Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3. E Med & Surgery > 4- General Surgery > Flashcards

4- General Surgery Flashcards

1
Q

When should tobacco be discontinued prior to surgery?

A

8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What meds should be continued in the perioperative period? (3)

A

Meds w/ significant withdrawal sxs not affecting anesthesia

CV meds

Statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When should antiplatelet meds be d/c prior to surgery?

A

7-10 days prior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In low and mod risk patients, how does risk for operative mortality change for emergent procedures?

A

Doubles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the greatest RF/ predictor of DVT/ PE or bleeding risk?

A

Prior history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What nutrition state results in increased risk for surgical complications?

A

Severe malnutrition

Weight loss > 15% over prior 3-4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is the body using carbohydrate vs fat stores?

A

Carbohydrate stores @ 24-72 hours

Fat stores @ 72hrs- 10 days (adaptive changes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the nutritional status of a surgical pt hours after injury when pt exhibits sxs of shock and NE release?

A

Ebb phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the nutritional status of a surgical pt days after injury when pt exhibits catabolic > anabolic processes (hypermetabolic, hyperglycemic, increased CO)?

A

Flow phase (peaks 3-5 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the nutritional status of a surgical pt weeks after injury when pt exhibits anabolic processes such as corticoid withdrawal and repletion?

A

Recovery phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What lab test is used to indicate stress on the body if a pt has been in the hospital for a long time and has a half life of 21 days?

A

Serum albumin

< 3.5 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What lab test is used to indicate stress on the body, is highly sensitive, has a half life of 2-3 days and is used for trending purposes?

A

Prealbumin

< 5-17 g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What lab test is used to indicate stress on the body by indicating if a pt is protein deficient and has a half life of 8 days?

A

Serum transferrin

< 200 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the preferred nutrional support used for malnourished pts?

A

Enteral > parenteral

“if the gut works use it”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the nutritional caloric need for a “stressed” pt?

A

Stressed: 50 kcal/kgday, 2.5 protein/kg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What body temp should be maintained during immediate post op period for prevention of complications?

A

Core temp between 98.6- 100.4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What levels should glucose be maintained at through the surgical procedure?

A

150 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When should hair removal be performed (clippers) for surgery?

A

Immediately prior to prep of surgical field

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What skin antiseptics are preferred for prevention of surgical complications?

A

Chlorhexidine solutions (applied and air dry)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What oxygenation levels should be maintained intraoperatively?

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common method for prevention of VTE?

A

Mechanical (pneumatic compression)

+/- systemic anticoagulant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When should fluids and electrolytes be evaluated for POD 1 vs POD 2/ beyond?

A

POD 1- q 4-6 hrs

POD 2/ beyond- q 24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the preferred replacement IVF?

A

Crystalloids > colloids/ blood products

(colloids/ blood products more likely to stay in vascular compartment, colloids not used for rehydration/ bolus unless large amts of fluid loss)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most common crystalloid used in the peri-operative period?

A

Isotonic > hyper/ hypotonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What replacement IVF is used when cystalloids fail to sustain plasma volume due to low osmotic pressure (burns, peritonitis)?
Colloids
26
What Hg value is the common trigger for stable pts requiring a blood transfusion (1 unit = 1 g/dL increased in Hg)
7 g/dL (earlier if sxs, underlying disease, transplant)
27
What type of transfusion therapy is used for active bleeding in thrombocytopenic pts?
Platelets (not packed cells)
28
What type of transfusion therapy is used for pts with deficiencies in clotting factors, active bleeding, or risk of bleeding from emergent procedure?
FFP
29
What is included in post op care of decreased functional residual capacity?
Periodic hyperinflation w/ incentive spirometry and early mobilization
30
When does peristaltic function begin to return post surgery?
Gastric- slowly Small intestine- 24 hrs R colon- 48 hrs L colon- 72 hrs
31
What factors are the greatest contributors to post-op pain and what is the preferred tx?
Duration of surgery, degree of trauma Opioids
32
Pt presents with fever, wound crepitence, and gray/ dusky coloration of the skin. What post-op complication are you concerned for and what is the tx?
Necrotizing fasciitis Early/ aggressive surgical excision of affected tissue
33
What post-op wound complication is defined as partial/ total disruption of any or all layers of the operative wound and when is it most common?
Dehiscence 5-8 days post-op
34
What post-op wound complication is defined as rupture of all layers and extrusion of abdominal viscera?
Evisceration
35
Where is the most common location for Meckel's diverticulum?
Antimesenteric border of the ileum
36
What is the rule of 2's a/w Meckel's diverticulum? (6)
2% of population 2:1 male: female 2 yo 2 ft from ileocecal valve 2 inches long 2 types of mucosa
37
Pt presents w/ abdominal pain, bleeding, intestinal obstruction, (or asx). What post- op complication are you concerned for and what can be used for dx?
Meckel's diverticulum Dx w/ Meckel's scan, mesenteric arteriography, abd exploration
38
What is the tx for Meckel's diverticulum?
Resection
39
What post-op complication is more common in older pts w/ disease causing embolic formation or cardiac disease and presents w/ post-prandial/ intestinal angina with POOP on PE?
Mesenteric ischemia
40
What is included in the management for mesenteric ischemia aside from aggressive fluid resuscitation and NG tube? (3)
Surgery- abd exploration (embolectomy, colon resection) Abx Systemic anticoagulation
41
What is considered a high-output enteric fistula?
\> 500 mL/day
42
What is the most common cause of enterocutaneous fistulas?
Post-op complication
43
What is used for dx of enteric fistulas?
Imaging- CT +/- endoscopy
44
What is the treatment for enteric fistula? (2)
Spontaneous closure vs operative tx Control of drainage and skin protection
45
When is bariatric surgery indicated? (4)
BMI \> 40 BMI \> 35 w/ comorbidity Failure of non-surgical weight loss efforts Well-informed, compliant, motivated
46
What is the most common bariatric surgery performed in the US and what type is it (restrictive vs malabsorptive)?
Roux-en-y gastric bypass Restrictive and malapsorptive
47
What bariatric surgery is a band connected to a subcutaneous reservoir and what type is it (restrictive vs malabsorptive)?
Gastric banding Restrictive
48
Is a vertical banded gastroplasty a restrictive or malabsorptive bariatric surgery? (rarely performed)
Restrictive
49
Is a sleeve gastrectomy bariatric surgery restrictive or malabsorptive?
Restrictive
50
What will a CT scan show for a pt with appendicitis?
Enlargement w/ wall thickening, fat stranding +/- fecalith
51
What is included in the management for appendicitis?
Perioperative abx (3-5 days if perforated) Appendectomy
52
Pt who presents with diffiuse pain after localized tenderness and pain relief followed by peritonitis is concerning for what appendicitis complication?
Perforation
53
Pt who presents with high fever post appendicitis w/ perforation is concerning for what?
Peritonitis
54
Pt who presents with RLQ mass on PE with CT showing percutaneous drainage is concerning for what appendicitis complication and what is the tx?
Abscess Tx w/ abx and appendectomy (if not already performed) +/- drain placement
55
Where is diverticulitis most common and what can result from an acute attack?
Sigmoid Obstruction
56
What is included in the nonoperative management for diverticulitis?
Oral abx Clear liquids Low res diet (after sxs improve) High fiber diet (once normal po intake)
57
When is surgical management of diverticulitis indicated? (3)
2+ attacks Complications Failure to improve w/ 3-4 days of conservative management
58
What surgical procedure involves the colon being divided with the proximal end being brought through the abdominal wall?
Colostomy
59
What type of colostomy involves the distal end of the colon oversewn and placed in the peritoneal cavity as a blind limb?
Hartmann's procedure
60
What are the 2 types of colostomy?
Loop and ileostomy
61
What type of colon resection involves removal of the entire colon and rectum?
Proctocolectomy
62
What type of colon resection is performed for very low rectal cancers and involves removal of the lower sigmoid colon, entire rectum, and anus?
Abdominoperineal resection (APR)
63
What type of colon resection is performed for cancers of the middle and upper sections of the rectum and involves removal of the distal sigmoid colon and 1/2 of rectum with proximal sigmoid-distal rectum anastomosis?
Low anterior resection (LAR)
64
What is defined as a connection between 2 tubular organs?
Colonic anastomosis
65
How can you differentiate between an internal vs external hemorrhoid?
Internal- above dentate line, may bleed/ prolapse, non-painful External- below dentate line, do not bleed, pain/itching/scarring
66
What is the most common cause of rectal bleeding?
Internal hemorrhoids
67
How are hemorrhoids classified and when is hemorrhoidectomy considered?
Grades I-IV Consider hemorrhoidectomy for grades III-IV (mixed internal/ external, extensive thrombosis/ pain, persistent bleeding)
68
What is the office tx for grade II and III internal hemorrhoid?
Rubber band ligation
69
Pt presents with severe, sharp anal pain and PE shows a palpable, tender, fluctuant mass. What are you concerned for?
Anorectal abscess
70
What is included in the tx for anorectal abscess aside from wound care?
Surgical drainage + abx
71
What is defined as an abnormal communication between the anal canal and perianal skin?
Fistula in ano (50% chance after abscess)
72
How is fistula in ano diagnosed?
Cord like tract on DRE Goodsall's rule
73
What is the tx for fistula in ano?
Drainage/ curretage of fistula tract Placement of Seton (loop of drainage tube)
74
Pt presents w/ palpable, soft abd mass +/- pain/ enlargement with straining. Pt examined upright/ supine confirms sxs. What are you concerned for?
Abd wall hernia
75
What is the management for an abd hernia?
Surgical repair (can use laparoscopic if bilateral inguinal, recurrent, ventral/ epigastic)
76
Where will a direct inguinal hernia occur?
Through Hesselbach's triangle (inguinal ligament inferiorly, inferior epigastric vessels laterally, rectus muscle medially)
77
What kind of repair is used for an inguinal hernia?
Lichtenstein hernia repair (uses mesh)
78
What post-op complications are a/w inguinal hernias?
Scrotal hematoma Hemorrhage Difficulty voiding Pain Neuroma/ neuritis
79
When is there a low vs high risk for hernia recurrence?
Low risk for indirect inguinal hernias/ Shouldice and Lichtenstein procedure High risk for direct (if underlying process not corrected)

3. E Med & Surgery (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions