Culture Generale Flashcards
What is used to reverse narcotics
Naloxone
What is used to reverse benzodiazepines
Flumazenil
What is the traetment of malignant hyperthermia
IV dantrolene, cooling body, discontinuation of anesthesia
What are the side effect of spinal anesthesia
Urinary retention
Hypotension (neurogenic shock)
Triad of Wernicke’s encephalopathy
Confusion
Ophtalmoplegia
Ataxia
What treatment provides protection from Wernicke’s encephalopathy
Rally pack: thiamine, folate, magnesium
What treatment provides protection from oral/esophagal fungal infection during IV antibiotic treatment
PO Nystatin
What measures provide protection from postoperative atelectasis/pneumonia
Incentive spirometry, coughing, smoking cessation, ambulation
What are the classic W’s of postoperative fever
Wind: atelectasis Water: UTI Wound: wound infection Walking: DVT/ trombophlebitis Wonder drug: drug fever
What isFitz-Hugh-Curtis syndrome
Right upper quadrant pain from gonococcal perihepatitis in women
What are the signs of tetanus
Lockjaw, muscle spasm, laryngospasm, convulsions, respiratory failure
Pseudomembranous colitis can be caused by any antibiotic, but especially
Penicillins, cephalosporins and clindamycin
What is the treatment of pseudomembranous colitis
PO Metronidazole or PO vancomycin, discontinuation of causative agent. Never give antiperistaltics
What is the acronym for treatment options for anaphylactic shock
BASE
Benadryl - Aminophylline - Steroids - Epinephrine
What are the signs/symptoms of neurogenic
Hypotension and bradycardia
What is the treatment of neurogenic shock
IV Fluids (vasopressors reserved for hypotension refractory to fluid ressucitation)
What type of patient does not mount a normal tachycardiac response to hypovolemic shock
Patient on B-Blockers, spinal shock, endurance athlete
What is the tumor marker for hepatocellular carcinoma
Elevated a- fetoprotein
What is the most common site of metastasis of hepatocellular carcinoma
Lungs
What is the name of the periumbilical bruit heard with caput medusae
Cruveilhier-Baumgarten bruit
What is the most common site of AAA
Infrarenal (95%)
Classic triad of rupture AAA
1- Abdominal pain
2- Pulsatile abdominal mass
3- Hypotension
What is the mean normal abdominal aortic diameter
2
What are the signs of colonic ischemia
Heme positive stool
Or bright red blood per rectum (BRBPR)
Diarrhea
Abdominal pain
What is anterior spinal syndrome
Classically - Paraplegia - Loss of bladder/bowel control - Loss of pain / temperature sensation below level of involvement - Sparing of proprioception
Which artery is involved in anterior spinal cord syndrome?
Artery of Adamkiewicz - supply the anterior spinal cord
What are the most common bacteria involved in aortic graft infection
Staphylococcus aureus Staphylococcus epidermidis (late)
How is a graft infection with an aortoenteric fistula is treated?
Perform an extra anatomic bypass with resection of the graft
Which renal vein is longer
Left
Which vein crosses the neck of the AAA proximally
Renal vein (left)
What part of the small bowel crosses in front of the AAA
Duodenum
What is the risk factor for splenic artery aneurysm rupture
Pregnancy
Most common esophagal atresia with tracheoesophageal fistula is
Type C : proximal esophageal atresia with
distal TE fistula
How to remember the position of the Bochdalek hernia
Boch Da Lek = back to the left
What is the common inguinal hernia in children
Indirect
What is the Hesselbach’s triangle
Triangle form by :
Epigastric vessels
Inguinal ligament
Lateral border of the rectus sheath
What side is affected more by inguinal hernia
Right
From what abdominal muscle layer is the inguinal ligament derived
External oblique
How is the diagnosis of duodenal atresia made?
Plain abdominal film revealing a “double bubble”, ith one air bubble in the stomach and the other in the duodenum
Hirschprung’s disease is also know as
Aganglionic megacolon
What is the classic history of aganglionic megacolon?
Failure to pass meconium in the first 24hrs of life
What organ is often found protuding from an omphalocele, but is almost never found with a gastroschisis
The liver
What is the common bacterial cause of mesenteric lymphadenitis
Yersinia enterocolitica
What is the most common site of intussusception?
Terminal ileum involving ileocaecal valve amd extending into ascending colon
What is the most common cause of intussusception?
Hypertrophic Peyer’s patches, which act as a lead point; many patient have prior viral illness
What is the traetment of intussusception
Air or barium enema
What condition can mask abdominal pain
Steroids, diabetes, paraplegia
What is the unique differential diagnosis for the patient with AIDS and abdominal pain
In addition to allcommon abdominal conditions: CMV (most common) Kaposi's sarcoma Lymphoma TB MAI (Mycobacterium avium intracellulare)
Classically, what endocrine problem can cause abdominal pain
Addisonian crisis
DKA (diabetic ketoacidosis)
Sliding hernia
Hernia sac partially formed by the wall of a viscus ( bladder/cecum )
Littre’s hernia
Hernia involving a Meckel diverticulum
Hesselbach’s hernia
Hernia under inguinal ligament lateral to femoral vessels
Amyand’s hernia
Hernia sac containing a ruptured appendix
What is the differential diagnosis for a mass in a healed C - section incision
Hernia
Endometrioma
What is the first identifiable subcutaneous named layer
Scarpa’s fascia
Which nerve travel in spermatic cord
Ilioinguinal nerve
What type of hernia goes trough Hesselbach’s triangle?
Direct hernia due to a weak abdominal floor
What factors are associated with femoral hernia
Pregnancy, women, exertion
What is “Flail Chest” ?
Two separate fractures in three or more consecutive ribs
What is the major cause of respiratory compromise with flail chest
Underlying pulmonary contusion
Beck’s triad
Hypotension
Muffled heart sound
JVD
Kussmaul’s sign
JVD with inspiration
How is gastric decompression achieved with a maxillofacial fracture
Place an Oral Gastric tube, not a NG tube
What are the goals during assess,ent of the airway
Securing the airway and protecting the spinal cord
What are the life-threatening conditions that must be diagnosed and treat during the breathing step
Tension pneumothorax
Open pneumothorax
Massive hemothorax
What are typical sign of basilar skull fractures
Raccoon eyes, Battle’s sign, clear otorrhea or rhinorrhea, hemotympanum
What is the best way to diagnose or rule out artery injury
CT angiogram
What is the brief ATLS history
AMPLE history: Allergies Medication PMH Last meal (when) Events (of injury)
What labs test are used to look for intra abdominal injury in children?
Liver function tests :|^ AST or/and |^ ALT
How is myoglobinuria treated in electrical burns
To avoid renal injury, think HAM:
- Hydration with IV fluids
- Alkalinization of urine with IV bicarbonate
- Mannitol diuresis
