Gen Surgery Flashcards
Blood Loss I
> 750mL (0-15%)
No Symptoms
Blood Loss II
15-30% 750-1500mL HR 100-120 *Pulse Pressure decreased RR 20-30 Urine 20-30
Blood Loss III
30-40% *Systolic <100 *Tachy >120 Tachypnea >30 Urine <20
Blood Loss IV
>40% Systolic <70 Tachy >140 Tachpnea >35 Confused/Lethargic
Burns
Chest & Belly 18% Back 18% Arms 18% Anterior Leg 9% Posterior Leg 9% Head 4.5% Genitals 1% Palms 1%
Burn Parkland Formula
2nd + 3rd degree burns
Burn SA x wt x 4 = cc/24hrs
1st Half in 8 hours
2nd Half in 16 hours
Breslow:
<1mm - 1 cm margins
>1mm - 2 cm margins + sentinal
Actinic Keratosis
Solar Keratosis
PreCancerous
Small, rough, scaly lesion due to prolonged sun exposure
-Biopsy to exclude SCC
Tx: Scraping, freezing, 5FU
Seborrhagic Keratosis
Non Cancerous
Stuck on Greasy
Bowen’s Diseases
Squamous Cell Carcinoma In Situ Anal Cancer:
Variable Skin Changes: erythematous crusty, scaly plaques, itching burning, bleeding
Wide Local excisions + topical 5FU
Basal Cell Skin
80% Epidermis Cancer Sun Exposure Pearly Smooth papule with rolled edges: Pink, Papule, Pearly -Does not spread
Squamous Cell
16% Epithelial Cells Crusting ulcerated nodule or erosion Check for clinically positive Nodes -Surgical Excision
Melanoma
Asymmetry Borders Color Diameter Evolution
Depth is most important prognostic indicator
<1mm - 1 cm Margins
>1mm - 2cm Margins
+/- Sentinel Node Biopsy
+/- Lymph node dissection
Pancreatitis
Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion Hypertryglceride Ercp Drugs
Ranson Pancreatitis
Age > 55 (1 point) Glucose > 200 (1 point) WBC > 16,000 (1 point) AST > 250 (1 point) LDH > 350 (1 point)
BUN rises more than 5 mg/dL (1 point) Base deficit > 4 (1 point) Hct drops 10% or greater (1 point) PO2 < 60 (1 point) Calcium < 8 (1 point) Fluid sequestration > 6L (1 point)
