Breast/Bites Flashcards
What is the danger, presentation, and treatment of Snakebite
- Danger: Slit-like eyes, cobra cowl, rattlers
- Pt: Erythema, skin changes, pain at site
- Tx: Anti-venom IV, if you dont have that use a tourniquet/cut/suck the venom out
What is the danger, presentation and tx of a black widow bite?
- Danger: Black spider with hourglass belly
- Pt: Abdominal pain, pancreatitis
- Tx: IV calcium gluconate
What is the danger, presentation and tx of a brown recluse
- Danger: Attic, boxes, and ulcer at bite site
- Pt: Necrotic ulcer with ring of erythema
- Tx: Wide debridement, grafts
What is the danger, presentation and tx of a human bite
- Danger: Sex, fist fight, zombies
- Pt: Laceration only
- Tx: Wash, abx and drain if abscess
What is the danger, presentation and tx of a rabies bite
Danger: Domesticated animal and provoked = observe, Wild animal = kill and biopsy
What are the normal treatments for bee stings and what do you do for anaphylaxis?
- Normal: Remove pincer, treat pain
- Anaphylaxis: IM Epi 1:1000
What do you do if you cant kill and biopsy a wild animal that bites a person?
- (+) Bx -> IgG + Vaccine
- (-) Bx -> Observe
What is the treatment for Her2Neu+ breast cancer?
Trastuzumab
What are the treatment methods for ERPR + breast cancer patients?
- Aromatase inhibitors if postmenopause
- SERM if premenopause
Stage 1-4 breast cancer chemo options
Anthracycline, cyclophosphamide, paclitaxel
What is the procedure for evaulating a lump in a patient under 30
- Reassurance (2-3 cycles)
- If persists = get ultrasond
- If ultrasound shows area= aspirate
- If cyst resolves = reassurance
What is the procedure for evaulating a lumb in a patient over 30
- Ultrasond shows mast
- if aspirate is blody or cyst recurs
- Go to mammogram for biopsy
What are the two available techniques for screening for breast cancer?
- USPTF: Start at 50 go every 2 years
- ACS/NCI start at 40 go every 1 year
What is the equvalent of a mastectomy + ALND?
Lumpectomy + RT + ALND
What are the preventative measures for a BRCA 1/2 mutation?
Prophylactic mastectomy and bilateral salpingo-oophorectomy
What is the recommended treatment for bladder cancer?
Transurethreal resection + BCG or Cisplatin based chemo
What do the stone sizes correspond to in terms of actions?
- .5 cm = fluid and analgesics
- .7 cm = add MET
- 1.5 cm = stenting or lithotripsy
- Over 1.5 = surgery
What is Reynolds pentad?
Hypotension and AMS indicates cholangitis
What is the physical definition of shock?
SYS BP <90 or Uoutput <0.5 mL/kg/hr
What is the rule of nines?
- Head: 9
- Front of arm: 4.5
- Back of arm: 4.5
- Front Upper chest: 9
- Front Abdomen: 9
- Back: (same as front)
- Front of leg: 9
- Back of leg: 9
What are the features of electrical burns
- Arrhythmias
- Posterior shoulder dislocation
- Demyelination
MONA BASH
–Morphine sulfate for severe pain.
–Oxygen via nasal cannula to keep SaO2 > 92%
–Nitroglycerin (NTG) 0.3-0.6 mg SL q5min PRN chest pain. Max: 3 doses within 15 minutes.
–Aspirin. The first tab is 325 (chew), then 81mg QD after that. Avoid enteric coated Aspirin.
–Beta-blocker. Metoprolol tartrate 25mg po q6h
–ACE. Watch BP. May wait to see BB work if concerned about BP or start low dose, e.g. Lisinopril 5mg po BID
–Statin. High-intensity statin for all patients with ACS – atorvastatin 80mg po Qbedtime or rosuvastatin 20-40 mg daily.
–Heparin. For all patients with non-ST elevation ACS, start anticoagulation ASAP after you’ve made the diagnosis. Will start heparin instead of Lovenox. Heparin is easily reversible if needed. 60 U/kg IVB (max 4000 U); 12 U/kg/hr (max 1000 U/hr initially).
Which alcohols produce an anion gap
Methanol and ethylene glycol
What is the treatment method for cyanide poisoning?
Thiosulfate and amyl nitrate
