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13 Cards in this Set
- Front
- Back
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Dx
px with blood in urethral meatus of a high riding prostate |
bladder rupture
OR urethral injury |
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what can help measure how severe hypotension is in shock
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urine output & mental status
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MCC's of abd'l obstruction
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"ABC"
adhesion "bulge" = hernia cancer |
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what is the typical ER lab w/u for pt with acute abd'l pain
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"SHOT-GUN" APPROACH:
CBC w/ diff, BMP UA (UTI's/pyelo), urine B-HCG (if childbearing age) FOBT LFT's, amylase, lipase EKG & cardiac enzymes (if > 45 y/o) |
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signs/sx's of ACUTE mesenteric ischemia
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sudden severe abdominal pain (periumbilical) that is out-of-proportion to the physical exam
vomiting & diarrhea (usually bloody) EARLY PE: abd'l distension, +/- occult blood in stool LATE PE: abd'l distension, absent BS's, peritoneal signs, feculent odor to the breath |
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tx for acute mesenteric ischemia
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broad spectrum AB's
NG tube decompression angiogram (dx'c & tx) heparin anticoag papaverine infusion if embolism --> embolectomy + resection of necrotic bowel if thrombus --> thrombectomy + resection of necrotic bowel |
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what does papaverine do when given to a px with mesenteric ischemia
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decreases arterial vasospasm
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classic signs/sx's of CHRONIC mesenteric ischemia
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dull, crampy postprandial epigastric pain within the 1st hour after eating then subsides over 2 hours
"food fear" --> wt loss possibly n/v & early satiety abd'l bruit (50%) |
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Rx for chronic mesenteric ischemia
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SAME AS TX FOR ATHEROSLEROSIS ANYWHERE:
bypass endarterectomy angioplasty & stenting |
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what is seen on an xray or CT that indicates a ruptured viscus
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"viscus" = internal organ
Xray/CT: pneumoperitoneum (i.e. free air under the diaphragm) |
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which rejection is treatable with immunosuppressives
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acute rejection
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what is the mechanism of acute rejection
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proliferation of antidonor T-cells by recepient
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what time period does acute rejection occur
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6 days to 1 year, post-transplant
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