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shelf surgery > IV > Flashcards

IV Flashcards

1
Q

tamoxifen is used for what breast CA

A

estrogen and P positive

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2
Q

when is trastuzumab used in breast CA

A

when + for Her2neu

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3
Q

risk of combining trastazumab with chemo

A

cardiac toxicity

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4
Q

cervical mucus is produse clear and thin that stretches 6 cm when lifted vertically, what phase?

A

ovulatory

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5
Q

scant opaque thick cervical mucus

A

post and pre ovulatory phases

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6
Q

spinnbarkeit

A

when the cervical mucus stretches vertically

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7
Q

ferning cervical mucus

A

ovulatory phase

pH is 6.5 or greater

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8
Q

after MVA, CXR show alveolar opacities over both lower lobes and hours later complains of CP and SOB

A

pulmonary contusions

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9
Q

signs of fat embolism

A

respiratory distress, mental status changes and petechiae

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10
Q

what leads to hepatic encephalopathy

A

livers inability to convert ammonia to urea

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11
Q

what can precipitate hepatic encephalopathy

A

sedatives, hypovolemia, infection or excessive nitrogen load

patients develop diurnal sleep pattern disturbances (insomnia and hypersomnia)

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12
Q

treatment hepatic encephlopathy

A

nonabsorbable disaccharides like lactulose and lactitol

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13
Q

what is added to lactulose if patient with hepatic encephalopathy does not improve within 48 hours

A

rifaximin

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14
Q

chlordiazepoxide is used to treat what

A

alcohol withdrawal

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15
Q

triad of wernickes

A

altered mental status, ataxia and nystagmus

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16
Q

signs of opioid intoication

A

miosis and decreased respirations

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17
Q

major risk factors for pancreatic cancer

A 
first degree relative with it
hereditary pancreatitis
germline mutations like the BRCAs and peutx jeghers
cigarette smoking
obesity
nonhereditary chronic pancreatitis
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18
Q

where are majority pancreatic CA

A

head of pancreas

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19
Q

patient with epigastric pain, weight loss but no jaundice

imaging?

A

CT with contrast

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20
Q

what test is used for diagnosing chronic pancreatitis

A

secretin test that measure ability of pancreatic ductal cells to produce HCO3

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21
Q

urine crystals that are envelope shaped

A

Ca oxalate

22
Q

what predisposed to Ca oxalate stones

A

small bowel disease, surgical resection or chronic diarrhea

23
Q

when do struvite stones form

A

when urine is alkaline because of infection with urease producing bacteria

24
Q

what are the indications for ECT for depression

A

treatment resistance, psychotic features, emergency conditions like refusal to eat or drink and imminent risk for suicide

25
Q

what are the postoperative measures to decrease risk of pneumonia after surgery

A

incentive spirometry, deep breathing exercises, continuous positive airway pressure, intermittent positive pressure breathing

26
Q

clinical features of aortic regurg

A

diastolic decrescendo murmur, widened pulse pressure, water hammer pulse
heart failure symptoms

27
Q

most common cause of aortic regurg in developed countries

A

aortic root dilation or congenital bicuspid valve

28
Q

corrigan pulse

A

rapid abrupt upstroke followed by rapid collapse of peripheral pulse

29
Q

which patients are at increased risk of molluscum contagioiusm

A

those with cellular immunodeficiency

30
Q

C5-C8 deficiencies predispose to what

A

nisseria infections

31
Q

impairment phagocytosis leads to what diseases

A

chronic granulomatous disease
chediak higashi disease
jobs syndrome
defective leukocyte adhesion proteins

32
Q

hypersensitivity rashes are caused by what

A

circulating Ab type II or III

33
Q

radiolucency like along the costodiaphragmatic curves suggests what

A

free air under diaphragm, ruptured peptic ulcer

34
Q

what type of HS reaction is scabies

A

type IV

35
Q

Tx scabies

A

topical permethrin cream

36
Q

Tx polymyalgia rheumatica

A

glucocorticoids

37
Q

signs polymyalgia rheumatica

A 
age >50
subacute-chronic pain in shoulder an dhip girdles
morning stiffness>1 hour
constitutional symptoms
elevated ESR>40 mm/h
38
Q

polymyalgia rheumatica is associated with what other condition

A

giant cell arteritis

39
Q

signs of giant cell arteritis

A

HA, jaw claudication, vision loss, tenderness over temporal artery

40
Q

fibromylagia

A

young-middle aged women with widespread pain, fatigue, and cognitive/mood distrubances

41
Q

what causes lumbar spinal stenosis

A

enlarging osteophytes at the facet of joints and hypertrophy of ligamentum flavum

42
Q

what occurs with lumbar spinal stenosis

A

back pain that radiates to buttocks and thighs, numbness and paresthesias
worse during walking and lumbar extension

43
Q

how to confirm spinal stenosis

A

MRI

44
Q

signs of ankylosing spondylitis

A

progressive limitation of back motion
most often in young men
back pain and stiffness are typically worse in the morning and improve as the day progresses

45
Q

Hx recent URI followed by cardiac failure suggests what

A

dilated cardiomyopathy secondary to viral myocarditis

46
Q

what virus canc ause myocarditis

A 
Coxsackie B
parvo
HSV6
adeno
entero
47
Q

echo of dilated cardiomyopathy

A

diffuse hypokinesia from low ejection fraction

48
Q

eccentric hypertrophy

A

chronic volume overload seen in valvular regurg

49
Q

risk factors for descending aortic aneurysms

A

atherosclerosis, HTN, hypercholesterolemia and smoking

50
Q

risk factors for ascending aortic aneurysms

A

cystic medial necrosis or CT disorders

shelf surgery (7 decks)

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