Emrcs Wrongs Flashcards
UTI. Mc organism
Proteus. Urease producing.
Favours struvite stone (alkaline)
Anal fissure associated with sickle cell or leukaemia
Leukaemia. Not sickle cell
Contraindication to epidural
Coagulopathy
Active infections (even appendicitis)
Annular pancreas. Most likely obstructs at
2nd part of duodenum
Vwd and haemophilia
Apla sym
Aptt increase. Pt normal
Increased aptt
Urea to creat ratio in dehydration
Increased
Cephalic vein and brachial artery separated by
Bicipital aponeurosis
VIT def
B1
B3
Beri beri
Pellagra
Chordoma
Bone tumour. Skull base and sacrum mc. X-ray- destructive lesion with soft tissue mass
Blood products with
Gram +ve inf-
Gram -ve inf-
Blood products with
Gram +ve inf- platelet
Gram -ve inf- packed red cells
Best for hiv testing
P24 antigen testing
Most imp in sepsis:
vasoconstrictor
Inotrop
Nor adr not dopamine
Dopamine
(Always give inotrop via central line)
Lower GI bleed mc causes:
Newborn-
Less than 1 Yr-
1-2 Yr-
More than 2yr-
Lower GI bleed mc causes:
Newborn- anal fissure
Less than 1 Yr- fissure /intussusception
1-2 Yr- me Mel’s or polyp
More than 2yr- polyps or ibd
Upper GI bleed mc causes:
Newborn-
Less than 1 Yr-
1-2 Yr-
More than 2yr-
Upper GI bleed mc causes:
Newborn- hemorrhagic disorder
Less than 1 Yr- gastritis
1-2 Yr- peptic ulcer
More than 2yr- varices
Diaphragm disease
Formation of small compartments within small bowel. Associated with NSAIDS
Renal tumour from a long standing staghorn calculus
Scc. Not adeno or tcc
Which analgesic to avoid in renal transplant
NSAIDs. (Nephrotoxic)
Ansa cervicalis
C1 c2 c3
Salivary gland enlargement.
1. Associated with sicca or other autoimmune disorders
2. Isolated enlargement
Sjogrens
Miculicz
Cluster randomised trial
More prone to unit of analysis error
Very large goitre with retrosternal extension. Complication after thyroidectomy?
Tracheomalacia
Metastatic calcification
Increased calcium levels, so deposition
Parotid duct pierces which muscle
Buccinator
Root of lung. Vertebral levels
T5-T7
Left hilum structures
2 pulm veins, 1 pulm artery
Bronchial artery and vein
1 primary bronchus
2 pulmonary plexus
Bronchopulmonary LN
Hilum right lung structures
2 pulm vein nd 1 pulm artery
1 bronchial artery and vein
2 bronchus
2 pulm plexus
LN
1st radiologic sign in perthes
Sclerosis of femoral head
Retinal and cerebellar Hemangioma
Von hippel lindau
Acid base balance in PE
Resp alkalosis due to hyperventilation
Rectal varices doc
Terlipressin
Massive PE treatment
Thrombolyse with alteplase 50 mg bolus
Knee locking. Delayed knee swelling.
Torn meniscus
Prostate lymph node
Internal iliac.
Coupling injury
Active electrode touches a metallic instrument
Drug that can be used in varicose veins
Pentoxifylline
Hypothermia. Which hormone production decreases
Insulin
Pancreatitis with b/l parotid enlargement
Viral parotitis
Duodenal atresia associated with
Trisomy 21
Proportion of patients presenting for chole will have cbd stones
10%
Pseudohematuria
Rifampicin. Quinine. Levodopa. Phenytoin
Level of hyoid bone
C3
Chest pain. AR murmur. Inf wall MI alike ecg
PROXIMAL aorticdissection
Only inotrop that can be given in peripheral line
Metaraminol. Not nor adr or adr or dobutamine
Percentage of normotensives in pheo
10%
Approx blood loss for each class of shock :
Class 1 -
Class 2 -
Class 3-
Class 4-
3vs 4- drop in GCS in 4
Approx blood loss for each class of shock :
Class 1 - < 750
Class 2 - 750-1500
Class 3- 1500- 2000
Class 4- >2000ml
False elevation of serum ferritin
Any septic focus present
Drugs tgat can cause malignant hyperthermia
Suxamethonium
Halothane
Sudden stoppage of dopaminergic drugs like Ldopa and antipsychotics
Neuroleptic malignant syndrome. Hyporelfexia, lead pipe rigidity
Absorption independent of pancreatic secretion for folic acid or b12?
Folic acid.
B12 needs protease action.
Upper limb (axillary/subclavian) thrombosis. Best treatment
Catheter direct tPA
VWf stabilizes
Factor 8
Iron is absorbed at
Total body iron
Most of iron is at
Proximal small bowel (duodenum and jejunum)
4g
Hb
Thebesian veins drain into
Atrium
Sartorius innervated by
Superficial br of femoral N
Long head of biceps is innervated by
Tibial component of sciatic nerve
Acid base disorder nd calcium relation
Alkalosis lowers calcium
Brain death
Fixed pupil
No corneal reflex
Absent occulo vestibular reflex
No response to supraorbital pressure
No cough reflex
Co2- 6 kpa
Crutch palsy
Radial nerve
Marfan syndrome. Defective protein
Fibrillin
Tender hyperthyroid goitre
Subacute thyroiditis
Ct indications in children
LoC> 5 mins
Vomiting >3
Ent bleed
Seizure
Lesion > 5 cm
Superficial irregular pigmented patches with itching
Seborrhoeic wart.
DO SHAVE BX
Bolam test
Professional standards met?
Consent 2 form
Parent for children
Consent 4
When pt is unable to consent
Upper third esophageal Ca
Radical chemo radio or mceveon 3 field
Hematoma in transphenoidal hypophysectomy
Bi temporal hemianopia
Atrial repolarisation on Ecg
None
Fistula in ano in crohns pt. Managed by
Loose seton
Conns syndrome. Parotid secretion Na and K
Same as kidney!! Less Na and more K
Rare disease or condition. Best study design
Case control study
Atracurium
2 important points
Histamine release
Metabolised by hydrolysis. Not kidney or liver.
Malena after stoma
Diversion colitis
X-ray KUB ureter landmark
Tip of transverse process of L2 to L5
Mc adverse event following
Packed red cells
FFP
Pyrexia
Urticaria
Popcorn cells seen in which Hodgkin lymphoma type
Lymphocyte predominant
Best investigation to assess for possible compression of upper airways eg due to retrosternal goitre
Flow volume loop
Thoracic duct
Azygous vein
Right to left at louis(T4-T5). Enters left subclavian at c7
Right. Post to eso. Ascends up to T4. Arches for ward to drain into svc
Anaemia with sore tongue
B12 def
Tunneled lines popular for long term chemo
Groshong and Hickman. It’s like chemoport.
Young Asian female. Pulseless peripheries.
Takayasu. Variable cvs and cns symp.
Prolactin release
stimulated by
Inhibited by
Thyrotrophin releasing hormone.
Dopamine #
When to stop ufH preSX
6hrs preop.
Cleared from circulation by 2 hours.
Commonest cause of LGI bleed in adult
Diverticular
Uncomplicated lap chole. Risk of wound infection
3-5%
Most imp urinary acid base buffer
Phosphate
Most water is absorbed at
Jejunum and ileum
Halothane most imp side effect
Hepatotoxicity
Adrenaline dose for anaphylaxis
1:1000 im (0.5 ml)
Bleeding PR post illeocolic anastomosis
Anastomotic staple line bleed
Long standing venous ulcer. Which bx
Punch bx
Sudden spontaneous spleen rupture cause
Epstein Barr
Metastatic breast cancer with lytic deposits in femoral shaft.
Mx
IM nailing. Not RT since it will reduce risk of fracture.
If near neck, THR
Pancreatic secretions volume
1000-1500ml
Mc type of fistula in ano
Intersphincteric
Lymphatic drainage of female urthera
Internal iliac
Acute haemolytic transfusion reaction. Test to confirm
Direct Coombs
Chords tympani in middle ear
Medial to par flaccida
Hematuria. Textile industry. Rubber industry.
Tcc renal cancer
Causes of AVN.
PLASTIC RAGS
Pancreatitis
Lupus
Alcohol
Steroids
Trauma
Idiopathic,infections
Caisson
Radiation, rheumatoid
Amyloid
Gaucher
Sickle cell anemia
Supination and pronation restriction. Tenderness in proximal forearm.
Radial #
Gustilo 3A- adequate skin cover
Gustily 3B- inadequate skin cover gustily sc- vascular injury
Management?
3A ); _ debridement and external fi’xation. Closedefect later
3B - skeletal and soft tissue reconstruction within 72hrs
3C - immediatevasador repair
Consider angioplasty when
Small well defined block. Good distal run off
Mc location of gastrinoma
Duodenum
SD percentage rule
68-95-99.7
UTI mc organism
Proteus
Associated with fissure. Conditions
Tb
Crohns
Syphillis
Leukaemia!
Not sickle cell
Tourniquet deflation changes
Fall in CVP,SVR,
Increase in end tidal co2
Increased fibrinolytic
Fall in temp
Raised K and lactate
Division of common carotid artery
C4