咽頭異物の除去喉頭異物による窒息時は，1歳以上の幼児の場合，Heimlich法（abdominal thrusts 急激に上腹部を圧迫し気道内圧を上げる方法）を行い，1歳未満の乳児の場合は，胸部突き上げ法や背部叩打法(back blow)を行って異物を除去する． pediatricsemergency medicine卒試 Oct 20, 2020, 4:41 AM HirotoShishido
胃腸症状を伴う心筋梗塞下壁梗塞を疑う
下壁梗塞においては時に迷走神経トーヌスが過剰に亢進することがあり，Bezold―Jarisch reflexとして知られる。迷走神経が緊張すると消化管の蠕動運動は亢進し，高じれば悪心や嘔吐，下痢などの消化器症状を呈することとなる。実際には下壁梗塞の約半数に消化器症状が認められるとする報告もある。 cardiology卒試国試 Oct 20, 2020, 4:25 AM HirotoShishido
Cadmium toxicityカドミウム
合金製造，メッキ，アルカリ蓄電池製造
・☆腎障害…腎皮質に蓄積（1/3は腎に蓄積）
・近位尿細管の再吸収障害（Fanconi症候群）➡低分子蛋白尿（主としてβ2-MG），腎性糖尿，アミノ酸尿，代謝性アシドーシスなど
・多発骨折（腎性骨軟化症）
・☆歯牙のカドミウム輪（黄色環） poisoning卒試国試 Oct 20, 2020, 3:35 AM HirotoShishido
Koch's phenomenonBCG接種後，10日以内の早期に接種部に炎症（発赤，化膿など）が起こった場合，結核の既感染が疑われる．この場合，☆速やかにツ反検査を行う（遅くとも接種後2週間以内）． infectious disease卒試国試 Oct 20, 2020, 2:08 AM HirotoShishido
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 Oct 19, 2020, 8:47 AM 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 Oct 19, 2020, 5:22 AM HirotoShishido
ERG for retinitis pigmentosa, cataractRetinitis pigmenosa
波形が減弱消失し平坦化する．
☆Cataract
白内障や硝子体出血などで水晶体，硝子体の混濁が強く，眼底が透見できない場合に，視機能を推測する検査としては網膜電図（ERG）の他にも超音波B-mode検査が有効である． ophthalmology卒試国試直前 Oct 19, 2020, 5:10 AM HirotoShishido
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 Oct 18, 2020, 8:22 AM HirotoShishido
treatment of polydactylyAmputation of least functional digit Usually >1 yr of age (when functional status can be assessed) plastic surgerypediatrics卒試 Oct 18, 2020, 7:47 AM HirotoShishido
gestational age for Nuchal translucency U/S11-14w OBGY卒試 Oct 18, 2020, 7:10 AM 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 Oct 18, 2020, 6:45 AM 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 Oct 18, 2020, 5:00 AM HirotoShishido
Etiology of Postpartum Pyrexiafever>38°C on any 2 of the first 10d postpartum, except the 1st day
B-5W
Breast: engorgement, mastitis
Wind: atelectasis, pneumonia
Water: UTI
Wound: episiotomy, C/S site infection
Walking: DVT, thrombophlebitis Womb: endometritis OBGY卒試 Oct 18, 2020, 4:08 AM HirotoShishido
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 Oct 16, 2020, 4:27 AM 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 Oct 14, 2020, 5:01 AM HirotoShishido
