Pestana Review notes

Question 1

Tx for increased ICP?

Answer 1

dexamethasone/decadron

Question 2

Workup for acromegaly?

Answer 2

somatomedin C + pituitary MRI

Question 3

tumor markers in testicular CA?

Answer 3

alpha-fetoprotein and beta-hCG

Question 4

hyperacute rejection

Answer 4

within minutes; preformed Abs

Question 5

acute rejection

Answer 5

5 days - 3 mos; s/s organ dysfunction; tx = steroids

Question 6

chronic rejection

Answer 6

years; gradual, insidious loss of function

Question 7

CVP in tamponade or tension pneumo?

Answer 7

high

Question 8

What is the max CVP acceptable?

Answer 8

15mmHg

Question 9

What is the ideal urinary output?

Answer 9

0.5-2mL/kg/hr

Question 10

CVP in vasomotor shock?

Answer 10

low

Question 11

Normal PCO2?

Answer 11

35-45

Question 12

anterior cord syndrome

Answer 12

bilateral loss of motor, pain, and temp sensation

Question 13

central cord syndrome

Answer 13

paralysis + burning pain in upper extremities; normal lower extremities

Question 14

MOA hemisection/Brown-Sequard?

Answer 14

clean-cut (knife) injury

Question 15

ipsi: paralysis and loss of proprioception distal to the injury
contra: loss of pain

Answer 15

hemisection/Brown-Sequard

Question 16

bilateral loss of motor, pain, and temp sensation

Answer 16

anterior cord syndrome

Question 17

paralysis + burning pain in upper extremities; normal lower extremities

Answer 17

central cord syndrome

Question 18

MOA anterior cord syndrome?

Answer 18

burst fracture of vertebral body

Question 19

MOA central cord syndrome?

Answer 19

forced hyperextension of the neck (rear ended)- usu elderly

Question 20

MOA central cord syndrome?

Answer 20

forced hyperextension of the neck (rear ended)- usu elderly

Question 21

plain pneumo percussion findings?

Answer 21

hyperresonant to percussion

Question 22

hemothorax percussion findings?

Answer 22

dull to percussion

Question 23

CXR findings pulm contusion?

Answer 23

white out

Question 24

stab wound first step if stable pt?

Answer 24

digital exploration of wound in ER to check for peritoneal invasion

Question 25

Vaccs needed after splenectomy?

Answer 25

Pneumococcus, HiB, meningococcus (all encapsulated)

Question 26

Initial tx for crush injury?

Answer 26

fluids, osmotic diuretics, alkalinization of urine

Question 27

Rule of 9s Adult

Answer 27

``` 9 head 9 arm 9 arm 18 leg 18 leg 36 trunk ```

Question 28

formula to estimate fluid need adult

Answer 28

kg body weight x % burned x 4 | given in 1st 8 hours

Question 29

What fluid in burn victim?

Answer 29

ringers lactate

Question 30

Rule of 9s infant

Answer 30

``` 18 head 9 arm 9 arm 27 legs 36 trunk ```

Question 31

formula to estimate fluid need in baby

Answer 31

20mL/kg/hr

Question 32

Normal PO2 value

Answer 32

75-105mmHg

Question 33

6yo, insidious devel of a limp, decreased ROM in hip and knee. Dx?

Answer 33

avascular necrosis of the capital femoral epiphysis (Legg-Calve-Perthes disease)

Question 34

13yo fat kid, groin or knee pain, limp, sole of affected foot points in. Dx?

Answer 34

slipped capital femoral epiphysis

Question 35

Toddler, febrile illness, now wont move hip. Dx?

Answer 35

septic hip

Question 36

punched out bone lesion

Answer 36

multiple myeloma

Question 37

multiple myeloma abnormal labs?

Answer 37

Bence-Jones proteins in urine, abnormal Igs in blood

Question 38

Tx multiple myeloma?

Answer 38

chemo, thalidomide

Question 39

hip pain, leg shortened, adducted, internally rotated,. Dx?

Answer 39

posterior hip dislocation

Question 40

hip pain, leg shortened, externally rotated. Dx?

Answer 40

broken hip

Question 41

radial nerve injury s/s

Answer 41

unable to dorsiflex (extend) wrist

Question 42

median nerve distribution

Answer 42

radial 3.5 fingers

Question 43

L4-L5 distribution

Answer 43

side of big toe

Question 44

L5-S1 distribution

Answer 44

side of little toe

Question 45

HLA-B27 diseases

Answer 45

Ankylosing spondylitis, uveitis, inflammatory bowel disease

Question 46

Marjolin ulcer

Answer 46

squamous cell carcinoma of the skin from a chronic leg ulcer

Question 47

acid + low bicarb = ?

Answer 47

metabolic acidosis

Question 48

normal bicarb level?

Answer 48

24

Question 49

squamous cell carcinoma of the skin from a chronic leg ulcer

Answer 49

Marjolin ulcer

Question 50

base + high bicarb = ?

Answer 50

metabolic alkalosis

Question 51

Tx for metabolic alkalosis?

Answer 51

lots of KCl

Question 52

impaired ventilation causes what ABG problem?

Answer 52

acidosis

Question 53

abnormal hyperventilation causes what ABG problem?

Answer 53

alkalosis

Question 54

PCO2 low = ?

Answer 54

alkalosis

Question 55

PCO2 high = ?

Answer 55

acidosis

Question 56

increased ventilation corrects what ABG problem?

Answer 56

acidosis

Question 57

reduced ventilation corrects what ABG problem?

Answer 57

alkalosis

Question 58

solids easier to swallow than liquids?

Answer 58

achalasia

Question 59

xray finding achalasia?

Answer 59

megaesophagus

Question 60

tx achalasia?

Answer 60

balloon dilatation

Question 61

diagnostic for carcinoid syndrome?

Answer 61

24 hour urine collection for 5-hydroxyindoleacetic acid

Question 62

sigmoid volvulus xray finding

Answer 62

parrot's beak - huge air filled loop in the RUQ that tapers to the LLW

Question 63

firm, rubbery breast mass

Answer 63

fibroadenoma

Question 64

huge breast mass in younger girl

Answer 64

cystosarcoma phyllodes

Question 65

bilateral tenderness related to menstrual cycle

Answer 65

mammary dysplasia

Question 66

bloody nipple discharge in young woman

Answer 66

intraductal papilloma

Question 67

green vomiting and double-bubble xray

Answer 67

duodenal atresia, annular pancreas, or malrotation