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  • What is the difference between angioplasty and bypass surgery?
    What is the difference between angioplasty and bypass surgery?
    These two types of treatments are known to be recommended for those who are having some heart problems. Angioplasty is the process wherein the coronary artery will be widened in order to allow the blood to pass through. This requires the use of a balloon catheter so that the artery can be widened from the inside. Those who undergo this method of treatment can recover faster as compared to someone who undergoes bypass surgery but this is not for everyone. Bypass surgery is known to be a more effective treatment for CHD. A bypass is known to increase the flow of oxygen-rich blood to the heart. The number of people who get bypass surgeries has decreased recently because of people’s lifestyle change.

  • Which factor of the following is not responsible for the decrease in collagen synthesis?
    Which factor of the following is not responsible for the decrease in collagen synthesis?
    Anemia-collagen synthesis is an essential part of wound recuperating, is influenced by numerous fundamental elements. Protein exhaustion impairs fibroplasia. hypoproteinemia prompts reduction of fibroblast multiplication, proteoglycan and collagen synthesis, angiogenesis, and wound renovating. Despite the fact that anemia was once accepted to be a huge reason for wound interruption, research has proven that, without the lack of healthy sustenance or hypovolemia, anemia with a hematocrit more noteworthy than 15% does not meddle with wound recuperating. conversely, atomic oxygen is basic for collagen synthesis since it is one of the elements required for the hydroxylation of lysine and proline. additionally, hypoxia favors wound infection. the part of age in collagen synthesis isn't clear, however the frequency of wound disappointment and incisional hernias is more noteworthy in patients more seasoned than 60. fibroplasia happens at a slower rate in more seasoned creatures. maybe more than some other factor, wound infection is related with the danger of wound disappointment.

  • What is the most common cause of fatal transfusion reactions?
    What is the most common cause of fatal transfusion reactions?
    1. a clerical error.-the most common cause of fatalities related to transfusion reactions result from abo-incompatible transfusion related to clerical error. most such reactions occur if a type o person receives type a red cells owing to a clerical error that occurs either at the time the blood sample was drawn, during processing in the laboratory, or at the time a unit is administered. the importance of extremely careful labeling, transfer, and handling of specimens and of cross-matched blood products cannot be overemphasized. allergic and other reactions are common but rarely fatal. the transmission of bacterial organisms (e.g., staphylococcus aureus) has been reported especially with platelet concentrates maintained at or near room temperature. fortunately, such reactions are rare.

  • Which of the following is the most appropriate next step? A 23-year-old woman seeks help for exquisite pain with defecation and blood streaks on the outside of her stools, which she has been having...
    Which of the following is the most appropriate next step? A 23-year-old woman seeks help for exquisite pain with defecation and blood streaks on the outside of her stools, which she has been having...
    1. lateral internal sphincterotomy -the clinical picture is classic for anal fissure, which is perpetuated by the fact that the anal sphincter is too tight. forceful dilatation under anesthesia, lateral sphincterotomy, or botulinum toxin injections are acceptable options to break the cycle. the only one of those choices given is the sphincterotomy. excision (choice a) used to be done for this condition, before the role of the too tight sphincter was elucidated. fistulotomy (choice b) is not the answer. she has a fissure, not a fistula. incision and drainage (choice c) is another option that addresses a wrong diagnosis. we do that for perirectal abscess, which produces severe pain with fever and leukocytosis, but without blood streaks, and drains spontaneously after several days if not diagnosed and treated. rubber band ligation (choice e) is the answer for internal hemorrhoids. internal hemorrhoids can bleed, but typically do not hurt. thrombosed external hemorrhoids can hurt tremendously, but those are not amenable to rubber band ligation.

  • Which of the following changes in body composition does not occur in "catabolic" surgical patients?
    Which of the following changes in body composition does not occur in "catabolic" surgical patients?
    Catabolism is the set of metabolic pathways that break down molecules into smaller units that are either oxidized to release energy or used in other anabolic reactions. Catabolism breaks down large molecules into smaller ones. Catabolism provides the chemical energy necessary for the maintenance and growth of cells. Examples of catabolic processes include glycolysis, the citric acid cycle, the breakdown of muscle protein to use amino acids for the breakdown of fat in adipose tissue to fatty acids. There are many signals that control catabolism. Most of the major signals are hormones and molecules involved in metabolism itself.

  • Which of the following is the most appropriate next step in management? A young man sustains a gunshot wound to the base of his neck. He was shot point blank with a .38 caliber revolver. The...
    Which of the following is the most appropriate next step in management? A young man sustains a gunshot wound to the base of his neck. He was shot point blank with a .38 caliber revolver. The...
    1. angiogram, esophagogram, esophagoscopy, and bronchoscopy prior to surgical exploration -gunshot wounds to the base of the neck need exploratory surgery, but the exact approach and incision are determined by a more accurate knowledge of the location and extent of the injuries. thus, if time permits, diagnostic studies should precede surgical intervention. the major vessels, the tracheobronchial tree, and the esophagus are the potential targets that have to be investigated. observation (choice a) might be appropriate for a stab wound in a completely asymptomatic patient. in gunshot wounds, we have to expect that injuries will exist, and they should not be neglected waiting for overt clinical signs. ct scan (choice b) has done wonders for our assessment of closed head injuries and blunt abdominal trauma, but it is not the study that would tell us what has happened to the major vessels, the esophagus, or the tracheobronchial tree in a gunshot wound. immediate surgical exploration, either through the neck or the chest, or in combination, might be forced by a rapidly deteriorating situation. in the absence of such imperative, a decision to open the neck (choice d) or the chest (choice e) is premature at this point

  • Which of the following is most appropriate to provide diagnostic confirmation of the nature of the problem and eventual therapy? Several months after sustaining a crushing injury to his arm, a...
    Which of the following is most appropriate to provide diagnostic confirmation of the nature of the problem and eventual therapy? Several months after sustaining a crushing injury to his arm, a...
    1. sympathetic block and surgical sympathectomy-the description is that of causalgia, also known as reflex sympathetic dystrophy. if sympathetic block relieves the symptoms, permanent cure will be obtained with surgical sympathectomy. venous occlusion (choice a) would produce swelling but not this kind of pain. cervical ribs (choice b) can produce neurologic and vascular symptoms in the arm, but they are related to activity and position and do not have the nature described here. normal pulses make arterial insufficiency (choice c) unlikely. furthermore, there is no description of intermittent claudication. compartment syndrome (choice d) might have happened at the time of injury, but if that were the case, it would be too late to do a fasciotomy.

  • Which of the following statement(s) is/are true concerning excessive scarring processes?
    Which of the following statement(s) is/are true concerning excessive scarring processes?
    1. simple reexcision and closure of a hypertrophic scar can be useful in certain situations such as a wound closed by secondary intention-true keloids are uncommon and occur predominantly in dark skinned people with a genetic predisposition for keloid formation. in most cases, the gene appears to be transmitted as an autosomal dominant pattern. the primary difference between a keloid and a hypertrophic scar is that a keloid extends beyond the boundary of the original tissue injury. it behaves as a tumor and extends into or invades the normal surrounding tissue creating a scar that is larger than the original wound. histologically, keloids and hypertrophic scars are similar. both contain an overabundance of collagen. although the absolute number of fibroblasts is not increased, the production of collagen continually out paces the activity of collagenase, resulting in a scar of ever increasing dimensions. hypertrophic scars respect the boundaries of the original injury and do not extend into normal unwounded tissue. there is less of a genetic predisposition, but hypertrophic scars also occur more frequently in orientals and the black population. they are often seen on the upper torso and across flexor surfaces. some improvement in a keloid can be obtained with excision followed by intra-lesional steroid injection. however, the resulting scar is unpredictable and potentially worse. reexcision and closure should, however, be considered for hypertrophic scars, if the condition of closure can be improved. this is especially pertinent for wounds that originally healed by secondary intention or that are complicated by infection. keloids typically develop several months after the injury and rarely, if ever, subside. hypertrophic scars usually develop within the first month after wounding and often subside gradually.

  • Which of the following statement(s) is/are true concerning the diagnosis and management of hypovolemic shock?
    Which of the following statement(s) is/are true concerning the diagnosis and management of hypovolemic shock?
    1. complications are less frequent after treatment of hemorrhagic shock than septic or traumatic shock-hypovolemic shock is readily diagnosed when there is an obvious source of volume loss and overt signs of hemodynamic instability and increased adrenergic output are present. after acute hemorrhage, hemoglobin and hematocrit values do not change until compensatory fluid shifts have occurred or exogenous fluid is administered. these values decrease once transcapillary refill, osmotic-induced shifts, or non-rbc volume resuscitation expands the blood volume. it is imperative that the distinction be made between hypovolemic and cardiogenic forms of shock, because appropriate therapy differs dramatically. restoration of perfusion in hypovolemic shock requires reexpansion of circulating blood volume in conjunction with necessary interventions to control ongoing volume loss. continued hemodynamic instability after fluid resuscitation implies that shock has not been reversed or that there is ongoing blood or volume loss. in severe, prolonged hypovolemia, ventricular contractile function may itself become depressed and require inotropic support to maintain ventricular performance, but in general, pharmacologic interventions directed toward increased contractility in situations of inadequate preload are ineffective, further complicate metabolic derangements, and are not indicated until adequate volume replacement has been completed. complications are less frequent after treatment of hemorrhagic shock than in situations of septic or traumatic shock. in the later circumstances, the massive activation of inflammatory mediator response systems and consequences of their disseminated, indiscriminate cellular injury can be quite profound.

  • Abnormal sounds superimposed on breath sounfs including sibilant wheezes, crackles
    Abnormal sounds superimposed on breath sounfs including sibilant wheezes, crackles
    Adventitious lung sounds are abnormal sounds that are heard when auscultating a patient's lungs and airways. These sounds include abnormal sounds such as fine and coarse crackles (crackles are also called rales), wheezes (sometimes called rhonchi), pleural rubs and stridor.

  • The use of antibiotics can be based on either the clinical course of a patient without the benefit of well-defined microbiologic data (empiric therapy), or targeted at specific identified pathogens...
    The use of antibiotics can be based on either the clinical course of a patient without the benefit of well-defined microbiologic data (empiric therapy), or targeted at specific identified pathogens...
    1. with the empiric use of antibiotics, a diligent search for the septic source should be undertaken and continued until identified-the use of empiric therapy without the benefit of well-defined microbiologic data is appropriate when there is sufficient clinical evidence to support the diagnosis such that it would be imprudent to withhold antimicrobial therapy. in this setting, however, a diligent search for the septic focus source should be undertaken and continued (cultures, radiographic procedures, etc.), and initial limits should be placed in the course of empiric therapy with continued reevaluation based on the clinical course of the patient. the choice of antibiotic agents should be based on the clinical situation and known activity patterns within the given institution. single broad-spectrum agents, although suffering slightly from a lack of individual pathogen specificity, are useful in this setting in that they provide a broad coverage against several groups of pathogens and may avoid some of the toxic effects with specific combined modality regimens. similarly, for directed therapy, single-agent therapy has been demonstrated to be equivalent to combined therapy and should be chosen in an attempt to select agents with appropriate sensitivities which retain suitable clinical efficacy but exhibit minimal toxicity. after review of cultural reports, many patients have demonstrated polymicrobial infection. because experimental clinical evidence supports the concept of aerobic-anaerobic synergy, therapy should be directed against all potential components of the infection if the body site is such that these microorganisms may be present.

  • What are these?
    What are these?
    Mayo

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