Simulation 09_2023 Flashcards
What agent reverses the anesthetic effect of cortare (rocuronium bromide)?
4 vials of Neostigmine (total 2mg) and 2 vials of atropine (total 1mg)
both the drugs have anticholinesterase activity
What is and how does anti-phospholipid syndrome present?
its a systemic autoimmune dx with antibodies against cells, coagulation factors and complement system.
Causes venous/arterial thrombosis, abortions, fetal deaths, thrombocytopenia, autoimmune hemolytic anemia
Sjogrens syndrome presents with
Xerostomia or xerophthalmia
CREST sign is from which autoimmune dx
systemic sclerosis
- calcinosis, raynauds phenomenon, esophageal dysmotility, sclerodactyly, telangectasia
What is primary prophylaxis for anti phospholipid syndrome?
What is secondary prophylaxis?
acetylsalicylic acid for thrombophylaxis
!! If the pt also had lupus use hydroxychloroquine +/- ASA
Secondary: oral anticoagulation
Apple core image is a sign of cancer in which organ
colon
does lorazepam have a hypnotic activity?
no, its an anxiolytic
Which area corresponds to “Bunnell’s no-man’s land” at hand level
zone 2
At the hand level, there are five different areas of injury to the flexor tendons, characterized by different prognoses; Zone 2 presents the worst prognosis for anatomical reasons. Bunnell’s area begins at the level of the distal palmar fold and ends in the middle part of F2, where the insertion of the superficial flexor tendon bends ends.
daBRAFenib, a drug to treat melanoma, targets which molecule?
BRAF
Nivolumab targets?
PD-1
PD-L1 inhibitors are
atezolizumab, durvalumab and avelumab
Ipilimumab is an
CTLA-4 inhibitor
define subclinical hyperthyroidism
low TSH
normal free T4 and T3 levels, without or with minimal symptoms of hyperthyroidism.
What is the pathogenesis of ventricular pseudo-aneurysm
It forms following a transmural infarction that causes wall rupture, which in turn is delimited by thrombosis. This prevents the evolution into hemopericardium and the consequent probable tamponade.
what is the valsalva manuver for varicocele evaluation
during increased abdominal pressure by the patient
Subclinical, when they are neither visible nor palpable but seen on Doppler
grade 1 when it is palpable only during Valsalva
grade 2 when it is palpable even when at rest
grade 3 when visible.
what are side effects of RX
Breast cancer
secondary lymphoma
pulmonary fibrosis
coronary stenosis
NOT LEUKEMIA
How many stages of Angle’s occlusion of teeth
3
In a women with breast cancer treated with adjuvent hormone therapy for 5 years, what do you do to prevent osteoporosis
Prescribe antiresorptive therapy (bisphosphates or denosumab) to protect the bone and adequate supplementation with calcium and vitamin D
What is guilain barre syndrome?
an inflammatory polyradiculoneuritis with ascending tingling, starting from the extremities (hands and feet) and moving up the limbs and trunk in a few days.
leads to paralysis of the four limbs, with areflexia, and with dysautonomia (note respiratory and sphincter function)
TX is IV immunoglobulins
NOT GENETIC
How are levels of validity of scientific work expressed?
Level A includes evidence from multiple randomized experimental studies, Level B includes evidence from one randomized experimental study OR multiple quasi-experimental studies OR multiple large cohort studies, while Level C includes evidence from observational studies (excluding cohort ones) OR by expert consensus.
The appearance of dizziness following efforts, loud noises or increases in external pressure suggests
Minor’s syndrome
What is waste water
water that requires appropriate purification treatments before being eliminated into the environment
When does ascending pyelonephritis occur?
the main causes of infection for women consist in the deformation of the urethra during sexual intercourse, while for men it is often secondary to endoscopic maneuvers.
Factor VII or VIII deficiency is? age of onset? Signs? Signs on coagulation panel
x-linked hereditary haemorrhagic coagulopathy, haemophilia A or B, depending on whether there is a deficiency of factor VIII or IX respectively
Usually the first manifestations occur around the age of one year (include haemarthrosis, muscle haematomas, ecchymoses and mucosal haemorrhages)
The coagulation analysis shows a lengthening of the aPTT with normal platelet counts and prothrombin time.
MDR TB means?
TB due to a strain resistant to rifampicin and isoniazid
What does flucytosine treat?
is an anti-fungal
Placental alkaline phosphatase and alpha-fetoprotein are used in the diagnosis of
germinoma (often in the pineal region)
Symptoms in a case of foodborne botulism?
Autonomic system disorders
manifests 12-36 hours after incubation/ingestion
TX of multiple sclerosis?
high dose corticosteroids in acute situations then dimethyl fumarate/monoclonal antibodies (ocrelizumab, natalizumab) for long term
The Gelli-Bianco law provides that punishment can be excluded for a doctor in the event of
incompetence
BMI divisions
normale fra 18.5-25, sovrappeso fra 25 e 30, obesità sopra i 30, sottopeso sotto i 17.5.
Russells sign in anorexia/ED
The callus on the back of the hand
TX for bulemia nervosa?
Fluoxetine specifically, and serotonergic drugs in general, are the only drugs that have been shown to be able to reduce the symptoms of binge eating/vomiting in patients with bulimia nervosa,
Which drugs have a hyporexia effect (reduce appetite)
topiramate
Are calcified nodules on pulmonary CT malignant?
the nodules of calcific consistency are benign. On the contrary, solid, non-calcific nodules should be well monitored based on size. For nodules larger than 3 mm it is important to check them again over time, nodules larger than 1 cm are usually studied with contrast medium and examined in depth with functional tests such as PET CT
which joints affected in psoriatic arthritis? What do you see on RX?
distal interphalangeal joints
on rx: pencil in a cup.