Flashcards in Medical 1.4 Deck (35)
On which side of the rib does the neurovascular bundle run?
Along inferior margin of rib
Hence when doing Thoracentesis, you should put the needle in just over the top of the rib
Dental prophylaxis: which heart conditions do not require antimicrobial ppx for dental procedures?
- Bicuspid AV
- Acquired aortic/mitral valve disease (including MVP with regurgitation)
- HOCM with latent/resting obstruction
Ferrous (Fe2+) iron in heme becomes oxidized to the Ferric (Fe3+) state. Ferric heme is unable to bind to oxygen.
HIT: diagnostic criteria?
- 2 points: Platelet count fall >50 percent
- 1 point: Platelet count fall 30-50 percent
2) Timing of platelet fall:
- 2 points: Clear onset between days 5-10
- 1 point: Possible fall at 5-10 days but not clear
3) Thrombosis or other sequelae
- 2 points: Confirmed new thrombosis after IV unfractionated heparin
- 1 point: Progressive/recurrent thrombosis or suspected thrombosis
4) oTher causes for thrombocytopenia
- 2 points: none apparent
- 1 point: possible
- 0 points: definite
0-3 pts: low prob
4-5 pts: intermediate prob
6+ pts: high prob
Fracture of pars interarticularis of vertebra
Spondylolysis that is severe enough to allow the vertebral body to shift out of place
Therapeutic Hypothermia: Inclusion Criteria?
- Witnessed VT/VF arrest
- < 15 min to onset of CPR and < 60 min to ROSC
- GCS < 8 post-resuscitation
- SBP > 90 (i.e. not in cardiogenic shock)
Testicular cancer: most common?
Germ cell tumors
Germ cell tumors: types?
2) Nonseminomatous germ cell tumors (NSGCTs): AKA everything else
Testicular cancer: prognosis?
Excellent: 95% 5-year survival
Testicular cancer: risk factors?
- Cryptorchidism (abdominal cryptorchidism > inguinal cryptorchidism)
- Testicular feminaztion syndromes
Testicular cancer: clinical presentation?
Painless testicular mass
Primary biliary cirrhosis
Summarize beta-blocker specificity
Non-selective (B1 = B2): Propranolol, Nadolol, Labetolol
B1-selective: Esmolol, Atenolol, Metoprolol ("BEAM" of beta blockers)
Alpha and Beta: Carvedilol, Labetalol
Iliotibial band syndrome: symptoms?
Pain where iliotibial band crosses the lateral epicondyle of the femur (just lateral and superior to the knee joint)
Iliotibial band syndrome: exam findings?
Positive Noble test
Noble test: We perform the Noble compression test with the patient in a lateral decubitus position and the examiner standing behind them [7,17,30]. The patient’s hip is in a neutral position or slightly flexed. The clinician uses their opposite hand to hold and palpate the top knee, which is the one being examined (ie, clinician’s left hand palpates patient’s right knee and vice versa). The examiner places their thumb on the posterior border of the ITB just proximal to the LFE, while the fingers of the same hand support the underside (ie, medial side) of the knee. Using the other hand, the examiner passively flexes the knee from zero (straight lower extremity) to approximately 60 degrees, while the thumb positioned on the ITB maintains moderate but steady pressure. If the maneuver reproduces the patient’s typical pain this is considered a positive test. Pain is typically most pronounced at approximately 30 degrees of knee flexion.
Treatment given before the main treatment, to shrink tumor burden and make it easier to remove
May include chemo, radiation, or hormone therapy
First treatment given for a disease (or treatment that is generally agreed to be the best treatment for that condition)
Treatment given after cancer has disappeared following the initial therapy
Used to kill any cancer cells that may be left in the body. May include radiation therapy, stem cell transplant, etc
Also called Consolidation therapy
So named because of the characteristic MSK pain it causes, especially in the lumbar spine
Precursor to Squamous Cell Carcinoma
Sometimes considered to be "SCC in situ"
Basal cell carcinoma: appearance?
- Waxy, translucent, or pearly
- Telangiectasias often present (a feature that contributes to easy bleeding)
Basal cell carcinoma: common locations?
Head and Neck
Can often lead to cosmetic disfigurement
Superficial type of squamous cell carcinoma
Skin cancer that originates in the Pilosebaceous glands (hair follicle/sebaceous gland)
Characteristic central craterlike depression filled with keratin
Describe the dose adjustments in converting regular Metoprolol to Metoprolol XL
When converting, use THE SAME total daily dose.
Example 1: Metoprolol 25mg BID should be converted to Metoprolol XL 50mg daily
Example 2: Metoprolol 25 XL BID converts to Metoprolol 25 (regular) BID
Name as many types of Skin cancer as you can
- Squamous cell carcinoma
- Basal cell
Sensation of electric shock radiating down the spine or into the limbs after neck flexion