uworld 4 Flashcards
people who have gone transabominal blunt trauma who are hemodynamically stable with negative FAST exam but high risk features (anemia, guarding) should undergo what?
CT
what is this: fever, phayrngeal pain, earache, pooling of saliva, deviation of uvula
peritonsillar abscess
how can syringomyelia develop?
years after spinal cord injury (whiplash) –> CSF retention –> enlargement of central canal
what is this: soft scrotal mass that increases with valsalva and decreases in supine?
varicocele
bad outcome of varicocele
subfertility, testicular atrophy
treatment of varicocele
boys, young men: gonadal vein ligation
older, post-baby making: scrotal support, NSAIDs
varicocele happens more on left or right and why?
left
because the left spermatic vein drains into the left renal vein which can become compressed where it passes between the SMA and the aorta
hydroceles are peritoneal fluid where?
between layers of parietal and visceral layers of tunica vaginalis
how does hyperventilating help decrease ICP?
CO2 washout–> cerebral vasoconstriction
is RA pressure (preload) elevated or decreased in hypovolemic, septic, and cardiogenic shock
hypovolemic: decreased
septic: normal or decreased
cardio: increased
is pulmonary capillary wedge pressure elevated or decreased in hypovolemic, septic, and cardiogenic shock
hypovolemic: decreased
septic: normal or decreased
cardio: increased
is SVR elevated or decreased in hypovolemic, septic, and cardiogenic shock
hypovolemic: increased
septic: decreased
cardio: increased
unilateral leg edema that worsens with activity is most likely…
venous valve incompetency
stress fracture risk factors
repetitive activities
low Ca and vitamin D
female athlete triad: low bone density, amenorrhea, low calories
stress fracture vs shin splints (medial tibial stress syndrome)
stress fracture: athletes; point tenderness
shin splints: overweight people; diffuse tenderness
management of small vs. large primary spontaneous pneumothorax
small (<2 cm): observe, oxygen
large (>2cm): needle aspiration, chest tube
myocardial contusion presentation
tachycardia
new bundle branch blocks
arrhythmias
diaphragm rupture presentation
abdominal pain
pain referred to shoulder
SOB
vomiting
bronchial rupture presentation
pneumothorax that doesn’t improve with chest tube
pneumomediastinum
subcutaneous emphysema
most common complication supracondylar fracture of humerus
entrapment of brachial artery and median nerve
which nerve damaged with proximal humerus fracture?
axillary nerve
which nerve damaged with anterior shoulder dislocation?
axillary nerve
diagnosis of ischemic colitis
CT: bowel wall thickening, fat stranding
c-scope: cyanotic, friable mucosa, hemorrhagic ulcerations
manage ischemic colitis
bowel rest, IVF
antibiotics- enteric coverage
if necrosis–> resect
differential for anterior mediastinal mass
thymoma
teratoma
thyroid neoplasm
terrible lymphoma
4 T’s
acute mediastinitis presentation
post-op cardiac surgery –> wound contamination
fever, tachy, WBCs, chest pain, wound drainage
diagnosis and treatment of acute mediastinitis
dx: clinical
tx: drainage and abx
patients with septic shock should be given what type of fluid
crystalloid 0.9% saline
is ejection fraction increased or decreased in hypovolemic shock?
increased
what type of bladder injury would cause peritoneal signs?
rupture of bladder dome
two most common artery aneurysms
- popliteal
2. femoral
all patients with clavicle injuries should undergo what?
neurovascular exam- check out brachial plexus and subclavian artery
most common organ injuries due to blunt abdominal trauma
spleen
liver
acalculous cholecystitis presentation
in critically ill patients (multiple organ failure, trauma, sepsis etc)
similar to cholecystitis symptoms
imaging of acalculous cholecystitis
gall bladder wall thickening and distention
pericholecystic fluid
treatment of acalculous cholecystitis
abx
percutaneous cholecystectomy, under radiology guidance
