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Surgery UWorld > Amboss > Flashcards

Amboss Flashcards

1
Q

what vessel feeds the pancreas?

A

splenic artery

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2
Q

when does legg calve perthes disease present?

A

2-5 year olds

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3
Q

what is legg calve perthes disease?

A

avascular necrosis of femoral head

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4
Q

what are imaging findings in legg calve perthe disease?

A

joint space widening and flattening of femoral head

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5
Q

what is management of legg calve perthe?

A

nsaids and minimal weight bearing

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6
Q

what is first line for BPH treatment?

A

alpha blockers like terazosin then finasteride

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7
Q

what is management of pneumothorax caused by intubation?

A

put in a chest tube

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8
Q

what size breast cancer indicates chemotherapy in addition to surgical removal?

A

more than 2 cm

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9
Q

an ankle fracture in a teenager can lead to what complication down the road? how?

A

leg legnth discrepancy because if it involves the growth plate then the plate will close early compared to other leg

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10
Q

what testicular tumor makes loads of testosterone?

A

leydig cell tumor

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11
Q

which testicular cancer often makes estrogen? what sx can it cause?

A

sertoli cell cancer and causes gynecomastia

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12
Q

is SVC syndrome common in hodkin or non hodkin lymphoma?

A

non hodgkin

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13
Q

what is treatment for intusssusception?

A

air enema

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14
Q

how does pulmonary contusion appear on xray?

A

will be patchy infiltrate around injured area

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15
Q

what cancers are peutz jehgers ysndrome patients at risk of developing?

A

ovarian breast and pancreatic and of course colorectal

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16
Q

what test is done to confirm hereditary hemochromatosis?

A

genetic testing

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17
Q

what is histology of papillary thyroid cancer?

A

orphan annie eyes

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18
Q

what is most common thyroid cancer?

A

papillary thyroid cancer

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19
Q

what is histology of follicular thyroid cancer?

A

invasion of surrounding blood vessels and capsular space

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20
Q

what is first step in evaluating esophageal cancer?

A

EGD

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21
Q

what are two most common bugs in HAP?

A

pseudo and staph a

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22
Q

what is abx for HAP?

A

vancomycin and cefepime

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23
Q

in what situation is an IVC filter appropriate for DVT treatment?

A

if patient develops one after surgery and has contraindications to anticoagulation

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24
Q

how does follicular lymphoma present?

A

pretty much lymphadenopathy without any associated sx

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25
Q

who gets follicular lymphoma?

A

common in elderly folks/adults

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26
Q

what is translocation of follicular lymphoma?

A

t14 and 18

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27
Q

how do you treat symptomatic PDA in pre term infant compared to full term?

A

pre term gets indomethacin and full term gets surgery closure

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28
Q

a patient with a heel fracture after a fall needs what additional imaging? why?

A

xray of back because could have compression fracture

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29
Q

what is management of patient with penile fracture?

A

retrograde urethroscopy then surgical fixation and catheterization

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30
Q

what is rx of anorectal cancer?

A

radiochemotherapy

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31
Q

what is the most common cause of acute pancreatitis? what imaging should be done?

A

biliary pancreatitis…should get RUQ US

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32
Q

what sx can atelectasis cause in post op period?

A

can be as severe as dyspnea chest pain and cyanosis, but also can be asymptomatic

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33
Q

when does amniotic embolism onset?

A

during or immediately after delivery

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34
Q

if patient hears bubbling from throat when eating, what is likley diagnosis?

A

zenker diverticulum

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35
Q

what should patients on bisphosphonates do to help prevent osteonecrosis of the jaw?

A

good oral hygiene with frequent rinsing and dental work before intiating therapy

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36
Q

what happens in cerebral venous thrombosis?

A

thrombosis in venous system can lead to infection area

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37
Q

what are sx of cerebral venous thrombosis?

A

number one sx is headache, can have focal neurologic deficits, signs of elevated ICP and vision changes

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38
Q

what is rx of cerebral venous thrombosis?

A

start vanc, ceftriaxone and metronidazol e

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39
Q

what is treatment of peyronie disease prior to offering surgical repair?

A

collagenase injections

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40
Q

what is a complication of distal humerus fracture?

A

can injure the brachial artery and compromis blood supply to forearm and hand

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41
Q

what is a complication of mid shaft humerus fracture?

A

radial nerve injury leading to wrist drop

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42
Q

what are the two first line therapies for prolactinomas?

A

cabergoline of bromocriptine

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43
Q

what is another name for ectopic pregnancy?

A

interstitial pregnancy

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44
Q

middle ear barotrauma has what sx?

A

tympanic edema, hemorrhage and rupture and hearing loss

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45
Q

what is treatment of middle ear barotrauma?

A

NSAIDs and observation, hearing will return

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46
Q

what are signs of abdominal compartment syndrome?

A

distended abdomen, elevated CVP, AKI from oliguria, and just a critically ill patient

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47
Q

how do you measure intrabdominal pressure?

A

via bladder catheter sensor

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48
Q

what is rx for abdominal compartment syndrome?

A

abdominal decompression with laparotomy

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49
Q

what test is positive for AC joint injury?

A

adduction across body causes pain

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50
Q

what is imaging technique if concerned about AC joint injury in shoulder?

A

X ray

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51
Q

what is rx of AC joint injury?

A

sling, analgesics and surgery if severe

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52
Q

how does AC joint injury happen?

A

fall directly on shoulder

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53
Q

what abx should be given after a cat bite?

A

augmentin

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54
Q

patient with new hip fracture that is on blood thinners develops tachycardia and low BP, what is likely happening?

A

blood loss leading to hemorrhagic shock

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55
Q

explain how subclavian steal syndrome works

A

basically have block in subclavian and when you use the affected arm, blood flow from the vertebral artery id shunted to the subclavian and you get pre syncope sx

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56
Q

what are sx of subclavian steal syndrome?

A

pre syncope when using arm, decreased pulses and blood flow in affected arm

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57
Q

can venous insufficiency cause ulcers?

A

you bet

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58
Q

where do venous insufficiency ulcers occur?

A

medial ankle

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59
Q

where do peripheral arterial disease ulcers occur and what is unique about them?

A

at toe tips and lateral surface of ankle…they are very painful

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60
Q

what is cause of MALT lymphoma of the stomach?

A

H pylori infection

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61
Q

what is first line rx of malt lymphoma of stomach?

A

H pylor treatment

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62
Q

what is lost in symptomatci syringomyelia?

A

pain and temp sensation in upper extremity and eventually motor movement of upper extremity

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63
Q

what sensation is lost and where in tabes dorsalis?

A

vibration and proprioception in lower extremities

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64
Q

how long after UC diagnosis does patient start with annual colonoscopies?

A

8 years

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65
Q

what is treatment of ITP?

A

usually just observation…but if really severe can give corticosteroids then IVIG

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66
Q

what is rx of developmental dysplasia of the hip in kids less than 6 months?

A

wear a harness

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67
Q

what is rx of developmental dysplasia of the hip in kids 6-18 months?

A

closed reduction surgery

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68
Q

infant at like 3 weeks old has persistend conjugated jaundice, what should you think of?

A

biliary atresia

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69
Q

what is a big time complication of biliary atresia?

A

liver cirrhosis

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70
Q

what should be done for patients with biliary atresia?

A

kasai procedure where you connect liver to small intestine

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71
Q

what are signs of envenomation from a snake bite

A

swelling and pain at site, coagulopathy issues, and systemic effects like hypotension and tachycardia

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72
Q

what is cutoff for lobectomy as far as FEV and DLCO go?

A

FEV has to be greater than 1.5L and DLCO greater than 60%

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73
Q

pyloric stenosis is more common in formula or breastfed babies?re

A

formula

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74
Q

what are the two watershed regions of the colon?

A

rectosigmoid and splenic flexure

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75
Q

what is management of NEC when surgery isnt indicated?

A

abx (amox flagyl and gent) and NG tibe decompression

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76
Q

when is surgery indicated for NEC?

A

any signs of gangrenous or perforated bowel…high lactate, perotinitis, pneumoperitoneum

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77
Q

what is finding with surgical wound dehiscence of abdominal incision?

A

pink fluid leaking from surgical site

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78
Q

what is management of wound dehiscence?

A

get them to the OR to repair the sutures

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79
Q

what two med classes can be given to help pass kidney stones?

A

alpha blockers and calcium channel blockers

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80
Q

what should be monitored in a patient on warfarin?

A

PT

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81
Q

what should you not eat when on warfarin?

A

leafy green veggies

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82
Q

middle aged female has hypoechoic liver cyst found on imaging and takes OCPs, what is likely diagnosis?

A

hepatic hemangioma

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83
Q

what is risk with removing hepatic hemangioma?

A

severe hemorrhage

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84
Q

what are indications for inpatient observation following a TBI?

A

any signs of increased ICP, depressed skull fracture, skull fracture greater than 3mm,

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85
Q

what are the patient related risk factors for perioperative cardiac complication?

A 
ischemic heart disease
heart failure
Cr greater than 2
stroke
DM that is insulin dependent
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86
Q

what is a vascular complication after PCI?

A

cholesterol embolism

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87
Q

what are signs of cholesterol embolism?

A

skin changes, AKI, gut ischemia

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88
Q

what steps should be done in emergency settinf for spinal cord injury?

A

vitals, airway, stabilize neck and body, and INSERT foley

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89
Q

cholelithiasis occurs where?

A

cystic duct

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90
Q

choledocholithiasis occurs where?

A

common bile duct

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91
Q

acute cholecystitis occurs when a stone is where?

A

cystic duct

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92
Q

what are lab abnormalities in choledocholithiasis?

A

elevated LFTs, elevated GGT, elevated bilirubin and alk phos

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93
Q

when do you not use CT for appendicitis?

A

kids and pregnant women

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94
Q

what is rx of strep pharyngitis when you cant give penicillin?

A

macrolide…azithromycin or clarithromycin

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95
Q

what is a halo sign from blood in nose?

A

rapidly expanding clear fluid ring around blood on gauze…means it is CSF

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96
Q

what is common cause of CSF leak after trauma?

A

basilar skull fracture

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97
Q

what are signs of basilar skull fracture?

A

racoon eyes and CSF leak

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98
Q

what cranial nerve can be injured with uncal herniation?

A

occulomotor…CN III

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99
Q

how should you remove a battery that was swallowed?

A

always endoscopically because need to assess for any injuries

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100
Q

a knee dislocation comes with what feared complication?

A

popliteal artery injury

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101
Q

what should be done to evaluate for popliteal artery injury in knee dislocation?

A

ankle brachial index

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102
Q

what tumor marker can you monitor for HCC?

A

AFP

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103
Q

what tumor marker can you monitor for pancreatic and CRC?

A

CEA

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104
Q

if an old person falls and breaks their hip, what part did they break?

A

femoral neck fracture

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105
Q

what is management of femoral neck fracture in elderly person?

A

hip replacement

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106
Q

how does leg look on exam with femoral neck fracture?

A

externally rotated and shortened

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107
Q

what are first two parts of workup of thyroid nodule?

A

TSH and US

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108
Q

if patient has low TSH with a thyroid nodule, what should be done after US is completed?

A

thyroid scintigraphy

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109
Q

is a cold or hot thyroid nodule more concerning?

A

COLD

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110
Q

at what age is genu varum (bowing) abnormal?

A

after age 2

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111
Q

injury at 8th intercostal in mid axillary line of left side can lead to what structure?

A

left lower lobe of lung

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112
Q

what ribs does spleen live behind?

A

9-11

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113
Q

patient has epidural then a couple days later has severe headache and neck stiffness, what is happening

A

post LP headache from CSF leak

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114
Q

what is rx of post LP headaches?

A

if mild then will resolve on own, if severe then you should do epidural blood injection to help seal the dura mater

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115
Q

dilation of pampiniform plexus leads to what?

A

varciocele

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116
Q

if you are worried about avascular necrosis in scaphoid fracture, what should you do?

A

surgical fixation

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117
Q

what is often the first symptom of prolactinoma in a male/

A

ED

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118
Q

what is treatment of pancreatic cancer?

A

duodenopancreatectomy

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119
Q

what is rx of echinococcus of liver?

A

albendazole

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120
Q

what is treatment of seminoma testicular cancer?

A

radiation and orchiectomy

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121
Q

what is rx of non seminoma testicular cancer?

A

orchiectomy plus adjuvant chemo with bleomycin cisplatin and etoposide

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122
Q

what is rx of hyperparathyroidism?

A

surgery and if not a surgical candidate then cinacalcet

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123
Q

with PAD what is first line therapy?

A

exercise therapy along with statin, anti platelet therapy

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124
Q

if first line therapy for PAD does not work but patient does not have critical limb ischemia, what is next therapy tried?

A

cilostazol (vasodilator(

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125
Q

what operation should be done to manage a SAH?

A

surgical clipping of wherever is bleeding

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126
Q

at what point in ITP do you start corticosteroid therapy?

A

if platelets less than 30k

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127
Q

shoulder pain, horner syndrome in patient with smoking history should make you think what?

A

pancoast tumor

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128
Q

what is abx ppx for dental procedures?

A

amxoicillin

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129
Q

what is diagnostic test for hirschprung disease?

A

rectal biopsy

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130
Q

what are levels of CO, SVR PCWP and CVP in hemorrhagic shock?

A

low CO, CVP and PCWp and HIGH SVR

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131
Q

what is juvenile nasopharyngeal angiofibroma?

A

common tumor of nasopharynx in kids…presents with unilateral bloody mass

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132
Q

what is management of juvenile nasopharyngeal angiofibroma?

A

CT scan then surgical removal

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133
Q

patient knocks out a tooth and it is totally intact, what should be done?

A

rinse tooth and socket with saline and put that puppy back in

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134
Q

chest pain in a kid following respiratory infection and coughing should make you thnk about what? assume cardiac exam is normal?

A

spontaneous pnemomediastinum

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135
Q

what is PE finding of spontaneous pnuemomediastinum?

A

crepitus

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136
Q

what is imaging and management of spontaneous pneumomediastinum?

A

CXr and reassurance

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137
Q

what should be done for diabetic foot ulcer if no indication of infection?

A

should be surgically debrided

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138
Q

what is rx of meconium ileus as long as no signs of perforation?

A

gastrografin enema

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139
Q

what is treatment for cushing syndrome that is ACTH independent?

A

adrenalectomy

140
Q

patient who had whipple surgery now has metabolic acidosis, what is issue?

A

pancreatic fistula that causes leakage of bicarb

141
Q

what is a colles fracture?

A

extension fracture of distal radius that happens with falling on outstretched hand

142
Q

what are sx of colles fracture?

A

tenderness, soft tissue swelling and restricted range of motion

143
Q

what is rx of colles?

A

closed reduction, or if really severe do surgical fixation

144
Q

what procedue is done for midgut volvulus?

A

Ladd procedure

145
Q

what is presentation of midgut volvulus in infant?

A

bilious vomiting and abdominal distension

146
Q

what is imaging for midgut volvulus?

A

upper GI series

147
Q

generally, how should you manage a peri appendiceal abscess?

A

should drain itand give abx…high risk to do appendectomy

148
Q

what portion of spinal cord is in charge of vibration and proprioception?

A

posterior

149
Q

what part of spinal cord is in charge of movement and pain/temp?

A

anterior

150
Q

what breslow depth requires 1-2cm margins in melanoma removal

A

1-2mm depth

151
Q

what breslow depth requires sentinel node biopsy in melanoma?

A

anything greater than 1mm

152
Q

what is parkland formula? what is it used for?

A

4ml x body surface area burned x patient weight…fluid calc in patients with burns

153
Q

how is body surface area broken down for burns?

A

9% for each extremity and face, 9% for chest, 9% for abdomen, 9% for each half of back

154
Q

what size kidney stone needs to be removed?

A

over 1cm

155
Q

what should be done if patient with patellar dislocation has osteochondral fragment in joint space?

A

knee arthoscopy to remove the fragment then surgery to fix patella

156
Q

what imaging is used for acute limb ischemia diagnosis?

A

digital subtraction angiography, not ABI

157
Q

what imaging is used to diagnose a psoas abscess?

A

CT or MRI

158
Q

when is elective repair of abdominal aneurysm indicated?

A

greater than 5.5 cm, more than 1cm growth in a year, if it is saccular or symptomatic

159
Q

what are two firts line therapies for Carpal tunnel before surgery?

A

steroid injections and splinting

160
Q

how does blood appear on head CT?

A

hyperdense…white

161
Q

what is imaging for meniscal injury?

A

MRI

162
Q

when do you fix meniscal injuries

A

patients less than 40 years old, and when they are symptomatic

163
Q

a pelvic ring fracture often causes injury to what nerve?

A

obturator nerve

164
Q

where does obturator nerve provide sensory innervation?

A

small area on medial thigh

165
Q

what motion does obturator nerve make happen?

A

hip adduction

166
Q

what med can cause neutrophilia?

A

STEROIDS

167
Q

what should be monitored in patients with burns on extremities?

A

pulses and cap refill because they are at risk of ischemia

168
Q

what is treatment of patient with burn on extremity who starts to develop signs of ischemia?

A

escharotomy

169
Q

aside from choriocarcinoma, what other testicular cancer can produce hcg?

A

seminoma

170
Q

name the contraindications to organ donation

A

cardiac arrest before brain death, sepsis, incurable malignancy, CJD

171
Q

babies with gastroschisis are at increased risk of what other GI issue?

A

intestinal dysmotility (gastroparesis)

172
Q

what is imaging modality for patient with a suspected aortic injury?

A

CT angio if they are stable, TEE if unstable

173
Q

what is first step in management of chemical burns?

A

irrigate with water extesnively

174
Q

can hyper or hypothyroid cause CTS?

A

hypothyroidism

175
Q

patient with persistent elevated aldosterone should undergo what imaging?

A

CT scan of abdomen to determine etiology of aldosterone elevation (bilat versus unilateral)

176
Q

angiodysplasia is associated with what other disease?

A

ESRD

177
Q

patient has bleeding abdominal aorta and undergoes repair…then has total loss of leg movement, what happened?

A

probably had injury to anterior spinal artery leading to motor loss in legs

178
Q

what is management of an enterocutaneous fistula?

A

put in an ostomy pouch and feed parenterally

179
Q

acromegaly can do what to the heart?

A

cause congestive heart failure due to cardiomyopathy

180
Q

what is first line rx of esophageal stricture?

A

balloon dilation

181
Q

list the branches of the aorta starting at Celiac trunk

A 
Celiac
SMA
Renal
Ovarian/testicle
IMA
182
Q

what are echo findings of hypertrophic cardiomyopathy

A

mitral valve dysfxn, enlarged heart wall, asymmetric wall thickening

183
Q

what spot of aorta is most susceptible to injury in trauma?

A

isthmus

184
Q

what beta blockers for varices/

A

nadolol or propanolol…cant be cardiac selective like metoprolol

185
Q

what is management of intertrochanteric hip fracture in healthy person?

A

internal fixation…intramedullary nailing

186
Q

if preganant lady presents with itching and elevate dbilirubin, what is diagnosis??

A

cholestasis of pregnancy

187
Q

what is rx for cholestasis of pregnancy?

A

ursodeoxycholic acid

188
Q

what is location of chest tube placement for pneumothorax is adult?

A

5th mid axillary intercostal space

189
Q

what is location of chest tube placement for pneumothorax is kid?

A

2nd intercostal midclavicular line`

190
Q

what do you do with finger tip that has been amputated that you are transporting?

A

put it in ice with saline damp gauze wrapped around it

191
Q

is tylenol recommended for back pain?

A

no…doesnt work well

192
Q

supraclavicular and peri umblilical nodes are suggestive of what cancer?

A

gastric cancer

193
Q

what is treatment of gigantism?

A

transphenoidal adenectomy

194
Q

bullet to the neck means patient gets what kind of imaging?

A

CT angio of neck

195
Q

what is cushings triad in a TBI?

A

hypertension, bradycardia, irregular respirations

196
Q

if patient has cushings triad with a TBI then what is likely going on?

A

increased intracranial pressure

197
Q

when do you give Tetanus immune globulin to patient with a cut?

A

if cut is dirty and vaccination history is unclear…if wound is clean only need Tdap

198
Q

what imaging is used to diagnose bladder injury in trauma?

A

retrograde cystography

199
Q

what can you inject to help get rid of a erection? is this first or second line?

A

can inject phenylephrine…second line

200
Q

what is first line treatment of erection lasting too long?

A

take out the blood

201
Q

if kid needs significant fluid resuscitation and you cannot get venous access, what kind of line and where do you put it for access?

A

interosseuous line in proximal tibia

202
Q

what is acral lentiginous melanoma?

A

painless irregularly shaped brown macule that involves the toe and nail bed

203
Q

who is more likely to get acral lentinonous melanoma?

A

african americans and asians

204
Q

what is something a patient can develop after they have been inubated?

A

laryngotracheal stenosis

205
Q

when should you expect laryngotracheal stenosis in a patient?

A

if after extubation they have had progressive shortness of breath and difficulty breathing

206
Q

what is imaging modality to confirm laryngotracheal stenosis?

A

larygoscopy

207
Q

what nerve runs lateral to the fibula?

A

common peroneal nerve

208
Q

the common peroneal nerve causes what action at level of ankle?

A

dorsiflexion of the foot

209
Q

what is a common presenting symptom of PBC?

A

pruritis

210
Q

if patient has PBC, what should they be taking?

A

ursodeoxycholic acid

211
Q

when do you operate on a broken clavicle instead of using a sling?

A

if it is displaced more than 1 bone width

212
Q

what is imaging technique for patient with difficulty swallowing in oropharyngeal location?

A

videofluoroscopy

213
Q

what is weight cut off for receieving sugar containing fluid as maintenance fluid?

A

30kg and above does not need the sugar

214
Q

what is the tumor triad of VHL?

A

RCC
hemangioblastoma
pheochromocytoma

215
Q

are femoral hernias above or below the inguinal line?

A

below

216
Q

what is volar splinting used for?

A

carpal tunnel syndrome

217
Q

what is a roos stress test?

A

when patient lifts arm above head and have to open and close hand repeatedly

218
Q

what is a positive roos test indicative of?

A

thoracic outlet syndrome

219
Q

if patient has thoracic outlet syndrome, what is first treatement?

A

PT

220
Q

what is treatment for thoracic outlet syndrome if PT does not work?

A

surgical decompression

221
Q

what is pyoderma gangrenosum? what is it associated with?

A

skin lesion that becomes ulcerated and necrotic…assoc with Crohns

222
Q

what potassium level constitutes emergency treatment?

A

6.5 and above

223
Q

what are the two steps in management of posterior shoulder dislocation?

A

test axillary nerve function then do reduction

224
Q

gardner syndrome has what four manifestations?

A

colon polyps, osteomas, epidermal cysts and hyperproliferation of retinal epithelium

225
Q

turcot syndrome has what two features?

A

colon polyps and brain cancers

226
Q

head bobbing and heart murmur is classic for what murmur?

A

AR

227
Q

if patient has undiagnosed lower GI bleed and is becoming unstable, what should be done?

A

angiography for diagnosis and treatment

228
Q

female with fecal incontinence and loss of anal sphincter tone likely has what history?

A

vaginal laceration during a delivery

229
Q

patient with strictures in small bowel and history of bowel resection should undergo what procedure to manage strictures?

A

stricturoplasty…dont want to remove any more bowel

230
Q

posterior hip displacement leads to what positioning of the leg?

A

internall rotated and abducted

231
Q

which of wilms versus neuroblastoma crosses the midline in a child?

A

neuroblastoma crosses midline and wilms does not

232
Q

how long after heparin initiation does HIT usually happen?

A

5-10 days after

233
Q

patient who recently had endovascular surgery acutely has discoloration of an extremity without swelling, what happened?

A

atheroembolism

234
Q

if patient has a skin lesion and the “overlying skin cannot be pinched” what is the diagnosis?

A

epidermoid cyst

235
Q

in addition to propanolol, what should be done for variceal bleeding?q

A

ligation of the remaining varices

236
Q

what is management of a biliary cyst?

A

should remove it surgically

237
Q

what is management of phyllodes tumor?

A

surgical removal

238
Q

what type of collagen is affected in osteogenesis imperfecta?

A

type 1

239
Q

what are signs/symptoms of osteogenesis imperfecta?

A

blue sclera, deafness, short stature, frequent fractures, scoliosis

240
Q

what is tumor marker for ovarian cancer?

A

Ca125

241
Q

purple discoloration and crackling sounds from a wound indicate what?

A

necrotizinf fascitis

242
Q

what do you do to a wound with necrotizing fasciiitis?

A

surgical debridement and abx

243
Q

what abx for necrotizing fasciitis?

A

vanc and zosyn

244
Q

what is emergent treatment of an epidural hematoma?

A

craniotomy to release it and ligate the bleeding vessel

245
Q

why do you not do a burr hole for epidural hematoma/

A

because you cannot ligate vessel with that

246
Q

what causes a femoral hernia?

A

widening of the femoral ring

247
Q

what causes a direct inguinal hernia?

A

weakness of transversalis fascia

248
Q

what is treatment of cerebral vascular thrombosis?

A

dalteparin if patient stable and not worsening acutely, thrombectomy if they are worsening

249
Q

nodular cords in limbs should make you think about what?

A

superficial thrombophlebitis

250
Q

what meds should be given for acute drug allergy reaction?

A

methyprednisilone, cimetidine, diphemhydramine

251
Q

what nodes drain the distal vagina?

A

superficial ingunal

252
Q

what nodes drain the uterus?

A

external iliac

253
Q

what nodes drain the cervix and middle of the vagina?

A

internal iliac

254
Q

supracondylar humerus fracture can lead to what vasculature issue?

A

brachial artery injury causing loss of radial pulse

255
Q

if patient is going to need long term airway management, what type of airway should be put in?

A

tracheostomy

256
Q

if patient has renal srterystenosis and you add an ACE inhibitor, what lab abnormality may develop?

A

hypokalemia

257
Q

what is the management of rectal prolapse?

A

rectopexy

258
Q

what are signs of rectal prolapse?

A

painless rectal mass, addominal discomfort, incomplete evacuation, peri anal itching

259
Q

what part of mediastinum do teratomas occur in?

A

anterior

260
Q

what is most common type of mass in posterior mediastinum?

A

neurofibroma and schwannoma

261
Q

what acid base issue does post op atelectasis cause?

A

resp alkalosis

262
Q

what is usual treatment of SCLC (small cell lung cancer)?

A

radiation and chemo

263
Q

if patient has v tach but it stable and can converse, what kind of shock should you give?

A

synchronized cardioversion

264
Q

what is classic treatment of early stage breast cancer?

A

lumpectomy with radiation to follow along with sentinel node biopsy and hormone therapy if indicated

265
Q

what type of lesions does prostate cancer cause in back?

A

osteoblastic lesions (sclerotic)

266
Q

if patient receiving heparin is not becoming appropriately hypocoagulable, what is likely issue underlying?

A

antithrombin III deficiency

267
Q

how does finasteride help BPH?

A

prostatic apoptosis because inhibits testosterone conversion into DHT

268
Q

how does tamsulosin treat BPH?

A

alpha 1 antagonist relaxes sphincters

269
Q

in an unstable patient that you expect esophageal rupture, what imaging should be done?

A

CT

270
Q

what is treatment of thyroid tumor that is less than 1cm in size?

A

thyroid lobectomy

271
Q

what is treatment of thyroid tumor that is more than 1cm in size?

A

total thyroidectomy

272
Q

what is preferred treatment for patient with acute mesenteric ischemia with stable vitals?

A

endovascular revascularization

273
Q

what is preferred treatment for patient with acute mesenteric ischemia with unstable vitals?

A

ex lap

274
Q

alcohol induced lymph node tenderness should make you think about what?

A

follicular lymphoma

275
Q

what should be done with intact avulsed tooth out in field?

A

put back in socket manually then go to dentist/PCP

276
Q

which hip dislocation leads to internally fixed adducted leg?

A

posterior dislocation

277
Q

pt with stable esophageal rupture that is not leaking into pleural spaces should be treated how?

A

conseravtive management with abx and PPI and NPO

278
Q

an infant with a UTI and palpable bladder likely has what?

A

posterior urethral valves

279
Q

what is rx of posterior urethral valves?

A

ablation of the valves

280
Q

what is rx of post vascular surgery pseudoaneurysm?

A

US guided thrombin injection

281
Q

patients with cholelithiasis waiting on cholecystectomy should do what two things?

A

take urosdeoxycholic acid and have low fat diet

282
Q

what imaging should be obtained when someone ingests toxic chemicals?

A

Upper scope as soon as feasible

283
Q

which two rotator cuff muscles are in charge of external rotation?

A

teres minor and infraspinatus

284
Q

what imaging should be done when you expect posterior shoulder dislocation?

A

axillary x ray view

285
Q

what is management of posterior dislocation of shouldr?

A

closed reduction

286
Q

where does cervix lymph drain?

A

internal iliac

287
Q

what imaging to diagnose renal vein thrombosis?

A

either CT angiography or MR venography

288
Q

when should a pancreatic pseudocyst be operated on?

A

if more than 6cm or symptomatic

289
Q

what is procedure to fix psueodcyst of pancreas?

A

CT guided drainage

290
Q

what are findings of purulent cellulitis?

A

tender erythematous skin with purulent drainage

291
Q

what is treatment of constrictive pericarditis from TB?

A

pericardiectomy

292
Q

in patients you are worried about end organ perfusion, what should be monitored for volume status?

A

urine output

293
Q

what tissue is messed up in peyronie disease?

A

tunica labuginea

294
Q

when should adult patients receive vaccines after splenectomy?

A

2 weeks after

295
Q

what should be given to patient wiht open wound and unclear vaccination histroy against tetanus?

A

tetanus immuneglobulin and vaccine

296
Q

what two ppx drugs should organ transplant patients receive?

A

bactrim and valgancyclovir

297
Q

young patients with aortic aneurysm likely have what issue going on?

A

cystic medial necrosis from maybe ehlers or marfans

298
Q

what type of valve should younger people get?

A

mechanical ecause they are more durable

299
Q

why do you give tranexamic acid after a TBI?

A

to prevent cranial hemorrhage

300
Q

in addition to abx, what might you need to do for septic knee?

A

serial aspirations

301
Q

colles fracture is a fracture of what?

A

distal radius

302
Q

colles fracture can lead to injury of what nerve?

A

median nerve

303
Q

what is treatment of pururlent pericarditis?

A

pericardiocentesis

304
Q

how does a AAA form?

A

accumulation of foam cells in the tunica intima

305
Q

patient with metastatic lesions to spine causing spinal cord dysfunction should receive what?

A

steroids IV

306
Q

patients who will need long term foley should get bladder emptied how?

A

should have intermittent foley catheters

307
Q

autoimmune gastritis puts patients at risk for what?

A

gastric adenocarcinoma

308
Q

h pylori puts patients at risk for what cancer?

A

gastric MALT lymphoma

309
Q

what nodes does the prostate drain to?

A

internal iliac

310
Q

what nodes do the testis drain to?

A

para aortic

311
Q

what symptoms does somatostatinoma cause>?

A

diarrhea, steatorrhea, cholelithiasis, diabetes

312
Q

what is long acting anesthetic that is used a lot?

A

bupivicaine

313
Q

is lidocaine intermediate or long acting?

A

intermediate

314
Q

if patient has hypercalcemia from bone resorption what med can help lower it?

A

bisphosphonates

315
Q

patients in ICU can get stress stomach ulcers, but what else can they get in their stomach?

A

erosive gastropathy

316
Q

patient with renal artery stenosis should be started on what?

A

ace or arb

317
Q

in addition to ace/arb, what else might be needed for patient with renal artery stenosis?

A

if having severe sx then can do angioplasty without stents

318
Q

what ligament does the uterine artery run in?

A

cardinal ligament

319
Q

what are sx of herpes zoster opthalmicus?

A

loss of vision in one eye, pain and vesicular lesions

320
Q

what is a torus fracture?

A

buckle fracture in kids…pretty much have buckling of bone but not actually Broken

321
Q

what are two classic pathology findings in chronic organ rejection? what immune cell mediates these?

A

smooth muscle proliferation and fibrosis…host cd4

322
Q

at what age does an undescended testicle become a surgical operation?

A

after 4-5 months

323
Q

a boot shaped heart is indicative of what?

A

tetralogy of fallot

324
Q

smoking lung cancers like squamous and small cell occur where?

A

central = smoking

325
Q

in addition to graded exercise therapy, what medication should patient with PAD be started on initially?

A

clopidogrel

326
Q

should patient take metformin or ACE inhibitor on mornign of surgery?

A

no…risk of lactic acidosis and hypotension

327
Q

what are complications of hepatic adenoma?

A

rupture and hemorrhagic shock…can rarely be malignant transformation

328
Q

patient has UTI and big kidney stone, what should be done before removing the stone?

A

treat the UTI, because if you dont stone removal can lead to significant urosepsis

329
Q

do you have to stop OCP if you develop focal nodular hyperplasia of liver?

A

no patients just need reassurance

330
Q

should patients with hepatic adenoma stop taking OCPs?

A

YES

331
Q

vesicouretal reflux puts patients at risk of what kidney issue?

A

renal scarring

332
Q

what is size cutoff of pulmonary nodule for NO further evaluation?

A

smaller than 4mm

333
Q

what type of pain can patients have with adrenal crisis?

A

diffuse abdominal pain

334
Q

what worm can cause SBO?

A

ascariasis

335
Q

eschar around a diabetic foot ulcer raises concern for what?

A

underlying infection

336
Q

neurogenic shock does what to vitals?

A

bradycardia and hypotensive with hypothermia

337
Q

posterior hip doslocation leads to what leg positioning?

A

shortened and internally rotated with adduction

338
Q

what is treatment of posterior hip dislocation?

A

emergency closed reduction

339
Q

what is the physiologic cause of curling ulcers?

A

basically hypoperfusion leads to ulceration and necrosis

340
Q

which lung cancer makes PTHrp?

A

squamous cell

341
Q

which lung cancer makes centrally located cavitary lesions?

A

squamous cell

342
Q

what abx for septic knee from e coli?

A

cefepime

343
Q

patient with spontaneous small pneumothorax should receiev what even if they are totally stable?

A

supplemental O2

344
Q

what MSK issues can prolactinomas cause?

A

osteoporosis due to decrease in estrogen

345
Q

what is first line procedure for acute limb ischemia?

A

catheter directed thrombolysis and balloon catheter embolectomy

Surgery UWorld (3 decks)

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