management for transient ischemic attack(TIA)Secondary prevention of future stroke includes antiplatelet agents (eg, aspirin, clopidogrel) to prevent thrombus formation and ☆statin therapy (HMG-CoA reductase inhibitor; eg, atorvastatin, rosuvastatin) to reduce atherosclerotic plaque formation. Lifestyle modifications (eg, exercise, tobacco cessation) are also recommended. neurologyUWorld May 24, 2020, 3:25 AM HirotoShishido
prenatal screening for group B streptococcus
characteristics of the bacteriaGBS colonization by vaginal-rectal culture at 35-37 weeks gestation is recommended to identify colonized woman who require ★intrapartum penicillin/ampicillin to prevent neonatal GBS sepsis, pneumonia and meningitis
women with heavy colnization (eg. asymptomatic bacteriuria) needs ampicillin (★)regardless of screening status or rectovaginal culture results
hypothyroidism and T3synthetic T3 (liothyronine) is not recommended for the routine treatment of hypothyroidism, as it has a short half-life and patients can experience wide fluctuations in plasma T3 levels
orexin receptor antagonist☆raMELteon
→used for insomnia
☆with the lowest side effect burden in older adults
suvOREXANT
→ OREXin(hypocretin) ANTagonist
recommended in patients with liver disease, limited physical dependance pharmacologyUWorld Mar 22, 2020, 9:41 AM HirotoShishido
AFP↑ 5 diseases
AFP↓ 2 diseases☆accurate dating is crucial for determining whether levels of AFP are abnormal for gestational age
synthesized in fetal liver, GI tract, and yolk sac(early gestation only)
↑
hepatocellular carcinoma(including hepatoblastoma)
endodermal sinus(yolk suc) tumor
mixed germ cell tumor
ataxia telangiectasia(血管拡張性失調症 leads to lymphoma)
neural tube defect
↓
21 trisomy
18 trisomy(Edward) biochemistryoncologyUWorld Apr 26, 2019, 10:49 AM HirotoShishido
diffrentiate between folate and vitamin B12 deficiency↑ homocysteine in both
☆↑ methylmalonic acid only in cobalamin deficiency(cobalamin=cofacter for methylmalonyl CoA mutase)
(methylmalonyl CoA is converted to succinyl CoA with the cofactor vitamin B12. If there is not enough vitamin B12 present, methylmalonyl CoA is alternatively converted to methylmalonic acid) hematologyUWorld Jun 14, 2019, 1:49 AM HirotoShishido
enters the nerve terminals through endocytosis, when it ☆prevents binding and fusion of Ach-containing synaptic vesicles with the plasma membrane through the destruction of SNARE proteins
sporothrix schenckii
transmissionspores are traumatically introduced into the skin, typically by ☆a thorn("rose gardener's disease") microbiologydermatologyUWorld Mar 25, 2020, 9:40 PM HirotoShishido
picture
symptoms, transmission, diagnosis, treatmentcutaneous leishmaniasis
enlarging, pinkish papule at the site of the bites→ eventually develop into nodule or plaque and ulcerations
caused by Leishmania donovani
→can also cause(kala-azar)
(visceral protozoa infection) hepatosplenomegaly, pancytopenia
sandfly
macrophages containing ☆intracellular round oval amastigotes with rod shaped kinetoplasts
PTHrP(parathyroid hormone-related protein)→ ↑Ca (SCC of the lung)
☆Ectopicerythropoietin(EPO)→ polycythemia
(* RCC can also cause both anemia of chronic disease and iron deficiency anemia due to chronic hematuria)
