Hippo Exam questions missed Flashcards
What is pseudohyperkalemia
Pseudohyperkalemia is most often caused by hemolysis of red blood cells in a blood sample specimen. This can occur from prolonged application of a tourniquet, excessive fist clenching when drawing venous blood, or from use of a very small gauge needle or excessive aspiration force used during withdrawal of blood.
What cardiac monitor to use when pt is not experiencing heart palpitations daily?
Cardiac event monitor
Event monitors do not continously record the electrical activities of the heart, but only do so when symptoms are present. Some monitors record automatically when abnormal rhythms are detected, while other monitors require the patient to activate the device when symptoms begin. Because these monitors can be worn for longer periods of time and are only activated when the patient feels symptoms, this type of monitor is more appropriate for this patient.
most common cause of pulseless electrical activity?
Pulseless electrical activity (PEA) is the presence of organized electrical activity without sufficient mechanical contraction of the heart needed to produce a pulse. Severe hypovolemia is the most common cause of PEA. Hypovolemia results in reduced preload, which prevents the lengthening of cardiac sarcomeres that is needed to produce meaningful contractions.
should be avoided in patients experiencing hyperparathyroidism?
Certain diuretics may cause an increase in serum calcium due to decreased renal excretion, thus worsening symptoms in hyperparathyroidism. Lithium has also been implicated in increasing serum calcium levels, and causing hyperparathyroidism in patients treated chronically (> 10-15 years).
imaging modality of choice in suspected nephrolithiasis?
A non-contrast CT scan is extremely sensitive and specific for detecting all types of calculi in all locations as well as ruling out nephrolithiasis in a patient with abdominal pain. This test also allows better visualization for other causes of abdominal pain if not renal colic. Allows for quick diagnosis and treatment.
Carcinoid tumors
of the lung are rare neuroendocrine tumors. These occur sporadically, and studies have not delineated any definitive risk factors. They occur more commonly in the proximal airway, and patients present with cough, chest pain, and hemoptysis. Patients may also exhibit carcinoid syndrome, with flushing and diarrhea. On bronchoscopy, a carcinoid tumor typically appears as a pink or purple vascularized mass. Typical carcinoid tumors of the lungs rarely metastasize. Surgical resection is the first line treatment.
Hirschsprung disease
s caused by the absence of ganglion cells in a segment of the intestinal tract as a result of dysfunctional migration of neural crest cells during embryonic development. As a result, the colonic muscles fail to relax. In the majority of patients, aganglionosis is restricted to the rectosigmoid colon. The incidence is approximately 1/5000, and is four times more common in males than females. It almost always presents in newborns, and is characterized by failure to pass meconium, development of constipation and megacolon. A chromosomal abnormality is present in approximately 12% of individuals with Hirschsprung disease, with the most common one being, Down syndrome. Two to ten percent of individuals with Down syndrome having Hirschsprung disease.
Intussusception
ussusception is the most common cause of intestinal obstruction in children under 2 years of age, but rarely occurs in infants less than two months. Intussusception occurs when one segment of the intestine telescopes into another more distal segment. Males are twice as likely as females to get this condition. The primary manifestation is colicky abdominal pain followed by the onset of vomiting. The “classic” triad of colicky abdominal pain, vomiting, and bloody stools (sometimes described as “currant jelly”) is present in only 20% of cases. A sausage-shaped mass can sometimes be palpated in the abdomen. The classic ultrasound findings is the “target sign” which represents bowel-within-bowel.
What is the most worrisome complication associated with hip dislocation
Hip dislocation, often caused by ‘dashboard injury’ or posterior directed force causing posterior dislocation, may result in injury to the acetabular artery which may lead to avascular necrosis and femoral head collapse.
ulcerative colitis.
UC is an inflammatory bowel disease affecting the mucosal surface of the colon and typically begins distally. Bloody diarrhea is a hallmark of this disease, and radiographs show colonic dilation (’loss of haustral markings’) as an additional clue. Exacerbations can present similarly to other forms of colitis, and therefore the negative laboratory values help you narrow it down to UC. Maintenance of fluids and corticosteroids are the mainstay of treatment during acute exacerbations. Hemoglobin should also be monitored if there is significant blood loss.
What degree of rotational deformity is acceptable (and therefore does not require surgical correction) in a fracture of the fifth metacarpal?
E. No degree of rotational deformity is acceptable
No degree of rotational deformity is acceptable in a fracture of the fifth metacarpal (also known as a Boxer’s fracture). If any rotational deformity is present, the patient must be referred to a hand surgeon. Angulation may be acceptable however. Up to 40 of angulation in the fifth metacarpal and 30 in the fourth metacarpal.
What is the most worrisome complication associated with hip dislocation
Hip dislocation, often caused by ‘dashboard injury’ or posterior directed force causing posterior dislocation, may result in injury to the acetabular artery which may lead to avascular necrosis and femoral head collapse.
ulcerative colitis.
UC is an inflammatory bowel disease affecting the mucosal surface of the colon and typically begins distally. Bloody diarrhea is a hallmark of this disease, and radiographs show colonic dilation (’loss of haustral markings’) as an additional clue. Exacerbations can present similarly to other forms of colitis, and therefore the negative laboratory values help you narrow it down to UC. Maintenance of fluids and corticosteroids are the mainstay of treatment during acute exacerbations. Hemoglobin should also be monitored if there is significant blood loss.
What degree of rotational deformity is acceptable (and therefore does not require surgical correction) in a fracture of the fifth metacarpal?
E. No degree of rotational deformity is acceptable
No degree of rotational deformity is acceptable in a fracture of the fifth metacarpal (also known as a Boxer’s fracture). If any rotational deformity is present, the patient must be referred to a hand surgeon. Angulation may be acceptable however. Up to 40 of angulation in the fifth metacarpal and 30 in the fourth metacarpal.
. Pheochromocytoma
The classic pheochromocytoma is a neuroendocrine tumor of the adrenal medulla (originating in the chromaffin cells) that secretes high amounts of catecholamines, mostly norepinephrine, and to a lesser extent, epinephrine. The diagnosis can be established by measuring catecholamines, and metanephrines in plasma or in a 24-hour urine collection. Although urine testing is slightly less effective than plasma testing, it is still considered highly effective. A 24-hour urine collection specimen should be tested for creatinine, total catecholamines, vanillylmandelic acid, and metanephrine
