Amboss Flashcards
(345 cards)
1
Q
what vessel feeds the pancreas?
A
splenic artery
2
Q
when does legg calve perthes disease present?
A
2-5 year olds
3
Q
what is legg calve perthes disease?
A
avascular necrosis of femoral head
4
Q
what are imaging findings in legg calve perthe disease?
A
joint space widening and flattening of femoral head
5
Q
what is management of legg calve perthe?
A
nsaids and minimal weight bearing
6
Q
what is first line for BPH treatment?
A
alpha blockers like terazosin then finasteride
7
Q
what is management of pneumothorax caused by intubation?
A
put in a chest tube
8
Q
what size breast cancer indicates chemotherapy in addition to surgical removal?
A
more than 2 cm
9
Q
an ankle fracture in a teenager can lead to what complication down the road? how?
A
leg legnth discrepancy because if it involves the growth plate then the plate will close early compared to other leg
10
Q
what testicular tumor makes loads of testosterone?
A
leydig cell tumor
11
Q
which testicular cancer often makes estrogen? what sx can it cause?
A
sertoli cell cancer and causes gynecomastia
12
Q
is SVC syndrome common in hodkin or non hodkin lymphoma?
A
non hodgkin
13
Q
what is treatment for intusssusception?
A
air enema
14
Q
how does pulmonary contusion appear on xray?
A
will be patchy infiltrate around injured area
15
Q
what cancers are peutz jehgers ysndrome patients at risk of developing?
A
ovarian breast and pancreatic and of course colorectal
16
Q
what test is done to confirm hereditary hemochromatosis?
A
genetic testing
17
Q
what is histology of papillary thyroid cancer?
A
orphan annie eyes
18
Q
what is most common thyroid cancer?
A
papillary thyroid cancer
19
Q
what is histology of follicular thyroid cancer?
A
invasion of surrounding blood vessels and capsular space
20
Q
what is first step in evaluating esophageal cancer?
A
EGD
21
Q
what are two most common bugs in HAP?
A
pseudo and staph a
22
Q
what is abx for HAP?
A
vancomycin and cefepime
23
Q
in what situation is an IVC filter appropriate for DVT treatment?
A
if patient develops one after surgery and has contraindications to anticoagulation
24
Q
how does follicular lymphoma present?
A
pretty much lymphadenopathy without any associated sx
25
who gets follicular lymphoma?
common in elderly folks/adults
26
what is translocation of follicular lymphoma?
t14 and 18
27
how do you treat symptomatic PDA in pre term infant compared to full term?
pre term gets indomethacin and full term gets surgery closure
28
a patient with a heel fracture after a fall needs what additional imaging? why?
xray of back because could have compression fracture
29
what is management of patient with penile fracture?
retrograde urethroscopy then surgical fixation and catheterization
30
what is rx of anorectal cancer?
radiochemotherapy
31
what is the most common cause of acute pancreatitis? what imaging should be done?
biliary pancreatitis...should get RUQ US
32
what sx can atelectasis cause in post op period?
can be as severe as dyspnea chest pain and cyanosis, but also can be asymptomatic
33
when does amniotic embolism onset?
during or immediately after delivery
34
if patient hears bubbling from throat when eating, what is likley diagnosis?
zenker diverticulum
35
what should patients on bisphosphonates do to help prevent osteonecrosis of the jaw?
good oral hygiene with frequent rinsing and dental work before intiating therapy
36
what happens in cerebral venous thrombosis?
thrombosis in venous system can lead to infection area
37
what are sx of cerebral venous thrombosis?
number one sx is headache, can have focal neurologic deficits, signs of elevated ICP and vision changes
38
what is rx of cerebral venous thrombosis?
start vanc, ceftriaxone and metronidazol e
39
what is treatment of peyronie disease prior to offering surgical repair?
collagenase injections
40
what is a complication of distal humerus fracture?
can injure the brachial artery and compromis blood supply to forearm and hand
41
what is a complication of mid shaft humerus fracture?
radial nerve injury leading to wrist drop
42
what are the two first line therapies for prolactinomas?
cabergoline of bromocriptine
43
what is another name for ectopic pregnancy?
interstitial pregnancy
44
middle ear barotrauma has what sx?
tympanic edema, hemorrhage and rupture and hearing loss
45
what is treatment of middle ear barotrauma?
NSAIDs and observation, hearing will return
46
what are signs of abdominal compartment syndrome?
distended abdomen, elevated CVP, AKI from oliguria, and just a critically ill patient
47
how do you measure intrabdominal pressure?
via bladder catheter sensor
48
what is rx for abdominal compartment syndrome?
abdominal decompression with laparotomy
49
what test is positive for AC joint injury?
adduction across body causes pain
50
what is imaging technique if concerned about AC joint injury in shoulder?
X ray
51
what is rx of AC joint injury?
sling, analgesics and surgery if severe
52
how does AC joint injury happen?
fall directly on shoulder
53
what abx should be given after a cat bite?
augmentin
54
patient with new hip fracture that is on blood thinners develops tachycardia and low BP, what is likely happening?
blood loss leading to hemorrhagic shock
55
explain how subclavian steal syndrome works
basically have block in subclavian and when you use the affected arm, blood flow from the vertebral artery id shunted to the subclavian and you get pre syncope sx
56
what are sx of subclavian steal syndrome?
pre syncope when using arm, decreased pulses and blood flow in affected arm
57
can venous insufficiency cause ulcers?
you bet
58
where do venous insufficiency ulcers occur?
medial ankle
59
where do peripheral arterial disease ulcers occur and what is unique about them?
at toe tips and lateral surface of ankle...they are very painful
60
what is cause of MALT lymphoma of the stomach?
H pylori infection
61
what is first line rx of malt lymphoma of stomach?
H pylor treatment
62
what is lost in symptomatci syringomyelia?
pain and temp sensation in upper extremity and eventually motor movement of upper extremity
63
what sensation is lost and where in tabes dorsalis?
vibration and proprioception in lower extremities
64
how long after UC diagnosis does patient start with annual colonoscopies?
8 years
65
what is treatment of ITP?
usually just observation...but if really severe can give corticosteroids then IVIG
66
what is rx of developmental dysplasia of the hip in kids less than 6 months?
wear a harness
67
what is rx of developmental dysplasia of the hip in kids 6-18 months?
closed reduction surgery
68
infant at like 3 weeks old has persistend conjugated jaundice, what should you think of?
biliary atresia
69
what is a big time complication of biliary atresia?
liver cirrhosis
70
what should be done for patients with biliary atresia?
kasai procedure where you connect liver to small intestine
71
what are signs of envenomation from a snake bite
swelling and pain at site, coagulopathy issues, and systemic effects like hypotension and tachycardia
72
what is cutoff for lobectomy as far as FEV and DLCO go?
FEV has to be greater than 1.5L and DLCO greater than 60%
73
pyloric stenosis is more common in formula or breastfed babies?re
formula
74
what are the two watershed regions of the colon?
rectosigmoid and splenic flexure
75
what is management of NEC when surgery isnt indicated?
abx (amox flagyl and gent) and NG tibe decompression
76
when is surgery indicated for NEC?
any signs of gangrenous or perforated bowel...high lactate, perotinitis, pneumoperitoneum
77
what is finding with surgical wound dehiscence of abdominal incision?
pink fluid leaking from surgical site
78
what is management of wound dehiscence?
get them to the OR to repair the sutures
79
what two med classes can be given to help pass kidney stones?
alpha blockers and calcium channel blockers
80
what should be monitored in a patient on warfarin?
PT
81
what should you not eat when on warfarin?
leafy green veggies
82
middle aged female has hypoechoic liver cyst found on imaging and takes OCPs, what is likely diagnosis?
hepatic hemangioma
83
what is risk with removing hepatic hemangioma?
severe hemorrhage
84
what are indications for inpatient observation following a TBI?
any signs of increased ICP, depressed skull fracture, skull fracture greater than 3mm,
85
what are the patient related risk factors for perioperative cardiac complication?
```
ischemic heart disease
heart failure
Cr greater than 2
stroke
DM that is insulin dependent
```
86
what is a vascular complication after PCI?
cholesterol embolism
87
what are signs of cholesterol embolism?
skin changes, AKI, gut ischemia
88
what steps should be done in emergency settinf for spinal cord injury?
vitals, airway, stabilize neck and body, and INSERT foley
89
cholelithiasis occurs where?
cystic duct
90
choledocholithiasis occurs where?
common bile duct
91
acute cholecystitis occurs when a stone is where?
cystic duct
92
what are lab abnormalities in choledocholithiasis?
elevated LFTs, elevated GGT, elevated bilirubin and alk phos
93
when do you not use CT for appendicitis?
kids and pregnant women
94
what is rx of strep pharyngitis when you cant give penicillin?
macrolide...azithromycin or clarithromycin
95
what is a halo sign from blood in nose?
rapidly expanding clear fluid ring around blood on gauze...means it is CSF
96
what is common cause of CSF leak after trauma?
basilar skull fracture
97
what are signs of basilar skull fracture?
racoon eyes and CSF leak
98
what cranial nerve can be injured with uncal herniation?
occulomotor...CN III
99
how should you remove a battery that was swallowed?
always endoscopically because need to assess for any injuries
100
a knee dislocation comes with what feared complication?
popliteal artery injury
101
what should be done to evaluate for popliteal artery injury in knee dislocation?
ankle brachial index
102
what tumor marker can you monitor for HCC?
AFP
103
what tumor marker can you monitor for pancreatic and CRC?
CEA
104
if an old person falls and breaks their hip, what part did they break?
femoral neck fracture
105
what is management of femoral neck fracture in elderly person?
hip replacement
106
how does leg look on exam with femoral neck fracture?
externally rotated and shortened
107
what are first two parts of workup of thyroid nodule?
TSH and US
108
if patient has low TSH with a thyroid nodule, what should be done after US is completed?
thyroid scintigraphy
109
is a cold or hot thyroid nodule more concerning?
COLD
110
at what age is genu varum (bowing) abnormal?
after age 2
111
injury at 8th intercostal in mid axillary line of left side can lead to what structure?
left lower lobe of lung
112
what ribs does spleen live behind?
9-11
113
patient has epidural then a couple days later has severe headache and neck stiffness, what is happening
post LP headache from CSF leak
114
what is rx of post LP headaches?
if mild then will resolve on own, if severe then you should do epidural blood injection to help seal the dura mater
115
dilation of pampiniform plexus leads to what?
varciocele
116
if you are worried about avascular necrosis in scaphoid fracture, what should you do?
surgical fixation
117
what is often the first symptom of prolactinoma in a male/
ED
118
what is treatment of pancreatic cancer?
duodenopancreatectomy
119
what is rx of echinococcus of liver?
albendazole
120
what is treatment of seminoma testicular cancer?
radiation and orchiectomy
121
what is rx of non seminoma testicular cancer?
orchiectomy plus adjuvant chemo with bleomycin cisplatin and etoposide
122
what is rx of hyperparathyroidism?
surgery and if not a surgical candidate then cinacalcet
123
with PAD what is first line therapy?
exercise therapy along with statin, anti platelet therapy
124
if first line therapy for PAD does not work but patient does not have critical limb ischemia, what is next therapy tried?
cilostazol (vasodilator(
125
what operation should be done to manage a SAH?
surgical clipping of wherever is bleeding
126
at what point in ITP do you start corticosteroid therapy?
if platelets less than 30k
127
shoulder pain, horner syndrome in patient with smoking history should make you think what?
pancoast tumor
128
what is abx ppx for dental procedures?
amxoicillin
129
what is diagnostic test for hirschprung disease?
rectal biopsy
130
what are levels of CO, SVR PCWP and CVP in hemorrhagic shock?
low CO, CVP and PCWp and HIGH SVR
131
what is juvenile nasopharyngeal angiofibroma?
common tumor of nasopharynx in kids...presents with unilateral bloody mass
132
what is management of juvenile nasopharyngeal angiofibroma?
CT scan then surgical removal
133
patient knocks out a tooth and it is totally intact, what should be done?
rinse tooth and socket with saline and put that puppy back in
134
chest pain in a kid following respiratory infection and coughing should make you thnk about what? assume cardiac exam is normal?
spontaneous pnemomediastinum
135
what is PE finding of spontaneous pnuemomediastinum?
crepitus
136
what is imaging and management of spontaneous pneumomediastinum?
CXr and reassurance
137
what should be done for diabetic foot ulcer if no indication of infection?
should be surgically debrided
138
what is rx of meconium ileus as long as no signs of perforation?
gastrografin enema
139
what is treatment for cushing syndrome that is ACTH independent?
adrenalectomy
140
patient who had whipple surgery now has metabolic acidosis, what is issue?
pancreatic fistula that causes leakage of bicarb
141
what is a colles fracture?
extension fracture of distal radius that happens with falling on outstretched hand
142
what are sx of colles fracture?
tenderness, soft tissue swelling and restricted range of motion
143
what is rx of colles?
closed reduction, or if really severe do surgical fixation
144
what procedue is done for midgut volvulus?
Ladd procedure
145
what is presentation of midgut volvulus in infant?
bilious vomiting and abdominal distension
146
what is imaging for midgut volvulus?
upper GI series
147
generally, how should you manage a peri appendiceal abscess?
should drain itand give abx...high risk to do appendectomy
148
what portion of spinal cord is in charge of vibration and proprioception?
posterior
149
what part of spinal cord is in charge of movement and pain/temp?
anterior
150
what breslow depth requires 1-2cm margins in melanoma removal
1-2mm depth
151
what breslow depth requires sentinel node biopsy in melanoma?
anything greater than 1mm
152
what is parkland formula? what is it used for?
4ml x body surface area burned x patient weight...fluid calc in patients with burns
153
how is body surface area broken down for burns?
9% for each extremity and face, 9% for chest, 9% for abdomen, 9% for each half of back
154
what size kidney stone needs to be removed?
over 1cm
155
what should be done if patient with patellar dislocation has osteochondral fragment in joint space?
knee arthoscopy to remove the fragment then surgery to fix patella
156
what imaging is used for acute limb ischemia diagnosis?
digital subtraction angiography, not ABI
157
what imaging is used to diagnose a psoas abscess?
CT or MRI
158
when is elective repair of abdominal aneurysm indicated?
greater than 5.5 cm, more than 1cm growth in a year, if it is saccular or symptomatic
159
what are two firts line therapies for Carpal tunnel before surgery?
steroid injections and splinting
160
how does blood appear on head CT?
hyperdense...white
161
what is imaging for meniscal injury?
MRI
162
when do you fix meniscal injuries
patients less than 40 years old, and when they are symptomatic
163
a pelvic ring fracture often causes injury to what nerve?
obturator nerve
164
where does obturator nerve provide sensory innervation?
small area on medial thigh
165
what motion does obturator nerve make happen?
hip adduction
166
what med can cause neutrophilia?
STEROIDS
167
what should be monitored in patients with burns on extremities?
pulses and cap refill because they are at risk of ischemia
168
what is treatment of patient with burn on extremity who starts to develop signs of ischemia?
escharotomy
169
aside from choriocarcinoma, what other testicular cancer can produce hcg?
seminoma
170
name the contraindications to organ donation
cardiac arrest before brain death, sepsis, incurable malignancy, CJD
171
babies with gastroschisis are at increased risk of what other GI issue?
intestinal dysmotility (gastroparesis)
172
what is imaging modality for patient with a suspected aortic injury?
CT angio if they are stable, TEE if unstable
173
what is first step in management of chemical burns?
irrigate with water extesnively
174
can hyper or hypothyroid cause CTS?
hypothyroidism
175
patient with persistent elevated aldosterone should undergo what imaging?
CT scan of abdomen to determine etiology of aldosterone elevation (bilat versus unilateral)
176
angiodysplasia is associated with what other disease?
ESRD
177
patient has bleeding abdominal aorta and undergoes repair...then has total loss of leg movement, what happened?
probably had injury to anterior spinal artery leading to motor loss in legs
178
what is management of an enterocutaneous fistula?
put in an ostomy pouch and feed parenterally
179
acromegaly can do what to the heart?
cause congestive heart failure due to cardiomyopathy
180
what is first line rx of esophageal stricture?
balloon dilation
181
list the branches of the aorta starting at Celiac trunk
```
Celiac
SMA
Renal
Ovarian/testicle
IMA
```
182
what are echo findings of hypertrophic cardiomyopathy
mitral valve dysfxn, enlarged heart wall, asymmetric wall thickening
183
what spot of aorta is most susceptible to injury in trauma?
isthmus
184
what beta blockers for varices/
nadolol or propanolol...cant be cardiac selective like metoprolol
185
what is management of intertrochanteric hip fracture in healthy person?
internal fixation...intramedullary nailing
186
if preganant lady presents with itching and elevate dbilirubin, what is diagnosis??
cholestasis of pregnancy
187
what is rx for cholestasis of pregnancy?
ursodeoxycholic acid
188
what is location of chest tube placement for pneumothorax is adult?
5th mid axillary intercostal space
189
what is location of chest tube placement for pneumothorax is kid?
2nd intercostal midclavicular line`
190
what do you do with finger tip that has been amputated that you are transporting?
put it in ice with saline damp gauze wrapped around it
191
is tylenol recommended for back pain?
no...doesnt work well
192
supraclavicular and peri umblilical nodes are suggestive of what cancer?
gastric cancer
193
what is treatment of gigantism?
transphenoidal adenectomy
194
bullet to the neck means patient gets what kind of imaging?
CT angio of neck
195
what is cushings triad in a TBI?
hypertension, bradycardia, irregular respirations
196
if patient has cushings triad with a TBI then what is likely going on?
increased intracranial pressure
197
when do you give Tetanus immune globulin to patient with a cut?
if cut is dirty and vaccination history is unclear...if wound is clean only need Tdap
198
what imaging is used to diagnose bladder injury in trauma?
retrograde cystography
199
what can you inject to help get rid of a erection? is this first or second line?
can inject phenylephrine...second line
200
what is first line treatment of erection lasting too long?
take out the blood
201
if kid needs significant fluid resuscitation and you cannot get venous access, what kind of line and where do you put it for access?
interosseuous line in proximal tibia
202
what is acral lentiginous melanoma?
painless irregularly shaped brown macule that involves the toe and nail bed
203
who is more likely to get acral lentinonous melanoma?
african americans and asians
204
what is something a patient can develop after they have been inubated?
laryngotracheal stenosis
205
when should you expect laryngotracheal stenosis in a patient?
if after extubation they have had progressive shortness of breath and difficulty breathing
206
what is imaging modality to confirm laryngotracheal stenosis?
larygoscopy
207
what nerve runs lateral to the fibula?
common peroneal nerve
208
the common peroneal nerve causes what action at level of ankle?
dorsiflexion of the foot
209
what is a common presenting symptom of PBC?
pruritis
210
if patient has PBC, what should they be taking?
ursodeoxycholic acid
211
when do you operate on a broken clavicle instead of using a sling?
if it is displaced more than 1 bone width
212
what is imaging technique for patient with difficulty swallowing in oropharyngeal location?
videofluoroscopy
213
what is weight cut off for receieving sugar containing fluid as maintenance fluid?
30kg and above does not need the sugar
214
what is the tumor triad of VHL?
RCC
hemangioblastoma
pheochromocytoma
215
are femoral hernias above or below the inguinal line?
below
216
what is volar splinting used for?
carpal tunnel syndrome
217
what is a roos stress test?
when patient lifts arm above head and have to open and close hand repeatedly
218
what is a positive roos test indicative of?
thoracic outlet syndrome
219
if patient has thoracic outlet syndrome, what is first treatement?
PT
220
what is treatment for thoracic outlet syndrome if PT does not work?
surgical decompression
221
what is pyoderma gangrenosum? what is it associated with?
skin lesion that becomes ulcerated and necrotic...assoc with Crohns
222
what potassium level constitutes emergency treatment?
6.5 and above
223
what are the two steps in management of posterior shoulder dislocation?
test axillary nerve function then do reduction
224
gardner syndrome has what four manifestations?
colon polyps, osteomas, epidermal cysts and hyperproliferation of retinal epithelium
225
turcot syndrome has what two features?
colon polyps and brain cancers
226
head bobbing and heart murmur is classic for what murmur?
AR
227
if patient has undiagnosed lower GI bleed and is becoming unstable, what should be done?
angiography for diagnosis and treatment
228
female with fecal incontinence and loss of anal sphincter tone likely has what history?
vaginal laceration during a delivery
229
patient with strictures in small bowel and history of bowel resection should undergo what procedure to manage strictures?
stricturoplasty...dont want to remove any more bowel
230
posterior hip displacement leads to what positioning of the leg?
internall rotated and abducted
231
which of wilms versus neuroblastoma crosses the midline in a child?
neuroblastoma crosses midline and wilms does not
232
how long after heparin initiation does HIT usually happen?
5-10 days after
233
patient who recently had endovascular surgery acutely has discoloration of an extremity without swelling, what happened?
atheroembolism
234
if patient has a skin lesion and the "overlying skin cannot be pinched" what is the diagnosis?
epidermoid cyst
235
in addition to propanolol, what should be done for variceal bleeding?q
ligation of the remaining varices
236
what is management of a biliary cyst?
should remove it surgically
237
what is management of phyllodes tumor?
surgical removal
238
what type of collagen is affected in osteogenesis imperfecta?
type 1
239
what are signs/symptoms of osteogenesis imperfecta?
blue sclera, deafness, short stature, frequent fractures, scoliosis
240
what is tumor marker for ovarian cancer?
Ca125
241
purple discoloration and crackling sounds from a wound indicate what?
necrotizinf fascitis
242
what do you do to a wound with necrotizing fasciiitis?
surgical debridement and abx
243
what abx for necrotizing fasciitis?
vanc and zosyn
244
what is emergent treatment of an epidural hematoma?
craniotomy to release it and ligate the bleeding vessel
245
why do you not do a burr hole for epidural hematoma/
because you cannot ligate vessel with that
246
what causes a femoral hernia?
widening of the femoral ring
247
what causes a direct inguinal hernia?
weakness of transversalis fascia
248
what is treatment of cerebral vascular thrombosis?
dalteparin if patient stable and not worsening acutely, thrombectomy if they are worsening
249
nodular cords in limbs should make you think about what?
superficial thrombophlebitis
250
what meds should be given for acute drug allergy reaction?
methyprednisilone, cimetidine, diphemhydramine
251
what nodes drain the distal vagina?
superficial ingunal
252
what nodes drain the uterus?
external iliac
253
what nodes drain the cervix and middle of the vagina?
internal iliac
254
supracondylar humerus fracture can lead to what vasculature issue?
brachial artery injury causing loss of radial pulse
255
if patient is going to need long term airway management, what type of airway should be put in?
tracheostomy
256
if patient has renal srterystenosis and you add an ACE inhibitor, what lab abnormality may develop?
hypokalemia
257
what is the management of rectal prolapse?
rectopexy
258
what are signs of rectal prolapse?
painless rectal mass, addominal discomfort, incomplete evacuation, peri anal itching
259
what part of mediastinum do teratomas occur in?
anterior
260
what is most common type of mass in posterior mediastinum?
neurofibroma and schwannoma
261
what acid base issue does post op atelectasis cause?
resp alkalosis
262
what is usual treatment of SCLC (small cell lung cancer)?
radiation and chemo
263
if patient has v tach but it stable and can converse, what kind of shock should you give?
synchronized cardioversion
264
what is classic treatment of early stage breast cancer?
lumpectomy with radiation to follow along with sentinel node biopsy and hormone therapy if indicated
265
what type of lesions does prostate cancer cause in back?
osteoblastic lesions (sclerotic)
266
if patient receiving heparin is not becoming appropriately hypocoagulable, what is likely issue underlying?
antithrombin III deficiency
267
how does finasteride help BPH?
prostatic apoptosis because inhibits testosterone conversion into DHT
268
how does tamsulosin treat BPH?
alpha 1 antagonist relaxes sphincters
269
in an unstable patient that you expect esophageal rupture, what imaging should be done?
CT
270
what is treatment of thyroid tumor that is less than 1cm in size?
thyroid lobectomy
271
what is treatment of thyroid tumor that is more than 1cm in size?
total thyroidectomy
272
what is preferred treatment for patient with acute mesenteric ischemia with stable vitals?
endovascular revascularization
273
what is preferred treatment for patient with acute mesenteric ischemia with unstable vitals?
ex lap
274
alcohol induced lymph node tenderness should make you think about what?
follicular lymphoma
275
what should be done with intact avulsed tooth out in field?
put back in socket manually then go to dentist/PCP
276
which hip dislocation leads to internally fixed adducted leg?
posterior dislocation
277
pt with stable esophageal rupture that is not leaking into pleural spaces should be treated how?
conseravtive management with abx and PPI and NPO
278
an infant with a UTI and palpable bladder likely has what?
posterior urethral valves
279
what is rx of posterior urethral valves?
ablation of the valves
280
what is rx of post vascular surgery pseudoaneurysm?
US guided thrombin injection
281
patients with cholelithiasis waiting on cholecystectomy should do what two things?
take urosdeoxycholic acid and have low fat diet
282
what imaging should be obtained when someone ingests toxic chemicals?
Upper scope as soon as feasible
283
which two rotator cuff muscles are in charge of external rotation?
teres minor and infraspinatus
284
what imaging should be done when you expect posterior shoulder dislocation?
axillary x ray view
285
what is management of posterior dislocation of shouldr?
closed reduction
286
where does cervix lymph drain?
internal iliac
287
what imaging to diagnose renal vein thrombosis?
either CT angiography or MR venography
288
when should a pancreatic pseudocyst be operated on?
if more than 6cm or symptomatic
289
what is procedure to fix psueodcyst of pancreas?
CT guided drainage
290
what are findings of purulent cellulitis?
tender erythematous skin with purulent drainage
291
what is treatment of constrictive pericarditis from TB?
pericardiectomy
292
in patients you are worried about end organ perfusion, what should be monitored for volume status?
urine output
293
what tissue is messed up in peyronie disease?
tunica labuginea
294
when should adult patients receive vaccines after splenectomy?
2 weeks after
295
what should be given to patient wiht open wound and unclear vaccination histroy against tetanus?
tetanus immuneglobulin and vaccine
296
what two ppx drugs should organ transplant patients receive?
bactrim and valgancyclovir
297
young patients with aortic aneurysm likely have what issue going on?
cystic medial necrosis from maybe ehlers or marfans
298
what type of valve should younger people get?
mechanical ecause they are more durable
299
why do you give tranexamic acid after a TBI?
to prevent cranial hemorrhage
300
in addition to abx, what might you need to do for septic knee?
serial aspirations
301
colles fracture is a fracture of what?
distal radius
302
colles fracture can lead to injury of what nerve?
median nerve
303
what is treatment of pururlent pericarditis?
pericardiocentesis
304
how does a AAA form?
accumulation of foam cells in the tunica intima
305
patient with metastatic lesions to spine causing spinal cord dysfunction should receive what?
steroids IV
306
patients who will need long term foley should get bladder emptied how?
should have intermittent foley catheters
307
autoimmune gastritis puts patients at risk for what?
gastric adenocarcinoma
308
h pylori puts patients at risk for what cancer?
gastric MALT lymphoma
309
what nodes does the prostate drain to?
internal iliac
310
what nodes do the testis drain to?
para aortic
311
what symptoms does somatostatinoma cause>?
diarrhea, steatorrhea, cholelithiasis, diabetes
312
what is long acting anesthetic that is used a lot?
bupivicaine
313
is lidocaine intermediate or long acting?
intermediate
314
if patient has hypercalcemia from bone resorption what med can help lower it?
bisphosphonates
315
patients in ICU can get stress stomach ulcers, but what else can they get in their stomach?
erosive gastropathy
316
patient with renal artery stenosis should be started on what?
ace or arb
317
in addition to ace/arb, what else might be needed for patient with renal artery stenosis?
if having severe sx then can do angioplasty without stents
318
what ligament does the uterine artery run in?
cardinal ligament
319
what are sx of herpes zoster opthalmicus?
loss of vision in one eye, pain and vesicular lesions
320
what is a torus fracture?
buckle fracture in kids...pretty much have buckling of bone but not actually Broken
321
what are two classic pathology findings in chronic organ rejection? what immune cell mediates these?
smooth muscle proliferation and fibrosis...host cd4
322
at what age does an undescended testicle become a surgical operation?
after 4-5 months
323
a boot shaped heart is indicative of what?
tetralogy of fallot
324
smoking lung cancers like squamous and small cell occur where?
central = smoking
325
in addition to graded exercise therapy, what medication should patient with PAD be started on initially?
clopidogrel
326
should patient take metformin or ACE inhibitor on mornign of surgery?
no...risk of lactic acidosis and hypotension
327
what are complications of hepatic adenoma?
rupture and hemorrhagic shock...can rarely be malignant transformation
328
patient has UTI and big kidney stone, what should be done before removing the stone?
treat the UTI, because if you dont stone removal can lead to significant urosepsis
329
do you have to stop OCP if you develop focal nodular hyperplasia of liver?
no patients just need reassurance
330
should patients with hepatic adenoma stop taking OCPs?
YES
331
vesicouretal reflux puts patients at risk of what kidney issue?
renal scarring
332
what is size cutoff of pulmonary nodule for NO further evaluation?
smaller than 4mm
333
what type of pain can patients have with adrenal crisis?
diffuse abdominal pain
334
what worm can cause SBO?
ascariasis
335
eschar around a diabetic foot ulcer raises concern for what?
underlying infection
336
neurogenic shock does what to vitals?
bradycardia and hypotensive with hypothermia
337
posterior hip doslocation leads to what leg positioning?
shortened and internally rotated with adduction
338
what is treatment of posterior hip dislocation?
emergency closed reduction
339
what is the physiologic cause of curling ulcers?
basically hypoperfusion leads to ulceration and necrosis
340
which lung cancer makes PTHrp?
squamous cell
341
which lung cancer makes centrally located cavitary lesions?
squamous cell
342
what abx for septic knee from e coli?
cefepime
343
patient with spontaneous small pneumothorax should receiev what even if they are totally stable?
supplemental O2
344
what MSK issues can prolactinomas cause?
osteoporosis due to decrease in estrogen
345
what is first line procedure for acute limb ischemia?
catheter directed thrombolysis and balloon catheter embolectomy
