deck_1106041 Flashcards
What is afferent loop syndrome?
Obstruction of the afferent loop of a Billroth II gastrojejunostomy
What does ARDS stand for and what’s the pathophys?
Acute Respiratory Distress Syndrome (poor oxygenation caused by leaky capillaries)
What is blind loop syndrome?
Bacterial overgrowth of intestine caused by stasis
What is Boerhaave’s syndrome?
Esophageal perforation
What is Budd-Chiari syndrome?
Thrombosis of hepatic veins
What is carcinoid syndrome?
“B FDR”1)Bronchospasm2)Flushing3)Diarrhea4)R-sided HF
What is compartment syndrome?
Compartmental HTN caused by edema, resulting in muscle necrosis of the lower extremity, seen in the calf; pt may have a distal pulse
What is Cushing’s syndrome?
Excessive cortisol production
What is dumping syndrome?
Delivery of a large amt of hyperosmolar chyme into the small bowel, usually after vagotomy and a gastric drainage procedure (pyloroplasty/gastrojejunostomy); results in autonomic instability, abdominal pain, and diarrhea
What is Fitz-Hugh-Curtis syndrome?
Perihepatic gonorrheal infection
What is Gardener’s syndrome?
GI polyps and associated findings of Sebaceous cysts, Osteomas, and Desmoid tumors (SOD); polyps have high malignancy potential
What is HITT syndrome?
Heparin-Induced Thrombocytopenic Thrombosis syndrome: Heparin-induced plt ab’s cause plt’s to thrombose vessels, often resulting in loss of limb or life (aka, “white clot syndrome”)
What is Leriche’s syndrome?
CIA: Claudication of buttocks, thighs, Impotence, Atrophy of legs (seen w/ iliac occlusive disease)
What is Mallory-Weiss syndrome?
Post emesis/retching tears in the gastric mucosa (near gastroesophageal junction)
What is Mendelson’s syndrome?
Chemical pneumonitis after aspiration of gastric contents
What is Mirizzi’s syndrome?
Extrinsic obstruction of the common hepatic duct from a cystic duct gallstone
What is Munchausen syndrome?
Self-induced illness
What is Ogilvie’s syndrome?
Massive nonobstructive colonic dilation
What is Peutz-Jeghers syndrome?
Benign GI polyps and buccal pigmentation
What is Plummer-Vinson syndrome?
Syndrome of:1)Esophageal web2)Iron-deficiency anemia3)Dysphagia4)Spoon-shaped nails5)Atrophic oral and tongue mucosa(usually in elderly women; 10% develop SCC)
What is RED reaction syndrome?
Syndrome of rapid vancomycin infusion, resulting in skin erythema
What is refeeding syndrome?
Hypokalemia, hypomagnesemia, and hypophosphatemia after refeeding a starved pt
What is Rendu-Osler-Weber (ROW) syndrome?
Syndrome of GI tract Telengiectasia/A-V malformations
What is short-gut syndrome?
Malnutrition resulting from less than 100cm of viable small bowel
What is another name for Sipple’s syndrome?
MEN II
What is superior vena cava (SVC) syndrome?
Obstruction of the SVC (eg, by a tumor, thrombosis)
What is thoracic outlet syndrome?
Compression of the structures exiting from the thoracic outlet
What is the Tietze’s syndrome?
Costochondritis of rib cartilage; aseptic (tx w/ NSAIDs)
What is toxic shock syndrome?
S.aureus toxin-induced syndrome marked by fever, hypotension, organ failure, and rash (desquamation – esp palm and soles)
What is Trousseau’s syndrome?
Syndrome of deep venous thrombosis (DVT) associated w/ carcinoma
What is another name for Wermer’s syndrome?
MEN I
What is Zollinger-Ellison syndrome?
Gastrinoma and PUD
What is the mc indication for surgery w/ Crohn’s disease?
Small bowel obstruciton (SBO)
What is the mc type of melanoma?
Superficial spreading
What is the mc breast cancer?
Infiltrating ductal
What is the mc site of breast cancer?
Upper outer quadrant
What is the mc vessel involved w/ a bleeding duodenal ulcer?
Gastroduodenal artery
What is the mc cause of common bile duct obstruction?
Choledocolithiasis
What is the mc cause cholangitis?
Bile duct obstruction resulting from choledocolithiasis
What is the mc cause of pancreatitis?
EtOH
What is the mc bacteria in stool?
B.frag (Bacteroides fragiles)
What is the mc cause of SBO in adults in the US?
Adhesions
What is the mc cause of SBO in children?
Hernias
What is the mc cause of emergency abdominal surgery in the US?
Acute appendicitis
What is the mc site of GI carcinoids?
Appendix
What is the mc AXR finding w/ SBO?
Air-fluid levels
What is the mc electrolyte deficiency causing ileus?
Hypokalemia
What is the mc cause of transfusion hemolysis?
Clerical error
What is the mc cause of blood transfusion resulting in death?
Clerical error (wrong blood types)
What is the mc site of distant metastasis of sarcoma?
Lungs
What is the mc cause of shock in a surgical pt?
Hypovolemia
What is the mc cause of esophageal perforation?
Iatrogenic
What is the mc position of anal fissure?
Posterior
What is the mc cause of large bowel obstruction?
Colon cancer
What is the mc type of colonic volvulus?
Sigmoid volvulus
What is the mc cause of fever <48hrs post-op?
Atelectasis
What is the mc bacterial cause of UTI?
E.coli
What is the mc CXR finding w/ traumatic thoracic aortic injury?
Widened mediastinum
What is the mc abdominal organ injured in blunt abdominal trauma?
Spleen
What is the mc abdominal organ injured in penetrating abdominal trauma?
Small bowel
What is the mc benign tumor of the liver?
Hemangioma
What is the mc malignancy of the liver?
Mets
What is the mc PNA in the ICU?
Gram-negative bacteria
What is the mc cause of epidural hematoma?
Middle meningeal artery injury
What is the mc cause of lower GI bleeding?
Upper GI bleeding
What is the mc hernia?
Inguinal hernia (right>left)
What is the mc cause of esophageal laceration?
Iatrogenic instrumentation (eg, EGD=esophagogastroduodenoscopy)
When can a pt eat prior to major surgery?
Pt should be NPO after midnight the night before or at least for 8hrs before surgery
What risks should be discussed with all pts and documented on the consent form for a surgical procedure?
Bleeding, infection, anesthesia; other risks are specific to the individual procedure
If a pt is on antihypertensives, should the pt take them on the day of the procedure?
Yes (remember clonidine “rebound”)
If a pt is on an oral hypoglycemic agent (OHA), should the pt take it on the day of the surgery?
Not if the pt is to be NPO on the day of the surgery
If a pt is taking insulin, should the pt take it on the day of the surgery?
No, only half of a long-acting insulin and start D5 NS IV; check glucose levels often preoperatively, operatively, and postoperatively
Should a pt who smokes cigarettes stop before an operation?
Yes, improvement is seen in just 2 to 4 wks after smoking cessation
What laboratory test must all women of childbearing age have before entering the OR?
bHCG and CBC bc of the possibility of pregnancy and anemia from menses
What preoperative procedure should be performed before colon surgery?
Bowel prep with colon cathartic (goLYTELY), oral ABXs (neomycin and erythromycin base), and IV ABX before incision
What pre-op medication can decrease post-op cardiac events and death?
Beta-blockers
What must you always order pre-op for your pt undergoing a major operation?
-NPO/IVF-Pre-op ABXs-Type and cross blood (PRBCs)
Define the following procedure: Billroth I
Antrectomy w/ gastroduodenostomy
Define the following procedure: Billroth II
Antrectomy w/ gastrojejunostomy
Define the following procedure: Roux-en-Y limb
Jejunojejunostomy forming a Y-shaped figure of small bowel; the free end can then be anastomosed to a second hollow structure (eg, gastrojejunosomty)
Define the following procedure: Brooke ileostomy
Standard ileostomy that is folded on itself to protrude from the abdomen approximately 2cm to allow easy appliance placement and collection of succus
Define the following procedure: CEA
CarotidEndArterectomy; removal of atherosclerotic plaque from a carotid artery
Define the following procedure: Bassini herniorrhapy
Repair of inguinal hernia by approximating transversus abdominis aponeurosis and the conjoint tendon to the reflection of Poupart’s (inguinal) ligament
Define the following procedure: McVay herniorrhaphy
Repair of inguinal hernia by approximating the transversus abdominis aponeurosis and the conjoint tendon to the Cooper’s ligament (which is basically the superioir pubic bone periosteum)
Define the following procedure: Lichtenstein herniorrhaphy
“Tension-free” inguinal hernia repair using onlay mesh (synthetic graft material)
Define the following procedure: Shouldice herniorrhaphy
Repair of inguinal hernia by imbrication of the transversalis fascia, transversus abdominis aponeurosis, and the conjoint tendon and approximation of the transversus abdominis aponeurosis and the conjoint tendon to the inguinal ligament