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shelf surgery > III > Flashcards

III Flashcards

1
Q

management of rib fractures

A

pain management and respiratory support

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2
Q

TB radiograph findings

A

patchy or nodular opacity, multiple nodules, cavity in apical posterior segments of upper lobes

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3
Q

patient with massive hemoptysis >600ml

next step?

A

bronchoscopy

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4
Q

what position do you put a patient in with massive hemoptysis

A

bleeding lung side down to preevnt bleeding into opposite lung

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5
Q

when to use pulmonary arteriography with massive hemoptysis

A

when bronchoscopy fails to localize source

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6
Q

initial XR for scaphoid fracture

A

unremarkable or radiolucent lines in nondisplaced spachoid fracture

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7
Q

what to do with amputated finger

A

wrap with saline moistened gauze and put in bag on ice

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8
Q

most common respiratory complication in first 24 hours post surgery

A

atelectasis

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9
Q

what methods are used to increase FRC post surgery

A

chest physiotherapy, incentive spirometry, coughing and frequent respositioning

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10
Q

how do AAA differ from thoracic AA

A

all aortal layers are involved, no flaps or false lumens

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11
Q

how can AAA cause hematuria

A

rupture into retroperitoneum and cause aortocaval fistula with IVC leading to venous congestion in the bladder and the distended veins in bladder can rupture

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12
Q

how can ruptured AAA cause lower extremity weakness

A

dissection into spinal arteries causing spinal cord ischemia

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13
Q

how to confrim ruptured AAA

A

contrast chest CT or transesophageal echo

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14
Q

presentation of mediastinal tumor

A

slow onset retrosternal chest pain, dysphagia or dyspnea

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15
Q

why is diaphragmatic ruture more common on L side

A

because liver is on Right

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16
Q

signs of tension pneumothorax

A

tympanic percussion, tracheal deviation to contralateral side, jugular venous distension, hypotension

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17
Q

Tx tension pneumo

A

emergency needle thoracostomy in 2nd intercostal space in MCL

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18
Q

becks triad

A

hypotension, pulsus paradoxus, JVD and muffled heart sounds

cardiac tamponade!

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19
Q

what not to do in tension pneumo

A

positive pressure ventilation because can cause one way valve increasing intrathoracic P and worsening hemodynamic collapse

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20
Q

signs of retroperitoneal abscess

A

fever chills and deep abdominal pain

21
Q

how to detect pancreatic laceration

A

serial CT. abdominal CT at first may miss it

22
Q

dx splenic injury

A

CT

23
Q

XR for gastric perforation

A

free air under diaphragm

24
Q

common causes of infected aortic aneurysms

A

staph and salmonella

25
Q

early dumping syndrome

A

postgastrectomy complication

rapid empyting of hypertonic gastric content into duodenum and small intestine

26
Q

signs early dumping syndrome

A

diaphoresis, craminging and weakness and lightheadedness

27
Q

knee hurts with twisting and has popping sound

A

meniscus

28
Q

Dx test for meniscal injury

A

MRI

29
Q

anterior dislocation humeral head

what nerve can be damaged

A

axillary

30
Q

damage to axillary nerve will cause what

A

paralysis of deltoid and teres minor muscles and loss of sensation over lateral upper arm

31
Q

damage to radial nerve will cause what

A

wrist drop and senosry loss posterior arm forearm and lateral dorsal hand

32
Q

damange to ulnar nerve will cause what

A

claw hand from paralysis intrinsic mucles

33
Q

damage to musculocutaneous will cause what

A

loss innervation to biceps, brachialis and coracobrachialis

34
Q

signs of long thoracic nerve injury

A

winged scapula

35
Q

how to confirm Dx psoas abscess

A

abdominal CT

36
Q

AP and lateral lumbar films are used for what

A

ureteral stones, bowel obstruction and perforated abdominal viscus

37
Q

what can cause psoas abscess from continguosu spread

A

potts disease( TB)

38
Q

gastroschisis

A

protrusion red intestines to right side of normal umbilicus

39
Q

omphalocele

A

protrustion of abdominal contents into base of umbilical cord. covered with peritoneum and overlying skin

40
Q

umbilical granuloma and Tx

A

umbilical mass in newborns, soft moist pin and pedunculated

silver nitrate is Tx

41
Q

what vv are damaged in subdural hematoma

A

bridging veins

42
Q

what can cause hypoxemia

A

reduced inspirted oxygen tension, hypoventilation, diffusion limitation, shunt and V/Q mistmatch

43
Q

normal A-a gradient and respiratory acidosis

A

hypoventilation

44
Q

how do you calculate A-a gradeint

A

PAO2-PaO2

45
Q

what are causes of alveolar hypoventilation

A

pulmonary/thoracic diseases
neuromuscular diseases
drug induced by anesthetics, narcotics and sedatives
primary central nervous system dysfunction– brainstem lesion, infection and stroke

46
Q

signs of duodenal hematoma

A

blunt trauma, epigastric pain and vomiting

47
Q

Tx for duodenal hematoma

A

nasogastric suction and parenteral nutrition

48
Q

electrical alterans (varying peaks of Q wave)

A

tamponade

shelf surgery (7 decks)

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