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SB9 Flashcards

1
Q

Confirmatory diagnosis for esophageal tear?

A

Water-soluble contrast

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2
Q

middle mediasternal mass diferencial?

A 
Bronchogenic cyst
Tracheal tumor
Pericardial cyst
Lymphoma
LN enlargement
Aortic aneurysm of the aortic arch
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3
Q

risk factor for bladder ca?

A 
Smoking
Work(Painter and metalworker)
Chronic cystitis
An iatrogenic drug-like CPD
Pelvic radiation exposure
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4
Q

epidemiology of malignant hyperthermia?

A

Gen.Mutation alters control of intracellular Ca
Volatile anesthetics
Succinylcoline
Exessive heat

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5
Q

CM?

A 
can occur during induction/maintenance or soon after cessation of GA
Masseter muscle/generalized rigidity
Sinus tachycardia
Hypercapnia resistant to MV
Rhabdomyolysis
Hyperkalemia
Hyperthermia(Late manifestation)
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6
Q

treatment?

A

Respiratory/ventilator suport
Immediate cessation of the causative agent
Dantrolene

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7
Q

Comma diagnosis finding?

A

Impaired brainstem activity
Motor dysfunction(decorticate/decerebrate rigidity)
LOC

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8
Q

Lymphangitis epidemiology?

A

Cutaneous injury–pathogen invasion of lymphatics in the deep dermis
S.Pyogenes and MSSA

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9
Q

CM?

A

Tender erythematous streak proximal to wound
Regional tender LDP
Systemic Sx(fever, tachycardia)

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10
Q

TX?

A

Cephalexin

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11
Q

what about sporotricosis?

A

Nodular(not streak) and develop within weeks(unlike days in lymphangitis)

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12
Q

Greater trochanteric pain syndrome(trochanteric bursitis)?

A

Age >=50
Wommen > Men
Obesity
Low bac & LE symptom

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13
Q

CM?

A

Chronic lateral hip pain
Pain on hip flexion and lying on the affected side
Normal range of motion(ABD may agravate pain)

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14
Q

diagnosis?

A

Focal tenderness on G.Trochanter are
X-Ray to r/o other joint disorder
U/S-Degeneration of tendon or tendinosis

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15
Q

tx?

A

Exercise, Physical therapy, activity modification
NSAID
Corticosteroid injuction

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16
Q

Pathophysiology?

A

Repetitive use of Gluteus medius and minimus

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17
Q

what about meralgia paresthetica (LFCN injury)?

A

Variable area MID lateral thigh pain

No trochanteric tenderness

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18
Q

Sternal dehiscence?

A

Separation of the approximated sternum in cardiac surgery.
COPD and Other factor affect wound healing are risks
Internal thoracic artery harvesting can cause sternal ischemia and it is a risk

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19
Q

CM?

A

pain or chest instability during chest movement
Palpable rocking or clicking on the sternum
can occur w/o superficial tissue infection/mediastinitis

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20
Q

Management?

A

Emergency(wire and bone fragment can damage cardia tissue)

Emergency wound exploration wound debridement, and sternal fixation

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21
Q

Compressive sternal dressing and negative pressure wound therapy?

A

Used in sternal wound failure to protect wound speed healing

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22
Q

Vertebral osteomyelitis RF?

A

Injection drug user(S.A MCC)
SCD
IC
Recent distant infection

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23
Q

CM?

A 
Chronic(> 6 weeks), Insidious back pain unrelieved by rest
Fever <50%
Tenderness at spinal percussion
Normal or elevated WBC
Elevated ESR and Thrombocytosis
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24
Q

Diagnosis?

A

MRI

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25
Management?
IV ab | May/may not need surgery
26
what about vertebral compression fracture?
Have the same Sx but VCF occur in an old patient with risk of osteoporosis
27
Medullary thyroid ca?
``` Tumors arise from thyroid parafollicular cells Calcitonin secreting(calcitonin measurement used for metastasis risk assessment recurrence) ```
28
Associated genetic abnormality?
RET proto-oncogene(MEN2 ) A--paratyroid and pheochoromocytoma B--Pheochromocytoma and marfanoid habitus
29
CM?
Asymptomatic thyroid mass Flushing and diarrhea(rarely) Serum Ca usually normal due to downregulation of Calcitonin receptor
30
Diagnosis?
FNAC
31
Management?
Thyroidectomy Serial calcitonin measurement post-surgery Levothyroxine replacement
32
Diagnosis of acute mesenteric ischemia?
CT angiography | Need immediate operation
33
Managment?
embolectomy with endovascular bypass Broad-spectrum AB Anticoagulation in absence of bleeding
34
Hemobilia?
Bleeding to biliary tract
35
Risk?
``` Hepatobiliary procedure(like liver biopsy, cholecystectomy and ECPG) Biliary tract tumour Blunt abdominal trauma ```
36
CM?
``` UGI bleeding (melena and hematochezia) RUQ pain Jaundice (inc DB) Hemorrhagic shock/Anemia Leukocytosis ```
37
Management?
Usually, management is conservative(resuscitation)--IV fluid and transfusion Angiography with embolization or surgery
38
Leriche syndrome?
Aortic occlusion at iliac artery branching
39
CM?
Bilateral Hip, Buttock, and thigh claudication Absent/Diminished LE pulse LE atrophy Impotence(always present)
40
syringomyelia pathogenesis?
meningitis/trauma/inflammatory disorder and tumour--affected cerebrospinal flow---months/years after developing a cystic cavity in the central channel--surrounding structure damage
41
Diagnosis and management?
MRI | Shunt placement
42
Indication for aortic valve replacement?
Sever AS + One of the following 1--the onset of symptom 2-LVEF<50 % 3--Undergoing other cardiac surgery(like CABAG)
43
Sever AS criterion?
Aortic jut velocity >4m/sec MTVPG >40 mmHg Valve area < 1 cm 2
44
Acute graft versus host disease pathogenesis?
Donor T cells affect host | Occurs in the first 100 days
45
CM?
Maculopapular rash Acute profuse watery diarrhea Hepatobiliary inflammation
46
Diagnosis?
Colonoscopy then biopsy after ruling out CD and CMV
47
Management?
Graft removal | Corticosteroid
48
Poterior hip dislocation?
Hip placed on adducted Internally rotated, and flexed position Sciatic nerve injury b/c near to it Leg shortening
49
Indication for just clinical observation in pleural effusion develops after cardiothoracic surgery?
should fulfill all below three criterion 1-Mild to moderate size and not enlarging 2-Develop starting from 1-2 days after surgery 3-No respiratory symptom
50
what to do in Acute decompensation in the cirrhotic patient?
Do abdominal U/S(to r/o HCC and PV thrombosis) | Normally cirrhosis patient needs U/C screening for HCC every 6 month
51
Diagnosis of hydatid cyst of the liver(E.G)?
Large smooth hydatid cyst with septation(dauter septation) | Ig E Ab in serum
52
Management?
Albendazole Percutanious intervantion if > 5 CM Surgery if rapture(signs are fever and eosinophilia)
53
CM of plantar faciatis?
Pain in first steep of walking | Localized tenderness with dorsiflexion of the toe(Unlike Achilles tendinopathy which is worsened by ankle flexion)
54
Raptured plantar fascia CM?
Sudden onset palmar pain Loss of the height of the palmar arch Visible ecchymosis or swelling
55
Tarsal tunnel syndrome CM?
Pain, paraesthesia, and numbness at the sole foot | Pain elicited by taping posterior tibial nerve
56
A complication of primary sclerosing colangitis?
Biliary stricture Cholangitis and cholilitiasis Cholangiocarcinoma, Colon cancer and biliary cancer Cholestasis
57
Diagnosis?
MRCP( Intra and extrahepatic biliary duct stricture with intermittent dilation)
58
What to do inpatient with the first diagnosis of PSC?
Colonoscopy to r/o IBD(UC>CD)
59
Torus palanitus?
A benign boney growth located at the midline of hard palate SIze < 2 CM ,It may enlarge over time Usually asymptomatic The underlying skin may ulcerate and affect healing Surgery may consider if asymptomatic May affect eating, speech, and dental implantation in later life--may consider surgery
60
MC opportunistic infection after organ transplantation?
CMV(reactivation)
61
CM?
Nausea, Abd.Pain and bloody diarrhea(colitis) Viremia BM suppression (Pancytopenia)
62
Investigation?
Atypical lymphocyte in blood End organ biopsy at the affected site Colonoscopy(multiple large,ahallow,erosion or ulcer)
63
What to do in a patient with a positive fecal occult blood test?
Colonoscopy Upper GI endoscopy(If have IDA, UGIB Sx and if colonoscopy fails to show any lesion) Video capsule endoscopy if bot fails to show a lesion
64
Trousseau syndrome?
Mucin secreting tumor--platelet-rich microthrombi--Superficial venous thrombosis at unusual sites
65
Risk?
``` Pancreatic Ca(MC) Prostate Stomach Colon Acute leukemia ```
66
Thyroglobulin?
Precursor for T3 and T4 | Used for asses recurrence in case of Troid ca
67
How to do the level?
First, withdraw the supplemental levothyroxine(T4)--this allows to increase TSH--Stimulate remaining Thyroid cells ---Detect/Rising TG level
68
Why Levothyroxine has been given after Thyroidectomy for thyroid ca?
Treat deficiency | it inhibits TSH production--Reduce thyroid gland stimulation
69
A complication of using radioactive Iodine radiation after thyroidectomy for ca?
Sialadenitis Pulmonary fibrosis Dry mouth
70
Acute diverticulitis CM?
``` Occur inpatient with diverticulosis MC involve sigmoid LLQ pain and tenderness (<20) Mild fever Change bowel habit(constipation or diarrhea) Nausea and vomiting Bladder irritation sx(U,F..) Sterile pyuria(+LE/WBC but no bacteria/-nitrate) ```
71
Management?
Broad-spectrum AB | Surgery if complication
72
Diagnosis?
Imaging (CT scan)
73
Risk for diverticulosis?
Old age Obesity Diet poor in fiber and high meat Smoking

Surgery 1 (11 decks)

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