Stitelman Shelf Review Flashcards
A tachycardic, febrile patient presents with bloody diarrhea and abdominal pain. X-rays show a non-obstructed dilated colon and thick haustral markings that do not extend across the whole lumen? Diagnostic signs (4)? Major complication? Treatment? Treatment if patient has IBD?
Toxic Megacolon. Fever, tachycardia >120, WBC >10.5k, and anemia. Colonic perforation. IV fluids, NG, NPO, antibiotics. IC corticosteroids. Surgery if it doesn’t resolve.
If you notice foot drop and the dorsum of the first and second toes are numb, what has been damaged?
Deep Peroneal Nerve injury.
How can you tell if an anesthetic is an amide or an ester? Complications with esters?
Amide = 2 “i’s” - Lidocaine, Bupivacaine, Prilocaine. Ester = 1 “i” - Cocaine, Benzocaine. Esters are degraded to PABA, which can cause an allergic reaction in patients.
What is this?

Intraparenchymal Hemmorrhage.
What is this?

Epidural Hematoma
What is this?

Acute Subdural Hemmorrhage.
What is this?

Acute subarachnoid hemmorrhage.
At what size should Thoracic Aortic Aneurysms be operated on? What about AAA?
6.5cm. 5.5cm.
A milky chylous pleural effusion is suggestive of?
Thoracic duct injury.
ABI < 0.9? ABI <0.6? ABI <0.4 for a patient who smokes that notices pain in their calf.
Claudication. Rest pain. Limb ischemia.
A patient complains of acid reflux pain when lying down? Two types? Treatment?
Hiatal Hernia. 1: sliding, treat symptoms. 2. Paraesophageal, requires surgery.
Normal Urine Specific gravity?
1.010-1.025
10% rule with pheochromocytoma?
10% are extra-adrenal/malignant/found in children/familial/not HTN/calcified
Drugs to treat acute rejection (4)?
Azathioprine/Mycophenylate (Imuran/Cellcept) - inhibit T cells (can’t make purine). Cyclosporine/Prograf (FK-506/Tac) - can’t make cytokines.
What are MEN I tumors?
Parathyroid (hyperplasia). Pituitary (prolactinoma). Pancreatic (gastrinoma, insulinoma).
What are MEN II a tumors?
Pheochromocytoma. Medullary Cancer. Parathyroid hyperplasia.
What are MEN II b tumors?
Pheochromocytoma. Medullary Cancer. Mucosal neuroma. Marfan’s.
Normal Hgb level for Men? Women?
14-17. 12-15.
Causes of Macrocytic Anemia?
B12/Folate Deficiency (look out for issues in stomach or terminal ileum).
Causes of Microcytic Anemia?
Iron deficiency or hemoglobinopathy.
Warfarin inhibits what factors and proteins? Complications (apart from bleeding)? What coagulation test do you monitor?
Vitamin K dependent factors - II, VII, IX, X, Protein C and S. Skin necrosis. PT or INR.
What does Heparin bind to and inhibit? What coagulation test do you monitor with use?
ATIII. PTT time.
How do you know someone has an accessory spleen post splenectomy? Where should you look for it?
Absence of Howell-Jolly bodies. Splenic Hilum.
A patient with HIV develops bloody diarrhea?
CMV infection.