june 2 Flashcards
patients with right sided heart failure are ___-dependent
preload
testicular tumours are often first noticed after…
a groin injury or during sexual activity
do spermatoceles transilluminate?
yes - filled with fluid
do varicoceles transilluminate?
no
how does candida appear in culture?
as pseudohyphae with budding yeasts
how can you prevent superinfection of a blistering sunburn?
topical silver sulfadiazine or mupirocin
do you need to give topical treatment to prevent superinfection on a non-blistering sunburn?
no
how do you treat an acute gout episode in a patient on anticoagulants?
colchine (NSAIDs may precipiate bleeding so avoid)
febuxostat MOA
inhibits xanthine oxidase
probenicid MOA
blocks reabsorption of uric acid in the kidneys
where is the most common site of intracranial hemorhage from hypertensive vasculopathy?
basal ganglia
which nerve is compressed in uncal herniation?
CNIII
presentation of uncal herniation?
dilated non-reactive ipsilateral pupil
treatment of severe hypercalcemia?
isotonic saline and calcitonin
symptoms of severe hypercalcemia
weakness, GI distress, neuropsychiatric symptoms
what prosthetic valve most commonly gets prosthetic valve thrombosis?
mitral valve
presentation of prosthetic mitral valve thrombosis?
similar to mitral valve stenosis - dyspnea, etc.
what creatinine level is considered a marker of severe preeclampsia?
> 1.1
when should a patient with severe preeclampsia deliver?
if they are past 34 weeks - IMMEDIATELY
the ‘five whys’ are used in…
root cause analysis
flowcharts are used in which type of analysis?
failure mode and effects analysis
lambert eaton syndrome is associatd with…
small cell lung cancer
having ‘good days and bad days’ is characteristic of which type of dementia?
dementia with lewy bodys
what is the most common dermatologic sign in antiphospholipid syndrome?
livedo reticularis
a calcium-phosphorous product > 55 increases the risk of…
soft tissue calcification
extreme preterm delivery is a risk factor for which peripartum complication?
retained placenta
hordeolum =
bacterial infection of eyelash follicle
hordeolum AKA
stye
chalazion cause
obstruction of meibomian tear gland
onion skinning of bone =
ewing sarcoma
which usually occurs in the metaphysis, ewing sarcoma or osteosarcoma?
osteosarcoma
where does ewing sarcoma usually occur?
long bone diaphysis and pelvic bones
does plasmodium falciprum have a dormant phase?
no
which are is plasmodium falciprum found?
africa
does plasmodium vivax have a dormant phase?
yes
where is plasmodium vivax found?
non-african countries
which drug targets the dormant phase of plasmodium vivax ?
primaquine
chloroquine treats malaria infection in what stage?
erythrocyte stage
Presentation of microscopic colitis?
frequent watery bowel movements, fecal urgency, nightime diarhea WITHOUT systemic symptoms (fever, weihgt loss)
does microscopic colitis present with systemic symptoms (weight loss, fever)?
NOO
biopsy findings of microscopic colitis?
mononuclear infiltrate
patients with microscopic colitis should avoid…
NSAIDS and smoking
what is the best way to prevent HSV transmission to a sexual partner?
consistent condom use
can HSV spread when there is no outbreak?
yes - asymptomatic viral shedding causes infection of partner as well
rifaximin MOA
antibiotic that reduces ammonia production by colonic bacteria
carbamazepine is associated with which renal complication?
SIADH
is the urinary Na concentration high or low in SIADH?
high
sonohysterography =
saline infusion ultrasonography
what test is best to diagnose uterine fibroids?
sonohysterography
chronic bicarb loss from diarrhea is a risk factor for which type of kidney stone?
uric acid kidney stones (bicarb loss acidifies urine)
which patients receive ultrafiltration?
those with massive volume overload that dont respond to diuretics
t wave inversion in leads v1-v3 indicates
right ventricular heart strain
which type of lung cancer most commonly causes large cavitary lesions?
squamous cell lung cancer
acute cerebellar ataxia may occur after…..
a viral illness
prognosis of acute cerebellar ataxia (acute postinfectious cerebellar ataxia)?
resolves in 1-3 weeks
acute cerebellar ataxia (acute postinfectious cerebellar ataxia) most commonly follows which infections?
coxsackie, herpesvirus
delerium accelerates the process of…
dementia
delerium increases the risk of…
cognitive decline
which type of aortic dissection requires emergent surgical intervention?
TYPE A (those involving the ascending aorta)
TYPE B aortic dissections require emergent surgical intervention if…
they are decreasing organ perfusion
are IV antibiotics used as infection prophylaxis in burn patients?
no. -topical are used
why does early removal of eschar through excision and grafting help decrease bacteiral infections?
eschar is an avascular protein rich substrate for bacterial and fungal proliferation
XRAY findings of inhaled foreign body?
hyperinflated lung on effected side and mediastinal shift towards unaffacted side
why may hypotension in acute adrenal insuffiency not improve with epinephrine?
cortisol is needed as well to potentiate the effects
which nerves are spared in anterior spinal cord syndrome?
the dorsal columns
syringomeliia is associated with…
chiari I malformation
pathophys of a post-amputation neuroma?
local inflammatory reaction where nerves were cut leads to tangle of unmyelinated fibers
no left foot movement upon sqeeuzing the gastrocnemius indicates…
achilles tendon rupture
can active plantar flexion stilll be present in someone with an achilles tendon rupture?
yes - because of accessory muscles
chest wall clicking or instability is a symptom of.?
sternal dehiscence
can sternal dehiscence be managed conservatively?
NO ITS A SURGICAL EMERGENCY
why is sternal dehiscence a sugrical emergency?
the sternum requires fixation to prevent cardiac damage from loose wires or bone fragments
which two pathogens commonly cause deep infection following puncture wounds?
staph aureus and pseudomonas aeruginosa
chronic alveolar airway destruction in COPD leads to formation of…
large alveolar blebs
complication of alveolar blebs in COPD?
rupture -> air leak -> pneumothorax
what are the risk factors for upper extremity deep vein thrombosis
- central venous catheters
- repetitive arm motions
- weight lifting
what type of nutriotional support should burn patients receive?
high calorie enteral nutrition
severe complication of succinocholine?
life threatening cardiac arythmia due to hyperkalemia
which anesthetic can lead to adrenal insufficiency?
etomidate
neurotoxicity due to B12 inactivation is an adverse effect of which anesthetic?
nitrous oxide
treatment of IBD induced toxic megacolon?
IV corticosteroids (methylprednisosone)
what is the most common cause of death from infective endocarditis?
acute heart failure
surgical indications in infectious endocarditis?
- acute heart failure
- persistent bacteriema/abscess/fistula
- heart block
- large vegetation
how do the kidneys compensate in response to acidosis?
- increases bicarb reabsoprtion (meaning more Cl extretion)
- increase NH4 excretion (which removes H)
which testicular neoplasm produces excessive testosterone or estrogen?
Leydig cell tumour
lung nodules < ___ are unlikely to be malignant
0.8 cm
treatment of symptomatic meningioma?
surgical resection
which heart murmur is associated with ankylosiing sponylitis?
aortic regurgitation
breathing effects of ankylosing spondylitis?
decreased chest wall expansion
tendon related complication of ankylosing spondylitis?
enthesitis (tenderness at joint insertion sites)
which receptors may be activated during CO2 insufflation during laparoscopy?
peritoneal stretch receptors
effects of peritoneal stretch receptors?
increase vagal tone -> bradycardia
how do you treat an air embolus?
put patient in left lateral position and give high flow oxygen
why is the left lateral position important in a patient with suspected air embolus?
traps embolus at lateral part of right ventricle (instead of the outflow tract or going into the pulmonary arteries)
why is high flox oxygen used to treat air embolus?
promotes reabsorption of nitrogen (major component of air embolus)
why are veins susceptible to air emboli?
relatively low hydrostatic pressure
