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Surgery Rotation > General > Flashcards

General Flashcards

1
Q

Follow up <1cm lung nodule with what imaging?

A

Chest CT

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2
Q

If you think somone may have a PE but scores low on Wells score, do what test?

A

D-dimer to rule out PE

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3
Q

When do you do a needle biopsy with a lung nodule?

A

when there’s evidence of metastasis

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4
Q

When do you do a lobectomy with the lung?

A

if there was no evidence of metastasis

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5
Q

When checking Ca levels, be sure to correct for _________ levels. What is the equation?

A

albumin

Ca corrected= Ca + (.8 x (4-albumin))

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6
Q

First line imaging for nephrolithiasis

A

ULTRASOUND

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7
Q

What are 3 major indications for dialysis?

A

uremic coagulopathy, uremic encpehalopathy, uremic pericarditis

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8
Q

What causes breast dimpling?

A

when lymph drainage is compromised–> edema in the interfollicular dermis

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9
Q

How do you get nipple retraction

A

suspensory ligaments of the breast are called Cooper’s ligaments, get retraction from tumor infiltrating these ligaments

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10
Q

what is torus palatinus?

A

fleshy immobile mass on hard palate

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11
Q

_______ fractures are at risk of osteonecrosis

A

scaphoid

-b/c blood supply can be disrupted

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12
Q

________ is caused by 3 or more adjacent rib fractures that break in 2 places and create an unstable chest wall segment that moves in a paradoxical motion w/ respiration.

A

flail chest

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13
Q

blunt abdominal trauma, mild respiratory distress, and NG tube in lung—>_____. What side is it more common on?

A

diaphragmatic hernia

-left b/c right is protected by the liver, can get strangulation of bowel

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14
Q

Fever, leukocytosis, and parotid inflammation suggest? What age group is most prone? Why? What’s most common bacteria?

A

bacterial parotitis, elderly and dehydrated post op patients, staph aureus,
MAKE SURE TO HYDRATE ADEQUATELY

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15
Q

hypoactive bowel sounds and gas filled loops on x ray

A

ileus

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16
Q

widened mediastinum and left sided hemothorax and pericardial effusion are signs of ______ rupture

A

aortic

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17
Q

________ can follow cardiac surgery and presents with fever, chest pain, leukocytosis, mediastinal widening and requires drainage, surgical debriedment, and prolonged antibiotic therapy

A

acute mediastinitis

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18
Q

history of acid ingestion think _______ because the acid leads to fibrosis 6-12 weeks later. What other symptoms?

A

pyloric stricture, early satiety, nausea and nonbilious vomiting, weight loss

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19
Q

________ are more commonly seen in kids and are from blood building up between mucosa and submucosa of duodenum. Why is kids more? What are sx?

A

duodenal hematoma

  • form b/c kids have thinner abdominal wall musculature, less adipose tissue, more pliable ribs
  • epigastric pain and vomiting 24-36 hours after injury (blunt abdominal trauma)
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20
Q

_________ is the most effective at preventing post op pneumonia in patients

A

incentive spirometry and deep breathing–> promote lung expansion

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21
Q

___________ presents as erythema and swelling with air in tissue on CT (black), hypotension, fever

A

necrotizing fascitis

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22
Q

__________ is a major side effect of suucinylcholine

A

cardiac arrythmia from hyperkalemia

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23
Q

Nitrous oxide inactivates _______ by inhibiting methionine synthase

A

vitamin B 12

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24
Q

Propofol major side effect is _________ from myocardial depression

A

severe hypotension

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25
Q

What two major categories lead to acute mesenteric ischemia?

A

1) cardiac embolic events: AFib, valvular disease (infective endocarditis),
2) acute thrombosis due to PAD or low cardiac output

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26
Q

bile is necessary for ____ soluble vitamins

A

fat

K- so if dec bile–>dec K–>INC INR

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27
Q

___________ happen to bone with female athlete triad which is

A

stress fracture, low bone density/low caloric intake/hypomenorrhea

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28
Q

_____________ is the most common cause of lower extremity edema that worsens throughout the day and gets better at night

A

venous valve incompetence

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29
Q

treat spontaneous pneumothorax by _______. Who tends to get these

A

observation and oxygen (which enhances speed of resorption), tall and thin young men

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30
Q

___________ is the most sensitive finding in blunt aortic injury

A

mediastinal widening

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31
Q

Patients with septic shock first require aggressive ___________ with __________ prior to the initiation of vasopressors to restore adequate tissue perfusion

A

fluid resuscitation, IV saline .9%

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32
Q

__________ can be a sign of organ hypoperfusion

A

lactic acidosis

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33
Q

__________ is recommended for complicated diverticulitis with abscess formation

A

CT guided percutaneous drainage

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34
Q

stress fractures of 2nd,3rd,4th toe treat with

A

rest and analgesics

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35
Q

Stress fractures of 5th toe treat

A

more aggressively b/c greater risk of nonunion

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36
Q

___________ leads to accumulation of air in the pleural space and the pneumomediastinum

A

bronchial rupture

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37
Q

obstructive jaundice presents with an increase in __________ bilirubin

A

conjugated–>tea colored urine (build up of conjugated bili in urine)

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38
Q

gastric varices arise with ________. How do you treat?

A

splenic vein thrombosis (b/c this forces all the splenic drainage to travel through short gastric–>large gastric varices at risk of rupture and bleeding)
-splenectomy

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39
Q

What’s the most common cause of splenic vein thrombosis

A

chronic pancreatitis

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40
Q

The first step in working up a pancreatic leak is to test draining fluid for _________

A

amylase

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41
Q

If you find calcified gallbladder, what’s next step?

A

lap chole

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42
Q

If you find stones in gallbladder but patient is asymptomatic, what’s next step?

A

observation

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43
Q

3 clinical signs of fat embolism syndrome

A

petechiae, neurologic dysfunction, respiratory distress

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44
Q

what’s best management for a patient with continuing knee pain who is in their 20s and pain meds/rest aren’t helping?

A

consider MRI

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45
Q

What 3 things make up Cushing’s reflex

A

hypertension, bradycardia, respiratory depression

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46
Q

4 Ts of anterior mediastinal mass

A

thymoma, teratoma, thyroid neoplasm, terrible lymphoma

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47
Q

____________ can occur as a local vascular complication of cardiac catheritazation that presents with hemodynamic instability and flank pain. How do you dx?

A

retroperitoneal hematoma, CT of abdomen and pelvis without contrast

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48
Q

SCC arising in a burn wound is known as ________

A

Marjolin ulcer

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49
Q

why do you need to bridge warfarin with unfractionated heparin first

A

because warfarin inhibits Protein C/S, Factors 2,7,9,10 but predominately does C and S first which is actually prothrombotic so want to prevent that with unfractionated heaprin

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50
Q

LMWH is metabolized by the

A

kidney

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51
Q

hard signs of vascular injury (____________) should lead to _______

A

pulsatile bleeding, bruits, expanding hematoma, distal ischemia (absent pulses, cool extremities),
-URGENT surgical repair

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52
Q

soft signs of vascular injury are and how to manage?

A

diminished pulses, bony injury, hemorrhage, neurologic abnormality
-CT, angiography, doppler

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53
Q

aortoiliac occlusion is known as _________ and what is the triad? who’s at greatest risk

A

Leriche
-bilateral hip, thigh, buttock claudication
-impotence
-absent or diminshed femoral pulses
Men with atherosclerosis and hx of smoking

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54
Q

For the knee, medial _______ tear won’t show up on xray so need MRI

A

meniscus

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55
Q

if a patient has pain and paresthesias following emboelctomy—>

A

repurfusion injury (from prev ischemia)—>compartment syndrome

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56
Q

what is pulsus alterans

A

change in peripheral pulses with each change in systolic blood pressure (worse in left ventricular failure)

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57
Q

__________ leads is from blow to an externally rotated and abducted arm

A

anterior dislocation of the humerus

-so will also have a problem with shoulder abduction

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58
Q

Why does triple AAA repair result in bowel iscehmia?

A

inadequate colonic collateral arterial perfusion to the left and sigmoid colon after loss of IMA after graft placement

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59
Q

complications of placing a central venous catheter (CVC, central line) are _______

A

pneumothorax, pericardial tamponade

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60
Q

terminal hematuria (at end of voiding cycle) and suggests bleeding form which 3 sites and in an old man who smokes think

A

bladder, prostate, posterior urethra

-urothelial cancer

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61
Q

hypovolemic shock leads to _____ preload and _____ CO and _____ BP.
To maintain organ perfusion, the body ___SNS activity–> ___ in SVR, and _____ in HR.
The LV becomes _____ in size, so then it ____ ejection fraction

A
  • dec preload, dec CO, dec BP
  • inc SNS, inc SVR, inc HR
  • dec, inc
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62
Q

______ presents with deviation of the uvula, fever, pharyngeal pain, earache, trismus(spasm of jaw muscles)

A

peritonsilar abscess

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63
Q

The most rapid means of normalizing the PT is by giving vitamin K dependent clotting factors through ______

A

FFP

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64
Q

patients with clavicular fracture should undergo ________ to rule out damage to vessels (subclavian)

A

angiogram

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65
Q

in a 40 yr old man, outer thigh surface hip pain is most likely from _______. Contrast with osteoarthritis

A

trochanteric bursitis

-osteoarthritis is not common in under 50 and the pain is deep within the joint

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66
Q

With suspected variceal hemorrhage what’s next step, then?

A
  • place 2 large bore IV catheters
  • volume rausicitaiton, IV octreotide, antibiotics
  • endoscopic therapy
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67
Q

________ is a complication of blunt thoracic trauma and sx such as tachypnea, tachycardia, and unilateral patchy infiltrate in alveoli

A

pulmonary contusion

-ARDS has bilateral patchy infiltrate

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68
Q

what does cardiac index measure?

A

CO (SV x HR)

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69
Q

How is varicocele affected by valsalva, standing, and being supine

A

dec in supine, inc w/ standing and valsalva

-can present as “ bag of worms”=irregular mass

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70
Q

in upper GI bleed with Hgb <7, give what?

A

IV fluid’s, bowel rest, packed red blood cells

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71
Q

clinical manifestations of zinc deficiency

A

impaired taste, alopecia, personal rash w/ pustular involvement,

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72
Q

What medicine can you give in PBC?

A

ursodeoxycholic acid

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73
Q

________ is characterized by dilated submucosal veins and arteriovenous malformations. It’s a common cause of recurrent, painless GI bleeding. Diagnose by ______ although it can be frequently missed because of suboptimal prep

A

angiodysplasia, colonoscopy

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74
Q

Manage gastric adenocarcinoma with what imaging

A

CT

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75
Q

_______ results in transudative pleural effusions and is thought to occur due to small defects of the diaphragm

A

hepatic hydrothorax

-typically on the right side b/c the diaphragm on this side is less muscular than the left

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76
Q

Crohn’s disease has _______ granulomas and ________ inflammation

A

non-caseating, transmural

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77
Q

What are the mainstays of primary prophylaxis of esophageal varies hemorrhage?

A

non-selective beta blocker and endoscopic vatical ligation

-go to TIPS(trans jugular intrahepatic portosystemic shunt) when pt has failed med and ligation management

78
Q

What are 4 causes of cirrhosis?

A

viral hepatitis (C more than B), chronic alcoholism, NAFLD, and hemochromatosis

79
Q

start screening UC patients with colonoscopy after _____ years of initial diagnosis

A

8 years and repeat every 1-2 years after

80
Q

What are some drugs that can lead to acute pancreatitis

A

anti-seizure, valproate, didanosine, metronidazole, diuretics

81
Q

with mechanical ventilation be sure to watch FiO2 as it can lead to ____________

A

oxygen toxicity

82
Q

Pulmonary capillary wedge pressure is a measure of ______ ventricular end diastolic pressure and is elevated in patients with ____ ventricular failure

A

Left, left

Can get pulmonary edema

83
Q

Chest pain due to _____ can mimic angina

A

GERD

84
Q

Increased intrapericardial can cause obstructive shock from __________

A

Pericardial tampaonade

85
Q

An incorrectly placed endotracheal tube can lead to _______ edema. Will see what sx and how do you fix?

A

Pulmonary, dec breath sounds on one side, underventilation of left lung typically,
-fix by repositioning the tube

86
Q

________ bilirubin is water soluble so a build up of this means you will see dark urine

A

conjugated

87
Q

_______ is an esophageal motility disorder where you have pain with BOTH solids and liquids

A

achalasia

88
Q

_______ cause dysphasia for solids but not liquids and aren’t associated with weight loss. They cause circumferential and distal narrowing of the esophagus

A

esophageal stricture

89
Q

shingles is typical in what age group and what tends to reactivate it

A

elderly, stress/radiation

90
Q

esophageal perforation is also known as _______ syndrome and how does it present

A

Boerhaave syndrome, severe retrosternal pain from severe straining or vomiting, subcutaneous emphysema, odynophagia

91
Q

Use what two drugs to dec systemic thromboembolism risk

A

anticoagulants

-warfarin, apixaban, dabigatran)

92
Q

AFib is most likely from ectopic foci in what location

A

pulmonary veins

93
Q

With aortic dissection, what imaging is preferred in hemodynamically unstable patients with chronic kidney disease (HIGH Cr)? What about in stable pts w/o CKD?

A

transesophageal echo

stable: CT angiography but beware because need dye

94
Q

Mitral stenosis can lead to _______ enlargement—>which can displace the left _______ and you can develop what

A

Left atrial, main stem bronchus, AFib( irregularly irregular rhythm)

95
Q

What is considered the first line vasopressor in septic shock

A

Norepinephrine

96
Q

What is the first line and second line tx of immune thrombocytopenic purpura?

A

Corticosteroids, then IVIG

97
Q

What are the 3 most common causes of chronic cough (>8 weeks)?

A

Asthma, allergies( post nasal drip), GERD

98
Q

Drug hypersensitivity reactions can cause _______ kidney injury and what findings on UA?

A

intrinsic, leukocyte casts, rash

99
Q

Aminoglycosides can cause ________ kidney injury

A

intrinsic

100
Q

Patient with dry mucous membranes, tachycardia, unremarkable UA

A

pre renal kidney injury

101
Q

what do you typ see on radiography of 60 yr old patient with neck pain and dec sensation over posterior forearm

A

bony spurs from osteoarthritis and secondary muscle spasm

102
Q

three signs of lead posoining

A

GI (constipation), neurologic (peripheral neuropathy),microcytic anemia
-basophilic stippling

103
Q

carcinoid syndrome can lead to a defect in what vitamin?

A

niacin b/c lots of serotonin released and all the tryptophan is used to make niacin

104
Q

in cor pulmonale, can use ______ to dec fluid overload but this can actually lead to _______

A

loop diuretics, hypovolemia—> prerenal injury

105
Q

antiphospholipid syndrome can lead to a _______ PTT

A

prolonged, b/c lupus anticoagulant binds phospholipids in most assays so leads to prolonged PTT

106
Q

Management of osteomyelitis

A

CBC and inflammation markers—> MRI–> CT

107
Q

give platelet transfusion at what number

A

<50,000

108
Q

Give packed red blood cell transfusion when Hgb is less than

A

9

109
Q

Steps for suspected variceal hemorrhage

A

1) Get 2 large bore IV
2) volume resuscitation, IV octreotide (to dec vasodilaiton), antibitotics

  • if no bleeding: beta blockers and endoscopic band ligation
  • continued bleeding: balloon tamponade
  • early rebleeding: repeat endoscopic therapy
110
Q

acidosis leads to _______kalemia, alkalosis leads to ______kalemia

A

hyper(acid), hypo (base)

111
Q

beta adrenergic activity and insulin leads to inc K into cells so leads to ______kalemia

A

HYPO

112
Q

What is myasthenic crisis

A

life threatening characterized by severe respiratory muscle weakness leading to respiratory failure ( can see paradoxical chest movement)

113
Q

primary biliary cholangitis is treated with what and what are 2 associated complications?

A

ursodeoxycholic acid and liver transplantation (for advanced disease)
-fat soluble malabsorption, metabolic bone disease (osteomalacia, osteoporosis), hepatocellular carcinoma

114
Q

NSAIDs are a common cause of _______ which can manifest as ________ in the elderly

A

GI ulcers, iron deficiency anemia

115
Q

spontaneous pain and odynophagia for hot and cold foods where the pain is relieved with nitroglycerin signal ? what’s next step?

A

esophageal spasm, esophageal manometry( would show repetitive, nonperistalsic high amplitude contractions)

116
Q

anticoagulation with warfarin puts patients at risk for _______. IF have signs of back pain, weakness, dizziness think

A

HEMORRHAGE, retroperitoneal hematoma

117
Q

________ is most commonly due to diverticular disease and presents with pneumaturia, fecaluria, or findings consistent with UTI

A

colovesical fistula

-UTI’s b/c of mixing of flora

118
Q

acute bacterial prostatitis and prostatic abscess

A

kind og go together and have systemic sx, so tender prostate and fever

119
Q

_______ typ presents with AST & ALT (in the 1000s), heaptic encephalopathy, liver dysfunction (INR>1.5)

A

acute liver failure

-most commonly from drug toxicity (acetaminophen)

120
Q

In _______ you can see equalization of diastolic pressures. Why is that and how do you diagnose?

A

cardiac tamponade, rapid accumulation of blood in the pericardial space leads to inc in diastolic pressures and impairment in venous return, dx with echocardiogram
-tamponade can be a side effects of CABG

121
Q

if you think a PE is likely, what imagine study to verify? If patient has peptic ulcer dz, have to consider propensity to bleed with anticoagulation so consider what to manage instead?

A

CT angiogram, IVC filter

-D-dimer when you think it’s unlikely

122
Q

exertional syncope is typically from? What are 3 signs?

A

outflow obstruction (aortic stenosis)

  • delayed and weak pulses (pulsus parvus et tardus)
  • single and soft 2nd heart sound (S2)
  • mid to late peak systolic murmur
123
Q

_______ is an acute lung injury secondary to chemical burn from aspirated sterile gastric contents and is present within HOURS after surgery

A

aspiration pneumonitis

-can see hypoxemia, CXR: bilateral infiltrates

124
Q

________ is an infectious disease caused by aspiration of infected oropharyngeal secretions (occurs DAYS after)

A

aspiration pneumonia

125
Q

when does negative pressure pulmonary edema occur?

A

when a patient has upper airway obstruction (like laryngospasm from extubation)—> negative intrathoracic pressure (b/c of inspiration against the obstruction)
-more common in young men or after head and neck injury

126
Q

Criteria for starting long term oxygen therapy

A

Resting arterial tension (PaO2) <55 or SaO2

PaO2<59 and SaO2<89 with cor pulmonae

127
Q

______ are usually found in the MIDDLE mediastinum and can present with vague chest discomfort

A

Bronchogenic cyst

128
Q

Thymomas are in the ______ mediastinum

A

Anterior

129
Q

All neurogenic rumors are found in the ________ mediastinum

A

Posterior (meningoceles, esophageal leiomyomas)

130
Q

What is postural hypotension?

A

a drop in systolic blood pressure (>20) and a drop in diastolic (>10) on standing form supine

131
Q

_________ has demonstrated long term survival and improved quality of life with patients who have COPD w/ SIGNIFICANT chronic hypoxemia

A

long term supplemental oxygen

-can also see secondary polycythemia vera (Inc red cell prod)

132
Q

prolonged PR interval signals _________

A

heart block

133
Q

_______ can cause high output cardiac failure by shunting the blood from the arterial to venous side —> _____ preload. Why is there heart failure in this case

A

Arteriovenous fistula, inc preload

-b/c even though there’s high output, the circulation is unable to meet the oxygen demands of peripheral tissues

134
Q

elderly patient with UTI grows E coli and tx with ciprofloxacin, then few days later she becomes confused and has watery diarrhea with UA showing occasional yeast. What do you do?

A

she might have C diff so get a stool culture (PCR) and start vanco, metro( is for fulminant Cdiff)

135
Q

esophageal perforation can be due to what 3 things? What are 3 sx? How do you diagnose?

A

endoscopy, severe wretching, trauma

  • chest pain radiating to the back, tachypnea, pleural effusion (left sided)
  • this diagnosis is emergent and life threatening and use contrast water soluble esophagogram (if inconclusive use barium)
136
Q

What are the two types of dysphagia?

A

Oropharyngeal dysphagia has problems initiating swallowing with cough, choking, and nasal regurgitation (think person had a stroke and at high risk of aspiration). Diagnose with videofluroscopic modified barium swallow

  • Esophageal dysphagia can be dysphagia to solids AND liquids at rest—> motility disorder. Do barium swallow w/ possible manometry
  • Esophageal dysphagia can be dysphagia just to solids and progresses to liquids–>mechanical obstruction. If no hx of radiation, do upper endoscopy. If hx of radiation or complex stricture do barium swallow w/ manometry
137
Q

__________ is the most common cause of lower GI bleeding in adults. Bleeding is typically painless but may be associated with ________

A

diverticulosis, lightheadedness and hemodynamic instability

138
Q

In an overweight person who you suspect pancreatitis but they don’t drink, this is probably from what etiology? What’s best step imaging step

A

gallstones, RUG ultrasound b/c CT isn’t sensitive for stones

139
Q

if you have a patient over excessively overdosed on acetaminophen, what’s next best step of management? (PT is 120s, AST/ALT in 8000s, Cr HIGH, bilirubin 4)

A

refer for liver transplant

-only about half of ALF patients will survive without a liver transplant

140
Q

___________ is characterized by the development of hemorrahgic lesions after ischemia or exposure of gastric mucosa to various injury agents (alcohol, aspirin, cocaine)

A

acute erosive gastropathy

141
Q

when you see cirrhosis and ascities, with fever and lethargy think _________ and hepatic encephalopathy.

A

spontaneous bacterial peritonitis,

-diagnose with paracentesis w/ dx criteria being positive ascities fluid and neutrophil count >250

142
Q

Characteristic features of of pancreatic cancer are a palpable __________ and what do the bile ducts look like?

A

gallbladder, intra and extrahepatic biliary dilation

143
Q

what is first line tx for diffuse esophageal spasm

A

calcium channel blockers

144
Q

How do you diagnose esophageal cancer

A

upper GI endoscopy

145
Q

How do liver metastasis present

A

Can be single or multiple modules

146
Q

laxative is characterized by _________ diarrhea with melanosis coli which is?

A

watery, frequent, dark brown discoloration of the colon

147
Q

VIPomas have _____kalemia and ______chloridya

A

hypokalemia,hypochloridya and tea colored stools

148
Q

lactose intolerance is characterized by a _______ hydrogen breath test

A

postive

149
Q

what is postcholecystectomy syndrome and how do you dx?

A

persistent abdominal pain or dyspepsia either post op months to years after

  • can be a retained common bile duct or cystic duct stone
  • dx w/ ERCP, MRCP
150
Q

_______ can present with unexplained fever, leukocytosis, RUQ pain

A

acalculous cholecystitis

151
Q

triad of epidural abscess

A

focal back pain (or HA), abnormal inflammatory markers (ESR, fever, leukocytosis), neurologic deficits
AND hx of IV drug abuse

152
Q

Peripheral artery disease is defined by an ABI of?

A

ABI

153
Q

cancer makes up what component of virchow’s triad?

A

hyper coagulability

154
Q

initial management of claudication in a smoker is?

A

smoking cessation

155
Q

why does skin turn reddish brown with chronic valvular incompetence?

A

hemosiderin deposition

156
Q

The best medical management for sustained improvement in claudication is?

A

a walking program which can double the walking distance

157
Q

what nerve injury leads to foot drop and problems with dorsiflexion?

A

COMMON peroneal nerve injury

158
Q

Jaw pain with chewing is associated with what vascular issue?

A

giant cell arteritis which is managed with steroids

159
Q

No doppler signal, loss sensory and nerve function, paralysis of muscles and mottled skin signal?

A

irreversible ischemia

160
Q

Parkland formula

A

4ml x (%body burned) x wt. in kilos, give half over the first 8 hours and the rest the next 16 hrs

161
Q

What is an atrial myxoma and how does it affect heart sounds?

A

benign heart tumor, it’s a rumbling diastolic murmur that disappears when pt lies on left side
-common in LA but rare in RA

162
Q

What organ does VIPoma commonly show up in and what are sx?

A

pancreas, watery diarrhea, hypokalemia, achlorhydria, malar flush in kids

163
Q

The ______ artery is responsible for most posterior nosebleeds

A

sphenopalatine

164
Q

Eikinella is a habitant of where in the human body

A

oral flora

165
Q

_______ causes chronic joint pain, crepitus with movement, and is associated with advanced age and obesity

A

osteoarthritis

166
Q

Restrictive lung disease has _____ lung volumes, _____ Aa gradient, _____ diffusion CO

A

Dec lung volumes, inc Aa, dec CO diffusion

167
Q

Beta 1 receptors _____ LV end systolic volume

A

Decrease because inc myocardial contractility so inc cardiac output

168
Q

A _______ is from extrusion of synovial fluid from the knee joint to the gastrocnemius or semimembranosus bursa. When can it happen?

A

Popliteal-bakers cyst, after strenuous exercise (posterior knee and calf pain and area of eccymosis by medial malleolus (crescent sign)

169
Q

What is TTP? What is the terrible pentad of TTP? How do you tx?

A

defect of ADAMS13–>inc vWF (shistocytes b/c of inc platelet aggregation and RBCs have to move through this)

5: fever, neurologic, renal, hemolytic anemia, platelets
- tx: plasma exchange

170
Q

antihistamines can lead to ________ effects and how do they affect bladder?

A

anticholinergic, detrusor hypo contractility

171
Q

In patients of non-African descent of suspected anemia, what are initial tests? What about African descent?

A

CBC (non-African), hemoglobin electrophoresis (African)

172
Q

A _________ is a typical complication of advanced osteoporosis. How can a person on corticosteroids affect this?

A

vertebral compression fracture, quicker progression

173
Q

how does herniated disk present?

A

radicular pain along the thigh to below the knee (sciatica) and positive straight leg test due to nerve compression

174
Q

________ is the most common cause of secondary HTN and should be suspected in all patients with diffuse atherosclerosis and resistant HTN. There is also sometimes an abdominal bruit

A

renovascular HTN

175
Q

What 3 ways can you check for Hpylori eradication test?

A

urea breath test, fecal antigen test, upper endoscopy after 4 weeks of tx

176
Q

What’s best way to check for a preoperative MI?

A

Dipyridamole-Thallium Scan (checks blood supply to heart under stress)
-let’s you know if there is reversible ischemia

177
Q

Non-traumatic intraparenchymal hemorrhage most often is from what cause?

A

HTN

178
Q

if see small vesicles on an erythematous base and pallor on conjunctivae in kids eye think

A

herpes simplex conjunctivitis

179
Q

how to test for carpal tunnel in pregnancy?

A

nerve conduction studies

180
Q

insulinoma sx

A

tachycardia, tremors, sweating, nervousness

181
Q

APML can present with ______ and cytopenias

A

DIC

182
Q

Pt is <50 years old, a smoker and has substernal chest pain that wakes her up in her sleep, ambulatory ST elevation, CT angio is normal. Tx w/?

A

diltiazem or CCB

-vasopastic angina

183
Q

_______ is the most common cause of MSK chest pain, what do you fo for tx/ imaging?

A

reassurance and symptomatic chest pain management (tylenol, NSAIDs)

184
Q

Pt. has a DVT but what are 3 contraindications to anticoagulation and how to tx?

A

active bleeding, recent surgery, acute hemorrhagic stroke

PLACE AN IVC filter

185
Q

Breastfeeding jaundice is typically in the _______ and with high _____ bilirubin, and the baby has ______ wt loss, ____ urine output. How to tx?

A

first week of life, indirect, inc wt loss, dec uo,

-try and inc mom breastfeeding (every 2-3 hrs) and if can’t then may need to consider formula

186
Q

patient who had multiple gun shot wounds to abdomen, think what organ might be removed so predispose to what?

A

spleen, impaired opsonization (antibody mediated phagocytosis)

187
Q

The _____ is typically visible on CXR in kids <3. It’s close to the RA

A

thymus

188
Q

if see foreign body on child CXR who’s symptomatic, tx with? If asx?

A

flexible endoscopy, observe for 24 hrs

189
Q

biliary atresia typically has inc ____ bilirubin and dark urine, clay colored stools

A

conjugated

190
Q

when have suspected intusseception, dx w/

A

U/S guided air contrasts enema

191
Q

if see foreign body on child CXR, tx with?

A

flexible endoscopy

192
Q

What is Ogilve’s syndrome and what part of the colon is most likely to rupture

A

pseudo-obstruction of the colon that is associated with bed ridden, neurologically impaired, and older patients, drugs (opioids)
-cecum is most likely to rupture b/c it’s the colon with the largest diameter

Surgery Rotation (4 decks)

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