03-02-2012, 08:56 PM
REAL EXAM QS STEP 3 USMLE….
1…HYPOSPADIASIS IS THE CONTRAINDICATION OF CIRCUMCISION…
2…HORIZONTAL TESTIS WITH PAIN AN D SWELLIN..UROLOGY CONSULT ASAP IF CHILD IS YOUNG AND NO FEVER …
3..ULTRASOUND IS ANS TO EVERY FLANK PAIN ,URGENCY FREQENCY FEVER MORE THAN 100.2 AND HEAMTURIA…CALL UROLOGIST IF URETREAL STONE IS MOR THAN 3 CM LESS THAN THIS WILL PASSS AWAY WITH I VF BLOUSES…
4…..NO CONTRAST STUDY OF ANY KIND IF PT IS ALLERIGIC OR IF CRETININE IS MORE THAN 2…
5…BOYS DON’T GET UTI THEY ALWAYS GET VUR….DO VOIDING URETHROGRAM..
6…THE MOST C C OF INABILITY TO VOID IN IST 24 H IS POST URETHRAL VALVE….
7……MEN DON’T GET CYSTITIS WOMEN DO BCZ OF THEIR URETHRA CLOSE TO VIGINA..MEN GET PROSTTIS….
8….PYLO ..NEED HOSPITAL ADMISSION,IV ABX,AND RENAL ULTRASOUND…9….IF K IS LOW IST CHECK MG IF ITS LOW …
10….RECTAL PROLAPSE ,MECO NIUM ILIUS,PUDOMONS AND STAPHLO INFECTION,NASAL OLYP ,MALABSORBTION,PAN INSUFFICIENCY AND RECURRENT BRONCHTIESIS IS DUE TO CYSTIC FIBROSIS, CHEST PHYSICAL THERAPY HIGH CALORIC DIET AND PANC ENZY ADMINSTRATION FAT SOULBLE VITAMAIN IS GOOOD IN MANAGEMNET ITS AR…WITH THE DEFECTIVE GENES AT CH 7…GTFR..GENES
11…IF ANIMAL WHO BITES IS RABID LIKE BAT AND DOG OR RACUUNE JUST KILL THE ANIMAL AND EXAMINE THE BRAIN AND LOOOK FOR NEGRI BODYIF POSITIVE GIVE PT VACCINE AND IGAT SEP PLACE AND SPRINKLE HALF IG AROUND THE WOUND…12…
IF P T HAS DOG BITES BY NEIGHBOURS DOG WHO HAD FULL VACCINATION JUST WASH THE WOUND WITH SOAP AND WATE R AND CLOSE PBSERVE THE WOUND...
12…MITOCHONDRIAL INHERITANCE ….ITS JUST AN APPOSITE OF SEX LINK WHRE ONLY FEMALE HAS THE DISEASE LIKE IN THE PREVIOUS ONLY MEN HAVE THE DISEASE…
13…UPSLANTING PALPEBRAL FISSURE,EPICANTHAL FOLD , FLAT NASAL BRIDGE, SIGLE PALMER CREASE,LARGE TONGUE,,,,IS DOWN SYNDROME….MSAFP WILL B DECREASE..AND THEY HAVE DUDINAL ATRESIA,LEUKIMIA AND ALZIMERZ
14…AGE IS THE MOST COMMON FACTOR IN ALZIMERZ..
15….BERRY ANURYSM IF ADULT POLYCYSTIC DISEASE…AND RF IS COMMON…GET ULTARSOUND…
16….PSUDOHYPERTHYROIDISM….LOW SERUM CA AND HIGH POSPHATE LEVEL…AND HIGH PTH
17…VIT D RESISTANT RICKETS…..X LINK DOMINENT….TRAITS…SO MALES HAVE MORE SEVER FORM OF DISEASE…
18
VONGERKIES DISEASE….. IS A G6 P DEFICIECY DISEASE…I NC LIPID,INC TG,NA AN D K R LOW USUALLLY..
19….
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…20….CAH…IS DUE TO 21 HYDROXYLASE DEFICIENCY….DEC CORTISOL AND DEC MINERLOCORTICOID. PT HAS HYPONATRIMIA AND HYPERKALEMINA…DEHYDRATION,HYPOTENTION.SHOCK …
21…BE SHOWS THAT CECUM IS DOWN THERE IN LEFT LQ..AND PT HAS NV AND BILIARY VOMITUS AND BIRD BEAK APPREANCE ON UGI IS VULVULUS…RECTAL TUBE AND SIGMOIDOSCOPY IS THE ANS..
22…
BABY BECOME CYANOSES WHEN TRY TO FEED HER AND CYANOSIS DIDN’T IMPROVE BY REMOVING THE BOTTLE AFTER BABY BORN FEW H AFTER THIS HAPPENED IS DUE TO TRANSPOSITION OF GREAT V IS IF NORMAL SIZ EHERAT EGGGAND STRING PATTERN..INC PUL VACULATURE PATTERN…ECHO SHOWS RVH AND RVSTRAINTAD,
23….. CYANOSIS AFTER A WK IS DUE TO TOF…..
24…TRICUPID ATRISIA…EARLY CYANOSIS BUT DEC VASCULAR MARKING ON CXRWITH LAD AND LVH….
25…..PUL ATRESIA CYANOSIS IS EARLY BUT LUNG VASCULAR MARKING R NORMALAND THERE IS CARDIOMAGALY…
25,,,,TOXIC SYNOVITIS INVOLVE USUALLY LARGE JOINTS,,,AND THERE IS NO INC ESR OR WBC…
26….FIX SPLITTING OF SEC HEART SOUND…ASD NO NEED FOR GIVING ABX PROPHYLAXISIS IF FIX BY SURGERY OR PT IS ASYMPTOMATIC…
27….TRICUPID REGURG …. MID DIASTOLIC RUMBLE AT LOWER LEFT STERNAL BORDER
28…THE EARLY SIGN OF DIG TOXICITY IS FREQENT VOMITING AND THEIR THERAPETIC DOSE IS 4 NG AS COMPARED TO 2 NG INADUL T IN ADULT THE SIGN IS YELLOW VISUAL CHANGES..AND IN ELDERLY CONFUSION IS IST SIGN OF DIG TOXICITY…HYPOKALEMIA IS THE MAIN CAUSE…SO GIVE THE K AND FIX THE LO W MAG WHICH IS USUALLLY PRESENT AND GIVE DIGIBAND…NEVERDO CV OR NEVER GIVE EPI ..PHPHENYTOIN IS GRETA…. AND PACEMAKERS TOOO..
29…RDS…IS COMMON IN DIABETIC MOMS BABY DUE TO LACK OF SURFACTANTANYT AND PREMATURITY….RTOLEFT SHUNT,DEC LUNG COMPLIANCE,GROUND GLASS APPERANCE .MV IS HIGH AND NEED INTUBATION AND PEEP…
24…IF PT HAS HYPERLIPIDIMIA AND HTN GIVE ALPHA BLOCKER NOT BETA BLOCKERS..AND DON’T EVER GIVE DIURETICS TO THE…25 SPIRAL CT.……IS... BESTTO CONFIRN MASSIVE PE AND APPENDIX
25…IF A ASTHAMAA AND HTN IN A PT GIVE CA CHANEEL BLOCK SAME IS WITH ACHALSIA ND HYPERTENTION.
26….BB OR COLONIDINE IS BEST IN HTN AND ALCOHAL WITHDRAWL PT..27…..UNEQUAL PUPIL..IN INTRA CRANIAL P…IS SIGN OF UNCAL HERNIATION SO INTUBATE AND HYPERVENTILATE KEEP THE CO2 LESS THAN 30 AND GIVE MANITOL AND FOR VASOSPASM PROPHYLAXIS GIVE NIMODIPINE..
28…IF CAUS EOF STROKE IS HEART ALWAYS GIVE HEAPARIN AND COUMDINE…
29….. IF CH MITRAL STENOSIS DON’T GIVE TPA..
30….UA ,UC IS IS T THING TO DO WITH HEMATURIA IF PT IS YOUNG AND IF MORE THAN 50 DO THE CYSTOSCOPY IF ITS OAINLESS HEMATURIA AND IF PIANFUL DO THE SAME.
31….GOLD STANDRAD FOR UTI IS U C
32….IF CLINICAL SUSPITION IS HIGH THAT CHILD HAS MENINGITIS…. JUST GIVE CEFTRIXONE TO A KID OR OLDER IV THEN DO LP DON’T WAIT FOR THE LP BCZ IT TAKES TIM ENA DU CANT AFFORD TO PUT PT LIFE IN DANGERS U CAN ALWAYS CHANGE ABX
33……IF MOM SAID THAT I WILL NOT LET U DO THE LP THEN DO IT BCZ ITS MED EMERGENCY….
34….FEVER.EXUDATIVE PHARANGITIS AND GENERLIZED LYMAPHADENOPATHY INA 14 YR OLD DO THE MONO SPOT T O CHECK THE HETROPHILE ITS IS NOT POSITIV E IN IST 2 WKS SO IST DO THE CBC AND SMEAR TO LOOK FOR ATYPICAL LYPHOCYTES…
35…..IF AMPICILLLIN CAUS E RASH DON’T DO ANY THING IT WILL GO AWYAS ITS COMMON IN IMONONUCLEOSIS PT…
36….N O CONTACT SPORT AND SYMPTOMATIC TRETEMENT ONLY
37….IF U GIVE THE IG TO A KID AND HE HAD ANAPHYLAXIS…ITS IGA DEFICIENCY
38…MASTOIDITIS…IS A MASTOID AIRCELL SWELLLING IN IS CH BY THE POST AURICULAR SWELLING…OVER MASTOID PROCESS..DISPLACE THE EAR LATREALLLYIV ABX REQ AND ITS A SERIOUS COMPLICATIONOF TE AOM..
39…KAWASAKI IS A MEDIUM V VASCULITIS …
40…..MECONIUM ILIUS AND CLUDING AND RECUREENT RES INFECTION MEAN CHECK FOR THE SWEAT CHOLORIDE TEST..41…
INDIRECT COMBS TEST IS POSITIVE.IN ABO INCOMPTIBILITY
42…AV NODAL REENTRY I S THE MOST C C CAUSE OF SVT
43….DON GIVE VERAPAMIL IN SVT IN INFANT
44…VISIBL E GASTRIC PARISTALIC WAVE AND OLIVE SHAPE MASS IN EPIG IS PYLORIC WITH NON BILIRY PROJECTILE VOMINTTING IN A IST BPORN BOY WHO IS MORE THANA MONTH OLD,,, ULTARSOUND…. AND PYLOROMYOTOMY ONCE U FIX THE ELETROLYTES WHICH IS MEDICIAL EMERGENCY BRING CHORIDE UP TO 90 AND MOV ETHE BICARB DOWN TO 24….ITS USUALLY HYPOCHOLOREMIC HYPOKALEMIC ALKALOSIS…
45….STAPHLO IS THE CAUSE OF SEPTIC ARTHRITIS IN ALL GAES EXCEPT SEXUALLLY ACTIVE EVEN IN THE SICKLERS…
46….COOL MIST THERAPY …CROUP…IF NOT EFFECTIVE RACEMIC EPI…
47…..ENTEROVIRUS IS THE MOST OF ASEPTIC MENINGITIS…
48….HERPEZ IS MOST COMON CAUSE OF ENCEPHALITIS PCRIS DIAGNOSTIC AND IV ACYLOVIR HERPEZ 1 IS THE CAUSE…
49…3YR OLD COPY CIRCLE.UNDRESS COMPLETELY DRESS PARTIALLLY STACK 8 BLOCK
50…4 YRS OLD COPY CRISS BUTTON CLOTHING,DRESS COMPLETELY.CATHES BALL
51…4-5 COPY SQ…..52…
5 YRS…COPY TRIANGLE.TIES SHOES SPREAD WITH KNIFE
53….STREOID SALT RESTRICTION AND PNUMO VAC IS THE BEST FOR UNCOMPLICATED NEPHROTIC SYND
54…MINIMAL CHANGE IS THE MOST CC OF NEPHROTIC YOUNGER THAN 17 AND MEMBRANOUS IS MOST COMONCAUSE AFTER WORDS.
55..FOCAL IS MOST CC OG GLOMULITIS IN AID AND IN D A
56…OSTEO MYLITIS IS ANENATES MOSTL INVOLVE MORE THAN I BONE AND IN KIDS TRAUMAIS A CAUSE IN MORE HAN 2/3 OF THE CASES
57…CUSHING TRID IS POSITIV EIN INC INTRACRAIAL P….BRADY .HTN.IRREGULAR BREATHING
58….CRESENT SHAP ON CT IS SUBDURAL BLEED MOST IN OLD AGE AND ALCOHALOC…BUT LENTICULAR SHAPED IS ALWAYS EPIDURAL…EVACUATION WITH BURR HOLE OF THE HEMATOMA IS REQ…59….MACULAR DEGEN…IS M CC OF BLINDNESS IF PT IS MORE THAN 60,,
60….STYE NEED JUST WARM COMP…
61…CHALAZION NEED WARM COMP AND EXCISION
62…VITROUS HEMORRAGE IS BLEED FROM NEO VACULARIZATI ON IN DIBETIC NEURO PATHY
63…. BOLAT LOSSS O F TEMP AND PAIN BELOW THELESION IS SYRINGOMYLIA ANG DANDY WALKER AND ARNOLD CHEARI IS MOST COMON ASOOCITED SYNDROME….THORACIC AND CERVICAL SPINAL CORD MOSTLY…MRI
64…..MRI IS GOOD FOR OSTEO ANF BONE BIOPSY IS THEBESTFOR OSTEOMY
65…BRANCHING DENDRITIC ULCER……SLIT LAMP AND FLUROCEIN HERPZ KERATITIS…NEED OGPH CONSULT FOR TOPICAL MEDICATION NO TOPICAL STEROIDS.
66…. ONLY TOPICAL STEROID CAN B GIVEN BY EYE DOC..
67…NO NITRO PRUSIDEIN PREG
68…REVERSE TRENDELENBURG IN THEAIR EMBOLISMM LEFT SIDE SO THAT AIR STLLL B IN TH E RT V OR ET ATRIUM SO CAN B REMOVED BY THECATHTER
69…AMOXICILLINN 10 DAYS FOR SINUSITIS
70….LIMISIL IS FOR NAIL FUGAL…NOTGIVEN ID HEPATO RENAL DISEASE POSITIVE
71….IN NAIL AND HAIR FUNGAL INF ALWAYS GIVE ORAL GRESIOFULVIN OR FLURADIBIN ORAL BCZ TOPIA WORKS ON OTHER DERMATOPHYTES
72
IF THERE IS TINEA CAPITUS ALWAYS CHECK THIR UNDERWEAR FOR T CRURIS OR RING WORMM …ROUND LESION WITH CENTRAL CLEARING AND WELL DEFINED BORDERS
73….IV STEROIDISIST IN SPINAL SHOCK AS WELL AS IN ACUTE MS
74…CRYPTO INC 40 FOLD CHANCE OD TESTICULAR CA
ORCHIOPEXY AFTER I YR IS BEST IN PT INTEEST BU T NOT DRC THE CHANC OF CA
75…INC ALPH FETP PROT IS IN YOLK SAC TUMOR THOSE R NON SEMINOMA AND THEY NEED ORCHIECTOMY.. PLUS RADUATION AND IF LN POSITIVE ADJUVENTTHERAPY
76….HCG IS CHORIO CA
77 SENINOMA IS RADIO SENSTIVE
78….LEYDIG CELL IN MALE ANDGRANULOSA CELL IN F CAUSE PRECOCCUOUS PREG
79….IF APT WITH SCOLOSIS HAS AN ANGLEOF 40 NEED BRACEC BY ORTHOPEDICS
80..IF ANGLE IS LESS THAN 40…CLOSE F/U
81…LAST TRIMESTER AND UPTO 6 M POST PARTUM..RECURENC Y V COOMON ADVISE PT HAVE ABORTION AND NO PREG IN FUTURE PIC IS JUST LIKE DILATED CMP ITS CALLLED PEROPARTUM CMP…..TRANSPLANT IS THE ONLY TREATMENT…
82…ACUTE CHOLE….. ULTRASOUND….. IF PREG PT IS IN PAIN AN D NOT GETTING BTTER AND IF STONE POSITIVE THEN DO THE LAP CHOLE AT SEC TROMESTER AND IF WE HAVE TO TO DO OPEN CHOLE THEN IN THIRD TRIMESTER IF PT IS AYMPTPMATIC NOW NO NED FOR SURGREY IF S/S CAME BACK D O IT AFTER DELIVERY 6 WKS AFTER ..
84….PSVT NARROW QRS..GIVE ADENO.
85…AFIB WIDE QRS…GIVE BB OR CA CH ANG IF CHF GIVE DIG
86…PRECARDIAL THUMP ONLY IN WITNESS C AREST
87….PAINLESS MI IS COMMON IN DIABETIC ANDIN ELDERLY
88LIDOCAIN CAUSE CONFUSION IN ELDERLY
MOST C RHYTHM IN THE MONITOR WITH PT WHO IS UNDERGOING CPR IS V F
89…ST ELEVATION IN 23 AND AVF AND ST DEP IN AVL..INF RMI…GIV EVOLUM EAND NO DIURETICS AND NO NITRATES…KEEP THE PRELOAD HIGH OTHERWISE PT WILL B IN CARDIOGENIC SHOCK…
90…CARDIAC SARCOMA IS MOST C MELIGNAT TUMOR AND LFT ATRIAL MYXOMA IS LIKE MOST BENIGN
91…NO DORSIFLEX AND NO EVERTION IF CPN IS DAMAGED CAUSE IS PROLONG LITHOTOMY POSITION…
92..THOMPSON TEST IS BEST TO DIAG THE ACHILIS TENDON RUTUTRE…BCZ PT FEEL SUDDENPOP IN TH ECALF MUSCLE…WHEN U SQ IN THIS TEST THE GASTRONEMIUS AND SOLIUS THERE IS NO DORSIFLEXTION OF THE ANKEL
93..ACL…IS SKI INJURY IS THE MOST C C OF ACL..ANT DRAWER TEST IS MOST USEFUL
94..CN 3 PALSY…EYE IS DOWN AND OUTWARD AND CANT DO ANY THING BUT MOVE LATERALLLY..
95…CN4 PALSY…ON MEDIAL GAZE PT CANT LOOK DOWN…
96…CN6 PALSY…EFECTED EYE CANT LOOK LATERALLY…
IBUTALID EIS GOO D FOR A FIB
97…IF AFIB IS LESS THAN 3 WK NO NEED FOR ANTI COAG JUST DO CARDIO VERTION
98
IF MORE THAN 3 WK DURATION DO THE ANTICOAG FOR 3 WKS AND LOOOK IN TEE THE THROMBUS IN RT ATRIUM AND IF NON THEN GO FOR CV
99….11HYDROXYLASE DEFICIENY CAUSE HYPERNATRIMIA NOT HYPO..
100…FROG LE G XRAY OF THE SHOULDER IF SUSPECTED DILOACTION ANT IS COMMON..
101…RECURRENCY IS MOST CC AND NEED SURGERY IF YOUNG PT OTHERWISE CLOSE REDUCTION AND IMMPBILZATION AND NSAID..
102…SREING OF PERAL ON ULTRASOUND ….FIBROMUSCULAR HYPERPLASIA IT IS THE MOST CC OF NEW ONSET HTN INA WOMEN.
103…AV NICKING I GRADE 2…ARTERIOLAR NARROWING IS GRADE I AND HEMARRAGE IS GRADE 3 AND PAPLIDEMA IS GRADE 4 RETINOPATHY
104..IF NO PAPILEEDEMA NO MELIGNANT HTN
105…NO HTN AND NO HEAMTURIA IN NEPHROTIC ITS IS IN GNPHRITIS
106…PAVILIZUMAB IS A MONO CLONAL ANTIBODY AGAIST RSV IS PROTECTIVE FROM RSV INF IN WINTER LIKE BRONCHIOLITIS..
107URTICARIA…R EDEMATUS ,BLANCHING RED AND WHIT EPLAQUE THE R RAISED PRURITIC AND RESOLVED IN 24 H
108…25 MG OF UNCONGUGATED BILI CAN CAUSE KERNICTURUS TO TH EBABY
ONLY UN CONGUGATED COMES IN URIN CONGUGATED CANT
PHOTO THERAPY AT 20 AND IF NOT EFFECTIVE THEN EXCHANG ETRANSFUSION
109…ABNORAMLA PLACEMENT OF LIG OF TRETZ IN THE RT HAND IS DIGNOSIS OF MALROTAION CALL SURGERY INMIDIATELY
110,,,ASD IS NOT WITH TOF 111…SHORT PR INT V PLUS DELTA WAVE IS WPW IF IT IS WITH AFIB JUST GIV EPROCAINAMID E NOTHING ELSE..
112
PL EDEMA IS ABSENT IN RDS.. GROUND GLASS ON XRAY AND NEED INTUBATION AND PEEP AN D WEGD IS ALWAYS NORMAL..
113…BYPASS TRACT THROUGH KENT BUNDLE IS POSITIVE IN WPW
114..TGA EKG IS NORMAL AND VACULARITY IS INC AND TVH AND TAD IS POSITIVE WITH CYANOSIS AT BITH OR IN 24 H
115….ANDROGENS R HIGH IN TH E CAH SEC TO 21 HYDROXYLASE DEF
116…ETHOSUXIMIDE IS TE IST DRUG OF CHOICE IN THE ABSENCE SEIZURE
117…HYPOTONIC DEHYD IS COMMON IN CHILDREN THROUGH DIRREA GIVE ORS AND PEDIALYTES
118..XRAY CHANGES IN JRA IS MINIMAL AND 80% OF THE KIDS WILL OUTGROW OF THIS CONMDITION
119…LEAD 20 IS POSIONING REMOV ETHE CHILD…AND LEVEL LESS THAN 49 NEED JUST EDTA AND BAL AND MOR ETANH 50 NEED THE BAL PLUS EDTA AND THIS IS FOR 7 DAYS AND PCN CELLIMIN E FOR 6 MONTH
HOSPITAILIZE CHILD IF IT IS MORETHAN 70 LEVEL OF LEAD …
INC FEP IS POSITIVE AND LEAD LINE BASOPHILIC STIPLING ANDWRIST DROP AND ENCEPHALOPATHY SEIZURE ….
120…MILK ALLERG Y IS A COMON CAUSE OF LOWER GI BLEED.
121…FALGYL IS BEST AN D COST EFFECT FOR CDIF AND VANCO ONLY IF IT IS NOT EFFECTIVE TOXIN IN STOOL IS DIAGONSTIC AND STOP ABX ..
122…CROHN IS TRANSMURAL AND FISTULA AND CA OXALTE STONE COMON AND ARTHRITIS AND OTHET STUFFF
123…IF PT IS T ORTHO STATIC IT MEANS MORE THAN 20 % FLLUID LOSS OR BLOOD LOSS..
124…FECAL LEUCO IS POSITIVE IN SHEGALLA ,SALMONELLA , YERSENIA,ECOLI
125…ROTA VIRUS IS M CC OF GASTROENTREITIS AND GIARDISIS IS MOST COMON CAUSE OF WATERY PARACITIC D CAUSE
126…BACTRIM IS GOOOD FOR TRAVELLER DIRREHEA
127…NO ABX IN THE TRETAMENT OF TOXIC SYNOVITI SSINCE THERE IS NO INC IN C REACTIVE PROT NO IN IN ESR AND NO INC IN WBC
128….LEAD SCREENING IS AT 12 M AND 24 M IN ALL CHILDREN
129…SAUSAGE SHAP MASS IN R U Q IS COMMON WITH INTUSSEPTION
130…SUBLAXED RADIAL HEAD IS COMON IN NURSE MIAD
131… MOST C C OF SURGERY IN TERM IN FANT IS IGUNO RAPHY
132…HELD ARM IN PRONATION BY THE KID BUT NO PAIN IS THE NURSE MAID
133…WALK ALONE IS 12 M….PUT FEET IN MOUTH SIX M
134…DADAMAMA 10 MHOLD BOTTLE 8 MONTH
135…SOCIAL SMILE 3 M
META PHYSIS,TRAUMA,BOYS AND HEAMOTOGENIOUS SPREAD NO XRA UNTIL 3 WK B SCAN POSITIVE EARLYB BIOPST GOLD MRI IS GOOD
136…COCKSACK B VIRUS IS TH EMOST C C OF MYOCARDITIS..FOR PE ECHO IS THE BEST
137…GARM STAINING OF SPUTUMIS THE BEST FOR PNUMONIA
138… TH ENON TREPONAMAL TEST I SUSED TO CHECK THE RESPONSE OF THE TREATMENT
139…ASLOW RIS 15 HIGH RISK 10 AND HIV IS 5 MM PPD WHICH I SPOSITIV E FOR TB
140….IN H AND RIF FOR 9 MONTH IS THE STANDRAD IF PT IS NOT RESISTANT FOR TB
141… 2 MONTH OF INH AND RIFAMP PAZ AN D ETHAMBUTOL AND 2 MONTH OF RIF AND INH
142…C JUJINI…INVOLVE SMAL AND LARG E BOWEL…. MOST CC OF LONGEST INC BATION PF CAUSE OF DIRREA…ERETHRO I
143… THE OSMOTIC DIRREA IS MOM AND LACTOSE INTOLENACE…STOPED WITH FASTING AND GAP IS MORE THAN 40 AND SECTERTORY IS NOT STOPED BY FASTING AND GAP IS LESS THAN 40
144…CAPMING TRIP IN SUMMER DIRREA IS DUE TO GIARDISIS..
145…DAY CARE IS ALSO GIARDISIS..SMALL BOWEL BIOPSY AND STRING TEST ..FLAYGYL AND LPERAMIDE IS GOOOD
146…. INF LUENZA VACCINE IS MUST FOR PT WITH COPD AS WELL AS SMOKING CESSATION
147…I/2 OF FREE WATER DEFICET IS REPLACED IN IST 24 H AND REST IN 48 HDESIRED TBW-CURRENT TBW…IS THE FWD…
CURREN T TOTAL BODY WATRE IS….O.6 MULTIPLIED BY WT INKILG
148 ….DESIREDTBW= NA DIVIDED BY 140MULTIPLIED BY CURRENT TOTAL BODY WATRE
149….K SOULUTION SHOUL D NOT B GIVEN MORE THAN 20 MEQ /H
150…. NUCLEAR MEDICINE RENAL SCAN IS GOOOD FOR UNILAT RAS BUT NOT FOR BILATERAL …IN WHICH W E DON’T GIVE ACE,,UNIL WE CAN GIVE..
151…IF RENAL ULTARSOUND IS POSITIVE FOR POLYCYSTIC KIDNEY UROOLOGY CONSULT IS NEXT
152…FENA IS LESS THAN 1 AND RATION OF BUN CRETININE IS MORE THAN 20 IN PRERENAL GIVE FLUID CHALLLENEG AND THEN GIVE LASIX…BUT IST PUT FOLEY
153…K MOR ETHAN 6.5 WITH CARDIO CHANGES NEED HD
154…ANCA IS WEGENERS NEED CYCLO AND BACTRIM FOR AN YR
155…IF OBST RUCTION IS AT THE URETER AND PELVISOR VESICOURETRERAL JUNCTION N EED NEPHROSTOMY TUB E BY UROLOGIST…OR URTERAL STENT PLACEMNTPERCUTANOUS NEPHROSTOMY IS REQ..
156…REMOV ETHE GFOLY IF URIN EIS CLOUDY IN FOLY AND GIV EPT ABX
157..TEE DETECT ABCESSES AND VEGETATION IN ENDOCARDITTIS SO IF PT IS NOT GETTING BETTER WITH ABX PCN /GENT OF NAF AND VANCO IN STAPHLO CASE THEN CALL CARDIOLOGY FOR TEE
158…CUSTARD CREAM MET STAPHLO FOOD POISONING SHORTEST INCUBATION PF SYMPTOMATIC TRETAMENT
BACTRIM IN PREG IS NOT SAFE GIVE AMPICILIN OR AMOXICILINE OR VENTIN ALSO CAN GIVE ZITHRO IT IS SAFE,,
NO ORAL HYPO GLYCEMIC IN PREGNCNY…JUST INSULIN KEEP THE FASTING BELOW 9 0 AND POST PONDRIAL LESS THAN 120
159…90 % OG GASTRIC ULCER IS DUE TO H PYLORI..MOC IS GOOD TRETAMENT FOR 14 DAYS AND ANTOBODIES IN SERUM OR UREA BREATH TEST IS GOOOD …
160…COBBLE STONE TRANSMURAL LESION WT LOSS MUCUS IN DURREA ABD PAIN…IS CROHN..
161…BLOOODY DIRREA AND PUSDO POLYP..IS UL COLITIS
162…MOLUSCUM CONTIGIOSUM IS COMON IN YOUNG BOYS WITH UMBLICATE D DEP AND ITS IS BEST TERATED BY CRYO AND ITS CAUSED BY POX VIRUS
163…ALWAYS IST THING IN HTN IS TO LIFE STYLE MODIFICATION SAME IN GERD..
164…D4T CAUSE NEUROPATHY
ABACAVIR SEVER HYPERSENSTIVITY REACTION,INDIANAIR IS NEPHRO LITHISIS…
165…SQUNINAVIR G I UPSET INC LIPID
166…DELAVIRIDINE..RASH AND INC LIVER ENZ
167…AZT LEUKOPENIA AND ANEMIA AND MYOSITIS.
168….HIV IS NOT REPORTABLE AIDS IS..
169…DDC,PANC ,NEUROPATHY
170..DDI…MORE SEVER NEUROPATHY AND PANC
171..HETROSEXUAL TRANS MITION IS MOST COOMON MODE OF TRANSMITION THESE DAYS.
172…INPREG START AZT IN THE IST DAY OF 2ND TRIMESTER AND IF SHE IS ALREADY ON KEEP ON CONTINUING THE AZT
173…HAART IS 2 NUCLEOSIDE AND ONE PI… DEC MORTALITY ..
174….NO MATTRE WHAT THE CD IS IF PT IS SYMPTOMATIC GIV EHAART
175…IF PT IS STUCK WITH NEEDLE OF A PT BLOOOD THEN GIV E BOTH AZT AND LUMIVIDINE AND INDIANAVIR..FOR 2 M
176…..IF PT STUCK WITH THE NEEDLE CHANCE OF GETTING HIV IS .3 % FROM VERTICAL TRANSMITION ITS 30% AND WITH AZY DURING LABOR AND PREG AFTER IST TROMESTER IT DEC TO 7%
177…GIVE BABY AZT FOR 6 WKS…AND CHECK HIVE TEST AT 6 AND 12 MONTHS,,
ALL BABIES BORN TO MOTHERS WHO HAV E HIV WILL HAV ETHE HIV POSITIV E TEST BCZ OF MATRENAL ANTIBODIES GOEST O BABY…
178….NON NUCLEOSIDE INHIBITERS R ENDING IN INE AND NEVREAPINE AND DELAVIRIDINE IS SOE AND OTHER IS EFAVERINZ..
179… C ANCA IS SP FOR WEGENERS DIEASES..
180..TAKAYASU IS TREATE DWITH STEROID AND METHOTREXATE…181..SP CORD COMPRESSION NEED MRI ASAP…182….MO BON E SCAN IN MULTIPLE MYELOMA
183…ST LEG RAISING TEST IS POSITVE IN DISC HERNIATION AND ITS MORE COMON IN L5-S1..184 SICKLE CELL TARIT PPL DON’T HAV EMALARIA BCZ NO DUFY ANTIGEN
184..…for nocturnal agitataion givehaloperidol never diazapine…
185….ZOLDIPEM IS A HABIT FORMING MEDICATION
186… BUPROPION IS GOOOD WHEN SEXUAL DYSFUNCTION IS POSITIVE BUT IT CAUSE SEIZURE..
187…..THE FACIAL DISCOLORATION IN PREG IS DUE TOINC ESTROGEN AND MSH ITS CALLLED MELASMA…
188..IST GIV E FLUIDS AND THEN STRAT CATHTRE IN CASE OF POST OP ANURIA..
189….. ALL GYNE SURGERIES ONE DAY SURGERY OR SAM EDAY SURGERY PT CAN B D/CED WHEN SHE WILL PEE..
190…DIRECT COMMMS TEST IS NEGATIV EIN TTP AND HUS BUT POSITIV EIN ABO INCOMPATIBILITY..
191…TERBUTALINE CAUSE TACHYCARDIA HYPOKALEMIA AND PUL EDEMAA
192…SVR DEC IN PREG SO BP IS DEC UNTIL IST26 WKS
193…PROTRUSON THROUGH INT RING IS INDIRECT INGUINAL H IT’S THE MOST MOST C C OG HERNIA IN BOTH SEXES..
194….HYPOXIMIA AND PLURAL FRICTION RUB WITH SOB AND SUDDEN CP…THINK OF PE…
195…BARRIER IS BEST TO PROTECT FROM PID….PID CAUSE ECTOPIC AND OCP PROTECT FROM PID B ALTERATION OF CEVICAL MUCUS… STOP OCP I MONTH SURGERY…ITS PROTECTIVE FROM OVARIAN AND UTREINE CA..
196….AP24PCR IS BEST TO DETREMINE EARLY SERO CONVERTION….OF HIV WITH IN A MONTH OR B4THAT…
197…POSITIVE REINFORCEMENT AND ALARM IS MOST EFFECTIVE TREATMENT AND FOR QUICK FIX IS DDAVP IN ENURSIS,,,
198…. APPOSITIONAL DEFIENT DISORDER ..THYE R KIDS THAT THEY JUST BARK…NOT OBEYING RULE BICKERING YELLING AT PARENTS AND FDS ….
199…CONDUCT DISORDER IS SAME AS ANTOSOCIAL BUT LESS THAN 18…
200….RASH IN TH E PALM AND SOLE AND IN AXILLLA ,,,STRAWBEERY TONGUE..SCARLET FEVER IT CAUSE RHU FEVER AND GLOMURO NEPHRITIS…
201…RECURRENT ABORTION DO KARYOTYPING BOT PARENTS…
202….DUB MOST CC IS ANOVULATION ..MOST AT ETREME AGE AND IT IS TREATED WITHOUT ENDOMETRAIL BIOSY IF PT IS LESS THAN THIRTY AND WITH IF MORE ..IN SEVER BLEEDING USE ESTROGEN 25 MG IV Q4H UNTIL BLEEDING IS NOT CONTROLLED..AND FOR MILD BLEEDING THE DOSE IS JUST 1.2 MG…PLUS MPA AN OCP IS ALSO GOOD…
203…NEVER TRANSFUSE A YOUNG PT UNLESS NOT IN HYPOVOLEMIC SHOCK DUE TO SEVER HEMARRGE AND FLUIDS R NOT BRINGING BP BACK OR LOW O2 SAT….
204….RISK OF HIV FROM NEEDLE STICK IS .3% AND RISK IF HEP C IS 1.7% AND RISK OF HEP B IS 9%..
205…INCOMPLETE ABORTION…BLEEDING PLUS PRODUCTS R COMING OUT OS OPEN..NEED DNC…
206….OS IS CLOSE BLEEDING …THRETENED ABORTION..
207…A MISSED ABORTION IS ETENTION OF FAILED IUP FOR MORE THAN 2 CYCLESIF S RETENTION LAST FOR MOR ETHAN 8 WK DIC…IMIDIATE D AN D E REQ..
208…DELIVERY OF TH EBABY IF MATURE IN PREECLEMSIA AND ABRUPTIO OR PLACENTA PREVIA IF NOT THEN GIVE STREOID…
209…IST TRIMESTER RECURRENT ABORTION IS DUE TO CHROMOSOMAL BUT SEC TRIMESTER R SEC TO MATERNAL SYSTEMIC DIEASES…
210…NO METHERGINE IF HISTORY OF HYPERTENTION IF SYTO DIDN’T STOP BLEED ING GO FOR HEMATE OR PG E2ALPHA BUT MAKE SURE PT IS NOTASTHAMATIC…
211…LDH MORE THAN 350 AND GLUCOSE MORE THAN 30 CA LESS THAN 8AGE MORE THAN 55 WBC MORE THAN 16KAST MORE THAN 250 AND NO ALT IS IN TH E TRANSON CRITARIA…ALL THIS IS A SIGN OF POOOOR PROG…
212,,IF HEMOLYSIS THEN NO INFECTION IF BOTH IS ABSENT IN A NEONATE THE CAUSEOF INC ID BILI IS PHYSIOLGICAL OR BREAST MILK JAUNDANCE….BUT IST CHECK CBC AND MAKE SURE U CHECK RETICULOCYTE COUNT AND SMEAR…IF HEMOLYSISI IS POSITIVE AND IN DIRECT COMB STOOO IT IS THEN ABO INCOMP..WHICH IS THE MOST CC OF 24 H HEOLYSISI OR JAUNDDANCE..IF INDIRECT BILI IS MORE THAN 15 ON 3RD DAY GIVE PHOTO THERAPY IF NOT DECLING THEN EXCHANG TRANSFUSION TO PRESENT BASAL GANGLIA KERICTERUS…
213…..ONLY UNCONGUGATED COMES IN URINE..AND ONLY STERCOBILN COMES IN FECES..
214…PUL EDEMA….GIVE 100 %O2…HAV EPT SIT UP…AND GIVE LASIXIV AND CHECK XRAY PERIODICALLLY AND CHECK GAS…CONTINOUS PULSE OX GIVE NITRO TOO IF STILL NOT IMPROV EINTUBATE AND MOVE HIM TO ICU…
215…INFORMED CONSENT IS IMP B4 REPORTING RAPE AND HER PH Y EXAM..IN RAPE U WILL PROBABLY NEVER OVER IT..WHEN PT ASK U ABOUT RAPE WHEN I WILL B OVER IT DOC…DON’T LIE..DON’T GIVE FALSE HOPE…DON’T OVER INFORM OR UNDER INFORM THE PT TELL HER HOW MUCH HE OR SHE WANA KNOW…
216…U R OBLIGATED TO TH EPT NOT THE FAMILY…
217…SPEND THE PT MORE TIME WITH FAMILY
218,,DON’T CHANGE THE SCHADULE TO VISIT IF HE IS MOVE TO HOSPICE REMMBER HE IS STILL UR PT…
allupurinol is not for acute gout indocin is and allupurinol only after checking 24 h uric acid in th e urine if less than 800 then probenecid and if more than this then allopurinol but only after 2 wks of acute state..
219….IN PHYSIOLOGICAL JAUNDANCE THE BILI SHOULD B DEC BY 2 MG BYTH E END OF WK…DUROING PHOTO THERAPY CHECK THE BILI 6 H…
220…SIGMPOD VULVULUS…ABD PAIN ,DISTENTION,OBSTIPATION,,,XRAY SHOW BIRD BEAK APPERANCE …SIGMOIDO I STHE BEST FOR DISG AND THERAPETICALLY AND TO PASS RECTAL TUBE…
221….THERE IS PROMINENT U SHAPED SIGMID COLON IN THE LOWER ABD…
222…LIKELIHOOOD RATIO=SENS DIVIDED BY 1-SP…
223…AMPHO B WITH FC IS BEST FOR CRYPTO..INDIA INK ANTIGEN IS SESTIVE HEACHE AND FEVER…
224…SAAG MORE THAN 1.1 IS DUE TOPORTAL HTN…PEROTONEAL CARCINOMATOSIS I S ALWAYS SAAG OF LESS THAN 1.1
BUDD CHERI AND PVT AL CAUSE PORTAL SO INC SAAG…
225..HEMOCHROMOTOSISI IN A THALASEMIA IS DUE TO IRPON OVERLOAD FROM FREQ BLOOOD TRANF…GIVE DEF…
226…CA PAN 19-9 AND BRXA 1AND 2 IS BREAST CA..
227…CT ABDOMINAL AND PELVIS AND SURGICAL AND PATHOLOGICAL STAGING FOR OVARINA NAD ENDO METRIAL CA…
228…AMENORREA ,PERIPHRAL VISION DEFECT AND GAALCTOREA…ITS MOST LIKE PROLACTONOMA GIVE BROMO IF THE PPROLACTIN IS MORE THAN 25 AND MORE THAN 200 IN PREG ..DO MRI…
229…CRYPTOC IS MOST C COF DIRHEAA..I N HIV230….MAC WILL B PREVENTED WITHWKLY CLARITHROMYCIN…ETHAMBUTAL..CAUSE UVEITIS..PROPHYLAXIX… IF CD LESS THAN 50-100……
230..INC AMOUNT OF LIGHT CHAIN IN THE URINE OR SERUM…MM…BENCEJONES PROEIN…LYTIC BONE LESION…
231….INDIRECT ING HERNIA ORIGINATE AT DEEP INGUNAL RING AN DLIES LAT TO IN F EPIG V..232..RAPID TAPERING OF STREOID IN ASTHAMA CAN CAUSE ADDDISON CRISES…
233…DHEAS IS INCREASE MORE THAN 700 IN ADRENAL TUMOR…IN POLYCYSTIC OVARIAN SYNDROM E…..234….FANESTRIDE…IS 5 ALPHA REDUCTASE INHIBITER THATINHIBIT TH ECONVERSION OF TESTO TO DHT…235…HIRSUTISM…TESTO GREATRE THAN 2.0 IS DUE TO ADROGEN SECRETING TUMOR…
236…NEUROLETICS ANTAGONIZE D2 RECEPTERS SO NO REGLANAND NO HALDOL IN PARKINSON DIEASE WILL FURTHER DEC THE DOPAMINE…237…LEVELOF ABI ROARIO.5 OR LESS NEED BYPASS IN PVD AS WELLL AS IF PT HAS CALUDICATION AT REST AND IF THERE IS SOME MUSCLE ATROPHY… NEED SURGERY OTHER WISE JUST CESAATION OF SMOKING AND REGULAR EXERCISE…
238.. A PAP SMEAR I S TAKEN FROM VIGINAL CUFFF…239…MYOPATHY IS SIDE EFFECT OF STATIN…
239..CHOLESTYRAMINE CAUSE INC TG…240…2 READING OF MOR ETHAN 140/90 6 H APART IS HTN…
239….IF LDL IS MORE THAN MOR ETHAN 160 AND 2 FACTOR POSITIVE GIVE STATIN…AND DIET MODIFICATION…
240….A LOUD SYSTOLIC EJECTION MURMER HEARD OVER TH E AORTIC POSITION IS CHARACTERSTIC…AND THRILLL WITH THIS IS IN SUPRASTRENAL NOTCH…
241…OLIGOSPERMIA WITHLOW FSH AND LH I S SUGGESTED OF PROLACTONOMA..
242…TEMP ARTERY BIOPSY IS MUST IN 24 AND 72 H AFTERSTARTINGOF STREOID.
243…STREPKINASE OR TPA ONLY IF ST ELEVATION IN TWO CONSECTIVE LEAD IS POSITIVE …AND R/O PERICARDITIS…
245..PUL STEOSIS ,PRIOR CPR.SURGERY LESS THAN 3 WK STROKE WITHIN I YR AND GIBLEED AND UNCONTROLLED HTN,MARFAN SYNDROME,,, I S CONTRAINDICATION OFOF TPA…
246…IF PE IS MASSIVE WITH LOW BP LIKE 70/40 GIVE FLUIDS AND GIVE TPA …OR STREPTO..
247…LDAL OF 140 WITH 2 FACTOR NEED DIET MODIFICATIONONLY…
248….mgso4 therapetic level is 4-7 and loss of dtr is at level of 10 and 12 bretahing prob and more than 15 heart prob..249…INILAT LEG SWELLLING AND WITH WARMTH AND REDNESS IN ABSENCE OF INFECTION I SMOST LIKELY DVT…PALPABLE CORD IS POSITIVE…GIVE HEAPRIN..
250..FACTOR V LADEN DEFICIENCY IN CAUCASION CAUSE DVT
251..BECKWEITH IS ASSOCIATED WITH WILMS AND NEUROBLASTOMA…
252…P53 SUPPESSER GENE IS ASSOCIATED WITH MANY MELIGNANICES.
253…NMYCO PROTOONCOGENE IS ASSOCIATED WITHNEUROBLASTOMA..PRESENT IN POS T MEDICASTINUM
POSTPARTUM BLUES RESOLVE AFTER 2 WK SITS NORMA…START WITH A PD OF WEEPING ON 3RD DAY…AND PEAK BET 5TH AND 7TH DAY… SUPPORTIV ETHERAPY IS BEST…REASUURANCE PT EDUCATION I S GOOOD..
254..RESPERIDONE AND HALOPERIDOL IS GOOOD FOR ACUTE AGIATATION…
255… POST PARTUM PYCHOSIS.. BIZZAR PERSECUTURY DELUTIONS,GARDIOSE SOME TIME,THOUGHT DISORGINATION,MAIC S/S MAY B PRESENT THEY R INC RISK OF SUCIDE AND INFANTICIDE SO SEP THE CHILD AND TRETA TH E PT..HALDOL IS GREAT FAMILY THERAPY AND BEHAVIOR THERAPY AND REGULAR VISIT BY MENTAL HEALTH PPPL FOR F/U
256….SUPPORTIV E GROUP OR INDIUAL THERAPY IS GOOD FOR POST PARTUM PSYCHOSIS…237…JH REACTION IS COMMON AFTER TRETMENT OF SYPHLIS BY PCN IT CAN AS LATE AS 15 DAYS HEADCHE, FEVER
257…MYALGIA.HYPOTENTION IS COMON TRETEMNT IS SALICYALTE OR PREDNISONE FOR JH REACTION
258…URETHRAL PHARANGEAL AND CERVICAL SWOB FOR CULTURE INTRA CELULAR DIPLOCOCI IS POSITIVE.
259… THE MOST COMON CAUSE OF EPIDYMITIS IS CHALMYDIA TRACHOMATIS AND TREAT MENT WITHDOXYCYCLINE NSAIDS,ICE PACK,SCROTAL LELEVATION,RED AND TENDER SCROTUM AND PAIN MORE WITH ELEVATION OF TESTIS FEVER AND INC WBC…POSITIVE
260…DARK FIELD FO RPRIMARY SYPHILIS AND TREATMENT WITH 2.4 M BENZA THIN E PCN G
361…CRYO IS BEST FOR MOLUUSUCM AND GENITAL WARTS
362…ACYCLOVIR DEC VIRAL SHEDDING BUT RECURRANE IS STILL COMMON.
363..DEC LABIDO AND INHIBITED ORGASM WITH SSRIS..
364..COGNITIV EPSYCHO THERAPY IS BEST FOR MAJOR DEP..
365….ADJUSTMENT DISDORDER AND DEP MOOOD…TREATMENT IS COUSELLING ABOUT STRESS MANAGEMENT AND BREIF PSYCHOTHERAPY..
366…ATYPICAL DEP IS ASSOCIATED WITHHYPERPHAGIA AND HYPERSOMIA AND TREATMNT IS MAO BUT DON’T GIVE WITH SSRI DUE TO SEROTININE SYND..
367… IF LITHIM IS NOT INDICATE DOR NOT EFFECTIVE CARBAMAZEPINE AND VALPORETE IS NEXT BEST CHOICE,
368…10 YR WAS TALKING TO THE TEACHER AND SUDDENLY STOP TALKING AND STARTED STAING AT HIM FOR FE SEC ..GIVE ETHOSUXIMDE..ABSENCE SEIZURE
369…WITHDRAWL AND FLAT EFFECTAPATHY AND LACK OF MOTIVATION IS POOOR PROG …IN SHIZO
370… DELUSION AND HALUCINATION FOR MORE THAN I MONTH IS SHIZO
371..CATATONIC..RIGIDITY AND POSTURING…LORAZEPAM IS GOOOD
372..DEKUTIONAL DISORDER IS DELUSION WICH IS NON BIZZAR AND FOR I MONTH…NO DELUSION AND HALUCINATION OF GRANDIOSE TYPE…
373…BREIF PSYCHOSIS …IS LESS THAN I MONTH AND EVERY THING DELUSION HALUCINATION AND DISORIENTAION IS POSITIVE
374.. BIPOLAR 1 IS PT IS PYCHOTIC WHEN PT IS DEP OR MANIC N ORAMAL IN BET AND FUCTION G IS GRETA IN BET
375… HEROIN WITHDRAWL ..METHADON IS THE BEST
376….DON’T GIV E FLUMAZEMIL WHEN MIXED DRUG OVER DOSE OR TRICYCLIC BCZ INC CHANCE OF SEIZURE WITH THIS…
377.. DUAL DIAG IS A TERM WHEN THERE IS SUBSTANCE ABUSE AND ANOTHER PHYCHATRIC CONDITION POSITIVE
378…ADMIT TH E DRUG PROB AND FAMILY SUPPORT IS IST THING
379…LONG TERM INDIVUAL AND GROUP THERAPY
DETOX. AND PREVENTION OF WITHDRWAL IN DRUG TRETAMENT….DRUG ADDICTION.
380….OCD IS POSITIV E 25% IN ANOREXIA..BRADY CARDIA HYPOKALEMIA AND BODY WT IS LESS THN A 15 % OF TH EIDEAL WT OF THE AGE
381…PROZAC IS GRETA IN BING EEATING AND COGNITIV EBEHAV THERAPY
382….BUSPRION IS BEST FOR THE GENARLIZED ANXIETY DISORDER
383..SYSTEMI C DESENSTIZATION AND COGNITIV ETHERAPY FOR GAD..DURATION SHOULD B AT LEAST 6 MONTH..
384… FACTIOU S DISORDER …TO BEHAVE AS A SICK ROLE.. TO CAUSE PHYSICAL AND PYCHOLOGICAL S/S OF TH E DIESEE
385…SSRIS IS THE BEST FOR OCD CLOMI IS SALSO GOOODIN OCD
386..VIGINISMUS…DIF DILATERS IS THE TRETMENT
387…ERECTILE DYSFUNCTION IS MOSR COMMON IN ELDERLY AND CAUSE IS USALLLY ANTI HYPERTENSIV EAN DOTHERS MED..SO D/C MEDSAND CHANG EIT WITH OTHERS..
388…NO VIAGRA WITH ANY NITRATED LIFE THRETENING HYPOTENTION.
389..BRONZ BABIES IS ALSO DUE TO PHOTO THERAPY
390..FEVER MORE THAN 105 IN TH ELAST DPT DON’T GIVE THIS PERTUSIS JUST GIV E DT
391….MATICULUS HANDWASHING AND AVOIDANC EOF CONTACT WITH FACE OR NOSE IS THE BEST TO DEC THE SPREAD OF INFLUENZA
393..RSV PNUMONIA IS MOST COMMON UNER 5 YRS
394…NO ANTIPYRETIC IN THE HEAT STROKE
JUST COOLING MEASURE..ICE ON THE BODY..
394….FROST BITE….RAPID REWARMING WITH HOT WATER…
395…OSGOOOD IS INFLAMATION OF TIBIAL TUBERIROSITY INA RUNNNER BEST TRETAMENT IS REST AND STOP VIGROUS ACTIVITY
396…PATELOFEMORAL SYNDROM EI S MOST COMON CAUSE OFANT KNEE PAIN IN TH ETEENAGERS… TRETEMENT IS AGGRESSIVE ISO METRIC RESISTANCE EXERCISES
397..BRACES AND CASTING FOR 1-2 YR S FOR LEGGG PERTHESE DISEASE.
PINNING IS REQ IN SLIPED FEMORAL DISEASE COMON IN OBESE KIDS IN 10-14 YRS OLD AGE,
398…TOXIC SYNOVITIS…NON WT BEARING…REST IN BED..NSAIDS .NO ABX ..BCZ NO GRAM STAIN POSITIV EAND NO WBC INC..
399…AVASCULAR NEC OF TH EFEMOARL NECK ..LEG PERTHESE
400… THE MOST C C OF INTOWING IN KIDS IS ANTEVERTON OF FEMUR
WATCH FUL WAITING IS ENOUGH IN THIS…
401…UA IS THE IST THING IN ENURESIS PT …USUALLY EMOTIONAL…OR SEXUAL ABUSE
402…BEHAVIOR MODIFICATION IS BEST TRETEMENT FOR THIS ENRESIS..
403…REGWEED POLLLEN IS M CC OF ALLERGIC RHINITI SIN US
404..VASOMOTOR RHINITIS IS TRIGGGER BY SMELL ODOR RTEMPSPIY FOOOD..NASAL OBSTRUCTION IS TH EPRIMARY SYMPTOM…NO SNEEXING ITCHING AND RHINORREA…IN VASO MOTOR RHINITIS…
405…BEST TREATMENT FOR ALLERGIC CONJTIVITI SIS CROMYLN SODIUMTHE MOST COMON CAUSE OF RAGWEED I S POLLEN..
406…EXTENSER LESION WHICH R PRURITIC ECZEMATIC IS COMON IN KID WITH ATOPIC DERMATITIS…. FLEXER LESION IN ADULT
407..ENVIRONMENTAL PREVENTION ALL TH ETRIGGGERING FACTOR SHOULD B PREVENTED….. IN ATOPIC..FOOOD MILK EGGGD FABRIC .
408… WET COMPRESSES IS TH EIST TRETAMENT OF THE SEBORRIC DERMATITIS…
409…KETOCONAZOLE CREAM FOR DIAPER RASH
410…MUPURIINE IS BEST FOR INFECTED ATOPIC DERMITITIS
411.HYDROXYZINE ,BENADRYL FOR ITCHING IS BEST AND NO HOT WATRE BATH,,
412…SMOOTH TEXTURE COTON GRAMENTS AND REGULAR FARMULA IF ALLLERGIC TO COW MILK…
RICE ALLLERGY IS THE LEAST ALLERGIC IN FOOOD SO USE
413..POSITIV EAND NEGATIV E PREDICTIV E VALUE DEPEND ON PREVALENC E OF TH E DIASESE
SAMPL ESIZE IS MOST IMP FACTOR IN THE SUCCESS OF ANY STUDY..
414..BICONCAVE AND FISH MOUTH VERTEBRA IS CLUE TO SICKLE CELL DISEASE
415
IN SICK TRET AGGRESSIVE FLUID //O2 AND PAIN CONTROL WITH NORCOTIC…AND GIVE INF AND PNUMOVAC AND PCN FOR INF…
416….SESSIL E LESION R MORE LIKE LY TO BECOME MELIG THAN PEDUNCULATE DONE..
417..ECOLI AND B FARI GALIS IS MOST C ORG IN THE DIVERTICULITIS
418….LEFT COLON CA,,CHANG EIN VBOWEL HABIT/WITH PENCIL LIK E STOOOLGROSS BLOOO DIN STOOOL.OBSTRUCTIVE S/SIN COLON CA
419…IN RT COLON CA….DIRREA MUCUC AND BLOOOD IN THE STOOL BUT OCCULT..ANEMIA.PALPABLE ABD MASSDYSPEPSIA…
420..CA OF RT COLON IS COMON IN WOMEN AND COLORECTAL CA IS MORE IN MEN..
421….ADENOMATUS POLYP SHOULD B REMOVED IF NOT BY COLONOSCOPE THEN BY LASERS ORLAPROTOMY..BC ZTHEY R MELIGNANT
422…INFILTRATING DUCTAL CA IS MOST CA..IN BREAST
423…MAMO IS T THEN BIOPSY
424… PREMENOPASAL AND POST MENOPAUSAL IF ER POSITIVE GIV ETIMOXIFEN
425…FIBROADENOMA IST FNA
426.. PAIN IN TH EBERAST I WK B4 MENSES IS FIBROCYSTIC DIEASE AND RECHECK PT AFTER 6 WKS I STH EBEST
427…LUMPECTOMY AND IRRAIDIATIONIS BEST AND MRM ONLY WHEN NIPPLE AND SKIN INVOLVED
427… KI RAS GENE …CA PAN…19-9 IS ALSO FOND IN TH ECA PAN CT IS TH EBEST..
428…PT LIE FLAT AND PUT OBJECT UNDER NECK OR UNDER BACK WILL RELIEVE PRESSURE…
429… PAIN FUL LEFT EYE WITH BLURRED VISION AND AND SHE WEARS CONTACT LENSES… HEPETIC CORNEAL ULCER…
430…UNILAT MUCUPURENT DISCHARGE IS BECT CONTUTIVITIS……NORMAL VISION IS POSITIVENO STAINING OF CORNEA ON FLUROCEIN WHIL E GREEN STAINING ON STAINING WITH FLUROCEIN IN HERPETIC ULCER
431..NO ABX IN VIRAL AND BEC WITH SULFACETAMIDE EYE DROPS…OR GARAMYCIN…
432…STAPHLO STREPTP MOST LY AND ADENO IS TH ECAUSE OF VIRAL..
433.ITCHY RED EYE IS ALLLERGIC CONJUCTIVITIS….TREATMNT AVOID ALLERGENS.IMUNOTHERPY.CHEMOSI S IS WITH ALLLERGIC CONJECTIVITIS…
434…EPISCLERITIS PT HAS A RED ,SORE AND TENDER EYE THERE MAY B REFLEX LACRIMATION,UT NO DISCHARGEITS COMON IN AUTOIMUN E DISEASES LIKE RA SLE
435…SCLERITIS IS MOR EPAINFUL EYE THAN EPISCLRTIS…
436….DAMOX OR TIMOLOL IST IF EYE IS PAINFUL AND HARD TO TOUCH AND SUDDENLOSS OF VISION WITH HAZY STEAMY CORNEA…ACUT ECLOSE ANGLE GLAUCOMA…LASER IREDECTOMY LATER..
437…MRIS IS BEST FOR DISC HERNIATION…
438…WHILASH IS MOS C INJURY….
439…UPPER 2/3 OF TH EURTER STONE ESWL….
440…IF STONE R LESS THAN 2CM AND LOCATED IN UPPER POLE OF TH E KIDENY ESWL IS TH EBEST… IF STON EIS MORE THAN 1 CM AN DLOCATE DIN LOWER POLE OF KIDNEY THEN COMBINED ESWL AND PERCUTANIOUS NEPHROLITHOMY…
441…MOS C TUMOR INMEN IS PROSTRATE AND MOST COMMON CAUS EOF DEATH IS LUNG
MOST COOMN CA IN FEMALE IS BREAST AND MCC OF DEATH IS BREAST CA
442..MOST CC O F DEATH FROM GENITAL CA IS OVARIAN CA
443…BEC PROSTITIS MOST CC IS ECOLI AND AND KLEBSELLA BACTRIM IS BEST
44.4….SWOLLEN TENDER BOGGY PRSTATE DON’T MASSAGED
445..BACTRIM AND CIPRO IS BEST FOR PROSTIOTIS..
446…MENNERES DIEASE..A MIDDLE AGE WOMNE WITH TINITIS HEARING LOSS AND VERTIGO….FLUCTUATING SENSONURAL LOSS.AURAL FULLNESS IS A CLUE…HCTZ,CHOLORPROMAZINE…
447…BREIF VERTIGO OFTEN POSITIONAL FINISHED BY FIXATION TO A POINT IS BPPV
448…. RATATORY HORIZONTAL NYSTAGMUS IS CH OF BPPV
449…AMOXICLIIN FOR 100 DAYS IS BEST FOR ACUT E SINUSITIS
450…FRONTAL SINUSITIS IS SERIOUS..
451… REASSURANCE AND SIMPLE EXERCISES IS GOOD FOR BPPV AND ACUTE ATTACK NEED BEZO DIAPINE AND LOW SALT DIET
452..VSTIBULAR NEURITIS IS MOSTLY AFTER URI…DOESN’T INVOLV E CHOCHLEAATAXIA N/V POSITIVENO AURAL PAIN,NO HERAING LOSSS RECOVERY USUALLY TAKES I .2 WKS..
453…. THICK AN D GREENISH DISCHARGE IS BEC T SINUSITIS..GIVE AMOXICILIN FOR 10 DAYS
454..BEC SISUSITIS MOST CC IS STAPHLO AURIUS
455..MASTOIDITIS IS CAUSED BY TH E STREPTO PNUME..
456…ACTE LABYRINTHTIS…NEED REST,ANTIEMITIC AND ANTIBOITICS,,AFTER URI MOST COMONHAVE MIDDLE EAR EFFUSION CHEMICAL IRRITATION OF INNNER EAR..
457..NORTRIPTALIN EIS BEST TRICYCLIC IN ELDERLY
458…ACH DEFICENCY IS COOMON IN ALZIMERS..APO E4 POSITIVE AGE IS TH EMOST COMON RISK FATOR
459..DONEZEPIL IS BEST IST FOR ALZIMERZ
460…DELIRIUM IS MOST COMON MENTAL DISORDER IN HOPSITAL
PROG MMEORY LOSS IST IN ALZIMERZ
461…DELUSION HALUCINATION AND LOST INTERST IN DAILY ACTIVITY VISEOSPATIAL DISTURBANCES LANGUAGE IMPAIRMENT ALL IN ALZIMERZ…
462…DISORG SLEEP WAKEFUL CYCLE OIS PATHOGONOMIC OF DELIRIUM..
463..PMR NO ALDOLASE HIGH NO CPK HIGH N MUCLA BIOPSY NORMAL ONLY INC ESR AND PAIN IN SHOULDER AND HIP…ASSOCIATE DWITH TEMP ARTERITIS…
464..ORAL PREDNISON E 10-20 I S BEST FOR PMR AND 60 MG OF IV IS FOR TEMPORAL FOR ATLEAT I YR
465,,SYSTOLIC ELVATION IS DANGROUS AND SHOUL DB TRETAED
466..SYNCOPE IN ELDERLY IS SEC O THEIR MEDICATIONS…
467..COUGH AND LOSS OF TASTE AND I NC K WITH ACE..
468…FGIVE LOSARTAN IN COPD IF EJECTION FARCTION IS LOW..BCZ OF COUGH OF ACE…
469…DEPRENYLE EARLY WILL DEC THE DISABLITY IN PARKINSON
470…DEP IS COMMON PROB IN PARKINSONS
471…BENIGN ESSENTIAL TREMORS NEED BETA BLOCKERS
472..DRE TO CHECK IMPACTED STOOL IN CONSTIPTAION PT
473..CAP REQUIRES..ERETROMYCINE,ZITHROMAXAND CLARITHRO MYCIN…
474…RELAPSIN UTI IN TH EMALE IS DUE TO CH PROSTITIS…
475..CUTUR THE PROSTARTE SECRETON IS DIG IN PROSTITIS.. ECOLI IS MOST COMON CAUSE IN CH AND CHALMYDIA IS MOST COMON IN ACUTE PROSTITIS…
476..INF VAC IS EFEFCTIV E AGAISNT BOTH A AND B TYPE..
477…H INF VAC IS LEAST EFEFCTED IF CD 4 IS LESS THAN 100…
VAC AND AMNTADINE IS GOOOD TO CONTRAL INF ..
478..HEADACH FEVER CHILLS MYALGIA..COUGH AN DCONGESTION IS INFLUEZA..
479…AMENTADINE IS 70 TO 80 % EFFECTIVE AGAIST INF A
480… ASYSTOL DIRETLY LEADING TO DEAT…
481…ATROPINE UP TO 4 MGAND THEN TC PACER AND THEN TV IF NOT EFFECTIVE ATROPINE..IN SYMPTOMATIC BRADY PT
482…V FIB SIST 200.300.360
SAM EIN PULSE LESS VTACH
483… THE BEST SUCCESS WITH CPR IS WHEN IT STARTED WITH IN 3 MINUTES OF C ARDIAC ARREST..
484..ONE ASYTOLE PROBABLITY OF SUCCESS IS ZERO
485…DOOOR TO NEEDLE TIM EFOR CLOT DISSOLVING IS WITH IN 30 MINUTES
486..16 G IS THE BEST FOR RESUSITATION.487..TH EMOST COMON ERROR IN ER IS AIRWAY MANAGEMENT
487…BEST THING TO CHECK IF PT IS ADEQUATELY PERFUSING IS CHECK UOP
488..INFECTION IS TH ETRIGGERING FACTOR IN DKA
489…THERE IS NO KETONES IN NKCOMA…
490…SERUM K IS ELAVTED DESPITE TOTAL K IS LOW IN IST PHASE OF DKA…
491..SPOT BLOOOD SUGAR WILL B ABNORAL TO GREATEST DEGREE IN DKA
NS IS TH EBEST FLUID IST BUT WHEN GLUCOSE REACH 250 ADD D5W…
492…GIVE MAG AND PO4 AND CHECK K EVERY 2 H…
493…KAUSSMAL AND SWETING AND ACETON E BREATH AND UTI OR ANY OTHER INFECTION WITH SUGAR OF 400 IS SKA
494…GIVE 10 UNIT OF REGULAR INSULIN S/Q B4 U D/C PUMP …
495..TURN OFFF PUMP WHEN ABG SHOW S CLOSURE OF GAP..
496..ABDOMINAL PAIN CT IS BEST
497…80% OF AAA R ASYMPTOMATIC AND MOST CC IS ATHEROSCLESIS..
498..DON’T GIVE N ACETYLECYSTEIN AND ACT CHORCOAL TOGTEHER DEC ABSORBTION 2 H AFTER OR 2 H B4
499…70%SORBITOL IS GOOOD TO GIVE WITH THEATIVATE D CHORCOAL…
500..NO CHORCOAL ..IN LITHIUM ,IRON,ETHANOL METHANOL AND HYDROCRBON
501…THROUGH WASHING OF WASHING WITH TAP WATER IF ALKALI SPILLL THEN ER …
502….ETHANOL IS GOOO D FOR ANTIFREEZ AND MATHANAL
503…HIT MOST COMON COMPLICATION IS THROMBOSIS JUST LIKE ANTI PHOPHO LIPID ANTIBODY AND IN LUPUS ANTI ANTI COAGULANT…
504…AST IS RANSON CRITARIA NOT ALT AND AYLASE IS NOT A CRITARIA…
505..EXOPHTHALAMOS.ABSENT RED REFLEX AND LEUKOCORIA IS DEFINARELY RETINO BLASTOMAA.
506..NSAID AND STEROID IS TRETAMENT FOR J H REACTION WHICH CAUSE HEACHE FEVER N V MAYLGIA…IN SYPHILIS TRETMNET
507..BEC VIGINOSIS I S MOST COOMON VIGINAL DISCHARGE AMINE OR WHIP TEST POSITIVE .CLUE CELL IS A CLUE PH IS MORE THAN 7.4
508…CAT SCRACH BITE NEED THE AUGUMENTEN..LIKE ALL OTHER BITES DOG AND HUMAN
509…PALPABLE THROMBOTIC CORD IN A UNILAT SWOLLEN RED AND WARM LEG IS DVT START HEPARIN…ESP IF IT IS PROXIMAL DOPLLER US AND D .DIMER IS DIAG
510..LGSIL HGSIL BOTH NEED COLPOSCOPY
511..CONIZATION SHOULD B INDICATED IN ANY OF THESE….TRANSFORAMTION ZON E IS NON VISULIZED…PAPSMERA IS WORSE THAN BIOPSY
..PAPSMEAR SHOWING ADENO CA…BIOPSY SHOWING MICRO INVASION….POSITIVE ENDO CERVICAL DISCHARGE..
512,,,,PAP SMEAR IS UN SATISFACTORY IF ENDOCERVICAL CELLL S R OT SEEN
513…ARTERIAL CLOTS R POSITIV EIN ANTIPHOSPHLIPID ANTIBODY.HIT,LUPUS ANTICOAG ANDANTICARDIOLIPINS NATOBODIES,HOMOCYSTONURIA.FACTOR 2 ABNORMALITY
514….U DON’T HAV ETO MONITOR DIG LEVEL WHEN PT IS TRETAED FOR A FIB…AMIDIARON VERAPAMIL AND QUINIDINE INC THE LEVEL…
516…..IN KIDS THERAPETIC DOSE OF DIG IS 4 NGM NOT 2 LIKE ADULT AND VOMITTING IS A CLUE TO TOXICITY AND IN ADULT CONFUSION AND PALE DISCOLURATION IS EARLY SIGN
517…HRT IS GOOOD TO PROTECT FROM HEART DISEASE WHICH IS NUMB I KILLER IN US IN BOTH SEXES..
518… HRT IS GOOOD AGAIST HEART DIEASES AND OSTEO AND MENOPUASAL SIGN SYMPTOM ..NO PROVEN STUDY IS YET TO PROVE THAT IT CAUSE BREAST CA
519..U MUST TELL THE PT THE RISK AND BENEFIT OF CPR WHEN U R TALKING ABOUT DNR..
520..PT CAN ALWAYS CHANGE HER LIVING WILL EVEN VERBALLY IN A SEC…
521…IF SON IS 27 AND DONATED ORGAN 10 YRS AGO AND PARENTS DDONT KNOW U MUST TALK TO PARENT AS A PHYSICIAN…THAT THIS IS WHAT UR SON WANTED…
522…IF U INTUBATE THE PT AND DNR IS PROVED EXTUBATE THE PT IMIDIATELY
523….IF U INTUBATE D PT AND SON CALLLED FROM NY THAT MY FATHER IS DNR AND I HAV E HIS LIVING WILL WHY U INTUBATED HIM…ASK SOCIAL WORKER TO CHECK THE VALIDITY OF THE LIVING WILLL AND IF OTS LEGAL THEN EXTUABTE THE PT….
524…IF UT IS NOT REMOVED AND INTACT THEN ALWAYS GIVE ESTROGEN AND PROG EVERY DAY TO DEC THE CHANCE OF ENDOMETRIAL CA…IF PT HAS NO UTERUS THEN ONLY ESTROGEN
525…IF PT IS IN REPRODUCTIVE AGE AND HAS ENDOMETRAIL CA THINK OF POLYCYSTIC OVARIAN SYNDROME BCZ ANOVUALTION CAUSE LACK OF PROGESTRON AND THIS UNAPPOSE D EFFECTOF ESTROGEN LEADS TO ENDOMETRIAL HYPERPLASIA…
526…SIADH..NEVER GIVE 3% SALINE UNLESS PT IS NOT SYMPTOMATIC FROM LOW SODIUM OTHER WISE JUST WATER RESTRICTIONIS BEST FOR CHRONIC CONDITION GIVE DEMECLOCYCLINE…
527…BRAIN DEATH ….MUST MAKE SURE PT IS NOT HUPOTHERMIC TEMPP SHOUL DB ABOVE 32 ATLEAST
528..AT 30TEMP PT CAN HAVE V FIB…
529…ANAPHYLACTIC RESPONSE IS DUE TO IGA DEFICIENCY AS IN CASE OF IVIG IF U GIVE AND PT HAS ANAPHYLAXIS THIS IS THE IGA DEF..
530…PHYCHOTIC DEP AND WHEN SSRIS OR TRICYCLIC IS NOT INDICATED THEN ECT IS BEST…TRANSIT MEMORY LOSS IS MAJOR SIDE EFFECT
531…WET MOUNT FOR TRICHOMOSIS AND BV…FLAGYL IS GOOD IF PREG CLINDA CREAM AND ZITHROMAX IS GOOOD..
532…C DIFFF IS BEST TREATED WITH FLAGYL AND VANC O ONLY IF ITS NOT EFFECTIVE
533..STOP… SALICYLATE 10 DYAS B4 SURGERY AND OCP I MONTH BEFORE..STOP COUMADIN 48 H B4 AND HEPARIN 4 H B4…
534…IF PT IS GOING FOR SURGERY AND INR IS MORE THAN 4 THEN GIVE FFP….IN NON EMERGENT SITUATION GIVE VITA K..
535…IN TORSEDESPOINTS…. GIVE MG SO2 IST IF NOT EFFECTIVE THEN GIV EISOPROTERENOL DRIP…OR PACING…BIT NOT QUINDINE OR PROCAINAMIDE THEY PROLONG QT FURTHER
536…C PERTIDE IS INC IN INSULOMA BUT DEC IN FALSE HYPERGLYCEMIA SEC TO SELF ADMISTRATION OF INSULIN…TO CREAT HYPOGLYCEMIA..
537…CUSHING….IST DO FREE CORTISOL IN SERUM IF IT IS MOR ETHAN 100 CUSHING IS POSITIVE
538…CLOZAPINE CAUSE AGRANULOCYTOSIS SO CHECK CBC OFTEN
539…TICLODIPINE CAUSE THE THROMBOCYTOPINIA…SOGIVE PLAVIX IFPLATELETS R LOW..
540…GIVE INF V AND AMANTADINE ,,,FOR MAXIMUM EFFICACY
AMNTADINE IS ONLY EFFECTIVE AGAIST HEMO INF A NOT B AS VAC…
541…HEINZ BODIES IN G6PDEFICIENCY …DON’T GIVE BACTRIM,DAPSON,PRIMAQUIN,THIAZIDES,SULFA
542…IF PT HAS PCP AND SULF AALLERGY THEN GIVE ATOVOQUIN,,
543..IF PTT IS PROLONG ANDFFP IS NOT WORKING THEN DO MIXING STUIES
544..FACTOR 13 DEFICIENCY BLEEDING IS SEVER BUT STILL NORMAL COAGS..
545..FACTOR 12 DEFICICEY NO BLEEDING SO PT CAN GO FOR SURGERY SAFELY
546..DIRETIC CAUSE CONTRACTIONALKALOSIS..547..CAP…STREP PNUMO…GIVE ERYTHRO ,ZITHRO,CLARITHRO ANY MACROLIDE WILL DO IT..RESISITANT CASES GIVE LEVAQUINOR CEFTRIOXNE
547..RAPI DSTREP POSITIVETY GIVE PCNV…IFNOT WORKING GIVE BRAOD SPECTRUM.
548…HETROPHILE IS NOT POSITIVE UNTIL 2-3 WK AFTER IM STARTS
549…HEPZES V 8 CAUSE KAPOSI…FOR FLAT WARTS GIVE 5 FU AND INDUATRED WARTS DO CRYO WITH LIQ HYDROGEN
550…HEP A IS THE MOST COMMON VAC THEY NEED WHEN GOING ABROAD..
551..CMV RETINITIS…NEED GANCICOLOVIR…CHECK CBC IF RESISTANT THEN FOSCARNET
552..PSA AND DRE IS SCREENING A T 50 YRS OLD MAN FOR PROSTATE CA
553…IF PSA IS MORE THAN 4 THEN TRANSRECTAL BIOPSY..
554..IF CA OF PROSTATE IS IN BONE ACID PO4 WILL RISE..GIVE LUPROLIDE AND FLUTAMIDE..
555..INC ALPHA FETO PROTEIN IS IN C IN EMBROYNAL AS WELL AS HCG ALSO INC..
556..DITAL RADILA FX IN KIDS WHO FALL ON OUTSTRECHED HAND IS A MED EMERGENCY AND NEED ORIF ASAP…557..SILVER FORK DEFORMITY COLLLES FX…NEED CLOSE REDUCTION AND LONG ARM CAST…MEDICAN N IS EFFECTED..DITAL RADIAL FX IT IS…
558.AI IS WITH MARFAN AND AORTIC DISECTION…CT WITH IV CONTRAST IS BEST…
559…STEEPLE SIGN IS IN CROUP..PIV..COOL MIST O2 AN D SEVER CASES NEED RACEMIC EPI AND STEROID…
560…HYDROXYUREA INC HB F SO ITS USEFUL IN THE SICKLING..
561…IF LITHIUM CAUSE HYPOTHYROIDISM DON’T DC MED JUST ADD SYNTHYROID WHEN U HAV ETO GIVE STERIOID AND SUNTHYROID ALWAYS GIVE IST CORTISOL THEN SYNTHYROID..JUST LIKE U GIV ETHIAMINE IST THEN GLUCOSE…
562..HB .H 3 ALPH A GENE R DELETED AND IN HB BART AL 4 R MISISNG…
563…MELIG HYPERTHERMIA GIVE DENTROLINE SIDE EFFECT IS MUSCLE WKNESS. IT IS AUTOSOMAL CONDITION AND NEED AVOIDANC EOF ALLL INHALATIONAL GASES AND SUCCINYCHOLINE..
564..NO SUCCINYCHOLINE IN THE SPINAL SHOCK PT AND IN BURN PT BCZ IT INC LIF ETHRETENING K ..
565…IF LOER GI IS NOT STOPED AND OT IS UNSTABLE PARTAIL COLECTOMY IS GOOOD..
566..IF P IS BLEEDING NUCLEAR SCAN WITH TAG RBC
567..INTUABTE THE PT IF PCO2 IS MOR ETHAN 50 AND PO2 IS LESS THAN 50..
568…IF PROLATIN INC ON FINDING THE CAUSE OF SEC AMNEREA DOTHEMRI TO C THE TUMOR…THENGIVE BROMO IST TO DEC THE SIZE JUST LIKE WE GIVE LEPRON TO HSRINK THE FIBROID ..
569…URGE INCOONTINCE I SMOST COOMON IN OL DAGE AND IT DUE TO DETRUSOR HYPERREFLEXIA..ANTICHOLINERGIC IS BEST
570..SEXUAL ABUSE AND AFTER MULTIPLE CSECTION AND VIGINAL SURGERIES STERSS INCONTINCE ,,HRT IS GOOD IN THAT,,,
571…CAMPING DIRREHEA IS GIARDISIS WATERY DIRREA AND GIVE FLAGYL LOPERAMIDE…572…CT WITHOUT CONTRAS T IF HEAD TRUMA TO R/O IN BLEED
572….ANY STROKE DO HEAD CT TO R/O INB SO U U CAN START TPA IF PT CAME LESS THAN 3 H AGO WINDOW PD FOR AMI IS WITHIN 3 H…BEST IS WHEN ITS LESS THAN 60 MINUTES..
573…KAWASAKI GIV EIVIG AND ASP AND CALL CARDIO TO DO AN ECHO TO C CA ANURISM
574…RASH IN IM IS DUE TO AMPICILLLIN IT WILL GO AWAY DON’T HAV ETO DO ANY THING…
575..MRM WHEN SKIN AND NIPPLE INVOLVED OTHER WISE ANY MELIG MASS NEED MASTECTOMY ANDIRRADIAATION
578..IF PT HAS MELIG OR BED RIDDEN ANTICOAG FOR LIFE OTHER WISE AFTER DVT JUST FOR 6 M..
579…HYDRATION AGGRESSIVE ONE AND FRUSAMIDE AND MANITOL IS BEST TREATMENT IN RHABDO…
580…BENIGN CYSTIC TERATOMAA IS MOS COMMON BENIGN TUMOR IN OVARY
581…24 H METANEPHRINE AND CATHACHOLAMINES AND CT ..IN CASES OF REFRACTORY NEW HTN AND HYPERGLYCEMIA SWEETING HEADACHE…
582…CORPUS LUTAL CYST IS MOST COMON WITH NEGATIVE PREG AND ABDOMINAL PAIN AND MASS IN ADNEXA…
583..IF BHCG IS LESS THAN 1500 TVUS FOR ECTOPIC AN DIF IT IS MORE THAN 6100 TRANS ABDOMINAL US IS GOOD
584..IF ECTOPIC IS LESS TAN 4CM AND PT IS STABLE WITH LESS PAINAND VITRALS R OKAY THEN GIVE METHOTREXATE…
585..CHECK BASAL MAMO AT 35-40 YRS OF AGE AND BET 40 –50 EVERY 2 YR MAMO AND AFTER 50 EVERY YR
586…IF PT HAD CA IN BREATS THEN CLINICAL EXAM IS 4-6 MONTH AND BREAST SELF EXAM EVERY ONTH AND MAMO EVERY YR
587…IF PT IS HYPOGYLEMIC D 50 IS INDICATE DAND IF CANT DRINK GLUCAGON IS EFEFCTIVE..
588…NO FLORINATED TOPICAL STREOID IN ROSEEA..IT PPT IT METRO GEL IS BEST…TETRA IF REFRACTORY
589…VILLOU SADENMOA REQ RESETION WITH COLONOCSCOPY OR LASER OR OPEN SAME IS FOR OTHER PREMELIGNAT SESSILE LESION
590…LEVEL OF DEPTH OF INVATION IS THE PROGNOSTIC IN MM…
591..IF BLEEDS OR CHANGE COLOUR SOR ITCH PUNCH BIOPSY…BIOPSY FROM CORNER IS A LOT BETTER THAN CENTER
ACTINIC KERATOSIS …NEED CRYO ITS PREMELIG TOOO CASE SQ CELL CA
592…IND ING H ORIGINATE AT DEEP ING RING AND IT IS LAT TO IEPIGASTRIC A
593….BHCG IST THEN PROGESTRON CHALLENGE IF SEC AMONRRHEA…IFIT IS AFTER DAND C THEN ASHERMAN SYNBNDROM EIS THE CAUSE..IF PROGESTRON CAUSE BLEEDING IT MEAN ENOUGH ESTROGEN IS POSITIVE IF NO BLEEDING THEN GIV E HUMAN G HCG….
594….REPEATED NEEDLE ASP AND ABX FOR 6 WKS IS GRETA IN SEPTIC ARTHRITIS NO INTRA ARTICULAR STEROID …
595…JUST IN CASE OF DONOCOCAL FEPTIC ARTHRITIS DON’T DO THE ASP BCZ WBC IS NOT LESS TAN 50 USUALLLY AND ANTIB IS ALL THAT PT NEED CEFTRIOSONE IV ..
596…PHYSIOLOGICAL JAUDNACE DIRECT BILI IS LESS THAN 2
597…IF URINARY INF OR OBSTRUCTION DO THE UA AND RENAL ULTARSOUND..
598..FLUID DEFICIT SHOULD B REPLACED HALF IN IST 24H AND REST IN NEXT 24 AND 48 H..
599…DON’T TOUCH THE HEMARAGIC BLISTER BUT PEEL THE WATERY ONE…PCN AND TETANUS REQ IN FROST BITE ..RAPID REWARMING WITH WATER IS BEST
600..TGV..IS MOST CC OF EARLY CYANOSIS AND INC VASCULAR ITY ON CXR AND RVH AND RT VENT HEAV E POSITIVE…601..THE MOST CC OF CYANOSIS IN LATER PF IS TOF…
602…C JUJINI …INC PD IS MORETHAN 16 H AND TRET WITH ERYTHRO…
603…SQUATING IN C IN PVR AND HELP IN THE HYPOXIC SPELLS IN PT WITH TOF…
604…. NO DIG OR DIURETIC IN HCM.,, BB AND CA CHENAL BLOCKERS R GOOOD NO NITRATE EITHER..
605…2 H POST PONRAIL TEST IN THE POST PRTUM VISIT TO MAKE SUR E PT IS NOT DIABETIC AFTER PREG AND GLUCOLA 50 G IS AT 28 WKS AND IF IT GIVES MORETAHN 140 GLUCOSE TEHN 3 H GGT..
606…TL IS DEC IN PREG M AND TV IS INC..
607..GULLAN BEERY ASCENDING PARALYSIS AFTER H INF VACCINATION OR ECOLI INF … GIVE IVIG OR PLASMAPHRESIS AND VENTILATION IS TO WATCH IN ACUTE CONDITION… AND RECOVERY IS DECENDING ORDER …
608..NC S AND DTR…NO DTR AND SLOW STUDIES IN GBSYNDROME
609… PT WITH CARPEL NEED SPLINT AND NSAID AND SURGERY ONLY REFRACTORY..NCS IST…
610..OLIGOCONAL BAND OF Igg IS DIAG OF MS IN CSF..IV METHYLPREDNISOLONE IN ACUTE CASES MRI IS TO F/U
611..CHEMIAL CONJUCTIVITIS IS USUALLY DUE TO SILVER NITARTES DROPS..GIVE ERYTHRO ORALLY..
SAME FOR CHALMIDIAL CONUNTCIVITIS..
613.. JUST MASSAGE IS ENOUGH IF DACTROCSTSTIS IS MILD…
614..NO DIURETIC AND ACE IN PREG..
615..PHOTOTHERAPY FOR SEASONAL DEP..
SSRI IS BEST FOR BULIMIA WITH COG THERAPY
GROUP THERAPY IS BEST FPOR ALCOHOLICS AND GRUG ADDICTS AND SEXUAL ABUSE
616.T4 LEVEL IS GOOD FOR C SECTION AFTER SPINA ANESTHSIA..
617…COCAIN OD ….BEHAVIOR MODIFICATION THERAPY…
618…PTU IS SAFE IN PREG AND DO THE SUBTOTAL THYROIDECTOMY IF HAV ETO BUT NO RAI…IN PREG..
619..IST BLOOOD CULTURE AND THEN DO ABX THERAPY LP CAN WAIT BUT ABX CANT V IMP CHAINOF ACTIONALWAYS IN EXAM
620…DO LPIF MOM IS SAYING NOIF UHAVE TO SAFE THE LIFE
621..SPINAL REFLEXES IS STILL POSITIVE AFTER BREAIN DEATH..
622…GASTRODUDINAL A WILL CAUSE BLEEDING IN PERF PEOTIC ULCER
623..FIBEROADENOMA FNA..FIBROCYSTIC CALL PT AFTER MENSES
624…INC PROTEIN BUT NOT IN LYPHOCYTES TUPICAL OF GBS..
625..CROSS TABLE LAT XRAY IS IST FOR AAA…
IF PT HAS CAD AND AAA FIX HEART IST BCZ AMIIS MOST COMMON CAUSE OF DEATH IN ALL VASCULAR DIEASE
627….MASTITIS,,,CONTINUE BREASTFEEDING AND GIVE NAFCILLIN…
628,,,DUURESIS AND ALKALIN ETHE URINE IN SALICYLATE POISIONING…
629..BLOODY DISCHARGE FROM NIPPLE IS INTRADUCTAL PAPILLOMAA.
630..H/OFBREAST TRAUMAA FAT NECROSIS ITS PAINFUL AND WILL DISSOLVE SO WATCHFUL WAITINGIS ALLTHAT IS REQ
631..PHYNTIN SHOUL DB GIVEN SLOWLY BCZ OF SEVER HYPOTENTION….
632… OXYTOSIN CAUSE HYPOTENTION WHILE METHERGIN EIS CAUSING HTN
633..ALWAYS IST LIFE STYLE MODFICATION IN GERD AND OA,AND HTN..
634 IF BPIS HIGH LIKE 180/110 IST READING IS MAKING THE PT HYPERTENSIV ESO TERAT IT GIVE COLINIDINE IF PT IS ELDERLY OR ALCOHOLIC.
635…NO VIGINAL EXAM INPLACENTA PREVIA ULTRASOUND IS GOOOD TO DIAG AND NO THRAOT EXAM IN EPIGOTITIS IN WHICH HIGH FEVER DROOLING AND INSPIRATOR STRIDER INTUBATION IS REQ… LAT NECK XRAY..
636…AFTER AAA MOST COMON CAUSE OF GI BLEEDS IS MESENTRIC ISCHEMIA…IF LDL IS MORE THAN 180 AND 2 RISK FACTOR START ON MEDS AND DIET
638 GIVE ROLAXIFEN FOR OSTEPOROSIS..IF RISK OF ENDMET CA OR BREAST CA…
639…IF BREAST CA AND SUPRACLAVICULAR NONEDS R POSITIVE ITS CLASS 4 ALREADY..IF LOBULAR CA 50% ITS BILATERAL…IF NODES POSITIVE EVERY ONE WILL GET ADJUVANT THERAPY
640….ITP FIRST TREATMENT IS STEROID IF FAIL SPENECTOMY IF BOTH FAIL CHEMO IN CASE OF BLEEDING IVIG. THIS WILL BLOCK THE FC RECEPTORS OF PHAGOCYTOS CELLS AND USED FOR EMERGENCY BLEEDING ONLY.
641… DANEZOL WORK BY DECREASE THE NUMBER OF PHAGOCYTOUS CELL FC RECEPTORS.
642…. LOVENOX CAN BE SELF MINISTERED BY PATIENT AT HOME. START WARFRIN ON DAY ONE OR TWO OF LOVENOX. . CI OF LOVENOX PUD SYMPTOMATIC PE CURRENT ACTIVE BLEEDING FEMILIAL BLEEDING DISORDERS, KNOWN DEFICIENCY OF AT3, PROTEIN C,PROTIEN S, NONCOMPLIANCE PREGNANCY, MORE THAN TWO EPISODES OF DVT OR PE
643.. RECURRENT DVT OR PROSTHETIC HEART VALVE- INR SHOULD BE 3.0-2.5. NO WARFARIN IN PREGNANCY DUE TO NASAL HYPOPLASIA AND CNS ABNORMALITIES- FLAGYL AND SULFONOMIDE INCREASE WARFERANE LEVEL BARBITURATES, CARBOMESAPYNE, RIFAMPIN DECREASE WARFERANE LEVEL. OCP SUCRALPHATE FRISEOFULVIN AND VIT. K, SETEROIDS AND SPIRONOLACTONE
645…LOVENOX IS GOOD BECAUSE NO PTT CHECK MORE PREDICTABLE RESPONSE BETTER SAFTY PROFILE EASY ADMINISTRATION LESS TIME IN HOSPITAL. PROTEIN S DEFFICIENCY IS MORE COMMON THAN AT 3 AND PROTEIN C . AT3 DEFFICIENCY OCCUR IN NEPHROTIC SYNDROME AND ARE RENAL VEIN THROMBOSIS AND OTHER DVT.
646..MIXING STUDIES WILL NOT HELP TO DECREASE THE PTT IN CASE OF LUPUS ANTICOAGULANT, RECURRENT ABORTION AND THROMBOSIS RISK NEED HEPRIN.
647.. CRYOPRECIPITATE CONTAIN FACTOR 5,8, 13 VWF AND FRIBRINOGEN
648.. FFP CONTAIN ALL FACTORS EXCEPT 5 AND 8.
649.. THE MOST C.C OF DELAY POST OP BLEEDING IS FATCTOR XIII DEFICIENCY ALL CLOTTING TESTS ARE NORMAL IN THIS CASE AND UREASE CLOT SOLUBILITY TEST IS POSITIVE. FFP IS THE BEST TREATMENT.
650.. VON WILLEBRAND DISEASE PROLONGED BLEEDING TIME NORMAL PTPTT. BECAUSE VWF IS IMPORTANT IN PLATELET AGGREGATION AND FUNCTION AS CARRIER PROTEIN FOR FACTRO VIII . IF MINOR BLEEDING GIVE DDAVP AND FOR FACTOR 8 CONCENTRATE OR CRYO FOR SEVERE BLEEDING.
651..GVHD- SINE SYMPTOMS RASH DIERREA LIVER PATHOLOGY CMV INFECTION NEED IRRADIATED RBC.
652.. CML- LOW LAP, VITAMIN B12 INCREAE WBC MORE THAN 100000 GRANULOCYTED FOUND IN ALL STAGES OF MATURATION PLATELET MORE THAN 400000 IF SMALL SPLENE GOOD PROGNOSIS IF PATIENT MORE THAN 45 AND PLATELETS LESS THAN 70 THAN POOR PROGNOSIS. ALLOBMT IS BEST IF GIVBEN EARLY WITHIN 12 MONTHS IN PATIENT LESS THAN 55 WHO HAVE HLA MATCH SURVIVAL IS 63 % FOR 3 YEARS. HYDROXYUREA DRUG OF CHOICE FOR HIGH BLASCOM AND LEUKOSTASIS SAFE IN THROMBOCYTOPENIA CONTINUED MAINTANENCE TREATMENT IS IMPORTANT. BUSULFIN IS IMPORTANT AS WELL AS ALPHA INTERFERON WHICH SUPPRESS THE PHILADELPHIA CHROMOSOME.
653..MM = MORE THAN 10% PLASMA CELL FOUND IN THE BONE MARROW IF LESS THAN 10 THAN IT IS MGUS M PROTEIN IN MM IS LESS THAN 3 GRAM IN MGUS AND MORE THAN 3 IN MM . NARMOCROMIC CORMOCYTIC ANEMIA LYTIC LESION FRACTURES OSTEOPOROSIS
654… HAIRY CELL LEUKEMIA= ESSENTIALLY A B CELL TYPE, FRIED EGG APPERANCE WITH CYTOPLASMIC PROJECTIONS SEEN ON THE BLOOD SMEARS TRAP + DRY TAP ON BONE MARROW ASPIRAION NEUTROPENIA – CAUSE INFECTION LIKE TB OTHER UNUSUAL INFECTION LIKE TUXO LEGIONELLA AND NOCARDIA. 2 CDA IS THE TREATMENT OF CHOICE COMPLETE REMISIION IN 85 –88% OF THE PATIENT AFTER A SINGLE CONTINUOUS 7 DAY IV INFUSION.
655.. HUS – SIMILAR TO TTP EXCEPT WO FEVER OR CNS INVOLVEMENT. MANAGEMENT IN ADULT IS SAME AS FOR TTP. DIERRIA SECONDARY TO ECOLI 0157H7.
656..SICKLERS (TRAIT) ARE MORE PRON TO HAVE PAINLESS HEMATURIA AND PYELO IN PREGNANCY NO ANEMIA NO INFECTION NO INCREASE MORTALITY THOSE WITH TRAIT ALSO HAVE PROBLEM WITH CONCENTRAIONO OF URINE NO PAIN CRISIS. IF SICKLER HAVE CV COMPLICATIONS GIVE EXCHANGE TRANSFUSION ON REGULAR BASIS. INFECTION IS NUMBER ONE CAUSE OF DEATH IN SICKLER’S DISEASE.
657.. ACUTE CHEST SYNDROME FEVER , CHEST PAIN TACHY INREASE WBS AND PULMORY INTARACTS AND INFECTION IF YOUNG.
658..CLL NUMBER MALIGNANCY IN US MORE THAN 60 YEAR OLD B LYMPHOCYTES FEVER IS INDICATION OF INFECTION AND NOT THE LEUKEMIA DECREASE GAMMA GLOBULINS INFECTION THRUMBOCYTOPEINA INCREASE INCIDENCE OF SOLID TUMOR OF LUNG AND SKIN, AML A POOR PROGNOSIS IS LYMP[HOCYTE DOUBLING TIME LESS THAN ONE YEAR. RAI CLASSIFICATION STAGE 0 = INCRESE LYMPHOCYTES ONLY STAGE 1= INCREASE LYMPHO + LYMPHO DENOPATY STAGE 2= INCREASELYMPHO SPLENOMEGALY STAGE 3 = LYMOCYTOSIS ANEMIA 4 LYMPHOCYTOSIS AND THRUMBO CYTOPENIA TREATMENT IS FOR STAGE 3 AND 4 ONLY. CHLORAMBUCIL + PREDNISONE FOR PATIENT WHO RELAPSE FLUDUABINE IS GOOD. MEDIAN SURVIVAL 5 YEAR AS LONG AS HIS IGG IS LESS THAN 0.3 G / DL GIVE GAMMA GLOBULIN THERAPY EVEN HE IS NOT HAVING INFECTION
659… SHCHILLING TEST TO FIND THE CAUSE OF B12 DEFICIENCY PERNICIOUS ANEMIA IS NUMBER ONE CAUSE OF VIT B12 DEFECIANCY HYPO THYROYDISM INCREASE RISK OF GASTRIC CANCE ATAXIC GAT SECONDARY TO DEGENERATAION OF POSTERIOR COLUMN IMPAIRED VIBRATION AND SENSE DECREASED REFLEXES DEMENSIA SEIZURES. INCREAE SERUM MMA INCREASE SERUM GRASTRIN LEVEL SERUM HOMOCYSTINE INCREASE
660… FE DEFICINCY ANEMIA MCV DECREAED RBC DECREAED RDW MORE THAN 16 TIBC INCREASE IRON DECREASE FERRITIN DECREASE. THALASSEMIA MINOR RDW IS NORMAL
661.. B. THAL.MAJOR= FETAL HGB INCREASE MORE THAN 50 % IT IS 2 –3 % IN THALASSEMIA MINOR MAJOR NEED BMT TO SURVIVE. ELECTROPHERIS IS NORMAL IN ALPHA TALASSEMIA. B. THALASSEMIA MIRON IS MORE COMMON IN ADULTS. PRESENT WITH MICROCYTIC-HYTPCHRONICANEMIA
662.. IF PTT DOES NOT CORRECT WITH MIXING STUDY SO PATIENT CAN HAVE FACTRO 8 INHIBITOR S , LUPUS ANTICOAG ANTICARDIOLIPIN ANTIBODY. HEMOPHILIA A NEED CRYO
663…DRUG INDUCE SLE HAS NO RENAL OR CNS PROBLEM IT IS MOST COMMON WITH HYDRYLAZINE AND PROCAINAMID AND TREATED BY DISCONTINUING THE MEDICATION ANTIHISTONES, ANTIBODIES ARE DIAGNOSTIC IF NEED TREATMENT STEROID IS GOOD.
664…FOR ACUTE LUPUS NEPHRITIS GIVE CYCLOPHOSPHAMIDE
665… HYDROXIUREA NA D ALPHA INTERFERON IS GOOD IN BLAST CRISIS LEUKOCYTOSIS ESSINTIAL THROMOCYTOSIS
666… PHILADELPHIA CHROMOSOME CARRIERS ARE HAVING GOOD PROGNOSIS IN CML AND BAD IN AML
667…AMANTADINE IS GIVEN IN FIRST 48 HRS AFTER H INFLUENZA OUTBREAK WITH VACCINE IT PROTECTS 95 % FLU VACCINE MAY BE GIVEN ALONG WITH PNEUMOVAX RELENZA AND TAMIFLU ARE NEURA MINIDASE INHIBITORS IT IS GOOD TO GIVE IF PATIENT IS HAVING SIGN SYMPTOMS LESS THAN 2 DAYS THEY ARE EFFECTIVE AGAINST A AND B TIFE THEY REDUCE THE SPREAD OF VIRUS RELENZA IN INHALOR AND TAMIFLU IS CAPSULE.
668…RABIES SERUM AND CSF MUST BE TESTED FOR RABIES AD AND NAGRI BODIES SEEN ON HIPPOCAMPAL BIOPSY SPECIMAN ARE DEFINITIVE HRIG+VACCINE ARE USEFUL IN GIVING TWO SEPARATE SIDES BUT ONLY IF GIVEN BEFORE BEGINNIG OF SYMPTOMS AFTER DOG AND CAT BITE IF STATUS IS UNKNOWN AND ANIMAL IS ON THE LOOS CONSULT PUBLIC HEALTH OFFICIALS IF ANIMAL IS RABID OR SUSPCECTED RABID GIVE VACCINE IMMEDIATELY IF ANIMAL IS HEALTHY AND AVAILABLE FOR 10 DAYS OBSERVATION DON’T START TREATMENT UNLESS ANIMAL DEVELOPS SIGN SYMPTOMS IF + THAN START HRIG +VACCINE ONLY RABID ANIMALS ARE NEED TO BE VACCINATED AGAINST LIKE FOXES ,BATS SKUNK OR RACOONS NOT FOR RODENT RABBIT SQUERELL CHIPMUNKS RATS MICE GUINIPIGS HAMSTERS. HRIG DOSE HALF OF IT SHOULD BE INJECTED DIRECTLY INTO THE WOUND AND THE REST IN THE GLUTIAL AREA. IN ADULT VACCINE SHOULD BE GIVEN ONLY ON DELTOID AREA ON DAYS 0,3,7,14,28
669… WHEN SHOULD BE MEDICATION STARTED IN HIV CD4 LESS THAN 500 VIRAL LOAD MORE THAN 5K TRIPLE THERAPY FOR 4 WEEKS AFTER NEEDLE STICK FROM HIV INDIVIDUAL DOUBLE COMBINATION LIKE AZT + 3TC IN PATIENT WITH LESS SEVERE DISESE
1…HYPOSPADIASIS IS THE CONTRAINDICATION OF CIRCUMCISION…
2…HORIZONTAL TESTIS WITH PAIN AN D SWELLIN..UROLOGY CONSULT ASAP IF CHILD IS YOUNG AND NO FEVER …
3..ULTRASOUND IS ANS TO EVERY FLANK PAIN ,URGENCY FREQENCY FEVER MORE THAN 100.2 AND HEAMTURIA…CALL UROLOGIST IF URETREAL STONE IS MOR THAN 3 CM LESS THAN THIS WILL PASSS AWAY WITH I VF BLOUSES…
4…..NO CONTRAST STUDY OF ANY KIND IF PT IS ALLERIGIC OR IF CRETININE IS MORE THAN 2…
5…BOYS DON’T GET UTI THEY ALWAYS GET VUR….DO VOIDING URETHROGRAM..
6…THE MOST C C OF INABILITY TO VOID IN IST 24 H IS POST URETHRAL VALVE….
7……MEN DON’T GET CYSTITIS WOMEN DO BCZ OF THEIR URETHRA CLOSE TO VIGINA..MEN GET PROSTTIS….
8….PYLO ..NEED HOSPITAL ADMISSION,IV ABX,AND RENAL ULTRASOUND…9….IF K IS LOW IST CHECK MG IF ITS LOW …
10….RECTAL PROLAPSE ,MECO NIUM ILIUS,PUDOMONS AND STAPHLO INFECTION,NASAL OLYP ,MALABSORBTION,PAN INSUFFICIENCY AND RECURRENT BRONCHTIESIS IS DUE TO CYSTIC FIBROSIS, CHEST PHYSICAL THERAPY HIGH CALORIC DIET AND PANC ENZY ADMINSTRATION FAT SOULBLE VITAMAIN IS GOOOD IN MANAGEMNET ITS AR…WITH THE DEFECTIVE GENES AT CH 7…GTFR..GENES
11…IF ANIMAL WHO BITES IS RABID LIKE BAT AND DOG OR RACUUNE JUST KILL THE ANIMAL AND EXAMINE THE BRAIN AND LOOOK FOR NEGRI BODYIF POSITIVE GIVE PT VACCINE AND IGAT SEP PLACE AND SPRINKLE HALF IG AROUND THE WOUND…12…
IF P T HAS DOG BITES BY NEIGHBOURS DOG WHO HAD FULL VACCINATION JUST WASH THE WOUND WITH SOAP AND WATE R AND CLOSE PBSERVE THE WOUND...
12…MITOCHONDRIAL INHERITANCE ….ITS JUST AN APPOSITE OF SEX LINK WHRE ONLY FEMALE HAS THE DISEASE LIKE IN THE PREVIOUS ONLY MEN HAVE THE DISEASE…
13…UPSLANTING PALPEBRAL FISSURE,EPICANTHAL FOLD , FLAT NASAL BRIDGE, SIGLE PALMER CREASE,LARGE TONGUE,,,,IS DOWN SYNDROME….MSAFP WILL B DECREASE..AND THEY HAVE DUDINAL ATRESIA,LEUKIMIA AND ALZIMERZ
14…AGE IS THE MOST COMMON FACTOR IN ALZIMERZ..
15….BERRY ANURYSM IF ADULT POLYCYSTIC DISEASE…AND RF IS COMMON…GET ULTARSOUND…
16….PSUDOHYPERTHYROIDISM….LOW SERUM CA AND HIGH POSPHATE LEVEL…AND HIGH PTH
17…VIT D RESISTANT RICKETS…..X LINK DOMINENT….TRAITS…SO MALES HAVE MORE SEVER FORM OF DISEASE…
18
VONGERKIES DISEASE….. IS A G6 P DEFICIECY DISEASE…I NC LIPID,INC TG,NA AN D K R LOW USUALLLY..
19….
…
…20….CAH…IS DUE TO 21 HYDROXYLASE DEFICIENCY….DEC CORTISOL AND DEC MINERLOCORTICOID. PT HAS HYPONATRIMIA AND HYPERKALEMINA…DEHYDRATION,HYPOTENTION.SHOCK …
21…BE SHOWS THAT CECUM IS DOWN THERE IN LEFT LQ..AND PT HAS NV AND BILIARY VOMITUS AND BIRD BEAK APPREANCE ON UGI IS VULVULUS…RECTAL TUBE AND SIGMOIDOSCOPY IS THE ANS..
22…
BABY BECOME CYANOSES WHEN TRY TO FEED HER AND CYANOSIS DIDN’T IMPROVE BY REMOVING THE BOTTLE AFTER BABY BORN FEW H AFTER THIS HAPPENED IS DUE TO TRANSPOSITION OF GREAT V IS IF NORMAL SIZ EHERAT EGGGAND STRING PATTERN..INC PUL VACULATURE PATTERN…ECHO SHOWS RVH AND RVSTRAINTAD,
23….. CYANOSIS AFTER A WK IS DUE TO TOF…..
24…TRICUPID ATRISIA…EARLY CYANOSIS BUT DEC VASCULAR MARKING ON CXRWITH LAD AND LVH….
25…..PUL ATRESIA CYANOSIS IS EARLY BUT LUNG VASCULAR MARKING R NORMALAND THERE IS CARDIOMAGALY…
25,,,,TOXIC SYNOVITIS INVOLVE USUALLY LARGE JOINTS,,,AND THERE IS NO INC ESR OR WBC…
26….FIX SPLITTING OF SEC HEART SOUND…ASD NO NEED FOR GIVING ABX PROPHYLAXISIS IF FIX BY SURGERY OR PT IS ASYMPTOMATIC…
27….TRICUPID REGURG …. MID DIASTOLIC RUMBLE AT LOWER LEFT STERNAL BORDER
28…THE EARLY SIGN OF DIG TOXICITY IS FREQENT VOMITING AND THEIR THERAPETIC DOSE IS 4 NG AS COMPARED TO 2 NG INADUL T IN ADULT THE SIGN IS YELLOW VISUAL CHANGES..AND IN ELDERLY CONFUSION IS IST SIGN OF DIG TOXICITY…HYPOKALEMIA IS THE MAIN CAUSE…SO GIVE THE K AND FIX THE LO W MAG WHICH IS USUALLLY PRESENT AND GIVE DIGIBAND…NEVERDO CV OR NEVER GIVE EPI ..PHPHENYTOIN IS GRETA…. AND PACEMAKERS TOOO..
29…RDS…IS COMMON IN DIABETIC MOMS BABY DUE TO LACK OF SURFACTANTANYT AND PREMATURITY….RTOLEFT SHUNT,DEC LUNG COMPLIANCE,GROUND GLASS APPERANCE .MV IS HIGH AND NEED INTUBATION AND PEEP…
24…IF PT HAS HYPERLIPIDIMIA AND HTN GIVE ALPHA BLOCKER NOT BETA BLOCKERS..AND DON’T EVER GIVE DIURETICS TO THE…25 SPIRAL CT.……IS... BESTTO CONFIRN MASSIVE PE AND APPENDIX
25…IF A ASTHAMAA AND HTN IN A PT GIVE CA CHANEEL BLOCK SAME IS WITH ACHALSIA ND HYPERTENTION.
26….BB OR COLONIDINE IS BEST IN HTN AND ALCOHAL WITHDRAWL PT..27…..UNEQUAL PUPIL..IN INTRA CRANIAL P…IS SIGN OF UNCAL HERNIATION SO INTUBATE AND HYPERVENTILATE KEEP THE CO2 LESS THAN 30 AND GIVE MANITOL AND FOR VASOSPASM PROPHYLAXIS GIVE NIMODIPINE..
28…IF CAUS EOF STROKE IS HEART ALWAYS GIVE HEAPARIN AND COUMDINE…
29….. IF CH MITRAL STENOSIS DON’T GIVE TPA..
30….UA ,UC IS IS T THING TO DO WITH HEMATURIA IF PT IS YOUNG AND IF MORE THAN 50 DO THE CYSTOSCOPY IF ITS OAINLESS HEMATURIA AND IF PIANFUL DO THE SAME.
31….GOLD STANDRAD FOR UTI IS U C
32….IF CLINICAL SUSPITION IS HIGH THAT CHILD HAS MENINGITIS…. JUST GIVE CEFTRIXONE TO A KID OR OLDER IV THEN DO LP DON’T WAIT FOR THE LP BCZ IT TAKES TIM ENA DU CANT AFFORD TO PUT PT LIFE IN DANGERS U CAN ALWAYS CHANGE ABX
33……IF MOM SAID THAT I WILL NOT LET U DO THE LP THEN DO IT BCZ ITS MED EMERGENCY….
34….FEVER.EXUDATIVE PHARANGITIS AND GENERLIZED LYMAPHADENOPATHY INA 14 YR OLD DO THE MONO SPOT T O CHECK THE HETROPHILE ITS IS NOT POSITIV E IN IST 2 WKS SO IST DO THE CBC AND SMEAR TO LOOK FOR ATYPICAL LYPHOCYTES…
35…..IF AMPICILLLIN CAUS E RASH DON’T DO ANY THING IT WILL GO AWYAS ITS COMMON IN IMONONUCLEOSIS PT…
36….N O CONTACT SPORT AND SYMPTOMATIC TRETEMENT ONLY
37….IF U GIVE THE IG TO A KID AND HE HAD ANAPHYLAXIS…ITS IGA DEFICIENCY
38…MASTOIDITIS…IS A MASTOID AIRCELL SWELLLING IN IS CH BY THE POST AURICULAR SWELLING…OVER MASTOID PROCESS..DISPLACE THE EAR LATREALLLYIV ABX REQ AND ITS A SERIOUS COMPLICATIONOF TE AOM..
39…KAWASAKI IS A MEDIUM V VASCULITIS …
40…..MECONIUM ILIUS AND CLUDING AND RECUREENT RES INFECTION MEAN CHECK FOR THE SWEAT CHOLORIDE TEST..41…
INDIRECT COMBS TEST IS POSITIVE.IN ABO INCOMPTIBILITY
42…AV NODAL REENTRY I S THE MOST C C CAUSE OF SVT
43….DON GIVE VERAPAMIL IN SVT IN INFANT
44…VISIBL E GASTRIC PARISTALIC WAVE AND OLIVE SHAPE MASS IN EPIG IS PYLORIC WITH NON BILIRY PROJECTILE VOMINTTING IN A IST BPORN BOY WHO IS MORE THANA MONTH OLD,,, ULTARSOUND…. AND PYLOROMYOTOMY ONCE U FIX THE ELETROLYTES WHICH IS MEDICIAL EMERGENCY BRING CHORIDE UP TO 90 AND MOV ETHE BICARB DOWN TO 24….ITS USUALLY HYPOCHOLOREMIC HYPOKALEMIC ALKALOSIS…
45….STAPHLO IS THE CAUSE OF SEPTIC ARTHRITIS IN ALL GAES EXCEPT SEXUALLLY ACTIVE EVEN IN THE SICKLERS…
46….COOL MIST THERAPY …CROUP…IF NOT EFFECTIVE RACEMIC EPI…
47…..ENTEROVIRUS IS THE MOST OF ASEPTIC MENINGITIS…
48….HERPEZ IS MOST COMON CAUSE OF ENCEPHALITIS PCRIS DIAGNOSTIC AND IV ACYLOVIR HERPEZ 1 IS THE CAUSE…
49…3YR OLD COPY CIRCLE.UNDRESS COMPLETELY DRESS PARTIALLLY STACK 8 BLOCK
50…4 YRS OLD COPY CRISS BUTTON CLOTHING,DRESS COMPLETELY.CATHES BALL
51…4-5 COPY SQ…..52…
5 YRS…COPY TRIANGLE.TIES SHOES SPREAD WITH KNIFE
53….STREOID SALT RESTRICTION AND PNUMO VAC IS THE BEST FOR UNCOMPLICATED NEPHROTIC SYND
54…MINIMAL CHANGE IS THE MOST CC OF NEPHROTIC YOUNGER THAN 17 AND MEMBRANOUS IS MOST COMONCAUSE AFTER WORDS.
55..FOCAL IS MOST CC OG GLOMULITIS IN AID AND IN D A
56…OSTEO MYLITIS IS ANENATES MOSTL INVOLVE MORE THAN I BONE AND IN KIDS TRAUMAIS A CAUSE IN MORE HAN 2/3 OF THE CASES
57…CUSHING TRID IS POSITIV EIN INC INTRACRAIAL P….BRADY .HTN.IRREGULAR BREATHING
58….CRESENT SHAP ON CT IS SUBDURAL BLEED MOST IN OLD AGE AND ALCOHALOC…BUT LENTICULAR SHAPED IS ALWAYS EPIDURAL…EVACUATION WITH BURR HOLE OF THE HEMATOMA IS REQ…59….MACULAR DEGEN…IS M CC OF BLINDNESS IF PT IS MORE THAN 60,,
60….STYE NEED JUST WARM COMP…
61…CHALAZION NEED WARM COMP AND EXCISION
62…VITROUS HEMORRAGE IS BLEED FROM NEO VACULARIZATI ON IN DIBETIC NEURO PATHY
63…. BOLAT LOSSS O F TEMP AND PAIN BELOW THELESION IS SYRINGOMYLIA ANG DANDY WALKER AND ARNOLD CHEARI IS MOST COMON ASOOCITED SYNDROME….THORACIC AND CERVICAL SPINAL CORD MOSTLY…MRI
64…..MRI IS GOOD FOR OSTEO ANF BONE BIOPSY IS THEBESTFOR OSTEOMY
65…BRANCHING DENDRITIC ULCER……SLIT LAMP AND FLUROCEIN HERPZ KERATITIS…NEED OGPH CONSULT FOR TOPICAL MEDICATION NO TOPICAL STEROIDS.
66…. ONLY TOPICAL STEROID CAN B GIVEN BY EYE DOC..
67…NO NITRO PRUSIDEIN PREG
68…REVERSE TRENDELENBURG IN THEAIR EMBOLISMM LEFT SIDE SO THAT AIR STLLL B IN TH E RT V OR ET ATRIUM SO CAN B REMOVED BY THECATHTER
69…AMOXICILLINN 10 DAYS FOR SINUSITIS
70….LIMISIL IS FOR NAIL FUGAL…NOTGIVEN ID HEPATO RENAL DISEASE POSITIVE
71….IN NAIL AND HAIR FUNGAL INF ALWAYS GIVE ORAL GRESIOFULVIN OR FLURADIBIN ORAL BCZ TOPIA WORKS ON OTHER DERMATOPHYTES
72
IF THERE IS TINEA CAPITUS ALWAYS CHECK THIR UNDERWEAR FOR T CRURIS OR RING WORMM …ROUND LESION WITH CENTRAL CLEARING AND WELL DEFINED BORDERS
73….IV STEROIDISIST IN SPINAL SHOCK AS WELL AS IN ACUTE MS
74…CRYPTO INC 40 FOLD CHANCE OD TESTICULAR CA
ORCHIOPEXY AFTER I YR IS BEST IN PT INTEEST BU T NOT DRC THE CHANC OF CA
75…INC ALPH FETP PROT IS IN YOLK SAC TUMOR THOSE R NON SEMINOMA AND THEY NEED ORCHIECTOMY.. PLUS RADUATION AND IF LN POSITIVE ADJUVENTTHERAPY
76….HCG IS CHORIO CA
77 SENINOMA IS RADIO SENSTIVE
78….LEYDIG CELL IN MALE ANDGRANULOSA CELL IN F CAUSE PRECOCCUOUS PREG
79….IF APT WITH SCOLOSIS HAS AN ANGLEOF 40 NEED BRACEC BY ORTHOPEDICS
80..IF ANGLE IS LESS THAN 40…CLOSE F/U
81…LAST TRIMESTER AND UPTO 6 M POST PARTUM..RECURENC Y V COOMON ADVISE PT HAVE ABORTION AND NO PREG IN FUTURE PIC IS JUST LIKE DILATED CMP ITS CALLLED PEROPARTUM CMP…..TRANSPLANT IS THE ONLY TREATMENT…
82…ACUTE CHOLE….. ULTRASOUND….. IF PREG PT IS IN PAIN AN D NOT GETTING BTTER AND IF STONE POSITIVE THEN DO THE LAP CHOLE AT SEC TROMESTER AND IF WE HAVE TO TO DO OPEN CHOLE THEN IN THIRD TRIMESTER IF PT IS AYMPTPMATIC NOW NO NED FOR SURGREY IF S/S CAME BACK D O IT AFTER DELIVERY 6 WKS AFTER ..
84….PSVT NARROW QRS..GIVE ADENO.
85…AFIB WIDE QRS…GIVE BB OR CA CH ANG IF CHF GIVE DIG
86…PRECARDIAL THUMP ONLY IN WITNESS C AREST
87….PAINLESS MI IS COMMON IN DIABETIC ANDIN ELDERLY
88LIDOCAIN CAUSE CONFUSION IN ELDERLY
MOST C RHYTHM IN THE MONITOR WITH PT WHO IS UNDERGOING CPR IS V F
89…ST ELEVATION IN 23 AND AVF AND ST DEP IN AVL..INF RMI…GIV EVOLUM EAND NO DIURETICS AND NO NITRATES…KEEP THE PRELOAD HIGH OTHERWISE PT WILL B IN CARDIOGENIC SHOCK…
90…CARDIAC SARCOMA IS MOST C MELIGNAT TUMOR AND LFT ATRIAL MYXOMA IS LIKE MOST BENIGN
91…NO DORSIFLEX AND NO EVERTION IF CPN IS DAMAGED CAUSE IS PROLONG LITHOTOMY POSITION…
92..THOMPSON TEST IS BEST TO DIAG THE ACHILIS TENDON RUTUTRE…BCZ PT FEEL SUDDENPOP IN TH ECALF MUSCLE…WHEN U SQ IN THIS TEST THE GASTRONEMIUS AND SOLIUS THERE IS NO DORSIFLEXTION OF THE ANKEL
93..ACL…IS SKI INJURY IS THE MOST C C OF ACL..ANT DRAWER TEST IS MOST USEFUL
94..CN 3 PALSY…EYE IS DOWN AND OUTWARD AND CANT DO ANY THING BUT MOVE LATERALLLY..
95…CN4 PALSY…ON MEDIAL GAZE PT CANT LOOK DOWN…
96…CN6 PALSY…EFECTED EYE CANT LOOK LATERALLY…
IBUTALID EIS GOO D FOR A FIB
97…IF AFIB IS LESS THAN 3 WK NO NEED FOR ANTI COAG JUST DO CARDIO VERTION
98
IF MORE THAN 3 WK DURATION DO THE ANTICOAG FOR 3 WKS AND LOOOK IN TEE THE THROMBUS IN RT ATRIUM AND IF NON THEN GO FOR CV
99….11HYDROXYLASE DEFICIENY CAUSE HYPERNATRIMIA NOT HYPO..
100…FROG LE G XRAY OF THE SHOULDER IF SUSPECTED DILOACTION ANT IS COMMON..
101…RECURRENCY IS MOST CC AND NEED SURGERY IF YOUNG PT OTHERWISE CLOSE REDUCTION AND IMMPBILZATION AND NSAID..
102…SREING OF PERAL ON ULTRASOUND ….FIBROMUSCULAR HYPERPLASIA IT IS THE MOST CC OF NEW ONSET HTN INA WOMEN.
103…AV NICKING I GRADE 2…ARTERIOLAR NARROWING IS GRADE I AND HEMARRAGE IS GRADE 3 AND PAPLIDEMA IS GRADE 4 RETINOPATHY
104..IF NO PAPILEEDEMA NO MELIGNANT HTN
105…NO HTN AND NO HEAMTURIA IN NEPHROTIC ITS IS IN GNPHRITIS
106…PAVILIZUMAB IS A MONO CLONAL ANTIBODY AGAIST RSV IS PROTECTIVE FROM RSV INF IN WINTER LIKE BRONCHIOLITIS..
107URTICARIA…R EDEMATUS ,BLANCHING RED AND WHIT EPLAQUE THE R RAISED PRURITIC AND RESOLVED IN 24 H
108…25 MG OF UNCONGUGATED BILI CAN CAUSE KERNICTURUS TO TH EBABY
ONLY UN CONGUGATED COMES IN URIN CONGUGATED CANT
PHOTO THERAPY AT 20 AND IF NOT EFFECTIVE THEN EXCHANG ETRANSFUSION
109…ABNORAMLA PLACEMENT OF LIG OF TRETZ IN THE RT HAND IS DIGNOSIS OF MALROTAION CALL SURGERY INMIDIATELY
110,,,ASD IS NOT WITH TOF 111…SHORT PR INT V PLUS DELTA WAVE IS WPW IF IT IS WITH AFIB JUST GIV EPROCAINAMID E NOTHING ELSE..
112
PL EDEMA IS ABSENT IN RDS.. GROUND GLASS ON XRAY AND NEED INTUBATION AND PEEP AN D WEGD IS ALWAYS NORMAL..
113…BYPASS TRACT THROUGH KENT BUNDLE IS POSITIVE IN WPW
114..TGA EKG IS NORMAL AND VACULARITY IS INC AND TVH AND TAD IS POSITIVE WITH CYANOSIS AT BITH OR IN 24 H
115….ANDROGENS R HIGH IN TH E CAH SEC TO 21 HYDROXYLASE DEF
116…ETHOSUXIMIDE IS TE IST DRUG OF CHOICE IN THE ABSENCE SEIZURE
117…HYPOTONIC DEHYD IS COMMON IN CHILDREN THROUGH DIRREA GIVE ORS AND PEDIALYTES
118..XRAY CHANGES IN JRA IS MINIMAL AND 80% OF THE KIDS WILL OUTGROW OF THIS CONMDITION
119…LEAD 20 IS POSIONING REMOV ETHE CHILD…AND LEVEL LESS THAN 49 NEED JUST EDTA AND BAL AND MOR ETANH 50 NEED THE BAL PLUS EDTA AND THIS IS FOR 7 DAYS AND PCN CELLIMIN E FOR 6 MONTH
HOSPITAILIZE CHILD IF IT IS MORETHAN 70 LEVEL OF LEAD …
INC FEP IS POSITIVE AND LEAD LINE BASOPHILIC STIPLING ANDWRIST DROP AND ENCEPHALOPATHY SEIZURE ….
120…MILK ALLERG Y IS A COMON CAUSE OF LOWER GI BLEED.
121…FALGYL IS BEST AN D COST EFFECT FOR CDIF AND VANCO ONLY IF IT IS NOT EFFECTIVE TOXIN IN STOOL IS DIAGONSTIC AND STOP ABX ..
122…CROHN IS TRANSMURAL AND FISTULA AND CA OXALTE STONE COMON AND ARTHRITIS AND OTHET STUFFF
123…IF PT IS T ORTHO STATIC IT MEANS MORE THAN 20 % FLLUID LOSS OR BLOOD LOSS..
124…FECAL LEUCO IS POSITIVE IN SHEGALLA ,SALMONELLA , YERSENIA,ECOLI
125…ROTA VIRUS IS M CC OF GASTROENTREITIS AND GIARDISIS IS MOST COMON CAUSE OF WATERY PARACITIC D CAUSE
126…BACTRIM IS GOOOD FOR TRAVELLER DIRREHEA
127…NO ABX IN THE TRETAMENT OF TOXIC SYNOVITI SSINCE THERE IS NO INC IN C REACTIVE PROT NO IN IN ESR AND NO INC IN WBC
128….LEAD SCREENING IS AT 12 M AND 24 M IN ALL CHILDREN
129…SAUSAGE SHAP MASS IN R U Q IS COMMON WITH INTUSSEPTION
130…SUBLAXED RADIAL HEAD IS COMON IN NURSE MIAD
131… MOST C C OF SURGERY IN TERM IN FANT IS IGUNO RAPHY
132…HELD ARM IN PRONATION BY THE KID BUT NO PAIN IS THE NURSE MAID
133…WALK ALONE IS 12 M….PUT FEET IN MOUTH SIX M
134…DADAMAMA 10 MHOLD BOTTLE 8 MONTH
135…SOCIAL SMILE 3 M
META PHYSIS,TRAUMA,BOYS AND HEAMOTOGENIOUS SPREAD NO XRA UNTIL 3 WK B SCAN POSITIVE EARLYB BIOPST GOLD MRI IS GOOD
136…COCKSACK B VIRUS IS TH EMOST C C OF MYOCARDITIS..FOR PE ECHO IS THE BEST
137…GARM STAINING OF SPUTUMIS THE BEST FOR PNUMONIA
138… TH ENON TREPONAMAL TEST I SUSED TO CHECK THE RESPONSE OF THE TREATMENT
139…ASLOW RIS 15 HIGH RISK 10 AND HIV IS 5 MM PPD WHICH I SPOSITIV E FOR TB
140….IN H AND RIF FOR 9 MONTH IS THE STANDRAD IF PT IS NOT RESISTANT FOR TB
141… 2 MONTH OF INH AND RIFAMP PAZ AN D ETHAMBUTOL AND 2 MONTH OF RIF AND INH
142…C JUJINI…INVOLVE SMAL AND LARG E BOWEL…. MOST CC OF LONGEST INC BATION PF CAUSE OF DIRREA…ERETHRO I
143… THE OSMOTIC DIRREA IS MOM AND LACTOSE INTOLENACE…STOPED WITH FASTING AND GAP IS MORE THAN 40 AND SECTERTORY IS NOT STOPED BY FASTING AND GAP IS LESS THAN 40
144…CAPMING TRIP IN SUMMER DIRREA IS DUE TO GIARDISIS..
145…DAY CARE IS ALSO GIARDISIS..SMALL BOWEL BIOPSY AND STRING TEST ..FLAYGYL AND LPERAMIDE IS GOOOD
146…. INF LUENZA VACCINE IS MUST FOR PT WITH COPD AS WELL AS SMOKING CESSATION
147…I/2 OF FREE WATER DEFICET IS REPLACED IN IST 24 H AND REST IN 48 HDESIRED TBW-CURRENT TBW…IS THE FWD…
CURREN T TOTAL BODY WATRE IS….O.6 MULTIPLIED BY WT INKILG
148 ….DESIREDTBW= NA DIVIDED BY 140MULTIPLIED BY CURRENT TOTAL BODY WATRE
149….K SOULUTION SHOUL D NOT B GIVEN MORE THAN 20 MEQ /H
150…. NUCLEAR MEDICINE RENAL SCAN IS GOOOD FOR UNILAT RAS BUT NOT FOR BILATERAL …IN WHICH W E DON’T GIVE ACE,,UNIL WE CAN GIVE..
151…IF RENAL ULTARSOUND IS POSITIVE FOR POLYCYSTIC KIDNEY UROOLOGY CONSULT IS NEXT
152…FENA IS LESS THAN 1 AND RATION OF BUN CRETININE IS MORE THAN 20 IN PRERENAL GIVE FLUID CHALLLENEG AND THEN GIVE LASIX…BUT IST PUT FOLEY
153…K MOR ETHAN 6.5 WITH CARDIO CHANGES NEED HD
154…ANCA IS WEGENERS NEED CYCLO AND BACTRIM FOR AN YR
155…IF OBST RUCTION IS AT THE URETER AND PELVISOR VESICOURETRERAL JUNCTION N EED NEPHROSTOMY TUB E BY UROLOGIST…OR URTERAL STENT PLACEMNTPERCUTANOUS NEPHROSTOMY IS REQ..
156…REMOV ETHE GFOLY IF URIN EIS CLOUDY IN FOLY AND GIV EPT ABX
157..TEE DETECT ABCESSES AND VEGETATION IN ENDOCARDITTIS SO IF PT IS NOT GETTING BETTER WITH ABX PCN /GENT OF NAF AND VANCO IN STAPHLO CASE THEN CALL CARDIOLOGY FOR TEE
158…CUSTARD CREAM MET STAPHLO FOOD POISONING SHORTEST INCUBATION PF SYMPTOMATIC TRETAMENT
BACTRIM IN PREG IS NOT SAFE GIVE AMPICILIN OR AMOXICILINE OR VENTIN ALSO CAN GIVE ZITHRO IT IS SAFE,,
NO ORAL HYPO GLYCEMIC IN PREGNCNY…JUST INSULIN KEEP THE FASTING BELOW 9 0 AND POST PONDRIAL LESS THAN 120
159…90 % OG GASTRIC ULCER IS DUE TO H PYLORI..MOC IS GOOD TRETAMENT FOR 14 DAYS AND ANTOBODIES IN SERUM OR UREA BREATH TEST IS GOOOD …
160…COBBLE STONE TRANSMURAL LESION WT LOSS MUCUS IN DURREA ABD PAIN…IS CROHN..
161…BLOOODY DIRREA AND PUSDO POLYP..IS UL COLITIS
162…MOLUSCUM CONTIGIOSUM IS COMON IN YOUNG BOYS WITH UMBLICATE D DEP AND ITS IS BEST TERATED BY CRYO AND ITS CAUSED BY POX VIRUS
163…ALWAYS IST THING IN HTN IS TO LIFE STYLE MODIFICATION SAME IN GERD..
164…D4T CAUSE NEUROPATHY
ABACAVIR SEVER HYPERSENSTIVITY REACTION,INDIANAIR IS NEPHRO LITHISIS…
165…SQUNINAVIR G I UPSET INC LIPID
166…DELAVIRIDINE..RASH AND INC LIVER ENZ
167…AZT LEUKOPENIA AND ANEMIA AND MYOSITIS.
168….HIV IS NOT REPORTABLE AIDS IS..
169…DDC,PANC ,NEUROPATHY
170..DDI…MORE SEVER NEUROPATHY AND PANC
171..HETROSEXUAL TRANS MITION IS MOST COOMON MODE OF TRANSMITION THESE DAYS.
172…INPREG START AZT IN THE IST DAY OF 2ND TRIMESTER AND IF SHE IS ALREADY ON KEEP ON CONTINUING THE AZT
173…HAART IS 2 NUCLEOSIDE AND ONE PI… DEC MORTALITY ..
174….NO MATTRE WHAT THE CD IS IF PT IS SYMPTOMATIC GIV EHAART
175…IF PT IS STUCK WITH NEEDLE OF A PT BLOOOD THEN GIV E BOTH AZT AND LUMIVIDINE AND INDIANAVIR..FOR 2 M
176…..IF PT STUCK WITH THE NEEDLE CHANCE OF GETTING HIV IS .3 % FROM VERTICAL TRANSMITION ITS 30% AND WITH AZY DURING LABOR AND PREG AFTER IST TROMESTER IT DEC TO 7%
177…GIVE BABY AZT FOR 6 WKS…AND CHECK HIVE TEST AT 6 AND 12 MONTHS,,
ALL BABIES BORN TO MOTHERS WHO HAV E HIV WILL HAV ETHE HIV POSITIV E TEST BCZ OF MATRENAL ANTIBODIES GOEST O BABY…
178….NON NUCLEOSIDE INHIBITERS R ENDING IN INE AND NEVREAPINE AND DELAVIRIDINE IS SOE AND OTHER IS EFAVERINZ..
179… C ANCA IS SP FOR WEGENERS DIEASES..
180..TAKAYASU IS TREATE DWITH STEROID AND METHOTREXATE…181..SP CORD COMPRESSION NEED MRI ASAP…182….MO BON E SCAN IN MULTIPLE MYELOMA
183…ST LEG RAISING TEST IS POSITVE IN DISC HERNIATION AND ITS MORE COMON IN L5-S1..184 SICKLE CELL TARIT PPL DON’T HAV EMALARIA BCZ NO DUFY ANTIGEN
184..…for nocturnal agitataion givehaloperidol never diazapine…
185….ZOLDIPEM IS A HABIT FORMING MEDICATION
186… BUPROPION IS GOOOD WHEN SEXUAL DYSFUNCTION IS POSITIVE BUT IT CAUSE SEIZURE..
187…..THE FACIAL DISCOLORATION IN PREG IS DUE TOINC ESTROGEN AND MSH ITS CALLLED MELASMA…
188..IST GIV E FLUIDS AND THEN STRAT CATHTRE IN CASE OF POST OP ANURIA..
189….. ALL GYNE SURGERIES ONE DAY SURGERY OR SAM EDAY SURGERY PT CAN B D/CED WHEN SHE WILL PEE..
190…DIRECT COMMMS TEST IS NEGATIV EIN TTP AND HUS BUT POSITIV EIN ABO INCOMPATIBILITY..
191…TERBUTALINE CAUSE TACHYCARDIA HYPOKALEMIA AND PUL EDEMAA
192…SVR DEC IN PREG SO BP IS DEC UNTIL IST26 WKS
193…PROTRUSON THROUGH INT RING IS INDIRECT INGUINAL H IT’S THE MOST MOST C C OG HERNIA IN BOTH SEXES..
194….HYPOXIMIA AND PLURAL FRICTION RUB WITH SOB AND SUDDEN CP…THINK OF PE…
195…BARRIER IS BEST TO PROTECT FROM PID….PID CAUSE ECTOPIC AND OCP PROTECT FROM PID B ALTERATION OF CEVICAL MUCUS… STOP OCP I MONTH SURGERY…ITS PROTECTIVE FROM OVARIAN AND UTREINE CA..
196….AP24PCR IS BEST TO DETREMINE EARLY SERO CONVERTION….OF HIV WITH IN A MONTH OR B4THAT…
197…POSITIVE REINFORCEMENT AND ALARM IS MOST EFFECTIVE TREATMENT AND FOR QUICK FIX IS DDAVP IN ENURSIS,,,
198…. APPOSITIONAL DEFIENT DISORDER ..THYE R KIDS THAT THEY JUST BARK…NOT OBEYING RULE BICKERING YELLING AT PARENTS AND FDS ….
199…CONDUCT DISORDER IS SAME AS ANTOSOCIAL BUT LESS THAN 18…
200….RASH IN TH E PALM AND SOLE AND IN AXILLLA ,,,STRAWBEERY TONGUE..SCARLET FEVER IT CAUSE RHU FEVER AND GLOMURO NEPHRITIS…
201…RECURRENT ABORTION DO KARYOTYPING BOT PARENTS…
202….DUB MOST CC IS ANOVULATION ..MOST AT ETREME AGE AND IT IS TREATED WITHOUT ENDOMETRAIL BIOSY IF PT IS LESS THAN THIRTY AND WITH IF MORE ..IN SEVER BLEEDING USE ESTROGEN 25 MG IV Q4H UNTIL BLEEDING IS NOT CONTROLLED..AND FOR MILD BLEEDING THE DOSE IS JUST 1.2 MG…PLUS MPA AN OCP IS ALSO GOOD…
203…NEVER TRANSFUSE A YOUNG PT UNLESS NOT IN HYPOVOLEMIC SHOCK DUE TO SEVER HEMARRGE AND FLUIDS R NOT BRINGING BP BACK OR LOW O2 SAT….
204….RISK OF HIV FROM NEEDLE STICK IS .3% AND RISK IF HEP C IS 1.7% AND RISK OF HEP B IS 9%..
205…INCOMPLETE ABORTION…BLEEDING PLUS PRODUCTS R COMING OUT OS OPEN..NEED DNC…
206….OS IS CLOSE BLEEDING …THRETENED ABORTION..
207…A MISSED ABORTION IS ETENTION OF FAILED IUP FOR MORE THAN 2 CYCLESIF S RETENTION LAST FOR MOR ETHAN 8 WK DIC…IMIDIATE D AN D E REQ..
208…DELIVERY OF TH EBABY IF MATURE IN PREECLEMSIA AND ABRUPTIO OR PLACENTA PREVIA IF NOT THEN GIVE STREOID…
209…IST TRIMESTER RECURRENT ABORTION IS DUE TO CHROMOSOMAL BUT SEC TRIMESTER R SEC TO MATERNAL SYSTEMIC DIEASES…
210…NO METHERGINE IF HISTORY OF HYPERTENTION IF SYTO DIDN’T STOP BLEED ING GO FOR HEMATE OR PG E2ALPHA BUT MAKE SURE PT IS NOTASTHAMATIC…
211…LDH MORE THAN 350 AND GLUCOSE MORE THAN 30 CA LESS THAN 8AGE MORE THAN 55 WBC MORE THAN 16KAST MORE THAN 250 AND NO ALT IS IN TH E TRANSON CRITARIA…ALL THIS IS A SIGN OF POOOOR PROG…
212,,IF HEMOLYSIS THEN NO INFECTION IF BOTH IS ABSENT IN A NEONATE THE CAUSEOF INC ID BILI IS PHYSIOLGICAL OR BREAST MILK JAUNDANCE….BUT IST CHECK CBC AND MAKE SURE U CHECK RETICULOCYTE COUNT AND SMEAR…IF HEMOLYSISI IS POSITIVE AND IN DIRECT COMB STOOO IT IS THEN ABO INCOMP..WHICH IS THE MOST CC OF 24 H HEOLYSISI OR JAUNDDANCE..IF INDIRECT BILI IS MORE THAN 15 ON 3RD DAY GIVE PHOTO THERAPY IF NOT DECLING THEN EXCHANG TRANSFUSION TO PRESENT BASAL GANGLIA KERICTERUS…
213…..ONLY UNCONGUGATED COMES IN URINE..AND ONLY STERCOBILN COMES IN FECES..
214…PUL EDEMA….GIVE 100 %O2…HAV EPT SIT UP…AND GIVE LASIXIV AND CHECK XRAY PERIODICALLLY AND CHECK GAS…CONTINOUS PULSE OX GIVE NITRO TOO IF STILL NOT IMPROV EINTUBATE AND MOVE HIM TO ICU…
215…INFORMED CONSENT IS IMP B4 REPORTING RAPE AND HER PH Y EXAM..IN RAPE U WILL PROBABLY NEVER OVER IT..WHEN PT ASK U ABOUT RAPE WHEN I WILL B OVER IT DOC…DON’T LIE..DON’T GIVE FALSE HOPE…DON’T OVER INFORM OR UNDER INFORM THE PT TELL HER HOW MUCH HE OR SHE WANA KNOW…
216…U R OBLIGATED TO TH EPT NOT THE FAMILY…
217…SPEND THE PT MORE TIME WITH FAMILY
218,,DON’T CHANGE THE SCHADULE TO VISIT IF HE IS MOVE TO HOSPICE REMMBER HE IS STILL UR PT…
allupurinol is not for acute gout indocin is and allupurinol only after checking 24 h uric acid in th e urine if less than 800 then probenecid and if more than this then allopurinol but only after 2 wks of acute state..
219….IN PHYSIOLOGICAL JAUNDANCE THE BILI SHOULD B DEC BY 2 MG BYTH E END OF WK…DUROING PHOTO THERAPY CHECK THE BILI 6 H…
220…SIGMPOD VULVULUS…ABD PAIN ,DISTENTION,OBSTIPATION,,,XRAY SHOW BIRD BEAK APPERANCE …SIGMOIDO I STHE BEST FOR DISG AND THERAPETICALLY AND TO PASS RECTAL TUBE…
221….THERE IS PROMINENT U SHAPED SIGMID COLON IN THE LOWER ABD…
222…LIKELIHOOOD RATIO=SENS DIVIDED BY 1-SP…
223…AMPHO B WITH FC IS BEST FOR CRYPTO..INDIA INK ANTIGEN IS SESTIVE HEACHE AND FEVER…
224…SAAG MORE THAN 1.1 IS DUE TOPORTAL HTN…PEROTONEAL CARCINOMATOSIS I S ALWAYS SAAG OF LESS THAN 1.1
BUDD CHERI AND PVT AL CAUSE PORTAL SO INC SAAG…
225..HEMOCHROMOTOSISI IN A THALASEMIA IS DUE TO IRPON OVERLOAD FROM FREQ BLOOOD TRANF…GIVE DEF…
226…CA PAN 19-9 AND BRXA 1AND 2 IS BREAST CA..
227…CT ABDOMINAL AND PELVIS AND SURGICAL AND PATHOLOGICAL STAGING FOR OVARINA NAD ENDO METRIAL CA…
228…AMENORREA ,PERIPHRAL VISION DEFECT AND GAALCTOREA…ITS MOST LIKE PROLACTONOMA GIVE BROMO IF THE PPROLACTIN IS MORE THAN 25 AND MORE THAN 200 IN PREG ..DO MRI…
229…CRYPTOC IS MOST C COF DIRHEAA..I N HIV230….MAC WILL B PREVENTED WITHWKLY CLARITHROMYCIN…ETHAMBUTAL..CAUSE UVEITIS..PROPHYLAXIX… IF CD LESS THAN 50-100……
230..INC AMOUNT OF LIGHT CHAIN IN THE URINE OR SERUM…MM…BENCEJONES PROEIN…LYTIC BONE LESION…
231….INDIRECT ING HERNIA ORIGINATE AT DEEP INGUNAL RING AN DLIES LAT TO IN F EPIG V..232..RAPID TAPERING OF STREOID IN ASTHAMA CAN CAUSE ADDDISON CRISES…
233…DHEAS IS INCREASE MORE THAN 700 IN ADRENAL TUMOR…IN POLYCYSTIC OVARIAN SYNDROM E…..234….FANESTRIDE…IS 5 ALPHA REDUCTASE INHIBITER THATINHIBIT TH ECONVERSION OF TESTO TO DHT…235…HIRSUTISM…TESTO GREATRE THAN 2.0 IS DUE TO ADROGEN SECRETING TUMOR…
236…NEUROLETICS ANTAGONIZE D2 RECEPTERS SO NO REGLANAND NO HALDOL IN PARKINSON DIEASE WILL FURTHER DEC THE DOPAMINE…237…LEVELOF ABI ROARIO.5 OR LESS NEED BYPASS IN PVD AS WELLL AS IF PT HAS CALUDICATION AT REST AND IF THERE IS SOME MUSCLE ATROPHY… NEED SURGERY OTHER WISE JUST CESAATION OF SMOKING AND REGULAR EXERCISE…
238.. A PAP SMEAR I S TAKEN FROM VIGINAL CUFFF…239…MYOPATHY IS SIDE EFFECT OF STATIN…
239..CHOLESTYRAMINE CAUSE INC TG…240…2 READING OF MOR ETHAN 140/90 6 H APART IS HTN…
239….IF LDL IS MORE THAN MOR ETHAN 160 AND 2 FACTOR POSITIVE GIVE STATIN…AND DIET MODIFICATION…
240….A LOUD SYSTOLIC EJECTION MURMER HEARD OVER TH E AORTIC POSITION IS CHARACTERSTIC…AND THRILLL WITH THIS IS IN SUPRASTRENAL NOTCH…
241…OLIGOSPERMIA WITHLOW FSH AND LH I S SUGGESTED OF PROLACTONOMA..
242…TEMP ARTERY BIOPSY IS MUST IN 24 AND 72 H AFTERSTARTINGOF STREOID.
243…STREPKINASE OR TPA ONLY IF ST ELEVATION IN TWO CONSECTIVE LEAD IS POSITIVE …AND R/O PERICARDITIS…
245..PUL STEOSIS ,PRIOR CPR.SURGERY LESS THAN 3 WK STROKE WITHIN I YR AND GIBLEED AND UNCONTROLLED HTN,MARFAN SYNDROME,,, I S CONTRAINDICATION OFOF TPA…
246…IF PE IS MASSIVE WITH LOW BP LIKE 70/40 GIVE FLUIDS AND GIVE TPA …OR STREPTO..
247…LDAL OF 140 WITH 2 FACTOR NEED DIET MODIFICATIONONLY…
248….mgso4 therapetic level is 4-7 and loss of dtr is at level of 10 and 12 bretahing prob and more than 15 heart prob..249…INILAT LEG SWELLLING AND WITH WARMTH AND REDNESS IN ABSENCE OF INFECTION I SMOST LIKELY DVT…PALPABLE CORD IS POSITIVE…GIVE HEAPRIN..
250..FACTOR V LADEN DEFICIENCY IN CAUCASION CAUSE DVT
251..BECKWEITH IS ASSOCIATED WITH WILMS AND NEUROBLASTOMA…
252…P53 SUPPESSER GENE IS ASSOCIATED WITH MANY MELIGNANICES.
253…NMYCO PROTOONCOGENE IS ASSOCIATED WITHNEUROBLASTOMA..PRESENT IN POS T MEDICASTINUM
POSTPARTUM BLUES RESOLVE AFTER 2 WK SITS NORMA…START WITH A PD OF WEEPING ON 3RD DAY…AND PEAK BET 5TH AND 7TH DAY… SUPPORTIV ETHERAPY IS BEST…REASUURANCE PT EDUCATION I S GOOOD..
254..RESPERIDONE AND HALOPERIDOL IS GOOOD FOR ACUTE AGIATATION…
255… POST PARTUM PYCHOSIS.. BIZZAR PERSECUTURY DELUTIONS,GARDIOSE SOME TIME,THOUGHT DISORGINATION,MAIC S/S MAY B PRESENT THEY R INC RISK OF SUCIDE AND INFANTICIDE SO SEP THE CHILD AND TRETA TH E PT..HALDOL IS GREAT FAMILY THERAPY AND BEHAVIOR THERAPY AND REGULAR VISIT BY MENTAL HEALTH PPPL FOR F/U
256….SUPPORTIV E GROUP OR INDIUAL THERAPY IS GOOD FOR POST PARTUM PSYCHOSIS…237…JH REACTION IS COMMON AFTER TRETMENT OF SYPHLIS BY PCN IT CAN AS LATE AS 15 DAYS HEADCHE, FEVER
257…MYALGIA.HYPOTENTION IS COMON TRETEMNT IS SALICYALTE OR PREDNISONE FOR JH REACTION
258…URETHRAL PHARANGEAL AND CERVICAL SWOB FOR CULTURE INTRA CELULAR DIPLOCOCI IS POSITIVE.
259… THE MOST COMON CAUSE OF EPIDYMITIS IS CHALMYDIA TRACHOMATIS AND TREAT MENT WITHDOXYCYCLINE NSAIDS,ICE PACK,SCROTAL LELEVATION,RED AND TENDER SCROTUM AND PAIN MORE WITH ELEVATION OF TESTIS FEVER AND INC WBC…POSITIVE
260…DARK FIELD FO RPRIMARY SYPHILIS AND TREATMENT WITH 2.4 M BENZA THIN E PCN G
361…CRYO IS BEST FOR MOLUUSUCM AND GENITAL WARTS
362…ACYCLOVIR DEC VIRAL SHEDDING BUT RECURRANE IS STILL COMMON.
363..DEC LABIDO AND INHIBITED ORGASM WITH SSRIS..
364..COGNITIV EPSYCHO THERAPY IS BEST FOR MAJOR DEP..
365….ADJUSTMENT DISDORDER AND DEP MOOOD…TREATMENT IS COUSELLING ABOUT STRESS MANAGEMENT AND BREIF PSYCHOTHERAPY..
366…ATYPICAL DEP IS ASSOCIATED WITHHYPERPHAGIA AND HYPERSOMIA AND TREATMNT IS MAO BUT DON’T GIVE WITH SSRI DUE TO SEROTININE SYND..
367… IF LITHIM IS NOT INDICATE DOR NOT EFFECTIVE CARBAMAZEPINE AND VALPORETE IS NEXT BEST CHOICE,
368…10 YR WAS TALKING TO THE TEACHER AND SUDDENLY STOP TALKING AND STARTED STAING AT HIM FOR FE SEC ..GIVE ETHOSUXIMDE..ABSENCE SEIZURE
369…WITHDRAWL AND FLAT EFFECTAPATHY AND LACK OF MOTIVATION IS POOOR PROG …IN SHIZO
370… DELUSION AND HALUCINATION FOR MORE THAN I MONTH IS SHIZO
371..CATATONIC..RIGIDITY AND POSTURING…LORAZEPAM IS GOOOD
372..DEKUTIONAL DISORDER IS DELUSION WICH IS NON BIZZAR AND FOR I MONTH…NO DELUSION AND HALUCINATION OF GRANDIOSE TYPE…
373…BREIF PSYCHOSIS …IS LESS THAN I MONTH AND EVERY THING DELUSION HALUCINATION AND DISORIENTAION IS POSITIVE
374.. BIPOLAR 1 IS PT IS PYCHOTIC WHEN PT IS DEP OR MANIC N ORAMAL IN BET AND FUCTION G IS GRETA IN BET
375… HEROIN WITHDRAWL ..METHADON IS THE BEST
376….DON’T GIV E FLUMAZEMIL WHEN MIXED DRUG OVER DOSE OR TRICYCLIC BCZ INC CHANCE OF SEIZURE WITH THIS…
377.. DUAL DIAG IS A TERM WHEN THERE IS SUBSTANCE ABUSE AND ANOTHER PHYCHATRIC CONDITION POSITIVE
378…ADMIT TH E DRUG PROB AND FAMILY SUPPORT IS IST THING
379…LONG TERM INDIVUAL AND GROUP THERAPY
DETOX. AND PREVENTION OF WITHDRWAL IN DRUG TRETAMENT….DRUG ADDICTION.
380….OCD IS POSITIV E 25% IN ANOREXIA..BRADY CARDIA HYPOKALEMIA AND BODY WT IS LESS THN A 15 % OF TH EIDEAL WT OF THE AGE
381…PROZAC IS GRETA IN BING EEATING AND COGNITIV EBEHAV THERAPY
382….BUSPRION IS BEST FOR THE GENARLIZED ANXIETY DISORDER
383..SYSTEMI C DESENSTIZATION AND COGNITIV ETHERAPY FOR GAD..DURATION SHOULD B AT LEAST 6 MONTH..
384… FACTIOU S DISORDER …TO BEHAVE AS A SICK ROLE.. TO CAUSE PHYSICAL AND PYCHOLOGICAL S/S OF TH E DIESEE
385…SSRIS IS THE BEST FOR OCD CLOMI IS SALSO GOOODIN OCD
386..VIGINISMUS…DIF DILATERS IS THE TRETMENT
387…ERECTILE DYSFUNCTION IS MOSR COMMON IN ELDERLY AND CAUSE IS USALLLY ANTI HYPERTENSIV EAN DOTHERS MED..SO D/C MEDSAND CHANG EIT WITH OTHERS..
388…NO VIAGRA WITH ANY NITRATED LIFE THRETENING HYPOTENTION.
389..BRONZ BABIES IS ALSO DUE TO PHOTO THERAPY
390..FEVER MORE THAN 105 IN TH ELAST DPT DON’T GIVE THIS PERTUSIS JUST GIV E DT
391….MATICULUS HANDWASHING AND AVOIDANC EOF CONTACT WITH FACE OR NOSE IS THE BEST TO DEC THE SPREAD OF INFLUENZA
393..RSV PNUMONIA IS MOST COMMON UNER 5 YRS
394…NO ANTIPYRETIC IN THE HEAT STROKE
JUST COOLING MEASURE..ICE ON THE BODY..
394….FROST BITE….RAPID REWARMING WITH HOT WATER…
395…OSGOOOD IS INFLAMATION OF TIBIAL TUBERIROSITY INA RUNNNER BEST TRETAMENT IS REST AND STOP VIGROUS ACTIVITY
396…PATELOFEMORAL SYNDROM EI S MOST COMON CAUSE OFANT KNEE PAIN IN TH ETEENAGERS… TRETEMENT IS AGGRESSIVE ISO METRIC RESISTANCE EXERCISES
397..BRACES AND CASTING FOR 1-2 YR S FOR LEGGG PERTHESE DISEASE.
PINNING IS REQ IN SLIPED FEMORAL DISEASE COMON IN OBESE KIDS IN 10-14 YRS OLD AGE,
398…TOXIC SYNOVITIS…NON WT BEARING…REST IN BED..NSAIDS .NO ABX ..BCZ NO GRAM STAIN POSITIV EAND NO WBC INC..
399…AVASCULAR NEC OF TH EFEMOARL NECK ..LEG PERTHESE
400… THE MOST C C OF INTOWING IN KIDS IS ANTEVERTON OF FEMUR
WATCH FUL WAITING IS ENOUGH IN THIS…
401…UA IS THE IST THING IN ENURESIS PT …USUALLY EMOTIONAL…OR SEXUAL ABUSE
402…BEHAVIOR MODIFICATION IS BEST TRETEMENT FOR THIS ENRESIS..
403…REGWEED POLLLEN IS M CC OF ALLERGIC RHINITI SIN US
404..VASOMOTOR RHINITIS IS TRIGGGER BY SMELL ODOR RTEMPSPIY FOOOD..NASAL OBSTRUCTION IS TH EPRIMARY SYMPTOM…NO SNEEXING ITCHING AND RHINORREA…IN VASO MOTOR RHINITIS…
405…BEST TREATMENT FOR ALLERGIC CONJTIVITI SIS CROMYLN SODIUMTHE MOST COMON CAUSE OF RAGWEED I S POLLEN..
406…EXTENSER LESION WHICH R PRURITIC ECZEMATIC IS COMON IN KID WITH ATOPIC DERMATITIS…. FLEXER LESION IN ADULT
407..ENVIRONMENTAL PREVENTION ALL TH ETRIGGGERING FACTOR SHOULD B PREVENTED….. IN ATOPIC..FOOOD MILK EGGGD FABRIC .
408… WET COMPRESSES IS TH EIST TRETAMENT OF THE SEBORRIC DERMATITIS…
409…KETOCONAZOLE CREAM FOR DIAPER RASH
410…MUPURIINE IS BEST FOR INFECTED ATOPIC DERMITITIS
411.HYDROXYZINE ,BENADRYL FOR ITCHING IS BEST AND NO HOT WATRE BATH,,
412…SMOOTH TEXTURE COTON GRAMENTS AND REGULAR FARMULA IF ALLLERGIC TO COW MILK…
RICE ALLLERGY IS THE LEAST ALLERGIC IN FOOOD SO USE
413..POSITIV EAND NEGATIV E PREDICTIV E VALUE DEPEND ON PREVALENC E OF TH E DIASESE
SAMPL ESIZE IS MOST IMP FACTOR IN THE SUCCESS OF ANY STUDY..
414..BICONCAVE AND FISH MOUTH VERTEBRA IS CLUE TO SICKLE CELL DISEASE
415
IN SICK TRET AGGRESSIVE FLUID //O2 AND PAIN CONTROL WITH NORCOTIC…AND GIVE INF AND PNUMOVAC AND PCN FOR INF…
416….SESSIL E LESION R MORE LIKE LY TO BECOME MELIG THAN PEDUNCULATE DONE..
417..ECOLI AND B FARI GALIS IS MOST C ORG IN THE DIVERTICULITIS
418….LEFT COLON CA,,CHANG EIN VBOWEL HABIT/WITH PENCIL LIK E STOOOLGROSS BLOOO DIN STOOOL.OBSTRUCTIVE S/SIN COLON CA
419…IN RT COLON CA….DIRREA MUCUC AND BLOOOD IN THE STOOL BUT OCCULT..ANEMIA.PALPABLE ABD MASSDYSPEPSIA…
420..CA OF RT COLON IS COMON IN WOMEN AND COLORECTAL CA IS MORE IN MEN..
421….ADENOMATUS POLYP SHOULD B REMOVED IF NOT BY COLONOSCOPE THEN BY LASERS ORLAPROTOMY..BC ZTHEY R MELIGNANT
422…INFILTRATING DUCTAL CA IS MOST CA..IN BREAST
423…MAMO IS T THEN BIOPSY
424… PREMENOPASAL AND POST MENOPAUSAL IF ER POSITIVE GIV ETIMOXIFEN
425…FIBROADENOMA IST FNA
426.. PAIN IN TH EBERAST I WK B4 MENSES IS FIBROCYSTIC DIEASE AND RECHECK PT AFTER 6 WKS I STH EBEST
427…LUMPECTOMY AND IRRAIDIATIONIS BEST AND MRM ONLY WHEN NIPPLE AND SKIN INVOLVED
427… KI RAS GENE …CA PAN…19-9 IS ALSO FOND IN TH ECA PAN CT IS TH EBEST..
428…PT LIE FLAT AND PUT OBJECT UNDER NECK OR UNDER BACK WILL RELIEVE PRESSURE…
429… PAIN FUL LEFT EYE WITH BLURRED VISION AND AND SHE WEARS CONTACT LENSES… HEPETIC CORNEAL ULCER…
430…UNILAT MUCUPURENT DISCHARGE IS BECT CONTUTIVITIS……NORMAL VISION IS POSITIVENO STAINING OF CORNEA ON FLUROCEIN WHIL E GREEN STAINING ON STAINING WITH FLUROCEIN IN HERPETIC ULCER
431..NO ABX IN VIRAL AND BEC WITH SULFACETAMIDE EYE DROPS…OR GARAMYCIN…
432…STAPHLO STREPTP MOST LY AND ADENO IS TH ECAUSE OF VIRAL..
433.ITCHY RED EYE IS ALLLERGIC CONJUCTIVITIS….TREATMNT AVOID ALLERGENS.IMUNOTHERPY.CHEMOSI S IS WITH ALLLERGIC CONJECTIVITIS…
434…EPISCLERITIS PT HAS A RED ,SORE AND TENDER EYE THERE MAY B REFLEX LACRIMATION,UT NO DISCHARGEITS COMON IN AUTOIMUN E DISEASES LIKE RA SLE
435…SCLERITIS IS MOR EPAINFUL EYE THAN EPISCLRTIS…
436….DAMOX OR TIMOLOL IST IF EYE IS PAINFUL AND HARD TO TOUCH AND SUDDENLOSS OF VISION WITH HAZY STEAMY CORNEA…ACUT ECLOSE ANGLE GLAUCOMA…LASER IREDECTOMY LATER..
437…MRIS IS BEST FOR DISC HERNIATION…
438…WHILASH IS MOS C INJURY….
439…UPPER 2/3 OF TH EURTER STONE ESWL….
440…IF STONE R LESS THAN 2CM AND LOCATED IN UPPER POLE OF TH E KIDENY ESWL IS TH EBEST… IF STON EIS MORE THAN 1 CM AN DLOCATE DIN LOWER POLE OF KIDNEY THEN COMBINED ESWL AND PERCUTANIOUS NEPHROLITHOMY…
441…MOS C TUMOR INMEN IS PROSTRATE AND MOST COMMON CAUS EOF DEATH IS LUNG
MOST COOMN CA IN FEMALE IS BREAST AND MCC OF DEATH IS BREAST CA
442..MOST CC O F DEATH FROM GENITAL CA IS OVARIAN CA
443…BEC PROSTITIS MOST CC IS ECOLI AND AND KLEBSELLA BACTRIM IS BEST
44.4….SWOLLEN TENDER BOGGY PRSTATE DON’T MASSAGED
445..BACTRIM AND CIPRO IS BEST FOR PROSTIOTIS..
446…MENNERES DIEASE..A MIDDLE AGE WOMNE WITH TINITIS HEARING LOSS AND VERTIGO….FLUCTUATING SENSONURAL LOSS.AURAL FULLNESS IS A CLUE…HCTZ,CHOLORPROMAZINE…
447…BREIF VERTIGO OFTEN POSITIONAL FINISHED BY FIXATION TO A POINT IS BPPV
448…. RATATORY HORIZONTAL NYSTAGMUS IS CH OF BPPV
449…AMOXICLIIN FOR 100 DAYS IS BEST FOR ACUT E SINUSITIS
450…FRONTAL SINUSITIS IS SERIOUS..
451… REASSURANCE AND SIMPLE EXERCISES IS GOOD FOR BPPV AND ACUTE ATTACK NEED BEZO DIAPINE AND LOW SALT DIET
452..VSTIBULAR NEURITIS IS MOSTLY AFTER URI…DOESN’T INVOLV E CHOCHLEAATAXIA N/V POSITIVENO AURAL PAIN,NO HERAING LOSSS RECOVERY USUALLY TAKES I .2 WKS..
453…. THICK AN D GREENISH DISCHARGE IS BEC T SINUSITIS..GIVE AMOXICILIN FOR 10 DAYS
454..BEC SISUSITIS MOST CC IS STAPHLO AURIUS
455..MASTOIDITIS IS CAUSED BY TH E STREPTO PNUME..
456…ACTE LABYRINTHTIS…NEED REST,ANTIEMITIC AND ANTIBOITICS,,AFTER URI MOST COMONHAVE MIDDLE EAR EFFUSION CHEMICAL IRRITATION OF INNNER EAR..
457..NORTRIPTALIN EIS BEST TRICYCLIC IN ELDERLY
458…ACH DEFICENCY IS COOMON IN ALZIMERS..APO E4 POSITIVE AGE IS TH EMOST COMON RISK FATOR
459..DONEZEPIL IS BEST IST FOR ALZIMERZ
460…DELIRIUM IS MOST COMON MENTAL DISORDER IN HOPSITAL
PROG MMEORY LOSS IST IN ALZIMERZ
461…DELUSION HALUCINATION AND LOST INTERST IN DAILY ACTIVITY VISEOSPATIAL DISTURBANCES LANGUAGE IMPAIRMENT ALL IN ALZIMERZ…
462…DISORG SLEEP WAKEFUL CYCLE OIS PATHOGONOMIC OF DELIRIUM..
463..PMR NO ALDOLASE HIGH NO CPK HIGH N MUCLA BIOPSY NORMAL ONLY INC ESR AND PAIN IN SHOULDER AND HIP…ASSOCIATE DWITH TEMP ARTERITIS…
464..ORAL PREDNISON E 10-20 I S BEST FOR PMR AND 60 MG OF IV IS FOR TEMPORAL FOR ATLEAT I YR
465,,SYSTOLIC ELVATION IS DANGROUS AND SHOUL DB TRETAED
466..SYNCOPE IN ELDERLY IS SEC O THEIR MEDICATIONS…
467..COUGH AND LOSS OF TASTE AND I NC K WITH ACE..
468…FGIVE LOSARTAN IN COPD IF EJECTION FARCTION IS LOW..BCZ OF COUGH OF ACE…
469…DEPRENYLE EARLY WILL DEC THE DISABLITY IN PARKINSON
470…DEP IS COMMON PROB IN PARKINSONS
471…BENIGN ESSENTIAL TREMORS NEED BETA BLOCKERS
472..DRE TO CHECK IMPACTED STOOL IN CONSTIPTAION PT
473..CAP REQUIRES..ERETROMYCINE,ZITHROMAXAND CLARITHRO MYCIN…
474…RELAPSIN UTI IN TH EMALE IS DUE TO CH PROSTITIS…
475..CUTUR THE PROSTARTE SECRETON IS DIG IN PROSTITIS.. ECOLI IS MOST COMON CAUSE IN CH AND CHALMYDIA IS MOST COMON IN ACUTE PROSTITIS…
476..INF VAC IS EFEFCTIV E AGAISNT BOTH A AND B TYPE..
477…H INF VAC IS LEAST EFEFCTED IF CD 4 IS LESS THAN 100…
VAC AND AMNTADINE IS GOOOD TO CONTRAL INF ..
478..HEADACH FEVER CHILLS MYALGIA..COUGH AN DCONGESTION IS INFLUEZA..
479…AMENTADINE IS 70 TO 80 % EFFECTIVE AGAIST INF A
480… ASYSTOL DIRETLY LEADING TO DEAT…
481…ATROPINE UP TO 4 MGAND THEN TC PACER AND THEN TV IF NOT EFFECTIVE ATROPINE..IN SYMPTOMATIC BRADY PT
482…V FIB SIST 200.300.360
SAM EIN PULSE LESS VTACH
483… THE BEST SUCCESS WITH CPR IS WHEN IT STARTED WITH IN 3 MINUTES OF C ARDIAC ARREST..
484..ONE ASYTOLE PROBABLITY OF SUCCESS IS ZERO
485…DOOOR TO NEEDLE TIM EFOR CLOT DISSOLVING IS WITH IN 30 MINUTES
486..16 G IS THE BEST FOR RESUSITATION.487..TH EMOST COMON ERROR IN ER IS AIRWAY MANAGEMENT
487…BEST THING TO CHECK IF PT IS ADEQUATELY PERFUSING IS CHECK UOP
488..INFECTION IS TH ETRIGGERING FACTOR IN DKA
489…THERE IS NO KETONES IN NKCOMA…
490…SERUM K IS ELAVTED DESPITE TOTAL K IS LOW IN IST PHASE OF DKA…
491..SPOT BLOOOD SUGAR WILL B ABNORAL TO GREATEST DEGREE IN DKA
NS IS TH EBEST FLUID IST BUT WHEN GLUCOSE REACH 250 ADD D5W…
492…GIVE MAG AND PO4 AND CHECK K EVERY 2 H…
493…KAUSSMAL AND SWETING AND ACETON E BREATH AND UTI OR ANY OTHER INFECTION WITH SUGAR OF 400 IS SKA
494…GIVE 10 UNIT OF REGULAR INSULIN S/Q B4 U D/C PUMP …
495..TURN OFFF PUMP WHEN ABG SHOW S CLOSURE OF GAP..
496..ABDOMINAL PAIN CT IS BEST
497…80% OF AAA R ASYMPTOMATIC AND MOST CC IS ATHEROSCLESIS..
498..DON’T GIVE N ACETYLECYSTEIN AND ACT CHORCOAL TOGTEHER DEC ABSORBTION 2 H AFTER OR 2 H B4
499…70%SORBITOL IS GOOOD TO GIVE WITH THEATIVATE D CHORCOAL…
500..NO CHORCOAL ..IN LITHIUM ,IRON,ETHANOL METHANOL AND HYDROCRBON
501…THROUGH WASHING OF WASHING WITH TAP WATER IF ALKALI SPILLL THEN ER …
502….ETHANOL IS GOOO D FOR ANTIFREEZ AND MATHANAL
503…HIT MOST COMON COMPLICATION IS THROMBOSIS JUST LIKE ANTI PHOPHO LIPID ANTIBODY AND IN LUPUS ANTI ANTI COAGULANT…
504…AST IS RANSON CRITARIA NOT ALT AND AYLASE IS NOT A CRITARIA…
505..EXOPHTHALAMOS.ABSENT RED REFLEX AND LEUKOCORIA IS DEFINARELY RETINO BLASTOMAA.
506..NSAID AND STEROID IS TRETAMENT FOR J H REACTION WHICH CAUSE HEACHE FEVER N V MAYLGIA…IN SYPHILIS TRETMNET
507..BEC VIGINOSIS I S MOST COOMON VIGINAL DISCHARGE AMINE OR WHIP TEST POSITIVE .CLUE CELL IS A CLUE PH IS MORE THAN 7.4
508…CAT SCRACH BITE NEED THE AUGUMENTEN..LIKE ALL OTHER BITES DOG AND HUMAN
509…PALPABLE THROMBOTIC CORD IN A UNILAT SWOLLEN RED AND WARM LEG IS DVT START HEPARIN…ESP IF IT IS PROXIMAL DOPLLER US AND D .DIMER IS DIAG
510..LGSIL HGSIL BOTH NEED COLPOSCOPY
511..CONIZATION SHOULD B INDICATED IN ANY OF THESE….TRANSFORAMTION ZON E IS NON VISULIZED…PAPSMERA IS WORSE THAN BIOPSY
..PAPSMEAR SHOWING ADENO CA…BIOPSY SHOWING MICRO INVASION….POSITIVE ENDO CERVICAL DISCHARGE..
512,,,,PAP SMEAR IS UN SATISFACTORY IF ENDOCERVICAL CELLL S R OT SEEN
513…ARTERIAL CLOTS R POSITIV EIN ANTIPHOSPHLIPID ANTIBODY.HIT,LUPUS ANTICOAG ANDANTICARDIOLIPINS NATOBODIES,HOMOCYSTONURIA.FACTOR 2 ABNORMALITY
514….U DON’T HAV ETO MONITOR DIG LEVEL WHEN PT IS TRETAED FOR A FIB…AMIDIARON VERAPAMIL AND QUINIDINE INC THE LEVEL…
516…..IN KIDS THERAPETIC DOSE OF DIG IS 4 NGM NOT 2 LIKE ADULT AND VOMITTING IS A CLUE TO TOXICITY AND IN ADULT CONFUSION AND PALE DISCOLURATION IS EARLY SIGN
517…HRT IS GOOOD TO PROTECT FROM HEART DISEASE WHICH IS NUMB I KILLER IN US IN BOTH SEXES..
518… HRT IS GOOOD AGAIST HEART DIEASES AND OSTEO AND MENOPUASAL SIGN SYMPTOM ..NO PROVEN STUDY IS YET TO PROVE THAT IT CAUSE BREAST CA
519..U MUST TELL THE PT THE RISK AND BENEFIT OF CPR WHEN U R TALKING ABOUT DNR..
520..PT CAN ALWAYS CHANGE HER LIVING WILL EVEN VERBALLY IN A SEC…
521…IF SON IS 27 AND DONATED ORGAN 10 YRS AGO AND PARENTS DDONT KNOW U MUST TALK TO PARENT AS A PHYSICIAN…THAT THIS IS WHAT UR SON WANTED…
522…IF U INTUBATE THE PT AND DNR IS PROVED EXTUBATE THE PT IMIDIATELY
523….IF U INTUBATE D PT AND SON CALLLED FROM NY THAT MY FATHER IS DNR AND I HAV E HIS LIVING WILL WHY U INTUBATED HIM…ASK SOCIAL WORKER TO CHECK THE VALIDITY OF THE LIVING WILLL AND IF OTS LEGAL THEN EXTUABTE THE PT….
524…IF UT IS NOT REMOVED AND INTACT THEN ALWAYS GIVE ESTROGEN AND PROG EVERY DAY TO DEC THE CHANCE OF ENDOMETRIAL CA…IF PT HAS NO UTERUS THEN ONLY ESTROGEN
525…IF PT IS IN REPRODUCTIVE AGE AND HAS ENDOMETRAIL CA THINK OF POLYCYSTIC OVARIAN SYNDROME BCZ ANOVUALTION CAUSE LACK OF PROGESTRON AND THIS UNAPPOSE D EFFECTOF ESTROGEN LEADS TO ENDOMETRIAL HYPERPLASIA…
526…SIADH..NEVER GIVE 3% SALINE UNLESS PT IS NOT SYMPTOMATIC FROM LOW SODIUM OTHER WISE JUST WATER RESTRICTIONIS BEST FOR CHRONIC CONDITION GIVE DEMECLOCYCLINE…
527…BRAIN DEATH ….MUST MAKE SURE PT IS NOT HUPOTHERMIC TEMPP SHOUL DB ABOVE 32 ATLEAST
528..AT 30TEMP PT CAN HAVE V FIB…
529…ANAPHYLACTIC RESPONSE IS DUE TO IGA DEFICIENCY AS IN CASE OF IVIG IF U GIVE AND PT HAS ANAPHYLAXIS THIS IS THE IGA DEF..
530…PHYCHOTIC DEP AND WHEN SSRIS OR TRICYCLIC IS NOT INDICATED THEN ECT IS BEST…TRANSIT MEMORY LOSS IS MAJOR SIDE EFFECT
531…WET MOUNT FOR TRICHOMOSIS AND BV…FLAGYL IS GOOD IF PREG CLINDA CREAM AND ZITHROMAX IS GOOOD..
532…C DIFFF IS BEST TREATED WITH FLAGYL AND VANC O ONLY IF ITS NOT EFFECTIVE
533..STOP… SALICYLATE 10 DYAS B4 SURGERY AND OCP I MONTH BEFORE..STOP COUMADIN 48 H B4 AND HEPARIN 4 H B4…
534…IF PT IS GOING FOR SURGERY AND INR IS MORE THAN 4 THEN GIVE FFP….IN NON EMERGENT SITUATION GIVE VITA K..
535…IN TORSEDESPOINTS…. GIVE MG SO2 IST IF NOT EFFECTIVE THEN GIV EISOPROTERENOL DRIP…OR PACING…BIT NOT QUINDINE OR PROCAINAMIDE THEY PROLONG QT FURTHER
536…C PERTIDE IS INC IN INSULOMA BUT DEC IN FALSE HYPERGLYCEMIA SEC TO SELF ADMISTRATION OF INSULIN…TO CREAT HYPOGLYCEMIA..
537…CUSHING….IST DO FREE CORTISOL IN SERUM IF IT IS MOR ETHAN 100 CUSHING IS POSITIVE
538…CLOZAPINE CAUSE AGRANULOCYTOSIS SO CHECK CBC OFTEN
539…TICLODIPINE CAUSE THE THROMBOCYTOPINIA…SOGIVE PLAVIX IFPLATELETS R LOW..
540…GIVE INF V AND AMANTADINE ,,,FOR MAXIMUM EFFICACY
AMNTADINE IS ONLY EFFECTIVE AGAIST HEMO INF A NOT B AS VAC…
541…HEINZ BODIES IN G6PDEFICIENCY …DON’T GIVE BACTRIM,DAPSON,PRIMAQUIN,THIAZIDES,SULFA
542…IF PT HAS PCP AND SULF AALLERGY THEN GIVE ATOVOQUIN,,
543..IF PTT IS PROLONG ANDFFP IS NOT WORKING THEN DO MIXING STUIES
544..FACTOR 13 DEFICIENCY BLEEDING IS SEVER BUT STILL NORMAL COAGS..
545..FACTOR 12 DEFICICEY NO BLEEDING SO PT CAN GO FOR SURGERY SAFELY
546..DIRETIC CAUSE CONTRACTIONALKALOSIS..547..CAP…STREP PNUMO…GIVE ERYTHRO ,ZITHRO,CLARITHRO ANY MACROLIDE WILL DO IT..RESISITANT CASES GIVE LEVAQUINOR CEFTRIOXNE
547..RAPI DSTREP POSITIVETY GIVE PCNV…IFNOT WORKING GIVE BRAOD SPECTRUM.
548…HETROPHILE IS NOT POSITIVE UNTIL 2-3 WK AFTER IM STARTS
549…HEPZES V 8 CAUSE KAPOSI…FOR FLAT WARTS GIVE 5 FU AND INDUATRED WARTS DO CRYO WITH LIQ HYDROGEN
550…HEP A IS THE MOST COMMON VAC THEY NEED WHEN GOING ABROAD..
551..CMV RETINITIS…NEED GANCICOLOVIR…CHECK CBC IF RESISTANT THEN FOSCARNET
552..PSA AND DRE IS SCREENING A T 50 YRS OLD MAN FOR PROSTATE CA
553…IF PSA IS MORE THAN 4 THEN TRANSRECTAL BIOPSY..
554..IF CA OF PROSTATE IS IN BONE ACID PO4 WILL RISE..GIVE LUPROLIDE AND FLUTAMIDE..
555..INC ALPHA FETO PROTEIN IS IN C IN EMBROYNAL AS WELL AS HCG ALSO INC..
556..DITAL RADILA FX IN KIDS WHO FALL ON OUTSTRECHED HAND IS A MED EMERGENCY AND NEED ORIF ASAP…557..SILVER FORK DEFORMITY COLLLES FX…NEED CLOSE REDUCTION AND LONG ARM CAST…MEDICAN N IS EFFECTED..DITAL RADIAL FX IT IS…
558.AI IS WITH MARFAN AND AORTIC DISECTION…CT WITH IV CONTRAST IS BEST…
559…STEEPLE SIGN IS IN CROUP..PIV..COOL MIST O2 AN D SEVER CASES NEED RACEMIC EPI AND STEROID…
560…HYDROXYUREA INC HB F SO ITS USEFUL IN THE SICKLING..
561…IF LITHIUM CAUSE HYPOTHYROIDISM DON’T DC MED JUST ADD SYNTHYROID WHEN U HAV ETO GIVE STERIOID AND SUNTHYROID ALWAYS GIVE IST CORTISOL THEN SYNTHYROID..JUST LIKE U GIV ETHIAMINE IST THEN GLUCOSE…
562..HB .H 3 ALPH A GENE R DELETED AND IN HB BART AL 4 R MISISNG…
563…MELIG HYPERTHERMIA GIVE DENTROLINE SIDE EFFECT IS MUSCLE WKNESS. IT IS AUTOSOMAL CONDITION AND NEED AVOIDANC EOF ALLL INHALATIONAL GASES AND SUCCINYCHOLINE..
564..NO SUCCINYCHOLINE IN THE SPINAL SHOCK PT AND IN BURN PT BCZ IT INC LIF ETHRETENING K ..
565…IF LOER GI IS NOT STOPED AND OT IS UNSTABLE PARTAIL COLECTOMY IS GOOOD..
566..IF P IS BLEEDING NUCLEAR SCAN WITH TAG RBC
567..INTUABTE THE PT IF PCO2 IS MOR ETHAN 50 AND PO2 IS LESS THAN 50..
568…IF PROLATIN INC ON FINDING THE CAUSE OF SEC AMNEREA DOTHEMRI TO C THE TUMOR…THENGIVE BROMO IST TO DEC THE SIZE JUST LIKE WE GIVE LEPRON TO HSRINK THE FIBROID ..
569…URGE INCOONTINCE I SMOST COOMON IN OL DAGE AND IT DUE TO DETRUSOR HYPERREFLEXIA..ANTICHOLINERGIC IS BEST
570..SEXUAL ABUSE AND AFTER MULTIPLE CSECTION AND VIGINAL SURGERIES STERSS INCONTINCE ,,HRT IS GOOD IN THAT,,,
571…CAMPING DIRREHEA IS GIARDISIS WATERY DIRREA AND GIVE FLAGYL LOPERAMIDE…572…CT WITHOUT CONTRAS T IF HEAD TRUMA TO R/O IN BLEED
572….ANY STROKE DO HEAD CT TO R/O INB SO U U CAN START TPA IF PT CAME LESS THAN 3 H AGO WINDOW PD FOR AMI IS WITHIN 3 H…BEST IS WHEN ITS LESS THAN 60 MINUTES..
573…KAWASAKI GIV EIVIG AND ASP AND CALL CARDIO TO DO AN ECHO TO C CA ANURISM
574…RASH IN IM IS DUE TO AMPICILLLIN IT WILL GO AWAY DON’T HAV ETO DO ANY THING…
575..MRM WHEN SKIN AND NIPPLE INVOLVED OTHER WISE ANY MELIG MASS NEED MASTECTOMY ANDIRRADIAATION
578..IF PT HAS MELIG OR BED RIDDEN ANTICOAG FOR LIFE OTHER WISE AFTER DVT JUST FOR 6 M..
579…HYDRATION AGGRESSIVE ONE AND FRUSAMIDE AND MANITOL IS BEST TREATMENT IN RHABDO…
580…BENIGN CYSTIC TERATOMAA IS MOS COMMON BENIGN TUMOR IN OVARY
581…24 H METANEPHRINE AND CATHACHOLAMINES AND CT ..IN CASES OF REFRACTORY NEW HTN AND HYPERGLYCEMIA SWEETING HEADACHE…
582…CORPUS LUTAL CYST IS MOST COMON WITH NEGATIVE PREG AND ABDOMINAL PAIN AND MASS IN ADNEXA…
583..IF BHCG IS LESS THAN 1500 TVUS FOR ECTOPIC AN DIF IT IS MORE THAN 6100 TRANS ABDOMINAL US IS GOOD
584..IF ECTOPIC IS LESS TAN 4CM AND PT IS STABLE WITH LESS PAINAND VITRALS R OKAY THEN GIVE METHOTREXATE…
585..CHECK BASAL MAMO AT 35-40 YRS OF AGE AND BET 40 –50 EVERY 2 YR MAMO AND AFTER 50 EVERY YR
586…IF PT HAD CA IN BREATS THEN CLINICAL EXAM IS 4-6 MONTH AND BREAST SELF EXAM EVERY ONTH AND MAMO EVERY YR
587…IF PT IS HYPOGYLEMIC D 50 IS INDICATE DAND IF CANT DRINK GLUCAGON IS EFEFCTIVE..
588…NO FLORINATED TOPICAL STREOID IN ROSEEA..IT PPT IT METRO GEL IS BEST…TETRA IF REFRACTORY
589…VILLOU SADENMOA REQ RESETION WITH COLONOCSCOPY OR LASER OR OPEN SAME IS FOR OTHER PREMELIGNAT SESSILE LESION
590…LEVEL OF DEPTH OF INVATION IS THE PROGNOSTIC IN MM…
591..IF BLEEDS OR CHANGE COLOUR SOR ITCH PUNCH BIOPSY…BIOPSY FROM CORNER IS A LOT BETTER THAN CENTER
ACTINIC KERATOSIS …NEED CRYO ITS PREMELIG TOOO CASE SQ CELL CA
592…IND ING H ORIGINATE AT DEEP ING RING AND IT IS LAT TO IEPIGASTRIC A
593….BHCG IST THEN PROGESTRON CHALLENGE IF SEC AMONRRHEA…IFIT IS AFTER DAND C THEN ASHERMAN SYNBNDROM EIS THE CAUSE..IF PROGESTRON CAUSE BLEEDING IT MEAN ENOUGH ESTROGEN IS POSITIVE IF NO BLEEDING THEN GIV E HUMAN G HCG….
594….REPEATED NEEDLE ASP AND ABX FOR 6 WKS IS GRETA IN SEPTIC ARTHRITIS NO INTRA ARTICULAR STEROID …
595…JUST IN CASE OF DONOCOCAL FEPTIC ARTHRITIS DON’T DO THE ASP BCZ WBC IS NOT LESS TAN 50 USUALLLY AND ANTIB IS ALL THAT PT NEED CEFTRIOSONE IV ..
596…PHYSIOLOGICAL JAUDNACE DIRECT BILI IS LESS THAN 2
597…IF URINARY INF OR OBSTRUCTION DO THE UA AND RENAL ULTARSOUND..
598..FLUID DEFICIT SHOULD B REPLACED HALF IN IST 24H AND REST IN NEXT 24 AND 48 H..
599…DON’T TOUCH THE HEMARAGIC BLISTER BUT PEEL THE WATERY ONE…PCN AND TETANUS REQ IN FROST BITE ..RAPID REWARMING WITH WATER IS BEST
600..TGV..IS MOST CC OF EARLY CYANOSIS AND INC VASCULAR ITY ON CXR AND RVH AND RT VENT HEAV E POSITIVE…601..THE MOST CC OF CYANOSIS IN LATER PF IS TOF…
602…C JUJINI …INC PD IS MORETHAN 16 H AND TRET WITH ERYTHRO…
603…SQUATING IN C IN PVR AND HELP IN THE HYPOXIC SPELLS IN PT WITH TOF…
604…. NO DIG OR DIURETIC IN HCM.,, BB AND CA CHENAL BLOCKERS R GOOOD NO NITRATE EITHER..
605…2 H POST PONRAIL TEST IN THE POST PRTUM VISIT TO MAKE SUR E PT IS NOT DIABETIC AFTER PREG AND GLUCOLA 50 G IS AT 28 WKS AND IF IT GIVES MORETAHN 140 GLUCOSE TEHN 3 H GGT..
606…TL IS DEC IN PREG M AND TV IS INC..
607..GULLAN BEERY ASCENDING PARALYSIS AFTER H INF VACCINATION OR ECOLI INF … GIVE IVIG OR PLASMAPHRESIS AND VENTILATION IS TO WATCH IN ACUTE CONDITION… AND RECOVERY IS DECENDING ORDER …
608..NC S AND DTR…NO DTR AND SLOW STUDIES IN GBSYNDROME
609… PT WITH CARPEL NEED SPLINT AND NSAID AND SURGERY ONLY REFRACTORY..NCS IST…
610..OLIGOCONAL BAND OF Igg IS DIAG OF MS IN CSF..IV METHYLPREDNISOLONE IN ACUTE CASES MRI IS TO F/U
611..CHEMIAL CONJUCTIVITIS IS USUALLY DUE TO SILVER NITARTES DROPS..GIVE ERYTHRO ORALLY..
SAME FOR CHALMIDIAL CONUNTCIVITIS..
613.. JUST MASSAGE IS ENOUGH IF DACTROCSTSTIS IS MILD…
614..NO DIURETIC AND ACE IN PREG..
615..PHOTOTHERAPY FOR SEASONAL DEP..
SSRI IS BEST FOR BULIMIA WITH COG THERAPY
GROUP THERAPY IS BEST FPOR ALCOHOLICS AND GRUG ADDICTS AND SEXUAL ABUSE
616.T4 LEVEL IS GOOD FOR C SECTION AFTER SPINA ANESTHSIA..
617…COCAIN OD ….BEHAVIOR MODIFICATION THERAPY…
618…PTU IS SAFE IN PREG AND DO THE SUBTOTAL THYROIDECTOMY IF HAV ETO BUT NO RAI…IN PREG..
619..IST BLOOOD CULTURE AND THEN DO ABX THERAPY LP CAN WAIT BUT ABX CANT V IMP CHAINOF ACTIONALWAYS IN EXAM
620…DO LPIF MOM IS SAYING NOIF UHAVE TO SAFE THE LIFE
621..SPINAL REFLEXES IS STILL POSITIVE AFTER BREAIN DEATH..
622…GASTRODUDINAL A WILL CAUSE BLEEDING IN PERF PEOTIC ULCER
623..FIBEROADENOMA FNA..FIBROCYSTIC CALL PT AFTER MENSES
624…INC PROTEIN BUT NOT IN LYPHOCYTES TUPICAL OF GBS..
625..CROSS TABLE LAT XRAY IS IST FOR AAA…
IF PT HAS CAD AND AAA FIX HEART IST BCZ AMIIS MOST COMMON CAUSE OF DEATH IN ALL VASCULAR DIEASE
627….MASTITIS,,,CONTINUE BREASTFEEDING AND GIVE NAFCILLIN…
628,,,DUURESIS AND ALKALIN ETHE URINE IN SALICYLATE POISIONING…
629..BLOODY DISCHARGE FROM NIPPLE IS INTRADUCTAL PAPILLOMAA.
630..H/OFBREAST TRAUMAA FAT NECROSIS ITS PAINFUL AND WILL DISSOLVE SO WATCHFUL WAITINGIS ALLTHAT IS REQ
631..PHYNTIN SHOUL DB GIVEN SLOWLY BCZ OF SEVER HYPOTENTION….
632… OXYTOSIN CAUSE HYPOTENTION WHILE METHERGIN EIS CAUSING HTN
633..ALWAYS IST LIFE STYLE MODFICATION IN GERD AND OA,AND HTN..
634 IF BPIS HIGH LIKE 180/110 IST READING IS MAKING THE PT HYPERTENSIV ESO TERAT IT GIVE COLINIDINE IF PT IS ELDERLY OR ALCOHOLIC.
635…NO VIGINAL EXAM INPLACENTA PREVIA ULTRASOUND IS GOOOD TO DIAG AND NO THRAOT EXAM IN EPIGOTITIS IN WHICH HIGH FEVER DROOLING AND INSPIRATOR STRIDER INTUBATION IS REQ… LAT NECK XRAY..
636…AFTER AAA MOST COMON CAUSE OF GI BLEEDS IS MESENTRIC ISCHEMIA…IF LDL IS MORE THAN 180 AND 2 RISK FACTOR START ON MEDS AND DIET
638 GIVE ROLAXIFEN FOR OSTEPOROSIS..IF RISK OF ENDMET CA OR BREAST CA…
639…IF BREAST CA AND SUPRACLAVICULAR NONEDS R POSITIVE ITS CLASS 4 ALREADY..IF LOBULAR CA 50% ITS BILATERAL…IF NODES POSITIVE EVERY ONE WILL GET ADJUVANT THERAPY
640….ITP FIRST TREATMENT IS STEROID IF FAIL SPENECTOMY IF BOTH FAIL CHEMO IN CASE OF BLEEDING IVIG. THIS WILL BLOCK THE FC RECEPTORS OF PHAGOCYTOS CELLS AND USED FOR EMERGENCY BLEEDING ONLY.
641… DANEZOL WORK BY DECREASE THE NUMBER OF PHAGOCYTOUS CELL FC RECEPTORS.
642…. LOVENOX CAN BE SELF MINISTERED BY PATIENT AT HOME. START WARFRIN ON DAY ONE OR TWO OF LOVENOX. . CI OF LOVENOX PUD SYMPTOMATIC PE CURRENT ACTIVE BLEEDING FEMILIAL BLEEDING DISORDERS, KNOWN DEFICIENCY OF AT3, PROTEIN C,PROTIEN S, NONCOMPLIANCE PREGNANCY, MORE THAN TWO EPISODES OF DVT OR PE
643.. RECURRENT DVT OR PROSTHETIC HEART VALVE- INR SHOULD BE 3.0-2.5. NO WARFARIN IN PREGNANCY DUE TO NASAL HYPOPLASIA AND CNS ABNORMALITIES- FLAGYL AND SULFONOMIDE INCREASE WARFERANE LEVEL BARBITURATES, CARBOMESAPYNE, RIFAMPIN DECREASE WARFERANE LEVEL. OCP SUCRALPHATE FRISEOFULVIN AND VIT. K, SETEROIDS AND SPIRONOLACTONE
645…LOVENOX IS GOOD BECAUSE NO PTT CHECK MORE PREDICTABLE RESPONSE BETTER SAFTY PROFILE EASY ADMINISTRATION LESS TIME IN HOSPITAL. PROTEIN S DEFFICIENCY IS MORE COMMON THAN AT 3 AND PROTEIN C . AT3 DEFFICIENCY OCCUR IN NEPHROTIC SYNDROME AND ARE RENAL VEIN THROMBOSIS AND OTHER DVT.
646..MIXING STUDIES WILL NOT HELP TO DECREASE THE PTT IN CASE OF LUPUS ANTICOAGULANT, RECURRENT ABORTION AND THROMBOSIS RISK NEED HEPRIN.
647.. CRYOPRECIPITATE CONTAIN FACTOR 5,8, 13 VWF AND FRIBRINOGEN
648.. FFP CONTAIN ALL FACTORS EXCEPT 5 AND 8.
649.. THE MOST C.C OF DELAY POST OP BLEEDING IS FATCTOR XIII DEFICIENCY ALL CLOTTING TESTS ARE NORMAL IN THIS CASE AND UREASE CLOT SOLUBILITY TEST IS POSITIVE. FFP IS THE BEST TREATMENT.
650.. VON WILLEBRAND DISEASE PROLONGED BLEEDING TIME NORMAL PTPTT. BECAUSE VWF IS IMPORTANT IN PLATELET AGGREGATION AND FUNCTION AS CARRIER PROTEIN FOR FACTRO VIII . IF MINOR BLEEDING GIVE DDAVP AND FOR FACTOR 8 CONCENTRATE OR CRYO FOR SEVERE BLEEDING.
651..GVHD- SINE SYMPTOMS RASH DIERREA LIVER PATHOLOGY CMV INFECTION NEED IRRADIATED RBC.
652.. CML- LOW LAP, VITAMIN B12 INCREAE WBC MORE THAN 100000 GRANULOCYTED FOUND IN ALL STAGES OF MATURATION PLATELET MORE THAN 400000 IF SMALL SPLENE GOOD PROGNOSIS IF PATIENT MORE THAN 45 AND PLATELETS LESS THAN 70 THAN POOR PROGNOSIS. ALLOBMT IS BEST IF GIVBEN EARLY WITHIN 12 MONTHS IN PATIENT LESS THAN 55 WHO HAVE HLA MATCH SURVIVAL IS 63 % FOR 3 YEARS. HYDROXYUREA DRUG OF CHOICE FOR HIGH BLASCOM AND LEUKOSTASIS SAFE IN THROMBOCYTOPENIA CONTINUED MAINTANENCE TREATMENT IS IMPORTANT. BUSULFIN IS IMPORTANT AS WELL AS ALPHA INTERFERON WHICH SUPPRESS THE PHILADELPHIA CHROMOSOME.
653..MM = MORE THAN 10% PLASMA CELL FOUND IN THE BONE MARROW IF LESS THAN 10 THAN IT IS MGUS M PROTEIN IN MM IS LESS THAN 3 GRAM IN MGUS AND MORE THAN 3 IN MM . NARMOCROMIC CORMOCYTIC ANEMIA LYTIC LESION FRACTURES OSTEOPOROSIS
654… HAIRY CELL LEUKEMIA= ESSENTIALLY A B CELL TYPE, FRIED EGG APPERANCE WITH CYTOPLASMIC PROJECTIONS SEEN ON THE BLOOD SMEARS TRAP + DRY TAP ON BONE MARROW ASPIRAION NEUTROPENIA – CAUSE INFECTION LIKE TB OTHER UNUSUAL INFECTION LIKE TUXO LEGIONELLA AND NOCARDIA. 2 CDA IS THE TREATMENT OF CHOICE COMPLETE REMISIION IN 85 –88% OF THE PATIENT AFTER A SINGLE CONTINUOUS 7 DAY IV INFUSION.
655.. HUS – SIMILAR TO TTP EXCEPT WO FEVER OR CNS INVOLVEMENT. MANAGEMENT IN ADULT IS SAME AS FOR TTP. DIERRIA SECONDARY TO ECOLI 0157H7.
656..SICKLERS (TRAIT) ARE MORE PRON TO HAVE PAINLESS HEMATURIA AND PYELO IN PREGNANCY NO ANEMIA NO INFECTION NO INCREASE MORTALITY THOSE WITH TRAIT ALSO HAVE PROBLEM WITH CONCENTRAIONO OF URINE NO PAIN CRISIS. IF SICKLER HAVE CV COMPLICATIONS GIVE EXCHANGE TRANSFUSION ON REGULAR BASIS. INFECTION IS NUMBER ONE CAUSE OF DEATH IN SICKLER’S DISEASE.
657.. ACUTE CHEST SYNDROME FEVER , CHEST PAIN TACHY INREASE WBS AND PULMORY INTARACTS AND INFECTION IF YOUNG.
658..CLL NUMBER MALIGNANCY IN US MORE THAN 60 YEAR OLD B LYMPHOCYTES FEVER IS INDICATION OF INFECTION AND NOT THE LEUKEMIA DECREASE GAMMA GLOBULINS INFECTION THRUMBOCYTOPEINA INCREASE INCIDENCE OF SOLID TUMOR OF LUNG AND SKIN, AML A POOR PROGNOSIS IS LYMP[HOCYTE DOUBLING TIME LESS THAN ONE YEAR. RAI CLASSIFICATION STAGE 0 = INCRESE LYMPHOCYTES ONLY STAGE 1= INCREASE LYMPHO + LYMPHO DENOPATY STAGE 2= INCREASELYMPHO SPLENOMEGALY STAGE 3 = LYMOCYTOSIS ANEMIA 4 LYMPHOCYTOSIS AND THRUMBO CYTOPENIA TREATMENT IS FOR STAGE 3 AND 4 ONLY. CHLORAMBUCIL + PREDNISONE FOR PATIENT WHO RELAPSE FLUDUABINE IS GOOD. MEDIAN SURVIVAL 5 YEAR AS LONG AS HIS IGG IS LESS THAN 0.3 G / DL GIVE GAMMA GLOBULIN THERAPY EVEN HE IS NOT HAVING INFECTION
659… SHCHILLING TEST TO FIND THE CAUSE OF B12 DEFICIENCY PERNICIOUS ANEMIA IS NUMBER ONE CAUSE OF VIT B12 DEFECIANCY HYPO THYROYDISM INCREASE RISK OF GASTRIC CANCE ATAXIC GAT SECONDARY TO DEGENERATAION OF POSTERIOR COLUMN IMPAIRED VIBRATION AND SENSE DECREASED REFLEXES DEMENSIA SEIZURES. INCREAE SERUM MMA INCREASE SERUM GRASTRIN LEVEL SERUM HOMOCYSTINE INCREASE
660… FE DEFICINCY ANEMIA MCV DECREAED RBC DECREAED RDW MORE THAN 16 TIBC INCREASE IRON DECREASE FERRITIN DECREASE. THALASSEMIA MINOR RDW IS NORMAL
661.. B. THAL.MAJOR= FETAL HGB INCREASE MORE THAN 50 % IT IS 2 –3 % IN THALASSEMIA MINOR MAJOR NEED BMT TO SURVIVE. ELECTROPHERIS IS NORMAL IN ALPHA TALASSEMIA. B. THALASSEMIA MIRON IS MORE COMMON IN ADULTS. PRESENT WITH MICROCYTIC-HYTPCHRONICANEMIA
662.. IF PTT DOES NOT CORRECT WITH MIXING STUDY SO PATIENT CAN HAVE FACTRO 8 INHIBITOR S , LUPUS ANTICOAG ANTICARDIOLIPIN ANTIBODY. HEMOPHILIA A NEED CRYO
663…DRUG INDUCE SLE HAS NO RENAL OR CNS PROBLEM IT IS MOST COMMON WITH HYDRYLAZINE AND PROCAINAMID AND TREATED BY DISCONTINUING THE MEDICATION ANTIHISTONES, ANTIBODIES ARE DIAGNOSTIC IF NEED TREATMENT STEROID IS GOOD.
664…FOR ACUTE LUPUS NEPHRITIS GIVE CYCLOPHOSPHAMIDE
665… HYDROXIUREA NA D ALPHA INTERFERON IS GOOD IN BLAST CRISIS LEUKOCYTOSIS ESSINTIAL THROMOCYTOSIS
666… PHILADELPHIA CHROMOSOME CARRIERS ARE HAVING GOOD PROGNOSIS IN CML AND BAD IN AML
667…AMANTADINE IS GIVEN IN FIRST 48 HRS AFTER H INFLUENZA OUTBREAK WITH VACCINE IT PROTECTS 95 % FLU VACCINE MAY BE GIVEN ALONG WITH PNEUMOVAX RELENZA AND TAMIFLU ARE NEURA MINIDASE INHIBITORS IT IS GOOD TO GIVE IF PATIENT IS HAVING SIGN SYMPTOMS LESS THAN 2 DAYS THEY ARE EFFECTIVE AGAINST A AND B TIFE THEY REDUCE THE SPREAD OF VIRUS RELENZA IN INHALOR AND TAMIFLU IS CAPSULE.
668…RABIES SERUM AND CSF MUST BE TESTED FOR RABIES AD AND NAGRI BODIES SEEN ON HIPPOCAMPAL BIOPSY SPECIMAN ARE DEFINITIVE HRIG+VACCINE ARE USEFUL IN GIVING TWO SEPARATE SIDES BUT ONLY IF GIVEN BEFORE BEGINNIG OF SYMPTOMS AFTER DOG AND CAT BITE IF STATUS IS UNKNOWN AND ANIMAL IS ON THE LOOS CONSULT PUBLIC HEALTH OFFICIALS IF ANIMAL IS RABID OR SUSPCECTED RABID GIVE VACCINE IMMEDIATELY IF ANIMAL IS HEALTHY AND AVAILABLE FOR 10 DAYS OBSERVATION DON’T START TREATMENT UNLESS ANIMAL DEVELOPS SIGN SYMPTOMS IF + THAN START HRIG +VACCINE ONLY RABID ANIMALS ARE NEED TO BE VACCINATED AGAINST LIKE FOXES ,BATS SKUNK OR RACOONS NOT FOR RODENT RABBIT SQUERELL CHIPMUNKS RATS MICE GUINIPIGS HAMSTERS. HRIG DOSE HALF OF IT SHOULD BE INJECTED DIRECTLY INTO THE WOUND AND THE REST IN THE GLUTIAL AREA. IN ADULT VACCINE SHOULD BE GIVEN ONLY ON DELTOID AREA ON DAYS 0,3,7,14,28
669… WHEN SHOULD BE MEDICATION STARTED IN HIV CD4 LESS THAN 500 VIRAL LOAD MORE THAN 5K TRIPLE THERAPY FOR 4 WEEKS AFTER NEEDLE STICK FROM HIV INDIVIDUAL DOUBLE COMBINATION LIKE AZT + 3TC IN PATIENT WITH LESS SEVERE DISESE