Other Flashcards
What statistical measurement is affected by prevalence?
Positive predictive value. All others are independant of prevelance!
AJCC Melanoma Staging
Tumor thickness and ulceration are determinants
Tis - Melanoma in situ
T1a - <0.8 mm without ulceration
T1b - >0.8 mm and < 1 mm w/orw/o ulceration OR <0.8 mm WITH ulceration
T2 - 1-2 mm thickness
T3 - 2-4 mm thickness
T4 - > 4 mm thickness
*T2-T4 are stratified as a or b for with or without ulceration.
What type of flap is the paramedian forehead flap?
Interpolated (mesolabial is also an example of this). Pedicle has to be divided in a second stage procedure.
Artey = supratrochlear
What type of flap is a rhomboid flap?
Transposition flap (elevated and pivoted toward defect).
Example of advancement flap
Unipedicle, bipedicle and V-Y flaps
Cogan’s syndrome features and TX
Autoimmune disease with episodic vertigo, interstitial keratitis, bilateral fluctuating SNHL. Presents in 20s/30s.
TX - steroids +/- immunosuppresants (azathioprine, cyclophosphamide)
ENT features that downs syndrome patients are at risk for?
OSA, CHL (OME), subglottic stenosis, atlantio-axial instability
Effective methods for keloid and hypertrophic scars
Silicone sheeting, steroid injections, low dose radiation
Contents of the infratemporal fossa?
Lateral and medial pterygoids, V3, chorda tympani, otic ganglion, IMAX and branches, pterygoid venous plexus.
Mechanism of epinephrine?
Acts on alpha and beta adrenoreceptors, alpha - vasoconstriction, beta - vasodilation
Mechanism of phenylephrine?
Alpha AGONIST –> vasoconstriction (same as oxymetazoline aka AFRIN)!
Mechanism of ephedrine?
Indirectly causes vasoconstriction by releasing stored catecholamines
Dedo classification
6 classes.
1 - Good cervical mental angle, minimal deformity, no accumulation of fat (younger patient) –> 6 - Low hyoid (poor candidate for face lift). Low and anterior hyoid is unfavorable.
What bug do you prophylactically treat for with leeches? What are two contraindications for leech therapy?
Aeromonas hydrophila
Immunosuppression, arterial insufficiency
Nasal tip support components (major)
Lower lat cartilages, lower lat cartilage attachement to septum, upper lat cartilage attachement to lower lat (scroll area)
Kartageners Syndrome
AR
Dyenin arm issue –> abnormal ciliary motion
-Rhinosinusitus, bronchiactesis, otitis media, male infertility, situs inversus.
Ameloblastoma Features
- Most common odontogenic tumor, benign
- Slow growing, usually in 3rd-5th decades of life
- Painless, near angle of mandible usually
- Soap bubble on imaging (cystic and solid)
- Surgical excision
What is Bezold’s abscess?
A bezold abscess occurs when purulence breaks through the mastoid tip into the region of the SCM. Management includes parenteral antibiotics, incision and drainage of abscess, cortical mastoidectomy, and myringotomy +/- ear tube placement.
What is Horner’s syndrome?
Ipsilateral miosis (pupillary constriction), ptosis and anhydrosis
Describe a case-control study vs cohort study vs cross-sectional study?
The “case” represents the presence of the disease or condition, which is the basis for identification of research subjects.
A Cohort study essentially does the reverse - it takes a population with a certain exposure and tracks which individuals eventually develop the disease/condition to evaluate incidence.
A cross-sectional study assesses a group of subjects at a single time point to evaluate prevalence of disease.
Mechanism of:
- Fluoroquinolone
- Cephalosporine
- Macrolide
- TMP-SMX (Sulfonamide)
- Glycopeptides (Vancomycin)
- Tetracycline (includes doxycycline)
- Penicillin
- Aminoglycoside
- Clindamycin
- Interferes with DNA replication by Inhibiting DNA gyrase and topoisomerase II. → Fluoroquinolone
- Disrupts a specific step in bacterial cell wall synthesis → Cephalosporin
- Inhibits protein synthesis by binding to the 50S subunit of the bacterial ribosome. → Macrolide
- Inhibits DNA synthesis by disrupting the folic acid synthesis pathway. → TMP SMX
*Vanco: Inhibits cell wall synthesis
*Tetracycline: Inhibits 30s subunit protein synthesis
*Penicillin: Inhibit cell wall synthesis
*Aminoglycoside: Inhibits 30s subunit protein synthesis
*Clindamycin: Inhibits 50s protein synthesis
Zargar Classification for Esophageal Injury
0 = normal
1 = Edema and erythema
2a = Hemorrhage, erosions, superficial ulcerations
2b = Circumferential lesions
3a = Deep gray or brown/black ulcers
3b = Extensive deep gray or brown/black ulcers
4 = Perforation
Relative Risk Formula
[Incidence of a disease in people exposed to a particular risk]/[Incidence of a disease in people not exposed to a particular risk]
Can only be calculated from prospective data!
What are the amide type anesthetics?
What are the ester type anesthetics?
Amide (2 “i’s” in the name): Lidocaine, bupivicaine (cardiotoxic), ropivicaine –> metabolized by LIVER, less likely to have allergic reaction
Ester (one “i’ in the name): Procaine, tetracaine, benzocaine –> deritives of PABA, MORE likely to have allergic reaction
What is the maximum dose of lidocaine with and without epinephrine?
WITH epi: 7 mg/kg
WITHOUT epi: 4 mg/kg
Calculation: maximum allowable dose (mg/kg) x (weight in kg/10) x (1/concentration of local anesthetic) = mL lidocaine
Where is histoplasmosis found, SX and microbio findings?
Ohio, Mississipi river valleys
Usualy pulmonary SX, Mucosal involvement is common and can resemble lesions of SCC or TB.
Biopsies can show the presence of poorly defined granulomas with macrophages and multinucleated giant cells.
Malignant Hyperthermia Findings and TX?
-Can be triggered by volatile agents such as succinylcholine
-Increased end-tidal CO2.
-hyperkalemia
-Other accompanying symptoms include hyperthermia, masseter spasm and generalized muscle rigidity, tachycardia, cardiac arrhythmias, sweating, and hypoxia.
-TX: Dantrolene (ca channel blocker)
Mechanism of TXA?
Reversibly binding to plasminogen and non-competitively inhibiting plasmin –> stabilizes fibrin clot.
Common uses for: CO2, KTP, Nd:Yag and argon lasers?
CO2: Respiratory papillomatosis
KTP: Stapes, tracheal surgery
Nd:Yag: Tracheal/bronchial lesions, esophagus, vascular lesions
Argon: Stapes, cutaneous lesions
Duration of local anesthetics (shortest to longest)?
Shortest: Plain lido (30-60 min) –> Lido with epi, Mepivicaine, Prilocaine –> Bupivicaine (up to 420 minutes)
Mnemonic for hyperintense T1 lesions?
3 F’s and 4 M’s:
Slow flow, fat, protein material, methemoglobin (in subacute hemorrhage), melanin, minerelization, magnevist (gadolinium).
Also FATT1E: T1 enhances Fat
H2O: T2 enhances water
What passes through the orbital apex tendinous ring (annulus of zinn)?
CN II, III, CN VI, nasociliary nerve, opthalmic artery
How does CT, MRI and PET work?
CT: Detection of mutiple Xrays around the body
MRI: Alignment of water molecules exposed to magnet
PET: Detection of photons emitted from a radionuclide absorbed into metabolically active tissue.
What anesthetic is most likely to induce methymoglobinemia?
Benzoicaine, Prilocaine
What anesthetic is most likely to cause cardiotoxicity?
Bupivicaine (longest acting, most cardiotoxic)
One main side effect of Ketamine?
Hypersalivation
Behcet Disease features?
Uveitis, oral apthous ulcers, genital ulcers
Sequence of local anesthetic effects?
Pain, temp, touch, motor function. Bupivacaine = best sensory blockade.
Bacteriocidal Abx (Kill directly): Penicillin’s and Cephalosporins Are Very Cidal For Real Microbes
Penicillin, cephalosporin, aminoglycosides, vancomycin, rifampin, fluoroquinolones, metronidazole
Bacteriostatic
Clindamycin, Bactrim (TMP-SMX), Azithro, Tetracycline
Good for immunocompetent patients
Stop bacterial growth
Common Side Effects of Tetracycline, Aminoglycosides, Vancomycin, Fluoroquinolones
Tetracycline: Teeth + T bone stains
Aminoglycosides: Outer hair cell damage/HL (starting with high frequency)
Vancomycin: Red man syndrome
Fluoroquinolones: Tendon rupture
