random Flashcards
(218 cards)
1
Q
indomethicin
A
prevents preterm labor, close PDA, treat gout
2
Q
steady state reached at how many half lives
A
5
3
Q
cyp-450 inhibitors
A
isoniazid, ketoconazole, erythromycin, fluoroquin, flagyl, allopurinol, verapamil, amiodarone, MAOIs, disulfiram
4
Q
best test for colovesicular fistula
A
CT scan
5
Q
SE mafenide
A
metabolic acidosis
6
Q
SE silver nitrate
A
hypochlor, hyponatremia
7
Q
SE silvadene
A
neutropenia, increased risk of kernicterus
8
Q
GI CMV treatment
A
ganciclovir
9
Q
SE tacrolimus
A
htn
10
Q
SE sirolimus
A
poor wound healing
11
Q
annular pancreas tx
A
duodenojejunostomy
12
Q
AVF needs
A
vein >3mm artery >2mm
13
Q
most sensitive phase of cell cycle for radiation
A
M phase
14
Q
respiratory quotient
A
CO2 prod/O2 consumed
15
Q
gold std for bladder injury
A
CT cystography
16
Q
appendicitis visceral pain
A
periumb pain
17
Q
appendicitis somatic pain
A
RLQ pain
18
Q
Pulm sequestration extralobar blood supply
A
systemic arterial and venous
19
Q
pulm sequestration intralobar blood supply
A
aorta, pulm vein
20
Q
1 presentation of pulm sequestration
A
infection
21
Q
copper def
A
neutropenia, pigment change, arrhythmia
22
Q
iron def
A
anemia, glossitis, brittle nails, cardiomeg
23
Q
Mg def
A
nausea, weakness, AMS
24
Q
selenium def
A
cardiomyopathy, growth retardation, pain, weakness
25
zinc def
poor wound healing, hair loss, testicular atrophy , diarrhea, dermatitis
26
best initial test to diagnose esophageal perf
gastrograffin
27
contrast enhancement during arterial phase with prominent central scar
FNH
28
sarcoma spreads via
hematogenous usual
29
spread via lymph nodes
clear cell, angiosarcoma, rhabdomyosarc, synovial, epitheliod
30
arterial enhancement with portal venous washout
HCC
31
Milan
3 < 3cm, 1 <5cm
32
UCSF criteria
1 <6cm, 3 <4.5cm total <8cm
33
ablation size cutoff
< 2 cm
34
amebic abscess treatment
flagyl
35
VHL
CNS hemangioblastoma, pheo, clear cell renal, cystadenoma of pancreas, papillary cystadenoma of epidid/broad ligament
36
atropine mechanism
competitive inhibitor of acetylcholine muscarinic R
37
most radiosensitive
seminoma
38
adenoid cystic carcinoma of salivary gland
slow, insidious onset, late presentation of distant mets, high avidity for nerves
39
fuel for colonic cells
short chain FA - acetate, butyrate, propionate
40
tx of undiff spindle cell (malignant fibrous histiocytoma of bone)
neoadj chemo and excision with wide margins
41
langerhans cells (aka dendritic cells) are derived from
monocytes
42
langerhans cells require stim by
colony stim factor 1
43
deep pressure and high freq vibration
pacinian corpuscle
44
warmth, skin stretch
ruffinis
45
cold, low freq vib
krause end bulb
46
light pressure and tactile sense
meissners
47
thermal regulation and hypotonic sweat
accrine
48
palms and soles
apocrine sweat (via sympathetic NS and acetylcholine)
49
predominant collagen type
type I
50
melanoma markers
S100, HMB-45
51
systemic treatment for melanoma
dacarbazine for + nodes or mets, stage IIIB or IV
52
treatment for >4 nodes + melanoma
XRT - also used for palliation
53
basal cell margins
0.3-0.5cm
54
lip cancer basal (top lip)
0.75cm margin
55
SCC margin
1 cm, Mohs for cosmetic area
56
needs 2 cm margin SCC
Marjolin, penile, vulvar
57
node dissection for SCC if
>2cm or >4mm deep
58
parotid basin lesions (ear, temple, etc.)
superficial parotidectomy, if + will need total parotidectomy and MRND
59
SCC need for chemo XRT
if neuro, nodal, vessel involvement or + margins
60
cholangiocarcinoma type I
common hepatic duct
61
cholangio type II
confluence of R + L hep ducts
62
cholangio type IIIa
spread to bifurc of R hep
63
cholangio type IIIb
spread to bifurc of L hep
64
cholangio type IV
extends to bifurc of both R and L or multifocal involvement
65
colangio type V
stricture @ jxn of CBD and cystic duct
66
increases risk of T cell lymphoma in small bowel
Celiac
67
marker for rhabdomyosarc
desmin
68
usual soft tissue sarcoma spread
hematogenous
69
soft tissue sarcoma usually mets to
lung
70
does not usually met to bone
colon cancer
71
most important factor in sarcoma
tumor grade
72
type of biopsy in soft tissue sarcoma
longitudinal excisional if < 4cm or longitudinal incisional if > 4cm
73
margin for soft tissue sarcoma
2 cm
74
chemo used if trying to limb spare in soft tissue sarcoma
doxorubicin based, also do XRT
75
post op chemo XRT for which soft tissue sarcoma
high grade, close margins, tumor > 5cm
76
soft tissue sarcoma MAID
mesna, doxarubicin, ifosfamide, dacarbazine
77
5 year survival for soft tissue sarcoma with resection
40%
78
NF1
CNS, peripheral nerve sheath, pheochromocytoma
79
gene in NF1
neurofibromin
80
gene in NF2
merlin
81
NF2
acoustic nerve tumor
82
LiFraumeni gene
p53
83
LiFrau cancers
breast, brain, acute leukemia, soft tissue sarcoma, adrenal cortical carcinoma
84
hereditary retinoblastoma gene
RB1
85
retinoblastoma tx
chemo, cryotherapy, radioactive plaques, laser treatment, XRT, surgery
86
tuberous sclerosis genes
TSC-1 : hamartin (tumor suppressor gene)
| TSC-2 tuberin (mTor pathway)
87
manifestation of TS
hamartoma, angiomyolipoma, brain, kidney, heart, eyes, lungs, skin. Have seizures, dev delay, skin abn, lung and kidney tumors
88
Gardners
Au Dom - FAP + extracolonic manifestation
89
manifestations in Gardners
abd desmoid, osteoma of skull, thyroid ca, epidermoid cysts, fibromas
90
APC gene
binds GSK = glycogensysthasekinase
91
Merkel cell carcinoma
neuroendocrine, aggressive, spreads via skin and LN, mets to bone
92
stains for Merkel cell carcinoma
NSE -neuron specific enolase, cytokeratin, NF protein
93
tx merkel cell
SLN biopsy or LND, 2-3 cm margin, post op chemoXRT
94
5 year survival merkel
60%
95
dermatofibrosarcoma protuber RF
arsenic
96
margin for DFP
3cm
97
glomus tumor is benign T/F?
T
98
where to ligate if need sympathectomy for hyperhid
T2-T4
99
crossing nerve of kuntz
2nd rib
100
HPV cancer types
16 and 18
101
Gleevec used in
GIST, CML, recurrent or metastatic DFP
102
all thymomas require resection T/F
T
103
pleomorphic (mixed) parotid tumor
benign
104
warthin tumor
benign
105
mucoepidermoid or adenoid cystic carcinoma
malignant
106
acinic cell carcinoma
malignant
107
no risk of transmission of hepatitis with transfusion of
albumin
108
branched AA
leucine, isoleucine, valine
109
essential AA
leucine, isoleucine, valine
110
where are essential AA metabolized?
skeletal muscle
111
fibroblasts are stim by
macrophages
112
central cord injury
ext weak arms>legs
113
posterior cord injury
paraplegia with loss of propriocept and vibration, pain and temp are preserved
114
can enhance immune fxn
arginine
115
involved in collagen formation
proline
116
involved in signal transduction
tyrosine
117
involved in protein metab and citric acid cycle
glutamine
118
muscle protein synthesis AA
leucine
119
echo in blunt cardiac injury if
HD unstable
120
abnormal EKG in blunt cardiac injury mandates
24-48 hr stay
121
calcitonin
decreased Ca and Phos levels
122
calcitonin increased in which thyroid cancer?
medullary
123
calcitonin ____osteoclast activity
inhibits
124
where is calcitonin produced?
C cells in thyroid
125
Colon cancer T1
submuc
126
colon cancer T2
muscularis prop
127
colon cancer T3
subserosa
128
colon cancer T4a
visc peritoneum
129
colon cancer T4b
other organs
130
colon cancer N1
1-3 nodes
131
colon cancer stage 1
T1N0M0 or T2N0M0
132
colon cancer stage 2
A: T3 N0M0
B: T4 N0M0
133
colon cancer stage 3
A: T1N1M0 or T2N1M0
B: T3N1M0 or T4 N1M0
C: any T, N2, M0
134
colon cancer stage 4
any T any N M1
135
hereditary spherocyt
splenect after age 5, Au Dom, eval if need chole, Coombs will be negative
136
CPP=
MAP- ICP
137
risk of SSI with dirty case
30%
138
risk of SSI with clean
2%
139
risk of SSI with clean contam
4%
140
risk of SSI with contaminated
8%
141
splenic abscess tx
splenectomy
142
panc abscess tx
open drainage
143
lung abscess tx
antibiotics alone
144
perirectal abscess tx
open drainage
145
epidural abscess tx
open drainage
146
gold std for diagnosing C diff
stool cytotox assay, but takes 24-48
147
aspergillosis tx
voriconazole or amphotericin
148
actinomyces tx
PCN- G
149
nocardia tx
bactrim
150
SBP is usually ___microbial
mono - E coli, pneumoco, klebsiella
151
PD cath infections
Staph aureus
152
tx PD cath infection
vanc + gent, remove catheter if fungal, pseudomonas, TB
153
tetanus tx if clean wound and vaccinated
No TIG, no TD
154
digoxin mech
inhibits Na/K to increase myocardial Ca, slows AV conduction, inotropic effect
155
SE of digoxin
hypokalemia, arrhythmia, visual changes, decreased blood flow to intestines
156
ASA OD
first respiratory alkalosis then metabolic acidosis
157
Ambien mech
zolpidem GABA R agonist
158
tramadol SE
seizure
159
duloxetine mech
SNRI
160
_____ can facilitate closure of fistulas in Crohns
infliximab
161
tx benzo OD
flumazenil
162
Wilsons/Cu OD
penicillamine
163
hemachromotosis/Iron
deferasirox
164
lead poisoning tx
dimercaptosuccinic acid
165
drotecogin alfa activated
activated prot C used to prevent thrombosis in septic patients
166
fast onset, less myocardial depression, less laryngospasm
sevoflurane
167
pungent and airway irritation
desflurane and isoflurane
168
enoflurance SE
seizure
169
halothane
slow onset, highest myocardial depression and arrhythmias, least pungent
170
halothane SE
hepatitis, fever, eosinophilia, jaundice, increased LFTs
171
```
caloric requirement
a. 0-1
b. 1-7
c. 7-12
d. 12-18
e >18
```
kcal/kg/day
a. 90-125
b. 75-90
c. 60-75
d. 30-60
e. 25-30
172
FW deficit =
TBW x (serum Na-140)/140
173
TBW =
in men weight x 0.6 in women weight x 0.5
174
adrenocortical carcinoma stage I
< 5 cm no local invasion, no mets
175
adrenocortical carcinoma stage 2
> 5cm, no local invasion, no mets
176
adrenocortical carcinoma stage 3
any T, any N, M0
177
adrenocortical carcinoma stage 4
M1
178
potency of steroids
hydrocort < predni < methylpred < dexameth
179
finasteride mech
5 alpha reductase inhibitor
180
tx of mediastinitis
debridement and flaps
181
hepatoblastoma
6 mo - 3 yrs, increased AFP, most p/w unresectable disease, associated with Beckwith-Wiedemann
182
malignant phyllodes mets to
lungs
183
Tetralogy of Fallot
overriding aorta, VSD, R vent outflow obst, RVH
184
highest MAC
NO
185
CI to using NO
PTX, SBO
186
Ranson criteria
WBC > 16, age >55, glucose >200 Hct decrease 10%, Ca <8 fluid >6L
187
avoid this anesthesia agent if egg allergy
propofol
188
paralysis first to go
face
189
paralysis last to go
diaphragm
190
paralysis first to recover
diaphragm
191
paralysis last to recover
face
192
undergoes hoffman elimination
cisatracuronium
193
rocuronium metab in
liver
194
pancuronium metab in
kidney
195
max dose lidocaine
5mg/kg
196
max dose marcaine/bupiv
3mg/kg
197
avoid this benzo in pregnancy
versed (midazolam)
198
calories needed in burn patient
25kcal/kg/day + 30kcal/day x %burn
199
protein needed in burn patient
1-1.5 g/kg/day + 3gx % burn
200
harris benedict equation
calculates basal metabolic rate from weight, age, height and gender
201
medium and short chain FA enter
portal system after entering enterocytes by simple diffusion
202
long chain FA enter
lymphatics (they enter along with chylomicrons)
203
FA synthesis occurs where
cytoplasm
204
saturated FA are used by
liver and heart
205
majority of body total cholesterol
is synthesized, not dietary
206
essential FAs
linoleic and linolenic
207
sucrose=
fruc + gluc
208
lactose =
galact + gluc
209
maltose =
gluc + gluc
210
Refeeding syndrome
decreased K, Mg, Phos
211
S phase specific agents
MTX, 5FU, pemetrexed, gemcitabine, etoposide, doxorubicin
212
SERMs
Tamoxifen - premenopausal, Raloxifene - post menopausal
213
MEN1
pit adenoma, parathyroid hyperplasia, panc tumor
214
MEN 2A
parathyroid hyperplasia, MTC, pheo
215
MEN 2B
mucosal neuroma, marfanoid, MTC, pheo
216
parathyroid hyperplasia, MTC, pheo
MEN 2A
217
pituitary adenoma, parathyroid hyperplasia, panc tumor
MEN1
218
mucosal neuroma, MTC, marfanoid, MTC, pheo
MEN2 B
