Approach to Cushing’s:
1- Confirm Cushing with 24h urine test
2- Measure ACTH if urine came +ve
3a- Low ACTH: CT abdomen
3b- high ACTH: High dexa suppression test
4a- +ve: MRI brain
4b- -ve: ACTH secreting tumor, perform CT chest
1- Confirm Cushing with 24h urine test
2- Measure ACTH if urine came +ve
3a- Low ACTH: CT abdomen
3b- high ACTH: High dexa suppression test
4a- +ve: MRI brain
4b- -ve: ACTH secreting tumor, perform CT chest
● PROPHYLAXIS IN SAUDI SOLDIERS GOING TO THE SOUTH: ATOVAQOUONE AND PROGUANIL
● PROPHYLAXIS IN SAUDI IN GENERAL : MEFLOQUINE
● PROPHYLAXIS FOR DEPRESSED PATIENT : ATOVAQUONE /PROGUANIL (mefloquine is contraindicated)
● PROPHYLAXIS IN SUDAN: MEFLOQUINE
● TX FOR MALARIA IN SAUDI : ARTESUNATE/pyrimethinamine/sulfadoxine
● TX for malaria in SOUTHEAST ASIA : ARTESUNATE AND MEFLOQUINE
● PROPHYLAXIS IN SAUDI IN GENERAL : MEFLOQUINE
● PROPHYLAXIS FOR DEPRESSED PATIENT : ATOVAQUONE /PROGUANIL (mefloquine is contraindicated)
● PROPHYLAXIS IN SUDAN: MEFLOQUINE
● TX FOR MALARIA IN SAUDI : ARTESUNATE/pyrimethinamine/sulfadoxine
● TX for malaria in SOUTHEAST ASIA : ARTESUNATE AND MEFLOQUINE
Smoking cessation approach:
Initial, Behavioral and motivational
Pregnant, behavioral (NRT if it fails)
Inpatient, NRT
Outpatient with cardiac problem, bupropion (Varenicline is debatable)
Outpatient without cardiac problem, Varenicline
Kidney problems, avoid Varenicline
Hx of seizures, anxiousness, or depression, avoid bupropion
Initial, Behavioral and motivational
Pregnant, behavioral (NRT if it fails)
Inpatient, NRT
Outpatient with cardiac problem, bupropion (Varenicline is debatable)
Outpatient without cardiac problem, Varenicline
Kidney problems, avoid Varenicline
Hx of seizures, anxiousness, or depression, avoid bupropion