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II Flashcards

(61 cards)

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1
Q

what are signs of a pulmonary contusion

A

symptoms within 24 hours of the trauma tachypnea, tachycardia and hypoxia
decreased breath sounds

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2
Q

CX of pulmonary contusion

A

patchy irregular alveolar infiltrate

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3
Q

tip off for myocardial contusion

A

elevated pulmonary capillary wedge pressure at baseline before fluid resuscitation

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4
Q

undifferentiated carcinoma in posterior nasal cavity is associated with what

A

EBV
more in mediterranean or east (asian) descent
also assoc with smoking and chronic nitrosamine consumption (salted fish)

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5
Q

signs of tertiary syphilis

A

ascending aortitis, tabes dorsalis, psychosis and tumors of skin, bone and liver

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6
Q

common cause of Post op fever around 1 week post surgery

A

catheter site infection
clostridium difficile
drug fever
PE/DVT

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7
Q

factors of post op fever that facor infection over contamination

A

systemic signs like fever, hypotension or leukocytosis
erythema and tenderness at catheter entry site
culture growth within 48 hours in both aerobic and anaerobic
two or more blood culture samples with same organism and drug susceptibility

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8
Q

what drugs are associated with drug fever post op

A

beta lactams and sulfonamides or allopurinol

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9
Q

signs of malignant hyperthermia

A

fever, tachycardia, acidosis and rhabdo

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10
Q

signs of PE

A

pleuritic chest pain, dyspnea, tachypnea, tachycardia and hemoptysis

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11
Q

coagulase negative gram + organisms that can cause acute cystitis

A

staph sapro in young women

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12
Q

common pathogens of foleys

A

E colie, klebsiella pneumo

proteus mirabilis

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13
Q

risk factors for pancreatic adenoacrcinoma

A

smoking
hereditary pancreatitis
nonhereditary chronic pancreatitis
obesity and lack of exercise

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14
Q

presentation of pancreatic adenocarcinoma

A 
weight loss, fatigue, anorexia
abdominal pain/back pain
jaundice
recent onset atypical DM
unexplained migratory superficial thrombophlebitis
hepatomegaly and ascites with mets
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15
Q

lab studies for pancreatic adenocarcinoma

A

ink alk phos and direct bili
elevated CA 19-9
US if jaundice
CT if not jaundice

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16
Q

pain description for pancreatic adenocarcinoma

A

epigastric pain that is gnawing and worse at night

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17
Q

what is trousseau sign

A

migratory thombophlebitis… pancreatic cancer

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18
Q

flat veins

A

hypovolemia

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19
Q

Left sided tension pneumo on CXR

A

tracheal deviation to the right

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20
Q

hamman sign

A

audible crepitus on cardiac auscultation

seen in tracheobronchial tears

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21
Q

posterior urethra inculdes what parts

A

prostatic and membranous

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22
Q

posterior urethral injuries are seen with what trauma

A

fracture of pelvis

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23
Q

what are sypmtoms of posterior urethral injury

A

suprapubic pain and inability to void
blood in urethral meatus and high-riding prostate due to displacement of the prostate by pelvic hematoma and scrotal hematoma

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24
Q

complications of rhinoplasty

A

nasal obstruction and epistaxis.

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25
why is septal perforation so hard to heal
the cartilage relies on overlying mucosa for nourishment so there is poor regenerating capacity
26
signs septal perforation
whistling noise during respiration
27
causes of septal perforation
rhinoplasty, syphilis, TB, intranasal cocaine use, sarcoid, granulomatosis with polangiitis
28
nasal furunculosis
staph folliculitis from nose picking or hair plucing | can spread to cavernous sinus
29
most common caus elimb ishcemia
emboli from the heart
30
5 Ps of ischemia
pain pallor pulselessness, paresthesia and paralysis
31
immediate Tx for limb ischemia
heparin bolus with continuous heparin infusion then EM vascular surgery
32
most common complications or cardiac caths
local bleeding hematoma, arterial dissection, acute thrombosis, pseudoaneurysm, or av fistula formation
33
what can happen with a hematoma if the arterial puncture site of a cardiac cath is above inguinal ligament
can extend into retroperitoneal space and present with sudden hemodynamic instability and ipsilateral flank or back pain
34
Dx lab for confirming retroperitoneal hematoma
non contrast CT
35
stat transthoracic echo is helpful for what Dx
pericardial effusion and cardiac tamponade
36
torus palatinus
chronic growth on hard palate benign | genetic and environmental factors
37
artery in epidrual hematoma
middle meningeal
38
cushings reflex
hypertension, bradycardia and respiratory depression | all from increased intracranial pressure
39
what happens with transtentorial uncal herniation
ipsilateral oculomotor nerve affected, ipsi posterior cerebral artery compressed and contralateral cerebral peduncal is pushed causing ipsilateral hemiparesis will have altered level of consciousness from compression reticular formation
40
how does damage to glossopharyngeal lead to increased risk syncope
dysfunction carotid sinus reflex
41
what to check in clavicular fracture
thorough neurovascular examination to rule out injury to brachial plexus or subclavian artery
42
if post clavicular fracture you hear bruit what do you need to order
angiogram
43
most frequent injured organis in blunt abdominal trauma
liver and spleen
44
what causes postop atelectasis
accumulatio pharyngeal secretions and tongue prolapsing posteriorly, airway tissue edea or residual anesthetic effects
45
preoperative strategies to reduce risk of post op respiratory problems
cmoking cessation 8 weeks prior control of COPD Tx resp infections prior education for PT, coughing, incentive spirometry
46
postop strategies to reduce risk of postop respiratory problems
incentive spirometry deep breathing exercises epidural analgesia instead of parenteral opioids continuous positive airway pressure
47
how does hyperventilation decrease intracranial pressure
cerebral vasoconstriction
48
ways to lower intracranial P
head elevation to increase venous outflow sedation to decrease metabolic demant IV mannitol to extract free water hyperventilation to dec CO2 and cause cerebral vascoconstriction remove CSF
49
fever neck pain and limited neck mobility secondary to pain
retropharyngeal abscess or meningitis | abscess is more painful extension where meningitis is more painful flexion
50
trismus
inability to open mouth
51
what cause retropharyngeal abscesses
usually after local penetrating trauma like chicken bone
52
Tx retropharyngeal abscess
broad spectrum antibiotics and drainage
53
atypical lymphocytosis on PBS
mono
54
tissue pressure in compartment syndrome
>30mmHg
55
where fdoes femoral nerve innervate
muscles in anterior compartment thigh (quads, sartorius and pectineus) knee extension and hip flexion sensation to anterior thigh and medial leg via saphenous branch
56
where does tibial nerve innervate
muscles post compartment thigh, post leg, plantar mm foot. sensation to leg except medial side and plantar foot
57
where does obturator nerve innervate
medial compartment thigh (adductors and gracilis) sensation medial thigh
58
peroneal nerve innervates
muscles andterior and lateral lef | sensation to anterolateral leg and dorsum foot
59
initial DVT post surgery, next step
heparin
60
what to do for hemodynamically stable patient with intraperitoneal blood identified on US
CT with contrast
61
what to do for hemodynamically unstable patient with intraperitoneal bleed
immediate laparatomy

shelf surgery (7 decks)

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