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Surgery > MTB 2 > Flashcards

MTB 2 Flashcards

1
Q

MC procedure that causes esophageal perforation?

A

Endoscopy

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2
Q

Most accurate test for esophageal perforation?

A

Esophogram w/diatrizoate meglumine and diatrizoate sodium sol’n (Gastrografin)

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3
Q

Do we use barium in esophageal perforation?

A

No. Can be caustic.

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4
Q

Complication w esophageal perforation w high mortality rate?

A

Mediastinitis

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5
Q

How do hemorrhagic ulcers present?

A

Hematemesis - coffee ground emesis

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6
Q

Acute, progressive worsening abdominal pain that radiates to right shoulder?

A

Gastric perforation

- acid irritation of phrenic nerve

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7
Q

Guarding, rebound tenderness, abdominal rigidity?

A

Gastric perforation

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8
Q

Treatment gastric perforation?

A
  1. NPO
  2. NG tube to suction 4L gastric juices
  3. IV normal saline and broad spectrum Abx
  4. Surgically repair perforation
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9
Q

Best initial test for Gastric perforation?

A

Upright CXR - free air under diaphragm

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10
Q

Most accurate test for Gastric perforation?

A

CT scan

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11
Q

Risk factors for gastric perforation

A 
Ulcer Dz
NSAIDs
H.Pylori
Burns
Head injury
Trauma
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12
Q

What can occur with a posterior stomach ulcer?

A

Pancreatitis - acid leaks out the back of stomach, damaging pancreas

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13
Q

Most accurate test for appendicitis?

A

CT

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14
Q

Tx for appendicitis?

A

Laparascopic surgery

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15
Q

Complications with appendicitis?

A

Abscess formation

Gangrenous perforation

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16
Q

Best test for acute pancreatitis

A

CT

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17
Q

Tx for acute pancreatitis

A

IVF

NPO until sx’s resolve

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18
Q

Complications with acute pancreatitis

A

Hemorrhagic pancreatitis

Pseudocyst

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19
Q

Best initial test for diverticulitis?

A

CT

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20
Q

Most accurate test for diverticulitis?

A

CT

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21
Q

Complications with diverticulitis?

A

Abscess formation

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22
Q

What tests do we avoid in diverticulitis?

A

Barium enema (Endoscopy)
colonoscopy
Risk of perforation

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23
Q

Most accurate test for cholecystitis?

A

HIDA scan

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24
Q

Complications with cholecystitis?

A

Perforation of GB

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25
Q

Treatment for cholecystitis?

A

Laparascopic surgery

Open surgery if perforation

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26
Q

What does US show for cholecystitis?

A

Pericholecystsic fluid, GB wall thickening, stones in GB

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27
Q

Two emergent conditions ass’d with abdominal pain radiating to back?

A

Pancreatitis

Aortic Dissection

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28
Q

What is seen on HIDA with cholecystitis?

A

Delayed emptying of GB in acute cholecystitis by failure to visualize GB from isotope accumulation

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29
Q

What is seen with Small Bowel Obstruction?

A

Failure to pass stool, flatus, complete absence of bowel sounds

30
Q

N/V, abdominal pain w/hyperactive bowel sounds?

A

SBO

31
Q

What is the most common causes of SBO?

A

Previous abdominal surgery

32
Q

What are the two types of obstruction?

A

Partial - small amt of GI contents pass

Complete - no GI contents pass

33
Q

High pitched “tinkling” in abdomen?

A

Intestinal fluid and air are under high pressure in the bowel

34
Q

Bowel obstruction si/sx’s?

A 
Severe waves of  intermittent crampy abdominal pain
N/V
Fever
Hyperactive bowel sounds
"tinkling"
Hypovolemia - third spacing
35
Q

What are causes of bowel obstruction?

A 
Adhesions - previous surgery
Hernias
Crohn Dz
Neoplasms
Intussusception 
Volvulus
Foreign bodies
Intestinal atresia
Carcinoid
36
Q

Hallmark sign for bowel obstruction?

A

Elevated lactate w/marked acidosis

37
Q

Best initial test for Bowel obstruction?

A

Abdominal Xray

38
Q

Multiple air-fluid levels w/dilated loops of small bowel?

A

SBO

39
Q

Most accurate test for bowel obstruction?

A

CT scan of abdomen

40
Q

CT shows transition zone from dilated loops of bowel w/contrast to area of bowel with no contrast?

A

SBO

41
Q

Treatment for SBO?

A
  1. NPO
  2. NG tube to help decompress bowel
  3. IVF
  4. OR for emergent surgical resection
42
Q

When is a closed reduction done?

A

Mild fractures w/out displacement

43
Q

When is an open reduction and internal fixation done?

A

Severe fractures w/displacement or misalignment of bone pieces

44
Q

What is tx for open fractures?

A

Skin must be closed and bone set in OR w/debridement

45
Q

What is a comminuted fracture?

A

Fx where bone is broken into multiple pieces

MCC - crush injury

46
Q

What causes a stress Fx?

A

Repetitive insults to bone

Athlete w/persistent pain

47
Q

When is CT or MRI needed in Fx?

A

Stress Fx

48
Q

What is the Tx for stress Fx?

A

Rehab
Reduced physical activity
Casting

49
Q

When do we see a compression Fx?

A

Specific fx of vertebra in osteoporosis

50
Q

What is a pathologic Fx?

A

Fx from minimal trauma to bone

weakened by dz

51
Q

Older person fractures a rib from a cough - what type of Fx?

A

Pathologic Fx

52
Q

Tx for pathologic fx?

A

Surgical Realignment of bone

53
Q

What is an open Fx?

A

Broken bone pierces the skin

High rates of bacterial infxn to local skin

54
Q

What is tx for open Fx?

A

Surgery

55
Q

Pt presents w/fall on outstretched hand, tenderness in anatomic snuffbox?

A

Scaphoid Fx

56
Q

What is Tx of Scaphoid Fx?

A

Wrist immobilization for 6-10 weeks if non displaced

Thumb spica cast

57
Q

When does Penile Fx occur?

A

Crush injury of erect penis
MC during sex w/woman on top
Tunica albunigea tears
Rapid hematoma formation

58
Q

What is the Tx for Penile Fx?

A

Emergent retrograde urethrogram to asses urethral injury and emergent surgery to evacuate hematoma, mend torn tunica albunigea

59
Q

MC shoulder dislocation?

A

Anterior

60
Q

Cause of anterior shoulder dislocation?

A

Injury that strains glenohumoral ligament

61
Q

Pt presents with arm held to the side w/externally rotated forearm w/severe pain?

A

Anterior shoulder dislocation

62
Q

Best initial test for shoulder dislocation?

A

Xray

63
Q

Most accurate test shoulder dislocation?

A

MRI

64
Q

Tx for anterior shoulder dislocation?

A

Shoulder relocation and immobilization

65
Q

Cause of posterior shoulder dislocation?

A

Seizure

Electrical burns

66
Q

Pt presents with arm medially rotated and held to the side?

A

posterior shoulder dislocation

67
Q

Tx for posterior shoulder dislocation?

A

Traction and surgery if pulses or sensation and diminished during PE

68
Q

Cause and Tx for clavicular fx?

A

Trauma

Simple arm sling

69
Q

What is trigger finger?

A

Stenosis of tendon sheath

Acutely flexed and painful finger

70
Q

Tx for trigger finger?

A

Steroid injections

If persistent - surgery to cut sheath

71
Q

What is Dupuytren contracture?

A

Men
> 40 yoa
Palmer fascia is constricted and hand cannot be extended

72
Q

Tx for Dupuytren contracture?

A

Surgery

Surgery (2 decks)

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