Helpful strategies to cope with shift work

isolated night shifts

bright light (>10,000 lux ) for 2 hours after rising

regular exercise

anchor sleep and naps

shifts must be rotated in a CLOCKWISE MANNER each change to a later not earlier 

ideally with a month or more per rotation

sporadic shifts are less disruptive for than longer stretches of nights of circadian rhythms, Anchor sleep involves sleeping for the same 4-h period 

regardless of the shift worked

--
No one ever wins, no one finally loses, except the dead, under the sun, they rot together, with absolute biological equality.

Disaster Plan

Mechanism of activation

Assessment of the hospital's capacity

establishment of disaster command

communication

supplies

administrative and treatment areas

training and drills

immediate discharge of predisaster patients?-not contemplated

assessment of likely hazards

coorperation between the hospital and the community

--
No one ever wins, no one finally loses, except the dead, under the sun, they rot together, with absolute biological equality.

Anaerobes

Clindamycin -respiratory or above diaphragm

Metronidazole - GI anaerobes

Carbapenams

Cephalsporins cefoxitin and cefotetan

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Gram neg rods

Fluroquinolones
Aminoglycosides
Carbapenams
Astreoram
Ceftriaxam 3:4 gen cephalosporins
Pipercillin


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Marfan Syndrome

Connective tissue defect
Musculoskeletal cardiac ocular

Pectus Excavatum-Funnel Chest

Most likely develop Kyphosis

Thumb print sign-epiglotitis on lat neck of child

Croup is associated with inspiratory stridor

3% chance of a couple having another child with bilateral cleft lip and palate

Infant born to diabetic mothers mothers often have cardiomegaly

Sudden symmetric addiction and flexion of limbs with concomitant flexion of head and trunk-west's syndrome

Hepatoblastoma -common malignant hepatic Tumour in one year old





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Congenital adrenal hyperplasia

Autosomal recessives disease

Excess or deficient production of sex steroid altering sex characteristics

Moat common cause of ambiguous genitalia.

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Staphyl aureus

Most likely cause of septic arthritis in 1 yr old.

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Pseudomonas aeruginosa

Most common cause of otitis externa in children.

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Congenital syphilis

Saber shin is a malformation of the tibia. It presents as a sharp anterior bowing of the tibia.

Saber shin is a sharp-edged anteriorly convex tibia.

Causes-It can result from syphilis,^[1]yaws, Paget's disease of bone, Vitamin D deficiency.^[2] orWeismann-Netter syndrome.

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Marasmus vs. Kwashiorkor

Marasmus-severe muscle wasting/bones prominent/loose skin

Kwashiorkor-Protrudent belly/itchy rash/xerosis (dry skin)/poor wound healing

Erythema infectiosum/5th disease

Slapped cheek-fever-lacy rash on trunk-not contagious after fever

Anesthetic Instruments

Necrotizing Enterocolitis

Abdo distention, bubbly intestinal wall, hepatic portal venous gas(linear branching areas of decreased sensitivity over liver periphery)

Steeple sign-croup Diag.

Neck X-ray, subglottic narrowing-inverted V shape.

Congenital toxoplasmosis

Jaundice seizures fever intracranial calcifications-newborn

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Candida Inf

White patches mucous membranes mouth

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Mumps-IgM sero (positive D)/pcr/viral

Complications-oochitis-oophoritis-encephalitis-pancreatitis-thyroiditis-myocarditis-arthritis-glomerulonephritis!
Ocular & hearing derangements

Fever headache malaise myalgias
Parotitis

RNA - rubula virus- paramyxoviridae


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