Lactation studies have not been conducted with oral budesonide, including ENTOCORT EC, and no information is available on the effects of the drug on the breastfed infant or the effects of the drug on milk production. One published study reports that budesonide is present in human milk following maternal inhalation of budesonide [see Data ]. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for ENTOCORT EC and any potential adverse effects on the breastfed infant from ENTOCORT EC, or from the underlying maternal condition.
vs. P. putida = choices ; 1. pyoverdin, 2. growth @ 42C (answered #2 not sure)
Growth in olive oil = M. furfur
Picture of stomatocytes= liver disease
Whats in the saliva of Le (a+b-)= answered Lea( not sure) other choices include H and A
Specimen of choice for whopping cough = nasopharangeal swab
Creatinine clearance calculation
ABO typing discrepancies (5 items or more )
Before addition of caffeine bilirubin = after addition of caffeine bili = = what is the conjugated and unconjugated bilirubin result
Abnormal acetaminophen result ( increased) what other relevant test mus be performed
Choices are 1. bun 2. crea 3. salicylate
Cryoprecipitate storage after thawing
Will you preapare platelet concentrate from wholeblood stored in ref for 24hours?
Picture of hypersegmented neutrophil = condition associated with it
Picture of burr cells = condition associated with it
Antibody panels = identify the unit to be transfused
Patient for coagulation study has 67% hematocrit what would you do.
Choices include 1. recollect with reduced anticoagulant 2. proceed with test 3. recollect with increased anticoagulant
Bisphosphonate therapy is a proven method of preventing femoral head collapse in patients with avascular necrosis and subchondral lucency.
Lai et al evaluated the effect of alendronate on patients with Steinberg stage-II or III osteonecrosis of the femoral head. They found that alendronate prevented early collapse of the femoral head at twenty-four months.
Agarwala et al evaluated the effect of bisphosphonate therapy on patient reported and radiographic outcomes in femoral head avascular necrosis. They found alendronate reduces pain, improves function and may prevent disease progression at 5 year followup.
Nishii et al evaluated the effect of alendronate on 20 hips with osteonecrosis of the femoral head without collapse. They found a lower frequency of collapse and less patient reported pain in patients treated with bisphosphonate therapy compared to controls at 12 month follow up.
Thanks to Dr. Chris Rice at UW Madison:
"Recent level 1 evidence seems to cast doubt on the efficacy of bisphosphonate treatment in precolapse AVN with medium to large lesions. There is also some thought that the supposed success seen in smaller lesions is due to the natural history of these lesions which often do not progress to collapse even in the absence of any treatment. "
Lee YK, Ha YC, Cho YJ, Suh KT, Kim SY, Won YY, Min BW, Yoon TR, Kim HJ, Koo KH Does Zoledronate Prevent Femoral Head Collapse from Osteonecrosis? A Prospective, Randomized, Open-Label, Multicenter Study. J Bone Joint Surg Am. 2015 Jul 15.
Answer 1: Cyclic parathyroid hormone therapy is used in osteoporosis treatment, and not in the treatment of femoral head avascular necrosis.
Answer 3 & 4: Neither RANK nor RANK ligand are being used in therapeutic forms currently. Denosumab, an anti-RANK ligand antibody, has shown early success in the treatment of bone lysis in oncologic applications.
Answer 5: Selective estrogen receptor modulator therapy is used in osteoporosis, and not in the treatment of femoral head avascular necrosis.