22 FEB 2017 2019 SURG Flashcards
what are the hallmark CT findings in pulmonary contusion?
patchy, irregular, nonlobular alveolar infiltrates not restricted by anatomical boundaries
what are the typical lab findings in acute mesenteric ischemia?
- leukocytosis
- elevated Hb
- elevated amylase
- metabolic acidosis
what is the most common infectious agent in bacterial parotitis?
staph aureus
what an be done pre- and post-operatively to prevent bacterial parotitis?
adequate fluid hydration and oral hygiene
mechanical bowel obstruction (eg from adhesions) causes (hyper / hypo) active bowel sounds, whereas prolonged postop ileus caused (hyper / hypo) active bowel sounds
- MBO: hyperactive
- prolonged postop ileus: hypoactive
unlike prolonged postop ileus, mechanical bowel obstruction (eg adhesions) will show __________ on x ray
air fluid levels
- what is the MOA of metoclopramide?
- what is the MOA of ondansetron?
- metoclopramide: DA antagonist - prokinetic agent
- ondansetron: serotonin receptor antagonist (can cause constipation)
what therapy can be used to temporarily fix flail chest? how does it work?
- mechanical positive pressure ventilation (MPPV)
- corrects paradoxical motion of flail segment by replacing normal negative intrapleural pressure with positive intrapleural pressure and forcing the segment to move outward with the rest of the rib cage during inspiration
what are the most common organisms responsible for prosthetic joint infection within 3 months?
- staph aureus
- gram negative rods
- anaerobes
what are the most common organisms responsible for prosthetic joint infection within 3-12 months?
- coagulase negative staph
- propionibacterium spp
- enterococci
what are the most common organisms responsible for prosthetic joint infection after 12 months?
- staph aureus
- gram negative rods
- beta hemolytic strep
what is the most potent regulator of cerebral blood flow?
paCO2
what are causes of postop fever within 2 hours?
- prior trauma / infection
- blood products
- malignant hyperthermia
what are causes of postop fever within 24hr - 7d?
- nosocomial infections
- SSI
- noninfectious (MI, PE, DVT)
what are causes of postop fever after 1 month?
- viral infections
- SSI
why is mechanical positive pressure ventilation (MPPV) contraindicated in hypovolemic shock?
- causes an acute increase in intrathoracic pressure, which, in a severly hypovolemic patient with low central venous pressure, can collapse venous capacitance vessels and cut off venous return
- sudden loss of right ventricular preload can cause acute circulatory failure and sudden cardiac death
which has a greater risk of avascular necrosis: intraacpsular or extracapsular femoral fractures?
intracapsular
which have a greater need for implanted devices: intracapsular or extracapsular femoral fractures?
extracapsular
what is Cushing’s reflex? what does it indicate?
- HTN
- bradycardia
- respiratory depression
- indicates increased ICP
what compartment pressure indicates significant compartment syndrome?
equal to or over 30 mm Hg
what imaging test is used for penile fracture?
retrograde urethrogram
patients with suspected prerenal AKI should be treated with what kind of fluid?
IV isotonic fluid (NS) - to restore renal perfusion
what are the 4 Ts for anterior mediastinal tumors?
- thymoma
- teratoma (includes other germ cell tumors)
- thyroid neoplasm
- terrible lymphoma
seminomas may show an elevation in what hormone?
B-HCG (AFP is essentially always normal)
nonseminomatous germ cell tumors have an elevation in what hormone?
AFP (many also do have an increase in B-HCG)
