اکنون در دسترس! پژوهش تلگرام ۲۰۲۵ — مهمترین بینشهای سال 
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آرشیو پست ها
A pregnant woman is diagnosed with essential thrombocytosis with positive JAK2. She is otherwise asymptomatic, without history of thrombosis or pregnancy loss.
What is the management during pregnancy?
A young male presents with central chest pain, hypotension, and bradycardia. ECG shows inferior MI. Which of the following is contraindicated in the acute management of this patient?
If PTH is inappropriately normal (it should be suppressed in hypercalcemia) or high, perform a 24-hour urine collection for calcium and creatinine and measure concurrent serum creatinine and calcium to calculate a creatinine clearance ratio (CaCrCl).
CaCrCl = (Urinary calcium × Serum creatinine) ÷ (Serum calcium × Urinary creatinine)
If GFR is < 60 mL/minute, consider impaired kidney function as the cause of low urinary calcium excretion.
If GFR is > 60 mL/minute:
CaCrCl < 0.01 suggests familial hypocalciuric hypercalcemia.
CaCrCl 0.01-0.02 suggests either primary hyperparathyroidism or familial hypocalciuric hypercalcemia. Genetic testing will often be necessary for diagnosis.
CaCrCl > 0.02 suggests primary hyperparathyroidism.
young male presents with a 2-day history of sore throat, followed by the development of a rash, lymphadenopathy, and splenomegaly. Lab elevated ALT. EBV -ve. What is the most likely diagnosis?
healthy, asymptomatic man presents to the pre-employment clinic. Routine labs show elevated serum calcium.
Further testing reveals low urinary calcium excretion. What is the most likely diagnosis?
Resistant HTN: elevated BP despite using 3 first line drugs (on of them must be diuretics)
patient known to have hypertension is currently on a calcium channel blocker
(CCB) and losartan. What should be added to the treatment regimen?
💊 Use long-term warfarin over DOACs for patients with AF and any of the following:
- Moderate-to-severe mitral stenosis (not mild)
- Rheumatic mitral stenosis
- Mechanical prosthetic valve
70-year-old male with a history of diabetes mellitus, hypertension, and known mild mitral stenosis presents with atrial fibrillation on ECG. What is the most appropriate anticoagulant therapy?
🦠 Staphylococcus aureus & Antibiotics coverage
MSSA (Methicillin-Sensitive Staphylococcus aureus) Preferred agents:
- Nafcillin / Oxacillin
- Cefazolin
- Flucloxacillin
MRSA (Methicillin-Resistant Staphylococcus aureus) Preferred agents:
- Vancomycin
- Linezolid
- Daptomycin
- Clindamycin
- TMP-SMX “Bactrim”
- Doxycycline
- Ceftaroline
patient diagnosed with IE confirmed by vegetation on TEE
Imaging showed fluid-filled abscess in the sternoclavicular region
blood cultures grow MSSA What is the appropriate abx?
🧠 Antibiotic & neuropathy
- Linezolid: irreversible peripheral neuropathy
- Fluoroquinolones: can be irreversible
- Metronidazole: reversible peripheral neuropathy
Chest CT 6 months ago shows diffuse emphysematous changes. Which of the following is the best intervention to improve his shortness of breath?
Which of the following blood culture isolates is most commonly associated with contamination rather than true bloodstream infection?
