Test 19 - Surgery Flashcards
Name 3 encapsulated organisms
Strep pneumoniae Nisseria meningitidis H. influenza
38 year old woman comes into the clinic with a rubbery, moveable breast mass she found on self examination. What do you do?
Diagnostic mammogram and ultrasound if over 30 Just ultrasound if under 30 If fluid filled - drain If suspicious for malignancy - core biopsy
34 year old male comes to ER complaining of episodes of coughing up blood and shortness of breath. While waiting to be seen he has a coughing episode where he coughs up 600 mL of blood. What do you do?
- First, secure airway, breathing and circulation 2. If still bleeding, go in with bronch, find bleed and stop it (electrocaudery, balloon tamponade, etc) 3. If bleeding stops after intubation, order labs (CXR, CBC, coagulation studies, renal function test, UA)
Patient comes in with a penis that is swollen, deviated to the right and he is in severe pain. 1. What is wrong? 2. What is treatment?
- Broken penis from sex with GOT. Patient feels a snapping sensation from tunica albuginae tearing, which causes a hematoma.
65 year old male has hip pain. Vitals normal. Labs as follows:
Alk phos: high
GGT: normal
Ca: normal
25OHD3: normal
Bone scan: increased uptake in several spots.
What is this patient at the highest risk of develping? Why?
Hearing loss. This patient has Paget’s Disease of the Bone aka osteotitis deformans. Hearing loss is seen in as many as 37% of Paget’s patients.
Symtoms of Paget’s diseases
disordered bone remodeling
woven bone larer than regualr bone prone to bowing or fracture of long bones
hip or knee pain
frontal bossing, headaches, cranial nerve palsies
HEARING LOSS - enlargement of the temporal bone, impingment of the cochlear nerve
Labs in Pagets
High alk phos
Normal Ca
Normal Phos
Mechanism of Pagets
disorderd bone remodeling caused by accelerated osteoclast activity, increasing bone resorption, causeing a reactionary increase in osteoblast activity. Result is structurally unsound, larger than normal bones with a “woven” lamelar pattern.
What group of people are at increased risk for subarrachnoid hemorrahage? (3)
Marfans, Elhers-Danlos, and moyamoya disease
What group of people are at increased risk for carpel tunnel syndrome? (4)
- People who use their wrists a lot
- Acromegaly
- Amyloidosis
- Hypothyroidism
What group of people are at increased risk for renal cell carcinoma?
Von–Hippel-Lindau syndrome
What group of people are at an increased risk for pulmonary hemorrhage?
Goodpasture’s Syndrome
Signs of a femoral artery aneurysm?
Pain in right anterior thigh that is worse with walking
Palpable pulsatile groin mass
Two most common locations of peripheral artery aneurysms?
Popliteal and femoral
What is ipratropium?
Anticholinergic used to dilate the airways in asthma and COPD
