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ER/ICU/Surg 10 Emerg

Surgical Emergencies and Transplantation

What would you suspect in an ER pt with blood in the urethral meatus or a high riding prostate? Urethral injury or bladder rupture
What are the two measures of how severe the hypotension is in shock? UOP, mental status
What causes a continuous machine-like heart murmur? PDA
List some shotgun labs for a pt with abdominal pain. CBC with diff, amylase/lipase, BMP with BUN/Cr/LFTs, beta hCG, UA, stool guiac, EKG (>45yo +/- cardiac enzymes esp if female or diabetic)
Cardiac cause of mesenteric ischemia? A fib causing emboli formation
Mgmt of mesenteric ischemia? Hemodynamic monitoring and support (dobumatine or dopamine PRN), broad spectrum abx, NG tube decompression, and angiogram
Classic presentation of chronic mesenteric ischemia? Dull, crampy, postprandial epigastric pain within first hr after eating then subsiding over 2h. Abd bruit in 50%.
Tx options for chronic mesenteric ischemia? Bypass, endarterectomy, angiography, stenting
What is seen on abd X-ray or CT scan that indicates a ruptured viscus? Free air
What is the classic finding in the abd exam of a pt with mesenteric ischemia Pain out of proportion to exam
During a surg procedure, anesth ntoices pt's temp has climbed quickly and her mm are ridgid. Recognizing this feared complication, the doctor should administer which med? Dantrolene.
What are a few contraindications to the transplant of the following organ?: heart smoking, pulmonary HTN
What are a few contraindications to the transplant of the following organ?: liver alcohol, multiple suicide attempts
What are a few contraindications to the transplant of the following organ?: lung smoking, poor cardiac/liver/renal f'n
What is the type of rejection that is treatable with immunosuppressive agents? What is the mechanism of this rejection? Within what time frame may it show up? Acute rejection: prolif of anti-donor T cells (6d-1yr)
A pt who recently received a bone marrow transplant develops a rash, nausea, and vomiting and is having continued bleeding from her gums after brushing her teeth. What should be suspected in this pt? Graft vs host disease
Created by: sarah3148



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