| Epocrates

By vgreene, 27 January, 2020

High intensity 50 LDL C lowering atorvastatin 40 or 80 mg rosuvastatin 20 or 40 mg

By vgreene, 27 January, 2020

Reasonable to start mod high intensity statin for secondary prevention in ASCVD 1 after factoring risk reduction potential adverse effects drug drug interactions health status pt preference if already tolerating high intensity statin reasonable to continu

By vgreene, 27 January, 2020

If HFrEF from ischemic heart dz w reasonable life expectancy eg 3 5y and not on statin Consider mod intensity statin per ACC AHA1

By vgreene, 27 January, 2020

If not very high risk1 ASCVD Starting mod high intensity statin or continuing high intensity if tolerating is reasonable after discussing net benefit

By vgreene, 27 January, 2020

If very high risk1 ASCVD High intensity max tolerated statin If LDL C 70 on max tolerated statin add on ezetimibe reasonable If LDL C 70 or non HDL C 100 despite max tolerated statin ezetimibe reasonable to discuss add on PCSK9i 1 per ACC AHA in pts w DM

(BMJ)—A 3-year-old girl with leukocyte adhesion deficiency type 1 presented with pain and drainage in her R ear. Exam: tender erythema in R postauricular region; ear canal obstructed by granulation tissue. Pseudomonas aeruginosa identified from ear swabs and blood cultures. Despite tx with IV ceftazidime and vancomycin + daily topical ofloxacin, R facial paralysis developed 5 days after admission. What’s the dx?

Sarcoidosis

Squamous cell carcinoma of ear canal

Malignant otitis externa

Ramsay Hunt syndrome

Cerebellopontine angle tumor

You are correct. CT scan of the temporal bone showed erosion in the mastoid tegmen, confirming dx of malignant otitis externa (MOE). MOE occasionally occurs in children w/ compromised host defenses. Unrelenting otalgia, markedly elevated acute-phase reactants, evidence of bone destruction on CT, and increased uptake in gallium-67 (on scintigraphy) should alert the clinician to MOE. Facial paralysis develops earlier and more frequently in pediatric cases. After 8wk of parenteral amikacin and meropenem, simple mastoidectomy at day 10, daily cleansing, and adjuvant hyperbaric oxygen at days 21-46, the pt’s sx improved, including partial recovery of facial nerve function 8wk after surgery.

Archives of Disease in Childhood 2019;104:879

By rray, 24 January, 2020

2002 DocAlert PDFs

By vgreene, 23 January, 2020

Select statin1

By vgreene, 23 January, 2020

Mod intensity 30 49 LDL C lowering atorvastatin 10 or 20 mg rosuvastatin 5 or 10 mg simvastatin 20 40 mg pravastatin 40 or 80 mg lovastatin 40 or 80 mg fluvastatin XL 80 mg fluvastatin 40 mg bid pitavastatin 1 4 mg

By vgreene, 23 January, 2020

High intensity 50 LDL C lowering atorvastatin 40 or 80 mg rosuvastatin 20 or 40 mg

Reasonable to start mod high intensity statin for secondary prevention in ASCVD 1 after factoring risk reduction potential adverse effects drug drug interactions health status pt preference if already tolerating high intensity statin reasonable to continu

If HFrEF from ischemic heart dz w reasonable life expectancy eg 3 5y and not on statin Consider mod intensity statin per ACC AHA1

If not very high risk1 ASCVD Starting mod high intensity statin or continuing high intensity if tolerating is reasonable after discussing net benefit

If very high risk1 ASCVD High intensity max tolerated statin If LDL C 70 on max tolerated statin add on ezetimibe reasonable If LDL C 70 or non HDL C 100 despite max tolerated statin ezetimibe reasonable to discuss add on PCSK9i 1 per ACC AHA in pts w DM

2002 DocAlert PDFs

Select statin1

Mod intensity 30 49 LDL C lowering atorvastatin 10 or 20 mg rosuvastatin 5 or 10 mg simvastatin 20 40 mg pravastatin 40 or 80 mg lovastatin 40 or 80 mg fluvastatin XL 80 mg fluvastatin 40 mg bid pitavastatin 1 4 mg

High intensity 50 LDL C lowering atorvastatin 40 or 80 mg rosuvastatin 20 or 40 mg

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