case files Flashcards

1
Q

if you find malignant cells on FNA (breast) what is the next step

A

core needle biopsy to determine invasive vs in situ

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2
Q

Tamoxifen cancer side effect

A

tamoxifen may cause uterine cancer

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3
Q

Aromatase inhibitors are used for what cancers?

A

ER + breast cancer (post menopausal)

Inhibit peripheral conversion of androgens to estrogen

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4
Q

Hoarseness and wheezing in GERD

A

atypical

may represent silent aspiration

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5
Q

Barrett pathology

A

squamous —> columnar

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6
Q

what is better therapy for GERD, PPI vs H2 block?

A

PPI is better

H2 develops resistance

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7
Q

long standing gerd w/ s/s refractory to medical management need?

A

EGD

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8
Q

whats better, ppi vs surgery for gerd?

A

TRICK! they are about equal

surgery is ok if pateitn doesnt want meds, cant afford them, just feels like it haha

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9
Q

Best test as objective indicator of gERD

A

24 hour pH monitoring

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10
Q

lung complication of esophogeal rupture

A

pleural effusion

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11
Q

test for esophogeal rupture

A

water soluable contrast esophagram

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12
Q

most common cause of esophogeal rupture

A

iatrgenic (egd)

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13
Q

5α-reductase inhibitor ( conversion of
testosterone to DHT). Used for BPH and malepattern
baldness.

A

Finasteride

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14
Q

α1-antagonist used to treat BPH by inhibiting smooth muscle contraction. Selective for α1A,D
receptors (found on prostate) vs vascular α1B receptors.

A

Tamsulosin

s/e may include dizziness

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15
Q

Surgical rx of BPH

A

TURP

transurethral resection of prostate

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16
Q

Tests for patients w/ BPH symtpoms

A

Creatinie- look for renal obstruction

PSA- ↑↑ would –> biopsy

UA

DRE

17
Q

First step in SBO management

A

NG tube decompress

Fluid resuscitate

foley

if necrosis, surgery after volume

18
Q

common bileduct dilation size in choledoco

19
Q

Treatment of severe cholangitis

A

ERCP decompression

+ abx/ supportive

20
Q

Bleeding from a abbarent submucosal stomach artery

A

dieulafoy erosion

21
Q

ulcer size requiring surgery

22
Q

Most common cause of pediatric upper GI bleed

A

extrahepatic portal venous obstruction–> esophageal varices

23
Q

do you do surgery for lower GI Bleeding

A

rarely

used only when bleed cannot be identified using all other methods

24
Q

Invasive lobular carcinoma in situ

A

15% of breast ca

orderly row of cells

not seen well on mamogram

usually bilateral, mult lesions

25
Arises from ductal atypia. Often seen early as microcalcifications on mammography.
Ductal carcinoma in situ Early malignancy w/o basement membrane penetration.
26
GCS eye max
max 4
27
GCS motor max
max 6
28
GCS verbal max
5
29
dilated pupil vs side of mass lesion
dilated side= mass lesion side
30
watery diarrhea categories
osmotic- lactose secretary- vibrio (↑ secretion) functional
31
Oral fluids for burns
less than 15% burn
32
Parkland formula and time
4 ml * kg* % burn 1/2 in first 8 1/2 in second 16 hours
33
what "degree" of burn is most painful
second
34
what degree of burn is painless
3 rx: will need grafting
35
Burn rx that cuases leukopenia
silver sulfadiazine does not penetrate eschar- wont help infection
36
Burn treatment that penetrates the full thickness
sulfamylon painful, may cause metabolic alk