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Internal medicine hub
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+124 години
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Архів дописів
🔬 Colorectal cancer:
Any patient with positive FOBT should be offered a colonoscopy within 3 to 6 months to optimize outcomes and reduce the risk of advanced colorectal cancer
Renin & Aldosteron:
- Elevated renin, aldosteron & BP → Renal artery stenosis
- Elevated renin & aldesteron with normal BP → Barrter syndrome
- Low renin with Elevated aldestron & BP → Conn syndrome
- Low renin & aldesteron with Elevated BP → Liddles syndrom
female evaluted for hypertension, labs showed low renin and high aldosteron, what is likely diagnosis?
💊 Anti-epileptic SE:
- Phenytoin: Gingival hypertrophy, chronic ataxia, osteoporosis
- Carbamazepine: Hyponatremia
- Topiramate: Weight loss, kidney stones, paresthesias, cognitive difficulties (word-finding troubles)
- Levetiracetam: Irritability/Agitation
- Valproic acid: Weight gain, hair thinning, tremor, thrombocytopenia, hyperammonemia, pregnancy risk
- Lamotrigine: Stevens-Johnson syndrome
patient known case of epilepsy, presented with Gum hyperplasia, this could be side effect of which medication?
Phenytoin
Gingival hypertrophy, chronic ataxia, osteoporosis
Carbamazepine
Hyponatremia, very cheap
Oxcarbazepine
Hyponatremia
Topiramate
Weight loss, kidney stones, paresthesias, cognitive difficulties (word-finding troubles)
Levetiracetam
Irritability/Agitation
Valproic acid
Weight gain, hair thinning, tremor, thrombocytopenia, hyperammonemia, pregnancy risk
Lamotrigine
Rash (Stevens-Johnson syndrome)
The goal in management for a patient with diabetes and cardiac disease is:
🔬 Wilson disease should be suspected when:
- Age <40y
- Hepatitis
- Extrapyramidal movement disorders (Wing-beating tremor)
child presents with increasing jaundice, flapping tremor, and decreased school performance. Stigmata of chronic liver disease are observed on examination. What is the most appropriate management?
💊 Treatment options if conventional DMARDs are not effective or well-tolerated:
- In patient with poor prognostic factors (such as positive RF, anti-CCP, radiographic erosions): use biologic DMARDs (adalimumab) in combination with conventional DMARD (ideally MTX)
- In patients without poor prognostic factors: consider switching to a different conventional DMARD
50F with RA presents with polyarthralgia & AM stiffness. Despite treatment with MTX, steroid & HCQ. Lab show elevated ESR & CRP, RF & elevated platelet count. What is next?
🫀 Post PCI complication:
- Bleeding: overt or retroperitoneal bleeding
- Vascular damage: pseudoaneurysm, AVF, limb ischemia or radial artery occlusion
- Contrast induced AKI
- Stroke: during cath.
- Cholestrol emboli syndrome
Male patients admitted as case of MI under went PCI, day after he expressed pain and swelling in his arm. US confirmed AV fistula. How to differentiate between Pseudoaneurysm and true AF fistual?
🫁 bronchiectasis:
- Prophylactic azithromycin shown to decrease exacerbation in non-CF bronchiectasis. given If ≥3 exacerbations per year or ≥2 hospitalization.
NOTE: Avoid treatment with recombinant human DNase (dornase alfa), as it can increase the frequency of exacerbations in patients with non-CF bronchiectasis.
Patient known case of post TB bronchiectasis on regular chest
physiotherapy. Has frequent exacerbations. Which of the following medications can reduce exacerbations?
75M with COPD presents with acute exacerbation due to pneumonia. After initial management with IV fluids, antibiotics, nebs, and nasal oxygen at 4 L/min, he becomes drowsy. What to do?
🫳🏻 Nephrology rotation tips:
- Most common cancer in kidney transplant recipients is: NMSC
- Most common cancer in patients on long-term dialysis is: RCC
What is the most common malignancy in kidney transplant recipients?
