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board2 Flashcards

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1
Q

CN findings with basilar skull fx

A

V VII VII VIII hearing loss nystagmus, ataxia, CSF leaks, XR and CT can be negative - CT has air fluid levels in sphenoid sinus, heomotypmanum, ring test for CSF- halo sign of clear fluid beyond blood tinged ring , battle sign (blood behind ear) and - racoon eyes

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2
Q

herniation affects which pupil

A

ipsilateral

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3
Q

which head bleed ccrosses suture lines

A

subdural

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4
Q

central herniation, tonsillar, transtentorial

A

central - cn VI palsy, tonsilar- respiratory arrest, foramen magnum, transtentorial - MC - temporal lobe uncus through tentorial notch - CN III ipsilarfixed dilated

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5
Q

treatment for immediate post traumatic head trauma seizure

A

none

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6
Q

complication of skull fracture in kids

A

growing fx- leptomeningeal cyst that enlarges, assn with tear in dura- have to re-xray fractures

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7
Q

grade III concussion

A

LOC - no sports- concern for second imapact syndrome -

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8
Q

post concussive sydnrome

A

no hard neuro defeicits like ataxia

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9
Q

machinary murmur

A

air embolism - air in RV - LL trendelenburg- trap airbubble in apical of RV away from outfloe tract

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10
Q

neck zones

A

zone 1- below cricoid cartilage, zone 2 madible to cricoid- mc - zone 3 - above angle of mandible

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11
Q

thoracotomy incision

A

5th ICS, open pericardium verically, anteriot to phrenic nerve

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12
Q

scapular fracture

A

associatd with occult chest injury - thoracic trauma

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13
Q

1nd 2nd rib fx

A

associated vascular injury- myocardial contusion, bronchiael tear, vascular injury

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14
Q

main cause of hypoxia in flail chest

A

pulmonary contusion - also dec vent and venous return- tx direct pressure, intubate, chest tube

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15
Q

continuouos bubbling of chest tube

A

bronchopleural fistula, tracheobroncheal injury, occurs within 2 cm of carina , assn hamans crunch

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16
Q

thoracotomy indicated if chest tube puts out what

A

1500 initial or 100 hr for 6 hrs

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17
Q

NG tube coiled in chest

A

diaphragm injury

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18
Q

left apical cap

A

thraumatic dissection

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19
Q

hypotension, JVD, muffled heart sounds

A

cardiac tamonadde- pulsus paradoxus - weaker pulse, lower systolic pressure with inspiration, electtrical alterenans- alteranting QRS amplitude

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20
Q

EKG finding myocardil contusion

A

new bundle branch bock, PVCs, heart block

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21
Q

injures associated with seatbelt sign

A

mesenteric laceration, viscus tear, ruptured diaphragm, CHANCE FX - duodenu/pancreas

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22
Q

indications for trauma ex lap

A

evisceratio, GSW, impalement, gross blood by NG, rectal, positive fast if unstable

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23
Q

grey turners sign

A

flank bruising, rp hematoma- ectpic, hemorrhagic pancreatiits, trauma, post cardiac cath patient

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24
Q

kehr sign

A

left shoulder pain due to subdiaphgram irriation or splenic supture

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25
cullens sign
periumbilical ecchymosis in hemorrhagic pancreatitis, ectopic pregnancy
26
rovsings sign
RLQ pain with LLQ palpation due to peritoneal irriation
27
cancer related tumor etiology for spinal cord compression
lung, breast, prostate, usually mets to thoracic
28
cancer patietn with dyspnea/cp
pericardial effusion/tamponade- lung and breast- radiation and chemo - low QRS voltage, JVD, hypotension, diminished heart sounds, pulsus paradoxus
29
mcc SVC syndrome, edema of face
bronchogenic lung ca
30
symptomatic hypercalcemia
cancer patinet - tumor PTHrP- mimics hyperPTH mcc, also osteo mets to bone
31
which cancer causes tumor related hyper PTH
SCC
32
pth-rp mechanism
mimics PTH, increased bone resportion, inc renal abs ca
33
sympoms of symptomatic hyperca
dehydration, ams, constipation, QT shortening, weakness, back and abd pain, polyruia - BONES STONES PSYCHIC MOANS AND GRAONS
34
how to treat hyper Ca in cancer patient
isotonic saline - restore volume- lowers Ca level - can also use loop , calcitonin, bisphosphonates
35
manifestations of cancer SIADH
casued by lung brain pancreas thymus prostate ca- EXCESS WATER Retention - sectopic ADH secretionn- cause shyponatremia, normovolemia, less than maximally dilute urine, excess urinary NA scretion
36
treatent of siadh
fluid restriction
37
rouleax formation on blood smear
sludging- hypervisciocity - tx hydration
38
what timeframe dose tumor lysis ocur
12-72 hours
39
what type of cancer tumor lysis
blood based- non hodgkins, AML CML
40
mechnisms of tumor lysis
elevation of K, mg phoos, dec ca, uric acid precpitation from lysis of cells
41
treatment of tumor lysis to prevent renal failure
elevated K and Pho- hydrate, lasix/glucose/iinsulin/polystyrene, phos binders, HD, treat uric caid by alkalization of urine, allopurinol
42
septic arthritis origin in newborn, children, sexually active sickle cell
newborn - staph, kids- staph, sexually active gonorrhe, SCA and lupus - salmonella, IVDA can get gram negative and psuedomonoas, located in SCM and axial skeleton
43
calcium pyrophosphate crystals
psuedogout, mc knee elderly
44
cauuse of gout
diuretic, inc intake, dec excretion, mc 1st mtp, middle age
45
needle shaped vs rhomboid crystals
gout- neddle shaped, pseudo - rhomboid
46
young patient with fever, migratory polyarthritis, skin lesions, polytendonitis
treat for GC
47
lyme disease - cause vector and skin lesions
borrelia burgdorferi- spirochete, vector ixodes - deer tick- erythema migrans - 7-10 days over bite, local spread, annular, bright borders and central clearing - SPIROCHETES MGIRATING
48
arthralgias, myalgias, fever, fatigue, headache, bells palsy, meningitis, dysrhythmias- haert block
lyme dz - tx doxy
49
antiphosholipid syndrome
DVTs, yong women, strokes - tx warfarin- hx miscarriages/abortion
50
hx RA with monocular flare up
consider septic arthriits
51
spine findings with RA
atlantoxial subluxation - upper motor sensory sxs- concern for cord- neck flexion injury
52
uretrhtisiis causing arthirtis, conjunctivits, unveritis
reiters syndrome - reactive arthritis
53
CREST syndroem
calcinosis, reynauds, esophageal dysmotlogity, sclerodacytlly, telangestcaisas - subtype of scleroderma
54
reynauds disease, criteria and tx
bilateral, 2 years, no gangrene, precipitated by cold or emtion, if its assn with scleroderma RA SLE then its phenomenon- treatment - supportive
55
rheumatic fever occurs after which infxn
strep - 3-4 weeks after - migratory polyarthritis, carditis, chorea (farm and ar movements ) erythema marginatum, subcutanous nodules - back of wrist, elbows knees
56
mosquito that transmits malaria
female anopheles - worst is facliparum - return traveller - send thick/thin blood smear, malaria is parisitic disease
57
cyclical fever, flu like symtpoms, cerebral edema, hemolytic anemia
malaria
58
dengue mosquito
aedes aegyti- fever, hemorrhage, low platelets, shock- rash blanches under pressure
59
mc organ injured in blunt trauma
spleen, kerhs sign
60
mc organ injured in penetrating trauma
liver
61
handlebar injury
pancreas/duodenum
62
blood at meatus, work up?
no foley, may have boggy prostate, perineal bruising - get RUG
63
anterior urethral injury vs posterior
straddle injury, foreign body, tx repoair, complications fistula/stricture, VS posterorio- pelvic fx, disteneded bladder, lowera bd pain, blood at meatus, - scotal hematoma- complciations impotence, incontinence
64
iin adults are bladder suptures intraabdomianl or preperitoneal
preperitoneal
65
trauma and gros shematuria
IVP, constrast CT urogram - concern for renal injuries , but renal vascular injuries require angiogram
66
trauma, ureter injury, penetrating trauma- work up?
CT urogram
67
bladder injry assn with pelivc fx, gross hematuria , work up?
RUG, if extravasation then exploratory
68
anesthias - amides vs esters
one I is ester, two II is amide like lidocaine/bupivicaine
69
max dose of lidocaine
4.5mg/kg (7 with epi), bupivicaine is 2mg/kg
70
TXA
1g in trauma, 1 g in next 8 hours 20mg/kg dose
71
MPT
1 1 1 prbc ffp platelets
72
first treatment for peds trauma in shock `
20mgkg fluid bolus
73
human bite
eikenelle
74
reptile bite
slamonella
75
cat and dog bites
pastuerella, casuses ascending lymphangitis, 6 hours onset
76
machinery murmur , neck vascular injury, tachypne tachy hypotension
air embolism, place in LLDECUB

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