Ramahi Trauma, Lungs, Upper GI Flashcards

1
Q

GCS of what requires intubation?

A

7 or below.

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2
Q

If oral/nasal airway obstructed, how will you secure the airway?

A

Cricothyroidotomy.

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3
Q

Hemothorax is what color on Xray? Pneumothorax? Contusion?

A

White. Black. Patchy.

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4
Q

Penetrating trauma to Zone 1 of the neck. Location and Therapy?

A

Clavicle to Cricoid. Aortography.

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5
Q

Penetrating trauma to Zone 2 of the neck. Location and Therapy?

A

Cricoid to angle of mandible. Doppler +/- exploratory surgery.

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6
Q

Penetrating trauma to Zone 3 of the neck. Location and Therapy?

A

Angle of mandible to below the ears. Aortography and triple endoscopy.

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7
Q

GSW to abdomen requires (2)?

A

Ex lap and tetanus prophylaxis.

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8
Q

Stab wound and patient is hemodynamically unstable with signs of peritonitis?

A

Ex lap and tetanus prophylaxis.

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9
Q

What do you do if you see air under the diaphragm?

A

Ex lap.

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10
Q

What has been damaged if you notice the handlebar sign?

A

Pancreatic rupture.

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11
Q

Fractures that go to the OR ASAP (5)?

A

Depressed skull, severely displaced, open, femoral neck, interochanteric.

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12
Q

4 stages of pressure ulcers? Therapy for Step 1-2? Therapy for Step 3-4?

A
  1. Skin blanches with pressure.
  2. blister/break in the dermis.
  3. destruction into the muscle.
  4. Involvement of joint or bone.
    1-2: Special mattress.
    3-4: Flap reconstruction surgery if Albumin >3.5 and bacterial load <100k.
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13
Q

Pleural Effusions - Two types? Light’s Criteria?

A

Exudative: Inflammatory processes (Cancer)
Transudative: Increased hydrostatic pressure or decreased oncotic pressure (Nephrotic, CHF, Cirrhotic).

Exudative if
Effusion Protein /Serum Protein >0.5
Effusion LDH/Serum LDH >0.6
Effusion LDH > 2/3 upper limit of normal Serum LDH.

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14
Q

Transudative effusion that has low glucose?

A

RA.

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15
Q

Transudative effusion that has high lymphocytes?

A

TB.

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16
Q

Transudative effusion that is bloody

A

PE.

17
Q

A tall thin asthmatic man presents with sudden dyspnea. What is the most concerning diagnosis? Tests? Treatment?

A

Spontaneous pneumothorax. CXR. Chest Tube - surgery if bilateral.

18
Q

When does a lung abscess require surgery (3)?

A

When antibiotics don’t work, if abscess >6cm, if empyema present.

19
Q

What do popcorn calcifications in the lung indicate? What about a concentric calcification?

A

Hamartoma.

Old granuloma.

20
Q

Most common presentation of Lung Cancer (4)?

A

Cough, Dyspnea, Hemoptysis, and Weight Loss.

21
Q

Most common lung cancer in non smokers? Location? Where does it metastasize? Effusion?

A

Adenocarcinoma.
Peripheral.
Bones, brains, adrenal, liver.
Exudative effusion high in hyaluronidase.

22
Q

A patient presents with dysphagia and halatosis? Tests? Treatment?

A

Zenkel’s (false) Diverticulum. Barium swallow. Surgery.

23
Q

Acid reflux pain after eating especially when laying down (worse with GERD)? Treatment?

A

Hiatal hernia. Surgery.

24
Q

A man presents with mid epigastric pain that is worse with eating, he endorses NSAIDS? What is he also probably infected with? Tests? Treatments?

A

Gastric Ulcers. H. Pylori. Upper GI endoscopy (EGD) with biopsy (CLO test). PPI, clarithromycin & amoxicillin (surgery if it doesn’t work).

25
Q

A man presents with mid epigastric pain that improves with eating? What is he also probably infected with? Tests? Treatments?

A

Duodenal Ulcers. H. Pylori. Upper GI endoscopy (EGD) with biopsy (CLO test). PPI, clarithromycin & amoxicillin (surgery if it doesn’t work).

26
Q

A patient who has recently lost a great deal of weight develops bilious vomiting and post prandial pain? Cause? Treatment?

A

SMA Syndrome. 3rd part of Duodenum is compressed by AA and SMA. Restore weight or Roux en Y.

27
Q

Bad (lab) prognostic factors for pancreatitis (7)

A

WBC >16k, GLC >200, LDH >350, AST >250, Drop in Ca, pH, and Hematocrit.

28
Q

Splenic vein thrombosis can lead to what GI complication?

A

Gastric varices.

29
Q

A patient presents with painless jaundice. CT reveals a large adenocarcinoma in the pancreatic head. Clinical signs? Treatment (and limitations)?

A

Trousseau sign of malignancy - migratory thrombophlebitis. Whipple, as long as no metastasis to outside abdomen, or to liver, SMA, portal vein, etc.

30
Q

Diagnosis of ARDS (3)?

A

PaO2/FiO2 <18.