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Surgery > Surgery clinical test prep > Flashcards

Surgery clinical test prep Flashcards

1
Q

Graves disease

A

ht

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2
Q

radioiodide scan show diffuse uptake

A

ht

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3
Q

Hashimotos thyroiditis

A

ht

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4
Q

sx’s= nervousness, insomnia, irritability, wt loss, diaphoresis, palpitations

A

ht

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5
Q

test of choice for hyperthyroidism

A

serum TSH

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6
Q

should T3 or T4 be evaluated?

A

T4. this is in excess

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7
Q

Methimazole

Propylthiouracil= MOA and A.A

A

ht tx

PTU= inhibits conversion of T3 and T4. A.A agranulocytosis=decrease in WBC’s

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8
Q

Ddx hyperthyroidism

A

heart disease, anemia, cirrhosis.

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9
Q

psammoma bodies

A

pa. most common thyroid cancer.

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10
Q

thyroid function test usually normal

A

pa

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11
Q

cold nodules found on thyroid scan

A

pa

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12
Q

thyroidectomy as tx

A

pa

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13
Q

rubbery, encapsulated goiter

A

fa

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14
Q

thyroid function tests are usually normal.

cold nodules found

A

fa

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15
Q

anaplastic epithelial chords with follicles

A

fa

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16
Q

sectreted by the chief cells

A

pth

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17
Q

what does parathyroid hormone do?

what does calcitonin do?

A

pth increases Ca blood conc

calcitonin= decdreases Ca blood conc

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18
Q

causes rickets, osyeomalacia, hypocalcemia so numbness/tingling in toes + fingers, tetany, muscle cramps

A

hypo pth

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19
Q

chvosteks sign (what is how do you get it)

A

tapping on facial nerve causes contraction of facial muscles

severe=IV Ca gluconate

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20
Q

trousseaus sign (what is it how do you get it)

A

inflating b/p cuff to a pressure higher then the pts systolic b/p for 3 minutes and you get carpel spasms. severe=IV Ca gluconate

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21
Q

prolonged QT interval

A

hypo pth

severe=IV Ca gluconate

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22
Q 
low serum Ca
High serum phosphate
low urine cAMP
calcifications on x-ray of basal ganglia
whats your dx
A

hypo pth

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23
Q

how do yo tx hypoparathyroidism?

A

mild to moderate= oral Ca+
severe=IV Ca gluconate
vit D=calcitriol

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24
Q

what should Ca levels be

A

8.4 to 10

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25
Q

MCC of hypercalcemia?

A

hyper pth

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26
Q

Adenoma is cause for 80% of cases

A

hyper pth

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27
Q

sx’s=nephrolithiasis
osteitis fibrosa cystica= brown tumors
gout
pancreatitis

A

hyper pth

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28
Q

how do you dx?

What do you see on x-ray

A

hypercalcemia with normal PTH level is abnormal due to calcium is suppressing the pth.
hypophosphatemia
hypercalciuria
urine cAMP is elevated.

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29
Q

What do you see on x-ray with hyperparathyroidism?

A

sub-periosteal bone reabsorption on 2nd and 3rd phalanges

osteopenia

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30
Q

hyperparathyroidism tx?

A

surgery or furosimde to excrete the Ca+ in the urine (not thiazide diuretics)

31
Q

cushings syn

whats it from, whats it look like?

A

due to excess levels og glucocorticoids (cortisol)

central obesity, moon face, hirsutism, buffalo hump, purple striae on abdomen, DM, infertility

32
Q

MCC of cushings syn?

whats the 2nd MCC?(cushings disease)

A

iatrogenic=prednisone

ACTH-secreting adenoma of the pituitary

33
Q

TOC to dx cushings?

and one other test?

A

overnight low dose dexamethasone test, measure the serum cortisol in the morning.
if less then 5=cushingds excluded
if more then 5= cushings
ACTH level.

34
Q

test for cushings dz

A

CRH test=if CRH causes ACTH levels to increase=cushings dz

35
Q

cushing syn tx?

A

tapper glucocorticoid

or surgery.

36
Q

When palpating the breast tissue and a smooth, rubbery mass is located?

A

fibroadenoma. get a mammogram

37
Q

A firm tender, irregular mass is usually a?

A

carcinoma

38
Q

Other breast cancer finding on PE?

A

nipple erosion, erythema, eczema like rash, nipple retraction, skin dimpling, differences in breast contour

39
Q

sx’s of (Mammary dysplasia) fibrocyctic dz?

A

painful, tender mass, fuctuates in size relative to menstrual cycle, usually bilat

40
Q

Ddx of breast mass?

A

cyst=non tender
fibroadenoma=benign tumor
breast abscess=erythem, tender, usually staph from nursing.

41
Q

mesothelioma sx’s
dx test?
tx?

A

DOE, cough, FEVER, wt loss dyshagia.
labs=CXR shows pleural thickening, effusion,
Get tissue sample (chemo does not help)
surgery

42
Q

Which lung cancer has lowest association with smoking?

which has the highest?

A

adenocarcioma

small cell

43
Q 
What do you see on CXR with:
small cell CA?
Large cell CA?
Adenocarcinoma?
squamous cell?
A

also called “Oat cell” looks like lymphocyte, centrally located,highly malignant to the brain and cause increase in SAIDH, ACTH”cushings”

  • LC=large spindle or oval cells, peripherally located, highly anaplastic
  • Adeno=Maybe Acinar or papillary, most common type found in nonsmokers + women, originale in alveoli tissue
  • squamous cell= found via sputum culture, associated with hypercalcemia
44
Q

What other S &S (depending on tumor location)?

A

small cell=Sperior vena cava syn; obstruction of SVC by mediastinal tumor
Horners syn= large cell, adeno
Pancoast tumor=squamous cell;upper extremity weakness, pain in arms

45
Q

pulmonary tumor work up, and tx

A

everyone gets a CXR, CT scan, tissue biopsy
small cell tx=chemo and radiation
all others=surgery

46
Q

what do Q-waves indicate

A

prior MI (when diagnosing CAD)

47
Q

what indicates a positive stress test

-what do you do if i is positive

A 
chest pain
ST segment depression
hypotension
arrhythmia
-cardiac catheterization
48
Q

tell me the ABCDE’s of heart health

A 
aspirin + antianginal tx
blood pressure + beta-blockers
cholesterol + cigarettes
diet + diabetes
exercise + education
49
Q

variant prinzmetal’s angina is evidenced by?

A

vasospasm’s with pain at rest
hallmark=ST segment ELEVATION
coronary angiography is defintive test

50
Q

3 sx’s for MI

A

substernal chest pain
diaphoresis
pain lasting longer then 30 minutes.

51
Q

EKG changes during MI

A

peaked T-waves
ST-segment elevation=acute infarct
Q-waves=necrosis
ST-segment depression

52
Q

low-pitched diastolic rumble

A

ms

53
Q

S2 is followed by an opening snap

A

ms

54
Q

mitral stenosis sx’s

A 
DOE
orthopnea
PND
palpitations, chest pain
hemoptysis
55
Q

whats the most important test to dx mitral stenosis and waht do you see on that test?
and how do you tx

A

echocardiogram= Left atrial enlargement
calcified mitral valve
tx=diuretics, infective endocarditis prophylaxis, warfarin

56
Q

harsh crescendo-decrescendo systolic murmur, radiates to carotid arteries

A

as

57
Q

S4 heart sound with precorial thrill

A

as

58
Q

definitve aortic stenosis test?
andthe other ones
tx?

A 
cardiac catheterization
CXR=calcified aortic valve
ECG=LVH
echocardiogram
tx=surgery
59
Q

Diastolic decrescendo murmur

with wide pulse pressure

A

ar

60
Q

austi flint murmur

A

ar

61
Q

displaced PMI and S3 present

A

ar

62
Q

tx arotic regurge?

A

if asymptomatic? salt restriction, diuretics, vasodialators, digoxin
surggery in medical emergency

63
Q

Post MI valvular defect?

A

acute ar

64
Q

holosystolic murmur at the apex

A

mr

65
Q

a fib is common finding with this valvular defect

A

mr

66
Q

S3, gallop, displaced PMI

A

reduce afterload, salt reduce, diurestics, digoxin

anti coagulate with warfin for a-fib

67
Q

blowing holosystolic murmur, with pulsatile liver

A

tr

68
Q

intensified with inspiration, reduced during valsalva maneuver

A

tr

69
Q

test of choice for tricuspid regurge

tx?

A

echocardiogram

tx=treat left sided heart failure, surgery

70
Q

midsystolic or late systolic click

A

mvp

71
Q

mid to late systolic murmur

A

mvp

72
Q

vasalva maneuver increases the murmur

A

mvp

73
Q

incomplete relaxation of the LES
aperistalsis of esophagus
dysphagia

A

achalasia

Surgery (7 decks)

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