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$$MS3 > Pastana surgery > Flashcards

Pastana surgery Flashcards

1
Q

Difference between tracheostomy and cricothyroidotomy?

A

Cricothyroidotomy is faster and easier to perform

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2
Q

Base of the skull fracture management?

A

CT of the cervical spine/avoid nasal ET tube

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3
Q

Pt who is on respirator suddenly died, what causes it?

A

Air embolism

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4
Q

What to do for hemodynamically stable and unstable pt who you are suspecting of intraabdominal bleeding?

A

Stable - CT

Unstable - FAST scan - OR

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5
Q

What happens if you give the pt too much fluid and blood in a long surgery?

A

Abdominal compartment syndrome - wound can be closed - use absorbable mash

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6
Q

If an injury has occurred to the bone, vasculature and the nerve, whats the order of fixing it?

A

Bone - vessels - nerve

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7
Q

How to manage circumferential burn?

A

Escharotomy

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8
Q

What are the topical agents for burned pts?

A

Silver sulfadiazine/mafenide acetate (causes acidosis)

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9
Q

Sign of envenomation?

A

Local pain/swelling/discoloration

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10
Q

Meds for black widow and brown recluse spider bites?

A

Black widow - IV Ca gluconate

Brown recluse - dapsone

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11
Q

What motion is limited in slipped capital femoral epiphysis?

A

Internal rotation

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12
Q

When is genu valgus (knock knee) normal?

A

between age 4-8

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13
Q

Old folks vs. young ppl who fall on out stretched hands?

A

Old folks - Colles fracture of the distal radius “dinner fork”
Young - scaphoid fracture - pain at “snuffbox”

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14
Q

What post op caution should be taken for intertrochanteric fracture?

A

Anticoagulation for DVT ppx

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15
Q

Tx for achilles tendon rupture?

A

Equinus cast/surgery (quicker)

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16
Q

Sign for compartment syndrome of lower legs?

A

Excruciating pain with passive extension

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17
Q

What is the tx for jersey and mallet finger?

A

Splinting

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18
Q

The back pain from herniated disc is exacerbated by what?

A

Coughing/sneezing/pooping

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19
Q

Which finding is the worst indicator for preoperative cardiac risk?

A

JVD

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20
Q

How long should you stop smoking before a surgery?

A

2 months

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21
Q

Pt is more difficult to “bag”/decrease BP/CVP goes up during surgery, what is it?

A

Tension pneumothorax

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22
Q

What is the first thing to think for a post op pt that becomes confused?

A

Hypoxia - give O2

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23
Q

Management of ogilvie syndrome?

A

NPO/NG tube/colonoscopic decompression

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24
Q

Two causes of hyponatremia?

A

SIADH/loss of isotonic fluid (body retain water)

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25
Q

C Diff not responsive to tx, what’s next step?

A

Total colectomy

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26
Q

What causes amblyopia?

A

Congenital impairment of one eye causes cortical blindness (e.g result of strabismus)

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27
Q

Topical tx for anal fissure?

A

Topical nitro/CCB

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28
Q

Anal fissure that fails to heal after surgical intervention suggests what?

A

Crohn’s disease

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29
Q

Perirectal abscess can eventually leads to what?

A

Fistula

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30
Q

Test for active lower GI bleed?

A

Angiogram (large bleed)/tagged RBC study (intermediate)/wait till it stops (low amount of bleed)

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31
Q

Massive upper GI bleed from a trauma pt, what is it and what tx?

A

Stress ulcer/angiographic embolization

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32
Q

Tx for sigmoid volvulus?

A

Flexible sigmoidoscopy

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33
Q

Ascending cholangitis complication?

A

Pyogenic liver abscess

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34
Q

Tx for breast cancer during pregnancy

A

Surgery right away
NO radiationtherapy/hormone therapy
NO chemo first trimester

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35
Q

Total mastectomy equals lumpectomy + ____?

A

radiation therapy

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36
Q

What is nesidioblastosis?

A

Hyperinsulinemia in newborns

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37
Q

Appropriate postural response of aldosterone?

A

Standing up - increase RAAS - increase aldosterone

Lying down decreases them

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38
Q

What is VACTER?

A

Congenital anomalies

Vertebral/anal/cardiac/TE fistula/renal

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39
Q

What is the diagnosis with an infant whose testicle is in the canal and can be easily brought down?

A

Overactive cremasteric muscle (normal)

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40
Q

How soon should exstrophy of the bladder be fixed?

A

within 1 or 2 days

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41
Q

What is the diagnosis with a infancy whose testicle is in the canal and can be easily brought down?

A

Overactive cremastic muscle (normal)

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42
Q

Infant has respiratory difficulty relieved by hyperextension of the neck

A

Vascular ring

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43
Q

What kind of valve disease is associated with Austin Flint murmur?

A

AR

Mid diastolic murmur heard best at cardiac apex

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44
Q

How do measure right and left atrial pressure?

A

Central venous pressure - right atrial pressure

Pulmonary capillary wedge pressure - left atrial pressure

45
Q

Tx for small cell lung cancer

A

Chemoradiation therapy only

46
Q

What is subclavian steal syndrome?

A

Stenotic plaque at origin of subclavian artery - blood supply to arm is intact for normal activity but when exercise - arm steals blood from vertebral artery from the brain to supply arm - arm claudication and posterior neurological symptoms such as visual and equilibrium symptoms

47
Q

What does it mean if a AAA is tender?

A

it is about to rupture in a day or two

48
Q

Management of ascending and descending aortic dissection?

A

Ascending - surgical repaire

Descending - medical management of HTN

49
Q

What does a negative FNA result mean? and when can’t we do FNA?

A

Negative FNA means nothing - mean better bx

Two situation - hemangioma of the liver/testicular mass

50
Q

What is the MC type of skin cancer?

A

Basal cell carcinoma (50%) and then SSC and then melanoma

51
Q

What is Mohs surgery?

A

Take out cancer in the face layer by layer

52
Q

Difference between basal and SSC of skin cancer?

A

Basal - local invasion

SSC - spread to lymph nodes

53
Q

What is it that a parent say his child didn’t have strabismus from birth but got it later in infancy?

A

Exaggerated convergence caused by refraction difficulties

Corrected by lenses right away

54
Q

What to give pt with acute angel closure glaucoma while he is waiting for surgery?

A

Systemic carbonic anhydrase inhibitor

Topical beta blocker/alpha 2 agonist

55
Q

Zone of floaters, what is it?

A

Retinal detachment

56
Q

Which neck cyst locates at the anterior edge of sternomastoid muscle?

A

Branchial cleft cyst

57
Q

Tx for little kid with nose bleed

A

Anterior septum bleed

Phenylephrine spray and local pressure

58
Q

tPA can be used for up to how long of a stroke?

A

3 hours

59
Q

What’s another name for IGF-1?

A

Somatomedin C

60
Q

If a kid is in a knee chest position whenever he’s having a headache, what is it?

A

Ependymoma

61
Q

New born boy that can’t pee, what could be the problem?

A

Posterior urethral valve

62
Q

Tx for kids with vesicoureteral reflux

A

Long term abx till they grow out of it

63
Q

Workup for hematuria

A

CT (look for kidney problems) and cystoscopy

64
Q

Pt have post op incontinence, what is it?

A

Post op urinary retention

65
Q

Time line for hyperacute, acute and chronic transplant rejection

A

Hyperacute - right after organ is resupplied
Acute - within 3 months
Chronic - years

66
Q

What cardiac complication can a young drug addict develop?

A

Aortic regurgitation (sudden HF)

67
Q

What is vasomotor shock?

A

From anaphylactic or spinal transection injury

CVP is low and pt is pink and warm and needs pressor

68
Q

Linear skull fracture w/o scalp wound, what to do?

A

leave it alone

69
Q

Management of acute subdural and epidural hematoma

A

Epidural - craniotomy

Subdural - craniotomy only if midline shift - otherwise medical management

70
Q

Rib fracture tx for elderly

A

Nerve block and analgesia by epidural catheter

71
Q

Management for gunshot wounds

A

If below level of nipple - exploratory surgery

72
Q

Management for pt who is bleeding a lot during prolonged trauma surgery

A

FFP/platelet transfusion

If hypothermia then stop surgery and warm him up

73
Q

extremity gun shot wound - no distal pulses, what to do next?

A

Surgery

74
Q

Under what circumstances can you do immediate skin graft on a burn pt?

A

When the burn is limited and 3rd degree

75
Q

Medical management of broken clavicle

A

Sling

76
Q

How does GI fistula manifest after abdominal wound closure after abdominal surgery

A

Drain into a pool and cause sepsis

Drain freely cause electrolyte/fluid loss/erode abdominal wall

77
Q

Tx for meconium ileus

A

Gastrografin enema

78
Q

Arterial embolization to extremity, what is the management for partial and complete obstruction?

A

Partial - tPA

Complete - embolectomy (Fogarty catheter)

79
Q

Surgical tx for mitral stenosis and regurg

A

Commissurotomy

Annuloplasty

80
Q

How to determine if pneumonectomy can be done?

A

Pul function evaluation

Extend of metastasis

81
Q

How long does amblyopia take to develop?

A

6-7 years

82
Q

What kind of chemotherapy is for testicular cancer?

A

Platinum based (-platin)

83
Q

Management approach to upper neck penetrating trauma

A

Arteriogram

84
Q

Post op pt develops bilateral pul infiltrate and hypoxia. What is it and what is the tx

A

ARDS

PEEP

85
Q

Penetrating urologic injury causing hematuria, what is the next step of work up?

A

Surgical exploration

86
Q

Infant with a palpable abdominal mass that moves up and down with inspiration, what is it?

A

Malignant liver tumor

87
Q

Best way to bx breast masses?

A

Mammography or U/S guided core bx

88
Q

What is the goal urinary output with burn pt?

A

1 or 2 ml/kg/hr

89
Q

Old woman who has pathologic fracture (like lifting a heavy bag and then broke her arm) suspect?

A

Metastatic bone cancer

90
Q

When does dehiscence typically occur post op

A

Day 5

91
Q

Newborn with bilious vomiting, double bubble sign on x ray, what could it be? And what is it if I tell you that the rest of the bowel has normal gas pattern?

A

Annular pancreas/malrotation/duodenal atresia

Malrotation

92
Q

What’s the purpose of Cushing reflex

A

Increase BP to overcome increased ICP to maintain brain perfusion

93
Q

Pt who had otitis media mastoiditis later develop fever, headache, blurred vision and seizure, think?

A

Brain abscess

94
Q

How small the kidney stone can be spontaneously passed?

A

Under 3mm

95
Q

What can be caused by hyper extension of the neck and what is its symptoms?

A

Central cord syndrome

Paralysis and burning pain upper extremities and no problem at lower extremities

96
Q

What study is needed to assess bladder injury

A

Retrograde cystogram with post void film

97
Q

What kind of fluid is used for pt with hypernatremia secondary to severe dehydration?

A

D5 1/2 saline

98
Q

What kind of fluid is used for pt with hyponatremia from rapid water intoxication?

A

hypertonic saline (3 or 5%)

99
Q

a late 20s woman has a mass in her breast that has been growing into a big mass over years, what is it? Is it malignant?

A

Cystosarcoma phyllodes

Usually not

100
Q

What management does very ill baby with congenital diaphragmatic hernia needs?

A

Extracoporeal (outside of the body) membrane oxygenation - like hemodialysis but for lungs

101
Q

An infant with sudden drop in platelet count and air in portal vein, what is it?

A

Necrotizing enterocolitis

102
Q

What should you put topically around the burn nears the eyes on a burn pt?

A

Triple abx ointment

103
Q

Dx for appendicitis

A

CT

104
Q

Tx for Oligivie syndrome?

A

Fluid and electrolyte correction/then colonoscopy to suck out all the air

105
Q

Pt has GI bleed. NG has bloody gastric content and whats the next step?

A

Endoscopy

106
Q

Doppler is the same as ___ when diagnosing peripheral artery disease

A

ABI

107
Q

Child with a brain tumor is in a hands and knees position, what kind of tumor is it?

A

Posterior fossa tumor (meduloblastoma or ependymoma)

Child is attempting to open up the CSF passage to relieve the headache

108
Q

Dx for acute mesenteric ischemia

A

Angiography

$$MS3 (8 decks)

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