Shelf Review

Question 1

Cause of anuria after surgery

Answer 1

Obstruction

Question 2

Vaccines for splenectomy

Answer 2

Pneumococcus
Hib
Meningococcus

Question 3

Treatment for malignant hyperthermia

Answer 3

Dantrolene
Ice packs (no anti-pyretics)

Question 4

When to screen for AAA?

Answer 4

Male 65-75 with 30 pack year history one time screening

Question 5

Complication of aorta repair

Answer 5

Artery of adamkiewicz is clamped
Decreased flow to spinal cord
Paraplegia/ anterior spinal cord syndrome

Question 6

Treatment of PAD

Answer 6

Smoking cessation, exercise program

Cilostazol- ssx improvement only

Question 7

Pt says his feet hurt when he goes to bed and needs to walk around…

Answer 7

Severe PAD, need gravity for circulation

Need urgent surgery

Question 8

PAD workup

Answer 8

ABI:
>1.4 calcified vessels
0.6-0.7 severe- angioplasty/stenting

U/S
CTA

Question 9

Pt with pulsatile abdominal mass, imaging?

Answer 9

Obvious AAA

Go straight to CT

Question 10

Carotid artery stenosis treatment

Answer 10

SSx: >50% stenosis -surgery
Assx: medical management unless >60% stenosis

Question 11

Malignant Pleural effusion

Answer 11

Friction rub, decreased breath sounds, hx cancer

Pain control, palliative

Question 12

Lung cancer in a non smoker

Answer 12

Adenocarcinoma

Question 13

Lung cancer with peripheral cavitation

Answer 13

Large cell carcinoma

Needs surgery because non responsive to chemo

Question 14

Screening for lung cancer

Answer 14

55-80 with 30+ pack year hx (current smoker or quit <15 yrs ago)
Low dose CT scan

Question 15

Work up for solitary pulmonary nodule

Answer 15

Look at prior imaging xray

Biopsy if >2cm

Question 16

Atrial myxoma

Answer 16

Murmur disappears with position change
Tx: resection
Complications: intracranial aneurysm or ischemia, chunks of tumor can break off and embolize

Question 17

Treatment for diffuse esophageal spasm

Answer 17

CCB, nitrates

Question 18

Most common cancers in young men

Answer 18

Testicular, lymphoma, leukemia

Question 19

FiO2 goal

Answer 19

<60%

Question 20

Bechet syndrome

Answer 20

Recurrent oral and genital ulcers
Thrombosis
Uvetitis
Erythema nodosum 
Young turkish people

Question 21

Anterior dislocation

Answer 21

Blow to externally rotated and abducted arm

Axillary nerve- deltoid and teres minor, sensory of lateral shoulder

Question 22

Renal artery stenosis

Answer 22

Refractory HTN (3+ meds)
Inc Cr after starting an ACE/ARB
Flash pulmonary edema
Diffuse atherosclerosis
Dx of HTN after 55 yr old
Asym kidneys
Abdominal bruit

Question 23

Atheroembolism

Answer 23

Cholesterol embolism
Complication of vascular/cardiac procedures
Blue toe syndrome, livedo reticularis, cerebral or intestinal ischemia, AKI, hollenhorst plaques

Supportive tx, statin

Question 24

Abrupt onset tachycardia that resolves with cold water immersion

Answer 24

Paroxysmal supraventricular tachy
AV nodal reentrant tachy

Vagal maneuvers: increase parasymp tone