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ZARET OSLER 14 Flashcards

1
Q

caine complication

A

methemoglobinemia

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2
Q

methemoglobinemia tx

A

methylene blue 1 amp - electron donator

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3
Q

ped blood vol

A

80 ml / kg

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4
Q

mannitol dose

A

500 mg / kg (0.5 GRAM / kg)

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5
Q

flumazenil dose

A

0.5 mg

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6
Q

ST depression 2,3, AVF

A

right coronary MI

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7
Q

MI pneumonic

A

MONA - morphine, oxygen, nitro IV 10-200mg , angio, ASA, ACE, atenolol (BB)

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8
Q

heparin mechanism

A

STIM antithrombin III

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9
Q

Lovenox

A

mechanism

factor 10a

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10
Q

spleen which Ig and 2 immune components IgM, opsonins - tuft + pep

A

spleen which Ig and 2 immune components

IgM,

opsonins - tuft + pep

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11
Q

Mattox maneuver

A

Left-sided medial visceral rotation (Mattox maneuver) exposes the entire length of the abdominal aorta and its branches (except the right renal artery).

The correct plane is entered by incising the lateral peritoneal attachment of the sigmoid and LEFT colon.

The plane of dissection is developed bluntly in front of the left common iliac vessels and behind the kidney,

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12
Q

Cattell-Braasch manoeuvre

A

pancreatic surgeons are like cattle

The right-sided equivalent of the Mattox manoeuvre, i.e. medial visceral rotation of the right-sided organs to bring them into the midline. It can be regarded as an extension of a Kocher’s manoeuvre; where as a Kocher’s lifts the duodenum off the retroperitoneum, in a Cattell-Brasch manoeuvre, dissection is continued down the right-sided white line of Toldt and then across the small bowel mesenteric root.

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13
Q

The bodies anticoagulants

A

plasminogen

antithrombin III

Protein C and S

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14
Q

first branch off ECA

A
  • thyroid
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15
Q

what is origin inf. thyroid

A
  • thyrocervical trunk
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16
Q

first branch subcl

A
  • vert
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17
Q

trypsin activates

A

subclavian steal - stenosis just prox to vert
-tx: carotid subclavian bypass

enzymes
trypsinogen activated by enterokinase

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18
Q

epidural hematoma

A

acute parotiditis - staph

  • lens , better prognosis, impact absorbed by skull, and more obvious presentation because arterial

subdural - WORSE

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19
Q

MOST common cause aortic stenosis -

A

BICUSPID congenital; ssx: syncope, dyspnea, agnina; fix if 1.5 cm narrowing (that gets hypertrophy)

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20
Q

orgs of nec fasc

A

gp A strep- BETA hemolytic

clostridium - gm + ROD

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21
Q

alt tx of c diff

A

marfanoid - ASCENDING dissection, AORTIC regurgitation

  • rifampin
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22
Q

tx HYPER Ca

A

SHORT QT interval - HYPERCa (post colon)

  • fluid - Lasix - piridronate - phosphate chelator, mithramycin
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23
Q

bacteria associated with chronic wound / chronic fistula and what is tx

A
  • actinomyces - sulfur granules - PNC! 6wks

hypotension / pulse 42 - ATROPINE

most common med of pancreas - thiazide

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24
Q

IPMN management

A

ONE cm IPMN in ACCESSORY duct - since accessory - surveillance

1.5 cm IPMN in main duct - take it out

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25
Q

lyme disease bacteria, classic findings, and tx

A

Borrelia bergdorfi -

1- erythema migrans

2- bells palsy or HEART BLOCK (Mobitz I - prolong P-R;
3- ARTHRITIS - NOT TREATABLE

Tx: DOXY or TETRACYCLINE

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26
Q

Tx for meningitis - adrenal hemorrhage - skin necrosis

27
Q

MOST common cause pneumaturia -

A

sigmoid diverticulitis

28
Q

diagnosis and treatment with abd pain and blisters on hands

A

porphyria cutanea tarda - diet control

29
Q

neurofibromas without MENIIb has a risk of what other pathology

A

5% have pheo!!

30
Q

tx STV -

31
Q

most common cause of massive hemoptysis - what is pathophys

A

TB - Rasmussen’s aneurysm - BRONCHIAL ARTERY - gom - TX- ANGIO

32
Q

segments of right UPPER LOBE

A
  • APA ant post apical
33
Q

hyper pig mouth and upper GI bleed what is diagnosis

A

– Peutz–Jeghers - hamartomas bleed

34
Q

black areas both axilla what is diagnosis

A
  • acanthosis nigricans - gastric carcinoma
35
Q

Turner’s syndrome findings - what is potential surgical complicaiton

A

with HA and HTN - COARCTATION

  • watch for reperfusion injury of bowel
36
Q

side effect of Herceptin -

A

cardiac toxicity

Long term weakening of the heart muscle leading to chest pain, breathlessness, a cough, swelling in the arms or legs and heart fluttering

37
Q

side effect of Adriamycin

A

5fu - cardiac

  • cardiac
38
Q

side effect of bleo

39
Q

MUST do MRM if -

A

early preg, multi centric, prev xrt, sarcoid, male, recurrent, inflammatory,

40
Q

graves tx

A
  • PTU and I131 first choice -
41
Q

grand maul sz post thyroidectomy cause and tx

A
  • HYPO Ca, if no response to Ca then give MAG empiric
42
Q

Mg toxicity

43
Q

eclamptic post delivery - HYPOtension with free fluid - diagnosis and cause

A

Sheehan’s - ANTERIORLY pit - if allow preg to be hypotensive

44
Q

anterior pit acidophils -

A

growth and prolactin

45
Q

calcified wall -of hepatic cyst what is test

A

echinococci - complement fixation test -

46
Q

persistent , brady, CPK elevated - what is dx

A
  • propofol infusion syndrome
47
Q

nephrogenic DI causes and tx

A

Dx:
lithium
amphotericin b

Tx:
HCTZ - seems crazy since already making lot of urine!! but free radical scavenger of the kidney

(NON-responder to ADH - ADH is actually high - Tx: HCTZ
(NOT DDAVP like used for central)

48
Q

unique characteristic of MENIIb pheos

A
  • 80% BILATERAL!
49
Q

replace SMA injury in contaminated trauma field with what

A

with INTERNAL iliac

50
Q

Ivor-Lewis

A
  • wide Kocher , pyloromyotomy, feeding j, take all gastrics

**LOOK THIS UP***

EXCEPT LEFT gastric

(careful - most common cause of variceal - right gastric)

51
Q

on table bp management of pheo -

A

NEOSINEPHRIN?

52
Q

3 places to use DDAVP

A

VW - develped for this
long pump run
DI

53
Q

med tx causalgia

A

neurontin

tegratol

54
Q

5 yo ptosis right eye; MRI head neg

A

most common presentation of myasthenia gravis - is unilateral ptosis

tenselon teest - edrephomia improves

treat with neostigmine

myasthena gravis tx - thymectomy -

55
Q

most common cause horners and what is treatment

A

pancost tumor

PRE-op radiation

56
Q

perioperative prep for myasthenia

A

plasmaphorisis

57
Q

tx’d with plasmophosis

A

periop for myasthenia gravis

TTP

58
Q

TTP pneumonic

59
Q

74 yo male with scrotal hematoma

A

renal cell carcinoma LEFT - gonadal into renal - tumor has extended into renal vein

60
Q

most common retro vs extremity sarcoma

A

liposarcoma

malig fibrohistiocytoma

61
Q

side effect of protamine

A

HYPOtension

62
Q

17 yo male sp MVC - GCS 6 - SAH - r Tib/fib fx - 3 day post inj - persistant brady - incr cpk - myoglobinuria neg

protonx , versed , propol

A

propofol infusion syndrome -

63
Q

abdominal aortic aneurysm surgery.

A

He

presents with new onset of massive hematochezia diagnosis and tx - EGD - fistula - extra anatomic

64
Q

ectopic thyroid source - hyperthyroid

A

stumi ovary - thryoid secreting ovarian teratoma

OSLER 14 (3 decks)

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