Amboss Flashcards
what vessel feeds the pancreas?
splenic artery
when does legg calve perthes disease present?
2-5 year olds
what is legg calve perthes disease?
avascular necrosis of femoral head
what are imaging findings in legg calve perthe disease?
joint space widening and flattening of femoral head
what is management of legg calve perthe?
nsaids and minimal weight bearing
what is first line for BPH treatment?
alpha blockers like terazosin then finasteride
what is management of pneumothorax caused by intubation?
put in a chest tube
what size breast cancer indicates chemotherapy in addition to surgical removal?
more than 2 cm
an ankle fracture in a teenager can lead to what complication down the road? how?
leg legnth discrepancy because if it involves the growth plate then the plate will close early compared to other leg
what testicular tumor makes loads of testosterone?
leydig cell tumor
which testicular cancer often makes estrogen? what sx can it cause?
sertoli cell cancer and causes gynecomastia
is SVC syndrome common in hodkin or non hodkin lymphoma?
non hodgkin
what is treatment for intusssusception?
air enema
how does pulmonary contusion appear on xray?
will be patchy infiltrate around injured area
what cancers are peutz jehgers ysndrome patients at risk of developing?
ovarian breast and pancreatic and of course colorectal
what test is done to confirm hereditary hemochromatosis?
genetic testing
what is histology of papillary thyroid cancer?
orphan annie eyes
what is most common thyroid cancer?
papillary thyroid cancer
what is histology of follicular thyroid cancer?
invasion of surrounding blood vessels and capsular space
what is first step in evaluating esophageal cancer?
EGD
what are two most common bugs in HAP?
pseudo and staph a
what is abx for HAP?
vancomycin and cefepime
in what situation is an IVC filter appropriate for DVT treatment?
if patient develops one after surgery and has contraindications to anticoagulation
how does follicular lymphoma present?
pretty much lymphadenopathy without any associated sx
who gets follicular lymphoma?
common in elderly folks/adults
what is translocation of follicular lymphoma?
t14 and 18
how do you treat symptomatic PDA in pre term infant compared to full term?
pre term gets indomethacin and full term gets surgery closure
a patient with a heel fracture after a fall needs what additional imaging? why?
xray of back because could have compression fracture
what is management of patient with penile fracture?
retrograde urethroscopy then surgical fixation and catheterization
what is rx of anorectal cancer?
radiochemotherapy
what is the most common cause of acute pancreatitis? what imaging should be done?
biliary pancreatitis…should get RUQ US
what sx can atelectasis cause in post op period?
can be as severe as dyspnea chest pain and cyanosis, but also can be asymptomatic
when does amniotic embolism onset?
during or immediately after delivery
if patient hears bubbling from throat when eating, what is likley diagnosis?
zenker diverticulum
what should patients on bisphosphonates do to help prevent osteonecrosis of the jaw?
good oral hygiene with frequent rinsing and dental work before intiating therapy
what happens in cerebral venous thrombosis?
thrombosis in venous system can lead to infection area
what are sx of cerebral venous thrombosis?
number one sx is headache, can have focal neurologic deficits, signs of elevated ICP and vision changes
what is rx of cerebral venous thrombosis?
start vanc, ceftriaxone and metronidazol e
what is treatment of peyronie disease prior to offering surgical repair?
collagenase injections
what is a complication of distal humerus fracture?
can injure the brachial artery and compromis blood supply to forearm and hand
what is a complication of mid shaft humerus fracture?
radial nerve injury leading to wrist drop
what are the two first line therapies for prolactinomas?
cabergoline of bromocriptine
what is another name for ectopic pregnancy?
interstitial pregnancy
middle ear barotrauma has what sx?
tympanic edema, hemorrhage and rupture and hearing loss
what is treatment of middle ear barotrauma?
NSAIDs and observation, hearing will return
what are signs of abdominal compartment syndrome?
distended abdomen, elevated CVP, AKI from oliguria, and just a critically ill patient
how do you measure intrabdominal pressure?
via bladder catheter sensor
what is rx for abdominal compartment syndrome?
abdominal decompression with laparotomy
what test is positive for AC joint injury?
adduction across body causes pain
what is imaging technique if concerned about AC joint injury in shoulder?
X ray
what is rx of AC joint injury?
sling, analgesics and surgery if severe
how does AC joint injury happen?
fall directly on shoulder
what abx should be given after a cat bite?
augmentin
patient with new hip fracture that is on blood thinners develops tachycardia and low BP, what is likely happening?
blood loss leading to hemorrhagic shock
explain how subclavian steal syndrome works
basically have block in subclavian and when you use the affected arm, blood flow from the vertebral artery id shunted to the subclavian and you get pre syncope sx
what are sx of subclavian steal syndrome?
pre syncope when using arm, decreased pulses and blood flow in affected arm
can venous insufficiency cause ulcers?
you bet
where do venous insufficiency ulcers occur?
medial ankle
where do peripheral arterial disease ulcers occur and what is unique about them?
at toe tips and lateral surface of ankle…they are very painful
what is cause of MALT lymphoma of the stomach?
H pylori infection
what is first line rx of malt lymphoma of stomach?
H pylor treatment
what is lost in symptomatci syringomyelia?
pain and temp sensation in upper extremity and eventually motor movement of upper extremity
what sensation is lost and where in tabes dorsalis?
vibration and proprioception in lower extremities
how long after UC diagnosis does patient start with annual colonoscopies?
8 years
what is treatment of ITP?
usually just observation…but if really severe can give corticosteroids then IVIG
what is rx of developmental dysplasia of the hip in kids less than 6 months?
wear a harness
what is rx of developmental dysplasia of the hip in kids 6-18 months?
closed reduction surgery
infant at like 3 weeks old has persistend conjugated jaundice, what should you think of?
biliary atresia
what is a big time complication of biliary atresia?
liver cirrhosis
what should be done for patients with biliary atresia?
kasai procedure where you connect liver to small intestine
what are signs of envenomation from a snake bite
swelling and pain at site, coagulopathy issues, and systemic effects like hypotension and tachycardia
what is cutoff for lobectomy as far as FEV and DLCO go?
FEV has to be greater than 1.5L and DLCO greater than 60%
pyloric stenosis is more common in formula or breastfed babies?re
formula
what are the two watershed regions of the colon?
rectosigmoid and splenic flexure
what is management of NEC when surgery isnt indicated?
abx (amox flagyl and gent) and NG tibe decompression
when is surgery indicated for NEC?
any signs of gangrenous or perforated bowel…high lactate, perotinitis, pneumoperitoneum
what is finding with surgical wound dehiscence of abdominal incision?
pink fluid leaking from surgical site
what is management of wound dehiscence?
get them to the OR to repair the sutures
what two med classes can be given to help pass kidney stones?
alpha blockers and calcium channel blockers
what should be monitored in a patient on warfarin?
PT
what should you not eat when on warfarin?
leafy green veggies
middle aged female has hypoechoic liver cyst found on imaging and takes OCPs, what is likely diagnosis?
hepatic hemangioma
what is risk with removing hepatic hemangioma?
severe hemorrhage
what are indications for inpatient observation following a TBI?
any signs of increased ICP, depressed skull fracture, skull fracture greater than 3mm,
what are the patient related risk factors for perioperative cardiac complication?
ischemic heart disease heart failure Cr greater than 2 stroke DM that is insulin dependent
what is a vascular complication after PCI?
cholesterol embolism
what are signs of cholesterol embolism?
skin changes, AKI, gut ischemia
what steps should be done in emergency settinf for spinal cord injury?
vitals, airway, stabilize neck and body, and INSERT foley
cholelithiasis occurs where?
cystic duct
choledocholithiasis occurs where?
common bile duct
acute cholecystitis occurs when a stone is where?
cystic duct
what are lab abnormalities in choledocholithiasis?
elevated LFTs, elevated GGT, elevated bilirubin and alk phos
when do you not use CT for appendicitis?
kids and pregnant women
what is rx of strep pharyngitis when you cant give penicillin?
macrolide…azithromycin or clarithromycin
what is a halo sign from blood in nose?
rapidly expanding clear fluid ring around blood on gauze…means it is CSF
what is common cause of CSF leak after trauma?
basilar skull fracture
what are signs of basilar skull fracture?
racoon eyes and CSF leak
what cranial nerve can be injured with uncal herniation?
occulomotor…CN III
how should you remove a battery that was swallowed?
always endoscopically because need to assess for any injuries
a knee dislocation comes with what feared complication?
popliteal artery injury
what should be done to evaluate for popliteal artery injury in knee dislocation?
ankle brachial index
what tumor marker can you monitor for HCC?
AFP
what tumor marker can you monitor for pancreatic and CRC?
CEA
if an old person falls and breaks their hip, what part did they break?
femoral neck fracture
what is management of femoral neck fracture in elderly person?
hip replacement
how does leg look on exam with femoral neck fracture?
externally rotated and shortened
what are first two parts of workup of thyroid nodule?
TSH and US
if patient has low TSH with a thyroid nodule, what should be done after US is completed?
thyroid scintigraphy
is a cold or hot thyroid nodule more concerning?
COLD
at what age is genu varum (bowing) abnormal?
after age 2
injury at 8th intercostal in mid axillary line of left side can lead to what structure?
left lower lobe of lung
what ribs does spleen live behind?
9-11
patient has epidural then a couple days later has severe headache and neck stiffness, what is happening
post LP headache from CSF leak
what is rx of post LP headaches?
if mild then will resolve on own, if severe then you should do epidural blood injection to help seal the dura mater
dilation of pampiniform plexus leads to what?
varciocele
if you are worried about avascular necrosis in scaphoid fracture, what should you do?
surgical fixation
what is often the first symptom of prolactinoma in a male/
ED
what is treatment of pancreatic cancer?
duodenopancreatectomy
what is rx of echinococcus of liver?
albendazole
what is treatment of seminoma testicular cancer?
radiation and orchiectomy
what is rx of non seminoma testicular cancer?
orchiectomy plus adjuvant chemo with bleomycin cisplatin and etoposide
what is rx of hyperparathyroidism?
surgery and if not a surgical candidate then cinacalcet
with PAD what is first line therapy?
exercise therapy along with statin, anti platelet therapy
if first line therapy for PAD does not work but patient does not have critical limb ischemia, what is next therapy tried?
cilostazol (vasodilator(
what operation should be done to manage a SAH?
surgical clipping of wherever is bleeding
at what point in ITP do you start corticosteroid therapy?
if platelets less than 30k
shoulder pain, horner syndrome in patient with smoking history should make you think what?
pancoast tumor
what is abx ppx for dental procedures?
amxoicillin
what is diagnostic test for hirschprung disease?
rectal biopsy
what are levels of CO, SVR PCWP and CVP in hemorrhagic shock?
low CO, CVP and PCWp and HIGH SVR
what is juvenile nasopharyngeal angiofibroma?
common tumor of nasopharynx in kids…presents with unilateral bloody mass
what is management of juvenile nasopharyngeal angiofibroma?
CT scan then surgical removal
patient knocks out a tooth and it is totally intact, what should be done?
rinse tooth and socket with saline and put that puppy back in
chest pain in a kid following respiratory infection and coughing should make you thnk about what? assume cardiac exam is normal?
spontaneous pnemomediastinum
what is PE finding of spontaneous pnuemomediastinum?
crepitus
what is imaging and management of spontaneous pneumomediastinum?
CXr and reassurance
what should be done for diabetic foot ulcer if no indication of infection?
should be surgically debrided
what is rx of meconium ileus as long as no signs of perforation?
gastrografin enema
what is treatment for cushing syndrome that is ACTH independent?
adrenalectomy
patient who had whipple surgery now has metabolic acidosis, what is issue?
pancreatic fistula that causes leakage of bicarb
what is a colles fracture?
extension fracture of distal radius that happens with falling on outstretched hand
what are sx of colles fracture?
tenderness, soft tissue swelling and restricted range of motion
what is rx of colles?
closed reduction, or if really severe do surgical fixation
what procedue is done for midgut volvulus?
Ladd procedure
what is presentation of midgut volvulus in infant?
bilious vomiting and abdominal distension
what is imaging for midgut volvulus?
upper GI series
generally, how should you manage a peri appendiceal abscess?
should drain itand give abx…high risk to do appendectomy
what portion of spinal cord is in charge of vibration and proprioception?
posterior
what part of spinal cord is in charge of movement and pain/temp?
anterior
what breslow depth requires 1-2cm margins in melanoma removal
1-2mm depth
what breslow depth requires sentinel node biopsy in melanoma?
anything greater than 1mm
what is parkland formula? what is it used for?
4ml x body surface area burned x patient weight…fluid calc in patients with burns
how is body surface area broken down for burns?
9% for each extremity and face, 9% for chest, 9% for abdomen, 9% for each half of back
what size kidney stone needs to be removed?
over 1cm
what should be done if patient with patellar dislocation has osteochondral fragment in joint space?
knee arthoscopy to remove the fragment then surgery to fix patella
what imaging is used for acute limb ischemia diagnosis?
digital subtraction angiography, not ABI
what imaging is used to diagnose a psoas abscess?
CT or MRI
when is elective repair of abdominal aneurysm indicated?
greater than 5.5 cm, more than 1cm growth in a year, if it is saccular or symptomatic
what are two firts line therapies for Carpal tunnel before surgery?
steroid injections and splinting
how does blood appear on head CT?
hyperdense…white
what is imaging for meniscal injury?
MRI
when do you fix meniscal injuries
patients less than 40 years old, and when they are symptomatic
a pelvic ring fracture often causes injury to what nerve?
obturator nerve
where does obturator nerve provide sensory innervation?
small area on medial thigh
what motion does obturator nerve make happen?
hip adduction
what med can cause neutrophilia?
STEROIDS
what should be monitored in patients with burns on extremities?
pulses and cap refill because they are at risk of ischemia
what is treatment of patient with burn on extremity who starts to develop signs of ischemia?
escharotomy
aside from choriocarcinoma, what other testicular cancer can produce hcg?
seminoma
name the contraindications to organ donation
cardiac arrest before brain death, sepsis, incurable malignancy, CJD
babies with gastroschisis are at increased risk of what other GI issue?
intestinal dysmotility (gastroparesis)
what is imaging modality for patient with a suspected aortic injury?
CT angio if they are stable, TEE if unstable
what is first step in management of chemical burns?
irrigate with water extesnively
can hyper or hypothyroid cause CTS?
hypothyroidism
patient with persistent elevated aldosterone should undergo what imaging?
CT scan of abdomen to determine etiology of aldosterone elevation (bilat versus unilateral)
angiodysplasia is associated with what other disease?
ESRD
patient has bleeding abdominal aorta and undergoes repair…then has total loss of leg movement, what happened?
probably had injury to anterior spinal artery leading to motor loss in legs
what is management of an enterocutaneous fistula?
put in an ostomy pouch and feed parenterally
acromegaly can do what to the heart?
cause congestive heart failure due to cardiomyopathy
what is first line rx of esophageal stricture?
balloon dilation
list the branches of the aorta starting at Celiac trunk
Celiac SMA Renal Ovarian/testicle IMA
what are echo findings of hypertrophic cardiomyopathy
mitral valve dysfxn, enlarged heart wall, asymmetric wall thickening
what spot of aorta is most susceptible to injury in trauma?
isthmus
what beta blockers for varices/
nadolol or propanolol…cant be cardiac selective like metoprolol
what is management of intertrochanteric hip fracture in healthy person?
internal fixation…intramedullary nailing
if preganant lady presents with itching and elevate dbilirubin, what is diagnosis??
cholestasis of pregnancy
what is rx for cholestasis of pregnancy?
ursodeoxycholic acid
what is location of chest tube placement for pneumothorax is adult?
5th mid axillary intercostal space
what is location of chest tube placement for pneumothorax is kid?
2nd intercostal midclavicular line`
what do you do with finger tip that has been amputated that you are transporting?
put it in ice with saline damp gauze wrapped around it
is tylenol recommended for back pain?
no…doesnt work well
supraclavicular and peri umblilical nodes are suggestive of what cancer?
gastric cancer
what is treatment of gigantism?
transphenoidal adenectomy
bullet to the neck means patient gets what kind of imaging?
CT angio of neck
what is cushings triad in a TBI?
hypertension, bradycardia, irregular respirations
if patient has cushings triad with a TBI then what is likely going on?
increased intracranial pressure
when do you give Tetanus immune globulin to patient with a cut?
if cut is dirty and vaccination history is unclear…if wound is clean only need Tdap
what imaging is used to diagnose bladder injury in trauma?
retrograde cystography
what can you inject to help get rid of a erection? is this first or second line?
can inject phenylephrine…second line
what is first line treatment of erection lasting too long?
take out the blood
if kid needs significant fluid resuscitation and you cannot get venous access, what kind of line and where do you put it for access?
interosseuous line in proximal tibia
what is acral lentiginous melanoma?
painless irregularly shaped brown macule that involves the toe and nail bed
who is more likely to get acral lentinonous melanoma?
african americans and asians
what is something a patient can develop after they have been inubated?
laryngotracheal stenosis
when should you expect laryngotracheal stenosis in a patient?
if after extubation they have had progressive shortness of breath and difficulty breathing
what is imaging modality to confirm laryngotracheal stenosis?
larygoscopy
what nerve runs lateral to the fibula?
common peroneal nerve
the common peroneal nerve causes what action at level of ankle?
dorsiflexion of the foot
what is a common presenting symptom of PBC?
pruritis
if patient has PBC, what should they be taking?
ursodeoxycholic acid
when do you operate on a broken clavicle instead of using a sling?
if it is displaced more than 1 bone width
what is imaging technique for patient with difficulty swallowing in oropharyngeal location?
videofluoroscopy
what is weight cut off for receieving sugar containing fluid as maintenance fluid?
30kg and above does not need the sugar
what is the tumor triad of VHL?
RCC
hemangioblastoma
pheochromocytoma
are femoral hernias above or below the inguinal line?
below
what is volar splinting used for?
carpal tunnel syndrome
what is a roos stress test?
when patient lifts arm above head and have to open and close hand repeatedly
what is a positive roos test indicative of?
thoracic outlet syndrome
if patient has thoracic outlet syndrome, what is first treatement?
PT
what is treatment for thoracic outlet syndrome if PT does not work?
surgical decompression
what is pyoderma gangrenosum? what is it associated with?
skin lesion that becomes ulcerated and necrotic…assoc with Crohns
what potassium level constitutes emergency treatment?
6.5 and above
what are the two steps in management of posterior shoulder dislocation?
test axillary nerve function then do reduction
gardner syndrome has what four manifestations?
colon polyps, osteomas, epidermal cysts and hyperproliferation of retinal epithelium
turcot syndrome has what two features?
colon polyps and brain cancers
head bobbing and heart murmur is classic for what murmur?
AR
if patient has undiagnosed lower GI bleed and is becoming unstable, what should be done?
angiography for diagnosis and treatment
female with fecal incontinence and loss of anal sphincter tone likely has what history?
vaginal laceration during a delivery
patient with strictures in small bowel and history of bowel resection should undergo what procedure to manage strictures?
stricturoplasty…dont want to remove any more bowel
posterior hip displacement leads to what positioning of the leg?
internall rotated and abducted
which of wilms versus neuroblastoma crosses the midline in a child?
neuroblastoma crosses midline and wilms does not
how long after heparin initiation does HIT usually happen?
5-10 days after
patient who recently had endovascular surgery acutely has discoloration of an extremity without swelling, what happened?
atheroembolism
if patient has a skin lesion and the “overlying skin cannot be pinched” what is the diagnosis?
epidermoid cyst
in addition to propanolol, what should be done for variceal bleeding?q
ligation of the remaining varices
what is management of a biliary cyst?
should remove it surgically
what is management of phyllodes tumor?
surgical removal
what type of collagen is affected in osteogenesis imperfecta?
type 1
what are signs/symptoms of osteogenesis imperfecta?
blue sclera, deafness, short stature, frequent fractures, scoliosis
what is tumor marker for ovarian cancer?
Ca125
purple discoloration and crackling sounds from a wound indicate what?
necrotizinf fascitis
what do you do to a wound with necrotizing fasciiitis?
surgical debridement and abx
what abx for necrotizing fasciitis?
vanc and zosyn
what is emergent treatment of an epidural hematoma?
craniotomy to release it and ligate the bleeding vessel
why do you not do a burr hole for epidural hematoma/
because you cannot ligate vessel with that
what causes a femoral hernia?
widening of the femoral ring
what causes a direct inguinal hernia?
weakness of transversalis fascia
what is treatment of cerebral vascular thrombosis?
dalteparin if patient stable and not worsening acutely, thrombectomy if they are worsening
nodular cords in limbs should make you think about what?
superficial thrombophlebitis
what meds should be given for acute drug allergy reaction?
methyprednisilone, cimetidine, diphemhydramine
what nodes drain the distal vagina?
superficial ingunal
what nodes drain the uterus?
external iliac
what nodes drain the cervix and middle of the vagina?
internal iliac
supracondylar humerus fracture can lead to what vasculature issue?
brachial artery injury causing loss of radial pulse
if patient is going to need long term airway management, what type of airway should be put in?
tracheostomy
if patient has renal srterystenosis and you add an ACE inhibitor, what lab abnormality may develop?
hypokalemia
what is the management of rectal prolapse?
rectopexy
what are signs of rectal prolapse?
painless rectal mass, addominal discomfort, incomplete evacuation, peri anal itching
what part of mediastinum do teratomas occur in?
anterior
what is most common type of mass in posterior mediastinum?
neurofibroma and schwannoma
what acid base issue does post op atelectasis cause?
resp alkalosis
what is usual treatment of SCLC (small cell lung cancer)?
radiation and chemo
if patient has v tach but it stable and can converse, what kind of shock should you give?
synchronized cardioversion
what is classic treatment of early stage breast cancer?
lumpectomy with radiation to follow along with sentinel node biopsy and hormone therapy if indicated
what type of lesions does prostate cancer cause in back?
osteoblastic lesions (sclerotic)
if patient receiving heparin is not becoming appropriately hypocoagulable, what is likely issue underlying?
antithrombin III deficiency
how does finasteride help BPH?
prostatic apoptosis because inhibits testosterone conversion into DHT
how does tamsulosin treat BPH?
alpha 1 antagonist relaxes sphincters
in an unstable patient that you expect esophageal rupture, what imaging should be done?
CT
what is treatment of thyroid tumor that is less than 1cm in size?
thyroid lobectomy
what is treatment of thyroid tumor that is more than 1cm in size?
total thyroidectomy
what is preferred treatment for patient with acute mesenteric ischemia with stable vitals?
endovascular revascularization
what is preferred treatment for patient with acute mesenteric ischemia with unstable vitals?
ex lap
alcohol induced lymph node tenderness should make you think about what?
follicular lymphoma
what should be done with intact avulsed tooth out in field?
put back in socket manually then go to dentist/PCP
which hip dislocation leads to internally fixed adducted leg?
posterior dislocation
pt with stable esophageal rupture that is not leaking into pleural spaces should be treated how?
conseravtive management with abx and PPI and NPO
an infant with a UTI and palpable bladder likely has what?
posterior urethral valves
what is rx of posterior urethral valves?
ablation of the valves
what is rx of post vascular surgery pseudoaneurysm?
US guided thrombin injection
patients with cholelithiasis waiting on cholecystectomy should do what two things?
take urosdeoxycholic acid and have low fat diet
what imaging should be obtained when someone ingests toxic chemicals?
Upper scope as soon as feasible
which two rotator cuff muscles are in charge of external rotation?
teres minor and infraspinatus
what imaging should be done when you expect posterior shoulder dislocation?
axillary x ray view
what is management of posterior dislocation of shouldr?
closed reduction
where does cervix lymph drain?
internal iliac
what imaging to diagnose renal vein thrombosis?
either CT angiography or MR venography
when should a pancreatic pseudocyst be operated on?
if more than 6cm or symptomatic
what is procedure to fix psueodcyst of pancreas?
CT guided drainage
what are findings of purulent cellulitis?
tender erythematous skin with purulent drainage
what is treatment of constrictive pericarditis from TB?
pericardiectomy
in patients you are worried about end organ perfusion, what should be monitored for volume status?
urine output
what tissue is messed up in peyronie disease?
tunica labuginea
when should adult patients receive vaccines after splenectomy?
2 weeks after
what should be given to patient wiht open wound and unclear vaccination histroy against tetanus?
tetanus immuneglobulin and vaccine
what two ppx drugs should organ transplant patients receive?
bactrim and valgancyclovir
young patients with aortic aneurysm likely have what issue going on?
cystic medial necrosis from maybe ehlers or marfans
what type of valve should younger people get?
mechanical ecause they are more durable
why do you give tranexamic acid after a TBI?
to prevent cranial hemorrhage
in addition to abx, what might you need to do for septic knee?
serial aspirations
colles fracture is a fracture of what?
distal radius
colles fracture can lead to injury of what nerve?
median nerve
what is treatment of pururlent pericarditis?
pericardiocentesis
how does a AAA form?
accumulation of foam cells in the tunica intima
patient with metastatic lesions to spine causing spinal cord dysfunction should receive what?
steroids IV
patients who will need long term foley should get bladder emptied how?
should have intermittent foley catheters
autoimmune gastritis puts patients at risk for what?
gastric adenocarcinoma
h pylori puts patients at risk for what cancer?
gastric MALT lymphoma
what nodes does the prostate drain to?
internal iliac
what nodes do the testis drain to?
para aortic
what symptoms does somatostatinoma cause>?
diarrhea, steatorrhea, cholelithiasis, diabetes
what is long acting anesthetic that is used a lot?
bupivicaine
is lidocaine intermediate or long acting?
intermediate
if patient has hypercalcemia from bone resorption what med can help lower it?
bisphosphonates
patients in ICU can get stress stomach ulcers, but what else can they get in their stomach?
erosive gastropathy
patient with renal artery stenosis should be started on what?
ace or arb
in addition to ace/arb, what else might be needed for patient with renal artery stenosis?
if having severe sx then can do angioplasty without stents
what ligament does the uterine artery run in?
cardinal ligament
what are sx of herpes zoster opthalmicus?
loss of vision in one eye, pain and vesicular lesions
what is a torus fracture?
buckle fracture in kids…pretty much have buckling of bone but not actually Broken
what are two classic pathology findings in chronic organ rejection? what immune cell mediates these?
smooth muscle proliferation and fibrosis…host cd4
at what age does an undescended testicle become a surgical operation?
after 4-5 months
a boot shaped heart is indicative of what?
tetralogy of fallot
smoking lung cancers like squamous and small cell occur where?
central = smoking
in addition to graded exercise therapy, what medication should patient with PAD be started on initially?
clopidogrel
should patient take metformin or ACE inhibitor on mornign of surgery?
no…risk of lactic acidosis and hypotension
what are complications of hepatic adenoma?
rupture and hemorrhagic shock…can rarely be malignant transformation
patient has UTI and big kidney stone, what should be done before removing the stone?
treat the UTI, because if you dont stone removal can lead to significant urosepsis
do you have to stop OCP if you develop focal nodular hyperplasia of liver?
no patients just need reassurance
should patients with hepatic adenoma stop taking OCPs?
YES
vesicouretal reflux puts patients at risk of what kidney issue?
renal scarring
what is size cutoff of pulmonary nodule for NO further evaluation?
smaller than 4mm
what type of pain can patients have with adrenal crisis?
diffuse abdominal pain
what worm can cause SBO?
ascariasis
eschar around a diabetic foot ulcer raises concern for what?
underlying infection
neurogenic shock does what to vitals?
bradycardia and hypotensive with hypothermia
posterior hip doslocation leads to what leg positioning?
shortened and internally rotated with adduction
what is treatment of posterior hip dislocation?
emergency closed reduction
what is the physiologic cause of curling ulcers?
basically hypoperfusion leads to ulceration and necrosis
which lung cancer makes PTHrp?
squamous cell
which lung cancer makes centrally located cavitary lesions?
squamous cell
what abx for septic knee from e coli?
cefepime
patient with spontaneous small pneumothorax should receiev what even if they are totally stable?
supplemental O2
what MSK issues can prolactinomas cause?
osteoporosis due to decrease in estrogen
what is first line procedure for acute limb ischemia?
catheter directed thrombolysis and balloon catheter embolectomy
