The most common vaccine-preventable causes of sepsis and severe infections in patients with impaired splenic function are S. pneumoniae (pneumococcus), H. influenzae type b, and N. meningitidis (meningococcus)

Fluoroquinolones should generally be avoided during pregnancy and lactation unless a safer alternative is not available.

Patients with only 1 to 2 small (<1 cm) low-grade tubular adenomas should undergo repeat colonoscopy in 5 to 10 years. Finding 3 to 10 adenomas or any adenoma >1 cm, displaying high-grade dysplasia or with villous features, should prompt repeat colonoscopy at 3 years, and >10 adenomas at a single examination should prompt follow-up in <3 years, and a familial syndrome should be considered. Sessile adenomas removed piecemeal should be reviewed at 2 to 6 months to ensure complete removal.

Low-dose aspirin reduces the frequency of preeclampsia

Both clozapine and olanzapine are associated with more weight gain, insulin resistance and dyslipidemia than other antipsychotics

Eczema + Recurrent Infections + thrombocytopenia = Wiskott Aldrich Syndrome.

Sclerotherapy is the first-line treatment for problematic macrocystic hygroma (lymphangioma). Surgical removal of macrocystic LM is indicated if the lesion is symptomatic and sclerotherapy is no longer possible, or resection is possibly curative because the lesion is small and well localized.

Hypo-ca approach. (Tetanus including paresthesia and muscle spasms). Total < 2.12 mmol/l

Hyper-ca approach. (stones bones throans groans and psychiatric tones) total > 2.62 mmol/l

Approach to GERD symptoms and management.

Surgical therapy Indications (Equally effective alternative to medical therapy in certain patients with chronic GERD):
• Complications (e.g., Barrett esophagus, strictures, recurrent aspiration).


If s&s of GERD and Hx of vomiting blood. Endoscopy (BI) show multiple ulcers then fasting gastrin serum level (CT) . Treat with PPI and surgical resection but if mets do chemo. = zollinger

PE