 “growing pains” – bilat leg pains in growing child  normal  reassure

patients
 SSRIs  SIADH  euvolemic hyponatremia
 Beta blockers not first line in treatment of HTN
 Finasteride not used for BPH
 ORAL corticosteroids for COPD exacerbation
 Ottawa Ankle Rules
o Patients who were able to bear weight immediately following their
injury and who can take 4 steps independently AND:
 Pain is present in the malleolar zone and bony tenderness of
the posterior edge or tip of either malleolus is elicited (ankle
radiograph)
 Pain is present in the midfoot zone and bony tenderness of
either the base of the fifth metatarsal or the navicular region
is present.
 A “D” recommendation means the U.S. Preventive Services Task Force
(USPSTF) recommends against the service. There is moderate or high
certainty that the service has no net benefit or that the harms outweigh the
benefits. An “I” recommendation means the USPSTF concludes that the
evidence is lacking, of poor quality, or conflicting, and the balance of
benefits and harms cannot be determined. A “C” recommendation means
the USPSTF recommends selectively offering or providing this service to
individual patients based on professional judgment and patient
preferences. There is at least moderate certainty that the net benefit is
small. A “B” recommendation means the USPSTF recommends the
service. There is high certainty that the net benefit is moderate or there is
moderate certainty that the net benefit is moderate to substantial. An “A”
recommendation means the USPSTF recommends the service and there
is high certainty that the net benefit is substantial. The highest levels of
evidence and most recent evidence available are used by the USPSTF in
making all of its recommendations.
 Treat OM w/ amoxicillin
 Treat exercise bronchospasm w/ inhaled daily corticosteroid and as-
needed albuterol
 Long acting beta2 agonists should be used with inhaled corticosteroid
 Compartment syndrome – pain with stretching/minor injury; requires tissue
pressure study
 HIV prophylaxis w/ emtricitabine/tenofovir- increases HIV resistance if
used in people who already have HIV
 Single dose dexamethasone recommended in all patients with croup
 Testosterone replacement causes erythrocytosis- monitor Hct
 Statin therapy is beneficial in:
o Individuals with clinical ASCVD
o Primary elevations of LDL-C >190 mg/dL
o Patients age 40–75 with diabetes mellitus, an LDL-C level of 70–
189 mg/dL, and no clinical ASCVD
 o Patients age 40–75 without clinical ASCVD or diabetes, an LDL-C
level of 70–189 mg/dL, and an estimated 10-year ASCVD risk
>7.5%. For patients age 40–75with diabetes, an LDL-C level of 70–
189 mg/dL, and no clinical ASCVD, a moderate-intensity statin is
recommended.
 Quetiapine – increased risk of death in elderly pts w/ dementia due to
CVD/stroke
 Fentanyl preferred narcotic in ESRD (99% hepatic elimination)
 Biscuspid aortic valve is most likely cause of valvular disease in a family
 One time screening for HCV recommended in individuals born 1945-1965
 Doxycycline for chemoprophylaxis of Lyme disease
 Hereditary hemochromatosis dx'd by random ferritin and transferrin
measurement
 Hypoparathyroidism  heart failure
 The U.S. Preventive Services Task Force (USPSTF) recommends screening
smokers for lung cancer with
low-dose CT. Patients should be age 55–80 and healthy. They should be current
smokers or have quit
within the past 15 years, and have a 30-pack-year history of smoking. The screening
test is low-dose CT
of the chest. Abdominal ultrasonography to screen for abdominal aneurysms is
recommended for any male
age 65–75 who has ever smoked (USPSTF B recommendation). A bone density test
screens for
osteoporosis and is recommended for women age 65 or older or in younger women
at increased risk. The
USPSTF recommends against PSA testing (D recommendation) for prostate cancer,
as well as screening
for carotid artery stenosis.
 Indomethacin for cluster headaches
 Migraine prophylaxis – beta blockers, amitriptyline, anticonvulsants
(topiramate, valproate)
 Migraine treatment – sumatriptan, dihydroergotamine
 First line therapy for GERD is lifestyle modification
