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Topnotch SURGERY > Chapter 1 > Flashcards

Chapter 1 Flashcards

1
Q

24 yr old woman scheduled for an elective cholecystectomy. The best method of identifying a potential bleeder is which of the ff?

A

A complete history and PE

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2
Q

The most common indication for blood transfusion in surgical procedure?

A

Volume replacement

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3
Q

After undergoin transurethral resection of the prostate, a 65 yr old man experiences excessive bleeding attributed to fibrinolysis. It is appropriate to administer?

A

AMINOCAPROIC ACID

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4
Q

Most important management of DIC

A

Treatment of underlying cause

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5
Q

22 yr old man is brought to the ER in profound shock after a fall from the fourth floor of a building. After resuscitation, small bowel resection and hepatic segmentectomy are performed at laparotomy. He receives 15U of packed RBC,M4U of fresh frozen plasma and 8L of Ringers lactate. On closure diffuse oozing of blood is noted. What is the most likely dx?

A

PLATELET DEFICIENCY

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6
Q

Most important management of immediate transfusion reation?

A

Stop the transfusion: initiate diuresis, alkaline urine

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7
Q

64 yr woman undergoing radical hysterectomy under GA is transfused with 2 U of packed RBC. A hemolytic transfusion reaction during anesthesia will characterized by

A

BLEEDING AND HYPOTENSION

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8
Q

Shock that occurs in the setting of adequate intravascular volume?

A

Cardiogenic shock

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9
Q

30 yr old brought to ER following high speed car accident. He was the driver and the windshield of the car was broken. On exam, alert, awake, oriented and no respi distress. Extremities unable to move, warm and pink. Vital signs on admission HR 54bpm and BP 70/40mmHg

A

NEUROGENIC SHOCK

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10
Q

The preferred test in the diagnosis of cardiac tamponade?

A

ECHOCARDIOGRAPHY

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11
Q

Persistentlymelevated base deficit in a trauma patient is usually due to

A

ONGOING BLEEDING

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12
Q

First priority in the the treatment of trauma?

A

Ensuring an adequate airway

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13
Q

Treatment of choice for patients with Von Willebrand’s disease?

A

Intermediate purity Factor VIII/DDAVP

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14
Q

The most direct method to determine the presence of blood within the pericardium

A

Pericardial window

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15
Q

32 yr old female fails from the 10th floor of the building in suicide attempt. Px obvious head and extremity inuries. Primary survey reveals that the patient is totally apneic. By which method is the immediate need for a definitive aiway in the px

A

OROTRACHEAL INTUBATION

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16
Q

The most common indication for intubation

A

ALTERED MENTAL STATUS

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17
Q

Surgical aiway choice in patients with laryngeal fractures?

A

TRACHEOSTOMY

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18
Q

Is the most common method used to establish definitive airway

A

OROTRACHEAL INTUBATION

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19
Q

85 yr old ventilator-dependent male was endotracheallymintubatedn10 days ago. Unresponsive and not candidate for early intubation. ICU attending elects to perform tracheostomy at th bedside.mduring procedure copious dark blood is encountered.

A

ANTERIOR JUGULAR VEIN

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20
Q

Immediate management of px with tension pneumothorax

A

NEEDLE THORACOSTOMY (2nd ICS MCL)

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21
Q

Thoracostomy

A

4th or 5th ICS (MAL)

The higher or farther from the diaphragm

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22
Q

Most important indication for CTT

A

Absent breath sounds

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23
Q

Block Subclavian artery

A

Trapdoor thoracotomy

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24
Q

Lower limit of pleura/lung reflection at the MIDCLAVICULAR LINE

A

Lung 6th rib

Pleura 8th rib

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25
Q

Lower limit of pleur/lung reflection at the lateral border of erector spine

A

LUNG 10th rib

PLEURA 12th rib

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26
Q

Flail chest injuries compromises ventilation because of

A

UNDERLYING LUNG CONTUSION

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27
Q

Trauma px with hypotension have lost approximately how much of blood volume

A

30-40% (CLASS III SHOCK)

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28
Q

Saphenous vein cutdown

A

1cm SUPERIOR AND ANTERIOR MEDIAL MALLEOLUS

INTRAOSSEUS INFUSION (

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29
Q

The most reliable indicator of organ perfusion during resuscitation

A

Urine output

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30
Q

The most common cause of cardiogenic shock or cardiac failure in trauma patients

A

TENSION PNEUMOTHORAX

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31
Q

Priormto catheterization in stable patients at risk for urethral injury, one should perform

A

Urethrogram

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32
Q

Contraindications to urethral catheterization

A

Blood at the meatus

Scrotal or perineal hematoma

High riding prostate

Tx: SUPRAPUBIC CYSTOSTOMY

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33
Q

Gold standard in the diagnosis of presence of intra-abdominal injuries

A

DPL

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34
Q

Hemobilia is characterized by the triad of

A

RUQ pain, UGIB, jaundice (QUINCKE’s triad)

Tx: selective arteriogram + embolization

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35
Q

Most commonly injured part of the diaphragm

A

LEFT

Not protected; right covered by liver

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36
Q

Duodenal hematoma is best diagnosed by

A

BARIUM/CONTRAST STUDY (COILED SPRING SIGN)

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37
Q

The Pringle maneuver is used to control bleeding coming from

A

LIVER

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38
Q

60 yr old attacked with baseball bat and sustains multiple blows to the abdomen. He presents to the ER in shock and brought to OR. Laparotomy reveals massive hemoperitoneum and a stellate fracture of the right and left lobes of the liver

A

PACKING THE LIVER

39
Q

Left sided medial visceral rotation

A

MATTOX MANEUVER

40
Q

Right sided medial visceral rotation

A

CATELL MANEUVER

41
Q

The most sensitive CXR findinf suggesting tear of the aorta

A

WIDENED MEDIASTINUM

42
Q

Safest way to lower down ICP

A

VENTRICULOSTOMY

43
Q

Hard signs of peripheral arterial injuries

A

Pulsatile hemorrhage

Absent pulses

Acute ischemia

44
Q

Single most important factor predicting burn related mortality?

A

BURN SIZE

45
Q

Recommended fluid resuscitation solution for burns

A

PLR

parkland’s formula

46
Q

Management of patients with significant intra oral/pharyngeal burns

A

IMMEDIATE ET INTUBATION

antibiotics and steroid are contraindicated

47
Q

How is smoke inhalation injury diagnosed

A

History and PE

48
Q

The definitive diagnosis of burn wound sepsis can be made by

A

WOUND CULTURE

49
Q

Predominant organism causing fatal burn wound infection

A

PSEUDOMONAS SP

50
Q

Antidote for chemical burns caused by HYDROFLUORIC ACID

A

CALCIUM GLUCONATE

51
Q

Malignancy most commonly developing from MARJOLIN’S ULCER

A

SQUAMOUS CELL CA

52
Q

Impaired healing due to ZINC DEFICIENCY

A

ACRODERMATITIS ENTEROHEPATICA

53
Q

Major cell responsible for wound contraction

A

MYOFIBROBLAST

54
Q

The first cells to enter the wound site during wound repair

A

NEUTROPHILS

55
Q

Extend from the xiphoid from the pubic

A

Midline

56
Q

Obliquely

McBurneys incision extending to the flank of the px

A

Muscle splitting loin

57
Q

Non absorbable

A

Nylon
Prolene
Stainless steel
Silk

58
Q

Natural suture

A

Catgut
Silk
Chromic catgut

59
Q

Synthetic

A 
Nylon
Vicryl
Monocryl
PDS
Prolene

Face: nylon, prolene

60
Q

Single strand of suture material

A

Monofilament

Nylon
Monocryl
Proleme
PDS

61
Q

Fibers are braided or twisted together

A

Microfilament

62
Q

Suture characteristics

A

Nonabsorbable suture has better tensile strength but can persist and become a focus of infection or a draining sinus tract

63
Q

Suture removal

A

7-10 days

64
Q

The layer of the GIT that imparts the greatest tensile strength and greatest suture holding capacity

A

SUBMUCOSA

65
Q

Pressure ulcer stage when there is partial thickness skin loss

A

STAGE II

66
Q

Non blanchable erythema of intact skin

A

Stage I

67
Q

Earliest known genetic alteration in colorectal cancer

A

APC gene

68
Q

Microsatellite instability is the hallmark of what hereditary cancer syndrome

A

LYNCH SYNDROME (HNPCC)

69
Q

Virus implicated in th development of Burkitt’s Lymphoma

A

EBV

70
Q

The most common arrythmia seen during laparoscopy procedures

A

Bradycardia

71
Q

Tumor marker elevated in primary liver cancer and geem cell tumors

A

AFP

72
Q

Most important factor determining the exten of DNA damage ff radiation

A

CELLULAR LEVEL OF OXYGEN

73
Q

Most sensitive phase of cell cycle radiation

A

G2 and M phase

74
Q

Taxanes blocks tumor growth at mitosis through

A

Formation of excess microtubule

75
Q

A lethal and rapidlyrogressive soft tissue caused by microaerophilic streptococcus

A

Meleney’s synergicpstic

76
Q

Right iliac fossa

A

Kidney transplant place

77
Q

Most common complication after placing a central venous line

A

ARRHYTHMIA

78
Q

Most dreaded complications of placing a swan gans

A

Pulmonary artery

79
Q

Mainstay of treatment of severe soft tissue infections

A

Wide debridgement

80
Q

Most common skin malignancy

A

Basal cell CA

81
Q

Waxy, cream colored, rolled, pearly borders, pallisading arrangement

A

Basal cell CA

82
Q

Tx of melanoma

A

Surgical

83
Q

Standard staging procedure to evaluate tue regional nodes for patients with clinically node-negative melanoma

A

SLNB

84
Q

Tumors arising from areas of previous radiation/lymphedema

A

ANGIOSARCOMA (Stewart-Treves Syndrome)

85
Q

Kaposi sarcoma tx

A

Radiation

86
Q

Epidemic peurperal mastitis transmitted via

A

Suckling neonate

87
Q

Chronic inflammatory condition of nipple areola complex that originates from areolar glands

A

HIDRADENITIS SUPPURATIVA

88
Q

Types of mastectomies

A 
Radical mastectomy (Halsted/Meyer)
MRM: Patey and Dyson, Scanlon,mMadden and Auchincloss
89
Q

The level of axillary lymph nodes are based on structure

A

PECTORALIS MINOR

90
Q

Most frequent site of metastasis for breat cancer

A

BONE

91
Q

True anatomic precursor of invasive ductal CA

A

DCIS

92
Q

Paget ds may be confused with type of melanoma

A

SUPERFICIAL SPREADING MELANOMA

93
Q

Breast cancer type confirmed by the presence of intra-cytoplasmic mucin

A

LOBULAR CA

“Indian file configuration”

94
Q

Breast cancer treatment during pregnancy

A

1st and 2nd trimester MRM

3rd trimester BCS

Topnotch SURGERY (1 decks)

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