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62 Cards in this Set

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What is the Child's classification for?
A means of assessing the severity of liver cirrhosis, it looks at:

Albumin level
PT
Bilirubin
Ascites
Encephalopathy
What are some causes of ascites?
Cancer
CHF
Renal failure
Cirrhosis
TB
Which patients would not be good candidates for parenteral nutrition?
Those with GI disease:

Ex: Pancreatitis
Total parenteral nutrition is given by what method?
Through Central line
What electrolyte inbalance is assoc with paralytic ileus?
Hypokalemia
What is the max potassium that can be given IV?
20 mEq in 1 Liter
10mEq over 1 hour
What is the best treatment for a 2 cm mass squamous cell carcinoma?
Lobectomy
How do you treat Small cell lung CA?
Chemo
Radiation
A pt with mitral valve prolapse is scheduled for colonoscopy. What should you do?
Antibiotics before procedure
What prophylactic med should a young man with mechanical valve be on?
coumadin
What vessel can be used in CABG
saphenous
Left internal mammary(Lima)
Radial artery
What do you call Severe stenosis of LAD artery?
a widow maker
What is a contraindication for heart transplant?
Cancer
Indications for carotid endarterectomy
70% occlusion
Best method to prevent post-surgery DVT and PE
Early ambulation
What is the recommended prophylaxis for GI surgery?
IV ampicillin and gentamycin
Which heart defects cause a left-to-right shunt?
VSD
ASD
PDA
AV septal defect
Aortopulmonary window
When is an intra-aortic ballon pump indicated?
When initial interventions do not reverse a low-output state due to cardiac failure
What are indications for heart valve replacement?
Aortic valve degeneration or calcification
All symptomatic pts with aortic regurge
Asymptomatic pts with cardiomegaly
Chronic mitral regurge
what are the side effects of ASA
GI Bleed
Resp depression
Resp and metabolic acidosis
Hypersensitivity
what are the adverse effects of Indomethacin (indocin)
GI
Acute Pancreatitis
Neutropenia
Thrombocytopenia
Allergic Reactions
Describe the NYHA classifications
Class I: no limitation or symptoms from activities

Class II: mild limitation of activity; comfortable with rest or with mild exertion

Class III: marked limitation of activity; comfortable only at rest

Class IV: any physical activity brings discomfort and symptoms occur at rest.
What is the Tx for RA?
NSAIDS
DMARDS
Name some DMARDs
1st line agents:
Methotrexate
Gold
Hydroxychloroquine

2nd line agents:
Sulfasalazine
Penicillamine
Azathiorprine(Imuran)
describe the different levels of bone density
Normal: 0 to -1.0
Osteopenia: -1.0 to -2.5
Osteoporosis: < -2.5
Severe: < -2.5 plus fx
What are some treatments to prevent osteoporosis?
HRT
Calcium supplements
Bisphosphonates
Selective estrogen receptor modulators (SERM’s)
rapid buildup and breakdown at the same time causing weak poorly formed bone is characteristic of this condition
Paget's disease
What are S/Sx of Paget's disease?
Bowed legs
thick skull
Deafness
Hyperparathyroidism
Osteosarcoma
This serum marker is elevated in Paget's disease
serum alkaline phosphatase
What are some X-ray findings in Paget's disease?
Blade of grass: V-shaped pattern between healthy and diseased bone

Brim sign: thickened iliopectineal line in the pelvis

cotton wool sign: in the skull
How do you treat Paget's disease?
Bisphosphonates:
Alendronate
Risendronate
Pamidronate

Monitor bone markers and Alk phos
T/F: With bone tumors, if you know the primary CA, then no bone Biopsy is necessary
TRUE
This bone tumor is benign, found mostly on the tubular bones of hands and feet
Solitary chondroma (enchondroma)
How do you treat Enchondroma
Benign tumor so leave alone, but send to an orthopedic for F/U 1-2yrs

If symptomatic – curretage & graft
MC Primary malignant bone tumor
Multiple Myeloma
How do you diagnose Multiple Myeloma?
Bence Jones Proteins
Lytic bone lesions
Pathologic fractures
Nodular skin lesions
How do you treat multiple myeloma?
Palliative
cytoxan-melphalan (cyclophosphomide) or steroids
Radiation therapy
A benign tumor composed of fatty tissue
Lipoma
Organism assoc. with a puncture wound through sneaker causing osteomyelitis

How do you treat?
Pseudomonas

Tx: Cipro
what is the initial imaging test for osteomyelitis?
A 3-phase bone scan with technetium 99m
MCC of nongonococcal septic arthritis? (acute bacterial arthritis)
S.aureus
What percentage of people with Paget's develop osteosarcoma?
20%
What condition causes wedging of the vertebral body?
Scheuermann’s Kyphosis
What are the MC type of cancers to spread to bone?
Breast cancer- MC
Prostate
Lung
Multiple myeloma
This bone tumor originates in immature nerve tissue within bone marrow
Ewing’s sarcoma
Which cancers spread to bone?
BLTPK

Breast
Lung
Thyroid
Prostate
Kidney
T/F: Osteolytic bone tumors are the most common
TRUE
the name for multiple enchondromas
Ollier’s Dz
Hard, painless mass fixed on the bone suggests?
Enchondroma
To diagnose this disease you look for Ig and use electrophoresis
multiple myeloma
This is a transitional tumor that is benign but due to rapid growth is considered CA

occurs at metaphysis-epiphysis junction
Osteosarcoma (Giant cell tumor)
This bone CA can cause acute renal failure (Kidney can’t handle incr proteins)
Multiple myeloma
a pedunculated lesion in metaphysis suggests?
Osteochondroma
This malignant bone CA affects the pelvis, prox. femur & shoulder girdle
Primary chondrosarcoma
Physical therapy has been shown to exacerbate and prolong this condition
Myositis ossificans
What is the treatment for myositis ossificans?
Rest
Ice
Elevation
What is chondromalacia?
softening of cartilage
What test is the most senitive noninvasive examination for detecting avascular necrosis
MRI
Positive birefringence and deposition of calcium pyrophosphate is characteristic of this condition
Pseudo Gout
what is the treatment for SLE?
anti-inflammatory agents
Shortening and thickening of palmar fascia
Dupuytren’s Contracture
What's the treatment for Rhabdo?
IV Fluids
Mannitol
NaHCO3
Lasix