Random ;) Flashcards
1
Q
Pain out of proportion to the physical
A
Ischemia
2
Q
Peritonitis gets? Surgery
A
Exploratory laparoscopy
3
Q
Patient comes in with Rebound tenderness and guarding ?
A
Peritonitis
4
Q
Image the RUQ with ?
A
Ultrasound
5
Q
Colicky abdominal pain?
A
Obstruction
6
Q
Image the RLQ with ?
A
CT SCAN
7
Q
Biopsy of UC shows ?
A
Superficial inflammation with crypt abscesses
8
Q
Treatment for Fistula
A
LIFT= Fistulotomy
9
Q
Treatment for anal fissures
A
Pastes or Creams for pain and muscle tone relaxation (nitroglycerin, calcium channel blocker)
10
Q
Bright red blood on toilet paper after bowel movement- most common dx?
A
Hemorrhoids
11
Q
Colonoscopy of US shows?
A
Continuous inflammation from rectum through colon
12
Q
Treatment for anal cancer
A
Nigro protocol
That is ; preoperative use of chemotherapy with 5 -fluorouracil and mitomycin and medical radiation for SSC of the anal canal
Adenocarcinoma should be tx surgically
13
Q
Screening for Anal cancer ?
A
A preventive practice, especially in HIV positive men, anal pap
14
Q
Ulcerative colitis, 8 years from dx
A
Colonoscopy annually, prophylactic colectomy
15
Q
Treatment for familial adenomatous polyposis?
A
Prophylactic colectomy
16
Q
1000s of polyps by 20 ? Dx
A
Familial adenomatous polyposis
17
Q
Young AA women with sickle cell disease; what type of stones will she have?
A
Pigmented stones
18
Q
Risk factors for gallstones
A
Fat, female, fertile, forty
19
Q
USS findings for choledocolithiasis
A
Dilated ducts
20
Q
What do you do for cholangitis
A
ERCP
21
Q
Treatment for choledocolithiasis
A
ERCP and Sphincterotomy
22
Q
Treat cholangitis with (abx)
A
Metronidazole + ciprofloxacin
23
Q
Pancreatitis: what test do you get
A
Ultrasound - rule out gallstones as the cause
24
Q
Best dx test for cholecystitis
A
HIDA SCAN (AKA nuclear scan )
25
Dx of cholecystitis on USS
Pericholecystic fluid, thickened gallbladder wall, gallstone
26
Dx acute pancreatitis by?
Elevated lipase
27
Antibiotic used in necrotizing pancreatitis
Meropenem
28
Most common causes (2) of pancreatitis?
Gallstones and alcohol
29
Pancreatic Pseudocyst: when do you operate ?
6 weeks or 6cm
30
Tx of chronic pancreatitis
Opiates
31
Acute pancreatitis weeks ago, now early satiety ? And how would u confirm
Pancreatic pseudo cyst . CT scan
32
In order , the dx of Boerhaave’s?
Gastrografin swallow, Barium Swallow, EGD
33
First dx step in GERD
Empiric PPI
34
Best test in working up esophageal cancer
EGD with biopsy
35
Bird’s beak esophagus?
Achalasia
36
Esophageal cancer at the top of esophagus
Squamous cell carcinoma
37
Best tx for achalasia
Myotomy
38
1st step in working up esophageal cancer
Barium swallow
39
Self limiting upper GI bleed
Mallory Weiss tear
40
Esophageal cancer at the bottom of the esophagus
Adenocarcinoma
41
You dx a stricture of the biliary tree. What do you do ?
Stent it
42
How do you dx pancreatic cancer
Endoscopic ultrasound with biopsy
43
How do you dx primary sclerosing cholangitis?
MRCP
44
You dx primary sclerosing cholangitis with strictures. What do you do?
Ursodeoxycholic acid to transplant
45
Lost of direct bilirubin elevated
Obstructive
46
Painful jaundice
Gallstones
47
Thin walled , distended gallbladder
Courvoisier sign, painless jaundice , biliary cancer somewhere
48
Tx for choledocolithiasis
ERCP
49
How do you dx cholangiocarcinoma
ERCP with endoscopic brushes
50
Post op foley in place, 0 urine output? What’s next
Unkink the catheter
51
Dx a MI after CABG
CKMB
52
Tx of MI after surgery
Medical, PCI
53
Day 2 post op : patchers hypertensive, tachycardic, diaphoretic and confused. Dx ?
Delirium tremens , Give benzos (lorazepam )
54
Wound opens and intestines come out , what do you do?
Warm saline dressing, bed rest , emergent OR
55
Elderly post op X-ray shows dilated colon. Dx and tx
Ogilvie’s.
Place rectal tube, colonoscopy decompression , give neostigmine ( pyridostigmine)
56
Post op , low urine output . First step?
Give fluids
57
A wound is leaking salmon colored fluid, but skin is intact . What do you do?
Limit straining . Elective OR
58
Post op has urge to void but can’t . What do you do ?
In and out catheter
59
Fever on day 12, post op , what is it ?
Wound - abscess
60
Fever on day 2 post op, what to you do?
Chest X-ray start antibiotics
61
Fever on day 1 post op , what is it ?
Atelectasis
62
Fever on day 0 , right after induction , what do you do?
Dantrolene
63
Fever on day 3 post op , what do you do ?
Urinalysis, antibiotics
64
Fever on day 5 post op , what is it ?
DVT
65
Fever on day 5 post op , what do you do ?
Ultrasound, heparin
66
Fever on day 7 post op, what do you do ?
Ultrasound or ct scan, rule out abscess
67
Fever on day 3 post op, what is it?
UTI
68
Fever on day 3 post op, what is it ?
Pneumonia
69
Fever on day 1 post op , what do you do ?
CXR, incentive spirometer
70
What metabolic condition is an absolute contraindication to surgery?
DKA
71
A malnourished patient needs to go to surgery; what’s the ideal course of action ?
Oral feedings for 10 days > oral feedings for 5 days > parenteral feedings for any time
72
If someone needs surgery, when should they stop smoking ?
8 weeks before surgery
73
In terms of the heart , two things you don’t want to have if going to surgery?
MI within 6months , JVD
74
What are the causes for anion gap metabolic acidosis
```
MUDPILES
Methanol
Uremia
DKA
Propylene glycol
Isopropanol (isoniazid)
Lactate
Ethylene glycol
Salicylates
```
75
What cause respiratory alkalosis
Hyperventilating
Pain
Anxiety
Hypoxemia
76
If u have metabolic acidosis, what is the next thing you look at ?
Anion gap
77
What are the causes of respiratory acidosis
```
Hypo ventilated
Opiates
Asthma
Copd
OHS
```
78
Salmon colored lesion in endoscopy of the esophagus-dx
Barrett’s esophagus
79
What is the first step in Mx of GERD
PPI
80
Burning retrosternal chest pain better with sitting and antacid, dx?
GERD
81
Risk of parenteral nutrition
Fungemia
82
What metabolic condition is an absolute contraindication to surgery
DKA
83
Thyroid nodule+ radiation to head and neck gets ?
FNA
84
Thyroid nodule uss size that automatically goes to FNA
>1cm
85
Thyroid nodule with low TSH “hot” nodule on RAIU- next step is
Mx the hyperthyroidism (no biopsy)
86
Thyroid nodule with a normal TSH- next step
Uss
87
Thyroid nodule in a px with weight loss, heat intolerance and increased DTRs- what you do ?
Get TSH
88
What’s the tx for metastatic follicular carcinoma
Radioactive iodine
89
Pathology shows orphan-Annie nuclei - dx
Papillary thyroid cancer
90
Medullary thyroid cancer- what you should associate with it
Calcitonin, C cell, MEN2A/2B
| RET oncogene
91
Thyroid nodule with low tsh no hot nodule on RAIU- next step
Uss ( then FNA
92
Painful thyroid , dx
De quervain’s thyroiditis
93
Afib, fever , hypotension, jaundice , dx?
Thyroid storm
94
When do you treat hypothyroidism
Symptoms, TSH >10
95
Which PVD can be stented
In femoral artery and <3cm
96
How do you dx peripheral vascular disease
ABIs then uss then arteriogram
97
Pain pulselessness poikilothermic paresthesias pale, dx?
Acute limb ischemia
98
What medication is used to treat peripheral vascular disease
Cilostazol
99
Treatment for localized breast cancer
Radiation, surgery ( lumpectomy + radiation or mastectomy) , sentinel lymph node dissection
100
Side effects of tamoxifen
DVT
| UTERINE CANCER
101
Woman <30 with a cyst that recurs. Next step
Biopsy
102
Her2 neu positive, ER/PR negative, post menopausal, tx
Trastuzumab
103
Her2 neu negative, ER/PR positive premenopausal, tx
tamoxifen
104
What’s the screening timing for breast cancer
50q2 Or 40q1
105
Ulcer on sacrum
Decubitus ulcer , roll patient
106
First test to dx PVD
Abi
107
Ulcer on malleolus
Venous stasis
108
Hairless leg, shiny or scaly legs , decreased pulses
PVD
109
Best test for PVD
Arteriogram
110
Ulcer that heals and breaks down over and over
Marjoljn ulcer, SCC
111
Ulcer on heels and toes
Diabetic, neuropathy ulcer
112
Define excisional and incisional biopsy
Excisional- biopsy by removing the entire mass
Incisional- biopsy by removing a piece of the mass
