10/2018 Flashcards
HIV+ fever, weight loss, hepatosplenomegaly, mass consistent with lymphoma
Aggressive high-grade B-cell Lymphoma is most common HIV+ lymphoma
Central line catheters Most likely to DVT? Most likely to infect?
Femoral MC to DVT and infect. Worse in obese patients.
Preferred site for CVC lines? Preferred site for HD catheters?
Right Subclavian is best for CVC RIJ is best for HD catheter
What is absorbed in the duodenum?
Fe, Ca
What is absorbed in the ileum?
B12, bile salts
What is absorbed in the ileum?
B12, bile salts
Frey syndrome
Associated w/ parotidectomy - wrong regrowth of parasympathetics of auriculotemporal nerve to sweat glands. Ipsilateral sweating when eating.
During parotidectomy, injury to greater auricular nerve…
often transected. causes numbness to lower external ear and pre & post-auricular skin.
Anastomosis leak rates in colorectal?
ileocolic is lowest = 1-3% Colocolonic = 1-10% Coloanal is highest = 10-20%
MC tumor of appendix? MC malignancy of appendix? Worse prognosis of appendiceal tumors? MC Mucinous tumor?
Carcinoid is MC tumor but not always malignant. Adenocarcinoma = MC malignant of appendix Worse prognosis = Signet-ring cell carcinoma MC mucinous = benign mucinous cystadenoma
most potent stimulator of bile secretion?
secretin
Coin lodged in…upper esophagus …lower esophagus …stomach
Use…rigid esophagoscopy for upper …flexible esophagoscopy for lower …can watch and wait (battery must be retrieved regardless)
afferent loop syndrome symptoms and treatment
pain, nausea, bilious/non-bilious vomiting and RELIEF after bilious vomiting. Tx is surgical, re-connect with shorter limb (30cm), enteroenterostomy or conversion of billroth-2 to b-1 or a RY.
Septic pelvic thrombophlebitis
venous seeding of microorganisms that may trigger thrombosis. 2–4 days postpartum. Cord-like mass near ovary on affected side. Tx with 7-10 days heparin + abx
Hodgkin’s lymphoma staging
If “B symptoms” then get a B Stage 1 = single lymphatic site Stage 2 = 2 or more sites but doesn’t cross diaphragm Stage 3 = crosses diaphragm (spleen counts) Stage 4 = non-lymphatic organs
Pancreas outputs during secretin test for chronic pancreatitis, panc cancer, malnutrition, ZE, end-stage pancreatitis
PSC symptoms? Tx?
Nausea, ithcing, fatigue in setting of Crohn’s with recurrent strictures.
Stenting can help to relieve the obstructions, but the definitive treatment for PSC is liver transplantation.
Aortic stenosis valve measurement? Tx?
Normal AV area = 3-4cm^2
AV stenosis is < 50% this area.
Tx electively when AV stenosis with symptoms. Tx emergent when AV stenosis with CHF.
Mechanism of action of…SMX?
…Fluorquinolones
…Vancomycin
…Aminoglycosides
…Macrolides
inhibit dihydropteroate synthetase
inhibit DNA gyrase
inhibits cell wall synthesis
binds to 30s rib subunit
binds to 50s rib subunit
Hepatitis B.
What’s the significance of: HBsAg? Anti-HBsAg? HBcAg? Anti-HBcAg? HBeAg?
HBsAg - infection! Acute (or chronic if persistent) infection and will clear when infection is cleared
Anti-HBs - usually appears in serum after infection is cleared or if vaccinated.
HBcAg - not detectable in serum due to intracellular
Anti-HBc - appears early after infection. Persists.
HBeAg - marker of HBV replication
Hepatitis panel, what would you see for an Acute infections? Chronic infection? Immunity?
