april 20 Flashcards

(45 cards)

1
Q

clinical features of a hypermetabolic state following severe burn?

A
  • increased gluconeogenesis & insulin resistance
  • increased basal metabolic rate/body temp
  • increased protein & lipid catabolism - lean muscle wasting
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2
Q

oliguria = < ____ ml of urine over 24 hours

A

500

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3
Q

management of a duodenal hematoma?

A
  • bowel rest, nasogastric decompression, and parenteral nutrition
  • drainage/surgery only required if hematoma persists after a few weeks
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4
Q

what is emphysematous cholecystitis?

A

cholecystitis caused by gas forming organisms such as clostridium

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5
Q

complications of emphysematous cholecystitis?

A

hemolysis, gangrene, necrosis, perforation and septic shock

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6
Q

treatment of emphysematous cholecystitis?

A
  • emergency cholecystectomy

- broad spectrum antibiotics

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7
Q

presentation of emphysematous cholecystitis?

A
  • rever, RUQ pain, nausea/vomiting

- crepitus in abdominal wall adjacent to gallbladder

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8
Q

when the head of the humerus is anteriorly displaced, the deltoid appears…

A

flattened

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9
Q

which nerve is commonly injured in antierior dislocation injuries?

A

axillary nerve

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10
Q

how do you treat a malignant pericardial effusion?

A

Acute: pericardiocentesis, cytologic fluid analysis
Chronic: prolonged drainage (pericardial window)

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11
Q

do varicoceles transilluminate?

A

no

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12
Q

does an inguinal hernia transilluminate?

A

no

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13
Q

does a spermatocele transilluminate?

A

yes

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14
Q

do hydroceles transillluminate?

A

yes

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15
Q

why can mechanical ventilation in a hypovolemic patient cause decreased cardiac output?

A

increase in intrathoracic pressure can collapse venous capacitance and cutoff venous return to the heart

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16
Q

treatment of adhesive capsulitis?

A

gentle range of motion exercises

  • NSAIDS
  • corticosteroid injection
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17
Q

unilateral bloody discharge with no masses found =

A

intraductal papilloma

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18
Q

serous/bloody nipple discharge + a palpable mass =

A

invasive ductal carcinoma

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19
Q

XRAY shows free air under the diaphgram suggesting ulcer rupture… next step?

A

EMERGENCY SURGICAL EXPLORATION

20
Q

what type of scan should be used to assess for a cervical spine injury?

21
Q

why is XRAY not the recommended scan for assessing for a cervical spine injury?

A

not sensitive enough

22
Q

Patients with high risk injury for cervical spine injury always require…

23
Q

A patient has a low risk type injury for cervical spine injury. What criteria indicate that they require a scan?

A
  • intoxicated
  • alterations in mental status
  • spinal tenderness
  • neurological
  • distracting injury
24
Q

what conditions predispose patients to small intestinal bacterial overgrowth?

A
  • anatomical abnormalities such as surgery/strictures

- motility disorders (scleroderma, diabetes)

25
presentation of SIBO?
- diarrhea, weight loss, bloating, flatulance | - anemia, malabsorption, etc
26
diagnostic tests for SIBO?
jejunal aspirate OR carbohydrate breath testing (lactulose, glucose)
27
Dumping syndrome is a complication of..
gastric bypass
28
path of dumping syndrome ?
carbohydrate rich foods are rapidly emptied into the small bowel, -> osmotic fluid shift from plasma to intestine ->abdominal pain and diarrhea
29
symptoms associated with dumping syndrome?
-abdominal discomfort and diarrhea shortly after meals, accompanied by tachycardia, diaphoresis, and flushing -
30
hyperechoic breast mass on ultrasound is usually...
benign
31
what causes a complicated parapneumonic effusion?
bacterial invasion of pleural space
32
pH of a complicated parapneumonic effusion?
low (<7.2)
33
glucose of a complicated parapneumonic effusion?
low (<60)
34
WBCs in a complicated parapneumonic effusion?
> 50 000
35
protiein in a complicated parapneumonic effusion?
high
36
is CMV pneumonitis acute or indolent in onset?
acute
37
is pneumocystitis pneumoniia acute or indolent in onset?
insidious
38
crescent sign is seen in...
ruptured popliteal cyst
39
what is crescent sign?
an arch of bruising
40
symptoms of a ruptured popliteal cyst?
posterior knee and calf pain, tenderness and swelling of the calf, crescent sign
41
Whats an infectious complication of steroid injection into a joint?
septic bursitis
42
diagnosis of septic bursitis?
bursal fluid aspiration (xray if suspected fracture or foreign body)
43
treatment of septic bursitis
systemic antibiotics / drainage
44
pain on medial / lateral squeezing of the calcaneous =
stress fracture
45
zone of lucency or sclerosis in the poster calcaneous on XRAY =
calcaneous stress fracture