EBM Flashcards

1
Q

How many burns are treated in the US each year?

A

450,000 burns treated each year

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2
Q

Who is at higher risk for burns?

A

low income families
rural parts of the country
children & elderly

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3
Q

What is the appearance of burns?

A

1st degree: red w/o blistering, dry, painful (sunburn)
2nd degree: red w/ blisters, moist, painful, yellow or white
3rd degree: stiff & white/brown/black, charred, eschar, leathery, painless

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4
Q

What is eschar?

A

dead tissue cast off after the burn

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5
Q

What are the most dangerous things in burns?

A

shock
sepsis
respiratory insufficiency

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6
Q

What happens to the cardiovascular system w/ burns?

A

capillary permeability increases, loss of proteins, fluids
systemic hypotension
end organ hypo perfusion
**crush them with fluids

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7
Q

How do you diagnosis an infection secondary to a burn?

A
fever symptoms
pain, swelling, change in appearance of burn wounds
Look @ extent of burn: rule of nines
Severity: depends on % of total body surface area is burned
High risk: >20% burned
high WBC count
High fasting blood glucose
Pathogens in blood urine culture
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8
Q

What are symptoms of patients w/ sepsis or infection following a burn?

A

high temp
etc
etc look up

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9
Q

How do you treat burn patients?

A

ABCs
Fluid resuscitation: use Parkland formula
Feeding tube (high carb)
Skin Grafting (get rid of burns unlikely to heal)
Get them to a burn unit
Treat psychosocial issues

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10
Q

What is the role of inflammation in thermal injuries?

A

systemic capillary permeability
protein leakage into interstitial space
edema
hypovolemic shock
damaged tissue–>inflammation (helps heal, but can hurt)
SIRS can result if inflammation lasts too long–>sepsis. Bad.

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11
Q

T/F May times prostate cancer is clinically inconsequential.

A

True. Although sometimes it can spread.

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12
Q

When are most cases of prostate cancer diagnosed?

A

after the age of 65

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13
Q

How does inflammation relate to prostate cancer?

A

occurs in every step of prostatic malignancy
mutated cell avoids apoptotic signals & keeps dividing & releasing inflammatory mediators.
oncogenic cells escape & can cause more inflammation @ other sites.

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14
Q

How do you diagnose prostate cancer?

A
nocturia
dysuria
hematuria
increased urinary frequency
bone pain
high PSA
rectal exam
family hx
ethnicity
Best thing: prostate needle biopsy
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15
Q

How is prostate cancer treated?

A
surgery
radiotherapy
????
Alternative: 
external beam radiotherapy 
endocrine therapy (try to suppress testosterone, remove testicles)
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16
Q

What do inflammatory responses lead to?

A

removal of damaged tissue
tumorneogenesis
mutation of DNA thru ROS
???

17
Q

What is influenza?

A

viral respiratory infection caused by a number of H & N antigen variants

18
Q

How many people die from influenza & flu & pneumonia?

A

50K per year

19
Q

Who is at high risk for flu-related complications?

A

over age 50
pregnant
chronic medical condition
less than 6 months old

20
Q

Why are we susceptible to new flu strains?

A

antigenic drift

**influenza frequently mutates & surface proteins change & this makes it difficult for our immune system to adapt

21
Q

What are the severe symptoms associated w/ influenza?

A
tachycardia
myalgias
high fever
exacerbation of underlying medical conditions: COPD, asthma, Diabetes
nausea
vomiting
diarrhea
22
Q

How do you diagnose influenza?

A

**can’t be diagnosed by symptoms alone. Could be common cold.
Rapid Diagnostic Tests: around 20 minute test
Longer tests: viral culture, PCR, immunofluorescent & serologic tests
Chest X ray in elderly

23
Q

What is the pathogenesis of influenza?

A

Innate response: activated alveolar macrophages: TNF alpha & NO
Adaptive Immune Response: dendritic cells activate cytotoxic T cells & T helper cells
inflammatory cytokines are released

24
Q

What is the treatment for influenza?

A

vaccine to prevent
fluids & rest
antiviral medications: neuraminidase inhibitor (tamiflu), M2 protein inhibitors

25
Q

T/F Influenza is a viral respiratory infection that can lead to pneumonia.

A

TRUE