ZARET OSLER 14 Flashcards
caine complication
methemoglobinemia
methemoglobinemia tx
methylene blue 1 amp - electron donator
ped blood vol
80 ml / kg
mannitol dose
500 mg / kg (0.5 GRAM / kg)
flumazenil dose
0.5 mg
ST depression 2,3, AVF
right coronary MI
MI pneumonic
MONA - morphine, oxygen, nitro IV 10-200mg , angio, ASA, ACE, atenolol (BB)
heparin mechanism
STIM antithrombin III
Lovenox
mechanism
factor 10a
spleen which Ig and 2 immune components IgM, opsonins - tuft + pep
spleen which Ig and 2 immune components
IgM,
opsonins - tuft + pep
Mattox maneuver
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,
Cattell-Braasch manoeuvre
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.
The bodies anticoagulants
plasminogen
antithrombin III
Protein C and S
first branch off ECA
- thyroid
what is origin inf. thyroid
- thyrocervical trunk
first branch subcl
- vert
trypsin activates
subclavian steal - stenosis just prox to vert
-tx: carotid subclavian bypass
enzymes
trypsinogen activated by enterokinase
epidural hematoma
acute parotiditis - staph
- lens , better prognosis, impact absorbed by skull, and more obvious presentation because arterial
subdural - WORSE
MOST common cause aortic stenosis -
BICUSPID congenital; ssx: syncope, dyspnea, agnina; fix if 1.5 cm narrowing (that gets hypertrophy)
orgs of nec fasc
gp A strep- BETA hemolytic
clostridium - gm + ROD
alt tx of c diff
marfanoid - ASCENDING dissection, AORTIC regurgitation
- rifampin
tx HYPER Ca
SHORT QT interval - HYPERCa (post colon)
- fluid - Lasix - piridronate - phosphate chelator, mithramycin
bacteria associated with chronic wound / chronic fistula and what is tx
- actinomyces - sulfur granules - PNC! 6wks
hypotension / pulse 42 - ATROPINE
most common med of pancreas - thiazide
IPMN management
ONE cm IPMN in ACCESSORY duct - since accessory - surveillance
1.5 cm IPMN in main duct - take it out
lyme disease bacteria, classic findings, and tx
Borrelia bergdorfi -
1- erythema migrans
2- bells palsy or HEART BLOCK (Mobitz I - prolong P-R;
3- ARTHRITIS - NOT TREATABLE
Tx: DOXY or TETRACYCLINE
Tx for meningitis - adrenal hemorrhage - skin necrosis
- STEROIDS
MOST common cause pneumaturia -
sigmoid diverticulitis
diagnosis and treatment with abd pain and blisters on hands
porphyria cutanea tarda - diet control
neurofibromas without MENIIb has a risk of what other pathology
5% have pheo!!
tx STV -
ADENOSINE
most common cause of massive hemoptysis - what is pathophys
TB - Rasmussen’s aneurysm - BRONCHIAL ARTERY - gom - TX- ANGIO
segments of right UPPER LOBE
- APA ant post apical
hyper pig mouth and upper GI bleed what is diagnosis
– Peutz–Jeghers - hamartomas bleed
black areas both axilla what is diagnosis
- acanthosis nigricans - gastric carcinoma
Turner’s syndrome findings - what is potential surgical complicaiton
with HA and HTN - COARCTATION
- watch for reperfusion injury of bowel
side effect of Herceptin -
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
side effect of Adriamycin
5fu - cardiac
- cardiac
side effect of bleo
- pulm
MUST do MRM if -
early preg, multi centric, prev xrt, sarcoid, male, recurrent, inflammatory,
graves tx
- PTU and I131 first choice -
grand maul sz post thyroidectomy cause and tx
- HYPO Ca, if no response to Ca then give MAG empiric
Mg toxicity
- APNEA!
eclamptic post delivery - HYPOtension with free fluid - diagnosis and cause
Sheehan’s - ANTERIORLY pit - if allow preg to be hypotensive
anterior pit acidophils -
growth and prolactin
calcified wall -of hepatic cyst what is test
echinococci - complement fixation test -
persistent , brady, CPK elevated - what is dx
- propofol infusion syndrome
nephrogenic DI causes and tx
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)
unique characteristic of MENIIb pheos
- 80% BILATERAL!
replace SMA injury in contaminated trauma field with what
with INTERNAL iliac
Ivor-Lewis
- wide Kocher , pyloromyotomy, feeding j, take all gastrics
**LOOK THIS UP***
EXCEPT LEFT gastric
(careful - most common cause of variceal - right gastric)
on table bp management of pheo -
NEOSINEPHRIN?
3 places to use DDAVP
VW - develped for this
long pump run
DI
med tx causalgia
neurontin
tegratol
5 yo ptosis right eye; MRI head neg
most common presentation of myasthenia gravis - is unilateral ptosis
tenselon teest - edrephomia improves
treat with neostigmine
myasthena gravis tx - thymectomy -
most common cause horners and what is treatment
pancost tumor
PRE-op radiation
perioperative prep for myasthenia
plasmaphorisis
tx’d with plasmophosis
periop for myasthenia gravis
TTP
TTP pneumonic
FAT RN
74 yo male with scrotal hematoma
renal cell carcinoma LEFT - gonadal into renal - tumor has extended into renal vein
most common retro vs extremity sarcoma
liposarcoma
malig fibrohistiocytoma
side effect of protamine
HYPOtension
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
propofol infusion syndrome -
abdominal aortic aneurysm surgery.
He
presents with new onset of massive hematochezia diagnosis and tx - EGD - fistula - extra anatomic
ectopic thyroid source - hyperthyroid
stumi ovary - thryoid secreting ovarian teratoma