Deck 3 Flashcards
1
Q
signs of greater trochanteric bursitis
A
chronic lateral hip pain, pain worse with hip flexion or lying on lateral side, focal tenderness on the trochanter
2
Q
what is the pleural fluid like in esophageal perf
A
high amylase (from saliva) and maybe some food particles
3
Q
in zollinger ellison why is there fat malabsorption
A
the increased acid from the stomach secretions cause pancreatic enzyme inactivation
4
Q
best way to decrease poor pulmonary outcomes in rib fracture
A
proper pain control
5
Q
where are toddlers fractures located
A
distal tibia and its a spiral fracture
6
Q
signs of duodenal hematoma
A
billous emesis, blunt abdominal trauma, gastric dilation with scant gas
7
Q
risk factors for rectus sheath hematoma
A
abdominal trauma or forceful abdominal contractions from coughing, anticoag therapy, older age, female
8
Q
signs of rectus sheath hematoma
A
acute onset abdominal pain with leukocytosis, blood loss anemia, palpable abdominal mass
9
Q
aspiration pneumonitis signs
A
tachy, new pulmonary infiltrates, abrupt onset dyspnea,
10
Q
legg-calves-perths
A
ideopathic avascular necrosis of the femur
11
Q
TRALI signs
A
respiratory distress and non cardiogenic pulmonary edema, bilateral pulmonary infiltrates
12
Q
ABX for lung abcses
A
ampicillin-sulbactam or a imipenem or clinda
13
Q
what does the biliary tree look like on cholangiagram for primary sclerosing cholangitis
A
stricturing/dilation of intrahepatic &/or extrahepatic bile ducts on cholangiography
14
Q
who gets primary sclerosing cholangiitis
A
people with crohns or IBD
15
Q
clinical features of a thyroid storm
A
fever, tachy, agitation, coma, lid leg, nausea,
16
Q
signs of granulomatosis with polyangiitis
A
renal involvement, nose bleeds, lower airway bleeds in alveoli
17
Q
what is osler-webber-rendu syndrome
A
hemorrhagic telangectasias
18
Q
signs of AVMs
A
nose bleeds, brain bleeds, recurrent epistaxis, chronic bleeds (GI)
19
Q
dx of a person with RUQ pain on OCPs and hypotension
A
hepatic adenoma rupture
20
Q
signs of acute cholangitis
A
RUQ pain, hypotension, increase tbili, fever, jaundice
21
Q
anion gap in sepsis
A
high anion gap from increased lactate
22
Q
what is used as an indicator for priority of liver transplants
A
MELD-Na score
23
Q
what marker is used for pancreatic cancer
A
CA19-9
24
Q
RUQ pain, fever, and air in gallbladder wall dx
A
emphysematous cholecystitis
25
leg exam of femoral neck fracture
shortened leg, externally rotated
26
where can retropharngeal abbcesses travel to
mediastinum
27
pre-op management of pheo
alpha blocker and then beta blocker
28
what is SVR like in hypovolemic shock
it is increased bc CO is decreased
29
etiology of perianal abscess
infection of an occluded anal crypt gland
30
imanagement of a pt with clear lower limb ischemia from trauma
urgent surgery
31
post surgery colitis etiology
ischemic colotis at the watershed zones
32
what are the watershed zones in the colon
rectosignmoid juction and splenic flexure
33
signs of peritonitis
guarding, rigid, distention, inability to tolerate sitting upright
34
slow onset joint effusion and catching sensation dx
meniscal tear
35
G6PD exacerbation Hb and indirect bili levels
low Hb and high bili
36
what is gilbert syndrome
this is decreased activity of the UDP glucuronyltransferase
37
when is gilberts caught
typically in times of injury or stress to the body with infection
38
what is a baker cyst
this is extrusion of fluid from the joint space to the semimembraneous/gastroc bursa
39
signs of baker cyst rupture
acute popping sensation, acute calf pain, warmth, eccymosis distal to medial malleolus in the shape of a crescent
40
CT scan signs of acute diverticulitis
colonic wallt thickening
41
what muscle is helpful for dividing planes of axillary nodes
pec minor
42
signs of catecholamine surge
pale, tachy, extreme hypertensin
43
what can exacerbate a pheo
injury, illness, anesthesia induction
44
post amputation stump pain with slight palpation dx
likely a neuroma
45
indications for emergency thoracotomy post chest tube
>1500 ml initial output OR continued h
46
first line treatment of mild UC
mesalamine (5-aminosalycilic acid)
47
new onset ascites with cirrhosis workup
abdominal US
48
greatest risk of acute glenohumeral dislocation
redislocation
49
is more or less Cl reabsorbed during acidosis
less is reabsorbed aka it is excreted bc the body wants to remain electro neutral so there is decreased Cl reabsorption as more HCO3 is reabosorbed
50
CA19-9 level in cholangiocarcinoma
elevated
51
if a patient is draining pancreatic fluid what is their acid/base status
they will become acidodic because they are losing base
52
is calcium citrate soluble
yace
53
normal pH of urine
>5.5
54
uric acid stone pH urine
<5.5
55
etiology of post cholecystectomy diarrhea
bile acid diarrhea from excess bile dumping into the colon causing irritation and then diarrhea
56
treatment of bile acid diarrhea
cholestyramine (bile acid binding resin)
57
late complications of cholecystectomy
recurrent CBD stone, stricture, sphincter of ODDI dysfunction
58
what does prominent V waves mean on JVP waveform
this is pathopneumonic for Tricuspid regurg
59
primary causes of tricuspid regurg
myxomatous degeneration of the chordae tendinae
60
pathophys of tricuspid regurg from LV failure
chronic dilation of the RV causes stretching of the chordae tendinae so they have increased tension and cant close properly
61
pain sequence of patients with bowel perf
1) sudden sharp pain at perf 2) after perf-2 hours: temporary relief 3) generalized peritonitis +/- sepsis
62
whats the most important prognostic factor for cancers
tumor stage
63
signs of urethral stricture
high postvoid volume, weak stream
64
treatment of proctatitis
fluoroquinolone
65
why do patients get hypercalcemia with immobilization
this is because as you are sitting there is increased osteoclastic bone resorption and then this causes elevated Ca and then there is suppressed PTH b
66
management of sigmoid volvulus
endoscopic untwisting
67
clinical signs of dumping syndrome
occurs within 15-30 mins after eating, tachy, flushing, nausea, vomiting, diarrhea, cramps
68
signs of bacterial overgrowth in the small intestine
frequent watery loose stools, excess gas, decreased B12 (bacteria eat it up)
69
treatment of bacterial overgrowth in small intestine
ABX
70
NEXUS criteria for needing CT imaging to remove C-collar
intoxication, somnolence, neuro deficit, spinal tenderness, altered mental status, distracting injury
71
do you see filling defect in a fat embolism
no bc its microvascular occlusion
72
triad of fat embolism
alterened mental status, respiratory distress, petechial rash
73
most common skin cancer to result from a burn/ulcer
SCC
74
liver abscess following diverticulitis trtment management
percutatneous drainage
75
what is a keratocanthoma
this is a rapidly growing nodule with ulceration & keratin plug
76
presentation of tarsal tunnel syndrome
Burning pain, numbness, or paresthesia of the medial ankle, heel, sole and toes
77
etiology of tarsal tunnel syndrome
compression of the tibial nerve under the flexor retinaculum in the medial ankle
78
what is pes planus
this is flat feet essentially flat arches
79
tinnel sign
tapping on the tibial nerve in the posterior medial malleolus
80
what is ludwig angina
this is cellulitis of the sublingual and submandibular space
81
what is the immediate risk of ludwig angina
airway obstruction
82
how do you diagnose colovesical fistula
CT scan with rectal contrast
83
signs of colovesical fistula
bubbly urine, turbid, mixed flora in the urine on microscopy
84
lung imaging pulmonary fibrosis
subpleural honeycombing, reticular opacities
85
clinical signs of pulmonary fibrosis
Chronic progressive dyspnea, nonproductive cough, fatigue, Fine "Velcro" inspiratory crackles, digital clubbing
86
what antibiotic is best for encapsulated bacteria and is broad spectrum
amox clav
87
signs of complicated SBO and management
fever, hemodynamic instability (hypotension, tachycardia), guarding, leukocytosis, and significant metabolic acidosis --> take to surgery
88
for patients with blunt cardiac trauma do you use TE-echo or regular echo (stable vs. unstable)
stable- reg echo // unstable- TE-echo
89
what are indications for immediate laparotomy following blunt abdominal trauma
hemodynamic instability, peritonitis, evisceration, impalement
90
are internal hemorrhoids painful
no
91
what ABX should be avoided in a patient with aortic aneurysm
fluoroquinolone, bc of collagen
92
treatment of anal fissure
High-fiber diet & adequate fluid intake, Stool softeners, Sitz baths, Topical anesthetics & vasodilators (eg, nifedipine, nitroglycerin)
93
what is evisceration
this is when there is rectus abdominis dehiscence and then bowel herniatrion
94
what is leriche syndrome
this is a triad of bilateral leg claudication, absent femoral/popliteal pulses, and impotence due to
95
etiology of leriche syndrome
aortoiliac occlusion
96
primary hyperparathyroidism dx findings
elevated PTH, elevated Ca, low phosphorous
97
presentation of primary hyperparathyroidism
most ppl asymptomatic, mild nonspecific sx, renal stones, etc.
98
how to dx primary hyperparathyroidism
parathyroid imaging and parathyroidectomy
99
most common cause primary hyperparathyroidism
parathyroid adenoma
100
most common bugs for septic bursitis
skin flora
101
LA size, LV size and LV ejection fraction in acute mitral regurg
all normal except ejection fraction might be slightly increased bc the end systolic volume is less
102
signs of nasal septal perforation
whistling during respiration and
103
common post op complication after rhinoplasty
nasal septal perforation
104
what do you injure falling on your lateral ankle
you invert your foot so you injure your anterior talofibular ligament
105
do you need xray for likely ATFL injury
no
106
treatment of ATFL injury
conservative management with ice, braces and crutches
107
burn patients with organ dysfunction etiology
hypoperfusion or just dysfunction due to infection etc. do not assume there is a bowel obstruction first
108
how to dx osteomyelitis
bone biopsy unless BCX are positive and there are imaging findings
109
how do you dx gallstones
abdominal U/S
110
causes of noninfective endocarditis
cancer or hypercoagualbe state
111
signs of back pain being malignancy
worse at night, not relieved by rest or ibuprofen
112
if a chest tube is persistenly leaking what should you do
a broncoscopy because there is likely a tracheal injury allowing air in
113
what ABX for calculous cholecystitis
pip-tazobac
114
soft signs for arterial injury
diminished pulses, unexplained hypotension, stable hematoma, associated neuro defecit
115
what to do if only soft signs for arterial injury
do more imaging
116
hard signs for arterial injury
distal limb ischemia, absent pulses, active hemorrhage, bruit or thrill at site of injury
117
sounds of mitral stenosis
diastolic rumble and early diastolic murmur
118
CT signs of pulmonary contusion
peripheral anterior ground glass opacities (blood)
119
triad of fat embolism
pulmonary distress, neuro changes, and petechial rash
120
etiology of supporative parotitis
salivary gland stasis causes retrograde seeding of bacteria
121
clinical signs of supporative parotitis
Firm, erythematous pre/postauricular swelling, systemic findings, elderly paitents
122
etiologies of paralytic ileus
abdominal surgery, opioid use, inflammation, ischemia, electrolyte abnormalities
123
imaging of paralytic ileus
uniformly dilated bowel wtih no air fluid levels, NO transition piont,
124
when do you have to do valve repair before surgery
if they are having sx of the valve impiarment
125
what two cancers are associated with RB1 mutation
osteosarc and retinoblastoma
126
what mutation is associated wtih ewings
chromosome 22 translocation
127
lytic bone lesion in the distal femur with "sunburst" periosteal reaction (concentric layers of reactive bone
osteosarc
