Review Flashcards
(198 cards)
1
Q
What is the timing and treatment for prehabilitation of the abdominal with Botox? What is the affect of treatment?
A
2-4 weeks prior
Higher rates of primary closure
2
Q
What is the treatment of HIV associated lipodystrophy?
A
ploy-l-lactic acid (Sculptra)
3
Q
What percentage of infections are accounted for by Biofilms? What is the most common organisms for breast implants?
A
80%
Staph epidermadis (coag negative staph)
4
Q
Where is the lumbar artery perforator flap found?
A
Between erector spinae and the quadratus lumborum
Lumber is found in the quad by the ER
5
Q
What is the mechanism of action for papavarine? What is the usual concentration? Mechanism?
A
Phosphodiesterase inhibitors
30mg/dL
Inhibit phosphodiesterase which Inhibit cGMP
6
Q
What is the management of aromatase inhibitors and tamoxifen for preop, micro cases?
A
Aromatase inhibitors continue
Tamoxifen stop (data inconclusive, 28 days prior)
7
Q
What is a viable option for Poland syndrome? What vessel if IMA is not available?
A
Diep flap reconstruction
Thoacodorsal artery may be an option for anastomosis
8
Q
What is the cause of osteogenesis imperfecta?
A
Type I collagen production
9
Q
What is the first sign of scleroderma? What is the progression in the fingers? What is the leading cause of death?
A
Systemic sclerosis disease
Raynaud’s phenomena
Progresses from distal to proximal in the finger
10
Q
What is xeroderma pigmentosa?
A
Autosomal recessive disorder affecting the DNA repair, nucleotide excision repair
Early skin cancer development, sensitivity to light
Non melanoma skin cancer by 8-9 years old
11
Q
What is the defect in Marfans syndrome?
A
Fibrilin 1
12
Q
What is the enzyme necessary for collagen cross linking and what viatamin is needed?
A
Lysyl oxidase and requires
vitamin C
13
Q
What is implicated in Menke’s disease?
A
Defect in copper transport
Leads to poor muscle tone, failure to thrive, brittle hair
14
Q
Where is the defect on the abdominal wall in omphalocele and gastroischesis?
A
Omphalocele: central abdomen
Gastroischisis: right of the umbilicus
15
Q
Why does omphalocele happen? When does the intestines herniate and return to the abdomen?
A
Failure of intestines to return to the abdominal cavity
Herniate week 6 return week 10
16
Q
What are eccrine glands classified as and what are they important in?
A
Exocrine sweat glands
Implicated in thermoregulation
17
Q
What is silver nitrate effective against adverse reactions and what is the most common use? Side effect?
A
Effective against staph and pseudomonas
Toxic epidermal necrolysis
Electrolyte disturbances
18
Q
What is a side effect of silver sulfadiazine? What to do
A
Transient leukopenia
Switching to a different topical for a few days will return the count to normal
19
Q
What are the intraoperatice factors contributing to flap thrombosis?
A
Anastomosing irradiated vessels
Intraop hypotension and large volume fluid administration
20
Q
What is the treatment for melanoma of the nail bed? In situ etc
A
Wide local excision based on depth with local flap
No need for amputation
21
Q
What is the most effective technique to minimize costal cartilage warping?
A
Harvesting the central portion of the rib
22
Q
What is the defect in Mayer Rotinsky Hauser syndrome? What is present?
A
Congenital disorder of Mullarien duct aplasia
Ovaries and normal external genitalia
Can be abscence of vagina or abscence of both vagina and uterus
23
Q
What is PAIS and CAIS syndrome? What are they genetically and what do they all have?
A
Complete or partial androgen insensitivity syndrome
All have undescended testes and testosterone in the male range
24
Q
What is Klienfelter syndrome? What do they present with?
A
47 XXY small testes and testicular insufficiency
25
What is McKusik Kaufman syndrome?
Present with hydrometricolpos (distal vaginal obstruction
Postaxial polydactyl
Congenital cardiac defects
Four types ranging from imperforate hymen to vaginal atresia with cloacal abnormalities
26
What is the flap of choice for a type IB posterior vaginal wall defects when abdominoplasty and bilateral medial thigh lift was done?
Free ALT flap
27
What are the effects of tretinoin? What is the main pharmaceutical mechanism of action?
Increased epidermal and dermal thickness
Thinning of the stratum corneum
MOA inhibition of AP1 transcription factor binding to DNA decreasing protease activity
28
How does vitamin A help in corticosteroid wound healing issues?
Promotes re epithelialization
29
What are the effects of long term corticosteroid use on the three phases of wound healing?
1: inflammatory: decrease the expression of cytokines
2: proliferatice: decrease keratinocyte growth factor (driver of re epithelialization)
3: remodeling: decreased macrophages no conversion of type 3 collagen to type I leading to less tensile strength
30
What type of fluid is TPN in terms of tonicity? What can be helpful in extrav injuries?
Hypertonic
Hyluronidase
31
Where is the plane of dissection for a transversus abdominis release? Above and below the arcuate line
Between transversus abdominis and transversalis fascia above
Between peritoneum and transversus abdominis below
32
What is the plan for a tap block?
Between transversus abdominis and internal oblique
33
Where are morel levalle lesions and what is the treatment?
Located between the deep fat and the deep fascia
Lesions with 400ccs or less would be considered for drain and doxycycline
Larger treat with open surgery and quilting
34
What are the skin layers from superficial to deep?
Dermis, subq fat, superficial fascia, deep fat, deep fascia, muscle, bone
35
What is the primary indication for closure of a neural tube defect?
Risk of infection, close within 48hrs
36
What is the effect of venous repair for venous outflow of the ear?
No change in survival rates
Decreases postoperative need for transfusion
37
What is the treatment for distal third of the leg defects in patients with severe PVD?
ALT free flap, can be flow through
38
What are the advantages of prepec placement for breast reconstruction vs sub pec?
Medial placement of implant
Less animation deformity
39
What is the basic design of the keystone flap?
V to y flaps at the opposing poles at 90 degrees
1:1 flap to defect length
Relies on central random perforators
Ok to release deep fascia surrounding the defect
40
What is the Gibson principle for cartilage grafting?
Cartilage warps to the opposite side of scoring. Based on the principle of releasing internal self locked stress
Ex a concave piece of cartilage is scored at the concave portion will make it straight
41
What are the three main flaps to fill pelvic dead space?
VRAM
Gracilis
Omental flaps
42
What is the blood supply of the para scapular flap and what does it branch off of?
**Circumflex scapular artery**
Branches off of the sub scapular artery of the axillary artery
Transverse scapular (Supra scapular) and dorsal scapular artery(transverse cervicle)
43
What is a flap used for vaginal reconstruction that can provide a sensation?
Pudendal fasciocutaneous flaps
Based on the terminal branches of the internal pudendal ateries (superficial perineal arteries)
44
What is the antibiotic duration for breast reconstruction?
Less than 24 hrs, ancef
45
What is the affect of vein grafting on digital reimplantation?
Does not decrease success
46
What are positive predictors of digital replant?
High volume centers
Warm ischemia time less than 12hrs
Cold ischemia time 24hrs
47
In RFFF penile reconstruction what nerves are coapted for erogenous sensation?
LABC to dorsal nerve of the penis
48
What is type 1 and type 2 nec fasc?
Type I: polymicrobial
Type II: monomicrobial
49
What is the treatment for strep pyogenes? What aesthetic procedure may be associated?
Gram positive cocci in chains, Group A strep, beta hemolytic
Treat with Clindamycin and PCN
Liposuction
50
What is another indication for chest wall reconstruction besides rib space and number?
Paralyzed diaphragm and herniation of abdominal contents below the level of the defect
Need to reconstruct with rigid or semirigid approach
51
What is the flap of choice for trochanteric defects?
TFL flap
52
What are flap options for ischial injury reconstruction?
Gracilis and biceps femoris
53
What is the treatment of choice for lower eternal defects?
Omental flap and skin graft or vram flap
54
What is the suture of choice for closure of oral mucosal lacerations?
Chromic gut suture
Loses tensile strength in 10-14 days
55
What is the prophylaxis for leech therapy? What is the organism?
Ciprofloxacin
Aeromonas
56
What is the best laser for hypervascular burn scar management? What wavelength?
PDL 585nm
Targets hemoglobin at 585nm
57
What is the hernia working group classification of hernias?
Grade 1 low risk no infection
Grade 2 comorbidities present that increase the risk of complications
Grade 3 discontinuity of the GI tract or wound infection
Grade 4 mesh infection
58
What is the transformation rate to SCC for leukoplakia of the mouth?
10%
59
What are the nerve transfers for C5-6 brachial plexus injuries? What time frame?
12-18 months
Spinal accessory to suprascapular nerve for shoulder abduction
Triceps branch of the radial nerve to axillary nerve transfer
Ulnar nerve to biceps transfer
Median nerve to to brachialis muscle branch
60
What are options for nerve transfer if total plexus injury?
Phrenic to musculocutaneous
61
What distal nerve transfer can be used for high ulnar nerve injuries?
Ain to ulnar motor branch
62
What percentage of patients undergoing lower extremity amputation walk when related to critical limb ischemia?
Less than 50%
Compared to post traumatic patients which is over 90%
63
How much of preserved proximal tibia is needed for the best functional outcome of below the amputation?
At least 10 cm
64
What is the path of dissection for free fibula flap?
Posterior septum
Peroneus Longus and brevis dissected off the fibula
Anterior septum is identified and divided
EDL muscle encountered first then EHL
Interosseous septum divided and Tibialis posterior identified and dissected off posterior trunk
65
What is the treatment for arterial thrombosis of the hand for example in ulnar hammer syndrome?
Catheter based arteriogrophy first
66
What is the management of dupuytrens flare?
NSAIDS rest elevation
67
What is the Budapest criteria for CPRS?
1 Continued pain out of proportion to original event
2. Three of the following (history):
A: numbness or increased pain
B: temperature asymmetry skin color changes
C: edema or sweating
D: decreased motor function or changes in hair or nail growth
(Physical) one symptom needs to be seen at time of evaluation in two of the categories
68
What is a tendon transfer for foot drop?
Tibialis posterior to foot
69
What is the treatment of choice for slac wrist?
Scaphoidectomy and four corner arthodesis
70
What is the Paneva Holevich technique for tendon repair?
Two stage technique where distal ends of the FDS and FDP, sutured to each other, lumbrical sutured over and a silicone rod is left in place for tendon sheath reconstruction.
Second stage the myotendenous junction is then released and pulled through the reconstructed sheath
71
What is the nerve transfer for foot drop?
Tibial nerve from FHL, FDL to tibialis anterior
72
What length is nerve grafts not successful?
Over 6cm
73
What is Olliers syndrome?
Both have Multiple endochondromas
Mafucci has multiple venous malformations
Olliers: no venous malformations
Both can transform to chondrosarcoma
Mutations in IDH 1 and 2
74
What is the receptor that is overactive in raynauds?
Alpha 2
75
What causes nail plate deformity from mucous cyst and where?
Eminates from the dip joint and presses on the germinal matrix causing the deformation of the nail
76
What is the treatment for Marjolins ulcer?
Squamous cell from chronic wounds, very aggressive
Need to treat with resection down to fascia, 2cm margins
77
What prevents the dorsal dislocations from re locating?
Volar plate, can divide and no need to repair
78
What is the cause of claw toe?
Injury to the FHL causing contraction and shortening after free fibula
79
What is the most common primary malignant bone tumor of the hand?
Chondrosarcoma
80
What is the treatment after volar dislocation of the pip joint?
Extension splinting with the DIp joint free for 4-6 weeks, due to central slip injury
81
How does thumb hypoplasia differ from thumb brachydactyl?
Distal phalanx is only affected in thumb brachydactyl
Proximal phalanx is affected in thumb hypoplasia
82
What is the most common injury mechanism for fingertip injuries in children?
Door or window crush injuries
83
What is epithelioid sarcoma and how is it treated?
Mimics infection diagnosed on biopsy as spindle cells or squamous cells
Treat with wide local excision
84
What is the blood supply of the rectus femoris muscle flap?
Descending branch of the lateral circumflex femoral artery
85
What is an ultrasound finding for carpal tunnel syndrome?
Increased cross sectional area of the nerve signifying edema
86
What are the changes in EMG and nerve conduction studies in carpal tunnel?
NCS: mild cases may be normal, or unchanged, increased latency in advanced disease
EMG: earliest sign of denervation: spontaneous muscle activity with fibrillation (seen after changes in NSC), abductor pollicis brevis muscle denervation on emg in late stage
87
What is the most common hand infection organism and what antibiotics used?
MRSA and vancomycin especially in IVDU since they are usually clinda resistant
88
What is the treatment of mallet finger and what is an absolute indication for surgery?
Splinting
Volar subluxation can be seen with v sign of the joint on x ray is an absolute indication for operative treatment
Relative indication: more than 50 percent of the count involved
89
When is congenital trigger thumb released?
After 1 year in fixed deformities
90
What tendon is most often ruptured in hook of hamate fracture?
FDP of the small finger
91
How is a Bennett fracture of the thumb cmc joint reduced?
Axial traction
Pronation and abduction of the thumb in extension while volar pressure is applied to the metacarpal base
92
What is the dominant pedicle of the trimmed great toe flap?
First plantar metatarsal artery
93
What is the pedicle for trimmed second toe flaps?
Medial plantar digital artery
94
What is the elsons test for the finger and what does it check for?
PIP joint is flexed over a table and patient is asked to extend against resistance, extension can be seen at DIP joint which is from the lateral bands
Checks for central slip injury
95
How long of a boney defect can a medial femoral condyle flap cover?
7 cm defects
Can have sensory changes in the saphenous nerve distribution, decrease in ROM
Femur fracture is rare
96
What is the difference in location of Captodactyly vs Clinodactyl vs Kronstadt deformity?
Kriner: radial and volar deviation of distal phalanx
Camptodactyly: flexion contracture of the PIP joint
Clinodactyly: small finger is radially displaced
97
What are the characteristics of stsg that contribute to secondary contracture?
Thickness: thicker less contraction
Meshed: higher secondary contracture
Placement on fascia have higher contracture
98
What tooth has a higher risk for agenesis in cleft lip and palate?
Lateral incisor
99
What is the treatment method of choice for lefort one distraction?
External distraction has better speech outcomes and more predictable
100
What is the FDA ages for helmet therapy of plagiocephaly?
3-18 months
101
What depth is the marginal mandibular artery in relation to platysma and facial vessels? Posterior belly of digastric
Below the platysma
Above the facial vein, facial artery is deep to the facial vein
Posterior belly of digastric runs between the facial artery and vein, the muscle is superficial to the hypoglossal nerve
102
When is bone grafting of the alveolus performed?
Between 8-12 years old in mixed dentition before rupture of the canine
Later times of grafting is associated with higher rates of graft failure
103
What is the treatment of infected thyroglossal duct cyst?
Antibiotics
I&D avoided due to possible fistula formation
104
What is the imaging for Masseter hypertrophy?
CT MRI
105
What are the seven bones that make up the orbit?
1. Sphenoid
2. Maxilla
3. Palatine
4. Zygoma
5. Ethmoid
6. Lacrimal
7. Frontal
106
What is the recommendation for the length of latency, activation and consolidation phase for mandibular distraction?
Latency: length of time for callus bone formation: 1 day
Activation: rate of expansion 2-4 times a day with 1-1.5 mm per day about 3-4 weeks
Consolidation: immobilization to allow for bone healing. Twice as long as activation phase about 8 weeks
107
What is the palpable structure superior to the thyroid cartilage?
Hyoid bone
108
What is the palpable ring below the thyroid cartilage?
Cricoid cartilage: isthmus of the thyroid lies just below the
109
Heat is the best approach for sagital synostosis?
Modified pi procedure or strip crani
110
What decreases infection risk of mandibular fractures?
Smoking
Antibiotics prior to fixation
External approach
111
What is the ideal coverage for superior anterior aspect areas auricular defect coverage?
Temporal parietal fascia flap
112
When is MRI ordered for neurocutaneous melanosis?
Before 6 months old
113
What does the mental nerve innervate?
Mentalis
Depressor Anguli oris
Depressor labii inferioris
114
What is the management of a stable zone 3 injury?
Ct angio or angiogram
115
What are the most commonly injured teeth with mandible distraction
First and second molars
116
What is the course of the nerve to the masseter muscle?
From foramen ovale. Obliquely below the zygomatic arch, through the sigmoid notch
Target branch is found between the deep and middle lobes of the masseter
117
In the furlow procedure what flaps are composed of muscle/ mucosa?
Flap that is created from anterior soft palate is transposed posteriorly and composed of LVP
Flap that starts posteriorly is mucosa only
118
What does the sistrunk procedure consist of?
Excision of cyst, middle part of the hyoid bone and surrounding tissue
119
What is the function of the inferior rectus muscle?
Raises and abducts the eye
120
What is the treatment for medium to small sized defects of the upper helical rim?
Anita Buch flap: chondrocutaneous advancement flap
121
Where does the thoracic duct terminate? What lab to diagnose chyle leak?
At the junction of the left subclavian and internal jugular
More than 110 mg/dL chylomycrons and triglycerides
122
What is the treatment for forehead feminization with thin frontal sinus bone?
Frontal sinus setback
123
What is possibly medialized in degeorge syndrome?
Internal carotid arteries
124
What is the pedicle for the submental flap? Where is it and what muscles can be included?
Runs between the ramus of the mandible and the submandibular gland
Can be taken with mylohyoid, platysma, anterior belly of digastric
125
What does the posterior belly of digastric receive its blood supply from?
Posterior auricular and occipital
126
What is the Markowitz Manson classification of NoE fractures? How to treat?
Type I: large bony fragment attached to canthal tendon- ORIF of fragment
Type II: canthal tendon attached and comminuted fracture, needs ORIF and wire fixation
Type III: avulsion of the medial canthal tendon trans nasal wiring
127
What is the effect of microneedling? When to perform?
Increase collagen and elastin
3-4 months after initial surgery
128
What is a useful graft in correcting the lateral cural collapse?
Lateral crural strut graft
129
What muscle is included in the TUG flap?
Gracilis muscle
130
What is a way to reduce post inflammatory hyperpigmentation during laser?
Reducing fluence
131
How to manage full thickness necrosis after face lift?
Allow to demarcate and local wound care
132
What are ways to decrease contour deformities in liposuction?
Cross cross pattern
Under correction and deeper tissue planes
133
What is a way to tell if a patient is a good candidate for Botox to platysma for jaw contouring?
Tell them to contract the platysma if jawline appears would be a good candidate
134
What is the treatment for hypoestheisa of the abdominal skin after abdominoplasty?
Observation
135
What nerves in innervate the sensory portion of the breast?
Anterior 2-5 for medial breast
Lateral 3-5 for lateral 5th also contributes to lower medial portion
136
What are causes of malignant hyperthermia?
Volitile anesthetics: iso sevo and desflurane
Succinylcholine
137
What happens if clitoral frenulum is divided? What is divided in the clitoral hood reduction?
Anterior rotation of the clitoris causing chafing
Lateral clitoral hood superficial skin only
138
What is the treatment for reactive hyperpigmentation?
Hydroquinone with glycolic acid cream or retinol
Hydroquinone works by inhibiting tyrosinase
139
What is the mechanism of TXA?
Amino acid lysine derivative: binds to sites on plasminogen preventing conversion to plasmin
140
What are the branches that supply the orbicularis muscle?
Zygomatic: innervates the lateral
Buccal: innervates the medial as well as the lacrimal pump mechanism
141
What is the consequence of over resection of the lower lateral cartilage?
Narrow the nasal tip
Alar retraction and external lasso valve dysfunction
142
What is a consequence of over resection of the upper lateral cartilage?
Inverted V deformity
143
What is the preferred incision for nipples sparing mastectomy with ptotic vs non ptotic breasts?
Lateral IMF non ptotic
Vertical radial ptotic
144
What is the advantage of long scar vs short scar technique?
Long scar: addresses neck
145
What is the efficacy of vaginal laser treatment?
It is not effective when compared to sham treatment
146
Where are the lymphatics located in the femoral triangle?
Medial to the femoral vein
147
What is a subdomal graft and what is it used for?
Strip of cartilage 8-10mm long 1.5 wide placed under the domes of the lower lateral cartilage
Used to control interdomal distance position and genu angle
148
What is the sequence of facial fat pad deflation?
Deep compartment deflation in early 40s: medial and lateral SOOF, deep medial cheek, medial portion of the buccal fat pad
Then superficial
Forehead is last in the 70s
149
What is the angle of divergence and what can be done to correct it?
Angle when looked at the worms eye view of the two domes of the nose should be 30 degrees
Interdomal sutures are used to correct
150
What are retractors of the lower lid?
Capsulopalpebral fascia and interior tarsal muscle(analogus to the muller muscle)
151
What are the markers for breast implant associated squamous cell carcinoma?
CK5/6 positive and p63 positive
152
What are signs of microscopic fat embolism from gluteal fat grafts?
Pulmonary edema: treatment is supportive no heparin
153
What cancers are Poland syndrome patients at risk for?
Hodgkin’s disease, leukemia, renal tumors lung tumors
Same risk as general population for breast cancer
154
What laser helps with hyperpigmentation, small blood vessels and fine rhytids?
IPL
Er yag has no effect on small blood vessels
155
What stain can be used to confirm milk discharge from galactocele?
Sudan 4 stain
156
How do you differentiate cervical vs marginal mandibular nerve branch injury?
If able to every the lip it is cervicle since marginal mandibular branch innervates the mentalis muscle
157
What is the treatment for bia alcl if found in One breast?
Bilateral total capsulectomy and removal of implants since 5% of the time can be in contralateral breast
158
How is female hair loss graded?
Ludwig classification
Vertex thinning
159
What is the lidocaine dosing for tumescent solution?
35 mg/kg
160
What is the effect of pull on the ptyragoid muscle on the maxilla in lefort I injuries?
Inferior and posterior
161
Tooth numbering system
162
What is the management of white clot in micro?
Compromised platelet/ vessel damage
Treat with Excision and vein graft
Also postop platelets would help
163
What are bone biopsies sent for when evaluating for osteo?
Sent for histopathology
164
What is the CME standards for ASPS?
25 category 1 cme credits in patient safety activity every 5 years when in the continuous certification program
Overall 125 category 1 cme credits every 5 years including the patient safety component
165
What is the treatment for midazolam overdose?
Flumazenil 3mg over 30 seconds
166
What is a consequence of spinal accessory nerve injury in the posterior neck?
Shoulder drooping decreased mobility GH joint capsulitis
No neck range of motion issues
167
What is the standard ancef intraop dosing
Every 4hrs
168
What is the diagnosis for pericardial tamponade?
Auscultation first if not emergent ultrasound
169
What are the different levels of evidence based on study
I prospective cohort or systematic reviews of these studies
II: lesser quality prospective cohort
Iii: case control
IV case series
V expert opinion
170
What is the patient safety and quality improvement act protect?
Healthcare workers who report medical malpractice
171
What does the 21st century cures act help define?
Helps define the electronic health record interoperability and allows patients to view their medical record
172
What is the mechanism of action for semaglutide?
Glp1 analogue: stimulates insulin production inhibits glucagon release and delays gastric emptying
Leads to 15 percent weight loss
173
What is the active ingredient in manuka honey?
Methyl glyoxal: alters the bacterial fimbria and flagella
High osmolality: draws water out
174
What is the innervation to the anterior hard palate?
Nasopalatine nerve a branch of v2
175
What supplies the sensation of the nasal roof and anterior nasal septum?
Anterior ethmoidal nerve branch of V2
176
What nerve supplies the hard palate?
Greater palatine nerve
177
What nerve supplies the soft palate?
Lesser palatine nerve branch of V2
178
What is the nerve supply of the buccal mucosa?
Buccal nerve branch of v3
179
After calcium gluconate given for hyperkalemia what is next step?
Insulin, albuterol then bicarbonate
180
What causes csf leak in rhinoplasty?
Injury to the cribriform plate
181
What must be included in the sistrunk procedure?
Resection of the suprahyoid region
182
What is the rule of 80s for salivary gland tumors?
80 percent in the parotid
80% are benign
80% of benign tumors are pleomorphic adenomas
183
What does vitamin A do in wound healing?
Increases collagen cross linking
184
What does vitamin c do?
Hydroxilation of proline
185
What is zinc used for in wound healing?
Promotes immune response and lymphocyte activation
186
What are symptoms of zinc deficiency?
Rash acne loss of taste increased infection infertility
Alopecia night blindness delayed wound healing
High in post bariatric surgery
187
How does b12 deficiency present?
Megaloblastic anemia
Glossitis
Ataxia
Altered mental status
188
What is klippel trenaunay syndrome?
Patchy port wine stain on an extremity overlying a lymphatic malformation with skeletal hypertrophy
189
What is parkes Weber syndrome?
Same as Klippel Trenauay syndrome but with AVF on MRI
190
What is osler Weber rendu syndrome?
Telengetsias of the skin and mucus membranes with nose bleeds and positive family history
191
What is a concern with SGLT2 inhibitors such as dapagliflozen?
Diabetic keto acidosis need to stop 3 days before
192
What is the birads classification?
1: normal
2: benign
3: probably benign less than 2%malignancy
4: suspicious features
5 probably malignant
193
What drugs cause AKI?
NSAIDs aminoglycosides and amphoteracin
Metformin is metabolized in the kidneys but an accumulation may lead to lactic acidosis and AKI
194
What are contraindications to lumpectomy and radiation?
Early pregnancy
Multi focal disease
Diffuse microcalcifications
Inflammatory breast cancer
Persistent positive margins
195
What is associated with accessory auricle tissue?
Risk of renal, cardiac anomalies and hearing loss
196
Who should a physician inform of a health info breach over 500 patients?
Affected individuals
US health and human services
Prominent media outlet within 60 days
If it’s fewer than 500 then hhs and patients
197
What decreases the risk of postoperative nausea and vomiting when administered on induction?
Propofol
198
What drugs are associated with a risk for postoperative nausea and vomiting?
Thiopental, halothane, remifentanil, nitrous
