Repetitive Nerve Stimulation Studies
diagnostic for B. toxin
VeStibular Neuritis : Acute, Nausea
Ga
pocphos!
OTA in kids < 16: Slit Eye Exam Look for
Uveitis
CAD can cauSe angina even after
meats:
Valve replacement iS 1St Line. Valuotomy
is 2nd ti
Mass in neck: FNA require Surgery
Must wear shoes if diabetic
DALY: Disabitity adjusted Lig 5
YPLL: Only mortality
— HAtypicat gtandutar cetts on Pap-————S—™
Cotposcopy w/ endocervical curettage
1 month of diarrhea, bloating & weight
Loss after returning from trip - Giardia
Cyanotic baby right after birth - ppv &
Sti tion HR ; g lizes tt
ust ob$ -i¢- HO
15cm or persistent
ter 2 5 oF age wilt St Likel
entarge
voluutus-Omphalocele Postpartum endometritis- iv antibiotics
Post Roux-en-Y gaStric bypass, nausea,
iti Sion & Falling- B41
Cthiamine)-desici hich is abSorbed i
jejunum
Age-Greatest risk factor for dementia
DOH oF hip- ultrasound in <6 months
Learn to identify V-tach
__Ng tube/ trachea deviated to right.
~ spec sorte dazeetan
Pain Crisis in SCO-94%.02-
02 Supplementation- Impending Acute chest Hypotension + acute abdominat pains crampey —
pain w/ bowel movements- Ischemic Cotitis
Post-cholecystectomy biliary Leak iS
diagnosed by ERCP
Renat art stenosis ci ith MR
Hypoxia, oliguria, low hematocrit post-op
in which 500 mt was lost- Give packed
OF Submandible - FNA
in mid pote oF tert kidney about 2.5 cm.
enhancing & cyStic in nature with internat
necrosis- Lest nephrectomy
Placenta accreta riSk increased by placenta
ia & prior C Secti Bacterial vacinosis- get_a wet ‘
besore giving met
prevalence ratio. IF extrapolated to
generalized population, only then SD, SE.
___and other measures willbe used.
.a-€ iC,
crusted plaque w/ areas of ulceration
on forehead- SCC
Actinie-keratosis-has_a-oritty-text
Cume in thigh post trauma, paintess, Slowly
Growing, Soft tissue mass. MRT Shows
Soft tissue mass- core needle biopsy
uSe incontinence brie¢s instead of catheter
to avoid UTI
Hand washing erior to Central Venous
catheter 10
t cnt Cc (
agter transfusion- Pick Fluid overload even
i¢ elevated JVP not mentioned
Timetine of cerebral ingarction- when last
aspiri
. - itis MRL of sei
not blood cultures
~ Suspected osteosarcoma- MRI First
then biopsy
~ Type 2 OM For 20 years- Hypertension even —
though creatinine iS normal Urine 4 protein
cauSe of HTN iS renal parenchymal disease
by OM CKD
— GIR w/Virat URT & 1/0 asthma - 02
Saturation Suddenty dropsS_bronchospasm
—OSA-Increased-putmonary HTN can be
seen on echo Paintess gross hematuria -Atways
transitional cell carinoma-2 om mass in
the bladder
stittbirth acter 2 Ks Ky Nst
in 3red-timester starting at 32 ks
Also do 2 or 3 ultrasound across
gestation to detect anamoties
z 5 Siin-an-otel man wit {
Stage pancreatic cancer- Don't treat it
Civer transplant man walks on beach &
gets Severe pain that radiates in his
him- Reassure becauSe Stranger’s anxiety
confusion + Fever + jaundice + tow platetets”
= TTO- plasmapharesis SMA type-I Cingantite)- death isi
{ue to resvirat fistress_Atso +
di¢ficulty Feeding and in mobility
SMA type IT (Dubowitz): never walk or
stand without assista
—SMA type TIT (Kugelberg-Welander—__
sundi }: imat-muSet “ness i
arms & tegs, Skeletal abnormatities . Trace —
OTRTI waddving gait. High CK
Ketorolac
08 Reetaminophen? oni Bt ay
5 Lonsittitis-Peritonsittar abscess-
Needle aSpiration & antibiotic therapy
ha oH hitia A9- Test ¢t ‘
blood for Factor & after delivery oF boy
minimal hair & intellectual development
diSorder- Ktinefetter even if height is Short CauStic alkali ingested - esophagoScopy
emergently performed
the test
veSicles on inside of mouth & posterior
oropharyn OCR oF an open vesicle
Vitamin 812 deficiency Scenario but
MRI Shows mitd cortical atroot
' vertictes& muttipte-s
sor Tot intensities:
Ignore the MRI
Returned From South West Asia 2 months
—ago, two pimples on nose that enlarged ____
—to- forma -Singte-open Sore, eventuatty——_—
fevetoving ascat 5¢- Leishmaniasis Gonococeal Arthritis - even if No gram Stain
and no culture - Continue antibiotics
Overhead work in 60 year old man
Sening Shoulder pain 4_day tat
pak Linabitity-rais higt
Rotator cuts tear
Sudden patpitations trigued by caffeine,
atcohol- SVTCAVNRD
Asymptomatic & smatt pleural errusions
from a known cause Like pneumonia require
no K
Lithogenie bite-cal : .
MR 2 ( + ( (3 -
echo not angiography
Do angio after ECG & cardiac biomarkers
Suggest
Severe dizziness & Spinning SenSation
when head moved . Brie¢ episode of double
isi {pain i k- Vertebral art
stenosis and Sudd a wis
fissection—CTangio stat Cirrhosis = Na tow-K ee
due to prostaglandin & ADH
Light periods ¢rom 6 months - on oce
____Reassure
Tick removed before 24-36 hours- Reassure
___and_¢ollow_upin2 weeks =
Share_Shooting butt pain i bient
; trotted-t rods-ancd
acetaminophen - add TCH or snRI
1St Line in neuropathic Pain
Paroxysmal cyanosis in a 3 month old
baby- Tetralogy of Falot 11
' fi sitive in-31-year-otd
Prevalence iS 1%- So PPV will explain
Paediatric H Lension--Renat_USG.$
iu ure ri
lack thyroid features? Do not do TFTS
~ Qualitative studies-study Sociat or
other phenomenon as to how people
think about the disease, Stigma etc
No erecautions for EBV transmission
Nodut DRE-Bioesy indicated: i
~ who has tife expectancy of greater than
10 years
fever& high COH-mataria Na, Cow K - Increased aldosterone,
Cow Renin
vaccinia i$ vaccine For Small POK
€ Polydipsia & polyuria -
Psychogenic polydipsia- DI would be
constant
Nuchat rigidity-Virat Cs¢ Findings - Aseptic
ingitis not viral hatitis
CAP (mitd-moderate) even in Sickle cell
trait- oral Azithro, doxy or amoxicillin
Patients with co-morbidities
A icittin-ct be & Levorl .
plow
height consistently in Same percentile Since many years v
G constitutionat Growth detay- detay in °
berty too-Don't pick thyroid thing
—_—unless Symptoms_are mentioned — Exertional dySpnea & exercise intolerance
in a lady with Of that can't climb one Flight
£ Stairs- Adenosi lear Stress test
aft sting Ecg not ise stress test
~ Paintess bony masses near knees & anktes-
osteochondroma- Sessile or pedunculated
tumor whose cortex iS continuous with
_cortex of underlying bone
3 cm non tender, ¢luctuant mass invoking
the lect eosteri fertuing +t
ing- ( a
Vestibular gland cySt are adjeacent to
urethra 7
[2 -P 49 ern Nqoronken Y knf
ae J, oa aaelle shectih
Cthw Avr pen As
dySuria, increased urinary Frequency & blood
tinged urine ina S2 ld '
‘ t hyst ‘ ‘ triosis
t-end triosis 10 years
BRCHA: Q 1 year
Ss tid Excision-N {or MRT
17 year old gir Losing weight and dieting
- Advice not to-to$ ight & tt
ue
Ingtiximab & azathioprine in Crohn's patient
Follow-up test : CBC to check anemia or
pancytopenia Betat is.02 fi bet
groups iS-found: Type TE error
Power = 1- Beta
Decease Beta
chest and abd to check For mets
Iat tum: during detivery HSV2
~ Women at 16 weeks are given cerclage or
bed rest if cervix <25 mm and then followed
-cohort
ine-teat vite tresiduat
volume 500 mi: Overflow incontinence eit < 22/23 whe 12
Pre-mature, non viable baby(¢used eyelids,
NO nipples or Lanugo)- Discontinue
suscitative errorts
authorities like State medical board or
Medicat director NOTCLINIC AOMIN
vey, x : x
bi thium, con tinue it Da ta iS Scarce
For patients making end of Life decisions,
__a capacity assessment Should be performed.
Extore aSoning & understanding ie ( (
Symetoms& quality oF life, reduce hospital
readmissions and durations of Stay
Schizophrenic patient agrees to treatment
but Says he won't adhere- change oral
medicine to injectible
f it 0 Facilit ‘ainst welt
High SuSpicion inden for PE in Syncope
tients Specially those who tak
—eontraceptives— ——-—-—@-—
Febrile non hemolytic transfusion reaction
__Acetaminophen
overflow incontinence due to OM-
neurogenic bladder
Syoptomabe & Sdem
Femoral aneurysm cauSes thrombosis oF
third toe- Aneurysm treated First Surgically
and thrombosis treated later iy puis
Patient wants doctor to Falsigya /
disability Form So She can get education-
Tett her other means i.e. work options No treatment for Igh deficiency-
identicy Ion degici by Looking at tg Levels
Attergic rhinitis—2nd-¢ i-histamines
‘intranasal Steroids
Macutar deg tion-ditated_sundoscori
exam
e isk OF morealityr . =, ;
( 1'0.5+1'0.5 X0.5) X 0.2
Wernicke -Korsakof¢- Dumb
to Sealy, red patches an ams, legs & body
Pityriasis rosacea
32 you old man with HIV- pneumococcal
A iate vaccines riven 7 years ag
~ when Dx was made- PCV 13 then PP SV 23
& weeks later and then ePSu 23 5 years later
and then at 65 yeas ofS
ort HD ia imailiaus on erased
Man on vent for 4 days due to pneumonia
€
\ abso Prpothuapy & .
Lovesicat-sistuta in-a-77 year otd-ma
t (Cc ¢
IBD in young Symptomatic patients
Sciatica due to Lumbar herniation -
_no further testing needed
~ CAD patient with BP 145/78 - HCTZ
Cool 140/90 fo eu
130/80 ‘hn DM 8 CCD So Smoking cessation and home oxygen therapy —
for cor pulmonate
colonoScopy annually iS recommended for
patients with more than 10 adenomas
Baby Fed with only cow's milk will be
deficient in iron
RAS in kids angioplasty or Calcium channet
blockers
New drug for COPD tested in hospital
patients only admitted during a Fixed time
Sampting bias and ¢ lizabitity-Biggest
Limitati _NauSea_and-general_-mataise_are-because-o¢ —
tow Sodi ie Lassiuen Seen.
‘Discontinue diuretic
Dying patient with Loud heath & Secretions
__Glycopyrrotate and Scopolamine =
Stitt ha bo See the kids
Sickling - urgent Surgical washout if high
ICP not controtied
( a ( t]
ability to re-abSorb
7 ise TTT
—EMG and- NCS 6 hours af¢ter transfusion- fever,
cyanosis, hypoxemia and hypotension- TRALT
_Putmonary contusion 24-48 hours later
Tmmunochemical test is not ELISA
0&®P to congirm Giardia
WOW syndrome -cardiac electrophySiologic
Study- Procainamide if¢ arrhythmia
How the Positive resut affects the
probabibility that the person consumes
atcohot- Likelihood Rati
Pericardiat-e¢susion-Dumb Dumb-Dumb-Dumt
Dumb Dumb-Betlieve the pictures
fre
inabilty to evacuate bladder / incontinence
and mass protuding from vagina -cyStocele
be
Medical emergency and the alert person
changes her mind Suddenty From the advance
directive -Do what the patient Says Normat CTG- Normat Labor
deceleration
80 digrerential between armS-Subclavian
artery Stenosis
__Coarctation causes dig¢erence between
upper-&towertimbs
Unstable patient with epiglottitis -
endotracheal intubation under direct
__laryngoscopyinOT
Y month old girl, Meningitis
-S.pneumoniae- Blue, diplococcus on CSF
Neonate iS tilt 1 month
Coperamide can increase the risk oF toxic
mega colon
Recognize tonic MC
Extent oF post bite injury may take hours
to days to fully assess
Urinalysis iS necessary in the diagnosis oF
urge incontinence transverse tract e-distat-t at
~ metaphysis with posterior displacemat oF
distal fragment- Decreased radial pulse
Brachial artery injury
— Lo
t my oe M
_ \ ft
Roo al
\
(YS 7
\\
1 \\
7 \\
tT \ for CTScan
no need to rule out with ultrasound
22 year old woman- widetysptit A2, 0
pulmonic murmur- Biggest riSk in 10 years
Pulmonary hypertension
Don't pick things nothing is tioned of
Unilateral gynecomastia can occur in puberty
47 year old woman, back pain worsens with
Sitting to Standing, Sitting For a Long time
I¢ a result does not cause a Significant
fice in clinical ti t clinicalt
Signicicant SB0s toms-hist partial
intussusception
RLS - chee! iti
Sudden chest and back pain in Marfgan-
Aortic dissection-CT Scan oF chest even iF
hemodynamically unstable
Hereditary angioedema discontinue Lisinopril
I N@ME-Schizophrenia-S io-but
( tl . (|
pick Schizophrenia
( ( Cul (
4 hour dose Should Switch to Sustained
retease or transdermal patches oF tong
king opiods tit hi Mes matron Wertott sv
Aeeendicities, unstable or clear Signs- OT
5 day history oF itchy raSh and hiStory oF
allergy - Urticarial raSh -Diephenhydramine
ilostazot for clavdicati
Two epiSodes of viSion loss& headaches
ESR high- prednisone
Vis
abo thaounds— stimesg 7
ib. Met wrod te
lopnenre
AL bLhardlr0 
