surgical procedures for acute otitis media (AOM)Indications
Not routinely indicated in acute AOM
Consider for patients with treatment failure or recurrent infection.
Procedures
・Myringotomy
Surgical incision into the tympanic membrane to drain fluid to relieve pressure/pain
Consider as an adjunct to antibiotic therapy for severe otalgia and a ☆bulging tympanic membrane
・Myringotomy with tympanostomy tube insertion
for chronic otitis media infectious diseaseENT国試過去3年 Jan 28, 2021, 5:25 AM HirotoShishido
Management of hypercalcemiaSevere(>14) case requires treatment
■Increase Urinary Ca2+ Excretion
★Isotonic saline (4-5 L) over 24 h ± loop diuretic (e.g. furosemide) but only if hypervolemic (urine output >200mL/h)
Calcitonin (remember to ask about fish allergies)
■Diminish Bone Resorption
☆Bisphosphonates(long term)
■Decrease GI Ca2+ Absorption
Corticosteroids can be used in hypercalcemia mediated by 1,25 Vitamin D.
Management of chronic kidney disease• diet
■ preventing HTN and volume overload
■ ☆low-protein diet
• Na+ restriction
■ preventing electrolyte imbalances
■ target of <2 g/d (5 g/d of salt)
• K+ restriction (40-60 mmol/d)
• PO43– restriction (1 g/d)
• avoid extra-dietary Mg2+ (e.g. antacids)
■ preventing uremia and potentially delaying decline in GFR
• protein restriction with adequate caloric intake (☆25-35kcal/kg day) in order to limit endogenous protein catabolism renal国試過去3年 Oct 17, 2020, 11:16 PM HirotoShishido
State trait anxiety inventoryinventory based on a 4-point Likert scale and consists of 40 questions on a ☆self-report basis. The STAI measures two types of anxiety – state anxiety, or anxiety about an event, and trait anxiety, or anxiety level as a personal characteristic.
自記式（被験者が記入）
●☆Minnesota（ミネソタ）多面人格検査（MMPI）
●矢田部-Guilford性格テスト（Y-Gテスト）
●文章完成テスト
●☆Beck（ベック）のうつ病自己評価尺度
Beck Depression Inventory (BDI)
●気分プロフィール検査（POMS）
Profile of Mood States
●状態特性不安検査（STAI） psychiatry国試過去3年 Oct 13, 2020, 8:34 PM HirotoShishido
asymmetric tonic neck reflexprimitive reflex found in newborn humans that normally vanishes around 6 months of age. It is also known as the "fencing reflex" pediatrics国試過去3年 Oct 9, 2020, 11:47 PM HirotoShishido
FGR児のふるえfetal growth restriction
FGR児に低血糖，低カルシウム血症や★赤血球増多症(The polycythemia results from increased erythropoietin secretion in response to fetal hypoxia.)を認めることは頻度的に多いが，それ以外は少ない．四肢が小刻みに震えた場合は，児の全身状態とともに観察し，けいれんと考えにくい場合には，低血糖または低カルシウム血症の可能性を考え，少量の血液で両者を同時に迅速検査することが多い pediatrics国試過去3年UWorld step2CK Oct 9, 2020, 11:17 PM HirotoShishido
vernal conjunctivitis春季カタル
large papillae (cobblestones) form on superior palpebral conjunctiva with corneal ulcers and keratitis
• seasonal(warm weather)
• occurs in children,lasts for 5-10yr then resolves ophthalmology国試過去3年 Sep 21, 2020, 8:17 PM HirotoShishido
hordeolum and chalazionhordeolum
麦粒腫 ものもらい
• infectious agent is usually S.aureus
• painful,red swelling of lid
① 蕁麻疹の一種であり，真皮下層または皮下組織の限局性浮腫．
② 蕁麻疹と同様に全身に出現するが，特に☆眼瞼，口唇に多い．気道に浮腫を生じた場合には，窒息の危険があるため，☆咽頭内視鏡検査で浮腫の状態を把握する必要がある．
③ 非遺伝性と遺伝性（C1インヒビター欠損症，非常にまれ）の病型がある． dermatology国試過去3年 Sep 21, 2020, 6:35 PM HirotoShishido
mastocytoma=☆urticaria pigmentosa
色素性蕁麻疹
① 皮膚（真皮）や他の臓器で肥満細胞が増殖する疾患．
② 生後1年ごろまでに発症する小児型と，成人に発症する成人型がある．小児型が多い．
③ 反復性の蕁麻疹様発作と，四肢や体幹に褐色斑，褐色調丘疹が多発する．
④ 病変部に機械的刺激を加えると，肥満細胞からのヒスタミン放出により，膨疹を生じる（Darier徴候 dermatology国試過去3年 Sep 21, 2020, 6:32 PM HirotoShishido
