Week 1-2 Flashcards
(169 cards)
1
Q
what is a colles fracture?
A
distal radius fracture
2
Q
what can be a complication of a colles fracture?
A
can have radial artery impingement
3
Q
what should be done if patient has colles fracture and radial artery impingement?
A
immediate closed reduction of the fracture
4
Q
what is a common complication of a glenohumeral displacement?
A
rotator cuff injry
5
Q
what is a test that can be done for cervical radiculopathy? how does it work?
A
shoulder raise test…when raising arm, patients pain will decrease if they have a cervical radiculopathy
6
Q
what are the two types of burn wound infections?
A
invasive vs non invasive
7
Q
what is difference in invasive vs non invasive burn wound infection?
A
invasive will show systemic signs of infection and invades non burned tissue
8
Q
what is difference in management of invasive vs non invasive burn wound infections?
A
invasive gets really broad abx coverage (meropenem and vanc) whereas non invasive gets narrow spectrum like cefazolin
9
Q
does patient who is perioperative have to have chest pain to be having an MI?
A
no because likely on lots of pain meds so can be masked
10
Q
what is a significant GI complication of C diff?
A
toxic megacolon
11
Q
what are sx of toxic megacolon?
A
severe abdominal pain, fever tachycardia and hypotension
12
Q
what will be seen on imaging in toxic megacolon?
A
large bowel dilation
13
Q
what is management of toxic megacolon?
A
bowel rest, NG tube and treat C diff
14
Q
what is short term management of malignant pericardial effusion?
A
drain that baby with pericardiocentesis
15
Q
what is long term management of malignant pericardial effusion?
A
put in a cardiac window for drainage
16
Q
what are three complications of cardiac cath at site of femoral access?
A
hematoma, avm, and pseudoaneurysm
17
Q
what are physical exam findings of pseudoaneurysm of femoral artery after cardiac cath?
A
systolic bruit and pulsatile mass
18
Q
what are physical exam findings of avm of femoral artery and vein after cardiac cath?
A
continuous bruit and no mass
19
Q
what is management of AVMs of femorals after cardiac cath?
A
if large surgery, if small observe
20
Q
what is imaging to find a meckel diverticulu,?
A
nuclear scintigraphy
21
Q
what can cause intussusception?
A
inflammation of peyers patches from viral illness, pathologic cuases like meckels diverticulum, tumor or polyp
22
Q
when should you think a pthologic not viral illness is causing intussuscpetion?
A
if happens multiple times
23
Q
what is a flail chest?
A
3 or more contiguous rib fractures that negatively impacts respiration
24
Q
what is common sign of a flail chest?
A
chest goes inward with inspiraiton
25
what can happen to heart in ankylosing spondylitis?
aortic regurgitation
26
eggshell calcification of liver cyst means what diagnosis?
hydatid cyst from echinococcus granulosa
27
what is usual cause of post op fever within hours of surgery
tissue trauma and cytokine reaction
28
what is cause of post op fever 1 day to 28 days after?
presumed bacterial infection
29
name two times it is common to get compartment syndrome?
after fracture and after ischemia to leg and surgery
30
how do you diagnose compartment syndrome?
delta pressure (diastolic minus compartment <30)
31
what is acute management of cerebreal edema following traumatic injury?
hypertonic saline/mannitol and head elevation
32
what is initial management of hypothermia?
rewarming in bath of water btw 98-102 degress
33
if warm water bath does not improve hypothermia of hands, what should be done and why?
angiography of affected area to investigate for thrombosis
34
what is imaging for suspected appendicitis?
US if pregnant or child, otherwise CT scan
35
why can you get hypercalcemia with immobilization?
from osteoclasts breaking down bone that isnt being used
36
what is acute mediastinitis?
infection of medisatinum following cardiothoracic surgery
37
what are signs and symptoms of acute mediastinitis?
fever, purulent drainage from sternal incision, high WBC count, chest pain
38
what is an imaging finding of acute mediastinitis?
widening of mediastinum
39
what is rx of acute mediastinitis?
surgical drainage and abx
40
what are signs and sx of an ileus?
nausea, vomiting, abdominal distension, abdominal pain. lack of bowel sounds
41
aside from surgery what are some other causes of ileus?
intraperitoneal/retroperitoneal hemorrhages, pancreatitis and electrolyte abnormalitis
42
what is rx of priapism?
aspirate blood from corpora cavernosa and give phenylephrine injection into cavernosa
43
what can be a complication of insufflation of patients abdomen with CO2 for laprascopic procedure?
can get increased vagal tone leading to severe bradycardia
44
when should you get a confirmatory chest xray for placement of a central venous catheter?
if it was complicated or did not use U S
45
what should you monitor if patient has medullary thyroid cancer?
calcitonin (represents risk of metastasis)
46
how does medullary thyroid cancer present
usually asymptomatic thyroid nodule
47
if patient has recently had cholecystectomy and has diarrhea, what is likely cause?
bile acid diarrhea
48
what is rx of bile acid diarrhea?
cholstyramine
49
what is pilonidal disease?
abscess formation/infection of bump between butt cheeks
50
what is rx of pilonidal disease
drainage
51
what type of herniation can occur with epidural hematomas
subfalcine herniation
52
which type of herniation does not involve the pupils?
subfalcine
53
what is rx of SCFE?
surgical pinning and non weight bearing
54
who gets SCFE?
adolescents that are obese
55
what is the difference in enteral and parenteral nutritional support?
enteral means via intestines and parenteral means via IV
56
in a burn patient, what should nutritional support be?
enteral nutrition as soon as possible
57
patients undergoing dialysis are at increased risk for what infection?
bacteremia
58
if patient with dialysis gets bacteremic following dialysis session, what abx should be given?
ceftazadime and vanc
59
what can be a significant complication related to epidural anesthesia?
epidural hematoma
60
what are sx of epidural hematomas?
sensation and motor disturbances, can also have bowel bladder issues
61
if a patient can hear better in loud situations than quiet, what should you think of as issue?
otosclerosis
62
what is a physical exam finding of otosclerosis?
reddish hue behind tympanic membrane
63
what is first line therapy for toxic megacolon fromIBD?
IV steroids
64
if patient with cirrhosis has new onset of ascites, what should be done? why?
abdominal US...despite ascites being normal in cirrhosis, if it is new raises concern for HCC
65
what is a common cause of laryngeal papillomas in kids?
HPV 6 or 11 from mom
66
what is symptoms of laryngeal papillomas?
usually just hoarseness
67
what is rx of laryngeal papillomas?
surgical debridemen
68
if following a trauma a patient is hemodynamically unstable but has no signs of internal bleeding on exam, what is most likely cause?
pelvic fracture and bleeding in to retroperitenum
69
what meds can cause open angle glaucoma?
topical steroids
70
what sx does a urethral stricture cause?
leads to weak or spraying stream, incomlete emptying and can cause increased frquency
71
what is rx of urethral stricture?
dilation, urethroplasty
72
if patient has had trauma and had pneumothorax with successful chest tube placement but it still leaking significant amounts of air through chest tube, what might be going on?
trachebronchial injry leading to air leakage
73
how do you assess for a tracheobronchial injury?
bronchoscopy
74
what is rx of tracheobronchial injury?
surgical fix
75
a pelvic fracture can cause what type of urethral injry?
posterior urethral injury
76
what are sx of posterior urethral injury?
blood at meatus, inability to pee, and high riding prostate
77
what are 6 indications for cervical spine imaging following trauma?
```
high energy mechanism
neurologic deficit
intoxication
AMS
spinal tenderness
distracting injury
```
78
what is a septal hematoma?
blood/fluid collection in nasal septum following trauma to nose
79
what are sx of septum hematoma of nose?
may have hard time breathing, will have fluctuant swelling of septum
80
what is management of septal hematoma of nose?
surgical drainage
81
if a septic joint is not responding to vancomycin and MRSA/Strep coverage, what bug should you think about and what abx?
kingella...ceftriaxone
82
what is blunt cardiac injury?
direct blow to chest without obvious cardiac injury leading to hemodynamic instability
83
what is risk with blunt cardiac injury?
big risk of arrythmias
84
patients with blunt cardiac injury should undergo what testing?
TEE
85
in shock, a low CVP means what type?
hypovolemic or distributive
86
in shock, a high CVP means what type?
cardiogenic or obstructive
87
what is management of a peritonsillar abscess if patient stable?
drain it and treat wtih antibiotics
88
what sx can hydronephrosis cause?
can lead to unilateral back pain and CVA tenderness
89
what will UA look like in hydronephrosis secondary to ureteral injury?
will look normal, as will kidney function
90
when do you excise hemorrhoids?
when they become thrombosed
91
how do you know if external hemorrhoid is thombosed?
will be purplish and patient will have severe anorectal pain
92
what type of hernia should be electively repaired?
femoral hernias
93
why are femoral hernias repaired electively but indirect and direct inguinals are not?
because femoral has much higher risk of incarceration
94
patient with traumatic brain injury has episodes of hypertension, fevers and diaphoresis, what is likely cause?
paroxysmal sympathetic overactivation
95
who gets paroxysmal sympathetic overactivation?
patients with TBIs
96
a breast mass with calcifications on imaging and fat globules and histiocytes on biopsy is most likely what?
fat necrosis of the breast
97
what breast mass looks malignant but is benign?
fat necrosis
98
what causes fat necrosis of the breast?
trauma and surgery
99
does fat necrosis of the breast increase the risk of breast cancer?
No
100
what is management of posterior hip dislocation?
reduction within 6 hours of injurty
101
what is risk with giving loads of normal saline? why?
can cause metabolic acidosis due to high levels of chloride in normal saline
102
a patient with severe burns should receive what fluids for resuscitation
lactated ringers
103
what does imaging show in ovarian torsion?
complex adnexal mass without blood flow
104
what is management of ovarian torsion?
laparoscopy
105
what is managment options for abscess from diverticulitis?
if greater than 3cm then percutaneous drainage, if less than 3cm then IV abx and observation
106
what is a perilymphatic fistula?
where endolymph leaks from semicircular canals and cochlea into surrounding tissue
107
what causes perilymphatic fistula?
brain trauma
108
what are sx of perilymphatic fistula?
sensorineural hearing loss, episodic vertigo
109
what is a complication of roux en y surgery in couple days following surgery?
anastomotic leak
110
what are sx of anastamotic leak from roux in y bypass?
abdominal pain, tachypnea and tachycardia
111
what is rx of anastamotic leak from roux in y?
surgery
112
what is a complication of cardiac cath that can happen at insertion site?
can get retroperitoneal hematoma if cath site is leaky
113
how does retroperitoneal hemorrhage present
unilateral back or flank pain and hemodynamic instability
114
what is imaging for retroperiotneal hemorrhage?
CT without contrast
115
what is rx of retroperioneal hemorrhage?
intensive support and monitoring
116
what is risk of using succinylcholine as anesthetic?
can lead to cardiac arrythmias due to release of potassium
117
leydig and sertoli testicular tumors secrete what hormones?
testosterone or estrogen
118
in testicular torsion, does it get bigger or smaller?
will get bigger
119
why does a torsed testicle appear heterogeneous?
because of ischemia to the testicle
120
what is hemobilia?
bleeding from liver
121
what is usual cause of hemobilia?
iatrogenic liver injury from surgery or biopsy
122
what are signs and sx of hemobilia?
ruq pain, melena, anemia, thrombocytosis and leukocytosis
123
how does someone develop charcot arthropathy?
repetitive trauma to bone and joint due to impaired snesation and proprioception
124
what is most common cause of charcot foot?
DM
125
what can happen with chronic charcot arthropathy?
can get collapse of foot arch, subluxation and bone deformitites?
126
what is management of charcot foot that has become chronic?
orthotics and surgical fixatio
127
acute charcot foot can lead to what findings?
swelling and redness of foot, warmth and edema as well
128
what is management of acute charcot foot?
put on foot cast
129
if patient has trauma and has a bad pelvic fracture, what is a big concern/
retroperitoneal hemorrhage
130
patient with bad pelvic fracture following trauma should receive what before further work up is completed?
pelvic binder to stabilize pelvis
131
what is usual management of an SBO?
if not totally blocked then bowel rest pain management and NG tube
132
what is management of SBO if totally blocked?
surgery
133
when a patient is being intubated, what happens to intrathoracic pressure and venous system?
intrathoracic pressure goes up, can cause venous system collapse due to increase in pressure, can be an issue in patients with hypovolemic shock
134
if patient has symptomatic hyponatremia, including sx of cerebral edema, what should be given?
hypertonic saline
135
what are signs and symptoms of sigmoid volvulus?
slowly progressive abdominal discomfort along with potential nausea and vomiting
136
what can contribute to development of sigmoid volvulus?
constipation
137
how does pain progress/onset with sigmoid volvulus?
slowly over course of a couple days
138
what is management of sigmoid volvulus?
emergency endoscopic detorsion
139
patient with difficulty breathing following cervical trauma most likely has what?
diaphragm paralysis
140
what should be done for patient with diaphragm paralysis from cervical spine injury?
oral intubation
141
calcitonin is marker for which thyroid cancer?
medullary thyroid cancer
142
what is management of papillary thyroid cancer?
surgical removal
143
copper deficiency leads to what problems?
skin depigmentation
ataxia
anemia
brittle hair
144
what two things are commonly elevated in acute mesenteric ischemia?
lactate and amylase
145
what is an auricular hematoma?
tender blood collection on anterior pinna of ear
146
who gets auricular hematomas?
ppl who play contact sports
147
what should you do to an auricular hematoma?
drain it then give abx to prevent secondary infection
148
what are sx of an auricular hematoma?
nothing....just fluctuant tender hematoma on ear
149
patient with trauma to chest who now has stable vitals but has persistent shortness of breath, what should you consider?
diaphragmatic injury
150
septic arthritis in a MCP joint requires what?
surgical drainage
151
afp elevation is associated with what GI tumor?
hepatocellular carcinoma
152
what are signs of complicated SBO?
fever, vital instability, metabolic acidosis
153
what is a common risk factor for SBO?
previous abdominal surgery
154
what is most important prognostic indicator for breast cancer?
TNMstaging
155
if a patient falls with an object in their mouth, what can be a serious complication?
carotid artery dissection
156
how does carotid artery dissection present?
gradual onset hemiplegia, aphasia,, neck pain and headache
157
what is imaging for carotid artery dissection/
CT and MR angio
158
what is most common cause of nosocomial bloodtsream infections?
central venous catheters
159
what type of toe movement makes plantar fascitis hurt more?
dorsiflexion of toes
160
retroperitoneal free air after blunt abdominal trauma to central abdomen should make you think what?
duodenal tear
161
patient who is post transplant develops interstitial pneumonia but is taking bactrim, what bug is it?
CMV pneumonitis
162
how long after blunt abdominal trauma can diaphragmatic injury present?
months to years...
163
what is management if patient swallows a fish bone?
endoscopic removal
164
what is dumping syndrome?
when patients have diarrhea and nausea along with tachycardia after meals after they had gastric surgery
165
what is antibiotic choice for clean surgeries for surgical site inection prophylaxis?
cefazolin
166
if patient cant have cefazolin, what is antibiotic choice for clean surgeries for surgical site inection prophylaxis?
Vancomycin
167
3 symptoms of bladder rupture injury?
suprapubic fullness/tenderness
hematuria
difficulty with urination
168
what is management of big cerebellar hemorrhage?
surgical intervention
169
what can cause salivary gland enlargement that is non tender?
alcoholism
