Deck 4

Question 1

why do myxomas create inflammation

Answer 1

bc they release IL-6

Question 2

what types of fluids does someone in septic shock need

Answer 2

crystalloid so either saline or crystalloid

Question 3

what abx do you use for C diff infection

Answer 3

vanc or fidaxomicin and if its severe you add IV metro

Question 4

relationship of trachea to esophagus

Answer 4

trachea is anterior to the esophagus

Question 5

does damage to the pancreas cause acute hemodynamic changes

Answer 5

no

Question 6

if there is no blood in the FAST exam where is the blood likely if a pt is unstable

Answer 6

likely the pelvis

Question 7

signs of inhalation injury

Answer 7

Prolonged smoke exposure in an enclosed space, Facial burns, Wheezing, nasopharyngeal blistering

Question 8

what does a aortic dissection look like from the CT angio

Answer 8

there is an intimal flap where you have hte disscetion in the lumen

Question 9

signs of graves opthomology

Answer 9

Lid lag, proptosis, diplopia

Question 10

pain worsened by passive dorsiflexion of big toe dx

Answer 10

plantar faciitis

Question 11

pathophys of hyperparathyroidism in chronic kidney diseaseq

Answer 11

chronic stimulation causes hyperplasia of the parathyroid causing secretion even in the setting of elevated calcium

Question 12

A-a gradient in atelectasis

Answer 12

elevated

Question 13

management of auricular hematoma

Answer 13

immediate drainage

Question 14

what is a hypopneon

Answer 14

purulent haziness and layering of leukocytes over the conjunctivae

Question 15

presentation of acute mesenteric ischemia

Answer 15

rapid onset periumbilical pain, hematochezia, pain out of proportion to exam findings

Question 16

seminoma hormone elevations

Answer 16

only bHCG

Question 17

mixed germ cell tumor hormone elevations

Answer 17

AFP and BHCG

Question 18

leydig cell tumor hormone elevations

Answer 18

estrodiol is high

Question 19

pseudoanerysm vs. AV fistula bruit

Answer 19

pseudoaneurysm is only systolic and AV fistula is continuous

Question 20

can you still actively plantar flex with achilles tendon rupture

Answer 20

yes, bc of collateral connections from other muscles and tendons

Question 21

signs of osteoarthritis on xray

Answer 21

loss of joint space, periarticular osteophytes, sclerosis of the acetabular surface

Question 22

xray signs of chronic osteomyelitis

Answer 22

ragged fracture, fragmentation of the bone

Question 23

chronic wound drainage post surgical fixation of long bone dx

Answer 23

chronic osteomyelitis

Question 24

what is tophous gout

Answer 24

slowly enlarging hard mass in people with gout due to bursal infiltration of gout crystals

Question 25

penile injury initial management

Answer 25

if evidence of urethral injury then they need retrograde urethrography

Question 26

intraperitoneal fluid bladder injury location

Answer 26

bladder dome

Question 27

retroperitoneal fluid bladder injury location

Answer 27

anterior wall of bladder

Question 28

what is the troussou sign

Answer 28

migrating thrombophlebitis (red itchy stretch marks)

Question 29

what is the troussou sign typicall associated with

Answer 29

most often pancreatic cancer, but can be others

Question 30

do you need to do genetic testing for hereditary spherocytosis

Answer 30

nope you can just do splenectomy after blood smear

Question 31

signs of non hemolytic transfusion reaction

Answer 31

fever, chills, mild shortness of breath, myalgias, nausea, etc

Question 32

cause of non hemolytic transfusion reaction

Answer 32

preformed antibodies to donor leukocytes

Question 33

treatment of methemeglobinemia

Answer 33

methylene blue

Question 34

treatment of carbon dioxide poisoning

Answer 34

hyperbaric O2 chambre

Question 35

pathophys of cushings reflex

Answer 35

rising intracranial pressures occlude vessels which decreases perfusion so MAP increases to allow for increased perfusion to the brain, causing very high BP, bradycardia and irregular respirations

Question 36

slow growing pinkish skin lesion

Answer 36

likely basal cell CA

Question 37

management of septic arthritis

Answer 37

IV ABX and I&D

Question 38

cardiogenic shock SVR

Answer 38

increased because CO is decreased

Question 39

first line medication in treatment of aortic dissection

Answer 39

labetolol to lower BP and HR

Question 40

management of PAD

Answer 40

first smoking cessation and exercise therapy, then meds, then surgery

Question 41

what indicates the severity of aspiration pneumonia

Answer 41

volume of aspirated fluid

Question 42

signs of cholangiocarcinoma

Answer 42

RUQ pain, weight loss, nausea, vomiting, fevers, signs of bile duct obstructin

Question 43

dx of cholangiocarcinoma

Answer 43

ERCP so that you can visualize the CBD

Question 44

what type of bilirubinemia in a cholangioCA

Answer 44

direct bc it is a blockage so its overflowing

Question 45

etiology of zenker diverticulum

Answer 45

cricopharyngeal muscle spasm

Question 46

what type of thyroid cancer is familial typcially

Answer 46

medullary

Question 47

which patients get pituitary adenoma vs. craniopharyngioma

Answer 47

pit adenoma - adults // craniopharyngioma - kids

Question 48

rotator cuff inflammation signs

Answer 48

pain with abduction and external rotation, normal ROM with impingement signs

Question 49

when do you perform surgical debridement after burns

Answer 49

>72 hours after

Question 50

when to cath someone for burns

Answer 50

immediately so you can monitor their urine output

Question 51

how does CMV manifest as reactivation

Answer 51

typically it is a colitis

Question 52

severe complication of IBD

Answer 52

toxic megacolon

Question 53

treatment of toxic megacolon from IBD

Answer 53

steroids

Question 54

signs of toxic megacolon on xray

Answer 54

loss of haustra, large dilated colon, air fluid levels

Question 55

most common cause of nosocomial blood stream infection

Answer 55

central venous catheters

Question 56

BCC or melanoma of the face exicsion technique

Answer 56

Mohs

Question 57

likely etiology of vomiting post Roux-en-Y bypass

Answer 57

anastamotic stenosis

Question 58

clinical clues for renovascular causes of HTN

Answer 58

recurrent flash pulmonary edema, malignant HTN, uncontrolled HTN despite multiple meds

Question 59

K+ values in renovascular disease

Answer 59

activated RAAS causes elevated aldosterone which causes low potassium

Question 60

expanding neck hematoma management

Answer 60

immediate wound exploration to decompress hematoma

Question 61

massive transfusion protocol blood products

Answer 61

FFP, packed RBCs, platelets

Question 62

AC joint sprain clinical clue

Answer 62

pain with adduction of the arm across torso

Question 63

pathophys of gallstones for a patient on TPN

Answer 63

gallbladder stasis

Question 64

next step for patients that cant tolerate anticoagulation for lower extremity DVT

Answer 64

IVC filter

Question 65

best way to maintain output function of a patient with hypertrophic cardiomyopathy

Answer 65

hemodynamic stability (give fluids)

Question 66

which type of echo is best

Answer 66

TEE

Question 67

posterior urethral injury presentation

Answer 67

blood at urethral meatus, high riding prostate

Question 68

next stp in management of posterior urethral injury

Answer 68

retrograde urethrogram

Question 69

low T3/euthyroid sick syndrome etiology

Answer 69

high circulating glucocorticoids and inflammatory cytokines cause decreased conversion of T4 --> T3

Question 70

dx of gallstone pancreatitis

Answer 70

RUQ ultrasound