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Med final 1 Peds - Endocrinology Pharmacy Terms Week One fac
Teacher 6 terms 58 terms 35 terms 17
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Terms in this set (513)
<5% = Low Risk
5-7.5% = Intermediate
>7.5% = Severe
If indetermediate, consider:
- Coronary Artery Calcium score greater than 300 or greater than 75% for age
ASCVD
- C-reactive protein level (hsCRP) above 2 mg/L
- Ankle-brachial index below 0.90
- LDL cholesterol level 160 mg/dL
- Family history
- HIGH intensity statin for LDL > 190 regardless of risk
<4cm low risk, US every 2-3 years
4cm-5.4cm need 6-12 month monitoring
Over 5.5cm = SURGERY
HIGH RISK surgery so need cardiac evaluation with AT LEAST chemical stress test
if sedentary and angio if indicated...elective procedure so if myocardium at risk,
Abdominal Aortic Aneurysm
DEFER surgery
If symptomatic over 5cm in men or 4.5cm in women = SURGERY
- Cholesterol atheroemboli are high risk after any vascular procedures esp those
with comorbidities
- differentiate from renal embolization which is due to A fib and can present like
pyelonephritis (but with increased LDH)
- oliguria or increasing serum creatinine levels who have had abdominal surgery,
who have received massive fluid resuscitation, who have a tense abdomen, or
Abdominal compartment syndrome who have liver or pancreatic disease with ascites
- measure abdominal pressure or bladder pressure for diagnosis
- treatment is surgical decompression
, - chronic liver disease
- chronic alcoholism
Acanthocytes (spur cells)
- of course with insulin resistance but heavily associated with STOMACH
ACANTHOSIS NIGRICANS
ADENOCARCINOMA
- associated with squamous cell carcinoma
Achalasia
Barrett's = adenocarcinoma
- 1st line is topical retinoid
- 2nd abx
- 3rd isotretinoin (for CYSTIC acne)
NON INFLAMMATORY ACNE
- open and closed comedones
Acne
- Tx: topical retinoid is the best
INFLAMMATORY ACNE
- papules, pustules, nodules, cysts
Pregnant patients should be off for ONE MONTH before conceiving
- no family history
Acquired cystic kidney disease (ACKD) - small kidneys, cysts in the renal parenchyma
- once ESRD, patient at significantly increased risk of renal cell carcinoma
- Tx: transsphenoidal pituitary surgery for removal of adenoma
- might not completely remove tumor but surgery can effectively debulk the
tumor and preserve vision in addition to significantly decreasing GH secretion as
Acromegaly
measured by IGF-1 levels
- radiation therapy afterward may continue to work on the tumor if symptoms
don't improve with surgery
- pain, n/n
Acute angle closure glaucoma - colorful halos, decreased vision
- ophthalmic emergency, gonioscopy
- non alcoholic, non acetaminophen induced, non infectious: N-acetylcysteine IV
Acute Liver Failure
is beneficial as we wait for transplace, REGARDLESS of tylenol use or not!! wtf!!
, - Can be complicated with Ventricular Septal Defect.
- VSD manifests as hemodynamic compromise in the setting of a new holosystolic
murmur AT LEFT STERNAL BORDER 3 to 7 days after an initial myocardial
infarction. Patient has symptoms of CARDIOGENIC SHOCK, SYNCOPE and CHF,
echo showing left to right blood flow. Emergency condition requiring EMERGENT
SURGERY
- if chest pain and new LBBB or 3rd degree block, go straight to cath
- if over 50 and typical angina presentation, then GREATER THAN 90% chance of
CAD
- can be complicated with papillary muscle rupture and acute mitral regurg
requiring EMERGENT SURGERY
- no syncope reported and murmur usually at apex, though it can also be left
sternal too -___-
- Patient's who we start on medical therapy can have adverse effects, for example
BB can lead to heart block so monitor and titrate dose
- as we await cath, start antiplatelet therapy and heparin
- please note, Bivalirudin is an anticoagulant that can be in place of Heparin :-<
- please note, in NSTEMI, Ticagrelor is preferred over Plavix for DAPT
- please note, in NSTEMI, Prasugrel can ONLY be used if initiated AT THE TIME of
PCI
- If stable then sudden chest pain, think RV infarct with acute right HF. Patient
cannot perfuse left heart and ultimately rest of the body...these patients are
PRELOAD dependent in order to keep cardiac output up. PCWP is LOW, but PA
and RA is high
- Biventricular failure you get low CO but high PCWP high RA. INOTROPIC
dependence
Acute MI
- Fibrin specific tPA preferred over streptokinase if available and PCI is not able to
be performed
- MENSES is NOT a contraindication for tpA
- New LBBB can mask ST elevation so if evidence of LBBB go for PCI or tPA if
unable
- no tPA if CVA within 3 months
NTEMI
- Ticagrelor is preferred over Plavix for DAPT
- urgent PCI within 24 hours if new ST depression with increased trops
- PCI in 72 hours if other risk factors
- obviously if chest pain, go now
CARDIOGENIC SHOCK
- PCWP high TA high and RA high
- dopamine is dose dependent, start at 2-5mics/kg/min and titrate up to 10mics if
needed
THROMBUS
- post MI patient presents with metabolic acidosis and evidence of peripheral
ischemia like abdominal pain, exremities with lack of perfusion
- hemodynamically BP is ok so no cardiogenic shock or rupture suspected
- likely developed apical aneurysm due to acute MI and developed thrombus
which is now causing embolic disease. Check echo!
Leave the first rating
Students also studied
Flashcard sets Study guides Practice tests
Med final 1 Peds - Endocrinology Pharmacy Terms Week One fac
Teacher 6 terms 58 terms 35 terms 17
More
Paola_Rico7 Preview TiffanieAbraham Preview Harmannat_Sandhu Preview
Terms in this set (513)
<5% = Low Risk
5-7.5% = Intermediate
>7.5% = Severe
If indetermediate, consider:
- Coronary Artery Calcium score greater than 300 or greater than 75% for age
ASCVD
- C-reactive protein level (hsCRP) above 2 mg/L
- Ankle-brachial index below 0.90
- LDL cholesterol level 160 mg/dL
- Family history
- HIGH intensity statin for LDL > 190 regardless of risk
<4cm low risk, US every 2-3 years
4cm-5.4cm need 6-12 month monitoring
Over 5.5cm = SURGERY
HIGH RISK surgery so need cardiac evaluation with AT LEAST chemical stress test
if sedentary and angio if indicated...elective procedure so if myocardium at risk,
Abdominal Aortic Aneurysm
DEFER surgery
If symptomatic over 5cm in men or 4.5cm in women = SURGERY
- Cholesterol atheroemboli are high risk after any vascular procedures esp those
with comorbidities
- differentiate from renal embolization which is due to A fib and can present like
pyelonephritis (but with increased LDH)
- oliguria or increasing serum creatinine levels who have had abdominal surgery,
who have received massive fluid resuscitation, who have a tense abdomen, or
Abdominal compartment syndrome who have liver or pancreatic disease with ascites
- measure abdominal pressure or bladder pressure for diagnosis
- treatment is surgical decompression
, - chronic liver disease
- chronic alcoholism
Acanthocytes (spur cells)
- of course with insulin resistance but heavily associated with STOMACH
ACANTHOSIS NIGRICANS
ADENOCARCINOMA
- associated with squamous cell carcinoma
Achalasia
Barrett's = adenocarcinoma
- 1st line is topical retinoid
- 2nd abx
- 3rd isotretinoin (for CYSTIC acne)
NON INFLAMMATORY ACNE
- open and closed comedones
Acne
- Tx: topical retinoid is the best
INFLAMMATORY ACNE
- papules, pustules, nodules, cysts
Pregnant patients should be off for ONE MONTH before conceiving
- no family history
Acquired cystic kidney disease (ACKD) - small kidneys, cysts in the renal parenchyma
- once ESRD, patient at significantly increased risk of renal cell carcinoma
- Tx: transsphenoidal pituitary surgery for removal of adenoma
- might not completely remove tumor but surgery can effectively debulk the
tumor and preserve vision in addition to significantly decreasing GH secretion as
Acromegaly
measured by IGF-1 levels
- radiation therapy afterward may continue to work on the tumor if symptoms
don't improve with surgery
- pain, n/n
Acute angle closure glaucoma - colorful halos, decreased vision
- ophthalmic emergency, gonioscopy
- non alcoholic, non acetaminophen induced, non infectious: N-acetylcysteine IV
Acute Liver Failure
is beneficial as we wait for transplace, REGARDLESS of tylenol use or not!! wtf!!
, - Can be complicated with Ventricular Septal Defect.
- VSD manifests as hemodynamic compromise in the setting of a new holosystolic
murmur AT LEFT STERNAL BORDER 3 to 7 days after an initial myocardial
infarction. Patient has symptoms of CARDIOGENIC SHOCK, SYNCOPE and CHF,
echo showing left to right blood flow. Emergency condition requiring EMERGENT
SURGERY
- if chest pain and new LBBB or 3rd degree block, go straight to cath
- if over 50 and typical angina presentation, then GREATER THAN 90% chance of
CAD
- can be complicated with papillary muscle rupture and acute mitral regurg
requiring EMERGENT SURGERY
- no syncope reported and murmur usually at apex, though it can also be left
sternal too -___-
- Patient's who we start on medical therapy can have adverse effects, for example
BB can lead to heart block so monitor and titrate dose
- as we await cath, start antiplatelet therapy and heparin
- please note, Bivalirudin is an anticoagulant that can be in place of Heparin :-<
- please note, in NSTEMI, Ticagrelor is preferred over Plavix for DAPT
- please note, in NSTEMI, Prasugrel can ONLY be used if initiated AT THE TIME of
PCI
- If stable then sudden chest pain, think RV infarct with acute right HF. Patient
cannot perfuse left heart and ultimately rest of the body...these patients are
PRELOAD dependent in order to keep cardiac output up. PCWP is LOW, but PA
and RA is high
- Biventricular failure you get low CO but high PCWP high RA. INOTROPIC
dependence
Acute MI
- Fibrin specific tPA preferred over streptokinase if available and PCI is not able to
be performed
- MENSES is NOT a contraindication for tpA
- New LBBB can mask ST elevation so if evidence of LBBB go for PCI or tPA if
unable
- no tPA if CVA within 3 months
NTEMI
- Ticagrelor is preferred over Plavix for DAPT
- urgent PCI within 24 hours if new ST depression with increased trops
- PCI in 72 hours if other risk factors
- obviously if chest pain, go now
CARDIOGENIC SHOCK
- PCWP high TA high and RA high
- dopamine is dose dependent, start at 2-5mics/kg/min and titrate up to 10mics if
needed
THROMBUS
- post MI patient presents with metabolic acidosis and evidence of peripheral
ischemia like abdominal pain, exremities with lack of perfusion
- hemodynamically BP is ok so no cardiogenic shock or rupture suspected
- likely developed apical aneurysm due to acute MI and developed thrombus
which is now causing embolic disease. Check echo!
