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board2 Flashcards

1
Q

CN findings with basilar skull fx

A

V VII VII VIII hearing loss nystagmus, ataxia, CSF leaks, XR and CT can be negative - CT has air fluid levels in sphenoid sinus, heomotypmanum, ring test for CSF- halo sign of clear fluid beyond blood tinged ring , battle sign (blood behind ear) and - racoon eyes

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2
Q

herniation affects which pupil

A

ipsilateral

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3
Q

which head bleed ccrosses suture lines

A

subdural

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4
Q

central herniation, tonsillar, transtentorial

A

central - cn VI palsy, tonsilar- respiratory arrest, foramen magnum, transtentorial - MC - temporal lobe uncus through tentorial notch - CN III ipsilarfixed dilated

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5
Q

treatment for immediate post traumatic head trauma seizure

A

none

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6
Q

complication of skull fracture in kids

A

growing fx- leptomeningeal cyst that enlarges, assn with tear in dura- have to re-xray fractures

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7
Q

grade III concussion

A

LOC - no sports- concern for second imapact syndrome -

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8
Q

post concussive sydnrome

A

no hard neuro defeicits like ataxia

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9
Q

machinary murmur

A

air embolism - air in RV - LL trendelenburg- trap airbubble in apical of RV away from outfloe tract

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10
Q

neck zones

A

zone 1- below cricoid cartilage, zone 2 madible to cricoid- mc - zone 3 - above angle of mandible

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11
Q

thoracotomy incision

A

5th ICS, open pericardium verically, anteriot to phrenic nerve

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12
Q

scapular fracture

A

associatd with occult chest injury - thoracic trauma

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13
Q

1nd 2nd rib fx

A

associated vascular injury- myocardial contusion, bronchiael tear, vascular injury

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14
Q

main cause of hypoxia in flail chest

A

pulmonary contusion - also dec vent and venous return- tx direct pressure, intubate, chest tube

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15
Q

continuouos bubbling of chest tube

A

bronchopleural fistula, tracheobroncheal injury, occurs within 2 cm of carina , assn hamans crunch

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16
Q

thoracotomy indicated if chest tube puts out what

A

1500 initial or 100 hr for 6 hrs

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17
Q

NG tube coiled in chest

A

diaphragm injury

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18
Q

left apical cap

A

thraumatic dissection

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19
Q

hypotension, JVD, muffled heart sounds

A

cardiac tamonadde- pulsus paradoxus - weaker pulse, lower systolic pressure with inspiration, electtrical alterenans- alteranting QRS amplitude

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20
Q

EKG finding myocardil contusion

A

new bundle branch bock, PVCs, heart block

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21
Q

injures associated with seatbelt sign

A

mesenteric laceration, viscus tear, ruptured diaphragm, CHANCE FX - duodenu/pancreas

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22
Q

indications for trauma ex lap

A

evisceratio, GSW, impalement, gross blood by NG, rectal, positive fast if unstable

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23
Q

grey turners sign

A

flank bruising, rp hematoma- ectpic, hemorrhagic pancreatiits, trauma, post cardiac cath patient

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24
Q

kehr sign

A

left shoulder pain due to subdiaphgram irriation or splenic supture

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25
Q

cullens sign

A

periumbilical ecchymosis in hemorrhagic pancreatitis, ectopic pregnancy

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26
Q

rovsings sign

A

RLQ pain with LLQ palpation due to peritoneal irriation

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27
Q

cancer related tumor etiology for spinal cord compression

A

lung, breast, prostate, usually mets to thoracic

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28
Q

cancer patietn with dyspnea/cp

A

pericardial effusion/tamponade- lung and breast- radiation and chemo - low QRS voltage, JVD, hypotension, diminished heart sounds, pulsus paradoxus

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29
Q

mcc SVC syndrome, edema of face

A

bronchogenic lung ca

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30
Q

symptomatic hypercalcemia

A

cancer patinet - tumor PTHrP- mimics hyperPTH mcc, also osteo mets to bone

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31
Q

which cancer causes tumor related hyper PTH

A

SCC

32
Q

pth-rp mechanism

A

mimics PTH, increased bone resportion, inc renal abs ca

33
Q

sympoms of symptomatic hyperca

A

dehydration, ams, constipation, QT shortening, weakness, back and abd pain, polyruia - BONES STONES PSYCHIC MOANS AND GRAONS

34
Q

how to treat hyper Ca in cancer patient

A

isotonic saline - restore volume- lowers Ca level - can also use loop , calcitonin, bisphosphonates

35
Q

manifestations of cancer SIADH

A

casued by lung brain pancreas thymus prostate ca- EXCESS WATER Retention - sectopic ADH secretionn- cause shyponatremia, normovolemia, less than maximally dilute urine, excess urinary NA scretion

36
Q

treatent of siadh

A

fluid restriction

37
Q

rouleax formation on blood smear

A

sludging- hypervisciocity - tx hydration

38
Q

what timeframe dose tumor lysis ocur

A

12-72 hours

39
Q

what type of cancer tumor lysis

A

blood based- non hodgkins, AML CML

40
Q

mechnisms of tumor lysis

A

elevation of K, mg phoos, dec ca, uric acid precpitation from lysis of cells

41
Q

treatment of tumor lysis to prevent renal failure

A

elevated K and Pho- hydrate, lasix/glucose/iinsulin/polystyrene, phos binders, HD, treat uric caid by alkalization of urine, allopurinol

42
Q

septic arthritis origin in newborn, children, sexually active sickle cell

A

newborn - staph, kids- staph, sexually active gonorrhe, SCA and lupus - salmonella, IVDA can get gram negative and psuedomonoas, located in SCM and axial skeleton

43
Q

calcium pyrophosphate crystals

A

psuedogout, mc knee elderly

44
Q

cauuse of gout

A

diuretic, inc intake, dec excretion, mc 1st mtp, middle age

45
Q

needle shaped vs rhomboid crystals

A

gout- neddle shaped, pseudo - rhomboid

46
Q

young patient with fever, migratory polyarthritis, skin lesions, polytendonitis

A

treat for GC

47
Q

lyme disease - cause vector and skin lesions

A

borrelia burgdorferi- spirochete, vector ixodes - deer tick- erythema migrans - 7-10 days over bite, local spread, annular, bright borders and central clearing - SPIROCHETES MGIRATING

48
Q

arthralgias, myalgias, fever, fatigue, headache, bells palsy, meningitis, dysrhythmias- haert block

A

lyme dz - tx doxy

49
Q

antiphosholipid syndrome

A

DVTs, yong women, strokes - tx warfarin- hx miscarriages/abortion

50
Q

hx RA with monocular flare up

A

consider septic arthriits

51
Q

spine findings with RA

A

atlantoxial subluxation - upper motor sensory sxs- concern for cord- neck flexion injury

52
Q

uretrhtisiis causing arthirtis, conjunctivits, unveritis

A

reiters syndrome - reactive arthritis

53
Q

CREST syndroem

A

calcinosis, reynauds, esophageal dysmotlogity, sclerodacytlly, telangestcaisas - subtype of scleroderma

54
Q

reynauds disease, criteria and tx

A

bilateral, 2 years, no gangrene, precipitated by cold or emtion, if its assn with scleroderma RA SLE then its phenomenon- treatment - supportive

55
Q

rheumatic fever occurs after which infxn

A

strep - 3-4 weeks after - migratory polyarthritis, carditis, chorea (farm and ar movements ) erythema marginatum, subcutanous nodules - back of wrist, elbows knees

56
Q

mosquito that transmits malaria

A

female anopheles - worst is facliparum - return traveller - send thick/thin blood smear, malaria is parisitic disease

57
Q

cyclical fever, flu like symtpoms, cerebral edema, hemolytic anemia

A

malaria

58
Q

dengue mosquito

A

aedes aegyti- fever, hemorrhage, low platelets, shock- rash blanches under pressure

59
Q

mc organ injured in blunt trauma

A

spleen, kerhs sign

60
Q

mc organ injured in penetrating trauma

A

liver

61
Q

handlebar injury

A

pancreas/duodenum

62
Q

blood at meatus, work up?

A

no foley, may have boggy prostate, perineal bruising - get RUG

63
Q

anterior urethral injury vs posterior

A

straddle injury, foreign body, tx repoair, complications fistula/stricture, VS posterorio- pelvic fx, disteneded bladder, lowera bd pain, blood at meatus, - scotal hematoma- complciations impotence, incontinence

64
Q

iin adults are bladder suptures intraabdomianl or preperitoneal

A

preperitoneal

65
Q

trauma and gros shematuria

A

IVP, constrast CT urogram - concern for renal injuries , but renal vascular injuries require angiogram

66
Q

trauma, ureter injury, penetrating trauma- work up?

A

CT urogram

67
Q

bladder injry assn with pelivc fx, gross hematuria , work up?

A

RUG, if extravasation then exploratory

68
Q

anesthias - amides vs esters

A

one I is ester, two II is amide like lidocaine/bupivicaine

69
Q

max dose of lidocaine

A

4.5mg/kg (7 with epi), bupivicaine is 2mg/kg

70
Q

TXA

A

1g in trauma, 1 g in next 8 hours 20mg/kg dose

71
Q

MPT

A

1 1 1 prbc ffp platelets

72
Q

first treatment for peds trauma in shock `

A

20mgkg fluid bolus

73
Q

human bite

A

eikenelle

74
Q

reptile bite

A

slamonella

75
Q

cat and dog bites

A

pastuerella, casuses ascending lymphangitis, 6 hours onset

76
Q

machinery murmur , neck vascular injury, tachypne tachy hypotension

A

air embolism, place in LLDECUB

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