Rosh Material #2 Flashcards
1
Q
first line pharm for PAD
A
cliostazol
2
Q
what is this showing
A
midline shift, compressesd lateral ventricle, biconvex lens shaped hematoma -> epidural hematoma
3
Q
best way to dx a strangulated groin hernia
A
clinical exam
4
Q
maintenance pharm of choice for mod-severe active UC
A
infliximab -> TNF blocking agent
5
Q
classification of hemorrhoids
A
1st: do not protrude thru anus
2nd: prolapse but reduce spontaneously
3rd: prolapse and require manual reduction
4th can not be reduced, may strangulate
6
Q
definitive tx for BPH
A
TURP: transurethral resection of prostate
7
Q
parkland formula for post burn fluids
A
4 mL/kg x wt in kg x %BSA burned
first half given in the first 8 hr
remaining given over 16 hr
8
Q
management of pancreatic pseudocyst: early vs late
A
early (< 4 weeks): don’t drain
late (> 4 weeks): drain if symptomatic
9
Q
cause of pancreatic pseudocysts in kiddos
A
abdominal trauma
10
Q
what is this showing
A
free abd air -> perforated ulcer
11
Q
what type of wound care is not recommended for veous stasis ulcers
A
mechanical debridement (wet to dry dressing)
12
Q
EKG changes of hyperkalemia
A
- peaked t waves
- dropped p waves
- wide QRS
- sine wave
13
Q
management of hyperkalemia
A
- calcium gluconate or chloride -> membrane stabilization
- insulin, albuterol, sodium bicarb -> redistribution
- furosemide -> elimination
- hemodialysis -> elimination
14
Q
first line tx for bcc
A
electrodessication and curettage
15
Q
what is this
A
btw lower calf and medial malleolus -> venous ulcer
16
Q
what is this
A
pressure point (toes, feet, lateral malleolus, tibia) -> arterial ulcer
17
Q
which type of ulcer has moderate to heavy exudate
A
venous
18
Q
what is this
A
plantar foot, tip of toe, lateral to fifth metatarsal -> neuropathic diabetic ulcer
19
Q
what is this
A
bony prominence (heel), macerated -> pressure ulcer
20
Q
mcc of esophageal stricture
A
GERD
21
Q
initial dx test for esophageal stricture
A
preendoscopy barium esophagram
22
Q
tx for esophageal stricture
A
dilation
high dose PPI
23
Q
3 rf for gastric carcinoma
A
male
h.pylori
processed meat
24
Q
dysphagia to solids AND liquids
A
achalasia
25
what is this showing
coffee bean/comma appearance -> **cecal volvulus**
26
what 3 pt pops make you think about small bowel cancer
long-standing reginal enteritis
celiac sprue
AIDS
27
what is this showing
zenker diverticulum
28
older adult w. transient oropharyngeal dysphagia, pulmonary aspiration, halitosis, neck mass
zencker diverticulum
29
moa for roux en y
bypasses most of the stomach, duodenum, and proximal jejunum
30
management of afib: unstable vs stable
unstable: cardiovert
stable: diltiazem vs metoprolol
31
3 rf for afib
HTN
CAD
rheumatic heart dz
32
nonblanchable erythema
pressure ulcer
33
tx for pressure injury must include
debridement of necrotic tissue
34
type of debridement for stage 1 or 2 pressure ulcers that are not infected
autolytic
35
what type of wound care is not recommended for pressure ulcers
wet to dry dressings
36
contraindication for sharp debridement
anticoagulation
37
CA 19-9 is elevated in what cancers (7)
gastric
pancreatic
gallbladder
cholangiocarcinoma
ovarian
adenocarcinoma
ampullary
38
tumor marker that helps determine prognosis in colon ca
carcioembryonic antigen (CEA)
39
managment of renal artery stenosis (large vessel renal artery occlusive dz)
1. ACE/ARB
2. percutaneous angioplasty +/- stent
3. revascularization vs resection
40
what test is used to differentiate pt's w. gastrinomas from other causes of hypergastrinemia
seceretin stimulation test ->
pt's w. zollinger-ellison tumors have a dramatic rise in serum gastrin after administration of sceretin
41
indications for lifestyle/H2 blocker/antacid trial for suspected GERD
mild/intermittent sx
42
indications for ppi trial for suspected GERD (3)
severe/frequent sx
erosive esophagitis
barretts
43
cardiac PE finding of hypothyroidism
diastolic htn
44
what is contraindicated in acute diverticulitis due to risk of bowel perf
colonoscopy
45
management of complicated diverticulitis w. pericolonic abscess > 4 cm
percutaneous drainage
46
displacement of the GEJ and herniation of a portion of the fundus into the thoracic cavity
paraesophageal hiatus hernia
47
abx for cellulitis:
simple vs pcn allergy vs MRSA
simple: cephalexin, amoxicillin, dicloxacillin
pcn allergy: macrolide, clindamycin
MRSA: bactrin, doxy, clindamycin
48
what electrolyte abnl is mc associated w. respiratory alkalosis
hypokalemia
49
what type of ABG abnl does severe diarrhea cause
metabolic acidosis
50
what type of hernia runs lateral to the inferior epigastric vessels
indirect inguinal
51
what type of hernia runs medial to the inferior epigastric vessels
direct inguinal
52
which type of inguinal hernia has a greater risk for strangulation
indirect
53
mc site for mesenteric ischemia
superior mesenteric a
54
what are the 3 office based procedures for hemorrhoids
rubber band ligation
sclerotherapy
excision
55
indication for rubber band ligation for hemorrhoids
healthy pt
grade I-III internal
56
indications for sclerotherapy for hemorrhoids
pt's on anticoagulants/antiplatelets
immunocompromised
portal htn
57
indication for hemorrhoid excision
actively thrombosed external
58
all pt's w. venous ulcers should undergo what testing
venous duplex US
ABI
59
cardiac functional status
60
LP findings of SAH
xanthochromia -> Hgb degradation products
61
what type of ABG abnl does pyloric stenosis cause
hypokalemic, hypochloremic metabolic alkalosis
62
what should you order for preop eval of a pt w. worsening COPD symptoms
CXR
63
2 rf for toxic megacolon
IBD
infectious colitis
64
mcc of sbo in resource rich regions w.o a hx of prior abd surgery
hernia
65
what kind of GI bleeding is caused by PUD
melena
black stool
FOBT (+)
66
hallmark lab finding of PUD
increased BUN:Cr ratio
67
what should everyone get to differentiate syncope from sz
ECG
68
san fran syncope rule to identify high risk pt's
**chess:**
CHF
Hct < 30%
ECG abnl
SOB
systolic BP < 90
69
young woman + abd pain + syncope
ectopic
70
older man + abd pain/flank pain + syncope
AAA
71
woman + prodrome n/v, sweating, warmth + syncope
vasovagal
72
malignancy + SOB + syncope
PE
73
mc visual sx in a pt w. a pituitary mass
diminished temporal vision
(bitemporal hemianopsia)
74
lactotroph adenoma is same-same
prolactinoma
75
first line tx for prolactinoma/lactotroph adenoma
dopamine agonists:
cabergoline
bromocriptine
76
mc pituitary tumor
prolactinoma
77
5 types of pituitary tumor
prolactinoma
growth hormone secreting
ACTH-secreting
TSH-secreting
nonfunctioning
78
2 mc s.e of dopamine agonists (cabergoline/bromocriptine)
nausea
postural hypotn
79
3 indications for I&D of perirectal abscess in the OR
ischiorectal
intersphincteric
supralevator
80
5 indications for abx for perianal abscess
associated cellulitis
systemic infxn
DM
valvular heart dz
immunosuppression
81
t/f: all perianal abscesses must be drained in the OR
f!
simple perianal can be drained in the ED
82
which "p" is a late finding in PAD
paralysis
83
mcc of early post op fever
inflammatory stimulus of surgery
84
mc noninfectious cause of postop fever
meds
85
2 meds mc associated w. postop fever
heparin
abx
86
4 mc infectious causes of posop fever
pna
infxn
uti
intravascular catheter infxn
87
t/f: atelectasis is a common cause of post op fever
f!
i guess it just happens concurrently
88
describe the tremor that occurs w. hyperthyroidism (2)
high frequency, low amplitude
present w. action
89
what is this showing
bent inner tube: sigmoid volvulus
90
XR sign associated w. cecal volvulus vs sigmoid volvulus
cecal: coffee bean/comma
sigmoid: bent inner tube
91
epigastric discomfort w. no apparent e.o organic dz seen on endoscopy x at least 1 mo
functional dyspepsia
92
management of functional dyspepsia: < 60 yo vs >/= 60 yo
< 60 yo w.o alarming sx: h.pylori testing
< 60 w. alarming sx: endoscopy
>/= 60: endoscopy for all
93
management of a known DVT in a pt w. contraindications to anticoagulation
IVC filter
94
indications for IVC filter
**documented VTE PLUS:**
absolute contraindication to anticoags
comlications of anticoags
failure of anticoags
limited cardiac reserve
95
psammoma bodies
papillary thyroid ca
96
pre op med for pheo
phenoxybenzamine
97
what med should be administered immediately at the time of catheterization for BPH pt
alpha 1 adrenergic antagonist (afluzosin/tamsulosin) ->
relax smooth m of bladder neck and prostatic capsule -> prevent early recurrence of retention
98
tx for IDA in a post bariatric surgery pt
IV iron
99
PE finding most suggestive of a symptomatic abdominal aortic aneurysm
abdominal mass
100
cardiac abnl mc seen w. marfans
mitral valve prolapse
101
3 major criteria for marfan's dx
ectopica lentis
aortic root dilation
aortic dissection
102
post MI pt w. pansystolic murmur radiating to the axilla, dyspnia, rales thorughout
papillary muscle rupture -> MR
103
indication for radioiodine therapy for hyperthyroidism
pt's w.o risk for subsequent thyroid ca, leukemia, or other malignancy
104
a septal hematoma is unlikely if there is
epistaxis
105
which bb's are beta 1 cardioselective
the ones that start with a-n
106
stress test finding of ischemia
ST depression during peak exercise
107
tx of choice for symptomatic recurrent arrhythmias
radiofrequency ablation of bypass tracts
108
5 indications for CABG
> 50% left main CAD
> 70% LAD w. EF < 50% or e.o ischemia on noninvasive tests
> 70% LAD/LCX stenosis
asymptomatic 3 vessel dz
DM w. 2 or 3 vessel dz
109
post op increased BUN:Cr and low FEN in an otherwise healthy pt
prerenal azotemia
110
mc post op pulmonary complication
atelectasis
111
2 rf for atelectasis
elderly
overweight
112
mc timeline for post op atelectasis
12-24 hr post op
113
tx of choice to preserve vision in a pt w. diabetic retinopathy
panretinal laser photocoagulation
114
hallmark PE finding of duodenal ulcer
epigastric tenderness
115
barrett's increases risk for which type of esophageal ca
adenocarcinoma
116
main complication of TIPS
increased risk of encephalopathy
117
3 structures best visualized w. TEE
left atrium
mitral valve
aorta
118
best therapy of choice for long term management of esophageal varices in a pt who can not tolerate bb
sclerotherapy
119
fatigue, weight loss, weakness, abd pain, loss of pubic hair, orthostatic hypotn
addison's
120
what is dressler's syndrome
pericarditis and pleuritis several days to weeks post MI
121
2 causes of cavitation on CXR
lung abscess
primary TB
122
most reliable site from which to identify the causative organism in osteomyelitis
bone bx
123
gs dx for thrombophlebitis of the lower leg
venography
124
mc site of osteomyelitis in IVDU and adults
vertebral spine
125
indication for ORIF
angulation > 40 degrees
126
splint of choice for colle's fx
volar forearm
127
fx thru the metaphysis of the distal radius w. dorsal displacement and angulation
colles fx
128
fracture of the distal radius with volar angulation
smith fx
129
what test do you order to evaluate a pt following trauma with blood at the meatus
urethrogram
*only test that won't damage the urethra 2/2 to pelvic fx*
130
abx for bowel perf
nafcillin
gentamicin
metronidazole
131
permanent flexion contracture of the hand at the wrist resulting in a claw-like deformity of the hand and fingers
volkmann's contracture
132
2 causes of volkman's contracture
untreated compartment syndrome
arterial injury
