High Yield Surgery Flashcards
Guarding and rebound case what is the next best step management
Exploratory laparotomy
Widened mediastinum
CT angiography
Inability to abduct the arm
Injury site and nerves affected?
Injury site: Surgical neck of Humerus
Nerves: aaxilla4y Nerve + Posterior circumflex humerus artery
Inability to extend the elbow
Injury site and the nerves affected?
Injury: midshaft of humerus
Nerves: Radial Nerve + deep brachual artery
Motor and sensory damage of first three digits
Injury site and nerves affected?
Injury to the supracondylar fracture of humerus
Median nerve and brachial artery
Weak grip and sensory damage of last 2 digits
Injury to the medial epicondylar fracture of humerus
ULNAR nerve
RuQ pain after fatty meals and resolves within a few hours
Can have elective sholecystectomy
BILIARY colic
Constant RUQ pain + fever + inflammation of gallbladder
Usually requires cholecystectomy within 72 hrs
ACUTE CALCULOUS CHOLECYSTITIS
ICU patients + cholecystitits symptoms + no stones visualised
Tx: antibiotics + percutaneous cholecystectostomy (cholecystectomy later when stabilised)
Acalculous cholecystitits
Cholecystitis symptoms + creates in RUQ + air fluid levels
Tx: cholecystectomy
Emphysematous cholecystitis
Fever + jaundice + RUQ pain (chariots triad) .
Tx: antibiotics + ERCP drainage
Acute Cholangitis
Claudication, pain while sleeping (rest pain hx of ACS
Tips of toes
Eripheral Artery Disease
Hyperpigmentatjoj of ankles
History of chronic LE edema
Medial malleolus
Chronic Venous Insufficiency
Painless ulcer usually at the sole of the 1st metatarsal
Diabetic foot ulcer
Painful, palpable, cord like swelling of veins
Asso qith GI malignancy and Buerger Syndrome (thromboangitis obliterans
Superficial thrombophlebitis
Flat, painful streaks usually extending proximal from skin infection (cellulite, erysipelas
Lymphangitis
Ipsilateral paralysis and normal sensation and contralateral pain. Or temp loss
Half transection
Brown square syndrome
Bilater sensory loss of upper extremities
Loc: central cord , elderly person with neck whiplash injury
Central Cord Syndrome
Anterior 2/3 of cord
Burst vertebral fracture or surgical damage to aorta branches
Bilateral weakness + pain = temp loss, normal sensation spared
Anterior cord syndrome
Recent chest trauma with paradoxic movement of chest with breathing
Flail chest
Fall on outstretched hand with pain in anatomical snuffbox with normal xray
Scaphoid fracture
Elderly patient with history of alcoholism with recent head trauma and altered mental status
Subdural haematoma
High speed MBC + upper extremity hypertension + hoarse voice
Traumatic aortic rupture
Blunt rauma + left sided chest pain + NG tube in the pulmonary cavity
Traumatic diaphragmatic hernia
Paediatric patient with trauma 24 hrs ago with new onset epigastric pain and Vomiting
Duodenal hematoma
Head trauma with brief LOc, now has headache and nausea and Vomiting
Epidural haematoma or rupture of the middle meningeal artery
Patient with pancreatic surgery with new onset non-anion gap metabolic acidosis
Pancreatic fistula
Child with extremity pain, fever, leukocytosis with periosteal elevation and osteopathic lesions on MRI
Osteomyelitis
Full thickness extremity burn with pain on passive stretch and rapidly increased swelling
Compartment syndrome from eschatology formation or escharotomy
Sudden onset respiratory distress after remov of central.line, hypoxaemia, obstructive shock but normal breath sounds
Venous air embolism.
Tall, young patient who experiences sudden onset respiratory distress, jvd and hyperresonance on percussion
Rimary spontaneous pneumothorax
Rebound, guarding with free air under the diaphragm on Xray
Erforated peptic ulcer
Diffuse rash with a net like appearance
Acute mesenteric ischaemia + lived reticularis
RUQ pain that radiates to the back
Acute pancreatitis
