Kaplan, SU2M, FA, Surgical Recall Flashcards by Alex Hamidi

Post op confusion, what labs do you need to order?

ABG
CXR
CBC

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What tumors are MC found in the middle mediastinum?

Bronchopneumonia and pericardial cysts, thyroid goiter, tracheal tumor

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What can cause compartment syndrome in a closed environment?

Fascial sheath

Cast

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Pt > 60 y/o w/RLQ pain can have what?

Cecil diverticulitis

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If a nodule is determined to be LOW probability of malignancy, what is the workup?

Intermediate?

High?

Serial CT scan

1 cm or larger —> PET scan and if + then biopsy

Biopsy and lobectomy

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LLQ pain, what is your DDx (4)?

Sigmoid volvulus
Sigmoid diverticulitis
Ovarian torsion
Ectopic pregnancy

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How do you diagnose a peripheral SCC?

Central?

CT guided FNA

Bronchoscopy

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What is obturator sign?

Pain w/IR of right thigh

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What are the symptoms of compartment syndrome?

#1 Pain - severe, worse w/muscle stretch
Pallor
Paresthesia
Poikilothermia (cold limb)
Paralysis
Pulselessness

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Lung SCC MC located where?

Growth?

Centrally in lung hilum

Slow, late METS

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What breast tumor is associated w/a radial scar?

Tubular carcinoma

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What are 3 signs of appendicitis?

Rovsings
Psoas
Obturator

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What tumors are MC found in the posterior mediastinum?

Neurogenic tumors, Esophageal tumors, hiatal hernia, vertebral lesion

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What is the MC cause of compartment syndrome?

What else?

fracture
Burn
Crush injury

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Treatment for Non small-cell lung cancer stage 1?

Surgical resection

Surgical resection + chemotherapy

Chemotherapy and XRT +/- surgical resection

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METS from breast cancer MC go where? What symptoms do they cause?

Bone - pain
Lung - dyspnea
Liver - ABD pain, jaundice, nausea

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What is Rovsing’s sign

Palpation of LLQ causes pain the RLQ

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What kind of breast cancer do men develop?

Almost 100% get ductal carcinoma

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1st step in w/u of a suspicious mass in postmenoupasual woman is what?

In woman < 30?

Mammogram

What characterizes breast cancer Stage II?

III?

IV?

Tumor is 2-5 cm

Nodal involvement or tumor > 5 cm

METS

Sipple syndrome = ?

MEN II

What shock has pt warm/flushed w/dec CO?

Inc CO but NO change in PCWP?

Neurogenic

Septic

What postop FEV1 must you have?

This means what must have preop?
If less you need what?

> 800cc

> /= 2 L needed for a pneumonectomy
V/Q scan

What are the RFs for breast Cancer?

NAACP 
Nullparity
Age at menarche (younger than 13)
Age at menopause (older than 55)
Cancer of the breast (self or family)
Pregnancy w/1st child (> 30 y/o)

What is light’s criteria?

pleural fluid to serum protein > .5 Pleural fluid to serum LDH > .6 Pleural fluid LDH > 2/3 upper limit of lab’s normal LDH

What is the treatment of inflammatory carcinoma of the breast?

Chemotherapy 1st!!! | Then radiation, mastectomy or BOTH

Spinal stenosis is d/t what? Symptoms? Best imaging?

OA of spine, #1 lumbar b/L leg and buttock pain MRI

Breast pain or tenderness that varies w/menstrual cycles; cysts and nodular fullness indicates what? Dx how?

Fibrocystic disease Aspirate is straw-colored or green

RLQ pain, what is your differential (4)?

Appendicitis Ovarian torsion Ectopic pregnancy Cecal diverticulitis

What presents as a solid, mobile, well-circumscribed round breast mass in pt < 40 y/o? MC in whom?

Fibroadenoma Pts under 30 y/o

What shock has pt pale/cool w/increased PCWP? Decreased?

Cardiogenic Hypovolemic

What is the blood supply to the prox 1/3 of the esophagus? Mid Distal?

Inf thyroid, anterior intercostals Esophageal aa, bronchial aa Left gastric, left inf phrenic

Pt presents w/a solitary pulmonary nodule, 1 step? Next? If suspicious for malignancy do what? If benign?

Old CXR CT w/thin sections Biopsy and resect Follow q3 months

How do you biopsy a nonpalpable mass seen on mammogram?

Stereotactic (aka mammotome) or needle localization biopsy

ABD pain after eating that is described as cramping and causes 10/10 pain w/no guarding, no rebound tenderness and a soft ABD indicates what? #1 RF?

Mesenteric ischemia AFib

Treatment for local recurrence in breast after lumpectomy and radiation is called what?

Salvage mastectomy

Lung large cell cancer located where? Growth?

Peripheral V. Malignant

Claudication is evaluated how? What is pathologic? Symptomatic?

Ankle-brachial index < 0.9 < 0.4

What is Psoas sign?

Pain w/extension of the hip

What is the initial treatment for trigger finger? What is it?

Steroid injection 1 finger is flexed

What is the MC location to tear the esophagus?

Left posterolateral aspect of distal esophagus

Lung Small cell located where? Growth?

Central Highly malignant

What is the management after stereotactic (mammotome) biopsy comes back as “atypical hyperplasia”?

Open needle location biopsy bc lots will have DCIS or invasive cancer

ER/PR + breast cancer treated with what? If postmenopausal? HER2/neu +?

Tamoxifen Aromatase inhibitor Trastuzumab

Lung Adenocarcinoma located where? Growth?

Peripheral Rapid, hematogenous/nodal METS Assoc w/lung scarring

What is it called when a bone gets broken into multiple pieces? MC cause?

Comminuted Crush injury