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Surgery Shelf > Deck 3 > Flashcards

Deck 3 Flashcards

1
Q

signs of greater trochanteric bursitis

A

chronic lateral hip pain, pain worse with hip flexion or lying on lateral side, focal tenderness on the trochanter

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2
Q

what is the pleural fluid like in esophageal perf

A

high amylase (from saliva) and maybe some food particles

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3
Q

in zollinger ellison why is there fat malabsorption

A

the increased acid from the stomach secretions cause pancreatic enzyme inactivation

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4
Q

best way to decrease poor pulmonary outcomes in rib fracture

A

proper pain control

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5
Q

where are toddlers fractures located

A

distal tibia and its a spiral fracture

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6
Q

signs of duodenal hematoma

A

billous emesis, blunt abdominal trauma, gastric dilation with scant gas

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7
Q

risk factors for rectus sheath hematoma

A

abdominal trauma or forceful abdominal contractions from coughing, anticoag therapy, older age, female

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8
Q

signs of rectus sheath hematoma

A

acute onset abdominal pain with leukocytosis, blood loss anemia, palpable abdominal mass

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9
Q

aspiration pneumonitis signs

A

tachy, new pulmonary infiltrates, abrupt onset dyspnea,

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10
Q

legg-calves-perths

A

ideopathic avascular necrosis of the femur

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11
Q

TRALI signs

A

respiratory distress and non cardiogenic pulmonary edema, bilateral pulmonary infiltrates

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12
Q

ABX for lung abcses

A

ampicillin-sulbactam or a imipenem or clinda

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13
Q

what does the biliary tree look like on cholangiagram for primary sclerosing cholangitis

A

stricturing/dilation of intrahepatic &/or extrahepatic bile ducts on cholangiography

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14
Q

who gets primary sclerosing cholangiitis

A

people with crohns or IBD

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15
Q

clinical features of a thyroid storm

A

fever, tachy, agitation, coma, lid leg, nausea,

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16
Q

signs of granulomatosis with polyangiitis

A

renal involvement, nose bleeds, lower airway bleeds in alveoli

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17
Q

what is osler-webber-rendu syndrome

A

hemorrhagic telangectasias

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18
Q

signs of AVMs

A

nose bleeds, brain bleeds, recurrent epistaxis, chronic bleeds (GI)

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19
Q

dx of a person with RUQ pain on OCPs and hypotension

A

hepatic adenoma rupture

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20
Q

signs of acute cholangitis

A

RUQ pain, hypotension, increase tbili, fever, jaundice

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21
Q

anion gap in sepsis

A

high anion gap from increased lactate

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22
Q

what is used as an indicator for priority of liver transplants

A

MELD-Na score

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23
Q

what marker is used for pancreatic cancer

A

CA19-9

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24
Q

RUQ pain, fever, and air in gallbladder wall dx

A

emphysematous cholecystitis

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25
Q

leg exam of femoral neck fracture

A

shortened leg, externally rotated

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26
Q

where can retropharngeal abbcesses travel to

A

mediastinum

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27
Q

pre-op management of pheo

A

alpha blocker and then beta blocker

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28
Q

what is SVR like in hypovolemic shock

A

it is increased bc CO is decreased

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29
Q

etiology of perianal abscess

A

infection of an occluded anal crypt gland

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30
Q

imanagement of a pt with clear lower limb ischemia from trauma

A

urgent surgery

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31
Q

post surgery colitis etiology

A

ischemic colotis at the watershed zones

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32
Q

what are the watershed zones in the colon

A

rectosignmoid juction and splenic flexure

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33
Q

signs of peritonitis

A

guarding, rigid, distention, inability to tolerate sitting upright

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34
Q

slow onset joint effusion and catching sensation dx

A

meniscal tear

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35
Q

G6PD exacerbation Hb and indirect bili levels

A

low Hb and high bili

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36
Q

what is gilbert syndrome

A

this is decreased activity of the UDP glucuronyltransferase

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37
Q

when is gilberts caught

A

typically in times of injury or stress to the body with infection

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38
Q

what is a baker cyst

A

this is extrusion of fluid from the joint space to the semimembraneous/gastroc bursa

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39
Q

signs of baker cyst rupture

A

acute popping sensation, acute calf pain, warmth, eccymosis distal to medial malleolus in the shape of a crescent

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40
Q

CT scan signs of acute diverticulitis

A

colonic wallt thickening

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41
Q

what muscle is helpful for dividing planes of axillary nodes

A

pec minor

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42
Q

signs of catecholamine surge

A

pale, tachy, extreme hypertensin

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43
Q

what can exacerbate a pheo

A

injury, illness, anesthesia induction

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44
Q

post amputation stump pain with slight palpation dx

A

likely a neuroma

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45
Q

indications for emergency thoracotomy post chest tube

A

> 1500 ml initial output OR continued h

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46
Q

first line treatment of mild UC

A

mesalamine (5-aminosalycilic acid)

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47
Q

new onset ascites with cirrhosis workup

A

abdominal US

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48
Q

greatest risk of acute glenohumeral dislocation

A

redislocation

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49
Q

is more or less Cl reabsorbed during acidosis

A

less is reabsorbed aka it is excreted bc the body wants to remain electro neutral so there is decreased Cl reabsorption as more HCO3 is reabosorbed

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50
Q

CA19-9 level in cholangiocarcinoma

A

elevated

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51
Q

if a patient is draining pancreatic fluid what is their acid/base status

A

they will become acidodic because they are losing base

52
Q

is calcium citrate soluble

A

yace

53
Q

normal pH of urine

A

> 5.5

54
Q

uric acid stone pH urine

A

<5.5

55
Q

etiology of post cholecystectomy diarrhea

A

bile acid diarrhea from excess bile dumping into the colon causing irritation and then diarrhea

56
Q

treatment of bile acid diarrhea

A

cholestyramine (bile acid binding resin)

57
Q

late complications of cholecystectomy

A

recurrent CBD stone, stricture, sphincter of ODDI dysfunction

58
Q

what does prominent V waves mean on JVP waveform

A

this is pathopneumonic for Tricuspid regurg

59
Q

primary causes of tricuspid regurg

A

myxomatous degeneration of the chordae tendinae

60
Q

pathophys of tricuspid regurg from LV failure

A

chronic dilation of the RV causes stretching of the chordae tendinae so they have increased tension and cant close properly

61
Q

pain sequence of patients with bowel perf

A

1) sudden sharp pain at perf 2) after perf-2 hours: temporary relief 3) generalized peritonitis +/- sepsis

62
Q

whats the most important prognostic factor for cancers

A

tumor stage

63
Q

signs of urethral stricture

A

high postvoid volume, weak stream

64
Q

treatment of proctatitis

A

fluoroquinolone

65
Q

why do patients get hypercalcemia with immobilization

A

this is because as you are sitting there is increased osteoclastic bone resorption and then this causes elevated Ca and then there is suppressed PTH b

66
Q

management of sigmoid volvulus

A

endoscopic untwisting

67
Q

clinical signs of dumping syndrome

A

occurs within 15-30 mins after eating, tachy, flushing, nausea, vomiting, diarrhea, cramps

68
Q

signs of bacterial overgrowth in the small intestine

A

frequent watery loose stools, excess gas, decreased B12 (bacteria eat it up)

69
Q

treatment of bacterial overgrowth in small intestine

A

ABX

70
Q

NEXUS criteria for needing CT imaging to remove C-collar

A

intoxication, somnolence, neuro deficit, spinal tenderness, altered mental status, distracting injury

71
Q

do you see filling defect in a fat embolism

A

no bc its microvascular occlusion

72
Q

triad of fat embolism

A

alterened mental status, respiratory distress, petechial rash

73
Q

most common skin cancer to result from a burn/ulcer

A

SCC

74
Q

liver abscess following diverticulitis trtment management

A

percutatneous drainage

75
Q

what is a keratocanthoma

A

this is a rapidly growing nodule with ulceration & keratin plug

76
Q

presentation of tarsal tunnel syndrome

A

Burning pain, numbness, or paresthesia of the medial ankle, heel, sole and toes

77
Q

etiology of tarsal tunnel syndrome

A

compression of the tibial nerve under the flexor retinaculum in the medial ankle

78
Q

what is pes planus

A

this is flat feet essentially flat arches

79
Q

tinnel sign

A

tapping on the tibial nerve in the posterior medial malleolus

80
Q

what is ludwig angina

A

this is cellulitis of the sublingual and submandibular space

81
Q

what is the immediate risk of ludwig angina

A

airway obstruction

82
Q

how do you diagnose colovesical fistula

A

CT scan with rectal contrast

83
Q

signs of colovesical fistula

A

bubbly urine, turbid, mixed flora in the urine on microscopy

84
Q

lung imaging pulmonary fibrosis

A

subpleural honeycombing, reticular opacities

85
Q

clinical signs of pulmonary fibrosis

A

Chronic progressive dyspnea, nonproductive cough, fatigue, Fine “Velcro” inspiratory crackles, digital clubbing

86
Q

what antibiotic is best for encapsulated bacteria and is broad spectrum

A

amox clav

87
Q

signs of complicated SBO and management

A

fever, hemodynamic instability (hypotension, tachycardia), guarding, leukocytosis, and significant metabolic acidosis –> take to surgery

88
Q

for patients with blunt cardiac trauma do you use TE-echo or regular echo (stable vs. unstable)

A

stable- reg echo // unstable- TE-echo

89
Q

what are indications for immediate laparotomy following blunt abdominal trauma

A

hemodynamic instability, peritonitis, evisceration, impalement

90
Q

are internal hemorrhoids painful

A

no

91
Q

what ABX should be avoided in a patient with aortic aneurysm

A

fluoroquinolone, bc of collagen

92
Q

treatment of anal fissure

A

High-fiber diet & adequate fluid intake, Stool softeners, Sitz baths, Topical anesthetics & vasodilators (eg, nifedipine, nitroglycerin)

93
Q

what is evisceration

A

this is when there is rectus abdominis dehiscence and then bowel herniatrion

94
Q

what is leriche syndrome

A

this is a triad of bilateral leg claudication, absent femoral/popliteal pulses, and impotence due to

95
Q

etiology of leriche syndrome

A

aortoiliac occlusion

96
Q

primary hyperparathyroidism dx findings

A

elevated PTH, elevated Ca, low phosphorous

97
Q

presentation of primary hyperparathyroidism

A

most ppl asymptomatic, mild nonspecific sx, renal stones, etc.

98
Q

how to dx primary hyperparathyroidism

A

parathyroid imaging and parathyroidectomy

99
Q

most common cause primary hyperparathyroidism

A

parathyroid adenoma

100
Q

most common bugs for septic bursitis

A

skin flora

101
Q

LA size, LV size and LV ejection fraction in acute mitral regurg

A

all normal except ejection fraction might be slightly increased bc the end systolic volume is less

102
Q

signs of nasal septal perforation

A

whistling during respiration and

103
Q

common post op complication after rhinoplasty

A

nasal septal perforation

104
Q

what do you injure falling on your lateral ankle

A

you invert your foot so you injure your anterior talofibular ligament

105
Q

do you need xray for likely ATFL injury

A

no

106
Q

treatment of ATFL injury

A

conservative management with ice, braces and crutches

107
Q

burn patients with organ dysfunction etiology

A

hypoperfusion or just dysfunction due to infection etc. do not assume there is a bowel obstruction first

108
Q

how to dx osteomyelitis

A

bone biopsy unless BCX are positive and there are imaging findings

109
Q

how do you dx gallstones

A

abdominal U/S

110
Q

causes of noninfective endocarditis

A

cancer or hypercoagualbe state

111
Q

signs of back pain being malignancy

A

worse at night, not relieved by rest or ibuprofen

112
Q

if a chest tube is persistenly leaking what should you do

A

a broncoscopy because there is likely a tracheal injury allowing air in

113
Q

what ABX for calculous cholecystitis

A

pip-tazobac

114
Q

soft signs for arterial injury

A

diminished pulses, unexplained hypotension, stable hematoma, associated neuro defecit

115
Q

what to do if only soft signs for arterial injury

A

do more imaging

116
Q

hard signs for arterial injury

A

distal limb ischemia, absent pulses, active hemorrhage, bruit or thrill at site of injury

117
Q

sounds of mitral stenosis

A

diastolic rumble and early diastolic murmur

118
Q

CT signs of pulmonary contusion

A

peripheral anterior ground glass opacities (blood)

119
Q

triad of fat embolism

A

pulmonary distress, neuro changes, and petechial rash

120
Q

etiology of supporative parotitis

A

salivary gland stasis causes retrograde seeding of bacteria

121
Q

clinical signs of supporative parotitis

A

Firm, erythematous pre/postauricular swelling, systemic findings, elderly paitents

122
Q

etiologies of paralytic ileus

A

abdominal surgery, opioid use, inflammation, ischemia, electrolyte abnormalities

123
Q

imaging of paralytic ileus

A

uniformly dilated bowel wtih no air fluid levels, NO transition piont,

124
Q

when do you have to do valve repair before surgery

A

if they are having sx of the valve impiarment

125
Q

what two cancers are associated with RB1 mutation

A

osteosarc and retinoblastoma

126
Q

what mutation is associated wtih ewings

A

chromosome 22 translocation

127
Q

lytic bone lesion in the distal femur with “sunburst” periosteal reaction (concentric layers of reactive bone

A

osteosarc

Surgery Shelf (6 decks)

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