Hi-Ho, Hi-Ho Flashcards
burn treatment that might lead to hyponutremia
silver nitrate
does not penetrate
burn fluid formula
4ml * kg * %burn
1/2 in 8
1/2 in 16
child with holosystolic murmur in left lower border
VSD
tetralogy murmur
harsh systolic ejection murmur
celiotomy is a?
fancy name for ex-lap
Is a FAST exam helpful in abdominal injury with hemodynamic stability?
50% sensitivity for abdominal injury- not great in stable pts
SBO s/s and cxr findings with needle shaped crystals in UA
Needs CT
probably has uric acid stones –> ileus (after stone passes, ileus resolves)
Family history of clotting pt has an elevated homocysteine. What rx should she be one?
homocysteine- very reactive --> DVTs ↑ homocysteine can usually be resolved by giving: B6 Folate \+/- B12
1st feeding intolerance, abdominal distention, and a rapidly dropping platelet count
Necrotizing enterocolitis
usually in pre-mes
Treatment: stop all feedings and administer broad-spectrum antibiotics, IV fluids, and IV nutrition
shows up with green vomiting, but instead of a
double bubble there are multiple air-fluid levels throughout the abdomen.
Intestinal atresia
condition results from a vascular accident
in utero.
Vital signs vs fluid DETERMINING SURGERY
- minor internal injuries/ responds promptly to fluid resuscitation might not need surgery –> CT
- major injuries and vital signs that do not improve with fluid resuscitation–> surgery.
Necrotizing enterocolitis rx
Treatment: stop all feedings and administer broad-spectrum antibiotics, IV fluids, and IV nutrition
Surgical if abdominal wall erythema, air in the portal vein, intestinal pneumatosis (presence of gas in the bowel wall), or pneumoperitoneum (signs of intestinal necrosis and perforation).
look for the words _________ in the description of the patient as your clue that you can choose CT scan as the correct answer in this setting.
“hemodynamically stable”
“signs of acute rejection of transplant–> RX?
needs steroid bolus
patient who is being allowed to pass a ureteral stone spontaneously develops chills, fever spike, and flank pain.
RX
IV antibiotics
immediate decompression of obstruction- ureteral stent or percutaneous nephrostomy
*The combination of obstruction and infection of the urinary tract is a dire emergency
Painless ulcer, chronically edematous, indurated, and hyperpigmented above the medial malleolus.
Venous stasis ulcers
ddx: Duplex scan
Treatment= support stockings, Ace bandages, Unna boot.
Surgery =vein stripping, grafting of the ulcer, endovascular ablation with laser or radiofrequency
Ulcer looks dirty, with a pale base devoid of granulation tissue. work up?
Doppler studies looking for a pressure gradient –>CT angio, MRI angio or arteriograms –> surgical
revascularization or angioplasty and stents.
Ogilvie syndrome
very common “paralytic ileus of the colon.” in elderly. after immobilization
large abdominal distention (tense non tender)
x-rays show massively dilated colon.
After fluid/ electrolyte correction, mechanical obstruction must be ruled out
RX IV neostigmine to restore colonic motility/ long rectal tube
Ogilvie syndrome
RX IV neostigmine to restore colonic motility/ long rectal tube
very common “paralytic ileus of the colon.” in elderly. after immobilization (massive dilated colon)
produce loss of upper gaze and the physical finding known as “sunset eyes”
Tumors of the pineal gland
Brain tumors in children are most commonly in the _____
posterior fossa.
cerebellar symptoms (stumbling around, truncal ataxia)
children often assume the knee-chest position to relieve their headache
Brain abscess rx
Actual resection is required.
_________ on xray highly suggests traumatic ruptured aorta
widened mediastinum
rx: endovascular repair
interval appendectomy
used when there is an abscess
abx and ct guided drainage
appendectomy after several weeks
best imaging for pelvic stuff
US
Best imaging for abdominal stuff
CT
gold standard imaging for PE
pulmonary angiography
is a trauma patient with a high INR at risk of dvt?
YES! high INR for them is not protective. They need LMWH within 36 hours of injury
Can you start empiric blood thinner if you think someone has a PE?
Yes
you do not have to wait for the test (if the patient is low risk for complications)
When would you never use heparin
if someone has ever had HIT
Stage 4 cancer means?
there are mets
Stage 3 cancer means?
there are lymph nodes involved
What chemo is used in colon cancer
FOLFOX
5-FU
leucovorin
oxaliplatin
If you find a polyp in colonoscopy, what is colonoscopy follow up
repeat in 3 years
if negative then, every 5 years
Rectal cancer needs _____ to reduce recurrence?
neo-adjuvant chemo
