JLGH Summer 2022 Recap
Q&A for Extended Learning
 
 

Q: What is the over-the-counter agent used for emergency contraception, and how soon after unprotected intercourse does it need to be taken to be effective?
 
A: Levonorgestrel should be taken as soon as possible within 72 hours of unprotected sex since its efficacy decreases with time. Note that it is ineffective if the patient has already ovulated.
 

Q: What method of complement 4d (C4d) staining is most conclusive in confirming the presence of SARS-CoV-2 viral antigens in the placenta of a SARS-CoV-2 positive pregnant patient?
 
A: In situ hybridization (ISH) staining proved to be more conclusive than C4d immunostaining in the Lancaster General Health Pathology report looking at two cases presented to Women & Babies Hospital triage. Not only did ISH staining confirm the presence of antigens, but it added evidence to the possibility of vertical transmission of the infection.
 

Q: What are the first three steps in treating hypertriglyceridemia in patients, and what is the most effective lifestyle modification to help these patients reduce their triglyceride levels?
 
A: The first steps are to rule out secondary causes, optimize blood sugar control, and optimize therapeutic lifestyle changes. Weight loss has been shown to be the most effective lifestyle change, with up to a 70% reduction in triglycerides in some patients, although dietary modifications and physical activity can also help.
 

Q: What is pneumomediastinum? What is its main presenting symptom?
 
A: Pneumomediastinum in a rare condition in which air is present in the mediastinum; it is most common in young patients. Its main presenting symptom is typically chest pain that often radiates into the neck or back.
 

Q: How long after receiving a 13-valent pneumococcal conjugate vaccine (PCV13) should a 68-year-old patient receive PPSV23? Will any additional shots be necessary?
 
A: A 68-year-old patient should receive PPSV23 at least one year after PCV13. No additional shots are then necessary, as the PPSV23 completes the vaccination series.