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ABSITE 2019 > Absite Review > Flashcards

Absite Review Flashcards

1
Q

Subdural hematoma

A

crescent shape, conforms to brain; 50% mortality, elderly

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2
Q

Epidural hematoma

A

lens shape, goes into brain, 10% mortality, middle meningeal artery, ‘lucid interval’

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3
Q

Cerebral perfusion pressure

A

CPP = MAP - ICP, want to keep ~70

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4
Q

Cushing’s triad

A

increased ICP:

HTN, bradycardia, Kussmaul respiration

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5
Q

Brown Sequard

A

spinal cord transected 1/2 way, loss of
ipsilateral motor
contralateral pain and temp

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6
Q

Central Cord Syndrome

A

Bilateral loss of upper extremity motor, pain, temp;
Legs relatively spared.
Hyperflexed C-spine injury

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7
Q

GSC

A

GCS Motor:
6 commands, 5 localizes, 4 withdraw pain, 3 flexion pain (decorticate), 2 extension pain, 1 none

GCS Verbal: 5 oriented, 4 confused, 3 inappropriate, 2 incomprehensible, 1 none

GCS Eyes: 4 spontaneous, 3 to command, 2 to pain, 1 none

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8
Q

Anterior spinal artery syndrome:

A

lose bilateral motor, pain and temp; keep position sense, light touch

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9
Q

Spinal Shock

A

Cord injury above T5 can cause spinal shock; Rx with fluids, may need alpha-agonist. Recognize by hypotension with bradycardia, warm perfused extremities (vasodilated).

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10
Q

Spinal Shock

A

Cord injury above T5 can cause spinal shock; Rx with fluids, may need alpha-agonist (phenylephrine). Recognize by hypotension with bradycardia, warm perfused extremities (vasodilated).

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11
Q

EtOH and Head Injury ___ ADH release which causes

A 
Inhibit ADH
Diabetes Insipidus (high UOP, low urine glucose, high serum osmolarity/Na)
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12
Q

Closed Head Injury may cause SIADH

A

oliguric, high urine osmolarity, low serum osmo/Na

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13
Q

AVMs vs Aneurysms

A 
AVM's: congenital, bleed age 40-60
aneurysms younger (age 20-59), are a/w HTN
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14
Q

Acoustic Neuromas

A

Arise from 8th CN at cerebellopontine angle,

hearing loss, vertigo, N/V

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15
Q

Krukenberg Tumor

A

Colon or stomach cancer met to ovary (signet cells on path)

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16
Q

Meig’s Syndrome

A

Pelvic tumor causing ascites and hydrothorax

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17
Q

Missed abortion

A

1st tri bleeding
Closed os
Sac on US
no heartbeat

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18
Q

Threatened abortion

A

1st tri bleeding

+heartbeat

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19
Q

Incomplete abortion

A

tissue @ os

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20
Q

PID

A

Risk of ectopic pregnancy

Ceftriaxone, Doxycycline

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21
Q

Appendicitis in pregnancy

A

50% premature delivery, fetal mortality 2-8%, maternal 1%

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22
Q

Ovarian Cancer Staging

A

stage I limited to ovary (5 yr survival only 66%); II in pelvis; III throughout abdomen; IV distant mets

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23
Q

infections can present w/in hours postop

A

ß-Strep and clostridial

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24
Q

Most common anaerobe in colon

A

b fragilis

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25
Q

Most common aerobic bacteria in colon

A

e. coli

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26
Q

Most common organism in the GI tract

A

Anaerobes

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27
Q

mechanism in gram negative sepsis

A

endotoxin (lipopolysaccharide A) release, triggers release of TNF-alpha, activates complement and coagualation cascade

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28
Q

early v. late gram negative sepsis

A

Early: decreased insulin, increased glucose (impaired utilization)
Late: increase insulin, increased glucose (insulin resistance)

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29
Q

First sign of sepsis

A

hyperglycemia

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30
Q

C. diff treatment

A

Oral vanco/flagyl

IV flagyl

31
Q

C. diff in pregnancy

A

oral vanc

32
Q

Tx for fulminant c. diff

A

total colectomy w/ ileostomy

33
Q

When do abscesses occur

A

7-10 days post op

34
Q

coagulase positive

A

staph aureus

35
Q

Coagulase neagtive

A

staph epidermidis

36
Q

Most common organism in SSI

A

s aureus

37
Q

Most common organism in ICU pneumonia

A

S. aureus
pseudomonas
E. coli

38
Q

Most common organism in line infections

A

s. epidermidis
s. aureus
yeast

39
Q

Necrotizing soft tissue infections

A

beta-hemolytic strep
C. perfringens
*overlying skin can look normal as infection spreads along fascial planes

40
Q

Tortuous abscesses in cervical, thoracic, abdominal areas

A

Actinomyces

41
Q

CNS symptomsin AIDS patients

A

Cryptococcus (tx amphotericin)

42
Q

Pulmonary symptoms in the Southwest

A

Coccidioidomycosis (tx amphotericin)

43
Q

Pulmonary symptomsin Mississippi & Ohio River valley

A

Histoplasmosis (tx amphotericin)

44
Q

Bacteria in primary SBP

A

monobacterial
50% E. coli
30% streptococcus
10% Klebsiella

Due to decreased host defenses not transmucosal migration

45
Q

Dx of SBP

A

peritoneal fluid w/ PMNs>250 or positive cultures

46
Q

Secondary SBP

A

intra abdominal source - polymicrobial (b. fragilis, E.coli, enterococcus

47
Q

Potency

A

dose required for effect

48
Q

ED50

A

drug level at which desired effect occurs in 50% of patients

49
Q

LD50

A

drug level at which death occurs in 50% of patients

50
Q

Gout TX

A

Colchicine: anti-inflammatory, binds tubulin
Indomethacin: NSAIDs, inhibits prostaglandin synthesis
Allopurinol: xanthine oxidase inhbitor
Probenecid: increases renal secretion of uric acid

51
Q

ME of metoclopramide (Reglan)

A

inhibits dopamine receptors

52
Q

ME of erythromycin

A

binds and activates motilin receptor

53
Q

ME of zofran

A

central acting serotonin receptor inhibitor

54
Q

ME of omeprazole

A

blocks H/K ATPase in stomach parietal cells

55
Q

ME of ranitidine

A

H2 receptor blocker to decrease acid

56
Q

ME of digoxin

A

Inhibits Na/K ATPase and increases myocardial calcium to slow AV conduction

*be cautious of hypokalemia, mesenteric ischemia

57
Q

ME of amiodarone

A

Good for acute arrhythmia

**side effect is pulmonary fibrosis, thyroid problems

58
Q

Best single agent shown to improve survival in patients w/ CHF

A

ACE inhibitors

59
Q

Best single agent shown to improve survival in patients after MI

A

beta blockers

60
Q

ASA poisoning

A

Respiratory alkalosis

Metabolic acidosis

61
Q

Tx of AIDS

A

AZT - reverse transcriptase inhibitor

Ritonavir - protease inhibitor

62
Q

Most common indication for laparotomy in HIV patients

A

CMV opportunistic infection (followed by lymphoma/neoplastic disease)

63
Q

Abdominal pain, bleeding, perforation in AIDS

A

CMV colitis

64
Q

MC neoplasm in AIDS

A

Kaposi sarcoma

65
Q

Upper GI bleed in AIDS

A

Kaposi sarcoma

66
Q

Lower GI bleed in AIDS

A

CMV

67
Q

Most common indication for liver transplant

A

Hepatitis C

68
Q

Most common infection in transplant patients

A

CMV (cellular inclusion bodies)

69
Q

Test for osteomyelitis

A

MRI

70
Q

Where does aspiration PNA occur

A

superior segment of right lower lobe

71
Q

TX brown recluse bites

A

oral dapsone

72
Q

bacteria in cat/dog bites

A

s. pyogenes, pasturella multocida (Tx w/ augmentin)

73
Q

Peritoneal dialysis catheter infection bug

A

s. epidermidis
s. aureus
pseudomonas

ABSITE 2019 (8 decks)

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