Cough for one week negative for all test no fever Answer choices were 3 antibiotics and just treat symptoms GIVES SYMPTOMS OF HYPOTHYROIDISM very apparent slow weight gain depressed decreased reflexes WHAT IS DX Autoimmune hypothyroidism STREP TX MACROLIDE OR PCN ALLERGY Amoxicillin Or CEPHALOSPORINS PCN ALLERGY CLINDAMYCIN AZITHROMYCIN CLARITHROMYCIN TDAP WITH EVERY PREGO AFTER 27 WEEKS A child gets vaccinated with the varicella vaccine Someone at school has chicken pox and she comes back with 20 vesicles The answer is chicken pox Breakthrough chicken pox can occur in children after given the varicella vaccine It occurs about 42 hours after exposure and is more common than once believed It is a form of vaccine failure but causes a mild illness with less than 50 vesicles 1 Daughter has red crusty eye What type of conjunctivitis is it and what to treat it with BACTERIAL SULFACETAMIDE Typically if you see the exudates it is bacterial conjunctiviti Sulfacetemide 10 Bleph 10 Isopto Cetamide or Sodium Sulamyd Bacterial Azithromycin 1 solution Erythromycin 0 5 ointment Gentamicin 0 3 solution Sulfacetamide 10 Bleph 10 Isopto Cetamide or Sodium Sulamyd Tobramycin Tobrex Bacitracin polymyxin B 500 u g ointment Ciprofloxacin 0 3 Ciloxan Ofloxacin 0 3 Ocuflox Besfloxacin 0 6 suspension Moxifloxacin 0 5 Vigamox more severe cases Gatifloxacin 0 3 Zymar more severe cases 2 Women w overactive bladder wants the med she saw on a commercial what S E do you teach her about I put dizziness dry mouth Other choices was Diarrhea The most common side effects of oxybutynin include dry mouth and constipation Tachycardia urinary hesitancy retention mydriasis dilation of pupil blurred vision and dry eyes hallucinations and agitation Darifenacin Dry mouth and constipation Solifenacin dry mouth blurred vision prolong qt interval Tolterodine prolong qt interval Festoterodine dry mouth and constipation 3 Med for over active bladder that has greates degree of M3 selectivity and minimal anticholinergic s sx DARIFENACIN Mirabegron beta 3 receptor agonist which will cause detrusor muscle relaxation Mirabegron is a sympathomimetic beta 3 adrenergic receptor agonist used to relax the smooth muscle of the bladder in the treatment of urinary frequency and incontinence It is unique amongst overactive bladder treatment options in that unlike other treatments such as solifenacinand darifenacin it lacks significant antimuscarinic activity 3 which is responsible both for the therapeutic effects of these medications and their broad range of adverse effects Darifenacin is another drug for overactive bladder It has the greatest degree of M3 selectivity so it can reduce the overactive bladder symptoms while having no effect on the M1 receptors in the brain or the M2 receptors in the heart This makes it well tolerated 4 Signs symptoms NOT compatible w just solely HYPERthyroidism Amenorrhea Menorrhagia was another answer choice Smooth silky hair was an answer choice An overactive thyroid gland hyperthyroidism or underactive thyroid gland hypothyroidism can cause menstrual irregularities including amenorrhea 5 Calculate dose for levothyroxine TSH 22 3 WEIGHT IS 71KG 112mcg her TSH was 22ish The normal range for thyroid stimulating hormone TSH is typically 0 4 4 0 mIU L For a normal healthy adult under the age of 50 the initial levothyroxine dosing is based on the patient s weight typically 1 6 1 8 mcg kg day However for obese patients the dose should be based on ideal body weight and for underweight patients the dose should be based on actual body weight Since the patient s TSH is elevated at 22 this indicates hypothyroidism and the levothyroxine dose will need to be increased to achieve a euthyroid state The dosage should be increased by 0 5 1 0 mcg kg day while monitoring for symptoms and side effects The levothyroxine dose will need to be re evaluated and the TSH rechecked in 6 8 weeks to ensure the patient has reached the appropriate euthyroid state The goal is to titrate the levothyroxine dose until the TSH is within the normal reference range 6 same lady what symptom Delayed reflexes Lethargy and fatigue Weight gain Menstrual problems such as irregular or absent menstruation decreased libido Swelling of the hands and feet as well as periorbital edema and infertility Depression dull facial expression Memory loss Muscle cramps arthralgias and paresthesia Delayed deep tendon reflexes Coarse skin and hair loss brittle nails Decreased blood pressure Bradycardia enlarged heart Atrophic or enlarged thyroid Anemia Hyponatremia Hyperlipidemia Decreased sweating and constipation Intolerance to cold Subclinical hypothyroidism TSH Elevated T4 Normal Weighs 130lbs 130lbs a 25 levothyroxine b 50 levo c Refer out 24 Kid taking low dose ics laba uncontrolled what next medium dose ics laba and refer out 12 year old starting dose low dose ics laba 8 No TB 10mm no risk factors 71 Correct Yes When evaluating a TST reaction health care providers should consider several criteria when determining whether a result is positive or negative An induration of 5 mm or greater can be considered positive for TB among individuals with HIV 69 or other immunosuppressed individuals such as those taking a TNF a antagonist 71 Individuals who emigrated from high endemic countries will be considered positive with a TST result of 10 mm or greater induration 70 In healthy individuals with no risk factor for TB a TST result of 15 mm or greater induration is needed for a positive result 68 For those who work in a mycobacteriology laboratory an induration of 10 mm or higher is needed for a positive result 67 9 Kid with slapped cheek fifth disease answer is parvo 19 The diagnosis for a child with a slapped cheek appearance is likely Parvovirus B19 infection also known as fifth disease 10 Roseola must common age range under 24 months old Roseola is most common in children 6 to 24 months old and it is uncommon in infants less than 3 months and children over 3 years old The key distinguishing features of roseola are the abrupt onset of fever followed by the rash the age range of the affected children and the lack of change in the child s playfulness and appetite despite the high fever THESE QUESTIONS WILL SAY MMRC 2 OR LESS 1 AND HOSPITALIZATIONS OR NOT THERE WAS THREE OF THEM KNOW ABE 11 COPD group A I put salmeterol GROUP A BRONCHODILATOR IPRATROPIUM BROMIDE WHICH IS A SAMA WAS AN ANSWER CHOICE AND IT DOES ACHIEVE BRONCHODILATION I DON T REMEMBER IF I PUT OLDASTEROL
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