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Indication for tpa in MI i.e STEMI
- >1mm STE in 2 contiguous leads except V2-V3
- V2-V3- men >40 2mm <40yo-2.5mm, in women 1.5
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When is TWI significant
only if QRS is positive
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4 reasons for Urology consult for stones
- stone >10mm
- Refractory pain
- Sepsis
- Renal failure
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Rash associated with Glucagonoma
necrolytic migratory erythema
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Darier's sign
wheals and erythema with rubbing of Mastocytosis rash
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Inheritance of Restless leg syndrome
autosomal dominant
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in working up RLS, need to rule out what?
anemia-do ferritin test
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1st line rx for RLS
pramiprexole
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Actinic keratosis is a premalignant lesion to what
SCC
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after ABO and Rh typing is done, what is looked at next?
presence of allo-antibodies-usualy E, L, K
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Rx for AOCD
treat underlying cause
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2 conditions with elevated TSH, T4, T3?
- thyroid hormone resistantce- usually clinically hypothyroids
- TSH secreting pituitary neoplasm also has high alpha subunit
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who can get PCI and thrombolytics
- 12 hours of symptom onset
- 90 minutes to ballon
- 30 mins to tPA from door to needle
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Common side effect of constipation in kids
urinary retention and UTI
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Athletic females who have secondary amenorrhea it is because of what
estrogen deficiency
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prophylaxis for latent Tb if INH resistance is suspected
rifampin for 6 months in kids, 4 mo in adults
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iron supplementation is recomended for ESRD patients when
trasnferrin saturation<30% and Ferritin <500
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Pheochromocytoma dx
- urinary metanephrines and catecholamines
- plasma metaneprhines
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Next stop after biochemical dx of pheo
MRI or CT
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When is MIBG scan used for pheot
if large tumor >5cm and metastatic disease is suspected
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Blood Pressure management in aortic dissection vs pheochromocytoma
- aortic dissection-BB then alpha
- pheo-alpha then bb
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suicide while on lithium, stop or continue lithium
continue
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Rx after chlamydia was given for urethritis but with no success
flagyl for trichomonas
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hairloss and scaling + postauricular lymphadenopathy
tinea capitis- oral griseofulvin
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+ tourniquet test
Dendgue fever
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First enzyme to rise in Mi
myoglobin
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Best enzyme to follow for re-infarction
CK-MB
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When to do Exercise thallium or stress echo
can exercise but baseline abnormal EKG
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When to do adenosine thallium or dobutamine echo
cannot exercise
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When is sestamibi nuclear stress test done
in obese patients
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Thallium is like what electrolyte
K
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Who gets ADP blockers
everytone getting angioplasty and stent
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Door to ballon time
90 minutes
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who gets PCI and thrombolytics
- acute CP < 12 hours
- STE in 2 continugous leads of 1mm or more except for V2-V3-
- if <40-2.5 in men
- >40 2mm in men
- women
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what properties do BB have
anti-anginal and anti-arrhythmic
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ACEI and ARB decrease mortality only when
when there is LV dysfunction or systolic dysfnx
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when is lidocaine or amiodarone given in acute mi
if vtach or vfib
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when is pacing done in acute mi
- 3rd degree av block
- 2nd degree type 2 block
- symptomatic bradyacardia
- bifascicular block
- new LBBB
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Side effect of ticlopidine
neutropenia
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complications of MI all cause?
hypotension
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NSTEMI vs STemi diff
heparin and GpIIb/IIIa abxicimab, eptifibatide, tirofiban
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Risk factors in lipid management
- Smoking
- HDL is low
- Age males >45, females >55
- FH
- HTN
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