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Surgery Shelf > Pestana > Flashcards

Pestana Flashcards

1
Q

Patient with bad, breath, smoker and alcohol use, firm cervical lymph node

A

squamous cell carcinoma

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2
Q

Man wakes up at night seeing floaters, bright flashes of light, and blurrying

A

Retinal detachment

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3
Q

70 yo man comes in with posterior nose bleed

A

hypertensive nose bleed (posterior pack/surgery)

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4
Q

Kid comes in with chemical burn of eye, the two major steps in treatment are

A

irrigation and pH testing prior to discharge

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5
Q

Elderly patient suddenly loses vision in one eye

A

Retinal embolic occlusion

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6
Q

60 yo man with hgbA1c of 8.5 has to squint to see TV

A

diabetic retinopathy

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7
Q

Pt with hold, swollen, tender eyelids, fever and fixed/dilated pupils

A

Orbital cellulitis

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8
Q

Mushy, ill-defined mass at base of neck that seems to go deeper (first step in surgical planning)

A

cystic hygroma, CT scan

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9
Q

young person with multiple enlarged lymph nodes and fevers/night sweats

A

lymphoma

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10
Q

recently discovered enlarged lymph node, next step?

A

f/u in 3-4 weeks

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11
Q

two most common causes of epistaxis in 20’s-30’s and treatment

A

septal perforation from cocaine, juvenile nasopharyngeal angiofibroma (posterior packing; surgery)

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12
Q

Patient with chronic sinusitis presents with double vision, what is dx and tx

A

cavernous sinus thrombosis, IV abx, CT scan, drainage

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13
Q

Man wakes up in morning with full facial dropping

A

Bell’s palsy

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14
Q

Large abscess at floor of mouth, dx and tx

A

Ludwig’s angina, threat to airway: I/D but also might intubate

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15
Q

Gradual unilateral numbness/paralysis of forehead and face, best diagnostic test

A

facial nerve tumor, gadolinium enhanced MRI

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16
Q

Hard painful lump in front of ear, producing facial paralysis

A

partoid tumor

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17
Q

Painless, visible lump in front of ear,

A

benign parotid tumor

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18
Q

Patient comes out of movie theatre and has severe front headache/eye pain, sees halos, fixed/dilated pupil

A

acute angle glaucoma

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19
Q

Two causes of white pupil in baby, tx

A

retinoblastoma, congenital cataract: surgical removal

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20
Q

IV drug user with holosystolic tumor that increases with inspiration

A

Endocarditis (tricuspid regurg)

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21
Q

S4 when patient is lateral decubitus position

A

Causes of hypertrophy (HOCM, aortic stenosis)

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22
Q

POD4 from perforated appendicitis and patient has . WBC of 15,000, what imaging test to we order?

A

CT scan to evaluate abscess

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23
Q

3 causes of low serum K+

A

renal losses, GI losses, increased potassium into cells (alkalosis, epinephrine)

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24
Q

FiO2 levels below __ % are considered safe

A

60

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25
Q

Goal PaO2 when intubated patient

A

55-80

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26
Q

Obstructive lung pattern (FEV1/FVC<80) with DLCO (low, normal, high)

A

low: COPD/emphysema, normal: chronic cronchitis, high: asthma

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27
Q

Causes of low DLCO with normal FEV1/FVC

A

anemia, pulmonary embolism, pulmonary hypertension

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28
Q

Immunosuppressed person with fever, chest pain and hemoptysis, RUL consolidation with ground glass apperance

A

invasive aspergillosis

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29
Q

3 years of difficulty swallowing solids and liquids, regug, mild weight loss that improves when standing up.

A

Achalasia

30
Q

Smoker and alcohol drinker with dysphagia to solids and now liquids, as well as 20 lb weight loss

A

Esophageal cancer

31
Q

5 days after cardiac catheterization, patient has AKI, eosinophilia, bilateral purple mottling of skin

A

cholesterol embolization

32
Q

Young man with acute left-sided chest pain, anxious and agitated, dilated pupils, ST segment depression and T-wave inversion, normal troponin. Dx and tx?

A

Dx: cocaine use, tx: IV diazapem

33
Q

Valve most commonly involved in IV-drug use endocarditis

A

tricupsid valve

34
Q

Patient present with chronic dysphagia (leading to aspiration), week of fever, chest pain and productive cough. X-ray shows cavity with air fluid level

A

Lung abscess.

35
Q

Pleural effusion has low pH and low glucose, high LDH, high protein

A

Empyema

36
Q

Large, loculated effusion in person with HIV dx/tx?

A

Dx: empyema, tx: long course of abx and chest tube

37
Q

Blunt abdominal trauma, 3+ rib fractures, R chest moves insward on inspiration

A

Flail chest

38
Q

Woman with no smoking history, 10 lb weight loss, hemoptysis, small (2.5 cm) irregular lesion in periphery of RUQ

A

adenocarcinoma

39
Q

Man with long smoking history, hypercalcemia (with low phosphate) hemoptysis, cavitary, necrotic lung lesion

A

Squamous cell carcinoma

40
Q

Patient with hemoptysis of >x ml per day or x ml per hour, requires intubation

A

600 per day, 100/hr, or massive hemoptysis, respiratory distress, etc

41
Q

Man trapped in a burning building, has stridor, singed eyebrows and carboxyhgb of 30%. Next step in tx

A

Endotracheal intubation

42
Q

Lung nodule greater than x cm requires additional f/u and surveillance

A

0.8

43
Q

0.8 cm solitary lung nodule in 50 yo non-smoker with no symptoms. Appropriate management is..

A

F/U CT in 3 months

44
Q

10 lb weight loss, night sweats, firm lymph nodes in cervical and axillary chains in a young person

A

hodgkin’s lymphoma

45
Q

Anterior mediastinal mass with beta-hcg and AFP expression, next diagnostic step

A

nonseminomatous germ cell tumor, FNA/testicular ultrasound

46
Q

Anterior mediastinal mass with beta-hcg expression only

A

seminomatous germ cell tumor

47
Q

young person with blistering of back skin and proximal muscle weakness (ptosis) who has a lump in the neck

A

thymoma

48
Q

Antibiotic of choice for homeless man with poor dentition, alcohol abuse, history of aspiration pneumonia with cavitary lesion in RUQ

A

Clindamycin (lung abscess growing anaerobic bacteria)

49
Q

treatment for a prolactinoma

A

bromocriptine (dopamine agonist) or trans-sphenoidal surgery

50
Q

thunger clap headache and nuchal rigidity dx/tx

A

subarachnoid hemorrhage, MRI and clipping/coiling of anuerysm

51
Q

small kid with headaches, bitemporal hemianopsia

A

craniopharyngioma

52
Q

loss of upward gaze, tumor

A

pineal tumor

53
Q

Person with two week history of otitis media, presents with new headache, fever, and papiledema, enhancement on CT scan

A

brain abscess

54
Q

tx of trigeminal neuralgia (shooting, lightening-like pain with light touch)

A

anti-convulsants (lamotrigine, gabapentin (RFA if fails)

55
Q

tx of extreme pain coming from a cold extremity that sustained a crush injury months ago

A

sympaphectomy (diagnosis is relief of symptoms from sympathetic nerve block)

56
Q

Best imaging for diverticulutis

A

CT scan w/ IV contrast

57
Q

Diverticulitis cutoffs for drainage or elective surgery

A

> 3 cm=drainage, <3 cm or unresolving=elective surgery

58
Q

Patient with gastric cancer undergoes gastrectomy, weeks ago and is now experiencing abdominal pain, diarrhea and nausea 20-30 mins after eating. What is next step in management?

A

Clinical dx: Dumping syndrome (hyperosmotic dumping). Diet changes (complex carbs, smaller meals), if that fails then would consider ocreotide and/or surgery

59
Q

Person with IBD or c. dif who has fever, hypotension, tachycardia and diffuse tenderness/distension of abdomen. Dx/best imaging study

A

Toxic megacolon, abd xray

60
Q

Diabetic man has a boil removed from his leg 2 weeks ago (or with ibd), now presents with 7 days of lower abdominal/groin pain, normal bowel sound, pain with hip extension and not with flexion

A

Psoas abscess

61
Q

Acute pancreatitis following cardiac cath procedure is most likely due to

A

cholesterol emboli (can also cause AKI and livedo reticularis)

62
Q

Tx of acute pancreatitis

A

IV fluid, and supportive care (pain control and NPO)

63
Q

45 yo man with epigastric pain, diarrhea, weight loss, severe PUD. Dx?

A

Zollinger-Ellison (gastrinoma) Dx: endoscopy, gastrin concentration

64
Q

65 yo woman with aortic stenosisCKD, and painless dark maroon-colored stools

A

Angiodysplasia (painless venous bleed)

65
Q

Patient after AAA repair presents with sudden onset abdominal pain followed by rectal bleeding/diarrhea within 24 hrs

A

Ischemic colitis (best test is flexible sigmoidoscopy)

66
Q

young woman with dysphagia and pain radiating to back, triggered by stress or hot/cold foods, relieved by nitroglycerin

A

Esophageal spasm

67
Q

preferred imaging for acute mesenteric ischemia in early stages

A

CT angiography

68
Q

Old person with afib presents with acute abdominal pain and rectal bleeding

A

Acute mesenteric ischemia

69
Q

Young woman’s CT scan shows well-circumscribed mass on liver, with increased arterial flow and central scar

A

focal nodular hyperplasia

70
Q

Young female hospital worker hypokalemia and metabolic alkalosis with brown mucosa on colonoscopy

A

Laxative abuse

71
Q

Patient with new onset diabetes, diarrhea, annular/red erosions with blisters over lower abdomen

A

Glucagonoma

72
Q

Diarrhea, flushing of face, wheezing and eleveated JVP. Diagnostic test?

A

Carcinoid syndrome, 5-hydroxyindeoleacetic

Surgery Shelf (2 decks)

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