Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

step 2 ck > TRAUMA/SURG/er > Flashcards

TRAUMA/SURG/er Flashcards

1
Q

Blunt abdominal trauma and tachycardia + shoulder pain + history of mononucleosis

most likely abdominal injury?

A

splenic laceration

shoulder pain is due to phrenic nerve irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

cyanide has what odor?

A

almond odor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

for surgery being a male over ____yo is considered a risk factor

A

45

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

if a male if <35 and has no hx of cardiac dz, what is the only presurg test needed

A

ekg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

cullen sign?

A

bruising around the umbilicus

hemorrhagic pancreatitis or ruptured AAA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

grey turner sign?

A

flank bruising

retroperitoneal hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

best test to look for air under diaphragm?

A

upright cxr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

electrical alternans on ekg?

A

pericardial tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

blackout on cxr (loss of vascular markings)

A

pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

severe abdominal pain but no rebound tenderness or guarding??

A

acute mesenteric ischemia

get angiography!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

where are the two places bowel ischemia typically occurs?

A

watershed areas = hepatic and splenic flexures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

number one risk factor for mesenteric ischemia (acute occlusion of mesenteric arteries)

A

atrial fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

hamman sign

A

crunching due to subcutaneous emphysema from esophageal perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how to dx esophageal perforation (mallory weiss or boerhoeves)

A

gastrograffin esophogram

dont use barium because it is caustic to the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

do not do what two tests in acute divertiulitis?

A

colonoscopy and barium enema (increased risk of perforation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 signs of appendicitis

A

rovsing
psoas (hip extension)
obturator (int rotation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

most accurate test for cholecystitis

A 
HIDA scan
(but we do U/S to dx typicallY)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

small bowel obstruction

usually hypo or hyperactive bowel sounds?

A

hyperactive!

high pitched tinkling sound indicates high pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q 
mechanism, sx, dx, and tx for the following:
1 anterior shoulder dislocation
2 posterior shoulder dislocation
3 clavicular fx
4 scaphoid fx
A

1 - strain on the glenohumoral joint, arm held to side externally rotated, xray then MRI (must rule out axillary artery and nerve injury), shoulder relocation and immobilization

2 - seizure or electrical burn, arm is medially rotated at side, xray then mri, traction and surgery is pulses or senses are diminished

3 - trauma, pain over location, xray is best test (must rule out subclavian artery/brachial plexus injury), simple arm sling

4 - FOOSH, pain at anatomical snuffbox, xray wont show for 3 weeks so clinical suspicion!, thumb spica cast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

tx for trigger finger?

A

steroid injection

if steroids fail, surgery to cut the sheath of the tendon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

fracture of long bones can often lead to what complication?

A

fat embolism ( confusion + petechial rash and dyspnea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

walking pain that worsens with walking but improves when he sits down or leans forward

A

spinal stenosis! (pseudoclaudication)

get an MRI –> tx with NSAIDs or surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

best tx for torn ACL

A

arthroscopic repair followed by rehab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q 
mechanism, sx, dx, and tx for the following:
1 MCL and LCL injury
2 ACL injury
3 PCL injury
4 meniscal injury
A

1 - trauma to the opposite side, pain, MRI, surgical repair
2 - direct trauma to knee, pain and +anterior drawer, MRI, arthroscopic repair
3 - direct trauma to knee, pain and + posterior drawer, MRI, arthroscopic repair
4 - knee injury, popping sound on flexion or extension, , MRI, arthroscopic repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

unhappy triad of sports trauma

A

ACL
MCL
and either Lateral or medial meniscus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

management of AAA

A

3-4 cm US every 2-3 years
4-5.4 cm US or CT every 6-12 months
>5.5 cm, asx = surgery

surgery is indicated at 5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

aortic dissection

A

false lumen in the intima of the aorta

sudden onset tearing chest pain radiating to back + asymmetric arm blood pressures

dx is done with TEE if unstable (fastest) or MRA (best) if patient is stable

tx ascending with surgery and BP control
tx for descending is BP control (BB)

28
Q 
post op fevers
POD 1-2
POD 3-5
POD 5-7
POD 7
POD 8-15
A 
1-2 wind (atelectasis or pna)
3-5 water (uti)
5-7 walking (dvt/pe)
7 wound (wound ifx or cellulitis)
8-15 weird (drug fever or deep abscess)
29
Q

mc finding for PE on ekg

A

nonspecfic ST changes

s1-q3-t3 is NOT the most common change seen

30
Q

tx for PE

A

heparin to coumadin bridge

if PE while on coumadin therapy, place an IVC

31
Q

old woman s/p total hip replacement 3 days ago now has 30 min of SOB and chest pain…..what do you do?

A

order EKG and spiral ct scan

if patient had an allergy to contrast, get a VQ scan instead of spiral ct

32
Q

noncon ct for…

contrast ct for…

A

noncon for trauma and bleeding

contrast for infection and cancer/mass lesions

33
Q

can youuse metforman with contrast study?

A

no, stop med proior to scan

34
Q

Charcoal is good for

A

Any ingestion

Can’t hurt and Is better than lavage

35
Q

What is the treatment for acetaminophen overdose that was more than 24 hours ago

A

No therapy needed

36
Q

What is next step if clearly toxic amount of acetaminophen was ingested(more than 8-10 g)?

A

N -acetylcysteine

37
Q

What symptoms do you see with aspirin overdose and what is the treatment

A

Tinnitus and hyperventilation leading to respiratory alkalosis and metabolic acidosis from lactate

Treatment is alkalinizing the urine which increases the rate of aspirin excretion

38
Q

Treatment of TCA overdose

A

Sodium bicarbonate is cardioprotective but does not increase TCA excretion

39
Q

What Will blood gas show for carbon monoxide poisoning?

A

Normal pO2 because oxygen does not detach from hgb

Lactic aciddosis develops

40
Q

What is the best diagnostic test for carbon monoxide poisoning

A

Routine oximetry will be falsely normal so the best and accurate test is carboxyhemoglobin level

41
Q

How do you differentiate carbon monoxide and methemoglobinenia on exam

A

Blood is red with carbon monoxide and brown with methemoglobinemia

42
Q

Treatment for methemoglobinemia

A

Methylene blue

43
Q

Treatment for carbon monoxide poisoning

A

Hyperbaric oxygen for severe disease or just 100% oxygen

44
Q

Cyanosis plus normal PO2 =

A

Methemoglobinemia

45
Q

Treatment for organophosphate poisoning or or nerve gas

A

Atropine

46
Q

What EKG abnormality will digoxin overdose show

A

Downsloping st segments
And
Hyperkalemia

47
Q

Treatment for digoxin overdose

A

Digoxin specific antibodies

48
Q

Treatment for lead poisoning

A

Chelating agent’s to remove the blood from the body like succimer or EDTA or dimercaprol

49
Q

Everyone with Mobitz two 2nd° AV block which is dropped Beats without progressive lengthening of PR interval
Gets what…

A

They get a pacemaker even if they are asymptomatic

50
Q

Next step if a patient is bradycardic and asymptomatic

A

Get an EKG… No atropine is needed if it is just an asymptomatic sinus bradycardia

51
Q

Treatment for Wolf Parkinson White syndrome

A

If acutely in an arrhythmia give procainamide or amiodarone

Curative therapy is radiofrequency ablation

52
Q

When is adenosine used?

A

For supraventricular tachycardia

53
Q

Treatment for atrial fibrillation and flutter

A

Control the rate with beta blocker or calcium channel blocker(dilt or verapamil) or digoxin

Then once rate is controlled give warfarin or ruvaroxaban to anticoagulate

54
Q

Hemodynamically unstable atrial arrhythmias are managed with…

A

Synchronized cardioversion

55
Q

Differences between methanol and Ethylene glycol poisoning

A

Both are treated with fomepizole and dialysis

Methanol presence with Eye toxicity and retinal inflammation and as the lingo I call presents with renal toxicity and envelope shaped crystals made of oxalate

56
Q

Treatment of dog cat and human bites

A

Give amoxicillin clavulanate

And tetanus vaccination booster if more than five years the last one

57
Q

When do you give rabies vaccine after bite?

A

Only if the animal has altered mental status or bizarre behavior or the attack was unprovoked by a stray dog that cannot be observed

58
Q

First step for head trauma resulting in loss of consciousness

A

Head CT without contrast to detect blood

59
Q

Treatment of subdural an epidural hematoma

A

Small ones are left alone… Large ones are treated with intubation and hyperventilation plus mannitol plus drainage

60
Q

Crescent versus biconvex/lens hematoma

A

Crescent is a sub dural and lens is an epidural

61
Q

After a successful surgery for epidural hematoma what will most likely benefit the patient

A

Ppi is given to prevent stress ulcers… Head trauma is a clear indication for stress ulcer prophylaxis

62
Q

Fluid replacement formula

A

Four x percent body surface area burned x weight in kilograms

Half is given in the first eight hours and then the other half is split up in the next 16 hours

63
Q

What is the most common cause of death several days to weeks after a burn

A

Infection due to loss of skin

64
Q

Tx for asystole

A

Epinephrine

65
Q

If defibrillation is not working for ventricular fibrillation after two attempts what is the next step

A

Give epinephrine plus shock and then try amiodarone

step 2 ck (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions