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Flashcards in Medical 1.4 Deck (35)
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1

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

2

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

3

Methemoglobinemia: pathogenesis?

Ferrous (Fe2+) iron in heme becomes oxidized to the Ferric (Fe3+) state. Ferric heme is unable to bind to oxygen.

4

HIT: diagnostic criteria?

1) Thrombocytopenia
- 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

5

Spondylolysis

Fracture of pars interarticularis of vertebra

6

Spondylolisthesis

Spondylolysis that is severe enough to allow the vertebral body to shift out of place

7

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)

8

Testicular cancer: most common?

Germ cell tumors

9

Germ cell tumors: types?

1) Seminomas
2) Nonseminomatous germ cell tumors (NSGCTs): AKA everything else

10

Testicular cancer: prognosis?

Excellent: 95% 5-year survival

11

Testicular cancer: risk factors?

- Cryptorchidism (abdominal cryptorchidism > inguinal cryptorchidism)
- Testicular feminaztion syndromes

12

Testicular cancer: clinical presentation?

Painless testicular mass

13

Antimitochondrial antibodies

Primary biliary cirrhosis

14

Rank-ligand inhibitor

Denusomab (Prolia)

15

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

16

Iliotibial band syndrome: symptoms?

Pain where iliotibial band crosses the lateral epicondyle of the femur (just lateral and superior to the knee joint)

17

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.

18

Neoadjuvant Therapy

Treatment given before the main treatment, to shrink tumor burden and make it easier to remove

May include chemo, radiation, or hormone therapy

19

Induction Therapy

First treatment given for a disease (or treatment that is generally agreed to be the best treatment for that condition)

20

Intensification Therapy

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

21

"Break-bone Fever"

Dengue fever

So named because of the characteristic MSK pain it causes, especially in the lumbar spine

22

Actinic Keratosis

Precursor to Squamous Cell Carcinoma

Sometimes considered to be "SCC in situ"

23

Basal cell carcinoma: appearance?

- Waxy, translucent, or pearly
- Telangiectasias often present (a feature that contributes to easy bleeding)

24

Basal cell carcinoma: common locations?

Head and Neck

Can often lead to cosmetic disfigurement

25

Bowen disease

Superficial type of squamous cell carcinoma

26

Keratoacanthoma

Skin cancer that originates in the Pilosebaceous glands (hair follicle/sebaceous gland)

Characteristic central craterlike depression filled with keratin

27

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

28

Name as many types of Skin cancer as you can

- Squamous cell carcinoma
- Basal cell
- Melanoma
- Keratoacanthoma

29

Lhermitte's sign

Sensation of electric shock radiating down the spine or into the limbs after neck flexion

30

Lhermitte’s sign: associated conditions?

- Multiple Sclerosis
- Cervical disk disease (herniation)
- Spinal cord tumor