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Flashcards in Breast/Bites Deck (42)
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1

What is the danger, presentation, and treatment of Snakebite

  • Danger: Slit-like eyes, cobra cowl, rattlers
  • Pt: Erythema, skin changes, pain at site
  • Tx: Anti-venom IV, if you dont have that use a tourniquet/cut/suck the venom out

2

What is the danger, presentation and tx of a black widow bite?

  • Danger: Black spider with hourglass belly
  • Pt: Abdominal pain, pancreatitis
  • Tx: IV calcium gluconate

3

What is the danger, presentation and tx of a brown recluse

  • Danger: Attic, boxes, and ulcer at bite site
  • Pt: Necrotic ulcer with ring of erythema
  • Tx: Wide debridement, grafts

4

What is the danger, presentation and tx of a human bite

  • Danger: Sex, fist fight, zombies
  • Pt: Laceration only
  • Tx: Wash, abx and drain if abscess

5

What is the danger, presentation and tx of a rabies bite

Danger: Domesticated animal and provoked = observe, Wild animal = kill and biopsy
 

6

What are the normal treatments for bee stings and what do you do for anaphylaxis?

  • Normal: Remove pincer, treat pain
  • Anaphylaxis: IM Epi 1:1000

7

What do you do if you cant kill and biopsy a wild animal that bites a person?

  • (+) Bx -> IgG + Vaccine
  • (-) Bx -> Observe

8

What is the treatment for Her2Neu+ breast cancer?

Trastuzumab

9

What are the treatment methods for ERPR + breast cancer patients?

  • Aromatase inhibitors if postmenopause
  • SERM if premenopause

10

Stage 1-4 breast cancer chemo options

Anthracycline, cyclophosphamide, paclitaxel

11

What is the procedure for evaulating a lump in a patient under 30

  1. Reassurance (2-3 cycles) 
  2. If persists = get ultrasond
  3. If ultrasound shows area= aspirate
  4. If cyst resolves = reassurance

12

What is the procedure for evaulating a lumb in a patient over 30

  1. Ultrasond shows mast
  2. if aspirate is blody or cyst recurs
  3. Go to mammogram for biopsy

13

What are the two available techniques for screening for breast cancer?

  • USPTF: Start at 50 go every 2 years
  • ACS/NCI start at 40 go every 1 year

14

What is the equvalent of a mastectomy + ALND?

Lumpectomy + RT + ALND

15

What are the preventative measures for a BRCA 1/2 mutation?

Prophylactic mastectomy and bilateral salpingo-oophorectomy

16

What is the recommended treatment for bladder cancer?

Transurethreal resection + BCG or Cisplatin based chemo

17

What do the stone sizes correspond to in terms of actions?

  • .5 cm = fluid and analgesics
  • .7 cm = add MET
  • 1.5 cm = stenting or lithotripsy
  • Over 1.5 = surgery

18

What is Reynolds pentad?

Hypotension and AMS indicates cholangitis

19

What is the physical definition of shock?

SYS BP <90 or Uoutput <0.5 mL/kg/hr

20

What is the rule of nines?

  • Head: 9
  • Front of arm: 4.5
  • Back of arm: 4.5
  • Front Upper chest: 9
  • Front Abdomen: 9
  • Back: (same as front)
  • Front of leg: 9
  • Back of leg: 9

21

What are the features of electrical burns

  • Arrhythmias
  • Posterior shoulder dislocation
  • Demyelination

22

MONA BASH

–Morphine sulfate for severe pain. 
–Oxygen via nasal cannula to keep SaO2 > 92%
–Nitroglycerin (NTG) 0.3-0.6 mg SL q5min PRN chest pain. Max: 3 doses within 15 minutes.
–Aspirin. The first tab is 325 (chew), then 81mg QD after that. Avoid enteric coated Aspirin.
–Beta-blocker. Metoprolol tartrate 25mg po q6h
–ACE. Watch BP. May wait to see BB work if concerned about BP or start low dose, e.g. Lisinopril 5mg po BID
–Statin. High-intensity statin for all patients with ACS – atorvastatin 80mg po Qbedtime or rosuvastatin 20-40 mg daily.
–Heparin. For all patients with non-ST elevation ACS, start anticoagulation ASAP after you’ve made the diagnosis. Will start heparin instead of Lovenox. Heparin is easily reversible if needed. 60 U/kg IVB (max 4000 U); 12 U/kg/hr (max 1000 U/hr initially).

23

Which alcohols produce an anion gap

Methanol and ethylene glycol

24

What is the treatment method for cyanide poisoning?

Thiosulfate and amyl nitrate

25

What is a treament for carbon monoxide poisoning?

100% FiO2 and hyperbaric

26

Organophosphate toxicity causes what?

SLUDGE

Salivation, lacrimation, urination, defecation, gastrointestinal upset, emesis

27

What is the treatment method for organophosphate toxicity?

Atropine and pralidoxime

28

What are the medical managements for peripheral vascular disease

  • Anti-platelets: Aspirin will do but clopidogrel if stented
  • Cilostazol or pentoxifylline for symptom control only, no impact on outcomes

29

How long do you have to gain control of acute limb ischemia

6 hours

30

What is the difference between bovine valves and mechanical valves

  • Bovine last <10 years duration and doesnt need anticoagulation
  • Mechanical 10-20 years duration and requires anticoagulation (warfarin)