Erythropoetin
90 % renal, 10% hepatic, need supplementation when GFR is less than 49<\/p>\n\n\n\n
Reticulocytes
In health, make up 1-2 % of total RBCs, increased in response to anema. Absence of reticulocytosis or presence of reticulocytopenia shows inadequate bone marrow response.<\/p>\n\n\n\n
Hemoglobin
normal is 12 for females and 15 for males. Ratio to hematocrit is 1:3<\/p>\n\n\n\n
MCV
determines red blood cell size – normal is 80-96<\/p>\n\n\n\n
MCH
reflects hgb content and color, normal is 31-37<\/p>\n\n\n\n
RDW
variation of RBC size – normal is 11.5-15%<\/p>\n\n\n\n
Normocytic, normochromic , normal RDW
acute blood loss, anemia of chronic disease<\/p>\n\n\n\n
Microcytic, hypochromic anemia, elevated RDW
Iron deficiency anemia<\/p>\n\n\n\n
Microcytic, hypochromic, normal RDW
alpha or beta thalassemia minor<\/p>\n\n\n\n
Macrocytic, normochromic, elevated RDW
Vitamin B12 deficiency, folate deficiency, pernicious anemia<\/p>\n\n\n\n
Macrocytosis without anemia
use of medications like tegretol, AZT, depakote, dilantin, alcohol<\/p>\n\n\n\n
Heart murmur seen in b12 deficiency
Hemic murmur<\/p>\n\n\n\n
Most common pathogen in CAP, ABRS, AOM
S. pneumoniae<\/p>\n\n\n\n
Common pathogen in ABRS, AOM, CAP particularly with recurrent infections and tobacco use
H. influenzae, more than 30% now pcn resistant via beta lactamase production<\/p>\n\n\n\n
First line treatment for Acute Bacterial Rhinosinusitis
Augmentin 500\/125 TID or 875\/125 BID<\/p>\n\n\n\n
Second line treatment for Acute Bacterial Rhinosinusitis
Augmentin 2000\/125 BID or doxy 100 mg BID or 200 mg QD<\/p>\n\n\n\n
Treatment for ABRS if allergic to PCN, Cephalosporins
Doxy, Levofloxacin, Moxifloxacin<\/p>\n\n\n\n
Treatment for ABRS if antibiotic resistance of failed initial therapy
Doxy, levofloxacin, moxifloxacin<\/p>\n\n\n\n
Presbycusis
slowly progressive hearing loss that is symmetric and high frequency<\/p>\n\n\n\n
1st line controller therapy in allergic rhinitis
Intranasal corticosteriods like Flonase, Nasonex, Nasacort, Omnaris. Side effects are that nasal irritation and bleeding may occur. Optimal efficacy may take 1-2 weeks.<\/p>\n\n\n\n
1st line rescue treatment in allergic rhinitis
Nasal antihistamines, esp if there is nasal congestion. sedation could occur. Drugs like astelin, Astepro, and patanase<\/p>\n\n\n\n
1st generation oral antihistamines
significant potential to cause sedation and anticholinergic effects so not a first line therapy. Ex. benadryl, chlor trimeton, dimetapp, vistaril.<\/p>\n\n\n\n
2nd generation oral antihistamines
These are preferred over because no anticholinergic effects but not as helpful with nasal congestion. Ex. claritin, clarinex, zyrtec, allergra<\/p>\n\n\n\n
Oral decongestants
alpha adrenergic agonist so vasoconstrictive. Take caution with the elderly, young children, HTN, bladder neck obstruction, glaucoma, and hyperthyroidism. Ex. sudafed<\/p>\n\n\n\n
Nasal decongestants
Alpha adrenergic agonist so vasoconstrictive. Can cause rebound congestion\/medicamentosa so limit use to 5-7 days.<\/p>\n\n\n\n
Intranasal anticholinergics
reduce runny nose because of drying action. No effect on other nasal symptoms. Dryness can occur. Ex.. Atrovent<\/p>\n\n\n\n
Found on fundoscopic exam of person with angle-closure glaucoma
deeply cupped optic disc because of increase intraocular pressure than pushes the optic disc backwards., acute, painful<\/p>\n\n\n\n
Amsler grid
screening test for macular problems.<\/p>\n\n\n\n
Tonometry
measurement of intraoccular pressure, screen for glaucoma<\/p>\n\n\n\n
Presbyopia
Hardening of the lens, close vision problems, adults over 45<\/p>\n\n\n\n
Senile cataracts
lens clouding, progressive vision dimming, distance vision problems, close vision usually retained and often improves. Risk factors are tobacco use, poor nutrition, sun exposure, systemic corticosteriod therapy. Potentially correctable with surgery.<\/p>\n\n\n\n
Open-angle glaucoma
Painless, gradual onset of increased intraocular pressure leading to optic atrophy. Causes a loss of peripheral vision if not treated. Avoidable with appropriate and ongoing intervention. more than 80% of all glaucoma. Treat with topical miotics, beta blockers, or surgery<\/p>\n\n\n\n
Angle closure glaucoma
sudden increases in intraocular pressure. Usually unilateral, painful, red eye, halos around lights, eyeball firm when compare to other. Immediate referral to opthmalogy<\/p>\n\n\n\n
Macular degeneration
thickening sclerotic changes in retinal basement membrane complex. Causes painless changes in vision including distortion of central vision. On fundo exam will see drusen (soft yellow deposits in macular region). Risk factors are tobacco use, sun exposure. No treatment available for dry form. Laser treatment or intraviteal injection of antivascular growth factor for wet form<\/p>\n\n\n\n
Treatment of suppurative (non gonococcal or chlamydial infection (s. aureas, s. pneumo, H. influ)
Primary: opthalmic with FQ ocular solution.
Secondary: opthalmic treatment with polymixin B with trimetroprim solution or with azithromycin 1%.<\/p>\n\n\n\n
Treatment of otitis externa (pseudomonas sp, proteus sp). Acute infection often S. aureus.
otic drops with ofloxacin or cipro with hydrocortisone or polymixin B with neomycin and hydrocortisone. Cleaning of ear canal important. Use 1:2 mix of white vinegar and rubbing alcohol after swimming. Do not use neomycin if eardrum punctured.<\/p>\n\n\n\n
Exudative pharyngitis
Caused by A, C, G streptococcus, viral, HHV-6, M. pneumo. 1st line therapy is PCN PO for 10 days or IM for 1 dose if problems with adherence.
2nd line: erythromycin for 10 days; 2nd generation cephalo for 4-6 days; azithromycin for 5 days, or clarithomycin for 10 days.
If vesicular or ulcerative, usually viral.<\/p>\n\n\n\n
Chicken pox
2-3 mm vesicles that start on trunk, appear on limbs 2-3 days later. Non clustered and at a variety of stages. Mild to moderately ill.<\/p>\n\n\n\n
Small pox
2-3 mm vesicles with generalized distribution without a pattern. All lesions at same stage. Severe systemic illness.<\/p>\n\n\n\n
Actinic keratoses
mostly on sunexposed areas. Red or brown, scaly, often tender. Sometimes flesh colored. Can turn into SCC. Can remain unchanged, spontaneously change or progress. Can treat with topical 5-FU, 5% imiquimod cream, photodynamic therapy with topical acid. Can do cryosurgery, laser resurfacing, chemical peel.<\/p>\n\n\n\n
Basal Cell carcinoma
more common,, sun exposed areas, arise de novo, papule, nodule with or without central erosion, pearly or waxy appearance, telangiectasia, low mets risk.<\/p>\n\n\n\n
Squamous cell carcinoma
less common, sun exposed areas, can arise for actinic keratoses or de novo, red, conical hard lesions with or without ulceration, less distince borders, more chance of mets especially if located on lip, oral cavity, or genitalia.<\/p>\n","protected":false},"excerpt":{"rendered":"
Erythropoetin90 % renal, 10% hepatic, need supplementation when GFR is less than 49 ReticulocytesIn health, make up 1-2 % of total RBCs, increased in response to anema. Absence of reticulocytosis or presence of reticulocytopenia shows inadequate bone marrow response. Hemoglobinnormal is 12 for females and 15 for males. Ratio to hematocrit is 1:3 MCVdetermines red […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-113920","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/113920","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=113920"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/113920\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=113920"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=113920"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=113920"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}