Length-time bias: in chronic dz like prostate ca Early detection looks like increase in survival a group of HIV+ individuals are all asymptomatic Patients with severe disease are less likely to be studied, because they dieĮ.g. detection, ascertainment, assessment bias. Investigator's evaluation is impacted by knowledge of exposure status parents of children with cancer recall exposure to a chemical
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Subjects with the disease are more likely to recall the exposure of interestĮ.g. if investigating the adverse events associated with a new drug, those with either the best or worst outcomes may be more likely to participate in a telephone survey about their experience with drug Selected participants are not representative of study population.Į.g. limit confounding x randomization, matching (age, race, socioeconomic state)Įffect Modification: Exposure/outcome is modified by the effect of another variable: (i.e Breast Cancer effect of OCP modified by family history of Breast cancer./ DVT: effect of estrogen - modified by smoking./ Lung Ca: effect asbestos- modified x smoking.) If not adjusted for can distort true association to or from the null hypothesis A factor that is positively or negatively associated with both the exposure and outcomeĬonfounders are not in the causal pathway Stop med, start agatroban, expix-, -rudinġ2) RMtSF (↓Plts & RBCs like HUS, with MS,OH hx) Poor wound heal, bldg, perifolicular, glossitis, Ua stones.ĩ) HSP (Child- 4-7 boy, rare adult)- normal labsġ0) WAS (child) (Plts & Inf hx) ↓Plts: (XR) Tx: ABx, IVIgġ1) HIT (↓Pts & BT, like ITP, but Heparin hx) Treatment: IVF, Lytes, Manitol if ICP, Liver-transħ) HEMOPHILIA ↑PTT (XR, Factor: 8/9 def: Give factorsĭiet lack fruit/veg, infant form overheated. Treatment: Plasmaphoresis, Roids, NSAIDs, no PLTs.: "Thrombocytopenic & Transient Personality" Treatment: "FaPP" Fresh Frozen Plasma, Plts,ĥ) TTP (Teen to<50) (↑BT, ↓Plt, ↓RBC) Fibrin dep. No AsprinĢ) ITP (Child/Adult) (↓Plt & ↑BT), no Fever or SMg.Ĭhild-no tx, Adult: Steroid #1,IVIg, Splenectomy. Dx, Tx, Complications?ġ0) <2yo: Bilious vomit with mucus & blood stool: "Currant jelly", palpable "sausage" mass. rule of 2s: 2" long, <2yo, 2' from ileocecal valve. Next?Ĩ) <2yo: Bilious vomit, sudden peritonitis, abdominal pain, distention, rectal bleeding & Draws (rotates) legs up (like tet spell)ĩ) <2yo: Variable vomit, bloody maroon stool. +DRE "Squirt Sign"Ħ) <2mo: *Premature*: Bilious vomit, rectal bleeding, fever, *Air in bowel wall*, Murmur (heart defect).ħ) <3mo: Nonbilious *projectile vomit*, palpable olive mass. double bubble sign.ĥ) <1yr: Feculant vomiting, distention, obstipation. #) 6mo spitting up regularly esp at night, not losing wt, no blood, non bilious,ġ)(<2 weeks): 'First day': Regurg of food (nonbileous), respiratory distress, cyanosis with feedingĢ) <1 week: feculant vomiting, no butholeģ) <1 week: Has not had BM, feculant vomiting, has squirt signĤ) <2 weeks: bilious vomiting, pregnancy complicated by polyhydramnios. Pediatric Vomiting & GI malformations:Timing, Dx, Assd dz? Continuous machine like, widened PP, bounding pulse, poor feeding, recurring resp. Radiates to carotid/neck,ħ0yo- atherosclerosis, deaf, blueberry muffin baby. Possitional: Pericarditis Rub NSAID/Asprin on it.ĪS: Harsh SEM crescendo/decrescendo, High pitch (blood going high), LVH- ↑O2 demand. Home meds: AsBC & NG (asa, ace, statin, Bb, clopidogrel, NG) Cath lab, tPA (if no cath lab + no bleeding, hx stroke, trauma or recent surgery) -MONA hAS Hep B. LMWH & Glycoprotein IIb/IIIa (abciximab, tirofiban, eptifibitide) "ABC, LOWHR Mortality in NSTEMI" 1st Hep MONA hAS Hep B, cath lab if continued sx Stable Angina: CP w/ exertion, relieved x Rest, NG _If thought to have 2nd MI 5 days later: Check CKmb.
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Stress test if non-acute indeterminate cases + Clopidogrel or Ticagrelor if acute MI, ++ Prasugrel if angioplasty is done. If case is clearly Ischemia & Asprin, Nitrates, O2 & morphine are options. #1 ECG - #2 Heart enzymes: Trop, CKmb, MG (rises 1st)