Per FA, should aminoglycosides be used in gram negative infection? S.viridans are Gram positive.
Black person here. Curly facial hair tends to curve back towards the skin a day or two after shaving. Hence the "pseudo" folliculitis. Not an infection but an inflammation from sharp edge of the hair growing into the skin. And yes it hurts! Generally sensitive to touch as well
I was between these two (cytarabine and imatinib) because I couldn't point out if it was AML or CML. I learned all of the usual clues for each one but I forgot about the fundamental difference of blasts vs mature forms (and that bands are bound to appear in CML too). If they give you a CML in the blast crisis, then look for Auer rods. Anyways, got it wrong and hope that won't happen again.
Now, understanding this I can see how the pharmacology works.
Cytarabine - AML (mostly -blasts and pro-cytes)
Antimetabolite, a purine analog, S-phase specific, inhibit DNA synthesis
Potent enough for the crazy proliferation going on
Imatinib - CML (mostly -cytes and a lot of basophils)
Tyrosine kinase inhibitor of bcr-abl and c-kit tumors
Antimetabolites can also be used, but the best answer is imatinib because it's the most specific for this type of cancer, as it turns off the pro-cancer switch (bcr-abl).
This book chapter describes this stuff well if you can access it through the library.
Regional Nerve Blocks in Anesthesia and Pain Therapy Traditional and Ultrasound-Guided Techniques pg.707
Irradiated blood destroys all nucleated cells, like in this case, we wouldn't want him to have foreign lymphocytes because it would cause GVHD for sure
Washed Blood eliminates plasma proteins, which is beneficial for patients with IgA deficiency for example
Shigella is the most likely causal organism over E. coli due to the vignette specifically stating the patient has had "bloody MUCOID stools with tenesmus."
Page 144 FA 2019 GI manifestations: Fever, crampy abdominal pain -> tenesmus, blood mucoid stools (bacillary dysentery).
Please correct me if I'm wrong, but I don't remember Sketchy mentioning bloody mucoid stools for E. coli and that detail doesn't seem to appear in FA.
This is acute rejection as stated in the question which is most commonly due to lack of proper immunosuppresion so you would increase the sterroid dose. If it was hyperacute or chronic it would be to remove the organ!
Bernard Soulier Syndrome has thrombocytopenia, otherwise looks similar to vWD
Allergic contact dermatitis: Type IV hypersensitivity reaction that follows exposure to allergen. Lesions occur at site of contact (eg, nickel D, poison ivy, neomycin E ).
His lips are dry. Vaseline creates a barrier that prevents moisture from evaporating, which improves his dry lip symptoms.
In practice, it is often used to cheaply retain moisture in many dry skin conditions. A doc I once worked with recommended that you put it on psoriasis before bed, wrap it in plastic wrap to prevent it from rubbing off, and bam you're good to go.
FYI, her triglycerides are also high (300 mg/dl), but need to be >1000 to be able to cause pancreatitis.
I did not understand why you don't check renal function.
Doesn't lithium affect both thyroid and kidney? Also, she has no clinical signs of hypothyroidism, so I figured we need to check her renal function.
Disregard for and violation of rights of others with lack of remorse, criminality, impulsivity; males > females; must be ≥ 18 years old and have history of conduct disorder before age 15. Conduct disorder if < 18 years old.
Itraconazole is given in an encapsulated formula which depends on an acidic pH to dissolve. PPIs like omeprazole increase the stomach's pH, thus decreasing the amount of itraconazole absorbed. Poor absorption does not allow itraconazole to reach its therapeutic plasma concentration. A solution for this would be to give the itraconazole via oral solution or IV.
The pulling feeling weeks after incision is just scar tissue remodelling.
She only has mild tenderness w/ deep palpation , no pain, no fever, no redness, etc.
As other comments pointed out, since she has metastatic breast cancer she likely has a poor prognosis and pain management becomes the most important aspect of her care.
1mg SubQ morphine q3h is less morphine than she is receiving currently with 5mg morphine q4h PO.
Morphine equivalents for PO:IV morphine is 3:1. Let's assume IV and subQ are equivalent so the ratio remains 3:1. (Idk if they are or not, but IV would definitely be the most potent)
5mg PO morphine q4h = 30mg daily orally. So you would need 10mg daily either IV or subQ to match her current pain regimen.
1mg subQ morphine q3h = 8mg daily via subQ.
Thus, **the only answer choice that increases her morphine dose is increasing the frequency of her PO dosign to q3h.
Patient with a recent URI, now a persistent productive cough without fever and clean CXR.
This is classic acute bronchitis.
Tx = supportive (NSAIDs + bronchodilators)
Oh absolutely not. Primary myelofibrosis ALSO presents with splenomegaly, pancytopenia and immature myeloid cells in the periphery. WBC counts for CML are typically >50,000. WTF is this question?
Why not HIDA? not therapeutic (ERCP is both dx + tx) + it is only used for suspected cholecystitis (not cholangitis) when U/S is equivocal.