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uWorld Flashcards

1
Q

Classic presentation of gallstones

A
  1. Biliary colic
  2. nausea/vomiting
  3. right sided shoulder/subscapular pain (referred)

Episode caused by viscus distention

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2
Q

Splenic injury from blunt trauma is managed how?

A

By patient’s hemodynamic status and response for IV fluids.

  1. If responsive- CT scan
  2. If unresponsive- laparotomy
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3
Q

Solitary Pulmonary Nodule (SPN)

A

< 3 cm in diameter
completely surrounded by lung parenchyma
does not contact pleura, hilum, or mediastinum

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4
Q

Atelectasis

A

Lobar or segmental collapse of lung that causes decreased lung volume.

Most severe during 2nd post-op night, can last up to 5 days.

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5
Q

Hypovolemic shock

A
  1. Flat neck veins
  2. Bruising
  3. Abdominal distention
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6
Q

Eschar

A

Firm, necrotic tissue formed on exposed tissue following burn wounds.

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7
Q

Signs of compartment syndrome

A
  1. Deep pain out of proportion to injury
  2. Pulselessness
  3. Paresthesias
  4. Cyanosis and pallor of extremity
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8
Q

Treatment for Slipped Capital Femoral Epiphysis (SCFE)

A

Surgical pinning of of slipped epiphysis in situ (where it is) to lessen risk of avascular necrosis of femoral head and chondrolysis.

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9
Q

Oliguria

A

< 400 cc urine/day, or < 6 cc/kg/day

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10
Q

Psoas abcess

A

complication of perforated appendix
significant abdominal pain with flexion of hip against resistance
Treat with antibiotics, IVF, bowel rest
appendectomy 6-8 weeks later

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11
Q

Dumping syndrome

A

Common postgastrectomy complication.
Caused by rapid emptying of hypertonic gastric content into duodenum and sm intestine. Leads to fluid shift from intravascular space to sm intestine, release of intestinal vasoactive polypeptide, stimulation of autonomic reflexes

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12
Q

Nasopharyngeal carcinoma (NPC)

A

higher frequency in mediterranean/far east
high association with epstein barr virus (EBV)
present with recurrent otitis media, recurrent epistaxis, nasal obstruction

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13
Q

signs of retroperitoneal abcess

A

fever
chills
deep abdominal pain

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14
Q

CO toxicity

A

mild: headache, nausea, dyspnea, malaise, altered mental status, dizziness
severe: seizure, come, syncope, heart failures, arrhythmias

Tx: 100% O2 via nonrebreather

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15
Q

most common benign breast disease in perimenopausal women

A

Intraductal papilloma

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16
Q

fibrocystic change of breast

A

benign

bilateral breast pain
cystic changes of breast
cyclic symptoms with cycle

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17
Q

Fibroadenoma of breast

A

benign

solitary lesion
painless
firm, mobile mass
15-25 yars old, does NOT change w/cycle

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18
Q

Ductal carcinoma in situ

A

postmenopausal women
nipple discharge
breast mass
ductal epithelium changes, do NOT penetrate basement membrane

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19
Q

Paget’s disease of breast

A

eczematous changes of nipple

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20
Q

Mediastinitis

A 
Fever
Tachycardia
Chest pain
Leukocytosis
Sternal wound drainage or purulent drainage

Tx: drainage, debridement, abx

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21
Q

Virchow triad

A

stasis
endothelial injury
hypercoaguability

22
Q

Signs of posterior urethral injury

A

blood at urethral meatus
inability to void
high-riding prostate

Tx: retrograde urethrogram (do NOT blindly insert Foley)

23
Q

Pulmonary contusion

A

can be caused by severe blunt trauma

sxs: dyspnea, tachypnea, chest pain, hypoxia worsened by intravascular volume expansion, patchy alveolar infiltrates on CXR

24
Q

most common cause of small bowel obstruction

25
Ladd's bands
congenital adhesions in children
26
Complete SBO
n/v abdominal bloating dilated loops of bowel on xray
27
most common cause of lower extremity edema
venous insufficiency (valvular incompetence)
28
risk factors of Peripheral Artery Disease (PAD)
1. increasing age 2. DM 3. cigarette smoking 4. HTN 5. HLD Dx: ankle-brachial index (ABI) using Doppler
29
Ankle-Brachial Index (ABI)
ratio of systolic blood pressure of posterior tibial and dorsalis pedis arteries over systolic of brachial artery NL: 1-1.3 abnormal 50% occlusion < 0.4 consistent with limb ischemia Tx: ASA and cilostazol
30
Post-procedure with dull abdominal pain and bloody diarrhea
Colonic ischemia causes: loss of collateral circulation manipulation of vessels with instruments prolonged aortic clamping impaired blood flow through inferior mesentaric
31
increased alkaline phosphatase | normal serum calcium and phosphorous
Paget's disease of bone
32
Sxs of splenic injury
``` LUQ abd pain Abdominal wall contusion Left lower chest wall tenderness Hypotension Left shoulder pain (referred- irritation of phrenic nerve and diaphragm, Kehr's sign) ```
33
Hamman sign
crunching sound on auscultation of the heart due to mediastinal emphysema sign of esophageal perforation
34
Causes of diabetic foot ulcers
neuropathy microvascular insufficiency immunosuppression
35
Minor head trauma
GCS of 15 normal mental status normal neurologic and funduscopic exam no physical findings of skull fracture Tx: no neuroimaging, discharge observe for 24 hrs
36
Mild Traumatic Brain Imaging (TBI)
``` GCS 13-15 brief loss of consciousness vomiting headache disorientation ``` Tx: CT head, if normal discharge home observe 4-6 hours if no symptoms
37
Moderate TBI
``` GCS 9-12 brief LOC vomiting headache disorientation ``` Tx: CT head, if normal discharge home observe 4-6 hours if no symptoms
38
Severe TBI
``` GCS <8 focal neurologic signs seizure prolonged LOC evident skull fracture ``` Tx: CT head, admit for neuro checks
39
Signs of necrotizing surgical infection
``` Intense pain in wound Fever, hypotension, tachycardia Decreased sensation at edges of wound Cloudy-gray discharge Tense edema outside involved skin Subcutaneous gas with crepitus ``` Tx: early surgical exploration
40
Uncomplicated diverticulitis
LLQ pain, tenderness fever leukocytosis inflammation and colonic wall thickening on CT Tx: bowel rest, oral abx, observation if elderly/immunocompromised- hospitalization
41
Complicated diverticulitis
diverticulitis with an abscess, perforation, obstruction, or fistula formation Tx: < 3cm fluid collection- IV abx, observation > 3cm fluid coll- CT guided drainage, drainage and debridement if CT guided does not work colonic resection if recurrent symptoms
42
Legg-Calve-Perthes disease
idiopathic avascular necrosis of the femoral capital epiphysis boys between 4-10 sxs: hip, knee, or groin pain with antalgic gait Tx: observation and bracing
43
vaccinations after splenectomy
S. pneumoniae N. meningitidis H. influenzae (encapsulated organisms)
44
anterior cord syndrome
commonly associated with burst fracture of vertebrae | total loss of motor function below lesion, loss of pain and temp below lesion bilaterally, intact proprioception
45
Systemic Inflammatory Response Syndrome (SIRS)
2 of 4 Temp > 38.5 C (101.3F) or < 35 C (95F) HR > 90 bpm RR > 20 /min WBC > 12k, < 4K, or > 10% bands seen in pancreatitis, autoimmune disease, vasculitis, burns
46
Glasgow Coma Scale
Eye opening (1-4), Verbal response (1-5), Motor response (1-6)
47
Ludwig angina
infection of submandibular and sublingual glands. Source usually from infected tooth (2nd or 3rd mandibular molar) risk of asphyxiation
48
Marjolin ulcer
Squamous Cell Carcinoma arising with burn wounds
49
Succussion splash
indicative of pyloric stenosis/stricture | auscultate upper abdomen, rock patient at hips
50
Sxs of compartment syndrome
Severe pain Pain with passive range of motion Paresthesias Pallor and paresis of affected limb pulse presence does not rule out

surgery (5 decks)

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