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Flashcards in uWorld Deck (50):
1

Classic presentation of gallstones

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

Episode caused by viscus distention

2

Splenic injury from blunt trauma is managed how?

By patient's hemodynamic status and response for IV fluids.
1. If responsive- CT scan
2. If unresponsive- laparotomy

3

Solitary Pulmonary Nodule (SPN)

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

4

Atelectasis

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

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

5

Hypovolemic shock

1. Flat neck veins
2. Bruising
3. Abdominal distention

6

Eschar

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

7

Signs of compartment syndrome

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

8

Treatment for Slipped Capital Femoral Epiphysis (SCFE)

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

9

Oliguria

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

10

Psoas abcess

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

11

Dumping syndrome

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

12

Nasopharyngeal carcinoma (NPC)

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

13

signs of retroperitoneal abcess

fever
chills
deep abdominal pain

14

CO toxicity

mild: headache, nausea, dyspnea, malaise, altered mental status, dizziness

severe: seizure, come, syncope, heart failures, arrhythmias

Tx: 100% O2 via nonrebreather

15

most common benign breast disease in perimenopausal women

Intraductal papilloma

16

fibrocystic change of breast

benign

bilateral breast pain
cystic changes of breast
cyclic symptoms with cycle

17

Fibroadenoma of breast

benign

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

18

Ductal carcinoma in situ

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

19

Paget's disease of breast

eczematous changes of nipple

20

Mediastinitis

Fever
Tachycardia
Chest pain
Leukocytosis
Sternal wound drainage or purulent drainage

Tx: drainage, debridement, abx

21

Virchow triad

stasis
endothelial injury
hypercoaguability

22

Signs of posterior urethral injury

blood at urethral meatus
inability to void
high-riding prostate

Tx: retrograde urethrogram (do NOT blindly insert Foley)

23

Pulmonary contusion

can be caused by severe blunt trauma

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

24

most common cause of small bowel obstruction

adhesions

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