UWORLD Flashcards
nasal congestion, epistaxis, headache, cranial nerve palsies, serous otitis media, spread to cervical lymph nodes and non tender neck mass…dx and association with what?
nasopharyngeal carcinoma associated with EBV reactivation
superficial unilateral hip pain in adult exacerbated by external pressure to upper lateral thigh
trochanteric busitis
common complication of scaphoid fracture
osteonecrosis/avascular necrosis because blood supply enters at distal pole and flows proximally
nonunion of fracture also
may not initially show up on xray so stabilize with thumb spica and
repetitive arm movements causing subacute pain on abduction associated with impingement syndrome
rotator cuff tendonopathy
anterior knee pain, tenderness, erythema, localized swelling common in occupations of repetitive kneeling…dx and common assocation
prepatellar bursitis
staph aureus
acute knee pain with “catching” or reduced range of motion…dx and treatment
meniscal tear…dx with MRI and surgery advised in younger patients with persistent pain
stress fracture due to repeptitive activity on 2,3,4 metatarsals vs 5th
middle ones rest and analgesics
5th = increased risk of nonunion and more aggressive treatment
respiratory distress, neurologic signs (confusion/visual field defects), petechial rash usually after fracture, pancreatitis, or orthopedic surgery
fat embolism syndrome
full thickness burn with circumferential eschar formation…what to watch out for
acute compartment syndrome
soft irregular mass in the testis that increases in size with standing and valsalva,
varicocele (more common on left side due to compression of left renal vein by SMA leading to retrograde stasis and valve impcompetence and dilation into spermatic vein
tests for medial collateral ligament tear and medial meniscus tear
MCL - laxity in valgus stress testing, manage with RICE for most cases…dx with MRI
medial meniscus - thallsy mcmurray test, internal rotation produces catching or pain
danger of using succinylcholine
depolarizing neuromuscular blocker = severe hyperkalemia nd cardiac arrythmia
adolescent presents with fever, pharyngeal pain, earache deviated uvula, muffled voice, jaw muscle spasm (trismus)
peritonsillar abcess…treat with I and D plus antibiotics to cover group A strep and respiratory anaerobes
post thyroidectomy, patient develops muscle cramps, anxiety, poor sleep, prolonged QT, NORMAL RENAL FUNCTION
hypocalcemia and hyperphosphatemia due to post surgical hypoparathyroidism
hypotension, vomiting, abdominal pain, fever post op triggered by surgery in patient with cushingoid features
acute adrenal insufficiency….treat with hydrocortisone or dexmeth with lots of fluids
impaired strength and pain/temperature in upper extremities…usually due to whiplash injury
syringomelia….enlargement of central canal of spinal cord due to CSF retention
upper and lower motor neuron deficits with no loss of sensory function…twitching muscle weakness, cramping
ALS
anterior shoulder dislocations can damage what nerve
axillary nerve (cannot abduct shoulder, and numbness over lateral shoulder)
humeral mid shaft fractions can damage what nerve
radial nerve (cannot extend wrist and digits)
fractures of medial epicondyle of humurus or deep lacerations of anterior wrist can damage what nerve
ulnar nerve (claw hand or sensory loss in middle hand)
biceps reflex mediated by what
c5 c6 musculocutaneous nerve
flaccid paralysis of lower extremity, UMN signs of spasticity and hyperreflexia, bowel and bladder dysfunction, preserved vibraiton and proprioceptions, loss of pain and temperature,
anterior cord syndrome from infarction fo spinal cord and decreased blood flow through anterior spinal artery
can be complication of thoracic aortic aneurysm repair
pain and weakness of abduction at shoulder….patient fails drop arm test (cannot lower arm smoothly)
rotator cuff tear (usu. supraspinatus), confirm dx with MRI
extra axial well circumscribed dural based pass that is partially calficfied…dx and treatment
meningioma…SURGICAL RESECTION
multiple ring enhacing lesions at grey white junction (intra axial)
brain mets…CT rest of body for possible source
short bursts of excruciating pain along front of face
trigeminal neuralgia (tic douloreaux)
triad of bilateral hip, thigh, and buttock claudication, impotence and symmetric atrophy of bilateral lower extremities
aortoiliac occlusion (leriche syndroem)
pain out of proportion to injury, pain on passive stretch, rapidly increasing swelling and tension, paresthesias
compartment syndrome
differentiated from arterial embolus (6 Ps)
and DVT (usually asymptomatic and not very very painful)
few hours after cardiac cath, sudden hemodynamic instability and ipsilateral flank/back pain…dx and mgmt
retroperitoneal hematoma (complication of cardiac cath) dx confirmed with non contrast CT scan abd pelvis or abdominal US
treat with bed rest, intensive monitoring, IV fluids or transfusion
post sternotomy, (less than 14 days), fever, tachycardia, chest pain, leukocytosis, sternal wound drainage, widened mediastinum
acute mediastiniitis, possible complication of cardiac surgery secondary to intraoperative wound contamination…treat with surgical debridement and antibiotics
