TrueLearn Flashcards
(86 cards)
Diverticulitis
Diverticulitis without peritonitis or hemodynamic instability can be managed conservatively with intravenous antibiotics and NPO status.
Abscesses less than 4 cm can generally be treated with antibiotics alone.
Medial Meniscus Injury Examination
The McMurray test is the best test to assess injury to the medial meniscus.
“Passive flexion and extension of the joint with internal and external rotation”
performed by holding the knee with one hand placed along the knee joint line, and flexing the knee to 90° while the foot is held by the calcaneus of the other hand. The tibia is externally rotated while the knee is extended through a full range of motion. If this maneuver is painful or if crepitus is palpated along the medial joint line, this constitutes a positive test and typically indicates a tear in the posteromedial meniscus. This test can be adjusted to assess the lateral meniscus as well, as the tibia can be internally rotated as the leg is extended. If pain or a “click” is felt, then this is consistent with a positive test and may indicate a lateral meniscus tear.
Corneal Abrasion
Corneal abrasions are a common ocular injury in POST-SURGICAL patients and are best diagnosed by slit-lamp examination with fluorescein staining (or an ocular exam with an ophthalmoscope, if a slit lamp is unavailable).
ACL tear
The anterior cruciate ligament (ACL) is the most common knee ligament to be injured, and patients commonly report a twisting motion before the injury. An ACL tear presents classically with a “pop,” swelling, instability, and LATERAL knee pain.
Paronychia
Paronychia is acute or chronic inflammation that involves the lateral or proximal nail folds and if associated with abscess, should be treated with incision and drainage followed by targeted antibiotics if it does not resolve
Abdominal Aortic Aneurysm
Aneurysm diameter and expansion rate are predictors of aneurysm rupture, with diameters greater than 5.5 cm and/or expansion of over 1 cm within a year increasing the risk exponentially. These patients should be referred to vascular surgery for potential repair.
Tinea Versicolor
Tinea versicolor is a fungal infection caused by Pityrosporum orbiculare or ovale. It causes annular hypopigmented scaly macules, which usually appear on the chest and back. It is common in young adults and teenagers due to increased sebaceous gland activity. A diagnosis can be made by the appearance of the classic “spaghetti and meatballs” on KOH prep. Initial treatment of choice is topical ketoconazole 2% or selenium sulfide 2.5% suspension. Oral antifungals may be used in resistant or recurrent cases.
Viscerosomatic for heart
T1 - T5
Brown-Sequard Syndrome characteristics
- ipsilateral loss of vibration
- ipsilateral spastic paresis below the lesion,
- ipsilateral flaccid paralysis at the level of the lesion
- and contralateral loss of pain and temperature below the lesion
Celiac dz histology characteristics
intestinal mucosa with flattened microvilli
villous atrophy that leads to the malabsorption of nutrients and many of the sequelae of the celiac disease
Lichens Planus
Rash recognized by the 6 P's pruritus, purple, planar, polygonal, papule/plaque) and Wickham striae.
It is classically associated with hepatitis C virus.
Disseminated Intravascular Coagulopathy
When a patient is in disseminated intravascular coagulopathy, the platelet levels are decreased, the fibrinogen level is decreased, and the fibrin degradation products are increased
Physiology jaundice
Physiologic jaundice occurs in most newborns and manifests as mild unconjugated hyperbilirubinemia and jaundice. It usually resolves within 1-2 weeks without treatment.
– total bilirubin exceeds 25 mg/dL = infants are at risk for potentially lethal kernicterus
– Unconjugated hyperbilirubinemia may be physiologic. Conjugated hyperbilirubinemia is never physiologic
Breslow Depth
Tumor thickness is the most important prognostic factor on biopsy, and a depth of invasion >0.8 mm is an indication for sentinel lymph node biopsy.
Acute viral or idiopathic pericarditis treatment
- NSAIDs
- Colchicine
**steroids only if there are contraindications to NSAIDs
Causes of A-Fib
Conditions associated with the development of atrial fibrillation
- hypertensive heart disease (most common)
- coronary artery disease
- left atrial enlargement
- valvular pathology (most common: mitral stenosis)
- cardiac surgery
- hyperthyroidism
- electrolyte abnormalities
- **alcohol **ingestion (both acute intoxication and chronic ingestion).
Iron intoxication diagnostic finding and treatment
CXR: Iron, as a metal, is also radio-opaque and can be visible on x-ray examinations
Tx: deferoxamine
MEN type I, IIa and IIb
Type 1:
-Pancreatic islet cell tumor
- Parathyroid hyperplasia
- Pituitary adenomas
Type IIa:
- Medullary thyroid cancer
- Parathyroid hyperplasia
- Pheochromocytoma
Type IIb:
- Medullary thyroid cancer
- Pheochromocytoma
- Marfanoid habitus
Rule of 9’s : % of body surface area
9%— head, each arm (front + back)
18% — each leg (front+ back)
18% — chest + abd only one side
Parkland formula for fluid management in patients with second- and third-degree burns.
The formula is mL of fluid/24 hours = 4 x body mass (kg) x % body surface area affected. 
Use rule of 9’s for BSA calculation
How to rule out preterm labor?
Collect FETAL FIBRONECTIN first in patients with signs or symptoms of preterm labor between 22 and 35 weeks of gestation.
negative fetal fibronectin result, the physician can be 99% sure that the patient will not go into preterm labor in the next 2 weeks
Corneal abrasion
- appears fluorescent green on slit-lamp exam
- tx: TOPICAL antibiotics (so NOT eye drops but instead an eye ointment)
»erythromycin
»trimethoprim/polymyxin B
»sulfacetamide sodium - if pt uses contacts – need abx to target pseudomonas
» ciprofloxacin
Acute pancreatitis – important lab value that is a mortality predictor
In any patient presenting with acute pancreatitis, the greatest laboratory predictor of mortality is change in BUN over the first 48 hours
Magnesium toxicity
–common findings of early onset toxicity include nausea, muscle weakness (often detected as decreased deep tendon reflexes), and low blood pressure
–As serum magnesium levels rise, the sinoatrial (SA) and atrioventricular (AV) node can be affected causing EKG changes such as a prolonged PR interval and intraventricular conduction delay. Eventually there will be loss of respiratory muscle tone leading to respiratory paralysis and/or arrhythmia leading to cardiac arrest
–Magnesium in high concentrations acts as a calcium antagonist, preventing muscular contraction
–tx: IV calcium gluconate.
