Ongiong Flashcards
Chylous ascites
accumulation of lipid-rich lymph in the peritoneal cavity due to disruption of the lymphatic system secondary to traumatic injury or obstruction
In adults, chylous ascites is associated most frequently with malignant conditions, particularly lymphomas
Sever nosebleed not controlled by anterior packing is probably what artery
sphenopalatine artery
situated in the posterior region of the nasal cavity, and is involved in most severe epistaxis episodes
VIPomas
Pancreatic endocrine tumors
MEN1
non-α, non-β islet cell pancreatic tumor that secretes VIP.
Watery Diarrhea, Hypokalemia, and Achlorhydria (WDHA
syndrome).
Charcot foot
condition causing weakening of the bones in the foot that can occur in people who have significant neuropathy
bones are weakened enough to fracture, and with continued walking, the foot eventually changes shape.
joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.
squamous cell lung carcinoma and calcium
Parathyroid hormone-related protein secreted by cancer cells–> ↑ Ca
Fever on POD #1-
– Most common cause, low fever (<101) and non
productive cough?
Atalectasis
CXR- see bilateral lower lobe fluffy infiltrates
Rx: Mobilization and incentive spirometry.
Fever on POD #1- very ill appearing with high fever
Nec Fasc- In subQ along Scarpa’s fascia.
Bugs: GABHS or clostridium perfringens
IV PCN, Go to OR and debride skin until it bleeds
Fever on POD #1 High fever (>104!!) muscle rigidity.
Malignant Hyperthermia
Ryanodine receptor gene defect
Rx: Dantrolene Na (blocks RYR and ↓ calcium)
Fever on POD #3-5-
– Fever, productive cough, diaphoresis
Pneumonia acutemed.co.uk
Check sputum sample for culture, cover w/ moxi
etc to cover strep pneumo in the mean time.
Fever on POD #3-5- – Fever, dysuria, frequency, urgency, particularly in a
patient w/ a foley.
UTI
UA (nitritie and LE) and culture.
Change foley and treat w/ wide-spec abx until
culture returns.
Fever > POD 7- Pain w/ salmon colored fluid from incision.
Dehiscence
Surgical emergency! Go to OR, IV abx, primary closure of fascia
Unexplained Fever > POD 7-
Abdominal Abscess
CT w/ oral, IV and rectal contrast to find it.
Diagnostic lap.
Drain it! Percutaneously, IR-guided, or surgically.
Fever > POD 7 – Pain at incision site, induration WITH drainage
Simple Wound Infection
Open wound and repack.
No abx necessary
stages of pressure ulcer
Stage 1 = skin intact but red. Blanches w/ pressure
– Stage 2 = blister or break in the dermis
– Stage 3 = SubQ destruction into the muscle
– Stage 4 = involvement of joint or bone.
3/4- Needs OR
Pleural Effusions –> see fluid _____ –> thoracentesis!
fluid >1cm needs thorocentesis
Light’s Criteria
Determines transudative if:
LDH < 200
LDH eff/serum < 0.6
Protein eff/serum < 0.5
Abscess you do not drain
Lung Abscess
air fluid level
Rx: Abx
Characteristics of benign lung nodules:
– Popcorn calcification = hamartoma (most common)
– Concentric calcification = old granuloma
– Pt < 40, <3cm, well circumscribed
rx: close follow up
Most common lung Ca in non-smoker
adenocarcinoma
perfieral Ca
Mets to adrenals
Patient with kidney stones,
constipation and malaise low PTH +, central lung mass?
Squamous cell lung cancer
Patient with lung cancer, shoulder pain, ptosis, constricted pupil, and facial edema?
Superior Sulcus Syndrome from Small cell carcinoma. Also a central cancer
Lambert Eaton Syndrome and lung cancer
from small cell carcinoma.
ARDS causes
Sepsis, gastric aspiration, trauma, low perfusion,
pancreatitis.
ARDS Diagnosis:
- ) PaO2/FiO2 < 200 (<300 means acute lung injury)
- ) Bilateral alveolar infiltrates on CXR
- ) PC wedge pressure is <18 means pulmonary edema is non-cardiac
ARDS rx
Mechanical ventilation w/ PEEP
HOCM murmur
SEM louder w/ valsalva, softer w/ squatting or handgrip.
Continuous machine like
murmur
PDA
Wide fixed and split S2 murmur
ASD
Zenker’s diverticulum true or false
False. Only contains mucosa
Dysphagia worse w/ hot &
cold liquids + chest pain that feels like MI w/ NO regurg
Diffuse esphogeal spasm.
Tx w/ CCB or nitrates
Achalasia Rx
w/ CCB, nitrates, botox, or heller myotomy
If hematemesis (blood occurs after vomiting, w/ subQ emphysema). Can see pleural effusion w/ ↑amylase
Boerhaave’s
Esophageal Rupture
rx: repair
