April 2018 Flashcards
(86 cards)
Statistics question… (Man Whitney?? Unpaired T test??)
Unpaired
• normally distributed — 2-sample t-test
• not normally distributed — Mann Whitney test
Paired
• normally distributed — paired t-test
• not normally distributed — Wilcoxon signed rank test (put your cocks together)
> two samples
• normally distributed —ANOVA (Analysis of variance)
• not normally distributed — Kruskal Wallis test
Mass in chest and liver hemangioma, Ix… (MRI liver, PET??)
MRI, Triphasic CT
Tc-99m RBC labelled SPECT can be sensitive for larger lesions
Causes hepatic metastases hepatocellular carcinoma hepatic cyst hepatic abscess regenerative nodules/dysplastic nodules cystic hepatic or biliary neoplasm haemangioendothelioma
Hereditary hemorrhagic telangiectasia (HHT), also known as Osler–Weber–Rendu disease. bnormal blood vessel formation in the skin, mucous membranes, and often in organs such as the lungs, liver, and brain.
Klippel–Trénaunay syndrome - blood vessels and/or lymph vessels fail to form properly. The three main features are nevus flammeus (port-wine stain), venous and lymphatic malformations, and soft-tissue hypertrophy of the affected limb
Von Hippel–Lindau disease. visceral cysts and benign tumors with potential for subsequent malignant transformation
Loss of weight, tiredness, hairy tongue lesion
Lichen planus - Hep C
Candidiasis - Patches look similar to Candida infection (oral thrush), except hairy leukoplakia lesions cannot be moved or dislodged. Both HIV/AIDS
Nerve injury, deltoid affection, which other muscle will be affecting
Deltoid - Axillary Nerve C5/6
- Teres Minor Ext R
lies at first behind the axillary artery, and in front of the subscapularis, and passes downward to the lower border of that muscle
Winds backward, in company with the posterior humeral circumflex artery, through a quadrangular space bounded above by the teres minor, below by the teres major, medially by the long head of the triceps brachii, and laterally by the surgical neck of the humerus, and divides into an anterior, a posterior, and a collateral branch to the long head of the triceps brachii branch..
Injury to knee and swelling, on 90 degrees tibia is more posterior than other side…
(PCL injury)
3 patients in surgical ward with Cl. Difficile, mode of infection
C. difficile is transmitted from person to person by the fecal-oral route, shed in faeces. Any surface, device, or material (e.g., toilets, bathing tubs, and electronic rectal thermometers) that becomes contaminated with faeces may serve as a reservoir for the C. difficile spores.
Test for rupture tendon achilles
Simmonds test
The sinus tarsi
the sinus tarsi, a canal between the articulations of talus and calcaneus.
Interosseous talocalcaneal ligament rund through it - binding the two bones.
There are three articulating facets between the talus and the calcaneus, delineated as the anterior, middle and posterior facets. The sustentaculum tali forms the floor of middle facet, and the anterior facet articulates with the head of the talus, and sits lateral and congruent to the middle facet. The posterior facet is the largest of the three, and separated from the others by the tarsal canal.
Testing for Extensor Pollicis Longus
Lift thumb with hand 90 degrees on table
EPB Dist R to PP (PIN)
EPL - Longer - from ulna to DP (PIN)
Ab PL - Ulnar to base of 1st MC (PIN)
Ab PB - scaph/trapezium to PP. recurrent branch of median.
Extensive Femoral Thrombus Management
Embolectomy if good inflow, operative angiogram - thrombolysis if occlusion, if no occlusion close arteriortomy.
If in poor health - heparin followed by iv infusion
Which hormone decreases in warm condition… TSH, ACTH, Vasopressin??
ACTH - Again fluid conservation
Vasopressin - AQP2 insertion into collecting duct - would likely increase!
TSH may decrease - less thermogenesis required.
Cleft Palate defect in
Failure of fusion occurs between primary palate (anterior section of premaxilla and attached four teeth) and secondary palate (hard and soft palate).
Cleft lip: On one or both sides of philtrum, occurring as failure of fusion of maxillary and frontonasal processes.
Mesonephric Duct
Trigone, prostatic urethra, epididymis, vas deferens and ejaculatory ducts.
Urinary bladder is formed partly from the cloaca and partly from the ends of the mesonephric ducts.
The ureter and mesonephric duct come to open separately into the vesicourethral portion.
The mesonephric duct participates in the formation of the trigone and dorsal wall of the prostatic urethra.
Testicular cancer with normal AFP and HCG
Spermatocytic seminoma - 5%, older >54, germ cell tumour. Normal AFP + HCG
Classical seminoma, younger 15-35. Normal AFP. HCG elevated in 10%
Non seminomatous germ cell tumours (42%). Younger 20-30. Elevated AFP (70%) and HCG (40%).
Teratoma
Yolk sac tumour
Choriocarcinoma
Mixed germ cell tumours (10%)
Relation of ulnar nerve to artery
Ulnar nerve is most ulnar all the way
Dorsal root ganglion in neck
Sensory
Thenar atrophy
Median - recurrent motor branch
opponens pollicis,
abductor pollicis brevis, and
superficial part of flexor pollicis brevis.
Dermatome of the little finger
C8
Iatrogenic small injury to esophagus
TPN
Ix for rupture esophagus after endoscopy…
water soluble contrast
Reciprocal of absolute risk reduction
ARR =incidence in exposed – incidence in unexposed
NNT = number of patients who need to be treated in order to avoid one adverse event, which is the reciprocal of the absolute risk reduction
https://litfl.com/risk-and-numbers-needed-to-treat/
Cushing reflex/triad
(↑BP ↓HR ↓RR)
Child with irreducible groin mass
Indirect inguinal hernias are the most common incarcerated pediatric inguinal hernias,
although incarceration of other pediatric hernias, such as femoral, umbilical, spigelian,
epigastric, direct inguinal, and lumbar, has been reported in the literature.
6yo, kid with groin swelling
patent processus vaginalis
