness and neck pain, and progresses into hoarseness, dysphagia, chest pain and syncope.

Pertinent physical findings are edema and erythema of the neck (which may sometimes compromise the face), and dilated veins of the arms and neck.
16-what is the best diagnostic test for SVCSct of chest and neck with contrast, CT scan is very useful because it can reveal the extent of obstruction and provide a histopathologic diagnosis (via percutaneous biopsy)
17-how does Anticholinergic toxicity is differentiated form stimulant drugsboth cause tachy and mydriasis however anticholenargic presence of dry skin (as opposed to diaphoresis) and other classic anticholinergic manifestations, such as ileus and urinary retention.
18-what are signs of cannabis intoxication1-tachycardia
2-tachypnea
3-hypertension
4-dry mouth
5-conjunctival injection
6- increased appetite.
19-symptoms of opioid withdrawal1-irritability
2-mydriasis
3-nausea, vomiting
4-abdominal cramping
5-lacrimation
6-myalgias
7-arthralgias
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