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Flashcards in SCORE questions Deck (77)
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1

What are the two histologic subtypes of Rhabdomyosarcoma?

1. Embryonal (most common)
2. Alveolar

2

what are the different types of embryonal rhabdomyosarcoma? (2)

1. Spindle cell- most common in paratesticular lesions
2. Botryoid- polypoid masses that fill the lumen of a hollow viscus (vagina, bladder)

3

Embyonal rhabdomyosarcoma:
1. young vs old
2. survival?

1. Occurs in younger patients, head and neck region
2. Favorable survival rate 60%

4

What is roving sign?

right lower quadrant pain induced by palpation in the left lower quadrant (for acute appendicitis)

5

What is dunphy sign?

increased pain with any coughing or movement and is related to inflammation that involves the parietal peritoneum

6

what is the obturator sign?

seen with inflammation of the appendix and refers to pain on internal rotation of the right hip

7

what is the iliopsoas sign?

most often seen with a rhetorical appendix and refers to pain on extension of the right hip

8

What is immune thrombocytopenia purpura (ITP)?

autoimmune destruction of platelets with clinical manifestations of thrombocytopenia and susceptibility to easy bleeding

9

What patient population does acute ITP target?

children

10

What is chronic ITP?

- accounts for most cases considered for splenectomy
- avg age 40's, women > men

11

What is the pathophys of ITP?

development of IgG antibody to platelet antigen

12

First, second and third line treatment of ITP?

1st: high dose steroids
2nd: IVIG
3rd: splenectomy

13

What 3 things does End tidal CO2 monitoring reflect?

1. Metabolism
2. Circulation
3. Ventilation

14

In which breast malignancy should patients proceed directly to axillary lymph node dissection?

Inflammatory breast cancer

15

What non depolarizing muscle relaxant is preferred for endotracheal intubation in patients with either hepatic or renal dysfunction?

Atracurium: (dose 0.3-0.6mg/kg), Hoffman elimination thus good for renal/hepatic impaired ppl, can cause histamine release leading to hypotension

16

What is Hoffman elimination? i.e. a type of metabolism

spontaneous degradation of drug at physiologic pH

17

Why is vecuronium the intubation drug of choice in reactive airway patients?

because it doesn't cause histamine release upon administration. (hepatic metabolism, 0.1mg/kg)

18

What is the longest acting of all muscle relaxants?

doxacurium (max effect at 6 min and duration of action is 83 min)

19

What is the most common primary lung tumor among infants and children?

Bronchial adenoma- 80% of these are Endobronchial carcinoid

20

what is the most common benign tumor of the lung in children?

- rare!! but most common is pulmonary hamartoma or chondroma

21

what stimulates the secretion of aldosterone?

extracellular fluid potassium

22

when compared with endoscopic sphincterotomy, transduodenal sphincteroplasty is associated with what?

decreased incidence of restenosis

23

what is a giant condyloma acuminatum? aka Burschke-Lowenstein tumor

- represents verrucous carcinoma
- large cauliflower lesion
- histologically benign but clinically malignant and can invade adjacent organs

24

Whats one disadvantage of Lactated ringers?

its relatively low sodium content (130 mEq) , hyponatremia can occur with prolonged use

25

What are the factors that negatively affect post-transplant outcomes?

1. Increased donor age >50
2. Female sex of donor
3. Increased hepatic steatosis of the donor liver
4. Severe donor hypernatremia prior to organ harvest
5. Prolonged cold ischemia time
6. ABO mismatach

26

most common presentation of branchial anomaly in adolescent is?

cystic mass (arising from the second cleft/pouch)

27

What are the phases of the cell cycle?

G1, S, G2, M
M: mitosis
S: DNA Synthesis
G1: gap1 separates previous cell division from the beginning of the DNA synthesis, determines length of cycle
G2: short gap phase

28

a neonate with hypo plastic left heart syndrome depends on what for survival?

patency of the facts arteriosus (facilitated by prostaglandin infusion)

29

What are 2 treatment options for hypo plastic left heart syndrome?

1. Cardiac transplantation requiring a donor aortic arch
2. Norwood procedure: converts the pulmonary artery into the main outlet for a functional single ventricle

30

what is an important principle with bypass grafting for aortoiliac occlusive disease?

place the proximal anastomosis as high as possible on the infrarenal aorta