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Qoy > Clerkships-SURGERY > Flashcards

Clerkships-SURGERY Flashcards

1
Q

How does PEEP increase oxygenation?

A

Increases FRC

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2
Q

First step in HIT, second step

A

Stop heparin

  1. Give a direct thrombin inhibitor such as

Argatroban, lepirudin

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3
Q

Progression of retinal detachment

A

First 20 question

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4
Q

NBT pancreatic adenoca

A

Ultrasound guided endoscopic biopsy

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5
Q

Wallenberg

A

PICA

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6
Q

Comminuted occipital condyle fracture

A

Hypoglossal palsy

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7
Q

kyphoplasty

A

puts cement in the vertebra to offer compression fracture relief

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8
Q

first step in treating PE

A

IVC filter (not heparinization, not thombolytic)

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9
Q

tx for biliary atresia

And PSC

A

liver transplant

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10
Q

Gallbladder path assoc. w UC

A

Primary sclerosis cholangitis

Pbc is only medium sized

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11
Q

Fibromuscular dysplasia

A

Renal artery stenosis/htn
Carotid dissection
“String of beads”

tx: stent and angioplasty

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12
Q

Amarousis fugax

A

?

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13
Q

“Salty” found in csf

A

Tau protein (beta-2 transferrin)

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14
Q

Cilostazol used only for

A

Peripheral artery disease

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15
Q

ABSOLUTE contraindication to surgery

A

DKA

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16
Q

Surgical abx ppx timing?

Choice of abx and target?

A

1 hour prior to surgical incision
+intra-operative dose for 6+ hr surgeries

cefazolin (kefzol) for GRAM+ COCCI (staph, etc., skin flora)

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17
Q

Which abx is the culprit in causing infectious colitis

A

clindamycin (kills “good” flora)

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18
Q

NBS in anuric kidney transplant patient

A

biopsy the allograft (suspect acute graft rejection)

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19
Q

next best step in TIA?

A

aspirin 1300mg/day

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20
Q

What to look for in munchhausen’s/factitious hyperinsulinemia

A

NORMAL C-peptide. remember, it would be elevated in real insulinoma

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21
Q

Tumor marker in pancreatic cancer

GIST?
MEN2A/B, medullary thyroid 
Small cell lung 
Burkitts
Neurofibromatosis 
Schwannoma 
Hepatocellular
Colorectal
A

k-ras, CA19-9

C-kit
ret
L-myc, neuron specific enolase
C-myc
Nf1
Nf2
AFP, ferritin
CEA
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22
Q

NBS in pyelonephritis

A

foley

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23
Q

Indications for hemodialysis

A

AEIOU

acidemia, electrolyte disorder, intoxication (lithium, ethylene glycol), overload of fluid (Pleural effusion periph edema, pulmonary edema) , uremia

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24
Q

Tx for benign essential tremor

A

Deep brain stim of thalamus

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25
Q

Uremic coagulopathy

Nephrotic syndrome?

A

Look for elevated bun/cr and that might lead to platelet dysfunction

Hypercoaguable! Lose ATIII in proteinuria

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26
Q

Hyperextention neck injury in the setting of stenosis

A

Central cord syndrome Loss of UL motor, preservation of LL motor

27
Q

BBS in gross hematuria

A

CT a/pelvis with contrast for suspected bladder cancer

28
Q

Protamine
FFP
Cryoprecipitate

A

Heparin reversal
Warfarin reversal
When fibrinogen is low/massive transfusions/ tPA admin.

29
Q

DVTs happen most commonly where

A

Femoral v

30
Q

Which clotting factor is not made by the liver

A

VIII

31
Q

Cauda equina syndrome

A

Saddle anesthesia
Urinary retention
Weakness

32
Q

Alpha 1 antitripsin liver characteristics

A

Intracellular red hyaline globules on PAS

33
Q

Hepatic Adenoma

A

Likely to rupture and bleed

Assoc with oral contraceptives

34
Q

Post splenectomy sepsis

A

Strep pneumo

35
Q

Preferred way to get someone’s nutritional status up?

A

Enteral Feeds

36
Q

Biggest predictor of peri-operative mortality? How to evaluate? Cutoff?

A

CHF; measure EF w/ echo; <35% postpone surgery

37
Q

NBS for all three neck zone trauma

A

Zone II always surgery
Zone I esophagram
Zone III arteriogram

38
Q

If a patient has had LOC at ANY POINT, NBS

A

CT head (after airway, etc. )

39
Q

Cushing’s treflex triad

A

Bradycardia, widened pulse pressure, irregular breathing

in the setting of elevated ICP

40
Q

What to do if someone has trouble voiding after surgery

A

Slow the rate of fluid admin intraoperatively

41
Q

In addition to abx what do you give for meningitis

A

steroids

42
Q

Broca’s area/expressive aphasia what area of the brain?

A

Inferior frontal gyrus

43
Q

Low urine output in elderly? Workup?

A

Renal ultrasound (but fluid bolus for younger people/prerenal)

Not fluids in this case bc of risk of CHF exacerbation, etc.

44
Q

RCC is assoc. with what syndrome

A

VHL

45
Q

Most common cause of death following myocardial contusion

A

Vfib

46
Q

NBS for blunt trauma to kidney

A

CT

47
Q

Priority of limb injury

A

1) bone 2) vessel (delay causes compartment) 3) nerve

48
Q

A-V fistulas are assoc. with what cardiac abn.

A

high output cardiac failure

49
Q

Cavernous malformation on MRI

A

popcorn lesion

50
Q

Confirmatory test for “echinococcal/hydatid cyst”

A

ELISA

51
Q

Temporal lobe hernia

Subfalcine Hernia

A

3rd nerve palsy

anterior cerebral artery occlusion

52
Q

Short and externally rotated leg vs internally rotated leg

A

EXternally rotated, femoral hEad fracture

Internally rotated, posterior dislocation of the hip

53
Q

What condition classically resolves when leaning forward (using a cans or pushing a cart etc)

A

Lumbar stenosis (don’t confuse with PVD)

54
Q

Transfusion related acute lung injury

A

Too much transfusion. White out. Looks like ards.

55
Q

Arm symptoms normally, but also dizziness/speech issues when exercising that arm. Path? Dx? Tx?

A

Subclavian steal syndrome, athero of the sublavian before it gives off the vertebral a. Reversal of flow thru vertebral.

dx- arteriogram
tx - surg bypass

56
Q

Wealthy man who is retired has claudication after walking 15 blocks. NBS?

A

nothing. Only workup if it affects the person’s life

57
Q

IVF maintenance of choice?

When to use other stuff?

A

D5 1/2 normal saline

Extremes: hypertonic and hypotonic (D5W) in acute hyponatremia and acute hypernatremia, respectively.

Fluid restriction for chronic hyponatremia.

Isotonic-normal saline for alkalotic “natremia.” Isotonic-LR for acidotic “natremia.”

58
Q

What to check in CO poisoning?

A

CARBOXYHEMOGLOBIN (not pulse ox; worthless because it’s an unloading issue)

59
Q

NBS in electrical burn

A

EKG

60
Q

how do you treat flail chest

A

nerve block

61
Q

Contraindications to FNA?

Drainage of abcess?

A

Liver hemangioma, scrotal mass (could spread the SSC)

Lung abcess, liver (amoebic) abscess.

note: echinococcal cyst (tx with albendazole/etOH then surgery)

62
Q

tx for incisional infection?

A

NO ABX.

63
Q

Vitamin deficiency w/ carcinoid?

A

Niacin. (serotonin/tryptophan derivative).

Diarrhea, dermatitis, dementia

Qoy (16 decks)

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