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22M K/C of AIDS on HAART presented with headache and left hemiparesis
Labs: rising titers of anti-toxoplasma IgG antibodies and positive IgM antibody.
MRI: multiple hypodense lesions. Management?
π Kidney biopsy:
Indication:
- Glomerular hematuria
- Macroalbumonuria or overt proteinuria
- AKI/CKD of unclear cause
- kidney transplant dysfunction
Complication:
- Retro-peritoneal hematoma (3%)
- Diagnosis: CT with contrast
- TTT: pRBC transfusion and angiography +/- embolization
π‘ Explanation: why alcoholic hepatitis not AIH?
- hx of alcohol use
- ALT:AST ratio 2:1
- ANA positive π€? Can be falsely positive in alcoholic hepatitis
- negative ASMA
ΩΨ°Ψ§ ΩΨ§ΩΩΩ Ψ§ΨΉΩΩ
ππ»
40's presented with jaundice and fatiguability, he drinks alcohol. labs:
AST 147
ALT 76 Bilirubin high Ferritin 450 TIBC normal Negative hepatitis serology ANA: +ve ASMA: -ve most likely diagnosis?
patient with cirrhosis due to hepatitis C infection presents with ascites that does not respond to repeated paracentesis. What is the appropriate management?
60M with DM, HTN, intermittent claudication, and stable angina is started on aspirin, statin & nitroglycerin. He still experiences angina with moderate exercise. most appropriate additional drug?
π Chemotherapy SE:
Anthracyclines
- SE: dose dependent CMP
- pre-ttt: Echo to assess EF
TKI
- SE: QT prolongation & pleural effusion
- daily ECG
Bleomycin
- SE: IPF
- pre-ttt: PFT
- ttt: steroid
Cisplatin
- SE: AKI, arrhythmia, ototoxicity and stocking gloves neuropathy
Methotrexate
- SE: AKI, leukoencephalopathy, transaminitis and Mucositis
- ttt: urine alkalization with NaHCOβ, IT glucarpidase and leucovorin
Vincristine
- SE: SM neuropathy
Cyclophosphamide
- SE: hemorrhagic cystitis & pneumonitis
- pre&post-ttt: mesna
patient presents with symptoms of easy fatigue. Laboratory results show:
MCV: 68, RBCs: 5, RDW: 20%. There are no iron studies available. What is the most likely diagnosis?
CKD patient presented to the ER with palpitations. ECG is showing peaked t waves. Labs: K= high Na= normal Creatinine= high. What will you do?
65 year old man presented with seizures for the last 3 days. Labs: sodium 112 (low), potassium 3.9 (normal), serum osmolality 240 (low), urine osmolality 860 (normal). What is l most likely diagnosis
22F admitted with pulmonary hemorrhage and rapidly progressive glomerulonephritis. She has a history of recurrent sinusitis and numbness in the right upper limb and left lower limb. likely diagnosis?
π G-CSF (Filgrastim)
Def: stimulates the bone marrow to produce neutrophils used to prevent or treat neutropenia
Indication:
- Post-HSCT To accelerate neutrophil recovery.
- 1ry Ppx when expected febrile neutropenia incidence >20%
- 2ry Ppx after febrile neutropenia has occurred in a prior chemo cycle
CI:
- AML
- massive splenomegaly
π΅ American Thyroid Association recommendations for management of gestational transient thyrotoxicosis:
- Hydration
- Do not give antithyroid drugs, since serum thyroxine levels return to normal by the end of the second trimester, and antithyroid drugs used in early pregnancy increase the risk for birth defects.
- If symptomatic therapy is indicated, consider beta-blockers, given at a low dose for a limited period of time
pregnant woman in either the 1st trimester with palpitations and hyperthyroidism symptoms. Vital signs are stable, and the pulse is 90. Which medication should be started initially?
middle-aged person who is a known case of rheumatoid arthritis presented with a history of left finger swelling, resembling "sausage fingers." What else would they complain of?
