Fat globules and foamy histiocytes on needle biopsy of breast mass?
Fat necrosis. Follow up with routine screening.
Treatment for Stress, Urge and Overflow incontinence?
Stress - Kegel exercises, urethropexy
Urge - oxybutinin (anticholinergic) (this stops you from peeing
Overflow - Bethanecol (long acting ach) and Alpha blockers (these allow you to pee easier)
What breast tumor is associated with rash on the breast?
paget's leads to adenocarcinoma!
Rash is eczematous, itchy
Who has a waddling gait? En blac (head doesn't move)? Hypokinetic?
Waddling - muscular dystrophy
En Black - Vestibular issue
Hypokinetic - Parkinsons
Air fluid levels in the gallbladder with no stones?
Ephesematous cholecystitis (bacterial) - give fluids, cholecystectomy and antibiotics against clostrididium and gram negative gas forming species!)
FSGS vs membranous glomerulopathy?
FSGS more in A.A.'s, IVDU, obesity and HIV
Membranous more in hepatitis
Doll face, lactic acidosis, short, protuberant abdomen at 3-4 months?
Glucose 6 phosphate deficiency (Type I glycogen storage disease). Normal LFTs, elevated lactate
Branching enzyme deficiency is just cirrhosis and failure to thrive (type IV)
Debranching enzyme (III) deficiency is the same but altered LFTs, normal lactate.
Rheumatoid arthritis, enlarged kidneys, hepatomegaly? Test?
Amyloidosis - see deposits if apple-green birefringence with congo red stain under polarized light.
Best radiologic test for multiple myeloma?
X-Ray! bone scan is not helpful because no new bone is forming.
Which one do you treat just that one for? Gonorrhea or Chlamydia?
Chlamydia if gonorrhe is not detected. Chlamydia is too hard to identify (can't C it!) so you have to treat emperically for it.
Solitary lytic lesions in kids?
Langerhans histiocytosis - treat conservatively! (parathyroid adenoma in adults!)
GVHD vs rejection?
GVHD is donor T cells fighting patients skin, liver and intestine (diarrhea)
Rejection is destruction of the foreign organ by host T-cells
Indications for ERCP?
Severe biliary pancreatitis, chronic pancreatitis, looking for ampullary cancers, need for tissue samples and need for duct exporation.
Treatment for coccidio meningitis?
IV amphotericin and IV flucystosine followed by oral flucystosine
Laryngomalacia vs choanal atresia
Laryngomalacia has stridor, choanal atresia has cyanosis and needs to be surgically repaired-worse with feeding, better with crying (keeping mouth open).
Non parathyroid mechanism of hypercalcemia in malignancy?
Cytokine activation unless its hodgkins and then its calcitriol
Levels of PTH in primary hyperparathyroidism?
elevated or often times normal! Secondary has higher levels.
Treatment for unstable supraventricular tachycardia (narrow complex)
Cardioversion! If stable can do adenosine or AV node blockers (digoxin, or procainimide)
What are pregnant women with a previous history of anorexia at risk for?
small for gestational age/premature, hyperemesis gravidarum, postpartum depression