Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GYO Boards > Misc > Flashcards

Misc Flashcards

1
Q

Antibiotics to treat low-risk neutropenic fever…

A

Augmentin/Cipro

If PCN allergy, use clinda/cipro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How do we define neutropenic fever?

A

Temp > 38.0 for > 1 hour or isolated temp > 38.3 WITH ANC <=500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do we treat high-risk neutropenic fever?

A

Zosyn or cefepime
If concern for line infection, add vanco
If concern for PNA, add gent or pulmonary fluroquinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

BUN: Cr in pre-renal vs ATN

A

20:1 vs <20:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Urine Osm in pre-renal vs ATN

A

> 500 vs <450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Urine specific gravity pre-renal vs ATN

A

> 1.020 vs <1.010

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Urine sodium pre-renal vs ATN

A

<20 vs >40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

FeNA in pre-renal vs ATN

A

<1% vs >2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Casts seen in prerenal vs ATN

A

Hyaline vs muddy brown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Calculate energy expenditure

A

Harris-Benedict equation:
energy need = 655 + 9.6(wgt in kg) + 1.7(hgt in cm) + 4.7(age in yrs)

For normal person, multiple by 1.3 to get energy needs for TPN

Carbs = 50-60%
Protein = 10-20%
Lipids = 20-30%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to calculate FeNa

A

(Serum Cr * urine Na)/(urine Cr * serum Na)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Causes of non-anion gap metabolic acidosis

A

RTA
Intestinal loss of bicarbonate (diarrhea/fistula)
Dilutional acidosis (rapid infusion of bicarbonate-free isotonic saline)
Ileostomy
Ureterosigmoidostomy
Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of malignant hyperthermia

A

Dantrolene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bladder innervation

A

Superior hypogastric plexus located over the sacral promontory
Hypogastric nerves contain sympathetic fibers and run below the ureter and lateral to the uterosacral - responsible for bladder compliance, urinary continence
Parasympathetic nerves come from pelvic splanchnic nerves and form the inferior hypogastric plexus which run along the parametria - responsible for detrusor contractability and rectal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Type II vs type III radical hysterectomy

A

Type II is nerve sparing thus decreasing urology morbidity —> no difference in survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What to do for ureteral injury

A

Above the pelvic brim: ureteroureterostomy or tranureteroureterostomy
Near bladder: Reimplantation
If much of pelvic ureter is removed, can perform a psoas hitch
If bladder is scarred preventing mobilization, a boari flap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Structures passing through the fossa ovalis

A

Fossa ovalis - opening in the fascia (covered by the cribiform)
Great saphenous vein, superficial epigastric artery, superficial external pudendal artery, femoral branch of the genitofemoral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most common fistula after radical hysterectomy; how do we diagnose and manage?

A

Ureterovaginal - 2-3%; present with watery vaginal discharge within 14 days of surgery

Diagnose with CT urogram or give pyridium and tampon test; Treat with stent or PCN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What bacteria cause vaginal cuff cellulitis? How do you treat it?

A

Polymicrobial - trx empirically with broad-spectrum penicillin with b-lactamase inhibitor (augmentin) or later-generation cephalosporin

Can also use flagyl and fluoroquinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the size threshold for draining an infection hematoma/abscess?

A

5 cm - can treat with gent/clinda or zosyn or cipro/flagyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the bugs that cause hospital acquired PNA? What do you treat with?

A

HAP is no longer an entity defined by the ID society - but bugs are H influenza, Strep and Staph; less commonly E. coli, Enterobacter, Klebsiella, Proteus and Serratia

Treat with augment, levaquin, second or third generation cephalosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are most common causes of community acquired PNA? How do you treat?

A

Strep pneumo, Klebsiellsa

Treat with respiratory quinolone or augmentin PLUS macrolide or doxy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How should we treat aspiration PNA?

A

Zosyn OR clinda + gent or cipro OR extended-spectrum cephalosporin + flagyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which type of hysterectomy has the highest risk of GU injury?

A

Laparoscopic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What to do with a ureteral crush injury…

A

Mild/minor - stent

Major/severe - resection of the injured portion with reanastomosis

26
Q

Initial management of an anastomotic bowel leak…

A

Antibiotics and percutaneous drainage

27
Q

What is blind loop syndrome?

A

Bacterial overgrowth in the small bowel —> chronic diarrhea and B12 deficiency

28
Q

What increases risk for LE lymphedema following hysterectomy for uterine cancer?

A

Obesity, removal of more nodes, extent of surgery, post-operative infection, radiation therapy, postoperative DVT

29
Q

Most common complication of a radical hysterectomy?

A

Bladder atony and urinary retention

30
Q

How can we prevent wound infections in vulvar surgery?

A

Spare saphenous vein, optimize glucose control and use appropriate abx; we can also perform sentinel LN biopsy

31
Q

What is incidence of lymphedema after inguinal LND? Risk factors?

A 
Incidence = 14-48%
RFs = obesity, # of nodes removes, extent of surgery, postoperative infection, RT to groin, postoperative DVT
32
Q

Intrinsic vs extrinsic apoptosis pathway

A 
Intrinsic = Mitochondrial mediated (get cytosolic cytochrome c —> activated by DNA damage, ER stress, oncogene activation; caspase 9 + cytochrome c = APAF1
Extrinsic = Death receptor mediated (TRAIL, TNFR); cascade 8
33
Q

What is apoptosis?

A

Programmed cell death

34
Q

What cascade is common executioner between intrinsic and extrinsic?

A

Caspase 3

35
Q

Characteristics of apoptotic cells under microscope?

A

Chromatin condensation, nuclear fragmentation, membrane blabbing and cell shrinkage, formation of apoptotic bodies

36
Q

What are gamma rays?

A

Emitted from unstable atomic nuclei during decay of radioactive material; used in brachytherapy

37
Q

What are electrons used for and why?

A

Superficial lymph nodes or skin lesions —> deposit most of energy at or near the surface

38
Q

Alpha particles

A

Positively charged emitted particles

39
Q

Depth of 60Cobalt gamma rays? What is half life of cobalt?

A

1 cm (1.2 MeV); half life is 5 years

40
Q

Tumor marker for breast cancer…

A

Ca 15-3

41
Q

Germ Cell Tumor Markers

A 
Dysgerminoma = LDH +/- bHCG
Endodermal sinus = AFP
Immature teratoma = +/- AFP
Choriocarcinoma = bHCG
Mixed germ cell = +/- AFP and bHCG
Embryonal = bHCG +/- AFP
Polyembryoma = bHCG +/- AFP
42
Q

What does thumbprinting on an abdominal X-ray mean?

A

Sign of colonic inflammation - C diff, UC, ischemia colitis

43
Q

In what germ cell tumor do we see multinucleated giant cells?

A

dysgerminoma (make bHCG)

44
Q

What are Sedlis’ criteria?

A 
High-intermediate risk factors for cervical cancer
Treat with RT if...
-deep stromal invasion (outer 1/3)
-LVSI
-tumor > 4cm
45
Q

What tumor do you NOT want to radiate?

A

Verrucous carcinoma - can become more aggressive with RT

46
Q

How to distinguish an endometrial stromal nodule from low-grade ESS

A

Tumor circumscription - LGESS shows irregular nodular growth pattern and worm-like plugs that fill and distend myometrial veins; with ESN there is no vascular invasion and a non-infiltrative border

47
Q

Translocations associated with endometrial stromal sarcomas

A 
LGESS = JAZF1/SUZ12 (t(7; 17)(p15;q21) 
HGESS = YWHAE/FAN22
48
Q

Hemostatic agents

A

Fibrillation
Tisseal (can use in a patient with a defective clotting system ie DIC)
Floseal/Surgiflo
Gelfoam

49
Q

How does hyperglycemia impair healing/increase infections?

A

Increased glucose levels impair phagocyte function and chemotaxis of granulocytes; also impairs fibroblast function

50
Q

At what chronic steroid dose do we need to be concerned about adrenal insufficiency?

A

20 mg of prednisone daily for > 5 days

51
Q

Definition of SIRS/sepsis

A

SIRS = two of more of the following in a setting of inflammation: temp > 38 or < 36, pulse > 90, RR > 20 or PaCO2 < 32, WBC > 12K or < 4K or > 10% band forms

Sepsis = SIRS due to known infection
Severe sepsis = sepsis with evidence of organ dysfxn, hypotension or hypoperfusion

52
Q

What is Xgris?

A

Drotrecogen alpha - a recombinant form of human activate protein C which is frequently deficient in sepsis —> was previously used in sepsis but no longer

53
Q

ASA classes

A

I: no chronic medical problems
II: Optimal control of mild chronic disease
III: Severe disease that limits activity without incapacitation
IV: Severe, incapacitating disease with constant threat to life
V: Moribund, death likely within 24 hours with or without surgery

54
Q

MET as measure of functional capacity

A

1 MET = self care, walk around house, walk 1-2 blocks at 2-3mph

4 MET = can climb a flight of stairs, walk up a hill, walk on level ground at 4 mph, run a short distance, move furniture, play golf

10 MET = Strenuous activity, swimming, skiing

55
Q

NY Heart Association Functional Classification of Heart Disease

A

I: Can carry 24 pound object up 8 steps, walk 5 mph, carry 80# object shovel snow
II: Can walk 4 mph, rake or weed garden, have sex, walk up 8 steps
III: Can make bed, push lawn mower, shower, walk 2.5 mph, dress
IV: None of the above

56
Q

Equation for SVR

A

SVR = [(MAP-PAWP)/CO]*80

Normal 700-1600 dynes/sec/cm-5

57
Q

What on PFTs predict high risk surgical candidate?

A

FEV1 < 1L, FEV1/FVC < 75%, MMV < 50%

58
Q

How far prior to surgery should a patient stop smoking to decrease risk?

A

8 weeks

59
Q

How to calculate anion gap?

A

AG = Na - (Cl + HCO3)

Normal = 12 +/- 4

60
Q

How to calculate serum osmolality?

A

Osmolality = 2[Na + K] + urea/2.8 + glucose/18

GYO Boards (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions