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24 Cards in this Set
- Front
- Back
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1. Intense pain in wound
2. Fever, hypotension, and tachycardia 3.decreased sensitivity at edges 4. Cloudy-gray discharge 5. Tense edema outside involved skin 6. subcutaneous gas w/ crepitus |
Necrotizing surgical infection
- early (urgent) surgical exploration/debridement |
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How does Mucormycosis present? What is the organism? Treatment?
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common after DKA -> fever, dull facial pain, bloody nasal discharge, diplopia and HA
- nasal turbinates are necrotic and proptosis of eye KOH of scraping shows hyphae - Fungus Rhizopus - Fatal if untreated: must surgical debridement + amphotericin B (only) |
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What disease is "neurogenic claudication"?
Dx by? Treatment? |
Lumbar spinal stenosis
- extension makes it worse; flexion makes it better standing and walking = worse sitting, laying down = better normal ABI and pulses Dx: MRI Tx: conservative or surgical (laminectomy) |
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Hypotension, JVD, Kussmaul's sign, clear lung fields, ST elevation in II, III, aVF and ST depression in I and aVL?
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Right ventricular infarction -> Rt sided heart failure
- ST depression in leads I and aVL (left most leads, so switch) - decreased preload, decreased CO and BP |
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What is treatment for Rt ventricular infarct?
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IV fluids
AVOID preload reducing meds (like nitrates and diuretics) |
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S1Q3T3 + RBBB + sinus tachycardia = ?
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Pulmonary thromboembolism
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What would you see in an interventricular septum rupture?
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Left-to-Right Shunt -> result in rt ventricular failure
AND Pansystolic murmur at left border NO ST elevations |
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If you see bilirubin in the urine (dark urine) what do you think?
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Conjugated hyperbilirubinemia (because unconjugated bilirubin is insoluble in water -> cannot be excreted in urine)
Also see pale stools |
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What is Rotor syndrome?
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benign defect of hepatic storage of conjugated bilirubin -> leaks into plasma
LFTs normal, see bilirubin in urine (dark) |
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What is Gilberts syndrome?
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icterus seen during stress
unconjugated hyperbilirubinemia (< 3) |
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What is paroxysmal noctural hemoglobinuria (PNH)?
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acquired hemolytic anemia, abnormal susceptibility of RBC membrane to hemolytic action of complement.
Triad: Unconjugated hyperbilirubin + thrombosis + pancytopenia |
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What is S/E of radioactive iodine (I-131)? What should you do to avoid this?
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Transient early thyrotoxicosis (can cause new-onset A.fib and tremor) - b/c dying thyroid cells release excess thyroid hormone into circulation
Recommended to pretreat pts with methimazole to deplete thyroid hormone stores before starting radioactive therapy (especially in elderly or CVS disease) Can give prednisone to prevent exacerbations of hyperthyroid ophthalmopathy that can occur with radioactive iodine treatment |
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Chest wall bruising, decreased breath sounds, hypoxia
CXR: patchy irregular alveolar infiltrate |
Pulmonary contusion
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What CN's go through the cavernous sinus?
What is pentad of cavernous sinus thrombosis? Treatment? |
CN 3, 4, V1+V2, 6
1. HA (frontal, severe) 2. low-grade fever 3. periorbital edema 4. CN palsies (CN 6) 5. Diplopia Tx: broad-spectrum antibiotics +/- steroids, heparin, surgery |
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Somogyi effect vs. Dawn phenomenon?
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Somogyi - noctural hypoglycemia (too high PM dose) -> 3am sugar is low -> counterregulatory hormones released (Epi, NE, glucagon)
Dawn: too low PM insulin dose -> b/c spikes of GH release shortly after falling asleep with decrease insulin effect -> high glucose level at 3am and continues to increase at 7am. |
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When is a large thymic shadow normal on CXR? What does it look like?
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less than 2 yrs -> it continues to grow in size until puberty and then atrophies
"sail" sign - sail of a ship |
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How does mycoplasma pneumonia present?
Dx? Treatment? |
more indolent (slow) course, non-productive cough and more extrapulmonary manifestations (HA, sore throat, skin rash-esp. erythema multiforme (dusky red, target-shaped lesions on extremities))
Dx: CXR: intersitial infiltrates sputum gram stain - PMNs but no organisms Tx: Macrolides (Azithromycin) |
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What is the most common atypical pneumonia?
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Mycoplasma pneumoniae
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gram-positive, weakly acid-fast, filamentous, branching rod?
Treatment? |
Nocardia - common in immunocompromised
Tx: TMP-SMX |
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Kid with hyperinflation of right lung, mediastinal shift to left, and severe hypoinflated left lung...what do you do?
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immediate RIGID bronchoscopy (NOT flexible) + direct laryngoscopy = both Dx and Tx
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What is the criteria for long-term O2 home therapy in COPD patients (2)?
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1. PaO2<55 or SaO2<88% on room air
2. Signs of cor pulmonale, pulmonary HTN or HCT > 55% when PaO2 < 60 Goal >90% SaO2 * improves survival when used for minimum of 15hrs/day |
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Disorder of the spinal nerve roots?
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Cauda Equina Syndrome (CES)
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How does Cauda Equina syndrome present? What is causes? How do you Dx and Tx?
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h/p: low back pain, bowel and bladder dysfunction, saddle anesthesia, impotence, sciatica, lower extremity sensory + motor loss
PE: poor rectal tone, perineal anesthesia, reflex abnormalities and increased post-void residual volume Causes: trauma, neoplasms Dx: emergent MRI Tx: immediate surgical decompression |
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Can osteoarthritis cause anemia of chronic disease?
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No only rheumatoid.
- more likely patient is taking NSAIDs and bleeding occulting in GIT causing iron def. anemia |
