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39 Cards in this Set
- Front
- Back
Dx
elderly woman with a history of cholelithiasis and recurrent abdominal pain and vomiting |
gallstone ileus
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60 yo woman who leaks urine when laughing or coughing
what are her nonsurgical options |
Dx: stress incontinence
NONSURGICAL OPTIONS: topical estrogen creams kegel exercises pessary |
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what is the late, life-threatening complication of CML
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BLAST CRISIS
fever bone pain splenomegaly |
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what are the classic symptoms of carpel tunnel
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WRIST PAIN
radiates up the arm worsens with hand flexion/grasping DECREASED HAND STRENGTH NUMBNESS IN FIRST 3 1/2 DIGITS: (i.e. thumb, index, middle & 1/2 of ring finger) THENAR MUSCLE ATROPHY TINNEL'S &/OR PHALEN'S SIGNS |
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what scenarios favor an anterior shoulder dislocation
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blow to abducted, externally rotated, & extended arm (e.g. blocking a basketball shot)
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what scenarios favor a posterior shoulder dislocation
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blow to anterior shoulder
seizure --> fall & land on shoulder electrocution |
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what nerve is damaged:
claw hand |
ulnar
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what nerve is damaged:
ape hand |
median
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what nerve is damaged:
wrist drop |
radial
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what nerve is damaged:
scapular winging |
long thoracic
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what nerve is damaged:
unable to wipe bottom |
thoracodorsal
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what nerve is damaged:
loss of forearm pronation |
median
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what nerve is damaged:
cannot abduct or adduct fingers |
ulnar
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what nerve is damaged:
loss of shoulder abduction |
axillary
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what nerve is damaged:
weak external rotation of arm |
suprascapular/axillary
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what nerve is damaged:
loss of elbow flexion & forearm supinaiton |
musculocutaneous
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what nerve is damaged:
loss of wrist extension |
radial
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what nerve is damaged:
trouble initiating shoulder abduction |
suprascapular
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what nerve is damaged:
unable to abduct beyond 10 degrees |
axillary
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what nerve is damaged:
unable to abduct beyond horizontal |
long thoracic/ spinal accessory
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what nerve may be injured:
fracture of shaft of humerus |
radial
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what nerve may be injured:
fracture of surgical neck of humerus |
axillary
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what nerve may be injured:
supracondylar humerus fracture |
median
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nerve most likely injured:
fracture of medial epicondyle |
ulnar
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what nerve may be injured:
anterior shoulder dislocation |
axillary
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what nerve may be injured:
injury to carpel tunnel |
median
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what nerve may be injured:
injury to distal radius |
median
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Rx for scaphoid fracture
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THUMB SPICA SPLINT then CAST:
4-6 wks distal fxr 10-12 wks middle fxr 12-20 wks proximal fxr (highest risk of necrosis) if displaced, OPEN-REDUCTION |
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what fractures are a/w ruptured thoracic aorta
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RIB FRACTURES
(1st & 2nd ribs have high incidence of cervical spine & vascular injuries) SCAPULAR FRACTURES STERNAL FRACTURES |
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what is the difference between monteggia fracture and galeazzi fracture
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MONTEGGIA
anterior dislocation of radial head with fracture of proximal ulnar diaphysis GALEAZZIA dislocation of distal radial-ulnar joint (DRUJ) with fracture of radial diaphysis |
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complication a/w fracture/injury:
fall of outstretched hand --> snuffbox tenderness |
avascular necrosis (scaphoid fracture)
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complication a/w fracture/injury:
anterior shoulder dislocation |
axillary nerve and artery
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complication a/w fracture/injury:
fracture of 5th metacarpal neck |
abscess (i.e. "fight bite")
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complication a/w fracture/injury:
humerus fracture |
radial nerve
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complication a/w fracture/injury:
hip fracture |
DVT (short-term)
avascular necrosis (long-term) |
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complication a/w fracture/injury:
femur fracture |
severe blood loss
fat emboli |
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complication a/w fracture/injury:
tibial fracture |
compartment syndrome
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complication a/w fracture/injury:
pelvic fracture |
hypovolemic shock
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What is the appropriate antibiotic coverage of an open fracture
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GRADE I OR II:
Cefazolin (or other 1st gen Ceph's) GRADE III (extensive soft tissue damage &/or high contamination): Cefazolin + AMG FARM INJURY: Cefazolin + AMG + PCN (for anaerobic coverage) |