Flashcards in UW 1 Deck (51):
What exam should be done w/Clavicular Fx and why?
Neurovascular to R/O damage to vessels
- Close proximity of Subclavian artery and brachial plexux
Pt with clavicular fx and bruit heard by clavicle?
Do angiogram to check vessel damage
How does shoulder appear in clavicular fx?
Shoulder is displaced inferiorly and posteriorly
Post op cardiac surgical pt w/fever, tachycardia, chest pain, leukocytosis, sternal would drainage?
How does Acute mediastinitis occur?
Complication of cardiac surgery due to intraoperative wound contamination
- w/in 14 days post op
How does CXR look for acute mediastinitis?
Tx for acute mediastinitis?
What murmur is common post CABG?
Tx w/rate control
Anticoagulate if > 24 hrs
Self-inflicted (nose picking)
Whistling noise heard during respiration?
Nasal septum perforation b/c of sepal hematoma thru septal abscess (post op)
When do we surgically treat Aortic stenosis?
What is surgery for Aortic stenosis?
Aortic valve replacement
Indications for Aortic valve replacement?
Pts w/severe AS undergoing CABG/valvular surgery
Asymptomatic pt with severe AS - poor LV fnc, LVH >15mmHg, valve area < 0.6 cm or abnormal response to exercise
Painless 3rd trimeter bleeding, bleeding w/out ctx
Risk factors: C-section (previous), prior PP, multiparity, advanced age
Dx for placenta previa?
Sudden onset abdominal pain and bleeding, hyperventilation, agitation, tachycardia?
Uterine Rupture - most common during labor
Painless antepartum hemorrhage + rapid deterioration of fetal heart tracing?
What thyroid cancer ass'd with Hashimoto's?
What characteristics ass'd with benign cardiac murmur in child?
If no ass'n with structural heart dz:
- Grade II/VI or less - intensity
- early or mid-systolic
- decrease w/standing or Valsalva
- normal S2
- no sx's
What sx's are seen in a pathologic cardiac murmur in child?
Infants -Diaphoresis or tiring w/feeds, poor weight gain
Children - chest pain, dizziness, syncope, SOB, fatigue
What PE findings are seen in pathologic cardiac murmur in child?
Harsh or Holosystolic
Grade III/VI intensity or higher
Increased w/standing or Valsalva
Decreased absent femoral pulses
What is the workup for child w/pathologic cardiac murmur?
CXR for cardiomegaly
EKG for hypertrophy
Echo - structural
What liver changes seen in HELLP?
Thrombi in portal capillary system
- Cause liver swelling w/distension of hepatic (Glisson's capsule)
Schisotocytes on PS, high BR, low haptoglobin,
Microangiopathic Hemolytic Anemia
When does amniotic fluid embolism usually occur?
What puts pregnant women at risk for CAP?
Decreased cell mediated immunity
What puts pregnant women at risk for Aspiration pneumonia?
Increased intra abdominal pressure
Choriamnionitis (intramniotic infxn) Risk factors?
PROM >24 Hours
Internal fetal/uterine monitoring devices
Genital tract pathogens
Maternal fever >100.4 + One of these:
- Maternal Tachycardia (>100)
- Uterine tenderness
- Malodorous/purulent amniotic fluid/vaginal d/c
- WBCs > 15,000
Fetal Tachycardia >160
When does PROM occur?
Can happen anytime throughout pregnancy
When is PROM a problem?
When it becomes PPROM - Prolonged
What can occur as a result of PROM?
What is the management for chorioamnionitis?
Get cervical cultures
Start IV Abx
Deliver immediately -schedule
TX for preterm fetus w/out chorioamnionitis?
Tocolytics = decrease ctx
Amp/gent - decrease risk of chorioamnionitis
What is uterine indicative of?
Upper genital tract infxn
How does acute cervicitis present?
Purulent vaginal discharge
MCC Trichomonas, Chlamidya, Gonorrhea
What is the MC risk factor for PROM?
Ascending infxn from lower genital tract
What is seen on US with PROM?
Maternal complications w/choriamnionitis?
Fetal complications with chorioamnionitis?
Serious bacterial Infxn
Indications for C-section?
Multiple previous c-sections
Defensive mechanism where IVDA contracts HCV and blames community lack of control of HCV?
Tx of choice OCD?
Tx of choice Tourette disorder?
Dopamine Antagonists - AP's like Risperidone (2nd G)
Defense mechanism where woman is angry at husband and throws his baseball card collection away?
Defense mechanism where woman agrees with abuse husband that she is worthless
Defense mechanism where person was rescued from burning building and now denies any memory of event?
Defense mechanism where person expression aggression with person by repeated passive failures to meet their needs
Eye conditions where patients see halos around lights?
Acute angle-closure glaucoma
Painful loss of vision
Acute angle-closure glaucoma