Review

Burn

80 kg 2nd, 3rd burns 40% TBSA. Initial rate

Atrial Myxoma

tumor on right side heart growing on atrial septum. Surgical excision + MVR. Diastolic murmur disappears when lying on side

Mid systolic click

Mitral valve prolapse. Apex. No treatment

Inclusion bodies on biopsy for colitis

CMV, transplant. Ganciclovir

Bleeding while on. Antidote

  • ASA: platelets

  • plavix: platelets, desmopressin

  • coumadin: FPP, K, PCC

  • Heparin: if bleeding give blood. Wait if not bleeding

  • factor xa inhibitors: activated charcoal if in 2 hours

  • direct thrombin inhibitors: responds to hemodialysis

chylous ascites on paracentesis

  • lymphatic injury or destruction

  • Lymphoma or any retroperitoneal obstruction. High TG

Pt with von wille brand

  • bleeding time abnormality

  • desmopressin, cryopreciptate

Tardive Dyskinesia

  • 1st gen antipsychotics

  • treatment with benztropine, diphenhydramine

nosebleed unresponsive from nasal packing

posterior, sphenopalatine artery

Transplant rejection

  • types

  • hyperacute: seconds. ABO. HLA. Immediate removal

  • acute: days/months. T cell mediated. Immunosuppression/steroids. Diagnosis with biopsy to differentiate from chronic.

  • chronic: months/years. Gradual fibrosis, loss of function. Retransplant

Pediatric cardiac anomalies

Local Anesthesics

  • Esters (1 i) and Amides

  • Esters more prone to allergic

Ophtho

  • ulcerative conjunctivitis: herpes

  • diabetic with cotton wool spot. Sudden eye pain: central retinal vein occlusion

  • Atherosclerotic, painless: artery occlusion

  • Pt with MS, painful loss of vision: optic neuritis

Carpel Tunnel

  • compression median nerve

  • PE: tinnel, phalen

  • work up: EMG is indirect. Don't pick. Pick nerve conduction study

  • treatment: nsaids, splinting, then CTR

Hidradenitis

  • apocrine (arm pits, groin, but) inflammation

PDA

  • treatment: indomethacin. Prostaglandins to open

  • MOA: cox inhibitor

Temporal arteritis

  • headache, jaw pain, eye pain, temporal artery pain

  • steroids first, then biopsy

Atypical Lung

  • aspergillosis: halo sign with pulmonary nodules, hemoptysis, dense consolidation on CXR

  • histoplasmosis

  • blastomycosis

  • Coccidiomycosis

Practice Questions

  • focal nodular hyperplasia: CT liver lesion with central scar

  • choledochal cyst: cystic dilation of bile duct. Surgical excision

  • pancreatic cystadenoma: premalignant. Distal pancreatectomy

  • 12 yo fall. PE is good. Xray c spine next.

  • low dose heparin or lovenox for DVT prior to surgery

  • penile cancer

  • Melanoma: wide local exision. Cut off fingers

  • needle localized open biopsy or stereotactic if no lump palpable for breast cancer. FNA if palpable mass

  • compartment syndrome: passive movement of the great toe

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