Med 1st exam

quickster2008's version from 2015-05-11 01:32


Question Answer
ASA level of an uncontrolled DM pt ASA 3
Read an EKG with inverted T waves in leads V3-V6. inferior-lateral ischemia
The effects of an Aortic Stenosis include:AVA diameter, jet velocity, mean gradient
Pt has a normal sinus rhythm on EKG with no pulse or respirationsPEA, find underlying cause and treat, start CPR, and call a code
EKG identify a 3rd degree blockpic
How long to wait to operate on a Bare metal stent. 6wk-3months
What has the lowest risk for a pt with HbA1c of 11? cataract
Elevated TSH indicatesHypothyroidism
Best smoking cessation time8 weeks
Want to reduce Sx to less than what to reduce pulmonary risks? 2 hours
Most pulmonary complications associated with which Sx? Open Gallbladder
Someone had a Drug Eluting Stent. When can we operate and do we remove any meds?Keep on Aspirin and wait 1 year
Test with highest Sensitivity and specificity. Echocardiogram
Aortic Stenosis
a. crescendo-descendo dystolic
b. crescendo-decrescendo systolic
c. decrescendo-crescendo systolic
d. decrescedno-crescendo dystolic
Crescendo-Decrescendo Systolic
Systolic Murmurs heard between S1 and S2
When to stop Warfarin before Sx? 4-7 days
Some with a Childs score of C.Decrease to A or B before Sx
Childs score includes all except.ASA score
which is worse viral or alcohol cirrhosisViral cirrhosis is worse than alcohol cirrhosis
Liver does not produce Liver does not produce insulin
Obstructive Sleep Apnea cause associated withCAD, Right sided HF, and a difficult airway
Obstructive Sleep Apnea associated with what symptomswitnessed apnea, loud snoring, morning sleepiness, and nighttime gasping of air
21 year old female pt needs Sx on bunion.Do a pregnancy test
What isn’t included in pre-op pt eval. Immunization record
What is best way to correct someone’s OSA?MMA maxillomandibular advancement
What increases chance of developing OSA? Neck size, weight, narcotic use
Definition of Sensitivityprobability of a positive test result if pt has the disease in question, aka recall rate
EKG identify Vfib. How do u tx?Use CPR to treat
Most common cause of death in pts under 44 years of age. Unintentional injury
Write a prescription for Zosyn
What is not associated with Opiod use? They are 1st line options for Tx of neuropathic pain.
What is true of Acetominophen? Safe for pregos, potential hepatotoxicity, not an NSAID
What is the best indicator of someone who has responded to infection treatmentnegative leukocyte esterase, platelets of 75,000, INR of 1, and glucose of 90.


Question Answer
CMT is static or progressive, spastic or flaccidflaccid progressive
What type of feet do CMT puts havecavovarus feet
Does charcot manifest through neuropathic or myopathic process?neuropathic
Type 1 CMT vs type 2Type 1-prob with myelin sheath, slowed nerve conduction velocity of <38m/s, while type 2 is axonal neuropathy and has a normal conduction velocity but magnitude of impulse is decreased
What it type 3 CMTtype 1 on steroids, earlier onset, delayed motor skills, loss of ability to walk as adult
T or F, CMT is one of the most common inherited neurological dzT
Pathology of CMTloss of myelin and axons seen in the DISTAL PART of LE, have hypertrophic nerves with ONION-BULB FORMATION
histopathology of CMT revealsdecreased number of myelinated fibers
order of muscle degeneration KNOW!!intrinsic, anterior leg muscles, preens brevis, preens longs & TP preserved until late stage of dz(work horses), triceps surae
what would happen if u lost PBTP takes over and inverts foot
Lose 1 grade of m strength everytime u transfer a m, don't want to go below3/5
clinical feature of CMTdropfoot, steppage gait, clawing of toes(lose intrinsics m), pseudoequinus(ankle is going to DF to bring FF down when it is in various)
Weakened anterior tibial m causes need for ____ to establish appropriate DF during ___ phase of gaitextensor substitution, swing
Position of FF and RF?FF varus thus RF going to go into values
Test for CMTcoleman block test
Labs for CMTEMG, NCV test, biopsy of sural nerve(best diagnostic test-see onion bulb appearance)
Surgical principles for CMTneed to do boney and ST procedures together
3 m's driving cavus footPL, deep post m group, achilles
1st layer of intrinsic mabductor hallucis, FDB, abductor digiti minimi
Soft tissue surgeryPlantar fascia release/steindler stripping, removes 1st layer of intrinsic m, PF, long plantar lig
Long plantar lig origin and insertionoriginates just distal to ant tuberosity, goes just distal to met heads
describe Tibialis posterior transfer, is it in phase or out of phasetransferred thr interosseous membrane to dorslolateral foot, going to weaken varus pull and improve DF of tendon, now going to fire during swing phase instead of stance
Main deforming force in CMT cavus footTP
Why would you do a PL transfer2 reasons, Reduce PF force of 1st ray, improve eversion strength of foot
what are the 2 options for transferring PB tendoncan do a transfer from lateral to anterior compartment(out of phase) or PL to PB tendon transfer
2 main forces the achilles tendon places on footPF, supinated
2 major deforming force musclesachilles, TP
would you do a achilles tendon lengthening or shortening procedure for CMTlengthening
what type of osseous surgery would u do, extra-articular or intra-articularextra-articular. extra means u are going to make a bone cut in one of these-calcaneus, midget, or 1st met
RF osseous surgerydwyer, lateral displacement osteotomy
midfoot osseous surgerycole or japas procedure
1st metatarsal osseous surferyDF osteotomy of base of metatarsal
procedure when pt has progression of CMT, arthritic, painful, nonfunctionaltriple arthrodesis
Which type of the following types of equines is most commonly seen in cavus foot?pseuodeuinus
define pseudoequinusFF PF not enough ankle ROM
Largest nerve in the bodysciatic n
sciatic n branches from ?sacral portion of lumbosacral plexus
where does sciatic n divide and what does it divide intodistal 1/3 of thigh, divides into tibial and common perennial n and has an articular br at the hip jt
sciatic nerve comes from sacral portion of lumosacral plexus is is formed by what branchesL4, L5, S1, S2, S3 branches
tibial nportion of lumosacral plexus is is formed by what branchesL4, L5, S1, S2, S3 branches
common perennial n portion of lumosacral plexus is is formed by what branchesL4, L5, S1, S2, branches
Sciaticasymptom not a dz, pain radiating down sciatic n from lower back problem
causes of sciaticaradiculopathy(most common cause) herniated disc pressing on nerve root, spinal stenosis-narrowed spinal canal, spondyloisthesis-slipped vertebra
LEsion at ___ would lead to weakness with ankle plantar flexionS1
lesion at ____ would lead to ankle dorsiflexionL5


Question Answer
Virchow's triadstasis of blood flow, endothelial injury, hyper coagulability
which is not a risk factor of DVT nephrotic syndrome, acute medial illness, central venous catheter, inflammatory bowl dz, pregnancy, hormone replacement, previous DVT HTNHTN
what is capriniidentifies unique pt individual risk factors, produces a score that can be used to help determine whether pox is indicated if so duration and type
What can be used for prophylaxisintermittent compression along with LMWH(enoxaparin, dalteparin), heparin, coumadin, or oral factor Xa inhibitors(rivaroxaban)
Function of prophylaxisdear ability to form clots
Coumarin and heparin, what do u give immediately?heparin, coumarin slow
prevents clots that break loose from becoming a PEIVC filter aka greenfiled filter
Which is false about POst-Thrombotic syndrome a. may present with pain, b. may see skin discoloration, telangiectasia, edema, c. may be complication of DVT all of those are correct
what can be a tx for hallux rigidus a. dancers pad b. corticosteroid injection c. orthoses d. all of aboved
Jt sparing procedurescheilectomy, metatarsal osteotomy, proximal phalanx osteotomy, chondropasty
Jt destructive proceduresresection arthroplasty, arthrodesis, interpositional implant arthroplasty, total jt replacement
what procedure would u do on a hypermobile 1st raycheilectomy (only jt sparing on list)
Etiologies of hallux rigid a. gout b. MTE c. long 1st met d. hypermobile 1st ray e. all of aboveall of above
appearance of healthy cartilagewhite, shiny
T or F cartilage can be broken down by imbalance of catabolism and anabolismT
what radiograph would u use to see a calcanealnavicular jtlateral oblique
what test, tests for rigidityhubscher maneuver
Is meaty's angle found on AP or lateral X-raylateral
T or F: bone scan is better to use to diagnose osteomyelitis than MRIT
Is pseudomonas a deep or superficial wounddeep
which antibiotic would u use on a DM pt who had a neg bone scanchipper
what stage of Eichenholtz would there be inflammatory period by no bony changes on radiograph0
causes of diabetic infectiongram+ gram - MRSA anaerobe aerobe
hallux amputation surgery done on pt to heal a nonhealing ulcer. What is the name of this surgerycurative