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19 Cards in this Set

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  • Back

Can you cut out an LCIS?

I guess not. Raloxifine, clinical exam, and mammography is the most appropriate treatment.

What elective procedures are acceptable for patients that are BRCA positive?

Prophylactic bilateral mastectomy and oophorectomy

Which diagnostic test is mainly for detecting nonpalpable breast cancers?




Which cancer is MMG less effective at finding?

Mammogram




Invasive Lobular Carcinoma

What is the next step after a patient has had a sterotactic core biopsy of a breast mass that shows cell types that have possible malignant capacity?

Breast Biopsy with needle localization.




Once the patient has clear margins and no malignancy then Tamoxifen chemo prevention should be started.

What is the Glasgow Coma Scale?

EMV, 465




Eye opening


4: Spontaneous


3: To speech


2: To pain


1: None




Motor


6: Obeys commands


5: Localizes Pain


4: Withdraws to pain


3: Decorticate (flexion)


2: Decerebrate (Extension)


1: None




Verbal Response


5: Oriented


4: Confused


3: Inappropriate Words


2: Incomprehensible Sounds


1: None

What are some indications for surgical intervention for closed head injuries?




Is surgery indicated for bilateral cerebral swelling?

Midline shift and focal hemorrhage.




No not really.

When surgery is not indicated for closed head injuries what is the medical management?

ICP monitor, mechanical ventilation, IV fluids.

What are the GCS levels of head injury?

Mild is 13-15


Moderate is 9-12


Severe is 8 or less.

What level of GCS should early intubation be done?

Severe < 8

Are intracranial mass and dilated pupil contralateral or ipsilateral?

Generally it is Ipsilateral.

When should porcine and cadaveric skin be used in burn patients?

When the TBSA affected is around 80%.

When is staged burn wound excision and skin coverage indicated?

Again, when the TBSA affected is around 80%. When there is not enough autologous skin graft available.



What is the preferred management for burn patients with enough autologous skin grafts (< 80% TBSA)

Early excision of the entire burn with autologous split thickness skin graft application.

When should split thickness grafts be used vs full thickness grafts?

Full-thickness grafts are best for areas that require more tensile strength like the foot or weight bearing surfaces.

What are the recommendations for patients that should be treated at a burn center?

< 10 or > 50 with Full thickness burns greater than 10%




Any age with >20% TBSA




Partial or full thickness involving face, eyes, ears, hands, genitalia, perineum, and over joints.




Chemical, electrical or significant trauma




Special support socially, emotionally, or with long term rehabilitaion.

What needs to be considered in a burn patient where the oropharynx is red, blistered, or dry?

Intubation

What test should be done in all patients in closed-space fires?

COHgb value

When is limb loss a consideration with LEVPOD?

When there is multilevel occlusion evidenced by ulceration (tissue loss)


Bypass is required.

When should amputation be considered in patients with LEVPOD?

When there is gangrenous tissue and patients are non-ambulatory.