treatment of vesicoureteral reflux• spontaneous resolution in 60% of primary reflux
■ in lower grades (I-III), goal is to prevent infection or renal damage via medical treatment
• medical treatment: daily ABx prophylaxis
• surgical treatment: ureteral reimplantation ± ureteroplasty, or subureteral injection with bulking agents (Deflux® or Macroplastique®)
■ indications include failure of medical management, renal scarring (e.g. renal insufficiency, HTN), breakthrough UTIs, persistent ☆high grade (IV or V) reflux urologypediatrics卒試 HirotoShishido
common age with premature thelarcheIt occurs in females younger than 8 years, with the highest occurrence before the age of 2. PT is rare, occurring in 2.2-4.7% of females aged 0 to 2 years old. pediatrics卒試 HirotoShishido
ERG for retinitis pigmentosa, cataractRetinitis pigmenosa
波形が減弱消失し平坦化する．
etiology of amblyopia• progressive suppression of visual input from eye receiving suboptimal image(blurry, deviated)
• in approximately half of the cases, amblyopia is secondary to strabismus (mainly ☆esotropia)
• other causes may include ★uncorrected refractive errors, anisometropia 不同視弱視 (asymmetric refractive errors, usually in the more ☆hyperopic eye), and deprivation due to structural ocular problems (ptosis, cataract, corneal opacity/scarring, retinoblastoma) ophthalmology卒試UWorld step2CK HirotoShishido
incubation period for each organisms which cause acute diarrheaemetic B cereus 1-6h
S aureus 2-4h
C perfringens 8-12h
diarrheal B cereus 8-16h
Norovirus 1d
Salmonellosis 大腸, V cholerae, EIEC, ETEC 1-3d
Rotavirus 2-4d
☆Campylobacter jejuni 大腸2-10d
EHEC 大腸3-8d
Yersinia 大腸5d
Cryptosporidium 7d
S typhi 大腸10-14d
Giardia lamblia 7-28d
E histolytica 大腸14-28d gastrointestinal卒試 HirotoShishido
Indication for operative management of Intussusception発症後時間が経過して壊死が疑われるまたは腹膜炎を伴う場合や，高圧浣腸で整復されない場合は，Hutchinson手技（開腹して内筒を押し出す整復法）を用いる． pediatricssurgery卒試 HirotoShishido
Etiology of Postpartum Pyrexiafever>38°C on any 2 of the first 10d postpartum, except the 1st day
treatment of pneumothorax■ stable, small (<2 cm between lung and chest wall on x-ray), minimal symptoms: observation + O2
■ symptomatic or large (>2 cm): aspiration
■ unstable/tension pneumothorax: needle decompression then chest tube, and VATS if unsuccessful
(25-50%) respiratorysurgery卒試 HirotoShishido
treatment of hyperkalemia■ [K+] <6.5 and normal ECG
◆ treat underlying cause, stop K+ intake, increase the loss of K+ via urine and/or GI tract
■ [K+] between 6.5 and 7.0, no ECG changes: add insulin to above regimen
■ [K+] >7.0 and/or ECG changes: first priority is to protect the heart, add ★calcium gluconate (counterbalances the membrane depressive effect of hyperkalemia) to above electrolytes卒試UWorld step2CK HirotoShishido
