Simulation 17_2023 Flashcards
define disinfection
the reduction and/or elimination of pathogens present in the air or on surfaces.
Sister Mary Joseph’s nodule, Krukenberg’s tumor, Blumer’s step sign are all?
typical of gastric adenocarcinoma
The Sister Mary Joseph nodule indicates a nodule in the periumbilical region, the Blumer step sign indicates nodules at the peritoneal level, while the Krukenberg tumor indicates nodules at the ovarian level.
Ficat classification
of aseptic necrosis of the femoral head
vinyl chloride monomer facts
CMV has been used in the past as an anesthetic gas as it is easily absorbed by inhalation.
Causes fatal arrhythmias, including AF and VF
It is currently used in the production of PVC.
Chronic “CMV disease” (Raynaud’s phenomenon, osteolysis, scleroderma) can occur in exposed workers.
is an IARC1 carcinogen
hepatocellular carcinomas or angiosarcomas. The latter histotype has a latency of onset of approximately 17 years and is very typical of previous exposure to CMV, unlike HCC; whose etiology is more varied (liver cirrhosis, chronic hepatitis, aflatoxins etc).
The most important marker of liver damage is
alanine amiotransferase (ALT)
(AST is an enzyme that can also be localized at the level of the myocardium, skeletal muscles and brain.)
BMI classes
underweight (BMI <18.5 Kg/m^2)
Normal weight (BMI between 18.6 and 25.0 Kg/m^2)
overweight (BMI 25.1-30.0 Kg/m ^2)
Severe obesity grade I (30.1-34.9 Kg/m^2)
Severe obesity grade II (35-39.9 Kg/m^2)
Severe obesity grade III (>40 kg/m^2)
ECG findings in mild/moderate mitral stenosis
mitral P wave, i.e. bifid in I, II and from V4 to V6 or diphasic in V1 and V2.
What is the gold standard for studying lung metastases?
CT
A singer has diffuse swelling of vocal folds. DX?
Reinke’s edema is a more or less widespread chordal edema, capable of causing dysphonia and, in the most severe cases, dyspnoea. Treatment consists of removing the triggering factors and, if necessary, a surgical approach
What is the main method used to stage cervical cancer?
Recto-vaginal examination in narcosis. The staging of cervical cancer is carried out through manual recto-vaginal exploration because it allows the evaluation of parameters, vagina and rectovaginal septum, the possible involvement of which more heavily influences the subsequent therapeutic strategy and prognosis.
T/F Staging on the “operating table” is typically carried out for ovarian cancer, for which only direct vision allows us to understand the real extent of the disease and therefore whether it is operable or not
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Acute otitis externa presentation, causes, otoscope presentation and TX
It is an inflammation of the external auditory canal mainly caused by Staphylococci and pseudomonas aeruginosa
SX: otalgia evoked by compression on the tragus, accompanied by hearing loss.
On otoscopic: edema of the external auditory canal with hyperemia. creamy secretions of variable colour.
TX: administration of topical preparations such as neomycin, washes with acetic acid, topical antifungals in the case of fungal infection.
TX of otitis media
Amoxicillin 50 mg/kg/day in 3 doses.
Amoxicillin represents the antibiotic therapy of first choice in the absence of otorrhea, recurrence or risk factors for bacterial resistance. If one of these elements is present, the use of the amoxicillin+clavulanic acid association is preferred.
What is meant by recurrent otitis media?
3 or more episodes in 6 months
T/F The current indications provided by the AHA/ACC state, in fact, that patients with minor risk factors can undergo elective surgery without additional investigations, whatever the nature of the planned operation, if their functional reserve is at least moderate. and, in case of poor functional capacity, whether the surgery is low or intermediate risk
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How many types of joint involvement in IBD
In chronic inflammatory diseases (IBD), the most frequent extra-intestinal manifestations are joint ones.
Three types of joint involvement are recognized: type I (oligoarticular), type II (polyarticular) and type III (spondyloarthropathy).
Knee is most often affected
Possible extraarticular manifestations of IBD
Uveitis
Osteomalacia
Osteoporosis
Amyloidosis
T/F The focal seizure, on the other hand, occurs without loss of consciousness.
T
Seborrhoic keratosis facts
TX?
represents the most frequent benign epithelial tumor, is typical of advanced age and the white race
No TX
Keratoacanthoma
Keratoacanthoma manifests itself with a rounded and reddish papule with a crater filled with keratotic material in the center
actinic keratosis presents itself as an asymptomatic desquamated lesion with an erythematous halo
T
while cryotherapy and 5-fluorouracil for actinic keratosis
T/F basal cell carcinoma as a pearly plaque with telangiectasias on the surface (often ulcerated in the center), while finally squamous cell carcinoma as a friable papule or ulcer with superficial serocrusts that bleeds episodically
T
Elective surgery and/or radiotherapy are treatments used for example for squamous cell carcinoma
TX for intestinal obstruction
Fasting, nasogastric tube placement, IV fluids, and viscerolysis.
There are then specific treatments depending on the etiology of the occlusion: in case of intussusception in the child, for example, we can use an enema, since the cause is usually the laxity of the mucous and submucosal tissues
the positioning of a stent is indicated in cases of colon cancer, in which one can also opt for a resection followed by anastomosis of the stumps
while colonoscopy can be decisive as a non-surgical treatment in cases of volvulus of the sigmoid colon, especially in elderly patients
In cases of occlusion due to adhesions caused by previous surgical interventions, as, probably, in our clinical case, the treatment consists of viscerolysis, i.e. the resolution of the adhesions through surgery. Antibiotic therapy, however, is generally reserved for cases in which intestinal infarction or ischemia is suspected.
All of them are true for heart failure TX
Dapaglifozin is indicated in patients with heart failure, regardless of diabetes
Eplerenone is an antialdosterone with low risk of gynecomastia
The implantation of an ICD is indicated for primary prevention in patients with NYHA class II-III, FE reduced, after optimized medical therapy for 3 months and at least 40 days from the last infarction
The CRT can be used both if the QRS > 150 msec with LBBBx pattern and between 130 and 150 msec with non-LBBBx pattern
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