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Surgery > Misc > Flashcards

Misc Flashcards

1
Q

breakdown of skeletal muscle tissue

A

Rhabdomyolysis

MCC: Crush injury, Seizures

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2
Q

Pathophysiology of Rhabdomyolysis
→ release of the following substances:

  1. ___ and serum ___ → pigment nephropathy → ATN
  2. ____ → cardiac arrhythmia
  3. ____ → metabolic acidosis
A 
Creatine phosphokinase (CPK) 
myoglobin (myoglubinuria)

Potassium

Lactic acid

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3
Q

Rhabdomyolysis
Classic triad:
Generalized weakness
(2)

A

Myalgia

Darkened urine

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4
Q

Rhabdomyolysis cx (3)

A

AKI (pre-renal 2/2 hypovolemia)
compartment syndrome
cardiac arrhythmias

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5
Q

Management of Rhabdomyolysis

  1. IVF
  2. ___
A

Correct hyperkalemia

Insulin, Albuterol, Potassium binders, HD

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6
Q

pneumoperitonuem
(air in CT or CXR)
suggests what dx?

A

ulcer perforation

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7
Q

widened mediastinum can be seen in what dx (2)

A

aortic rupture
esophageal perforation

pericardial effusion (?)

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8
Q

Pleural effusions can be seen in patients with
Free wall rupture s/p MI
recent CABG
(2)

A

perforated esophagus

aortic dissection

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9
Q

Tachycardia
Hypotension
JVD
+/- new RBBB

dx:

A

Pulmonary Embolism

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10
Q

Common complication of AAA repair?

A

Mesenteric Ischemia

ischemic colitis

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11
Q

No peritoneal signs, but causes severely tender abdomen (2)

A

Mesenteric (ischemia)

Compartment Syndrome

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12
Q

Desmopressin is used to stop bleeding in (2)

A

VWB disease
Hemophilia A

Hepatic Encephalopathy

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13
Q

Genital urinary causes of acute abdomen → PEPTO

A 
Pyelonephritis
Ectopic Pregnancy (Ruptured)
Testicular/Ovarian Torsion
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14
Q

GI causes of acute abdomen → DOPA

A

Diverticulitis
Obstructed bowel
Perforated bowel (2/2 PUD)
Appendicitis

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15
Q

Cardiovascular causes of acute abdomen →

MAAAAD Tummy

A

Mesenteric ischemia
AAA rupture
Aortic Dissection

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16
Q

Biliary Pancreatic causes of acute abdomen →

it’s in the name, girl

A

Pancreatitis (Gallstone)
Cholecystitis (Cholelethiasis)
Cholangitis (Choledocolithiasis)

17
Q

GI causes of LUQ pain (2)

A

Gastric Ulcer

Splenic lac/abscess/infarction

18
Q

GI causes of LLQ pain (2)

A

Diverticulitis

IBD (Ulcerative colitis & Chrons)

19
Q

Causes of Periumbilical pain →

MAAAAD Appetizers

A

mesenteric ischemia
AAA ruptured
Aortic Dissection
Appy (early)

20
Q

Causes of Epigastric pain →

9, guess as many as you can

A 
MI
AAA ruptured
Aortic Dissection
Esophagitis
Gastritis 
pancreatitis
GERD
PUD
Mesenteric Ischemia
21
Q

infection of the ascitic fluid in the absence of any focal intraabdominal findings

A

Spontaneous bacterial peritonitis

*monomicrobial infection
Associated w/ Cirrhosis

22
Q

Cirrhotic patient’s with a recent history of an UGI bleed are at increased risk for what complication?

A

Spontaneous bacterial peritonitis

23
Q

Diffuse abdominal pain/tenderness
Fever and chills
Worsening ascites
New-onset or worsening encephalopathy

Diagnosis

A

SBP

24
Q

Diagnostics for Spontaneous bacterial peritonitis

A

Paracentesis

*neutrophil count of ≥ 250/mm3 confirms SBP

**serum-ascites albumin gradient (SAAG) > 1.1 confirms portal HTN as cause of SBP

25
Q

RUQ pain in mother can also be ____ because guts pushed up in belly

A

appendicitis

26
Q

3 Common example of referred pain →

Right shoulder pain:

A 
Cholecystitis
Liver hematoma (diaphragmatic irritation)

Pancreatitis

(L shoulder) Spleen Lac

27
Q

Common example of referred pain →

Left shoulder pain (Kehr sign):

A

hemoperitoneum

splenic rupture

28
Q

Common example of referred pain →

Left-sided chest, arm, jaw pain:

A

myocardial infarction

29
Q

Common example of referred pain →

Periumbilical pain:

A

early stages of appendicitis

then localizes to RLQ (McBurney’s point)

30
Q

Altered mental status w/ peritonitis can be a sign of hemorrhagic shock due to intra-abdominal bleeding (especially in elderly post-op pts)

Next best step in management:

A

urgent laparotomy

Surgery (36 decks)

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