From Pearls Flashcards
Adjunct tx for DIC and Primary fibrinolysis
FFP/cryoprecipitate; EACA
Antidote for chemical burns caused by hydrofluoric acid
Calcium
1st cells to enter the wound
Neutrophils
Non absorbable sutures
Nylon, prolene, stainless steel, silk
Average time frame for suture removal
7-10 days
Microsatellite instability is the hallmark of?
Lynch syndrome
Early onset colon CA with excess synchronous and metachronous lesions
Lynch syndrome type I
Criteria for lynch syndrome
Amsterdam criteria (3-2-1-0)
Most commonly implicated human bite wound
Eikenella corrodens
Most commonly impicated animal bite wound
Pasturella multicoda
CEA (+)
Pagets disease
S 100
Melanoma
Intracytoplasmic mucin
Lobular CA
Hypertrophied papilla, ulcer, sentinel pile: managment
Laternal intestinal sphincteretomy (Golligher’s triad)
Arrow head sign
AP
Most common site of GI carcinoid
Appendix
Most common adenocarcinoma of the appendix
Mucous
A rare d/o caused by post sinusoidal cirrhosis due to vein thrombosis is diagnosed by?
Budd chiari; trascutaenous doppler US
Halo sign
Acutr calculous cholecystitis
Fotherhill sign - most defintive dx
Rectus sheath hematoma (CT scan)
Abdiminal mass lesion that is mobile from the patient’s right to left or left to right, Tillaux sign
Mesenteric cyst
Idiopathic retroperitoneal fibrosis is diagnostic
Ormond’s disease- CT scan with contrast
(+) hurthle/ askanazy cells ; management?
Hashimoto- thyroid hormone replacement
Hardy wood thyroid glands; what is the management?
Riedel’s thryoiditis- isthmusectomy
In a child with recurrent acute thyroiditis, what is the Dx of choice?
Persistent pyiform sinus fistula- ba swalow
Localization study for the most common cause of primary hyperparathyroidism
Tc labeled sestamibi(for solitary parathyroid adenoma)
Prominent S1, fixed S2, right ventricular heave
Ostium secundun
Rib notching on CXR, decreased femoral pulses: tx?
Coarctation of the aorta- bicuspid aortic valve: resection and EEA
Equalization of O2 sat in all chambers: mgmt?
TAPVC- connect PV to LA(emergency)
Hypoplastic RV, dependent pulmonary flow on PDA: mgmt
Blalock Taussig shunt(blalock para sa block)- tricuspid atresia
Horner syndrome+wasting of intrinsic muscles+ arm shoulder pain
Pancoast tumor: adenoCA of lungs
Microcolon, eggshell pattern
Meconium ileus
When performing a procedure to prevent midgut malrotation ; what other procedure should also be inculded
Appendectomy(Ladd’s procedure- annular pancreas)
Pt with a triad of abdominal pain, jaundice and mass, what is the disgnostic of choice
MRCP(choledochal cyst)
Major inducer of catabolism and cahexia during stress
TNF a
Induces fever
IL 1
Responsible for Ig production
IL 2
Mediator of acute phase response
IL 6
Activates macrophages
IFN y
Basic caloric requirement of a normal healthy adult
25 kcal/kg/day
Caloric requiremennt of a burn patient
35-40
Normal anion gap
<12
Tx of choice for patients with Von williebrand’s
DDAVP
Inherited platelet disorder of ADHESION
Bernard soulier
Estimated blood volume
7-8% of BW
Management for 20% blood loss
Crystalloids
Mgmt for up to 50% blood loss
Crystalloids + PRBC
> 50% blood loss management
Crystalloids+ PRBC+ plasma/albumin
Where is needle thoracostomy done
2nd ICS, MCL
Definitive mgmt for tension pneumothorax
CTT
Where is thoracostomy done
4th or 5th MAL
Flail chest compromises breathing due to
Underlying lung contusion
Trauma patients have lost approximately how much blood
30-40%
Saphenous vein cutdown is done where
1 cm superior and anterior to medial malleolus
Intraosseus infusion is done where
Proximal tibia or distal femur
Positive DPL
WBC- >500, amylase- >19, alk phosp- >2, bilirubin >0.01
RBC:
Anterior abdominal- >100,000
Thoracoabdominal- >10,000
1,000-10,000- do laparoscopy/thoracoscopy
Duodenal hematoma
Coiled spring sign
Right sided medial visceral rotation
Catell maneuver
Left sided medial visceral rotation
Mattox maneuver
Most sensitive xray finding suggesting tear of the aorta
Widened mediastinum
Best screening test for tear of aorta
Dynamic spiral CT
Defintive test for tear of aorta
Aortography
Normal ICP? When do you initiate ventriculostomy
4-14; initiate at 20
Burns that extend to the reticular layers of the dermis
2nd degree(deep partial thickness burn)
Earliest indicator of smoke inhalation injury
Decreaed P:F ratio
Cause of melting wound syndrome
Staphylococcus aureus
Antidote for wounds caused by hydrofluoric acid
Calcium
Malignancy from marjolin’s ulcer
Squamous
Average time frame for sutures
7-10 days
Pressure ulcer stage when there is partial thickness skin loss
II
Pressure ulcer stage when there is nonblanchable erythema of intact skin
i
Pressure ulcer stage when there is full thickness skin loss, not thru fadcia
III
Pressure ulcer stage when there is FT skin loss+muscle and bone involvement
IV
Microsatellite instability is the hallmarknof what
Lynch syndrome
Early onset colon Ca with excess synchronous and metachronous lesions
Lynch syndrome type I
Early onset colon Ca with excess synchronous and metachronous lesions and extra colonic malignancies
Type 2
Diagnostic criteria for lynch syndrome
Amaterdam criteria
EBV is associated with
Nasopharyngeal Ca, hodgkin’s lymphma and butkitts lymphoma
Virus implicated with adult T cell leukemia/lymphoma
HTLV
Tumor marker for germ cell tumors
AFP
Most important troubling side effect of cyclosporine
Nephrotoxicity
Most dreaded complication of placing a swan ganz catheter
Pulmonary artery rupture
Melanoma with best prognosis
Lentigo maligna
Most common type of melanoma
Superficial spreading
Pigmentation on the proximal or lateral nailfold
Subungal melanoma- hutchinson sign
Rare but aggressive cutaneous malignancy arising from neuroendocrine cells? Mgmt?
Merkel cell ca- excision to 3cm margin + prophylactic node dissection+ adjuvant radiation
Tumor arising from areas of previous radiation/lymphedema
Angiosarcoma (stewart treves syndrome)
Hidrandenitis supparativa mimics?
Paget’s or invasive breast CA
Most frequent site of metastasis for breast CA
Bone
True anatomic precursor for invasive ductal carcinoma
DCIS
Marker of increased risk for invasive breast CA
LCIS
Differentiate superficial spreading from Padget
S 100 (+) -melanoma; CEA (+)- Paget’s
Breast cancer with intracytoplasmic mucin and with indian file configuration
Lobular CA
BIRADS when u should do a Biopsy
4-5
Test for DIC
Protamine test