Step2/Level2 Question Thread

[Pisiform]

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So I couldn't find any question thread for step 2 so I decided to create one. Whenever anyone has a question, we can post in this thread or discuss concepts


I just had a question. Why do you give Estrogen to a teen with abnormal uterine bleed sec to anovulatory cycle. Whole concept of anovulatory cycle is that they have estrogen driven proliferation w/o subsequent progesterone. Wouldn't giving more estrogen makes thing worse?

Thanks

 

[RedSoxSuck]

So I couldn't find any question thread for step 2 so I decided to create one. Whenever anyone has a question, we can post in this thread or discuss concepts


I just had a question. Why do you give Estrogen to a teen with abnormal uterine bleed sec to anovulatory cycle. Whole concept of anovulatory cycle is that they have estrogen driven proliferation w/o subsequent progesterone. Wouldn't giving more estrogen makes thing worse?

Thanks

In adolescents, most common cause of AUB is immature HPO axis leading to anovulatory cycles. Without ovulation, they have persistent endometrial proliferation, followed by heavy cycles when ovulation does occur. So estrogen works quickly by promoting regrowth of endometrium.

 

[Keto]

AOM + When is observation the answer?

• Age 6 months to 2 years + unilateral AOM without otorrhea + mild illness + appropriate follow-up available + antibiotics can be started promptly if symptoms worsen
• Age 2 years + unilateral or bilateral AOM without otorrhea + mild illness + appropriate follow-up available + antibiotics can be started promptly if symptoms worsen
• In either case, the decision to observe without antibiotics should be made jointly between provider and parent/caregiver(s)
• Antibiotics should be started if improvement is not noted in 48-72 hours