Comparte
Ver el tema anteriorIr abajoVer el tema siguiente
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Mar Feb 12, 2013 3:37 am
Agranulocitosis causada por los siguientes medicamentos:

1. captopril
2. carbamazepina
3. chlorothiazida
4. clozapina
5. furosemida
6. Propiltiouracil
7. Cloramfenicol
8. Metimazol
9. METAMIZOL SODICO



1. Acute Glaucoma: Angulo cerrado

Patient has associated severe headache and vomiting. Complains of seeing halos around the lights. On examination : the pupils are mid-dilated and non-responsive to light and feel " hard as a rock". Presentacion es subita y es cuando se impide la salida del humor acuoso. Ocurre mientras el paciente duerme y el ojo se encuentra en midriasis. El dolor ocular es intenso.

2. Orbital cellulitis:
Patient has swollen, red and tender eyelids with fever and leukocytosis. With limited motion of that eye. Se presenta en casos relacionados a una sinusitis y en infantes y/o escolares.

3. Retinal Detachment:Desprendimiento de Retina

Patient complains of seeing more than a dozen "floaters" during the day and "cloud" at the top of the visual field ( which is the hemorrhage settling at the bottom of eye). Comun en paciente con DM II.

4. Embolic occlusion of retinal artery:
Sudden onset of loss of vision of eye. The patient is elderly.


Cont......



_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Miér Feb 20, 2013 6:50 pm
@khilap escribió:Si a las 5 dias encuentran neutrofilos en la lesion es por bacteria o algo mas?

Neutrofilos!!!!! Indica bacteria!!
Macrofagos es indicativo de cualquier otro bicho!

Infeccion numero uno en la lista es por virus!!!!! Asi que cualquier infeccion donde se encuentren linfocitos o datos de infeccion viral ya saben que esta es la respuesta. En si la pregunta toca el tema de una infeccion, piensen que siempre y por textos es viral despues son otras causas.

Neutrofilo=bacteria(En cuestion de infecciones).

_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Vie Mar 15, 2013 3:22 pm
Fluoroquinolones are contraindicated in pregnancy since they can cause arthropathy in the unborn fetus.

Children exposed to tetracycline in utero tend to show gray teeth. Completely contraindicated in the second half of the pregnancy and in children under the age of 8 years of age.

Trimethoprim-sulfamethoxazole can only be usedin the second trimester and only if no other safe option. This antibiotic is a C class medication and can interfere with folic acid metabolism in the first trimester and can contribute to kernicterus in the newborn.

Amoxicillin, nitrofurantoin and cephalexin are the first choice during any stage of pregnancy. Asymptomatic bacteriuria should always be treated in order to decrease the risk of pyelonephritis, preterm birth, low birth weight and perinatal mortality. Always treat!


Mitral stenosis in a pregnant woman and young can present as atril fibrillation. As the pregnancy propresses the patient can present symptoms related to pulmonary edema. The patient can suddenly present shortness of breath and is unable to lie flat. As part of her past history she could have recurrent throat infections. So mitral stenosis in a pregnant woman can present shortness of breath, atrial fibrillation and pulmonary edema due to left atrial overload and enlargement. During the physical exam one can find a diastolic rumble at the apex and/or an opening snap. Causative agent is streptococcus pyogenes.


Very Happy

_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Vie Mar 15, 2013 11:00 pm
Paciente con edema pulmonar agudo con saturacion menor de 89% y alergico a las sulfas. Radiografia de torax revela edema pulmonar bilateral.

Tratamiento de eleccion? acido etacrinico IV





_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Mar Mar 19, 2013 1:28 am
Abrupta Placenta - 4
Pt presents with vaginal bleeding, ABDOMINAL PAIN, and uterine tenderness. The absence of hemorrhage DOES NOT rule out this Dx. DDX:Placenta Previa, after adequate lab. testing absence of bleeding RULES OUT this dx.
****Risk factors are:1-HT and preecclampsia, 2.-Placental abruption in previous pregnancy, 3-trauma, 4-short umbilical cord, 6-COCAINE abuse. AP is the mcc of DIC in pregnancy, which results from a release of activated thromboplastin from the decidual hematoma in to maternal circulation. ****Risk factors are smoking and,Folate def. It can progress rapidly so careful monitoring is mandatory. Once dx is made, large-bore IV , as well as Foley cathater is inserted. Pts with AP in LABOR should be managed aggressively to insure rapid vaginal delivery, since this will remove the inciting cause of DIC and hemorrhage. Now if pt is stable tocolysis with MgSO4 is considered, but remember Ritordin is contra indicated in pt with HT.
***Again, once we dx the next step is Vaginal delivery with augmentation of labor if necessary. Now if mother and baby are not stable or if there is contra indication, then Emergency C-section is indicated.

Now if there is Dystocia ( narrowing of the birth passage) then Forcepts can be used.


ABCD of Homeostasis:
1-AIRWAY: An airway is needed for all unconscious pts, in the ER best method is Orotrachial intubation and in the field its needle cricothyroidectomy. For consciouns pt the best airway is chin lift with face mask.
2-BREATHING: Cervical spine injury should be analyzed but the first step is to establish ABC.

3-CIRCULATION: It needs control of bleeding and restoring the BP. In most external injuries pressure is enough to stop bleeding but in case of scalp laceration suturing is needed. Also all pts with hypotension should receive rapid infusion of isotonic fluid like ringer lactate to prevent life threatening hypotension. If IV line is not good for adults do saphaneous vein cut down and for children intraosseous membrane cannulation.


Absence seizures - 3
Ethosuximide is tx. Now remmeber that Phenytoin and Carbamazapine are first line drug used for primary generalized tonic clonic sezure or partial seizures, both work by blocking Na channels voltage dependent, Phenytoin is a second drug line for myoclonic and tonic clonic seizure, its available in both IV and oral forms, SE is gingivial hypertrophy, lymphadenopathy, hirsutism and rash, Both Phenytoina & Carbamazepine can cause Steven Johnson synd and Toxic Epidermal Necrolysis.

*****Tx is Ethusuxamide or VALPROATE. Classic EEG is symetric 3mhtz spike and wave .

Acarbose SE
It blocks carbohydrate break down in the intestinal tract. The most significant SE is GI disturbance due to increased undifested CHO in the stool.

ACE inhibitor SE, Respira, 6/2
CAPTOPRIL (Cough, Angioedema, Pregnancy, Taste change, hypOtention, Proteinuria,Rash, Increase renin, Lower AII) and HyperKalemia. Cough is caused by accumulation of Kinins possibly by activation of arachadonic acid pathway. Kinins are degraded by ACE, when there is noACE they increase.*****Angioedema that is seen in ER. Pt presents with non-inflamatory subcutaneous edema and laryngeal edema due to bradykinin stimulation.

Acetaminophen toxicity - 2
Acute alcoholic intake can reduce the risk of hepatic injury by Acetaminophen because it competes with CYP2E1, so there is less production of toxic metabolites. Chronic alcohol intake increases risk of hepatic injury by stimulating P450 system and decreasing the amount of Glutathione (used for metabolism of acetaminophen). Management process: 1-4-hr post ingestion AA levels are determined to decide whether the pt will benefit from NAC or not. 2-On the other hand if the pt has ingested >7.5 gr AA and levels will not be available w/i 8 hours of ingestion, he should be given the antidote.


Acetazolamide Toxicity
Causes normal anion gap metabolic accidosis due to renal loss of bicarbonate. Anion Gap is 140-(114+116)=10 which is normal anionic gap metabolic acidosis.

Achalasia - 3
Dx 1-Barium studies, 2-Esopgaguscopy 3-Manometry. ** the CONFIRMATION test is Manometry. We also need to do Endoscopy to rule out malignancy.

ACL Injury
It prevents gliding of tibia under femur. Injury is seen after Hyperextension. A poping sensation is felt at time of injury. Commonly asso with Medial Meniscus and Medial Colateral Ligament (TRIAD). Lachman test is a test for ACL tear. Flex and pull tibia. Drawer sign also test ACL but its less sensitive. Posterior Drawer sign tests PCL. Mc murry's sign tests Meniscus injury. Valgus test is for MCL.


Acne - 2
1-Comedons (black/white heads): cuase minimal inflamation and tx is topical retinoids. If reactivation occur add topical Erythromycin or Benzoyl peroxide. 2-Papular and inflamatory acne: with moderate-severe inflamation: Oral Doxycycline. 3-Nodular or scaring acne: Oral Isotretinoin.

Acromegaly

Actinomycosis
Cervicofacial actinomycosis presents as slowly progressing , non tender, indurated mass, which evolves into multiple abscesses, fistula, and draining sinus tracts with sulfur granules, which appear yellow. Actinomyces israelii is the agent, Tx is high dose IV peniciline for 6-12 weeks. Surgical debrement comes after penicillin therapy.

Acute adrenal insufficiency:
Acute onset of naseau, vomiting, abdominal pain and hypoglycemia and hypotension after a stressful event (surgery) in a pt sho is steroid dependant is typical. A clue is preoperative steroid use. Exogenous steroids depress pit-adrenal axis and a stressful situation can precipitate AAI. DDX: insulin induced hypoglycemia does not cause naseau and vomit and abdominal pain and hypotension.
Very Happy

_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
avatar
juanrou
Foroenarmita Avanzado
Foroenarmita Avanzado
Mensajes : 1655
Registro : 23/10/2011
Localización : guanajuato

Lema : tranquilidad

Re: Autorepaso......español y en ingles..!!

el Mar Mar 19, 2013 3:08 am
Gracias khilap pense que estaba estudiando bien , pro veo que debo rcharle mad ganas.
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Mar Mar 19, 2013 4:04 pm
@juanrou escribió:Gracias khilap pense que estaba estudiando bien , pro veo que debo rcharle mad ganas.

Siempre estoy leyendo y refrescando material en la mente. Guyton, Robbins y Harrison son a los cuales les estoy leyendo temas y articulos de diferentes de diferentes temas. Me gusta hacerlo y tengo que hacerlo por la situacion y trabajo que tengo. Very Happy

_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Vie Jun 07, 2013 4:31 pm
Very Happy

_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
XPaeZX
Foroenarmita Iniciado
Foroenarmita Iniciado
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 528
Registro : 09/05/2013
Localización : Guadalajara

Lema : Ignorance doesnt relieve one from the responsability of knowing

Re: Autorepaso......español y en ingles..!!

el Vie Jun 07, 2013 5:43 pm
It would be interesting if you could put extra questions/clinical vignettes Khilap! so that we can test ourselves and we can keep up with the hard work!

Pon mas preguntas o datos interesantes Khilap para que podamos mantenernos al tiro.
avatar
khilap
Administrador
Universidad : Universidad Autonoma de Guadalajara
Mensajes : 5055
Registro : 25/11/2008
Localización : Zagreb

Lema : Yo hago!

Re: Autorepaso......español y en ingles..!!

el Sáb Mayo 03, 2014 3:51 am
Esto les podra servir!

http://mudpiles.com/usmle2.php?action=Next&nextid=14

Claro que les puede servir!

_________________
http://foroenarm.foromotion.net/t416-reglamento-del-foro-enarm
Miembro Nº 9 del Club de Fans de la Dra. Koko
Síguenos en Facebook, sólo dale click en "Me gusta" en la página oficial del Foro ENARM

twitter@foro_enarm
Ver el tema anteriorVolver arribaVer el tema siguiente
Permisos de este foro:
No puedes responder a temas en este foro.