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April EOR Exams > Surgery > Flashcards

Surgery Flashcards

1
Q

What is the most common thyroid cancer?

A

papillary

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2
Q

What is the most common risk factor for bladder cancer?

A

smoking

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3
Q

What is split S1 and S2 heart beats a side effect?

A

atrial septal defect

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4
Q

What is a hypocalcemia a sign of?

A

hyperparathyroid

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5
Q

What are the symptoms of hypocalcemia?

A

trousseau’s and chovostek’s – hyperreflexia

-prolonged QT

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6
Q

What weight loss surgery has malabsorption and restrictive qualities?

A 
gastric bypass (roux en y) 
-sleeve and band are only restrictive
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7
Q

What are the signs and symptoms of B12?

A

AMS, neuro symptoms, increased MMA and homocysteine

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8
Q

What are the signs and symptoms of pheochromocytoma?

A

intermittent HA, hypertensive crisis, young pt

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9
Q

What is the tx of pheochromocytoma?

A

removal

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10
Q

What is the initial study when a patent has bad breath and food is getting stuck?

A

barium swallow

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11
Q

What is a trousseau’s sign a sign of?

A

hypocalcemia

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12
Q

What is a concern when doing a thyroidectomy?

A

hoarse voice - don’t cut the recurrent laryngeal nerve

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13
Q

What is the treatment of ulcerative colitis?

A

proctocolectomy

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14
Q

Dysphagia with solid foods and liquids, what is the dx?

A

achalasia or cancer

-can be dysphagia with food first then eventually liquid

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15
Q

Elderly man with foul undigested food, EGD shows webs, what is the dx?

A

Schatzki Ring

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16
Q

Palpitations, headache, excessive sweating, how do you dx?

A

urine metanephrines

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17
Q

What is the pancreatic cancer marker?

A

Ca 19-9

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18
Q

Other than a lactate dehydrogenase and beta-HCG what other test do you order with testicular cancer?

A

alpha-fetoprotein

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19
Q

How do you diagnose a thyroid mass?

A

fine needle aspiration or radioactive iodine

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20
Q

What is a nonhealing peptic ulcer disease a symptom of?

A

Zollinger-Ellison syndrome

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21
Q

How do you treat a 1 cm stone?

A

lithotripsy

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22
Q

Periumbilical pain - RLQ pain is a sign of?

A

appendictis

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23
Q

Blue discoloration of umbilicus is what?

A

Cullens

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24
Q

What is severe diarrhea after eating and surgery a sign of?

A

dumping syndrome

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25
Q

What is the dx when you have an alcoholic with vomiting blood?

A

Mallory Weiss Tear

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26
Q

What is the tx of necrotizing fasciitis?

A

surgery STAT

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27
Q

What is the description of grade 4 internal hemorrhoid?

A

prolapsed and cannot be reduced

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28
Q

Numbness and paresthesia is a sign of?

A

hypocalcemia

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29
Q

What do we try to prevent when a patient has GERD?

A

Barrett’s

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30
Q

Which obesity surgery has malabsorption?

A

bilopancreatic

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31
Q

Why does adjustable gastric bypass have a complication others don’t?

A

other procedures do not require anastomosis - which can lead to leakage

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32
Q

What is a complication of lap band?

A

slips

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33
Q

A patient presents with flank pain and hematuria, how do you dx?

A

non contrast CT

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34
Q

How do you dx pyloric stenosis, a child with mass and non bilious vomiting?

A

Ultrasound (upper GI series)

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35
Q

What is the treatment for gastroparesis?

A

metoclopramide

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36
Q

Post op, crackles, and cough, what do you order?

A

CXR

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37
Q

What do you bridge coumadin with to treat a pre-op DVT?

A

lovenox

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38
Q

What is the dx when you have severe bleeding from wound and prolonged everything?

A

DIC

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39
Q

What is the dx when you have severe bleeding and deficiency in factor IX?

A

hemophilia B

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40
Q

What is a characteristics of Ransons pancreatitis criteria?

A

LDH > 370

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41
Q

What is a diagnostic feature of celiac disease?

A

blunt mucosa

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42
Q

What does the TIPS procedure has a risk of causing?

A

hepatic encephalopathy

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43
Q

What do you watch a AAA with?

A

ultrasound

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44
Q

Which type of colitis bleed?

A

ulcerative

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45
Q

Patient with diverticulitis, then it sounds like it perforated later, what is the tx?

A

surgery right away

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46
Q

What hernia is in the inguinal ring?

A

inguinal hernia

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47
Q

Hyperparathyroidectomy causes what complication?

A

hypocalcemia

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48
Q

What is a symptom of hyperparathyroidism?

A

Vitamin D deficiency

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49
Q

How do you diagnose H plyori?

A

biopsy

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50
Q

What do you check in order to check a patient’s vitamin k?

A

PT

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51
Q

What is cholecystitis?

A

cystic duct inflammation

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52
Q

What does hemodialysis use?

A

AV fistula

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53
Q

What is the dx when there is a stone in the common bile duct?

A

choledocolithiasis

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54
Q

What procedure is a man most like to have?

A

whipple (87%)

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55
Q

Dry erosive nipple that is not healing with steroids, how do you dx?

A

biopsy - this is paget’s

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56
Q

What is the dx when you have a wound not healing with yellow drainage?

A

seroma

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57
Q

What dx test do you want to do when a patient presents with cool leg and low pulses?

A

ABI

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58
Q

What is the next step when a patient presents with cool leg an no pulses?

A

revascularization

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59
Q

What is the tx for a enlarged sigmoid volvulus?

A

sigmoidoscopy and decompression

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60
Q

What is a symptom of varicose vein?

A

lipodermatosclerosis

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61
Q

How do you treat H pylori?

A

treat with (CAP) – clarithromycin + amoxicillin +/- metronidazole + PPI (i.e. Omeprazole)

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62
Q

What is the dx when a patient has right facial droop and arm weakness?

A

left middle cerebral artery

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63
Q

What is a symptoms of subclavian steal syndrome?

A

blood pressure discrepancy

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64
Q

What are examples of transudative effusions?

A

congestive heart failure, pulmonary effusion, cirrhosis, ascites, nephrotic syndrome

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65
Q

What surgery is needed with ascending colon cancer?

A

right hemicolectomy

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66
Q

What should a holosystolic murmur make you think of?

A

mitral regurgitation

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67
Q

What vaccine is contraindicated after a kidney transplant?

A

nasal influenza

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68
Q

What is the treatment of MRSA cellulitis?

A

doxycycline or vancomycin

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69
Q

What is the dx when you have mass on in the hyoid bone?

A

thyroglossal

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70
Q

What is the cause of a women with RA that has PUD?

A

NSAIDs

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71
Q

Patient has temporal pain and high ESR, what is the dx?

A

giant cell arteritis

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72
Q

How would non cancerous in the esophagus look?

A

smooth and well defined

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73
Q

What is the sign for a DVT?

A

homans

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74
Q

What is a symptom of perforate PUD?

A

melena

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75
Q

What will a patient with mesenteric ischemia have in their past medical history?

A

Afib

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76
Q

What is the dx when a hernia is in the inner thigh?

A

femoral

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77
Q

What is the presentation of an anal fissure?

A

tearing rectal pain and bleeding which occurs with or shortly after defecation, bright red blood on toilet paper

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78
Q

What is the tx of an anal fissure?

A

sitz bath

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79
Q

What is the most common cause of an upper GI bleed?

A

peptic ulcer disease

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80
Q

What are the side effects of lidocaine?

A

central - seizure

cardiac - arrhythmia

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81
Q

What is the treatment of refractory heart failure?

A

combined vasodilator therapy

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82
Q

What do you bridge warfarin with?

A

heparin

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83
Q

What is found on PE with a obturator hernia?

A

lump in the medial thigh

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84
Q

What is the pathognomonic physical exam finding with acute mesenteric ischemia?

A

pain out of proportion

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85
Q

What is a symptom of chronic mesenteric ischemia?

A

fear of eating

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86
Q

What is multiple endocrine neoplasia, type II associated with?

A

medullary thyroid cancer

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87
Q

How do you workup a thyroid nodule?

A

ultrasound then FNA

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88
Q

When do you refer an AAA to a vascular surgeon?

A

> 5 mm in 6 months or exceeds 4 cm

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89
Q

What do you give post-carotid endarterectomy?

A

nifedipine

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90
Q

What is the treatment for a chronic fissure?

A

botulinum toxin and nifedipine cream

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91
Q

What is the treatment for claudication?

A

pentoxifylline and cliostazol

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92
Q

What would Crohn’s show on barium enema?

A

extension into the mucosa, submucosa and muscularis (cobble stoning)

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93
Q

What is the treatment for Chron’s that is refractory to steroids?

A

surgery

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94
Q

What are the signs and symptoms of autonomic dysreflexia?

A

sweating, flushing, and hypertension

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95
Q

Guy came in and you couldn’t feel one of his testes, what is the dx?

A

hydrocele

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96
Q

Why do you perform surgery on someone with chronic pancreatitis?

A

intractable pain

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97
Q

What kind of hernia is under the inguinal ligament?

A

femoral

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98
Q

Suspicion for rupture esophagus post endoscopy, what initial test will detect it?

A

chest x-ray

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99
Q

What is the treatment of hemorrhoids that do not hurt but bleed with defecation?

A

dietary modifications

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100
Q

Hemorrhoids below what hurt?

A

dentate line

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101
Q

What pre-op test do you want to check for someone with 10 years of DM and on dialysis?

A

electrolytes

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102
Q

Post-op patient is having EKG changes (inferior ST elevation and later ST depression, also is having a fever, what is the cause?

A

pericarditis

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103
Q

Tingling and pain down the left arm radiating to the left hand associated with the left side of the face swelling, what else will you see?

A

miosis

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104
Q

What are the symptoms of horner syndrome along with pancoast syndrome?

A

miosis, anhidrosis, ptosis, exophalthmos + brachial plexus affected symptoms that give the tingling

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105
Q

Guy is post-gastric bypass surgery, what is he most at risk for now?

A

B12 deficiency

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106
Q

Guy was over 50, had signs of anemia, and changes in stool, what do you suspect?

A

colorectal cancer

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107
Q

What is the dx when an inguinal hernia can not be reduced?

A

incarcerated

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108
Q

What are the characteristics of AAA?

A
  • 6 months check when between 2.5 - 5.0 cm
  • usually grows around .22 cm a year
  • 5 cm is when you refer it for surgery
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109
Q

When do you use milrinone (primacor)?

A

cardiogenic shock

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110
Q

What is the dx of IBD with rectal bleeding?

A

ulcerative colitis

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111
Q

Testicle pain that is relieved with elevation

A

epididymitis

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112
Q

Is a person with UC or Chron’s more likely to form a fistula?

A

crohns

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113
Q

Elective anorexia postprandial pain, what is the dx?

A

(chronic) mesenteric ischemia

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114
Q

Afib causes, what stroke?

A

cardiogenic

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115
Q

High CO2 and acidotic, what is the dx?

A

respiratory acidosis

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116
Q

Prolonged QT and post thyroidectomy, what is the dx?

A

hypocalcemia

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117
Q

What is hand flapping a sign of?

A

encephalitis

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118
Q

What is the tx of furuncle?

A

I and D

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119
Q

What is the citalozol used to treat?

A

claudication

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120
Q

What is the tx when you have pain at rest?

A

revascularization angiogram

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121
Q

How do you dx atelectasis?

A

chest x-ray

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122
Q

How do you confirm a lung nodule in a smoker?

A

open biopsy

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123
Q

What is not a risk factor for bladder cancer?

A

female

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124
Q

What can develop on post op day 5?

A

pulmonary embolism

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125
Q

What do you order when a patient has broncho excretions on post op day 2?

A

chest x-ray

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126
Q

Unilateral vision loss and headache, what is the dx?

A

central ocular artery occlusion

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127
Q

What is the tx of intussusception?

A

barium enema is dx and tx

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128
Q

How do you dx a Zenker’s?

A

barium swallow

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129
Q

What is a complication of a TIPS procedure?

A

hepatic encephalopathy

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130
Q

How do you dx a SBO?

A

air-fluid levels

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131
Q

What do you add is a PPI is not working?

A

H2 blocker

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132
Q

A patient presents with palpitations, hypertension, and sweating, what is the dx?

A

pheochromocytoma

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133
Q

What do you give to a patient preoperative for pheochromocytoma?

A

alpha blockers and beta blocks (in that order)

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134
Q

What is inferior to an inguinal hernia?

A

femoral

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135
Q

What is the tx for a pregnant woman with hemorrhoids?

A

laxatives

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136
Q

What levels do you check before a renal transplant?

A

CBC, electrolytes, LFTs

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137
Q

Diarrhea, flushing (carcinoid syndrome), how do you dx?

A

5 HIAA and metanephrines

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138
Q

Patient treated for PNA spikes, fever, and diarrhea, what is the tx?

A

metronidazole - they have c. diff

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139
Q

What is the tx for pancreatitis gallstones?

A

ERCP

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140
Q

What are the lab findings for a patient on warfarin?

A

elevated PT and INR

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141
Q

How do you dx Zollinger Ellison Syndrome?

A

increased gastrin level > 1000

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142
Q

What is the dx when the scrotum illuminates?

A

hydrocele

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143
Q

What is a risk factor for testicular cancer?

A

cryptorchism

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144
Q

How do you dx H pylor?

A

biopsy of esophagus and duodenum

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145
Q

What is the initial treatment for a bleeding esophageal varices?

A

hemolytic stability

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146
Q

ST elevation then anterior ST depression

A

MI

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147
Q

What is the best way to stage hepatocellular carcinoma?

A

Ultrasound then CT

148
Q

What are the signs and symptoms of toxic mega colon?

A

dilation > 6 cm + septic sx

149
Q

What vitamin helps with wound healing?

A

Vitamin A

150
Q

What do you give to a patient who has hives and their throat is closing?

A

epinephrine IV

151
Q

Pain on defecation, what is the dx?

A

anal fissure

152
Q

What is a lab finding of malnutrition?

A

serum prealbumin < 10 mg/dL

153
Q

What are the characteristics of a epidural hematoma?

A

Transient loss of consciousness from injury, then lucid period followed by increasing drowsiness, headache, and unilateral (contralateral) weakness.

154
Q

What are the signs and symptoms of hyperthyroidism (Thyrotoxicosis)?

A

Nervousness, weight loss with increased appetite, heat intolerance, increased sweating, muscular weakness and fatigue, increased bowel frequency, polyuria, menstrual irregularities, infertility

155
Q

What are the signs and symptoms of Graves disease?

A

non-tender and heat intolerance

156
Q

When do you treat chronic pancreatitis?

A

intractable pain

157
Q

How do you treat chronic pancreatitis?

A

pancreatic enzymes

158
Q

How do you evaluate head trauma?

A

CT without contrast

159
Q

Waxy pale burn from hot oil, what degree?

A

third degree

160
Q

What is the tx for tinea capitis?

A

oral griseofulvin

161
Q

60 yo woman w/ controlled HTN and DM comes in w/ recurrent DVTs. On Warfarin and HCTZ. She isn’t symptomatic however. INR was 2.5 (or 2.9). What should you do to treat her?

A

IVC filter

162
Q

Pt w/ claudication in butt, hips and impotence. Where is the arterial insufficiency most likely located?

A

Aortoiliac

163
Q

Pt s/p resection from gastric carcinoma. Now having paresthesias and decreased vibratory sense. What is the Dx?

A

Pernicious anemia- B12 deficiency

164
Q

Pt who got elective endoscopy after GERD dx. Wakes up w/ pain and Hypotension. What other PE sign would be seen?

A

SubQ emphysema

165
Q

Paraplegic pt who is beginning to get decubitus ulcer. What should you do?

A

Alleviate pressure points - turn patient every 2 hrs, you can get an ulcer within 30 mins.

166
Q

You see the apple core lesion on the barium. What do you dx this pt with and how do you treat?

A

Colon Cancer and Surgery

167
Q

Pt who is on mesalamine and keeps getting increasing sx of moderate Crohn’s. What would you start her on to help with her sxs?

A

Prednisone

168
Q

Pt on warfarin and the INR was 9. What should you tx them w/ if there’s no active bleeding?

A

PO Vit K

169
Q

Diet recommendation for someone on heparin?

A

Watch potassium

170
Q

Diet recommendation for someone on coumadin?

A

Avoid green leafy foods.

171
Q

What is the Trousseau’s sign. Also where is trousseau’s sign seen?

A

Hypocalemia
- Usually you get hypocalcemia after thyroid removal, because you can devascularized the parathyroid.

and seen in the hand

172
Q

Pt comes in w/ symptomatic hypercalcemia. What symptoms would you likely see?

A

Bone (get eroded), moans (constipation), stones, groans (fatigue).

173
Q

What medical history would indicate the need for parathyroidectomy?

A

Hip fracture from osteopenia

174
Q

Tx for testicular CA?

A

Orchiectomy

175
Q

Tx for thyrotoxicosis?

A

IV PTU

176
Q

Sxs of thyroid storm?

A

diarrhea, hypertension, weight loss, tachycardia, tremors

177
Q

Muscle protruding through mucosa in proximal esophagus, what would you dx?

A

Zenkers Diverticulum

178
Q

How would you treat Zenkers?

A

Diverticulectomy and Myotomy

179
Q

Lady had progressive left ear pain, then facial droop, inability to raise eyebrow.

A

Bells palsy

180
Q

Sign of UC?

A

Bloody diarrhea, continuous, no fistula.

181
Q

Treatment of UC?

A

Proctocolectomy

182
Q

Patient has paresthesias and muscle weakness/spasms after total thyroidectomy. Why?

A

Hypoparathyroidism –> hypocalcemia

183
Q

Patient has PUD that has not gone away with treatment over the year. Definitive Dx for diagnosis Zollinger Ellison?

A

Measure gastrin levels or secretin stimulation

184
Q

Gastrinoma can be located where?

A

pancreas or duodenum

185
Q

Woman with hematuria what would reduce her risk of bladder ca?

A

Smoking Cessation

186
Q

Consequence of feeding syndrome with anorexia?

A

Hypophosphatemia

187
Q

What cells do you see in asplenic pt?

A

Howell-jolly bodies

188
Q

What is the mechanism behind Addisons?

A

autoimmune adrenal insufficiency

189
Q

Test for Addison’s?

A

ACTH stimulation test

190
Q

Where is ACTH made?

A

Anterior pituitary, it stimulates adrenal gland to secrete cortisol, aldosterone, etc.

191
Q

Person gets N/V, fatigue after pituitary tumor removal. Test you should run?

A

24 hour urinary cortisol

192
Q

Woman w/ fluctuant, erythematous mass in axilla. Afebrile. First treatment for this?

A

I&D

193
Q

Pt w/ oliguria, increased BUN/Cr and low urine Na. Likely dx?

A

AKI - hypovolemia

194
Q

Pt with all the signs of a DVT. What would you likely see on PE?

A

Pain upon dorsiflexion of foot

Homan’s sign

195
Q

Pt was urinating 5.5L of fluid in 6 hrs. What was their metabolic state?

A

Hypokalemic alkalosis

196
Q

Pt had respiratory acidosis. What lab finding would you see?

A

pH - low < 7.35
PaCO2 - high >45
HCO3 - high >26

197
Q

Pt w/ PMH of PUD. Comes in w/ wt loss, projectile vomiting after she eats. Likely PE sign you would see

A

peritoneal signs - rebound tenderness

198
Q

Pt with ABI of 0.68 what is treatment?

A

Lifestyle modifications

199
Q

Pt post operative day 5, CXR shows lobar infiltrates what do you dx and how do you treat?

A

Pneumonia and Vanco, Zosyn

200
Q

SE of thyroidectomy?

A

Hypothyroidism

201
Q

Labs describing biliary disease with a positive autoimmune factor?

A

Primary biliary cirrhosis, sclerosing cholangitis (cause this is with UC)

202
Q

Moderate risk for colon cancer?

A

First degree relative

203
Q

What surgery to do for crohns?

A

Ileocolectomy

204
Q

Hydrocele presentation?

A
  • Owl or Pumpkin sign
  • Transilluminate
  • Swollen testicule
  • Painless
205
Q

Best test for staging of RCC?

A

CT scan

206
Q

Half life for heparin?

A

1.5 hrs

207
Q

which blood thinner is intrinsic and which is extrinsic?

A 
Heparin = intrinsic
Warfarin = extrinsic
208
Q

What level of PTT indicates heparin is a therapeutic level?

A

60-90

209
Q

What INR levels is normal in a patient on warfarin compared to a pt with prosthetic heart valves?

A

2-3 and 2.5-3.5

210
Q

What lab findings would you see in a pt with Von Willebrand?

A

PTT increases and PT is normal

211
Q

DIC increases PT and PTT, what usually causes this?

A

Pregnancy, trauma, malignancy

212
Q

Diagnostic test for description of perforated ulcer?

A

XR (look for airy in the diaphragm)

213
Q

Asks which of the following has relieving factor of sitting leaning forward

A

Pancreatitis and pericarditis

214
Q

Origin of anal fissure that is located below the dentate line?

A

Posterior midline

215
Q

What valvular abnormality will cause left atrial and ventricular hypertrophy?

A

Mitral Regurg, AFib, and S4

216
Q

What test to do for a stable patient with pulsatile abdominal mass?

A

Ultrasound

217
Q

Person had AAA fixed and 12L of fluids in but now has progressive oliguria and only 0.9 urine output, what do you want to do?

A

Give Norepi

218
Q

Severe HTN after carotid endarterectomy what do you want to give?

A

Nifedipine

219
Q

Afib and hypertension a picture of the CT of head what type of stroke?

A

Hemorrhagic

220
Q

Person had car accident, has hemorrhagic shock, what is causing their metabolic state?

A

lactic acidosis- d/t lack of perfusion and switch to anaerobic metabolism and make lactate

221
Q

Person in a car crash on warfarin now is hemorrhaging, what is the reversal agent?

A

FFP

222
Q

Person has right upper lobe small cell lung cancer that has spread to local lymph nodes, what is the primary treatment?

A

Chemotherapy

223
Q

Who would benefit most from renal artery angioplasty?

A

55 year old with HTN resistant to meds

224
Q

Waxy burn, sign of what degree burn?

A

3rd degree

225
Q

Ph was 7.48, CO2 44, HCO3 28, what metabolic state are they in?

A

Partially compensated metabolic alkalosis

226
Q

Ph 7.2 with high CO2 and low O2, what metabolic state are they in?

A

Resp acidosis

227
Q

Person had surgery 5 days ago, vital were stable (HR:96), EKG shows sinus tach with inferior ST elevations and lateral ST depressions?

A

Myocardial Infarction

228
Q

Person had a previous enlarged thyroid that was 1.6 then was aspirated and shrunk to 1.3 now its back at 2.9 what do you do?

A

Surgical exploration and resection

229
Q

Person has tachycardia, diaphoretic and tremor?

A

Subacute thyroiditis (painful thyroid mass)

230
Q

Person has hyperparathyroid and high ionized calcium what test do you want to order?

A

Parathyroid nuclear scan

231
Q

Why is it important to have good dental care?

A

Aspiration pneumonia

232
Q

Pt had surgery now has fever and increased respiratory sputum what test?

A

CXR to observe for pneumonia

233
Q

What will you see on chest xray of atelectasis?

A

Distal lobar collapses

234
Q

What will you see on chest xray of pneumonia?

A

Consolidation

235
Q

Fundal gastritis anemia indicates what?

A

Pernicious anemia

236
Q

Pregnant female with prolapsing hemorrhoids with straining not painful but has blood, what is the tx?

A

Metamucil

237
Q

Patient with internal and external hemorrhoids not painful had blood, what is the tx?

A

Rubber band ligation

238
Q

Crohn’s pathology?

A

Crypt inflammation and abscesses, which progress to tiny focal aphthoid ulcers.

These mucosal lesions may develop into deep longitudinal and transverse ulcers with intervening mucosal edema, creating a characteristic cobblestoned appearance to the bowel

239
Q

Air in the biliary tree indicates?

A

Gallstone ileus

240
Q

Girl is bleeding through her gums and has Increased aPTT and bleeding time, normal PT

A

Von willibrand

241
Q

Stones in the hepatopancreatic duct what should you do?

A

ERCP

242
Q

Person has ascites and palmar erythema what liver disease do they have?

A

Cirrhosis

243
Q

What vitamin is associated with bleeding?

A

Vitamin K

244
Q

Treatment for someone with von willebrand’s?

A

Desmopressin - cells express von willebrand’s factor and platelets stick to it

245
Q

Rectal abscess tx?

A

I&D

246
Q

Ileocecal stranding sign of what?

A

Crohns

247
Q

Person has intestinal inflammation for 5 years what is he at risk for?

A

Malignancy

248
Q

Treatment of an intra-abdominal abscess post appendectomy?

A

Drain then Rocephin + flagyl

249
Q

When to give abx for surgery?

A

Within 1 hr of incision

250
Q

Diverticulitis what procedure do you do?

A

Hartmanns (emergent procedure)

251
Q

Pt has flushing sweating dyspnea (carcinoid syndrome) what can you measure in their urine?

A

5-HIAA

252
Q

Most common area for a volvulus?

A

Sigmoid

253
Q

Scaly lesion on leg KOH + what do you give?

A

Topical antifungals

254
Q

Man comes in what a boggy testicle can’t palpate it, ultrasound shows non communicating with peritoneum, what do you want to do?

A

Hydrocelectomy

255
Q

Patient has an acute onset of headache, n/v, photophobia and neck pain?

A

Migraine

256
Q

Patient was hit by a bat had lucid interval, what do you suspect?

A

Epidural hematoma

257
Q

S/Sxs of diabetes insipidus?

A

mc neurogenic after brain surgery or trauma, lots of urination, sodium goes up in serum

258
Q

S/Sxs of SIADH?

A

paraneoplastic syndrome, to much adh, serum sodium goes down and low urine
output

259
Q

Tx for symptomatic hyperkalemia?

A

Calcium Glucagon (to stabilize cardiac myocytes)

260
Q

Treatment of Autonomic Dysreflexia?

A

CCB - nifedipine or nitrates

261
Q

What to order pre-operatively for a patient with Chronic Renal Disease?

A

Electrolytes

262
Q

Reaction to sulfa drugs (they describe the appearance of the rash)?

A

Erythema multiforme - target like apperance

263
Q

Preop testing reveals elevated BUN/CR and a decreased FENA <1%, likely due to?

A

Prerenal Azotemia

264
Q

Nec Fasciitis tx?

A

Surgical debridement

265
Q

Man has “cauliflower” looking protrusions from his rectum Tx?

A

Podophyllin (condylox)

266
Q

What is most worrisome if someone with constant upper abdominal pain?

A

Odynophagia

267
Q

How do you treat an anal fissure that is non-infected?

A

Sitz baths

268
Q

Numbness over the fourth and fifth fingers, what nerve?

A

Ulnar

269
Q

Baby with a burn, erythematous and blisters what degree?

A

2nd degree

270
Q

Pt with going for varicose vein surgery what do you see on skin?

A

Lipodermatosclerosis

271
Q

Spooning of the nails is a sign of what?

A

Iron Deficiency Anemia

272
Q

57 y/o post op day 1, with acute CP, SOB, sweating, EKG shows 3mm ST in V3 to 5, what else would you see?

A

Increase venous dilation

273
Q

Pt with skin wound, what vitamin do you give?

A

Vitamin E

274
Q

Management of fistula in crohn’s?

A

Seton placement and drainage, fistulotomy, fistulectomy

275
Q

S/Sx of addisons disease?

A

progressive anemia, low blood pressure, great weakness, and bronze discoloration of the skin.
- It is caused by inadequate secretion of hormones by the adrenal cortex.

276
Q

TIA symptoms, pt is safe to discharge who do you tell the pt to follow up with?

A

Neurology

277
Q

Adrenal insufficiency what vitamins are increased and decreased?

A

Increased K and decreased Na

278
Q

Muffled heart sounds, management

A

Pericardiocentesis

279
Q

15 min post central venous cath, develops acute dyspnea, decreased oxygen saturation, what likely occurred?

A

Pneumothorax

280
Q

Decreased FEV1, decreased FVC, increased TLC indicates?

A

COPD

281
Q

RUQ. jaundice, (+) murphys, mild leukocytosis, increased LFTs, indicates?

A

Choly

282
Q

Dilated paraumbilical veins and painful purple anal mass, indicates?

A

Cirrhosis

283
Q

HTN, hypokalemia, elevated serum cortisol/ACTH levels indicates?

A

Cushings

284
Q

Post prandial abd pain worse after 48 hours, periumbilical pain, N/V, mildly distended abd, hypoactive bowel sounds?

A

SBO or Mesenteric Ischemia

285
Q

Significant weight loss, severe epigastric abd pain and back pain with jaundice would make you think what?

A

Pancreatic cancer

286
Q

Adrenal mass, labs hypokalemia, HTN, confirm dx with what labs?

A

Serum cortisol and ACTH

287
Q

LLQ pain, diverticulitis, tender of DRE, what diagnostic test do you do next?

A

CT scan

288
Q

What medication is given following a carotid endarterectomy?

A

CCB

289
Q

72 w/ EoTH abuse with nystagmus and ataxia and AMS what vitamin is responsible for this?

A

Vitamin B1 (Thiamine)

290
Q

No taste anterior tongue, face droop, can’t wrinkled head, what is the dx?

A

Bells

291
Q

A2 + P2 separation 2nd beat sound w/ inspiration is likely due to?

A

ASD

292
Q

Explain atelectasis physiology

A

Inadequate alveolar expansion (e.g., poor ventilation of lungs during surgery, inability to fully inspire secondary to pain), high levels of inspired oxygen

293
Q

Male w/ DM pre-op and want to eval bleeding time, what lab test should be ordered?

A

LFTs/ Cr serum / TSH

294
Q

Jaundice + weight loss + boring pain to back + GB palpable would make you think?

A

Pancreatic tumor

295
Q

What type of cells are seen in Hodgkin’s Lymphoma?

A

Reed Sternberg cells

296
Q

What is the factor for Von Willebrand’s disease?

A

8

297
Q

How do you first diagnose a thyroid nodule?

A

ultrasound

298
Q

How do you treat biliary colic?

A

refer to surgery

299
Q

What do you tell a person that had H. pylori that went away?

A

tell them that they are fine

300
Q

What is heard with an atrial septal defect?

A

split S1 and S2

301
Q

What is it called when epididymitis is relieve with elevation?

A

Prehn’s sign

302
Q

What is Cullen’s sign a sign of?

A

acute pancreattis

303
Q

What electrolyte abnormality can occur with Cullen’s sign?

A

hypophosphatemia

304
Q

What is the tx for Crohn’s when the treatment is refractory?

A

surgery

305
Q

Peaked T waves on EKG are a sign of what?

A

hyperkalemia

306
Q

What is a risk factor for bladder cancer?

A

smoking

307
Q

Periumbilical pain radiating to RLQ, alk phos and billi high, what test do you do?

A

CT

308
Q

Complication of refeeding in anorexia?

A

hypokalemia

309
Q

The picture of stroke, person with afib and HTN, what kind of stroke?

A

ischemic

310
Q

Can’t move half the face or scrunch foredhead?

A

Bell’s palsy

311
Q

Someone with H pylori, what do you tell them to stop?

A

smoking

312
Q

Stocking glove paresthesia, what vitamin deficiency to do they have?

A

thiamine - B12 was not an option

313
Q

Anal fistula is associated with what disease?

A

Crohns

314
Q

Patient lives in Costa Rico, what is the organism affecting the patient?

A

mycoplasma tuberculae

315
Q

How do you diagnose mycoplasma tuberculae

A

sputum culture

316
Q

Patient is on warfarin and their INR is 9, what do you want to give?

A

FFP

317
Q

Teenager comes in with head injury and had a lucid interval, what is the dx?

A

epidural hematoma

318
Q

What scan do you want to do for a brain bleed?

A

CT non contrast

319
Q

Patient comes in with a family history of AAA, what do you want to do for surveillance?

A

US

320
Q

How do you assess nutrition in a pre op patient?

A

albumin

321
Q

Patient had flank and umbilical hematoma, what is the dx?

A

pancreatitis

322
Q

Patient had pruritic raised lesions after taking a medication, what is the dx?

A

allergic reaction to medication

323
Q

A healthy man comes in for pre op testing and states he runs 2 miles and swims, what is the appropriate pre op test for him?

A

observe

324
Q

How do you treat a non infected anal fistula?

A

surgery

325
Q

What do you treat an anal abscess?

A

I and D

326
Q

Enlarged painless mass in the scrotum, what is the dx?

A

testicular cancer

327
Q

What is CEA a marker for?

A

colon cancer

328
Q

What is the cause of Addison’s?

A

autoimmune

329
Q

Patient had surgery and now presents with hypothyroid, what do you do?

A

give levothyroxine

330
Q

What induces remission in chron’s?

A

prednisone

331
Q

Patient with crohn’s is not improving what do you do?

A

corticosteroids

332
Q

What is the definitive treatment for a sigmoid volvulus?

A

surgery

333
Q

Cellulitis, how do you treat?

A

IV vanco

334
Q

What are the findings with cholecystitis?

A

pain with US probe when you go over the RUQ

335
Q

What is the treatment for internal and external hemorrhoids at the same time?

A

band ligation

336
Q

Describe a grade 3 decubitus ulcer

A

full skin thickness but not through fascia

337
Q

Wound healing that is open, involves granulation and epithelial tissue, what stage of healing?

A

secondary intention

338
Q

Everything is increased (PT and PTT), what is the dx?

A

Von Willebrand’s

339
Q

Patient with peripheral vascular disease will present with what?

A

hemosiderin spots

340
Q

What is therapeutic and diagnostic for an upper GI bleed?

A

endoscopy

341
Q

What hernia also presents with GERD?

A

hiatal hernia

342
Q

Post op day #2-3 with fever, what is the dx?

A

pneumonia

343
Q

What do you give before surgery?

A

beta blocker

344
Q

What do you not give before surgery?

A

metformin

345
Q

Patient is contraindicated for colonoscopy ad has to check for cancer, what do you do?

A

double contract barium swallow (apple core lesions)

346
Q

What are the sx and how do you dx pyloric stenosis?

A 
sx = non bilious projectile vomiting 
dx = ultrasound
347
Q

Man is newly diagnosed with UC, when should he get his first colonscopy?

A

8 year post diagnosis

348
Q

When should a healthy person get their 1st colonoscopy?

A

50 years old

349
Q

Smoker has 1 cm mass in lung on CXR, what is the next step?

A

CT

350
Q

Tall thin man with scapular pain and different BPs in each arm, what is this?

A

aortic dissection

351
Q

Guy with PAD has bilateral calf pain and ABI with 0.8 (normal around 1.0), what is the next stp?

A

monitored exercise

352
Q

Patient has epigastric postprandial pain 2-3 hours, what is the dx?

A

chronic mesenteric ischemia

-use a CTA to diagnose

353
Q

Drug to give after carotid endarterectomy?

A

CCB

354
Q

What vaccine do you to give post splenectomy?

A

pneumococcal

355
Q

Post op day 5 with fever, cough, tachycardia, rales on auscultation, what is the dx?

A

pneumonia

356
Q

Post gastrectomy patient has tachycardia, diaphoresis, anxiety, diarrhea after eating sugary foods, what is the dx?

A

early dumping syndrome

357
Q

Chronic alcoholic patient has new onset epigastric pain, palpable mass, normal vitals, what is the dx?

A

pancreatic psudocyst

358
Q

Patient with exercise induced asthma what is recommended?

A

post op incentive spirometer

359
Q

Old man presenting with constipation, obstipation, what is the initial study?

A

colonoscopy or barium enema

360
Q

Patient has halitosis, regurgitation of food, what is the dx test?

A

barium swallow

361
Q

Pt had portocaval shunting and now has neuro sx, what happened?

A

hepatic encephalopathy

362
Q

Person with fistulas and aphthous ulcers, what is the dx?

A

Crohn’s

363
Q

Dude with history of hemorrhagic stroke and now has a PE, how do you treat?

A

IVC filter

364
Q

Woman with thickened skin, dimpling of hair follicles, skin changes, what is the dx?

A

inflammatory carcinoma

365
Q

30 year woman with urinary retention, increase frequency and urgency, noted detrusor muscle dysfunction, what is the dx?

A

MS

April EOR Exams (3 decks)

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