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MRCS > Revision > Flashcards

Revision Flashcards

1
Q

Effect of ACEi on potassium

A

increases potassium in body through decreasing excretion

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2
Q

Normal urine output

A

0.5 mL/kg/hr

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3
Q

Obstructive jaundice mechanism

A

Obstruction of the excretion of conjugated bilirubin into the gut for elimination into the feces
(bile salts accumulation doesn’t contribute to jaundice because bile salts are colorless)

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4
Q

Plan regarding meds for diabetic having surgery the next day

A

give dextrose-potassium-insulin before surgery to avoid hyperglycemia, hypoglycemia and hypokalemia
Desired glucose: 10mmol/L (above normal 5 because better in state of surgery)

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5
Q

Relation between obstructive jaundice and increased INR

A

bile is not reaching the gut, so fat soluble vitamins are not absorbed like vit K which is essential in prothrombin formation
Txt: Start regular vit K injections

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6
Q

Liver failure + high protein meal

A

mimics alcohol intoxication, altered mental status, tremor, can lead to coma
Liver deals with toxic products from protein digestion
Also, liver failure causes esophageal varices bleeding, gut absorption of this blood is toxic, same effect as high protein (impaired consciousness)

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7
Q

PTLKB

A

Particular Tumors Like Killing Bone

Prostate, thyroid, lung, kidney, breast

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8
Q

Fluid volume given over 24 hours for electric burns

A

4 mL x weight (kg) x %burn

Half of volume given over 8 hrs then other half over 16 hrs

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9
Q

Fluid volume given over 24 hours for flames and scalds

A

2 mL x weight (kg) x %burn

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10
Q

Malignant otitis externa

A

Erosive inflammatory process that happens in immunocompromised people
Presents with ear pain, headache and facial nerve palsy

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11
Q

Glue ear

A

otitis media with effusion

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12
Q

MEN1

A

Pituitary, pancreas, parathyroid

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13
Q

MEN2 A

A

Pheochromocytoma, thyroid, parathyroid

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14
Q

Superficial abscess organisms

A

Staph aureus, Strep pyogenes

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15
Q

Deep abscess organisms

A

E coli (gram neg), Bacteroides (anaerobe)

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16
Q

MEN2 B

A

Pheochromocytoma, thyroid, neuronal tumors

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17
Q

When are liver hemangiomas dangerous

A

when larger than 5 cm, they can rupture and cause intra-abdominal bleeding

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18
Q

De Quervain’s thyroiditis

A

Associated with viral infection, painful swelling of thyroid, pain exacerbated by coughing or swallowing
Inflammation initially causes release of T3/4 for 4 to 6weeks then hypothyroid state happens due to depletion

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19
Q

Riedel’s thyroiditis

A

Progressive fibrosis of thyroid, patient can become hypothyroid

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20
Q

Position of thoracic duct relative to esophagus

A

posterior and left of esophagus, passes diaphragm at T5

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21
Q

Which thoracic ganglion for sweating

A

T1 for facial sweating
T2,3 for palms
T4 for axilla
Can do intradermal botox or topical aluminum chloride

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22
Q

Wilm’s tumor

A

mutation or deletion of both copies of WT1 tumor suppressor gene on chrom 11p, “nephroblastoma”, accounts for 80% of GU tumors in kids <15 yrs, good prognosis

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23
Q

osteosarcoma xray sign

A

sunray sign

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24
Q

ewing’s sarcoma xray sign

A

onion ring sign, multiple concentric rings

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25
Q

chondrosarcoma xray sign

A

popcorn appearance, emerge from pre-existing chondromas

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26
Q

cardiac tamponade signs

A

beck’s triad: distended neck veins (increased JVP), muffled heart sounds, hypotension
+ arrhythmias
+ Kussmaul’s sign: increased venous pressure on inspiration
+ pulsus paradoxus: fading pulse during inspiration

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27
Q

osteomyelitis organisms

A

in sickle cell: Salmonella, Staph aureus
puncture with dirty nail: E coli
drug users: Pseudomonas

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28
Q

hartmann’s solution components

A

Na, Ca, Cl, lactate, K

lactate is converted to glucose through gluconeogenesis

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29
Q

type of suture for skin closure with risk of contamination

A

non-absorbable (slow healing tissue), monofilament (lower risk of infection) –> Prolene
multifilament (silk, dacron) have risk of harboring bacteria, absorbable sutures (vicryl) are used for fast healing tissues (bowels)

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30
Q

lesion in frontal lobe

A

motor disturbance in contralateral body part

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31
Q

lesion in dominant temporal lobe

A

dysphasia (language problems)

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32
Q

lesion in cerbellum

A

balance problems

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33
Q

lesion in parietal lobe

A

sensory disturbance in contralateral body part

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34
Q

vision problem associated with lesion in temporal lobe

A

upper homonymous quadrantanopia

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35
Q

vision problem associated with lesion in parietal lobe

A

inferior homonymous quadrantanopia

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36
Q

why are skin graft rejections rare after burns

A

burned tissue early on (3 days after burn) are immunosuppressed

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37
Q

liver injury grading

A

I: <10% subcapsular hematoma or laceration <1cm parenchymal depth
II: 10-50% hematoma or laceration 1-3cm depth and <10cm length
III: >50% hematoma or laceration >3cm depth
IV: laceration with parenchymal disruption involving 25-75% of a hepatic lobe or 1-3 segments
V: parenchymal disruption >75% of a hepatic lobe of >3 segments

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38
Q

erectile dysfunction causes

A

DM, drugs (PPI), vascular disease, pelvic surgery, pelvis or spinal injury, neurological disease, hormonal problem (low testosterone)

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39
Q

vertebral level at which spinal cord ends

A

adults: L1-2

neonates and kids: L3

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40
Q

aorta passes through diaphragm at

A

T12

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41
Q

IVC passes through diaphragm at

A

T8

42
Q

esophagus passes through diaphrgam at

A

T10

43
Q

full thickness burn appearance

A

leathery white or charred black

44
Q

femoral sheath components

A 
medial to lateral:
femoral canal (empty space which allows femoral vein to expand into when venous return increases during exercise)
femoral vein
femoral artery
(femoral nerve is not in sheath)
45
Q

vitamin K is essential for activation of which clotting factors

A

factor 2 (prothrombin), 7, 9, 10

46
Q

necrotizing fasciitis symptoms

A

like cellulitis but worsening rapidly with hemodynamic compromise and margin of infection advances rapidly
red/bronze discoloration, decreased sensation, hemorrhagic bullae, sepsis, thrombosis

47
Q

antibiotic to be used when allergic to penicillin

A

erythromycin or clarithromycin

avoid cephalosporin if can give other antibiotics due to cross-reactivity with penicillin

48
Q

arsenic, what cancer

A

skin, lung, bladder

in pesticides, metal smelters

49
Q

UV radiation, what cancer

A

basal cell carcinoma (skin)

50
Q

aromatic amines, what cancer

A

bladder

pesticides, dyes

51
Q

benzene, what cancer

A

leukemia, lymphoma, multiple myeloma

painters, printers, mechanics, petroleum

52
Q

only cranial nerve that does not arise from brain

A

accessory nerve 11 arises from cervical spinal cord

53
Q

what part of GI tract is RADIOtherapy indicated as adjuvant therapy

A

rectum cancer, used to reduce size and make them operable, can be used pre-op or post-op
only chemotherapy is used for any other GI malignancy

54
Q

dangerous side effect of TPN

A

if given without folate or B12 supplements, can cause megaloblastic anemia then pancytopenia

55
Q

deep peroneal nerve injury

A

foot drop, numbness in 1st webspace

56
Q

medial plantar nerve

A

sensation to 1st, 2nd, 3rd toes plantar aspect

57
Q

lateral plantar nerve

A

sensation to 4th, 5th toes plantar aspect

58
Q

ANCA positive antibodies, which disease

A

granulomatosis with polyangiitis (Wegener), anything polyangiitis
drug induced vasculitis is ANCA negative

59
Q

SLE antibody

A

anti-ds DNA, ANA

60
Q

rheumatoid arthritis antibody

A

anti-CCP

61
Q

systemic sclerosis antibody

A

anti-centromere, anti-Scl-70

62
Q

what fluid should be used to replace gastric fluid lost in NG tube

A

0.9% normal saline to avoid metabolic alkalosis, can add potassium chloride if hypokalemia
lactate in Hartmann’s is metabolized to bicarb which worsens alkalosis

63
Q

PFTs in obstructive lung disease

A

FEV1:FVC <0.75

64
Q

hemolytic anemia or recovery from acute hemorrhage results in what kind of anemia

A

macrocytic

65
Q

what spinal nerve injury results in problems in ventilation

A

C3
phrenic nerve comes from C3-4-5, injury at C3 damages whole nerve however at C4 can cause partial innervation and ventilation

66
Q

prostate cancer tumor marker

A

PSA

67
Q

testicular cancer tumor marker

A

HCG

68
Q

medullary thyroid cancer tumor marker

A

calcitonin

69
Q

parathyroid cancer tumor marker

A

PTH

70
Q

liver, testes, yolk sac cancer tumor marker (teratoma)

A

AFP

71
Q

ovary cancer tumor marker

A

CA 125

72
Q

pancreatic cancer tumor marker (less bowel, lung)

A

CA 19-9

73
Q

breast cancer tumor marker (less bowel, lung)

A

CA 153

74
Q

colon and stomach cancer tumor marker

A

CEA

75
Q

what proteins decrease in acute phase response

A

albumin and transferrin

76
Q

Carotid surgery complication on tongue

A

Hypoglossal nerve injury causing tongue muscles weakness

77
Q

Outstretched hand, supracondylar fracture, loss of pronation

A

median nerve injury

78
Q

What cells should be present for Barret’s esophagus to be diagnosed

A

intestinal metaplasia (squamous to columnar) + goblet cells

79
Q

Pseudomyxoma peritonei

A

rare mucinous tumor arising from appendix (post appendectomy), accumulation of large amounts of mucinous material in abdomen

80
Q

Colonic surgery injury caused by traction

A

spleen is torn, causes bleeding in left paracolic gutter

81
Q

Hypercalcemia causes mnemonic

A 
C alcium supplements
H yperparathyroidism
I atrogenic (thiazides)
M ilk alkali syndrome
P aget disease
A acromegaly and Addison disease
N eoplasia
Z ollinger Ellison disease MEN1
E xcess vit D
E xcess vit A
S arcoidosis
82
Q

Left varicocele sign of what

A

renal cell carcinoma, occludes renal vein

Abdominal ultrasound should be done

83
Q

Abduction of shoulder

A

supraspinatus

84
Q

Hashimoto + rapid growth of thyroid size

A

thyroid lymphoma (non hodgkin B cell lymphoma)

85
Q

Angle of the jaw is innervated by (sensation)

A

Greater auricular nerve

Sensation of the rest of the whole face is by trigeminal nerve

86
Q

Difference between thyroglossal cyst and dermoid cyst

A

thyroglossal: Below hyoid, moves when swallowing or tongue protrusion, anechoic on US (echogenicity suggests infection)
Dermoid: Above hyoid, doesnt move, heterogeneous and multiloculated on US

87
Q

Foot drop after hip replacement

A

sciatic nerve

88
Q

Curling ulcers vs cushing ulcers

A

curling: Stress ulcers in duodenum after burns, cause hematemesis
Cushing: Result of raised ICP (overstimulation of vagus nerve increases gastric acid secretion)

89
Q

Anal fissure treatments

A
  1. Stool softeners, topical GTN
  2. Botulinum toxin injection
  3. Sphincterotomy
90
Q

Exits of trigeminal nerve branches from the skull

A

Standing Room Only
V1: Superior orbital fissure
V2: Foramen Rotundum
V3: Foramen Ovale

91
Q

Kartagener syndrome is associated with

A

situs inversus

92
Q

Sciatic nerve roots

A

L4 - S3

93
Q

Choanal atresia

A

Occluded posterior nasal airway
Cyanotic when eating
Improves when cries

94
Q

Trendelenburg gait caused by injury of which nerve

A

superior gluteal nerve

95
Q

porta hepatis contents

A

hepatic artery, portal vein, common hepatic duct

96
Q

hematoma post thyroidectomy in which plane

A

pretracheal fascia (covers thyroid)

97
Q

mnemonic for branches of external carotid artery

A 
Some Attendings Like Freaking Out Potential Medical Students
S: sup thyroid artery
A: ascending pharyngeal
L: lingual
F: facial
O: occipital
P: post auricular
M: maxillary
S: sup temporal
98
Q

substance used for most accurate measurement of GFR

A

inulin (creatinine declines with age due to decline in renal function)

99
Q

mnemonic for factors affecting wound healing

A

DID NOT HEAL
D iabetes
I nfection, irradation
D rugs (steroids, chemo)

N utritional deficiency (vit A, C, zinc, manganese), Neoplasi
O bject (foreign material)
T issue necrosis

H ypoxia
E xcess tension on wound
A nother wound
L ow temperature, Liver jaundice

100
Q

C fibers transmit

A

painful mechanothermal stimuli

101
Q

A fibers transmit

A

A delta: pain
A gamma: painful mechanical stimuli, motor proprioception
A beta: touch and pressure

102
Q

B fibers

A

autonomic fibers

MRCS (12 decks)

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