General Flashcards
(192 cards)
1
Q
Follow up <1cm lung nodule with what imaging?
A
Chest CT
2
Q
If you think somone may have a PE but scores low on Wells score, do what test?
A
D-dimer to rule out PE
3
Q
When do you do a needle biopsy with a lung nodule?
A
when there’s evidence of metastasis
4
Q
When do you do a lobectomy with the lung?
A
if there was no evidence of metastasis
5
Q
When checking Ca levels, be sure to correct for _________ levels. What is the equation?
A
albumin
Ca corrected= Ca + (.8 x (4-albumin))
6
Q
First line imaging for nephrolithiasis
A
ULTRASOUND
7
Q
What are 3 major indications for dialysis?
A
uremic coagulopathy, uremic encpehalopathy, uremic pericarditis
8
Q
What causes breast dimpling?
A
when lymph drainage is compromised–> edema in the interfollicular dermis
9
Q
How do you get nipple retraction
A
suspensory ligaments of the breast are called Cooper’s ligaments, get retraction from tumor infiltrating these ligaments
10
Q
what is torus palatinus?
A
fleshy immobile mass on hard palate
11
Q
_______ fractures are at risk of osteonecrosis
A
scaphoid
-b/c blood supply can be disrupted
12
Q
________ is caused by 3 or more adjacent rib fractures that break in 2 places and create an unstable chest wall segment that moves in a paradoxical motion w/ respiration.
A
flail chest
13
Q
blunt abdominal trauma, mild respiratory distress, and NG tube in lung—>_____. What side is it more common on?
A
diaphragmatic hernia
-left b/c right is protected by the liver, can get strangulation of bowel
14
Q
Fever, leukocytosis, and parotid inflammation suggest? What age group is most prone? Why? What’s most common bacteria?
A
bacterial parotitis, elderly and dehydrated post op patients, staph aureus,
MAKE SURE TO HYDRATE ADEQUATELY
15
Q
hypoactive bowel sounds and gas filled loops on x ray
A
ileus
16
Q
widened mediastinum and left sided hemothorax and pericardial effusion are signs of ______ rupture
A
aortic
17
Q
________ can follow cardiac surgery and presents with fever, chest pain, leukocytosis, mediastinal widening and requires drainage, surgical debriedment, and prolonged antibiotic therapy
A
acute mediastinitis
18
Q
history of acid ingestion think _______ because the acid leads to fibrosis 6-12 weeks later. What other symptoms?
A
pyloric stricture, early satiety, nausea and nonbilious vomiting, weight loss
19
Q
________ are more commonly seen in kids and are from blood building up between mucosa and submucosa of duodenum. Why is kids more? What are sx?
A
duodenal hematoma
- form b/c kids have thinner abdominal wall musculature, less adipose tissue, more pliable ribs
- epigastric pain and vomiting 24-36 hours after injury (blunt abdominal trauma)
20
Q
_________ is the most effective at preventing post op pneumonia in patients
A
incentive spirometry and deep breathing–> promote lung expansion
21
Q
___________ presents as erythema and swelling with air in tissue on CT (black), hypotension, fever
A
necrotizing fascitis
22
Q
__________ is a major side effect of suucinylcholine
A
cardiac arrythmia from hyperkalemia
23
Q
Nitrous oxide inactivates _______ by inhibiting methionine synthase
A
vitamin B 12
24
Q
Propofol major side effect is _________ from myocardial depression
A
severe hypotension
25
What two major categories lead to acute mesenteric ischemia?
1) cardiac embolic events: AFib, valvular disease (infective endocarditis),
2) acute thrombosis due to PAD or low cardiac output
26
bile is necessary for ____ soluble vitamins
fat
| K- so if dec bile-->dec K-->INC INR
27
___________ happen to bone with female athlete triad which is
stress fracture, low bone density/low caloric intake/hypomenorrhea
28
_____________ is the most common cause of lower extremity edema that worsens throughout the day and gets better at night
venous valve incompetence
29
treat spontaneous pneumothorax by _______. Who tends to get these
observation and oxygen (which enhances speed of resorption), tall and thin young men
30
___________ is the most sensitive finding in blunt aortic injury
mediastinal widening
31
Patients with septic shock first require aggressive ___________ with __________ prior to the initiation of vasopressors to restore adequate tissue perfusion
fluid resuscitation, IV saline .9%
32
__________ can be a sign of organ hypoperfusion
lactic acidosis
33
__________ is recommended for complicated diverticulitis with abscess formation
CT guided percutaneous drainage
34
stress fractures of 2nd,3rd,4th toe treat with
rest and analgesics
35
Stress fractures of 5th toe treat
more aggressively b/c greater risk of nonunion
36
___________ leads to accumulation of air in the pleural space and the pneumomediastinum
bronchial rupture
37
obstructive jaundice presents with an increase in __________ bilirubin
conjugated-->tea colored urine (build up of conjugated bili in urine)
38
gastric varices arise with ________. How do you treat?
splenic vein thrombosis (b/c this forces all the splenic drainage to travel through short gastric-->large gastric varices at risk of rupture and bleeding)
-splenectomy
39
What's the most common cause of splenic vein thrombosis
chronic pancreatitis
40
The first step in working up a pancreatic leak is to test draining fluid for _________
amylase
41
If you find calcified gallbladder, what's next step?
lap chole
42
If you find stones in gallbladder but patient is asymptomatic, what's next step?
observation
43
3 clinical signs of fat embolism syndrome
petechiae, neurologic dysfunction, respiratory distress
44
what's best management for a patient with continuing knee pain who is in their 20s and pain meds/rest aren't helping?
consider MRI
45
What 3 things make up Cushing's reflex
hypertension, bradycardia, respiratory depression
46
4 Ts of anterior mediastinal mass
thymoma, teratoma, thyroid neoplasm, terrible lymphoma
47
____________ can occur as a local vascular complication of cardiac catheritazation that presents with hemodynamic instability and flank pain. How do you dx?
retroperitoneal hematoma, CT of abdomen and pelvis without contrast
48
SCC arising in a burn wound is known as ________
Marjolin ulcer
49
why do you need to bridge warfarin with unfractionated heparin first
because warfarin inhibits Protein C/S, Factors 2,7,9,10 but predominately does C and S first which is actually prothrombotic so want to prevent that with unfractionated heaprin
50
LMWH is metabolized by the
kidney
51
hard signs of vascular injury (____________) should lead to _______
pulsatile bleeding, bruits, expanding hematoma, distal ischemia (absent pulses, cool extremities),
-URGENT surgical repair
52
soft signs of vascular injury are and how to manage?
diminished pulses, bony injury, hemorrhage, neurologic abnormality
-CT, angiography, doppler
53
aortoiliac occlusion is known as _________ and what is the triad? who's at greatest risk
Leriche
-bilateral hip, thigh, buttock claudication
-impotence
-absent or diminshed femoral pulses
Men with atherosclerosis and hx of smoking
54
For the knee, medial _______ tear won't show up on xray so need MRI
meniscus
55
if a patient has pain and paresthesias following emboelctomy--->
repurfusion injury (from prev ischemia)--->compartment syndrome
56
what is pulsus alterans
change in peripheral pulses with each change in systolic blood pressure (worse in left ventricular failure)
57
__________ leads is from blow to an externally rotated and abducted arm
anterior dislocation of the humerus
| -so will also have a problem with shoulder abduction
58
Why does triple AAA repair result in bowel iscehmia?
inadequate colonic collateral arterial perfusion to the left and sigmoid colon after loss of IMA after graft placement
59
complications of placing a central venous catheter (CVC, central line) are _______
pneumothorax, pericardial tamponade
60
terminal hematuria (at end of voiding cycle) and suggests bleeding form which 3 sites and in an old man who smokes think
bladder, prostate, posterior urethra
| -urothelial cancer
61
hypovolemic shock leads to _____ preload and _____ CO and _____ BP.
To maintain organ perfusion, the body ___SNS activity--> ___ in SVR, and _____ in HR.
The LV becomes _____ in size, so then it ____ ejection fraction
- dec preload, dec CO, dec BP
- inc SNS, inc SVR, inc HR
- dec, inc
62
______ presents with deviation of the uvula, fever, pharyngeal pain, earache, trismus(spasm of jaw muscles)
peritonsilar abscess
63
The most rapid means of normalizing the PT is by giving vitamin K dependent clotting factors through ______
FFP
64
patients with clavicular fracture should undergo ________ to rule out damage to vessels (subclavian)
angiogram
65
in a 40 yr old man, outer thigh surface hip pain is most likely from _______. Contrast with osteoarthritis
trochanteric bursitis
| -osteoarthritis is not common in under 50 and the pain is deep within the joint
66
With suspected variceal hemorrhage what's next step, then?
- place 2 large bore IV catheters
- volume rausicitaiton, IV octreotide, antibiotics
- endoscopic therapy
67
________ is a complication of blunt thoracic trauma and sx such as tachypnea, tachycardia, and unilateral patchy infiltrate in alveoli
pulmonary contusion
| -ARDS has bilateral patchy infiltrate
68
what does cardiac index measure?
CO (SV x HR)
69
How is varicocele affected by valsalva, standing, and being supine
dec in supine, inc w/ standing and valsalva
| -can present as " bag of worms"=irregular mass
70
in upper GI bleed with Hgb <7, give what?
IV fluid's, bowel rest, packed red blood cells
71
clinical manifestations of zinc deficiency
impaired taste, alopecia, personal rash w/ pustular involvement,
72
What medicine can you give in PBC?
ursodeoxycholic acid
73
________ is characterized by dilated submucosal veins and arteriovenous malformations. It's a common cause of recurrent, painless GI bleeding. Diagnose by ______ although it can be frequently missed because of suboptimal prep
angiodysplasia, colonoscopy
74
Manage gastric adenocarcinoma with what imaging
CT
75
_______ results in transudative pleural effusions and is thought to occur due to small defects of the diaphragm
hepatic hydrothorax
| -typically on the right side b/c the diaphragm on this side is less muscular than the left
76
Crohn's disease has _______ granulomas and ________ inflammation
non-caseating, transmural
77
What are the mainstays of primary prophylaxis of esophageal varies hemorrhage?
non-selective beta blocker and endoscopic vatical ligation
| -go to TIPS(trans jugular intrahepatic portosystemic shunt) when pt has failed med and ligation management
78
What are 4 causes of cirrhosis?
viral hepatitis (C more than B), chronic alcoholism, NAFLD, and hemochromatosis
79
start screening UC patients with colonoscopy after _____ years of initial diagnosis
8 years and repeat every 1-2 years after
80
What are some drugs that can lead to acute pancreatitis
anti-seizure, valproate, didanosine, metronidazole, diuretics
81
with mechanical ventilation be sure to watch FiO2 as it can lead to ____________
oxygen toxicity
82
Pulmonary capillary wedge pressure is a measure of ______ ventricular end diastolic pressure and is elevated in patients with ____ ventricular failure
Left, left
| Can get pulmonary edema
83
Chest pain due to _____ can mimic angina
GERD
84
Increased intrapericardial can cause obstructive shock from __________
Pericardial tampaonade
85
An incorrectly placed endotracheal tube can lead to _______ edema. Will see what sx and how do you fix?
Pulmonary, dec breath sounds on one side, underventilation of left lung typically,
-fix by repositioning the tube
86
________ bilirubin is water soluble so a build up of this means you will see dark urine
conjugated
87
_______ is an esophageal motility disorder where you have pain with BOTH solids and liquids
achalasia
88
_______ cause dysphasia for solids but not liquids and aren't associated with weight loss. They cause circumferential and distal narrowing of the esophagus
esophageal stricture
89
shingles is typical in what age group and what tends to reactivate it
elderly, stress/radiation
90
esophageal perforation is also known as _______ syndrome and how does it present
Boerhaave syndrome, severe retrosternal pain from severe straining or vomiting, subcutaneous emphysema, odynophagia
91
Use what two drugs to dec systemic thromboembolism risk
anticoagulants
| -warfarin, apixaban, dabigatran)
92
AFib is most likely from ectopic foci in what location
pulmonary veins
93
With aortic dissection, what imaging is preferred in hemodynamically unstable patients with chronic kidney disease (HIGH Cr)? What about in stable pts w/o CKD?
transesophageal echo
| stable: CT angiography but beware because need dye
94
Mitral stenosis can lead to _______ enlargement—>which can displace the left _______ and you can develop what
Left atrial, main stem bronchus, AFib( irregularly irregular rhythm)
95
What is considered the first line vasopressor in septic shock
Norepinephrine
96
What is the first line and second line tx of immune thrombocytopenic purpura?
Corticosteroids, then IVIG
97
What are the 3 most common causes of chronic cough (>8 weeks)?
Asthma, allergies( post nasal drip), GERD
98
Drug hypersensitivity reactions can cause _______ kidney injury and what findings on UA?
intrinsic, leukocyte casts, rash
99
Aminoglycosides can cause ________ kidney injury
intrinsic
100
Patient with dry mucous membranes, tachycardia, unremarkable UA
pre renal kidney injury
101
what do you typ see on radiography of 60 yr old patient with neck pain and dec sensation over posterior forearm
bony spurs from osteoarthritis and secondary muscle spasm
102
three signs of lead posoining
GI (constipation), neurologic (peripheral neuropathy),microcytic anemia
-basophilic stippling
103
carcinoid syndrome can lead to a defect in what vitamin?
niacin b/c lots of serotonin released and all the tryptophan is used to make niacin
104
in cor pulmonale, can use ______ to dec fluid overload but this can actually lead to _______
loop diuretics, hypovolemia---> prerenal injury
105
antiphospholipid syndrome can lead to a _______ PTT
prolonged, b/c lupus anticoagulant binds phospholipids in most assays so leads to prolonged PTT
106
Management of osteomyelitis
CBC and inflammation markers---> MRI--> CT
107
give platelet transfusion at what number
<50,000
108
Give packed red blood cell transfusion when Hgb is less than
9
109
Steps for suspected variceal hemorrhage
1) Get 2 large bore IV
2) volume resuscitation, IV octreotide (to dec vasodilaiton), antibitotics
- if no bleeding: beta blockers and endoscopic band ligation
- continued bleeding: balloon tamponade
- early rebleeding: repeat endoscopic therapy
110
acidosis leads to _______kalemia, alkalosis leads to ______kalemia
hyper(acid), hypo (base)
111
beta adrenergic activity and insulin leads to inc K into cells so leads to ______kalemia
HYPO
112
What is myasthenic crisis
life threatening characterized by severe respiratory muscle weakness leading to respiratory failure ( can see paradoxical chest movement)
113
primary biliary cholangitis is treated with what and what are 2 associated complications?
ursodeoxycholic acid and liver transplantation (for advanced disease)
-fat soluble malabsorption, metabolic bone disease (osteomalacia, osteoporosis), hepatocellular carcinoma
114
NSAIDs are a common cause of _______ which can manifest as ________ in the elderly
GI ulcers, iron deficiency anemia
115
spontaneous pain and odynophagia for hot and cold foods where the pain is relieved with nitroglycerin signal ? what's next step?
esophageal spasm, esophageal manometry( would show repetitive, nonperistalsic high amplitude contractions)
116
anticoagulation with warfarin puts patients at risk for _______. IF have signs of back pain, weakness, dizziness think
HEMORRHAGE, retroperitoneal hematoma
117
________ is most commonly due to diverticular disease and presents with pneumaturia, fecaluria, or findings consistent with UTI
colovesical fistula
| -UTI's b/c of mixing of flora
118
acute bacterial prostatitis and prostatic abscess
kind og go together and have systemic sx, so tender prostate and fever
119
_______ typ presents with AST & ALT (in the 1000s), heaptic encephalopathy, liver dysfunction (INR>1.5)
acute liver failure
| -most commonly from drug toxicity (acetaminophen)
120
In _______ you can see equalization of diastolic pressures. Why is that and how do you diagnose?
cardiac tamponade, rapid accumulation of blood in the pericardial space leads to inc in diastolic pressures and impairment in venous return, dx with echocardiogram
-tamponade can be a side effects of CABG
121
if you think a PE is likely, what imagine study to verify? If patient has peptic ulcer dz, have to consider propensity to bleed with anticoagulation so consider what to manage instead?
CT angiogram, IVC filter
-D-dimer when you think it's unlikely
122
exertional syncope is typically from? What are 3 signs?
outflow obstruction (aortic stenosis)
- delayed and weak pulses (pulsus parvus et tardus)
- single and soft 2nd heart sound (S2)
- mid to late peak systolic murmur
123
_______ is an acute lung injury secondary to chemical burn from aspirated sterile gastric contents and is present within HOURS after surgery
aspiration pneumonitis
| -can see hypoxemia, CXR: bilateral infiltrates
124
________ is an infectious disease caused by aspiration of infected oropharyngeal secretions (occurs DAYS after)
aspiration pneumonia
125
when does negative pressure pulmonary edema occur?
when a patient has upper airway obstruction (like laryngospasm from extubation)---> negative intrathoracic pressure (b/c of inspiration against the obstruction)
-more common in young men or after head and neck injury
126
Criteria for starting long term oxygen therapy
Resting arterial tension (PaO2) <55 or SaO2
PaO2<59 and SaO2<89 with cor pulmonae
127
______ are usually found in the MIDDLE mediastinum and can present with vague chest discomfort
Bronchogenic cyst
128
Thymomas are in the ______ mediastinum
Anterior
129
All neurogenic rumors are found in the ________ mediastinum
Posterior (meningoceles, esophageal leiomyomas)
130
What is postural hypotension?
a drop in systolic blood pressure (>20) and a drop in diastolic (>10) on standing form supine
131
_________ has demonstrated long term survival and improved quality of life with patients who have COPD w/ SIGNIFICANT chronic hypoxemia
long term supplemental oxygen
| -can also see secondary polycythemia vera (Inc red cell prod)
132
prolonged PR interval signals _________
heart block
133
_______ can cause high output cardiac failure by shunting the blood from the arterial to venous side ---> _____ preload. Why is there heart failure in this case
Arteriovenous fistula, inc preload
| -b/c even though there's high output, the circulation is unable to meet the oxygen demands of peripheral tissues
134
elderly patient with UTI grows E coli and tx with ciprofloxacin, then few days later she becomes confused and has watery diarrhea with UA showing occasional yeast. What do you do?
she might have C diff so get a stool culture (PCR) and start vanco, metro( is for fulminant Cdiff)
135
esophageal perforation can be due to what 3 things? What are 3 sx? How do you diagnose?
endoscopy, severe wretching, trauma
- chest pain radiating to the back, tachypnea, pleural effusion (left sided)
- this diagnosis is emergent and life threatening and use contrast water soluble esophagogram (if inconclusive use barium)
136
What are the two types of dysphagia?
Oropharyngeal dysphagia has problems initiating swallowing with cough, choking, and nasal regurgitation (think person had a stroke and at high risk of aspiration). Diagnose with videofluroscopic modified barium swallow
- Esophageal dysphagia can be dysphagia to solids AND liquids at rest---> motility disorder. Do barium swallow w/ possible manometry
- Esophageal dysphagia can be dysphagia just to solids and progresses to liquids-->mechanical obstruction. If no hx of radiation, do upper endoscopy. If hx of radiation or complex stricture do barium swallow w/ manometry
137
__________ is the most common cause of lower GI bleeding in adults. Bleeding is typically painless but may be associated with ________
diverticulosis, lightheadedness and hemodynamic instability
138
In an overweight person who you suspect pancreatitis but they don't drink, this is probably from what etiology? What's best step imaging step
gallstones, RUG ultrasound b/c CT isn't sensitive for stones
139
if you have a patient over excessively overdosed on acetaminophen, what's next best step of management? (PT is 120s, AST/ALT in 8000s, Cr HIGH, bilirubin 4)
refer for liver transplant
| -only about half of ALF patients will survive without a liver transplant
140
___________ is characterized by the development of hemorrahgic lesions after ischemia or exposure of gastric mucosa to various injury agents (alcohol, aspirin, cocaine)
acute erosive gastropathy
141
when you see cirrhosis and ascities, with fever and lethargy think _________ and hepatic encephalopathy.
spontaneous bacterial peritonitis,
| -diagnose with paracentesis w/ dx criteria being positive ascities fluid and neutrophil count >250
142
Characteristic features of of pancreatic cancer are a palpable __________ and what do the bile ducts look like?
gallbladder, intra and extrahepatic biliary dilation
143
what is first line tx for diffuse esophageal spasm
calcium channel blockers
144
How do you diagnose esophageal cancer
upper GI endoscopy
145
How do liver metastasis present
Can be single or multiple modules
146
laxative is characterized by _________ diarrhea with melanosis coli which is?
watery, frequent, dark brown discoloration of the colon
147
VIPomas have _____kalemia and ______chloridya
hypokalemia,hypochloridya and tea colored stools
148
lactose intolerance is characterized by a _______ hydrogen breath test
postive
149
what is postcholecystectomy syndrome and how do you dx?
persistent abdominal pain or dyspepsia either post op months to years after
- can be a retained common bile duct or cystic duct stone
- dx w/ ERCP, MRCP
150
_______ can present with unexplained fever, leukocytosis, RUQ pain
acalculous cholecystitis
151
triad of epidural abscess
focal back pain (or HA), abnormal inflammatory markers (ESR, fever, leukocytosis), neurologic deficits
AND hx of IV drug abuse
152
Peripheral artery disease is defined by an ABI of?
ABI
153
cancer makes up what component of virchow's triad?
hyper coagulability
154
initial management of claudication in a smoker is?
smoking cessation
155
why does skin turn reddish brown with chronic valvular incompetence?
hemosiderin deposition
156
The best medical management for sustained improvement in claudication is?
a walking program which can double the walking distance
157
what nerve injury leads to foot drop and problems with dorsiflexion?
COMMON peroneal nerve injury
158
Jaw pain with chewing is associated with what vascular issue?
giant cell arteritis which is managed with steroids
159
No doppler signal, loss sensory and nerve function, paralysis of muscles and mottled skin signal?
irreversible ischemia
160
Parkland formula
4ml x (%body burned) x wt. in kilos, give half over the first 8 hours and the rest the next 16 hrs
161
What is an atrial myxoma and how does it affect heart sounds?
benign heart tumor, it's a rumbling diastolic murmur that disappears when pt lies on left side
-common in LA but rare in RA
162
What organ does VIPoma commonly show up in and what are sx?
pancreas, watery diarrhea, hypokalemia, achlorhydria, malar flush in kids
163
The ______ artery is responsible for most posterior nosebleeds
sphenopalatine
164
Eikinella is a habitant of where in the human body
oral flora
165
_______ causes chronic joint pain, crepitus with movement, and is associated with advanced age and obesity
osteoarthritis
166
Restrictive lung disease has _____ lung volumes, _____ Aa gradient, _____ diffusion CO
Dec lung volumes, inc Aa, dec CO diffusion
167
Beta 1 receptors _____ LV end systolic volume
Decrease because inc myocardial contractility so inc cardiac output
168
A _______ is from extrusion of synovial fluid from the knee joint to the gastrocnemius or semimembranosus bursa. When can it happen?
Popliteal-bakers cyst, after strenuous exercise (posterior knee and calf pain and area of eccymosis by medial malleolus (crescent sign)
169
What is TTP? What is the terrible pentad of TTP? How do you tx?
defect of ADAMS13-->inc vWF (shistocytes b/c of inc platelet aggregation and RBCs have to move through this)
5: fever, neurologic, renal, hemolytic anemia, platelets
- tx: plasma exchange
170
antihistamines can lead to ________ effects and how do they affect bladder?
anticholinergic, detrusor hypo contractility
171
In patients of non-African descent of suspected anemia, what are initial tests? What about African descent?
CBC (non-African), hemoglobin electrophoresis (African)
172
A _________ is a typical complication of advanced osteoporosis. How can a person on corticosteroids affect this?
vertebral compression fracture, quicker progression
173
how does herniated disk present?
radicular pain along the thigh to below the knee (sciatica) and positive straight leg test due to nerve compression
174
________ is the most common cause of secondary HTN and should be suspected in all patients with diffuse atherosclerosis and resistant HTN. There is also sometimes an abdominal bruit
renovascular HTN
175
What 3 ways can you check for Hpylori eradication test?
urea breath test, fecal antigen test, upper endoscopy after 4 weeks of tx
176
What's best way to check for a preoperative MI?
Dipyridamole-Thallium Scan (checks blood supply to heart under stress)
-let's you know if there is reversible ischemia
177
Non-traumatic intraparenchymal hemorrhage most often is from what cause?
HTN
178
if see small vesicles on an erythematous base and pallor on conjunctivae in kids eye think
herpes simplex conjunctivitis
179
how to test for carpal tunnel in pregnancy?
nerve conduction studies
180
insulinoma sx
tachycardia, tremors, sweating, nervousness
181
APML can present with ______ and cytopenias
DIC
182
Pt is <50 years old, a smoker and has substernal chest pain that wakes her up in her sleep, ambulatory ST elevation, CT angio is normal. Tx w/?
diltiazem or CCB
| -vasopastic angina
183
_______ is the most common cause of MSK chest pain, what do you fo for tx/ imaging?
reassurance and symptomatic chest pain management (tylenol, NSAIDs)
184
Pt. has a DVT but what are 3 contraindications to anticoagulation and how to tx?
active bleeding, recent surgery, acute hemorrhagic stroke
| PLACE AN IVC filter
185
Breastfeeding jaundice is typically in the _______ and with high _____ bilirubin, and the baby has ______ wt loss, ____ urine output. How to tx?
first week of life, indirect, inc wt loss, dec uo,
| -try and inc mom breastfeeding (every 2-3 hrs) and if can't then may need to consider formula
186
patient who had multiple gun shot wounds to abdomen, think what organ might be removed so predispose to what?
spleen, impaired opsonization (antibody mediated phagocytosis)
187
The _____ is typically visible on CXR in kids <3. It's close to the RA
thymus
188
if see foreign body on child CXR who's symptomatic, tx with? If asx?
flexible endoscopy, observe for 24 hrs
189
biliary atresia typically has inc ____ bilirubin and dark urine, clay colored stools
conjugated
190
when have suspected intusseception, dx w/
U/S guided air contrasts enema
191
if see foreign body on child CXR, tx with?
flexible endoscopy
192
What is Ogilve's syndrome and what part of the colon is most likely to rupture
pseudo-obstruction of the colon that is associated with bed ridden, neurologically impaired, and older patients, drugs (opioids)
-cecum is most likely to rupture b/c it's the colon with the largest diameter
