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Residency > Absite review > Flashcards

Absite review Flashcards

1
Q

Heparin MOA ?

A

Heparin activates AT-III (up to 1000× normal activity).

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2
Q

AT-III MOA ?

A

Inhibits Thrombin, factor 9,10 and 11

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3
Q

Protein C & S MOA ?

A

protein c degrades factor 5 and 8 and fibrinogen

protein S is a cofactor for protein c

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4
Q

Only factor not synthesized in the liver?

A

factor 8

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5
Q

DDAVP function?

A

Causes the release of vwf and factor 8 from the endothelium

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6
Q

cryoprecipitate content?

A

has the highest concentration of vWf and factor8

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7
Q

Heparin-induced thrombocytopenia (HIT) pathophysiology

A

Thrombocytopenia due to anti-heparin antibodies (IgG heparin-PF4
antibody) results in platelet destruction

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8
Q

patients with coronary stents and on plavix the need to undergo surgery what do u do?

A

you can stop plavix 7 days prior to surgery and bridge the patient on eptifibatide [GpIIb/IIIa inhibitor]

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9
Q

ε-aminocaproic acid MOA ?

A

inhibits fibrinolysis

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10
Q

the best way to detect bleeding risk prior to surgery is through?

A

history and physical exam

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11
Q

factor V leiden mutation pathophysiology?

A

defect on factor V makes it resistant to activated protein C

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12
Q

Most common cause of acquired hypercoagulable state is ?

A

Smoking

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13
Q

Dabigatran (pradaxa) MOA ?

A

Direct thrombin inhibitor

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14
Q

Tx of HITT (Heparin Induced Thrombocytopenic Thrombosis) ?

A

STOP the heparin and add Argatroban (direct thrombin inhibitor)

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15
Q

MCC of death from transfusion reaction?

A

TRALI (Transfusion related Acute Lung Injury)

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16
Q

Most abundant antibody is ?

A

IgG

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17
Q

Type 1 hypersensitivity reaction example ?

A

bee stings, penut allergy, hay fever

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18
Q

Type 2 hypersensitivity reaction example?

A

ABO incompatibility
Hyperacute rejection
myasthenia gravis

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19
Q

Type 3 hypersensitivity
reaction example?

A

serum sickness
SLE
(immune complex deposition)

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20
Q

What are tetanus prone wounds ?

A

(> 6 hours old; obvious contamination and
devitalized tissue; crush, burn, frostbite, or missile injuries)

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21
Q

when to give tetanus immunoglobulin in addition to vaccine?

A

(given intramuscular near wound site) – give
only with tetanus-prone wounds in patients who have not been immunized
or if immunization status is unknown

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22
Q

Most common immunodefeciency leading to infection is ?

A

Malnutrition

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23
Q

Most common anaerobe in the colon ?

A

Bacteroides Fragilis

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24
Q

Most common aerobic bacteria in the colon?

A

E.coli

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25
Q

Arrange fever causes sequentially over time

A

Fever sources (sequentially over time) – atelectasis, urinary tract
infection, pneumonia, DVT, wound infection, intra-abdominal abscess

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26
Q

Most common organism overall in surgical site infections

A

Staph aureus

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27
Q

Most common GNR in surgical wound infections

A

E.coli

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28
Q

most common aneorobe in surgical wound infections

A

Bacteroides Fragilis

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29
Q

Risk factor for SSI ?

A

Surgical factors: Long operations, Hemtoma or seroma formation

Patient factors: Advanced age, chronic disease, malnutrition, DM, Imunnosuppressive medication

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30
Q

Organisms associated with Necrotizing fascitis?

A

Beta henolytic (group A) strep
MRSA

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31
Q

characterisitc gram stain for Actinomyces?

A

Yellow sulfur granules on gram stain

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32
Q

MCC of fungemia?

A

Candida

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33
Q

Diagnosis of Spontaneous Bacterial peritonitis?

A

peritoneal fluid with PMN >250 or positive culture (50% ecoli, 30% streptococcus, 10% klebsiella)

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34
Q

Most common indication for liver transplantation is ?

A

Hepatits C

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35
Q

MC site of aspiration pneumonia in lungs?

A

superior segment of the right lower lobe

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36
Q

What are the bacteriostatic antibiotics?

A

tetracycline, clindamycin, erythromycin (all
have reversible ribosomal binding),
TMX-SMZ

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37
Q

Most common method of antibiotic resistance?

A

Transfer of plasmid

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38
Q

MCC of intraop bradycardia

A

inhalational anasthesia

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39
Q

which inhalational agent in anasthesia is good for neurosurgery?

A

Isoflurane – good for neurosurgery (lowers brain O2 consumption; no
increase in ICP)

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40
Q

last muscle to go down and 1st muscle to recover from
paralytics

A

Diaphragm

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41
Q

1st muscle to go down and last muscle to recover from paralytics

A

Muscles of the neck and face

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42
Q

which muscle relaxant undergoes hoffman elimination(elmination in blood and tissues)?

A

Cis-atrcurium

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43
Q

which muscle relaxant is the fastest?

A

Rocuronium

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44
Q

sugammadex reversal agent for which muscle relaxnats?

A

Rocuronium
Vecuronium

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45
Q

Maximum dosing of local anasthetics?

A
  • Lidocaine 4 mg/kg (7 mg/kg with epi)
  • Bupivacaine 2 mg/kg (3 mg/kg with epi)
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46
Q

Amides (all have an “i” in first part of the name)

A

lidocaine,
bupivacaine, mepivacaine; rarely cause allergic reactions

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47
Q

Esters of local anasthetics

A

tetracaine, procaine, cocaine; ↑ allergic reactions due to PABA
analogue

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48
Q

Opiods MOA?

A

CNS mu-receptor agonists

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49
Q

Combination of MOAI and opiods can lead to?

A

hyperpyrexic coma (serotonin release syndrome – fever,
tachycardia, seizures, coma)

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50
Q

Epidural insertion site for thoracotomy vs laparatomy?

A

Thoracotomy insertion level: T6–T9

Laparotomy insertion level: T8–T10

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51
Q

how to calculate serum osmolarity?

A

(2*NA)+(gluscose/18)+(BUN/2.8)
normal value (280-295)

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52
Q

Insensible fluid loss

A

10 cc/kg/day; 75% skin (#1; sweat), 25%
respiratory, pure water

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53
Q

GI fluid secretions amount for stomach, duodenum, pancreas and biliary system

A

● Stomach 1–2 L/day
● Biliary system 500–1,000 mL/day
● Pancreas 500–1,000 mL/day
● Duodenum 500–1,000 mL/day

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54
Q

highest concentration of potassium the body is in?

A

SALIVA

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55
Q

You need to replace Magnesium before correcting what electrolytes?

A

Potassium and calcium

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56
Q

Symptoms of hypernatremai?

A

PATIENT is HYPER :D
he is restless and irritable and is having seizures

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57
Q

Tx of refractory and severe SIADH?

A

conivaptan, tolvaptan (competitive
antagonist for kidney V2 receptor)

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58
Q

High anion gap acidosis causes?

A

“MUDPILES” = methanol, uremia, diabetic ketoacidosis, paraldehydes,
isoniazid, lactic acidosis, ethylene glycol, salicylates

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59
Q

Whats increases caloric needs ?

A

trauma sepsis surgery
burn
pregnancy
lactation

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60
Q

How to calculate calories and protein for burn patients?

A
  • Calories: 25 kcal/kg/day + (30 kcal/day × % burn)
  • Protein: 1–1.5 g/kg/day + (3 g/day × % burn)
  • Don’t exceed 3,000 kcal/day.
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61
Q

Fuel for small bowel eneterocytes?

A

glutamine

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62
Q

fuel for colonocytes?

A

short chain fatty acids

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63
Q

obligate glucose users?

A

Blood, Renal medulla, Brain, Bone marrow

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64
Q

Glycogen stores can supply the body with glucose for how long ?

A

12-24hours

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65
Q

Preoperative low serum albumin is associated with postoperative

A

increase mortality and morbidity

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66
Q

The best acute indicator of nutritional status is ?

A

prealbumin

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67
Q

Harris–Benedict equation calculates basal energy expenditure based on what parameters?

A

Age,height, weight and gender

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68
Q

Preooperative nutrition is indicated in ?

A

indicated only for patients with severe malnutrition
undergoing major abdominal or thoracic procedures.

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69
Q

At what day symptoms of refeeding syndrome usually after after initiating feeding?

A

Day 4

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70
Q

what are micelles?

A

ggregates of bile salts, long-chain free fatty acids, and
monoacylglycerides
* Enter enterocyte by fusing with membrane
* Bile salts – increase absorption area for fats, helping form micelles
* Cholesterol – used to synthesize bile salts
* Fat-soluble vitamins (A, D, E, K) – absorbed in micelles

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71
Q

Essential fatty acids

A

linolenic, linoleic

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72
Q

Non-essential amino acids

A

those that start with A, G, or C plus serine, tyrosine,
and proline

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73
Q

METABOLIC SYNDROME (NEED 3 to diagnose)

A

● Waist circumference (> 40 inches in men, > 35 inches in women)
● Insulin resistance (fasting glucose > 100)
● High TAGs (> 150)
● Low HDL (< 40 in men, < 50 in women)
● Hypertension(>130/85)

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74
Q

Most important prognostic indicator for lung CA and breast CA

A

nodal status

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75
Q

Most important prognostic indicator for sarcoma

A

Tumor grade

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76
Q

testicular CA, choriocarcinoma tumor marker

A

B-HCG

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77
Q

folinic acid with methotrexate vs 5FU

A

with methotrexate its reverse the effect
with 5FU it augments the effect

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78
Q

Cisplatinum s/e

A

nephrotoxic, neurotoxic and ototoxic

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79
Q

chemotheraputic agents that causes myelosuppression

A

vinblastine
carboplatin

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80
Q

prophylactic thyroidectomy is done in

A

patients with RET proto-oncogene with familt history of thyroid CA

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81
Q

examples of tumor suppressor genes

A

RB1
APC
p53
DCC
BRCA
bcl

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82
Q

Li–Fraumeni syndrome

A

defect in p53 gene → patients get childhood
sarcomas, breast CA, brain tumors, leukemia, adrenal CA

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83
Q

Cowden syndrome

A

defect in PTEN gene; get benign hamartomas
(skin, mucus membranes, GI tract); increased risk for CA (usually
thyroid, breast, and endometrial CA)

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84
Q

Hereditary diffuse gastric cancer

A

Defect in CDH1 gene

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85
Q

Genes involved in colon CA

A

APC, p53, DCC, and K-ras.

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86
Q

which type of cancer metastasise to small bowel

A

melanoma

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87
Q

Most common malignancy following transplant?

A

Skin cancer (Squamous skin cancer)

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88
Q

2nd MC malignancy following transplant?

A

Posttransplant lympho-proliferative disorder (PTLD) – next most
common malignancy following transplant (Epstein-Barr virus related)

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89
Q

Azathioprine and mycophenolate MOA

A

Inhibits de novo purine synthesis, which inhibits growth of T cells

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90
Q

Cyclosporine MOA?

A

Binds cyclophilin protein; CSA-cyclophilin complex then inhibits
calcineurin, which results in decreased cytokine synthesis (IL-2 most importantly)

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91
Q

FK-506 (Prograf, tacrolimus) MOA?

A

Binds FK-binding protein; actions similar to CSA but more potent

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92
Q

Sirolimus MOA ?

A

Binds FK-binding protein like FK-506 but inhibits mammalian
target of rapamycin (mTOR); result is that it inhibits T and B cell
response to IL-2

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93
Q

Anti-thymocyte globulin (ATG) MOA?

A

polyclonal antibodies
against T-cell antigens (CD2, CD3, CD4)
* Used for induction and acute rejection episodes

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94
Q

Side effect profile of Anti-thymocyte globulin (ATG)

A

Side effects:
*cytokine release syndrome (fever, chills, pulmonary
edema, shock) – steroids and Benadryl given before drug to try to
prevent this
*PTLD
*Myelosuppression

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95
Q

You can store the kidney before transplant for how long ?

A

48 hours

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96
Q

Most common complication following kidney transplant?

A

urine leaks

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97
Q

New proteinuria post kidney transplant suggest?

A

renal vein thrombosis

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98
Q

you can store liver for how long before transplantation?

A

24 hours

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99
Q

Most common reason for liver transplant?

A

chronic hep C

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100
Q

The most common complication post liver TXP?

A

biliary complications (bile leak)

101
Q

The most common vascular complication following liver TXP?

A

Hepatic artery thrombosis

102
Q

histopathology following acute rejection of liver transplant

A

portal triad lymphocytosis, endotheliitis
(mixed infiltrate), and bile duct injury

103
Q

histopathology following chronic rejection of liver transplant

A

disappearing bile duct phenomenon

104
Q

indication of of heart and lung transplant

A

those with life expectancy of less than 1 year

105
Q

MCC of late death and death overall following heart TXP

A

Chronic allograft Vasculopathy (progressive diffuse coronary atherosclerosis)

106
Q

MCC of late death and
death overall following lung TXP

A

bronchiolitis obliterans

107
Q

Function of c-reactive protein?

A

an opsinon, activates complement

108
Q

Chemotactic factors for inflammatory cell

A

PDGF, PAF, IL-1, TNF-a, IL-8, C3a, C5a, LTB-4

109
Q

chemotactic factors for fibroblasts

A

FGF, EGF, PDGF

110
Q

Angiogenesis factors

A

PDGG, EGF, FGF, IL-8

111
Q

Epithelisation factors

A

PDGF, EFG, FGF

112
Q

cause of fever in inflammatory response

A

IL-1

113
Q

interleukin that increases acute phase reactant production

A

IL-6

114
Q

IL-8 function

A

PMNs chemotaxis, Angiogenesis

115
Q

IL-10 function

A

Decreases the inflammatory response

116
Q

Activator of the classic complement pathway

A

Antigen-antibody complex

117
Q

Alternative complement pathway is activated by

A

bacteria, endotoxin and other stimuli

118
Q

complement factors present only in classical pathway

A

C1, C2, C4

119
Q

factors found only in alternative complement pathway

A

Factors B, D and P

120
Q

Factor that is common for both complement pathway

A

C3

121
Q

which factors are responsible complement opsinization

A

C3b, C4b

122
Q

Membrane attack complex is made up of what factors

A

C5b, C6b, C7b, C8b, C9b

123
Q

The primary mediators of reperfusion injury

A

PMNs

124
Q

Stages of wound healing

A

1-Homeostasis and inflammation (1-10 days)
2-proliferation (5 days-3 weeks)
3-Remodelling (3 weeks- 1 year)

125
Q

Epithelialization rate?

A

1-2 mm/ day

126
Q

Order of cell arrival in wound healing

A
  • Platelets
  • PMNs
  • Macrophages
  • Lymphocytes (recent research shows arrival before fibroblasts)
  • Fibroblasts
127
Q

Strength layer of bowel

A

submucosa

128
Q

leakage of large amounts of pink “salmon-colored”
fluid from wound indicates

A

Wound dehiscence

129
Q

why anastomotic leaks in the gastrointestinal
tract occur with increased frequency days 3-5 post anastamosis?

A

increased collagenase
activity in the small bowel allows collagen breakdown
to exceed collagen Deposition on Days 3 to 5 after an anastomosis

130
Q

Type 2 collagen found in?

A

Car(two)llage

131
Q

Type 4 collagen found in ?

A

Basement membrane

132
Q

Type III replaced by type I collagen by at which week of wound healing

A

End of proliferative phase (week 3)

133
Q

Ehlers-Danlos is a spectrum
of connective tissue disorders that can affect multiple types
of collagen but the most common is

A

Type V collagen

134
Q

Osteogenesis imperfecta type of collagen defect

A

Type 1 collagen defect

135
Q

Seat belt sign is concerning for what injuries

A

small bowel, pancreatic, lumber spine fractures and sternal fractures

136
Q

what defines massive blood transfusion

A

patients receiving ≥ 4 units pRBCs in the
first hour or ≥ 10 units pRBCs within 24 hours

137
Q

POSTIVE DPL ?

A

Positive if > 10 cc blood, > 100,000 RBCs/cc, food particles, bile, bacteria, > 500 WBC/cc

138
Q

Patient with Flank stab wound and stable what to do next?

A

possible injury to retroperitoneal contents (eg colon, kidney, ureter)
* Dx: abdominal CT scan with oral, rectal, and IV contrast (triple contrast)

139
Q

Resuscitative thoracotomy indications (ED thoracotomy)

A
  • Penetrating trauma (resuscitative thoracotomy indicated for any below):
    1. CPR was started within 15 minutes of a penetrating thoracic injury.
    2. CPR was started within 5 minutes of a penetrating extra-thoracic injury (eg
    penetrating abdominal trauma).
    3. Patient had signs of life and pulse or pressure was lost (SBP < 60) on way to ED or in
    ED.
  • Blunt trauma – resuscitative thoracotomy only if pressure or pulse lost in ED (CPR
    started within 5 minutes)
140
Q

The most important prognostic indicator in the GSC

A

Motor response

141
Q

Coagulopathy with traumatic brain injury is due to

A

tissue thromboplastin release

142
Q

Most common cause of facial nerve injury in trauma

A

Temporal bone fractures

143
Q

Hardest neck injury to find ?

A

esophageal injury

144
Q

Criteria for massive hemothorax that will need emergent thoracotomy

A

> 1,500 cc after initial insertion, > 200 cc/h for 4 hours, > 2,500 cc/24 h, or bleeding with
instability

145
Q

Unresolved hemothorax (retained hemothorax) after 2 well-placed chest tubes Tx

A

VATS drainage

146
Q

Persistent pneumothorax despite 2 well-placed chest tubes

A

Dx: bronchoscopy (look for
mucus plug or tracheobronchial injury)

147
Q

sucking chest wound (open pneumothorax) initial management ?

A

Cover wound with dressing that has tape on three sides → prevents development of
tension pneumothorax while allowing lung to expand with inspiration

148
Q

Flail chest definition?

A

≥ 2 consecutive ribs broken at ≥ 2 sites

149
Q

what can u see on CXR in diaphragmatic injury

A

see air–fluid level in chest from stomach herniation through hole

150
Q

most common site of aortic tear after trauma

A

proximal descending thoracic aorta at the ligamentum
arteriosum (just distal to left subclavian takeoff)

151
Q

highest risk factor for myocardial contusion?

A

sternal fracture

152
Q

boarders of cardiac box in penetrating chest injuries?

A

Clavicle, nipples and xiphoid process

153
Q

MC mechanism for duodenal trauma?

A

Blunt trauma (crush, deceleration injury)

154
Q

MC portion of the duodenum to be injured?

A

2nd part of the duodenum

155
Q

MC portion of duodenum to develop hematoma following trauma

A

usually in third portion of
duodenum overlying spine in blunt injury

156
Q

best study for diagnosing suspected duodenal injury

A

UGI study

157
Q

Right colon and transverse colon injuries Tx

A

Tx: 1) primary repair or 2) resection and anastomosis
(for destructive injuries [ie > 50% circumference or associated with significant colon
devascularization]); all are essentially treated like small bowel injuries.
* No diversion needed for right and transverse colon injuries

158
Q

Bed rest time with nonoperative management with splenic and liver injuries

A

5 days

159
Q

postsplenectomy sepsis greatest risk within

A

first 2 years

160
Q

Most important aspect of pancreatic trauma

A

Figuring out whether pancreatic duct is injured or not

161
Q

Hard signs of extremity vascular injuries

A
  1. Active bleeding
  2. Distal ischemia
  3. Absent distal pulses
  4. Expanding/pulsatile hematoma
  5. Bruit or thrill
162
Q

Soft signs of extremity vascular injuries?

A
  1. History of bleeding
  2. Unequal pulses
    3.Nonexpanding/nonpulsatile hematoma
  3. ABI <0.9
163
Q

Retroperitoneal zones of trauma

A

Zone 1 (Central retroperitoneum)
Zone 2 (Flank)
Zone 3 (pelvis)

164
Q

Triad of Hemobilia

A

RUQ pain, Jaundice and Melena

165
Q

percentage of Cardiac output to kidneys, brain and heart

A

kidney 25%
brain 15%
heart 5%

166
Q

Cardiac index

A

CO/Body surface area

167
Q

Anrep effect

A

automatic increase in contractility secondary to increase afterload

168
Q

bowditch effect

A

automatic increase in contractility secondary to increase in heart rate

169
Q

Causes of right shift of oxygen–Hgb dissociation curve (increased O2 unloading)

A

↑ CO2 (Bohr effect) ↑ temperature, ↑ ATP production, ↑ 2,3-DPG production, or
↓ pH

170
Q

Becks triad

A

muffled heart sound, jugular venous distension, Hypotension

171
Q

presentation of ventilated patients with PE

A

decrease ETCO2 and hypotension

172
Q

Intra-aortic balloon pump is used in

A

cardiogenic shock

173
Q

MOA of IABP

A

inflates on diastole and deflates on systole which decreases the afterload and increase diastolc coronary perfusion

174
Q

Beta 2 receptors

A

Relaxes bronchial smooth muscle, relaxes vascular smooth muscle;
increases renin

175
Q

Dobutamine MOA

A

Beta 1 agonist

176
Q

phenylephrine MOA

A

Alpha 1 agonist (vasoconstriction)

177
Q

Norepinephrine MOA

A

Alpha-1 and alpha-2; some beta-1 agonist

178
Q

Epinephrine MOA

A
  • Low dose – beta-1 and beta-2 (↑ contractility and vasodilation)
    Can ↓ BP at low doses
  • High dose – alpha-1 and alpha-2 (vasoconstriction)
179
Q

Vasopressin MOA

A

V1 receptor: Arterial vasoconstriction
V2 receptor (intrarenal): increase water reabsorption collecting ducts
V2 receptors (extrarenal): Increase release of Factor 8 and VWF

180
Q

Nipride (arterial vasodilator) main toxicity

A

cyanide toxicity

181
Q

Nitroglycerine MOA

A

predominately venodilation with ↓ myocardial wall tension from ↓
preload; moderate coronary vasodilator

182
Q

Hydralazine MOA

A

alpha blocker lowers BP

183
Q

Criteria for ARDS

A

.Acute onset
.Bilateral pulmonary infiltrates
.PaO2/FIO2 ≤ 300
.Absence of heart failure (wedge < 18 mm Hg)

184
Q

best predictor of extubation

A

rapid shallow breathing index

185
Q

plateau pressure is an index of

A

alveolar pressure

186
Q

peak pressure is an index of

A

large airway pressure

187
Q

what does PEEP increase in pulmonary lung measurements

A

increases FRC

188
Q

Mendelson syndrome

A

chemical pneumonitis from aspiration of gastric content

189
Q

MCC of postop renal failure

A

intraop hypotension

190
Q

prerenal failure urine osmolality and FeNA%

A

> 500
<1%

191
Q

Prerenal BUN:Cr ratio

A

> 20

192
Q

SIRS criteria

A

*Temp > 38 or <36
*HR >90
*RR> 20 or PaCo2 <32
*WBC >12,000 or <4000

193
Q

difference between second degree burn superficial (papillary) and deep (reticular)?

A

in superficial there is NO loss of hair follicles and NO need for skin grafts

194
Q

Admission criteria for burns

A

● 2nd- and 3rd-degree burns > 10% BSA in patients aged < 10 or > 50 years
● 2nd- and 3rd-degree burns > 20% BSA in all other patients
● 2nd- and 3rd-degree burns to significant portions of hands, face, feet, genitalia,
perineum, or skin overlying major joints
● 3rd-degree burns > 5% in any age group
● Electrical and chemical burns
● Concomitant inhalational injury, mechanical traumas, preexisting medical conditions
● Injuries in patients with special social, emotional, or long-term rehabilitation needs
● Suspected child abuse or neglect

195
Q

MC type of burn

A

scald burn

196
Q

Escharotomy indications

A
  • Circumferential deep burn to the extremitis that can affect blood supply
    *Chest torso/ neck burns that can affect ventilation
    *suspected increase in abdominal compartment pressure in torso burns
197
Q

most common infection and death in patients with > 30% BSA

A

pneumonia

198
Q

indications for intubation in inhalational burn injuries

A

*upper airway obstruction (stridor)
*worsening hypoxemia
*Patient expected to have massive fluid resuscitation (can worsen symptoms)

199
Q

Acid and alkali burns initial management

A

copious water irrigation

200
Q

hydrofluoric acid burn initial management

A

spread calcium on wound

201
Q

which is worse acid or alkali burn

A

alkali is WORSE liquefaction
necrosis.
Acid burns produce coagulation necrosis.

202
Q

blood supply to grafts day 0-3

A

imbibition (osmotic)

203
Q

blood supply to grafts after day 3

A

neovascularization

204
Q

Most common reason for skin graft loss

A

Seroma or hematoma formation under the graft

205
Q

clinical difference between STSG and FTSG

A
  • STSGs are more likely to survive – graft not as thick so easier for imbibition and
    subsequent revascularization to occur
  • FTSGs have less wound contraction – good for areas such as the palms and back of
    hands
206
Q

MC organism in burn wound infection

A

pseudomonas followed by staph

207
Q

silver sulfadiazine used for burns side effects ?

A

neutropenia and thrombocytopenia
(do not use in sulfa allergy)

208
Q

Silver nitrate ointment for burn s/e

A

electrolyte imbalance (hypo-everything :))
do not use in G6PD
can cause methglobulinemia

209
Q

best burn ointment for MRSA infection

A

Mupirocin

210
Q

sulfamylon ointment burn wound s/e

A

painfull application
can cause metabolic acidosis

211
Q

Some signs of burn wound infection

A

*conversion of 2nd to 3rd degree burn
*accelerated eshcar seperation

212
Q

Gold standard method to detect burn wound infection

A

burn wound biopsy

213
Q

MCC of pedicled or anastomosed free flap necrosis

A

venous thrombosis

214
Q

pressure sores stages

A

stage 1 : Erythema and pain with no skin loss
Stage 2 : Partial skin loss into the dermis
Stage 3: Full thickness skin loss where subcutaneous fat is exposed
Stage 4: bone, muscle, tendon is exposed

215
Q

Most lethal skin cancer

A

Melanoma

216
Q

most common melanoma site on skin

A

back in men
legs in women

217
Q

MC location of distant metastasis in melanoma

A

Lung

218
Q

Most aggressive type of melanoma

A

Nodular type

219
Q

MC type of melanoma

A

Superficial spreading type

220
Q

MC skin malignancy

A

Basal Cell Carcinoma

221
Q

main amino acid used as gluconeogenesis precursor

A

Alanine

222
Q

appearance of Basal cell CA

A

pearly appearance with rolled border ulcer

223
Q

actinic keratosis is a risk factor

A

squamous cell CA

224
Q

MC soft tissue sarcoma

A

malignant fibrous histiosarcoma

225
Q

spread of sarcoma through which route

A

hematogeneous route

226
Q

Most important prognostic factor for sarcomas

A

Tumor grade

227
Q

MC soft tissue sarcoma in children

A

rhabdomyosarcoma

228
Q

Anterior neck triangle contains

A

carotid sheath

229
Q

posterior neck triangle contains

A

accessory nerve and brachial plexus

230
Q

vagus nerve course

A

runs between internal jugular vein and common carotid artery

231
Q

phrenic nerve course

A

runs on top of the anterior scalene muscle

232
Q

long thoracic nerve course

A

run posterior to the middle scalene muscle

233
Q

Recurrent laryngeal nerve innervates

A

all of the larynx except cricothyroid muscle which is innervated by the superior laryngeal nerve

234
Q

Frey’s syndrome is caused by damage to which nerve

A

auriculotemporal nerve

235
Q

Thyrocervical trunk branches

A

Think STAT
(Suprascapular, Transverse cervical, Ascending cervical,
inferior Thyroid artery)

236
Q

1st branch of the external carotid artery

A

superior thyroid artery

237
Q

MC cancer of the oral cavity, pharynx and larynx

A

Squamous cell CA

238
Q

MC malignant tumor of the salivary glands

A

mucoepidermoid CA

239
Q

MC tumor overall of the salivary glands

A

pleomorphic adenoma (benign tumor)

240
Q

angioembolisation is done for which arteries in posterior nose bleeds

A

internal maxillary or ethmoidal arteries

241
Q

facial nerve branches

A

temporal
zygomatic
maxillary
marginal mandibular
cervical

242
Q

MC injured nerve with parotid surgery

A

greater auricular nerve

243
Q

MC location of esophageal foreign body

A

just below the circopharyngeus muscle

244
Q

posterior pituitary secretes

A

ADH, oxytocin

245
Q

hypothalamus secretes what hormones

A

CRH,GHRH,GnRH,TRH,
Dopamine

246
Q

anterior pituitary secretes

A

ACTH, TSH, LH, FSH, GH, Prolactin

247
Q

what hormone is elevated in acromegaly

A

elevated IGF-1 (best test)

248
Q

Nelson’s syndrome

A
  • Occurs after bilateral adrenalectomy; ↑ CRH causes pituitary
    enlargement, resulting in amenorrhea and visual problems (bitemporal
    hemianopia)
  • Also get hyperpigmentation from beta-MSH
249
Q
A

Residency (6 decks)

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