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

Primary Amenorrhea diagnosis. (Outflow obstruction like transverse vaginal septum happens when girl 👧 with normal or low FSH/LH and no period and with secondary sexual characteristics tuner stage more or eq 2= do US for anatomic abnormality)

Delayed puberty in girls occurs when breasts don't develop by age 13 or menstrual periods do not begin by age 16.
With delayed puberty, these changes either don't occur, or if they do, they don't progress normally. Delayed puberty is more common in boys than in girls. If constitutional usually there is FHx