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Surgery > Abdominal Trauma • Qx edition + Intestinal Ichemia > Flashcards

Abdominal Trauma • Qx edition + Intestinal Ichemia Flashcards

1
Q

Pseudocysts develop ______ postpancreatitis.

A

6 to 8 weeks

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2
Q

Seatbelt sign is highly correlative to

A

abdominal trauma

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3
Q

abdominal trauma next step in management

A

Focused Assessment with Sonography for Trauma (FAST),

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4
Q

abdominal trauma most accurate test

A

CT scan of the retroperitoneum.

Exploratory laparotomy is the answer for hemodynamically unstable patients.

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5
Q

Splenic Rupture can result from

A

BAT or abdominal procedures such as

surgery or even colonoscopy.

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6
Q

Splenic Rupture dx

A

FAST or CT scan

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7
Q

Splenic Rupture CT scan classification. How many grades does it have?

A

from I to V

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8
Q

Splenic Rupture CT scan classification. How is described each grade from I to III ?

A

Grade I: Subcapsular hematoma <10% of surface area
Grade II: Subcapsular hematoma 10–50% of surface area
Grade III: Subcapsular hematoma >50% of surface area or expanding

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9
Q

Splenic Rupture CT scan classification. How is described each grade from IV to V ?

A

Grade IV: Laceration involving segmental or hilar vessels

Grade V: Shattered spleen

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10
Q

Management for All hemodynamically unstable patients with a positive FAST exam showing splenic rupture

A

surgical exploration.

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11
Q

For hemodynamically stable patients with low-grade injuries (grades I–III), the best initial management is

A

supportive care and observation with monitoring of hemoglobin.

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12
Q

Management For hemodynamically stable patients with low-grade injuries (grades I–III), IF they worsen

A

angiographic embolization or surgical exploration is the next step in management.

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13
Q

Patients with high-grade injuries (grades IV–V) require

A

exploratory laparotomy

for more precise staging, repair, or removal of the spleen.

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14
Q

Removal of spleen = Vaccination against

A

encapsulated organisms

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15
Q

Splenic Infarction Pathop

A

occurs in patients with atrial fibrillation and hypercoagulable states when the splenic artery becomes occluded by an embolus. It can also occur in sickle cell disease and mononucleosis.

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16
Q

Splenic Infarction CxFx

A

acute LUQ pain that radiates to the left shoulder along with tenderness with splenomegaly.

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17
Q

Splenic Infarction Labs

A

reveal elevated LDH

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18
Q

Splenic Infarction Treatment

A

directed at resolving the underlying cause and providing pain relief

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19
Q

Splenic Infarction: Splenectomy is required only if

A

complications such as abscess formation ensue

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20
Q

Splenic Abscess is an infection that is seeded by

A

endocarditis.

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21
Q

Splenic Abscess cxfx

A

LUQ pain, and splenomegaly is seen on physical exam.

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22
Q

Splenic Abscess most accurate test is

A

CT scan.

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23
Q

Splenic Abscess tx

A

antibiotic therapy and splenectomy

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24
Q

Cullen

sign. What is it? Cause(s)

A

Bruising around the umbilicus. Hemorrhagic pancreatitis, ruptured abdominal aortic aneurysm

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25
Q

Grey
Turner
sign. What is it? Cause(s)

A

Bruising in the flank Retroperitoneal hemorrhage

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26
Q

Kehr

sign What is it? Cause(s)

A

Pain in the left shoulder Splenic rupture

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27
Q

Balance

sign What is it? Cause(s)

A

Dull percussion on the left and shifting dullness on the right
Splenic rupture

28
Q

Seatbelt

sign. What is it? Cause(s)

A

Bruising where a seatbelt was. Deceleration injury

29
Q

__________is the best initial test to evaluate free air under the diaphragm

A

Upright chest x-ray

Free air under the diaphragm indicates a perforation of the bowel.

30
Q

_______is the most appropriate next step in a patient suffering from acute mesenteric ischemia.

A

Angiography

31
Q

acute mesenteric ischemia. cx fx

A

complaints of abdominal pain 10/10 that is severe and out of proportion to physical findings. no guarding, soft abdomen, and no rebound tenderness.

32
Q

Ischemic Colitis pathop

A

lack of blood flow to the mesentery of the bowel. Ischemia of the bowel is most damaging to the mucosa.

33
Q

Ischemic Colitis cxfx

A

Abdominal pain that is described as cramping
Bloody diarrhea
+- fever

34
Q

Ischemic Colitis The best initial test

A

a CT scan of the abdomen.

35
Q

Ischemic Colitis most accurate test

A

angiography.

Colonoscopy with biopsy can also show ischemic mucosa, but it takes time for pathology to come back.

36
Q

Ischemic Colitis tx

A

IV normal saline and antibiotics if fever is present

37
Q

Acute mesenteric ischemia Patho

A

acute occlusion of mesenteric arteries, most commonly the superior mesenteric artery.

38
Q

The number one risk factor for Acute mesenteric ischemia is

A

atrial fibrillation, which can cause emboli to occlude the vessel.

39
Q

Acute mesenteric ischemia Cx Fx

A

excruciating pain that is out of proportion to the physical exam.

40
Q

Acute mesenteric ischemia labs

A

may show increased lactic acid and leukocytosis

41
Q

causes of abdominal pain that do not require surgery.

A

MI, GERD, lower lobe pneumonias, and acute porphyria

42
Q

Acute mesenteric ischemia best initial test is

A

abdominal x-ray showing air in the bowel wall.

43
Q

Acute mesenteric ischemia The most accurate test

A

angiography.

44
Q

Acute mesenteric ischemia most appropriate therapy.

A

Emergent laparotomy with resection of necrotic bowel

45
Q

Acute mesenteric ischemia . Endovascular therapy is indicated only if

A

there is a clear reason to avoid surgery.

46
Q

The most common locations for infarction are

A

watershed areas. Splenic flexure . rectosigmoid junction.

47
Q

Chronic mesenteric ischemia patho

A

results from atherosclerotic disease of 2 or more mesenteric vessels.

48
Q

In intestinal ischemia, _____is the equivalent of exertion in “chest pain with exertion.”

A

eating

49
Q

Chronic mesenteric ischemia best diagnostic test is

A

angiography.. first to delineate the location of the lesions; then stenting or bypass reestablishes blood flow to allow surgical correction.

50
Q

Median Arcuate Ligament Syndrome (MALS) cxfx

A

severe postprandial abdominal pain, nausea, and weight loss.

51
Q

Median Arcuate Ligament Syndrome (MALS) patho

A

The condition is caused by external compression of the

celiac trunk by the median arcuate ligament.

52
Q

Median Arcuate Ligament Syndrome (MALS) dx

A

is a diagnosis of exclusion. Confirm with duplex ultrasonography to measure blood flow through the celiac artery.

53
Q

Median Arcuate Ligament Syndrome (MALS) tx

A

The general approach to treatment of MALS is surgical decompression of the celiac artery.

54
Q

RUQ Pain causes

A

Chollecystitis
Billiary colic
Cholangitis
Perforated duodenal ulcer

55
Q

Pain causes LUQ

A

splenic rupture.

IBS–splenic flexure syndrome

56
Q

Pain causes Midepigastrium

A

Pancreatitis
Aortic dissection
Peptic ulcer disease

57
Q

Pain causes RLQ

A

Appendicitis
Ovarian Torsion
Ectopic pregnancy
Cecal diverticulitis

58
Q

Pain causes LLQ

A

Sigmoid volvulus
Sigmoid diverticulitis
Ovarian Torsion
Ectopic pregnancy

59
Q

Site of referred pain for Myocardial ischemia

A

Left chest, jaw, and left arm

60
Q

Site of referred pain for Cold foods such as ice

cream

A

“Brain freeze” secondary to rapid temperature change of the sinuses

61
Q

Site of referred pain for Gall bladder

A

Right shoulder/scapula

62
Q

Site of referred pain for Pancreas

A

Back pain

63
Q

Site of referred pain for Pharynx

A

Ears

64
Q

Site of referred pain for Prostate

A

Tip of penis/perineum

65
Q

Site of referred pain for Appendix

A

Right lower abdominal quadrant

66
Q

Site of referred pain for Esophagus

A

Substernal chest pain

67
Q

Site of referred pain for Pyelonephritis,

nephrolithiasis

A

Costovertebral angle

Surgery (28 decks)

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