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1. Glomerulonephritis - assessment - ANSWER ✔ Require BP
assessment
Renal function
serum albumin
Urine protein excretion
2. Acute Postinfectious Glomerulonephritis - ANSWER ✔ May follow
recent group A B-hemolytic strep infection (pharyngitis or impetigo)
3. Glomerulonephritis - Recovery - ANSWER ✔ In most cases full
recovery usually occurs within weeks
No specific treatment
4. Cryptoorchidism - ANSWER ✔ undescended testicles
Spont. descent of testes rarely occur after 6mo
Increased risk of infertility and testicular malignancy if untreated
,5. Cryptoorchidism - Assessment and Treatment - ANSWER ✔
Measurement of LH, FSH, inhibin B & testosterone can determine if
testes are present in infants 2-6mo
HCG stimulation test can be done after 6 mo to determine presence or
absence of functional abdominal testes
US, CT scan, and MRI are preferred to detect teste in the inguinal
region
No treatment recommended for retractile testes
Surgical orchidopexy should be performed if descent has not occured
by 6-12 mo
6. Headaches facts - ANSWER ✔ 5th most common reason for ED visit
adn 2nd most common reason for neuro consult in ED
May be primary or secondary
7. Primary Headaches - ANSWER ✔ Migraine
tension type
Cluster
8. Secondary headaches - ANSWER ✔ intracranial lesions
head injury
cervical spondylosis
dental or ocular disease
TMJ dysfunction
sinusitis
HTN
depression
,9. New, Severe, or acute headaches - ANSWER ✔ more likely to relate
to an intracranial disorder
10. Migraine - ANSWER ✔ Usually pulsatile
lasts 4-72 hours'accompanied by nausea, vomiting, photophobia, and
phonophobia
pain aggravated by routine physical activity
Aura of transit neuro symptoms may precede pain (commonly visual)
head pain commonly occurs without aura
Migraine with aura may be risk factor for stroke
11. Migraine symptom management - ANSWER ✔ Consists of
symptomatic and preventative therapy
rest in quiet darkened room
simple anagesics (tylenol, ibuprofen, asa, naproxen)
Limit simple anagesic use to <15 days/mo and combo anagesic to <10
days/mo to prevent medication overuse
12. Migraine common medications for symptom relief - ANSWER ✔
Ergotamines
Triptans
Prochlorperazine
Butalbital combo medications
neuromodulation
, 13. Migraine medication precautions and contraindications -
ANSWER ✔ Max dosages in 24 hours and limitations of number of
days per month
Ergotamine meds should be avoided during pregnancy, CVD, patients
taking potent CYP 3A4 inhibitors
Triptans should be avoided during pregnancy, hemiplegia or basilar
migraine, risk factors for stroke or TIA (uncontrolled HTN), DM,
hypercholesterolemia, obesity. Contraindicated in pts with coronary
or peripherial vascular disease.
Avoid opioid analgesics due to high rates of rebound headaches and
risk of overuse
14. Migraine preventative treatment - ANSWER ✔ Indicated if
migraines occur more than 2-3 x/mo or significant disability
associated with attack
Avoidance of triggers and maintenance of homeostasis with sleep,
meals, and hydration
Headaches diary
Prophylatic medications (topiramate, valproic acid, propranolol,
amitriptyline, venlafaxine)
Treat for several months, if remain symptom free -taper and withdraw
medications
15. Tension type headaches - ANSWER ✔ most common type of
primary headache disorder
Pt complaints: pericranial tenderness, poor concentration, constant
daily headaches with vise like or tight quality but NOT pulsatile