5/13/13 Flashcards
How do you elicit Murphy’s sign and what indicates a positive result?
pt exhales; place hand under costal margin, mid-clav; pt. inhales and abruptly stops
What is the most common reason for a (+) Murphy’s sign?
cholecystitis
ERCP utilizes a fiberoptic camera and fluoroscopic dye to visuslize what?
biliary and pancreatic ducts
What is seen on HIDA scan if there is obstruction of the gallbladder?
inability to visualize the gallbladder
What imaging modality should be used first in suspected cholecystitis?
US
What diagnostic procedure runs the risk of causing acute pancreatitis?
ERCP
What is the Tx of acute pancreatitis?
supportive: NG suction, NPO, fluids, electrolytes, analgesics; if severe: Abx
What modalitity should be used to remove a stone form the common bile duct?
ERCP
A forceful hyperextension of the knee or a non-contact torsional injury of the knee during deceleration would be most likely to tear which soft-tissue structure of the knee?
ACL
Forceful torsion of the knee with the foot planted would be most likely to tear which soft-tissue structure of the knee?
medial meniscus
What nerve is most likely to be injured in antero-inferior dislocation of the humeral head in the glenoid fossa?
axillary n.
What muscles receive motor innervation from the axillary nerve?
deltoid and teres minor
What cutaneous sensation does the axillary nerve provide?
lateral upper arm
What is the effect of positive-pressure ventilation on venous return to the heart? Why?
decreases it; increased intrathoracic pressure
Which location of aortic aneurysm causes a false lumen that results from a dissection between intimal layers?
thoracic
Whewre do ulcers resulting from venous insufficiency in the leg usu. ocur?
above the medial malleolus
What is the intervention of choice for duodenal hematoma causing obstruction?
NG suction and parenteral nutrition; hematoma will resolve in ~2 wks
What is a complication of subclavian central venous catheter placement that would result in distended neck veins, absent breath sounds on the right side, and general deterioration of the pt?
tension pneumothorax
What is the mechanism of hypovolemia in dumping syndrome following gastrectomy?
hypertonic food dumped into duodenum pulls in water
What is the usual tx for gastric dumping syndrome?
smaller, more frequent meals and avoidance of simple carbs
What medication may be used to treat resistant cases of dumping syndrome?
octreotide
