Ck Nbme 9

CK NBME 9 Pneumococcal vaccine schedule: all ages - Adults age 65 - Give PPSV23 alone for smokers, diabetics, and chronic heart/lung/liver disease - Give PCV13 followed by PPSV23 for high risk patients such those with CSF leaks, cochlear implants, sickle cell disease, asplenia, or immunodeficiency. PPSV23 is given 8 weeks later, revaccinate 5 years later, and after age 65 (see below) Adults age 65 Two options, but NBME seems to prefer the first one below - PCV13 followed by PPSV23 1 year later or - PPSV23 alone Kids - PCV13 only - 3 doses at 2, 4, 6 months of age - 4th dose at 12-15 months Pneumococcal vaccine schedule: children - Kids - PCV13 only - 3 doses at 2, 4, 6 months of age - 4th dose at 12-15 months Pneumococcal vaccine schedule: adults 65 - Adults age 65 Two options, but NBME seems to prefer the first one below - PCV13 followed by PPSV23 1 year later or - PPSV23 alone Pneumococcal vaccine schedule: adults 65 - Adults age 65 - Give PPSV23 alone for smokers, diabetics, and chronic heart/lung/liver disease - Give PCV13 followed by PPSV23 for high risk patients such those with CSF leaks, cochlear implants, sickle cell disease, asplenia, or immunodeficiency. PPSV23 is given 8 weeks later, revaccinate 5 years later, and after age 65 (see below) Post-transplant lymphoproliferative disorder - EBV infection. when T cells down due to immunosuppression, infected B lymphocytes replicate. up to half present with extranodal mass. txt is reduction of immunosuppressive meds - if severe, rituximab s/s of multiple myeloma - Increase in fractures, bone pain, lytic bone lesions, high calcium levels, kidney damage, frequent infections lithium utility in bipolar - which parts - all three: acute or chronic mania and depression txt acute depression in bipolar pts - lithium, lamotrigine, quietapine, lurasidone botulism - response on nerve stimulation - characteristic low amplitude response that improves with repeated stimulation