Deck 2 Flashcards by Jessica Pederson

signs of acute aortic dissection

back pain, hypertension, variation in bp of arms

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how to dx aortic dissection

CT angio or TEE

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complications post nissen

dysphagia, gas-bloat syndrome, gastropareisis

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management of traumatic avulsion of a tooth

rinse socket with saline and reimplant and splint tooth

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opioid induced constipation treatment

osmotic and stimulant laxatives

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when can you refer for bariatric surgery

BMI >40, BMI >35 with comorbid conditions, >30 with T2DM resistant to treatment

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signs of femoral artery aneurysm

pulsatile mass worse when walking, below inguinal canal in the groin,

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breast cancer in males signs

nipple inversion, unilateral, firm, nontender

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ascitic fluid amylase and protein levels and SAAG

low total protein, normal amylase, high SAAG

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best way to dx peripheral arterial disease

ankle-brachial index

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imaging findings of a splenic abscess

fluid collection and mass

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light criteria exudative effusion (pleural)

protein pleural/serum >0.5 // LDH pleural/serum >0.6

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treatment of hiradentitis suppurativa

prolonged antibiotic therapy

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treatment of acute close angle glaucoma (drugs)

topical: timolol, pilocarpine, apraclonidine // systemic: acetazolamide

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management of acute pancreatitis due to gallstones (no cholangitis)

lap chole post resolution (elective)

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management of acute pancreatitis due to gallstones (with cholangitis)

urgent ERCP to remove stones

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appearance of a renal cyst on CT

light no septations, simple wall, homogenous, absence of contrast on CT, asymptomatic

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best way to measure pulmonary morbidity post lung resection

FEV1

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presentation of SBO

typmpany on exam, distended abdomen, bilious emesis, hyperactive bowel sounds

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which benzo cannot be used if the pt has poor liver function

chlordiazepoxide, diazepam

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what is the criteria for foot imaging in ulcers

> 2cm, longstanding >1week, deep (exposed bone)

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what runs behind the knee that can be affected during posterior knee dislocation

popliteal artery do ankle brachial index

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management of pericardial effusion (malignant)

pericardiocentesis and pericardial window

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what does the galactomannan assay test for

aspergillus

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sunburst appearance on xray dx

osteosarc

where do GIST tumors come from (cells)

cells of cajal)

signs of ischemic bowel post AAA surgery

bloody diarrhea, fever, leukocytosis

rocking or clicking with movement after thoracic surgery

sternal dehiscence

treatment for sternal dehiscence

surgical exploration and fixation

why do you add bicarb to lidocaine

decrease pain with injection

blunt abdominal trauma with free air retroperitoneam organ damage

duodenum or ascending/descending colon

blunt abdominal truama with free fluid inretroperitoneam organ damage

pancreas or kidney

copper deficiency signs

brittle hair, neurologic dysfunction, skin depigmentation, osteoporosis

signs of gallstone ileus

dilated loops of bowel, hyperactive bowel sounds, air in the biliary tree

otalgia with a normal ear exam

likely is referred pain from a oropharygeal tumor

best test for dx gastric cancer

EGD

xray findings stress fracture

hairline lucency or periosteal thickening

management of stress fracture

rest and analgesia

what do you do after placing a central venous catheter

CXR to check for placement

eggshell calcifications cyst structure of liver

hyatid cyst from echinococcous infection from dogs

when not to do enteral feedings

NPO, pancreatitis, bowel obstruction

lateral vertical motion (abduction) difficulty injury

rotator cuff (SITS)

coffee bean sign on xray

cecal or sigmoid volvulus

signs of septal hematoma

soft fluctuant swelling

management of septal hematoma

incision and drainage

immediate management of an external hemorrhoid

hemorrhoidectomy

most common complications of lap appy

infection - intraabdominal abcess

why do you need to correct a varicocele

because it decreases fertility

thyroid hormone effect on SVR

decreases it because it has a dilatatory effect

steps for variceal bleeding

place 2 large bore IVs --> IV octreotide, fluids and ABX -->

age of women that get femoral hernia

older women

where are femoral hernias palpated

medial to the femoral artery and are nonpulsatile and tympanic

management of a zenker diverticulum

cricopharyngeal myotomy

where are thymomas in the mediastinum

they are in the anterior portion

where are bronchogenic cysts in the mediastinum

they are in the middle

changes in the kidney during metabolic alkalosis

increased H reabsorbtion, decreased Na excretion, decreased Cl excretion

avascular necrosis of the femur head Xray

no changes seen

penile pain, curvature and plaques

peyronie disease

empyema on xray

opaque, NOOOO air fluid level

signs of orbital compartment syndrome

periorbital swelling, hard eyelid, proptosis, limited EOM, diplopia, vision loss

management of orbital compartment syndrome

emergent orbital decompression

management of oral leukoplakia

biopsy and then smoking cessation +/- removal of lesion

what can happen long term with epiphysis fractures

limb length discrepancy

biggest risk factor for AAA

smoking > HTN/atherosclerosis or CAD

irregular exophytic growths on the vocal cords dx

papillomas from HPV

etiology of severe bradycardia and AV block after inserting laproatomy ports

peritoneal stretch receptors trigger vagal response

type of dressing to switch to after a wet-dry dressing

nonadherent moisture retaining dressing

what helps decrease patients risk of developing infection after burns

early debridement and grafting

causes of secondary varicocele

extrinsic compression panpiniform plexus supply by mass, venous thrombus

location of secondary varicocele

right sided

signs of GVHD

maculopapular rash, profuse watery diarrhea, liver inflammation

what is the hypermetobolic response to burns

increase in inflammatory markers causes increase in glucagon, epiniephrine (fever tachhy), increased basal metabolic rate

signs of gastric cancer

iron deficiency anemia, weight loss, abdominal pain, vomiting

what is acute colonic pseudo-obstruction

this is where you have electrolyte abnormalities or severe infection and your colon sort of shuts off and distends

causes of delayed emergence from anesthesia

preop drugs or long procedures, metabolic disorders, neurologic disorder

severe eccymosis and bleeding after gastric bypass etiology

vit c deficiency

do patients with mechanical valves need ABX prior to endocsopy

nope

signs of pyoderma gangrenosom

small papule or pustule --> rapidly progressive painful ulcer

who gets pyoderma gangrenosum

people with IBD, RA, malignancies

joint pop with Xray findings for low lying patella

quad tendon rupture

risk factors for dupuytren contracture

males >50yo, tobacco use, DM

what lab tests help evaluate CKD fractures

PTH

what is the dx for a patient with multiple renal infarcts

polyarteritis nodosa

risk factors for avascular necrosis of the femoral head

femoral head fracture, excessive alcohol use, glucocorticoid use, sickle cell, SLE

multiple bloody paracentesis dx

malignancy

new pulmonary infiltrates and increased secretions for a vent patient dx

ventilator acquired pneumonia

where does the patella dislocate to

dislocates lateral

characteristics of benign oral lesions

symmetrical (on both sides), normal overlying oral mucosa, lack of destruction of normal tissues

management of mandibular tori

reassurance

surveilance of medullary thyroid cancer labs

calcitonin

clinical signs of bladder cancer

hematuria, hydronephrosis, voiding sx

lab findings in refeeding syndrome

hypophosphatemia, hypomagnesia, hypokalemia

clinical signs of refeeding syndrome

muscle weakness, arrythmias, change in mental status, CHF

ABX for burn infection

piperacillin/carbapenam WITH vanc

do you do a colonoscopy on a pt with diverticulitis or active infection in colon

no bc it increases chances of perf

suprapubic tenderness/lower abdominal tenderness and delierium post surgery

acute urinary retention

cause of a hydrocele

persistent patent processus vaginalis

etiology of testicular torsion

twisting of the spermatic cord