pestena 3 Flashcards
___________ should be suspected when sudden death occurs in a chest trauma patient who is intubated and on a respirator
Air embolism
Penetrating urologic injuries rx
are as a rule surgically explored and repaired
Genu valgus (knock-knee) is normal between ages _________. No treatment is needed.
4 and 8
____________ is the most common primary malignant bone tumor.
Osteogenic sarcoma: It is seen in ages 10 to 25, usually around the knee
Hip- extremity shortened, adducted, and internally rotated.
posterior dislocation
Fungating mass grows out of the anus, metastatic inguinal nodes are often felt.
Squamous cell carcinoma of the anus is more common in HIV+
Nigro chemoradiation protocol, followed by surgery if there is residual tumor ( surgery rarely is required)
Modified vs Radical mastectomy
modified: whole breast out, pecs stay
full radical: breast and muscle out
Double bubble sign may be?
duodenal atresia, annular pancreas, or malrotation
Malrotation is diagnosed with
- contrast enema (safe, but not always diagnostic)
* upper GI study (more reliable, but more risky).
___________ are the most common reason for a newborn boy not to urinate during the first day of life
Posterior urethral valves
meatal stenosis should also be looked for
Posterior urethral valves test and rx
Voiding cystourethrogram= diagnostic test
endoscopic fulguration or resection will get rid of them.
tool for getting rid of big kidney stones
The most common tool used is extracorporeal
shock-wave lithotripsy (ESWL).
Other options include basket extraction, sonic probes, laser beams, and open surgery
retrograde cystogram x-ray must include __________ view, that might be obscured by the bladder full of dye.
post void films, to see extraperitoneal leaks at the base of the bladder
extraperitoneal: foley rx
For intraperitoneal leaks, surgical repair is done and protected with a suprapubic cystostomy
AP, lateral, and mortise x-rays show displaced fractures of both malleoli. rx?
Open reduction and internal fixation is needed if the fragments are displaced.
Anal fissure rx
stool softeners, topical nitroglycerin, local injection of botulinum toxin, forceful dilatation, or lateral internal sphincterotomy.
ccbs such as diltiazem ointment x 6 weeks have 80–90% success rate
Pancreatic cancers that have produced obstructive jaundice are often big enough to do ________ next
CT scan–> Percutaneous biopsy would then follow
A common final pathway for death in hemorrhagic pancreatitis is the development of _________
multiple pancreatic abscesses, and to anticipate
them and drain them, if at all possible, daily CT scans are recommended.
persistent fever and leukocytosis develop about 10 days after the onset of pancreatitis.
Pancreatic abscess
Pancreatic pseudocyst is usually about 5 weeks after
Cystosarcoma phyllodes
- very large, replacing and distorting the entire breast: yet not invading or becoming fixed.
- late 20s, grow over many years
- Most are benign, but potential to –> malignant sarcomas.
- Core or incisional biopsy is needed (FNA is not sufficient), and removal is mandatory.
Mammary dysplasia work up
Mammary dysplasia = fibrocystic disease, cystic mastitis ( 30-40 yo, gone by menopause)
if no“dominant” or persistent mass–> mammogram only
persistent mass –> Aspiration is done (not FNA, but aspiration w/ bigger needle and syringe).
If the mass persists or recurs after aspiration, formal biopsy is required.
Thyroid nodules test
FNA
Cystosarcoma phyllodes biopsy
FNA is not sufficient
Core or incisional biopsy is needed and removal is mandatory.
Most hyperthyroid patients are treated with ________ , but those with a “hot adenoma” have the
option of surgical excision of the affected lobe
radioactive iodine
dexamethasone suppression test results
- Suppression at low dosage= no disease
- Suppression at a higher dose= pituitary microadenoma.
- No suppression at either dosage identifies adrenal adenoma (or paraneoplastic syndrome).
Most hyperthyroid patients are treated with radioactive iodine, but those with a “hot adenoma” have the option of ____________
surgical excision of the affected lobe
pheochromocytoma pre op meds
Surgery requires careful pharmacologic preparation
with alpha-blockers.
extracorporeal membrane oxygenation (ECMO) is, and is helpful for?
ECMO (Extracorporeal Membrane Oxygenation) is a procedure that uses a machine to take over the work of the lungs and sometimes the heart.
Congenital diaphragmatic hernia with hypoplastic lung
