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Surgery > Lauren Pretest/USMLE world > Flashcards

Lauren Pretest/USMLE world Flashcards

1
Q

What should you check for with blunt deceleration trauma

A

look for aortic trauma

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2
Q

Consequence of aortoiliac occulsion in men

A

impotence

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3
Q

What do you think of with blood in stool s/p AAA repair?

A

bowel ischema

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4
Q

What should you worry about with chronic steroid users perioperatively

A

adrenal insufficiency due to inability to mount stress cortisol response

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5
Q

What should you do before someone hospitalized with gallstone pacreatitis leave the hospital?

A

cholecystectomy

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6
Q

Neuro injury with whiplash

A

syringomyelia/central cord syndrome/cape-like distribution of decreased strength/pain/temp with preservation of bibration a, light touch and position sense

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7
Q

What do you do with an RQ (respiratory quotient) > 1? Why?

A

decrease carbs in diet. excess carbs increase CO2 and make it harder to wean off vent if pt is on vent

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8
Q

What happens post op 2-3, when patient is tachypneic with decreased breath sounds in a lung field? What is the metabolic disturbance?

A

Post op atelectasis, respiratory alkalosis (due to tacy), prevent with incentive spirometry

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9
Q

Ddx for subcutaneous emphysema in thorax (3)

A

rupture of esophagus (often post endoscopy), rupture of trachea or bronchus, tension pneumo ( patient in distress)

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10
Q

Patient has petechiae, low platelet count, respiratory distress and hypoxemia after long bone fracture. Cause?

A

Fat embolism

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11
Q

What is the pre-op prophylaxis for patient with von Willebrand Disease? Mechanism?

A

Desmopressin (causes release of vWF and factor VIII)

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12
Q

What is the most common cause of Cushing syndrome?

A

pharmacologic/therapeutic administration of steroids

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13
Q

Fever, lethargy, hypoglycemia, hyponatremia, hyperkalemia. What is happening?

A

adrenal insufficiency

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14
Q

What is the preoperative care for a patient with a pheochromocytoma?

A

1-3 weeks of alpha blockade

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15
Q

What is the treatment for thyroid storm? Prophylaxis?

A

beta-blockade; prophylaxis = Drops of Lugal and iodine solution for 10 days

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16
Q

Patient presents with tetany two weeks after TPN is started. What is the deficit?

A

magnesium; looks like hypcalcemia but persists after adequate replenishment of calcium stores (via TPN)

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17
Q

If a patient has a metabolic alkalosis, do you give them LR and why?

A

No, because the lactate is converted to bicarb by the liver which would worsen the metabolic alkalosis

18
Q

What is the acute treatment for hyperkalemia? What is a temporary treatment of hyperkalemia? What are two definitive treatments for hyperkalemia?

A

Calcium gluconate (cardio-protective); insulin and glucose, kayexalate (takes hours) or dialysis.

19
Q

What are the signs of abdominal compartment syndrome?

A

increased peak airway pressure, decreased venous return, decreased cardiac output, decreased SVR, decreased renal and hepatic blood flow, decrease cerebral perfusion pessure

20
Q

Dx ZES?

A

elevated gastrin in the face of secretin administration

21
Q

What is the treatment for a bronchial carcinoid tumor?

A

resection and NO chemoradiation (not sensitive to it)

22
Q

Treatment for Zenker diverticulum?

A

excision and cricopharyngeal myotomy

23
Q

What is a requirement for the development of carcinoid syndrome from a carcinoid tumor?

A

once there are hepatic mets

24
Q

What is the treatment for gastric varices and portal hypertension in a patient who is not cirrhotic and has a healthy liver but just had pancreatitis?

A

splenectomy

25
Q

What is an apple core sign on barium enema study and what is the treatment?

A

large bowel obstruction likely due to cancer, treatment is resection and colostomy

26
Q

What are the indications for surgery in patients with diverticular disease?

A

1) hemorrhage, 2) failed medical treatment, 2) perforated with abscess, 4) perforated without abscess

27
Q

How do you diagnose Hirschprung?

A

full thickness biopsy 2cm above dentate line, find aganglionic cells

28
Q

What are the acute and chronic signs of increased intracranial pressure, respectively?

A

irregular respirations, bradycardia, and increased blood pressure; papilledema

29
Q

What does it mean if you have RBCs in the 4th vial of an LP?

A

Subarachnoid hemorrhage

30
Q

What is the treatment of renal cell carcinoma?

A

radical nephrectomy (NOT responsive to chemoradiation)

31
Q

What are indications for transurethral resection of the prostate in patients with BPH?

A

1) recurrent UTI, 2) refractory urinary retention, 3) upper tract dilation, 4), renal insufficiency due to obstruction, 5) bladder stones

32
Q

What is a limitation of Duplex studies?

A

cannot image proximal veins (but CAN tell the difference between acute and chronic clots)

33
Q

What is the parkland formula?

A

4 x wt x TBSA burned

34
Q

Guy with scrotal mass, has AFP and HCG, what kind of tumor is it?

A

Germ cell tumor. (seminoma doesn’t make AFP but it does make HCG)

35
Q

Prosthetic knee infection. Early pathogens (3mo)?

A

S. aureus and pseudomonas. S. epidermidis

36
Q

How do you treat duodenal hematomas?

A

NPO, TPN, NGT

37
Q

Old women and men: who has primary sclerosing cholangitis and who has primary biliary cirrhosis? and what antibody does one have that the other doesn’t?

A

Women have BooBs and pass on mitochondria: pBc, anti-mitochondrial

Men have SCrotum: pSC, associated with UC, NEEDS liver transplant

38
Q

when do you pump the bowel of toxins?

A

Ca channel blockers, Li, drug packets

39
Q

Old, dehydrated, post-op, what are you worried about?

A

Parotiditis

40
Q

Intubatedx5 days in SICU with fever, what are you worried about?

A

Parotiditis, Sinusitis, Acalculus cholecystitis

41
Q

just had trauma, hypoxemia worsened by IVF with CP and dyspnea

A

pulmonary contusion

42
Q

First sign of hypoxemia in old people

A

Agitation

Surgery (34 decks)

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