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UW 1 Flashcards

1
Q

What exam should be done w/Clavicular Fx and why?

A

Neurovascular to R/O damage to vessels

- Close proximity of Subclavian artery and brachial plexux

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2
Q

Pt with clavicular fx and bruit heard by clavicle?

A

Do angiogram to check vessel damage

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3
Q

How does shoulder appear in clavicular fx?

A

Shoulder is displaced inferiorly and posteriorly

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4
Q

Post op cardiac surgical pt w/fever, tachycardia, chest pain, leukocytosis, sternal would drainage?

A

Acute Mediastinitis

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5
Q

How does Acute mediastinitis occur?

A

Complication of cardiac surgery due to intraoperative wound contamination
- w/in 14 days post op

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6
Q

How does CXR look for acute mediastinitis?

A

Widened mediastinum

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7
Q

Tx for acute mediastinitis?

A

Surgical debridement
Drainage
Abx

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8
Q

What murmur is common post CABG?

A

A-fib
Tx w/rate control
Anticoagulate if > 24 hrs

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9
Q

Septal Perforation

A 
Self-inflicted (nose picking)
rhinoplasty
Syphillis
TB
Cocaine
Sarcoidosis
Wegener's
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10
Q

Whistling noise heard during respiration?

A

Nasal septum perforation b/c of sepal hematoma thru septal abscess (post op)

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11
Q

When do we surgically treat Aortic stenosis?

A

SAD
Syncope
Angina
Dyspnea (CHF)

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12
Q

What is surgery for Aortic stenosis?

A

Aortic valve replacement

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13
Q

Indications for Aortic valve replacement?

A

Symptomatic pts
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

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14
Q

Placenta previa?

A

Painless 3rd trimeter bleeding, bleeding w/out ctx

Risk factors: C-section (previous), prior PP, multiparity, advanced age

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15
Q

Dx for placenta previa?

A

Transabdominal sonography

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16
Q

Sudden onset abdominal pain and bleeding, hyperventilation, agitation, tachycardia?

A

Uterine Rupture - most common during labor

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17
Q

Painless antepartum hemorrhage + rapid deterioration of fetal heart tracing?

A

Vasa previa

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18
Q

What thyroid cancer ass’d with Hashimoto’s?

A

Lymphoma

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19
Q

What characteristics ass’d with benign cardiac murmur in child?

A

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
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20
Q

What sx’s are seen in a pathologic cardiac murmur in child?

A

Sx’s:
Infants -Diaphoresis or tiring w/feeds, poor weight gain
Children - chest pain, dizziness, syncope, SOB, fatigue

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21
Q

What PE findings are seen in pathologic cardiac murmur in child?

A 
Harsh or Holosystolic 
Diastolic
Grade III/VI intensity or higher
Increased w/standing or Valsalva
Abnormal S2
Decreased absent femoral pulses
22
Q

What is the workup for child w/pathologic cardiac murmur?

A

CXR for cardiomegaly
EKG for hypertrophy
Echo - structural
Cardiac referral

23
Q

What liver changes seen in HELLP?

A 
Centrilobar necrosis
Hematoma formation
Thrombi in portal capillary system 
- Cause liver swelling w/distension of hepatic (Glisson's capsule)
RUQ pain
Epigastric pain
N/V
24
Q

Schisotocytes on PS, high BR, low haptoglobin,

A

Microangiopathic Hemolytic Anemia

25
When does amniotic fluid embolism usually occur?
Labor | Delivery
26
What puts pregnant women at risk for CAP?
Decreased cell mediated immunity
27
What puts pregnant women at risk for Aspiration pneumonia?
Increased intra abdominal pressure | Relaxed LES
28
Choriamnionitis (intramniotic infxn) Risk factors?
PROM >24 Hours Prolonged labor Internal fetal/uterine monitoring devices Genital tract pathogens
29
Choriamnionitis Dx?
``` Maternal fever >100.4 + One of these: - Maternal Tachycardia (>100) - Uterine tenderness - Malodorous/purulent amniotic fluid/vaginal d/c - WBCs > 15,000 OR Fetal Tachycardia >160 ```
30
When does PROM occur?
Can happen anytime throughout pregnancy
31
When is PROM a problem?
When it becomes PPROM - Prolonged
32
What can occur as a result of PROM?
Preterm labor Cord Prolapse Placental Abruption Chorioamnionitis
33
What is the management for chorioamnionitis?
Get cervical cultures Start IV Abx Deliver immediately -schedule
34
TX for preterm fetus w/out chorioamnionitis?
Tx w/betamethasone Tocolytics = decrease ctx Amp/gent - decrease risk of chorioamnionitis
35
What is uterine indicative of?
Upper genital tract infxn
36
How does acute cervicitis present?
Purulent vaginal discharge | MCC Trichomonas, Chlamidya, Gonorrhea
37
What is the MC risk factor for PROM?
Ascending infxn from lower genital tract
38
What is seen on US with PROM?
Oligohydramnios
39
Maternal complications w/choriamnionitis?
Uterine atony Postpartum Hemorrhage Endometritis
40
Fetal complications with chorioamnionitis?
``` Preterm birth Serious bacterial Infxn Perinatal asphyxia Cerebral Palsy Death ```
41
Indications for C-section?
Breech Fetal distress Multiple previous c-sections
42
Defensive mechanism where IVDA contracts HCV and blames community lack of control of HCV?
Distortion
43
Tx of choice OCD?
SSRI
44
Tx of choice Tourette disorder?
Dopamine Antagonists - AP's like Risperidone (2nd G)
45
Defense mechanism where woman is angry at husband and throws his baseball card collection away?
Displacement
46
Defense mechanism where woman agrees with abuse husband that she is worthless
Introjection
47
Defense mechanism where person was rescued from burning building and now denies any memory of event?
Dissociation
48
Defense mechanism where person expression aggression with person by repeated passive failures to meet their needs
Passive aggressive
49
Eye conditions where patients see halos around lights?
Acute angle-closure glaucoma
50
Painful loss of vision
Acute angle-closure glaucoma | Optic neuritis
51
What is blood and thunder fundoscopy changes? | When do we see it?
``` Optic disc swelling Retinal hemorrhages Cotton wool spots Dilated veins Central Vein Occlusion ```

Mixed (19 decks)

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