Odds and Ends Flashcards
How much of the body weight is composed of intravascular fluid?
2/3 of body weight is TBW
1/3 of TBW is extracellular; 2/3 intracellular
of extracellular TBW, 1/3 is intravascular, 2/3 are interstitial
2/3 x 1/3 x 1/3 = 2/27
Each 10mL of infused potassium is thought to increase the serum K by how much?
0.1
Delayed fever following a transfusion (by about 1 week) is likely due to
minor antigen incompatibility (like Rh factor)
Adequate protein intake is ____g/kg/d, but this can increase to ___ g/kg/d in times of stress.
0.8; 2
Unlike pilonidal abscesses, these abscesses are much closer to the anus and are very painful on rectal examination.
perianal and perirectal
How is cecal volvulus diagnosed?
barium enema
What is Caroli disease?
Intrahepatic cystic dilation cooccurring with choledochal cysts (congenital cystic dilatiosn of the extrahepatic biliary ducts)
When is LAR used and when is APR used in colorectal cancer?
LAR: proximal and midrectal cancers
APR: distal rectal cancers/SCC of the anus that has failed the Nigro protocol
lower rectum (0–5 cm), middle rectum (6–10 cm), and upper rectum (11–15 cm from the anal verge).
Characteristics of patients that indicate that an invasive procedure will be necessary for its resolution include the following:
1) An effusion occupying more than 50% of the hemithorax or one that is loculated;
2) A positive Gram stain or culture of the pleural fluid;
3) A purulent pleural fluid that has a pH below 7.20 or a glucose below 60,
4) A lactic acid dehydrogenase level of more than three times the upper normal limit for serum.
Out of the benign lung tumors, _______ are found on the periphery of lungs, asymptomatic. ________ are found centrally in major bronchi (where they may cause obstruction) and _________ are found in the lung parenchyma or in the tracheobronchial tree.
1) hamartoma (epithelium AND mesoderm)
2) chondroma (mesoderm only)
3) fibroma (mesoderm only)
What is Reiter syndrome and what are the assoc. cardiac defects?
urethritis, conjunctivitis, arthralgia
pericarditis, AR
Criteria for ventilatory support:
1) apnea,
2) respiratory rate >30 breaths/min,
3) PaO2 55 mm Hg (except in COPD)
A BUN:Cr ratio of __ rules out high output renal failure
> 20
Which of the following is calculated, and not directly measured? PCWP PA pressure SVR right ventricular diastolic pressure right atrial pressure
SVR
Which coagulation factors are synthesized by the liver?
II, V, VII, IX, X, XI, protein C, S, and antithrombin
If dopamine causes an arrythmia, consider improving perfusion with
phenylephrine
arrythmia might be due to b1 stimulation (so dopamine, amrinone, and epinephrine will also cause it)
Peutz-Jeghers increases the risk of which cancers?
stomach, ovary, breast, cervix, lung
What is the treatment for splenic abscess?
IV abx and splenectomy (or, if “uncomplicated”/singular abscess, then CT drainage and IV abx)
Multiple Myeloma involves an increase in Bence Jones protein on UA, which is a monoclonal (light/heavy) chain protein.
LIGHT
What are the findings of analgesic nephropathy?
sloughing of the renal papillae
(acetaminophen results in oxidative damage via glutathione depletion, while aspirin blocks prostaglandin and thus prevents vasodilation, resulting in ischemia of the papilla)
Rank the following organs in increasing order per the amount of fluid they produce:
pancreas, high acid stomach, colon in the setting of diarrhea, low acid stomach, small intestine
pancreas < stomach (low acid) < small intestine < high acid stomach < colon in the setting of diarrhea
Obstruction rarely occurs in _______(this type) hernia, but strangulation is common.
Richter (involves the antimesenteric wall of the colon)
In the repair of sliding inguinal hernia, which structures can be damaged in male infants? In female infants?
Male infants: bladder
Female: ovary, Fallopian tubes
Though neck imaging is usually adequate to evaluate neck masses, which imaging should be used if there is stridor?
neck CT to evaluate if mass is close to airway
With what margins should SCC be excised?
1cm
How is sinonasal papilloma diagnosed and then treated?
diagnosed with CT; treatment is surgery (NOT radiotherapy which could result in malignant transformation)
For what is infliximab used in Crohn’s patients?
for healing of perirectal fistula (infliximab is antitumor necrosis factor, a monoclonal antibody)
In the recovery of AKI, which electrolyte abnormalities do you have to watch for?
Hypokalemia (possibly hyponatremia and hypochloridia, too). AKI = oliguria, but in final phase can have massive enuresis of urine high in sodium and chloride; tubules cannot concentrate urine as well so risk hypokalemia
What is more important in deciding if aortic valve should be replaced: valve area or gradient across valve?
GRADIENT. Area can depend on body habitus and is not as good of a predictor
What in bile prevents enteric infections?
Secretory IgA
From what is the colonic serosa derived?
peritoneum
What type of sequelae post-transplant is more common in small bowel transplant?
Graft vs. Host Disease (because of the GALT)
What is the treatment of TMJ disorder?
NSAID, muscle relaxant, heat, soft diet. Only surgery if conservative treatment doesn’t work.
Which layer in the colon can you find nerves, vessels, fibrous and elastic tissue, and Meissner’s plexus?
Which plexus has both sympathetic and parasympathetic–meissner’s or auerbachs?
submucosa!
Meissner = just parasympathetic
auerbach (between the two muscle layers, OUTSIDE of the submucosa) has both PNS and SNS
What is the diurnal variation exhibited by plasma cortisol?
high in morning, low in evening
What is the treatment of Bells palsy?
prednisone, acyclovir/valacyclovir (because most causes due to viruses), and topical eye lubricant gel
Migratory thrombophlebitis is a feature of what kind of cancer?
pancreatic
Diabetic nephropathy affects what part of the kidney the most?
glomerulus
What is the Killian triangle?
Formed by teh inferior pharyngeal constrictors superiorly and the cricopharyngeous inferiorly; outpouchings = Zenker’s diverticulum
Combining furosemide and gentamicin is dangerous because it can risk
hearing loss
Which artery supplies the upper outer 1/4 of the breast?
lateral thoracic artery
What are type 1, type 2, and type 3 aortic dissections?
1: proximal and distal
2: proximal
3: distal
If a melanoma is <__cm in diameter, excisional biopsy can be performed.
<1.5 cm
What injury is commonly associated with splenic injury?
left lower rib cage fracture
Which amino acid is mainly used to synthestize serotonin? Which mainly to synthesize dopamine, epinephrine, and norepinephrine?
serotonin: tryptophan
DA, NE, E: tyrosine
Primary small bowel lymphomas usually arise where?
ileum
What are the main modifiable risk factors for otitis media?
2nd hand smoke, use of a pacifier after 11 months, mold/dust exposure
What is the treatment of a duodenal carcinoid tumor?
Whipple procedure
T/F: Hypertrophic scars may undergo spontaneous regression.
True
Ghrelin is produced by ______ glands.
oxyntic
Intrinsic factor is secreted by _______- cells
parietal
What is the triad of HUS?
1) thrombocytopenia, 2) anemia, 3) renal failure
