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A 48-year-old female is treated appropriately for MRSA
bacteremia. An echocardiogram is negative for endocarditis.
There are no indwelling devices such as prosthetic heart valves
or vascular grafts. - ANSWER -Repeat blood cultures 2-4 days
after the initial set and as needed thereafter.
Contraindication to the use of GLP-1 agonists - ANSWER -
Patients with medullary thyroid cancer or multiple endocrine
neoplasm syndrome, or with a family history of these
conditions.
Coin rubbing is a traditional healing custom practiced in? -
ANSWER -Primarily
in east Asian countries such as
Cambodia,
Korea, China, and Vietnam.
Which initial finding in PE would be the strongest indication
for thrombolytic
,therapy? - ANSWER –
Hypotension
The U.S. Preventive Services Task Force (USPSTF)
recommends screening for abnormal blood glucose levels as
part of a cardiovascular disease risk assessment for adults
who are 40-70 years of age and who are overweight (BMI 25.0-
29.9 kg/m2) or obese (BMI >/= 30.0 kg/m2). - ANSWER -In those
with range consistent with impaired fasting glucose (100-125
mg/dL), diagnosis of the abnormal glucose level should be
confirmed soon by performing the same test on a different day.
BP goal in a patient with no other comorbids - ANSWER -In
2013 the members of the Eighth Joint National Committee (JNC
8) updated guidelines for the management of hypertension,
recommending treatment of systolic blood pressure to <150
mm Hg in patients >/= 60 years of age without comorbid
conditions, based on evidence that a systolic blood pressure
<150 mm Hg reduces rates of cardiovascular disease, stroke,
and death.
<60yo:
140/90
DM and CKD:
140/90
Infantile hemangiomas usually appear by 4 weeks of age and
stop growing by 5 months of age. As many as 70% leave
residual skin changes, including telangiectasia, fibrofatty
,tissue, redundant skin, atrophy, dyspigmentation, and scarring.
- ANSWER -- Oral propranolol
- Intralesional corticosteroids can be effective for small,
bulky, well localized lesions in infants.
- Laser therapy can also be used to treat early lesions or
residual telangiectasia.
- Once involution is complete, however, as is the case with
this child, elective surgical excision is the treatment of choice,
producing better outcomes.
Preferred initial treatment for lupus arthritis - ANSWER -
Hydroxychloroquine
You order an NT-proBNP level in a patient with symptoms and
signs of heart failure. Which one of the following would
contribute to a result that is higher than expected? - ANSWER -
Patients with a low GFR (high creatinine) or a low level of
albumin have higher NT-proBNP levels.
Treating postpartum depression - ANSWER -An SSRI is the
appropriate treatment for confirmed moderate to severe
postpartum depression along with psychotherapy, while mild to
moderate postpartum depression can be treated with
psychotherapy or an SSRI.
A pathogen for community-acquired pneumonia in a patient
who has a history of a hotel stay or cruise ship travel within
the past couple of weeks. - ANSWER -Legionella
, HPV vaccination doses for children - ANSWER -In 2016 the CDC
changed the recommendation for the number of HPV vaccine
doses for children ages 11-14. Children in this age group need
only two doses of HPV vaccine 6-12 months apart.
However, if they received two doses of HPV vaccine less than
5 months apart,
they still need to have the
third dose.
Children and young adults over the age of 14 and
those with certain
immunocompromising conditions still require three doses
of HPV vaccine.
Informed consent to treat is considered an important ethical
and legal part of caring for children and adolescents. -
ANSWER -Children below the age of majority must have proof
of permission to treat from a parent or guardian for non-
emergent care. This does not apply to emergency situations in
which a delay in care could result in serious harm.
- Another exception to parental consent is when a child is
considered emancipated under state law. This can happen with
a court order, or (in some states) if the child is married, is a
parent, is in the military, or is living independently.
- Either biologic parent can consent to treatment unless one of
them is explicitly