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AANP Lightning Round #3Follow up on the HIV confirmatory test discussion at my last lightning round, I am being told that for the exam (AS OF NOW) they are looking for the confirmatory test to be Western Blot, not the HIV 1 and 2 Antibodies as Leik 3rdedition is indeed saying. SOO it sounds like we are to choose Western Blot then, fyi! Ok, for those of you watching for the first time I like to do a quick disclaimer that any and all information shared during this hour is either from Leik 3rdedition, Hollier online review, or files in this group. I have yet to take the exam, but from whatI’m hearing it’s straightforward IF you know the material and my school always preached to know “buzz words”. If there’s anything you don’t agree with during this hour or want to add to, PLEASE let me know. Ok, let’s begin!Metformin max dose – 2000mg consider Basal Insulin African American male first line htn med : CCB, thiazideVitmin D 800 Ca 1200SSRI PAXIL Do not use and use. Erectile dysfunction Coarctation of Aorta: Know that systolic BP on lower extremities is supposed to be higher compare to upper extremities. In COA case its vise versa. Look for weak radial and bounding femoral pulse. Medial Tibial (Splints), NO XRAY Just REST ,NSAIDS, Legg-Calve Perthes disease: Key word: osteonecrosis of femur. 3-12 yearsPresentation: pain to hip or referral to medial aspect of kneeDx: Tredelenburg (positive in SCFE, Legg and dev dysplasia Xray:AP w/ Frog-leg view referSCFERisk: adolescent, obese male,Dx: Tredelenburg, no xray, resolves in about 14 daysMcMurrays Sign- Meniscus tearsLachmans- ACLIt is a self limiting over use injury often seen in young boys following a growth spurt. The child may c/o anterior knee pain. Tx with NSAIDs/restDrawer sign test- for knee stability- positive anterior drawer sign test for ACL, the positive drawers sign test for PCL Homans sign- lower leg pain on dorsiflexion of foot, assess for DVTVitamin B12 deficiency-Red beefy tongue –also called Pernicious anemiaPt. with GERD and Barrett’s esophagus: Refer to OncologistNephritic and nephritic syndrome: Nephritis is blood.....Nephroticis protein RBC casts in UA......kidney biopsyKawasaki disease- high fever enlarged lymph nodes red rash in groin are, conjunctivitis, dry cracked lips, strawberry tongue, swollen hands/feet, skin peels form hands/feet, TX high dose aspirin, gamma globulin