Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery Shelf > Pestana Notes > Flashcards

Pestana Notes Flashcards

1
Q

Acute epidural hematoma

A

CT scan –> stat craniotomy (otherwise fatal w/in hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute subdural hematoma

A

CT scan –> craniotomy to decompress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Chronic subdural hematoma

A

CT scan –> craniotomy to decompress (spectacular improvement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Basilar skull fracture

A

CT scan & cervical Xray –> “neurosurg consult” and Abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hypovolemic shock

A 
Clinical dx (HR, BP...) --> 1. 2 lg-bore IVs, fluid rescusitation
2. Foley cath     3. IV Abx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pericardial tamponade

A

Clinical dx –> pericardial window, possible thoracotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tension pneumothorax

A

Clinical dx only!!! –> STAT thoracostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cardiogenic shock (from MI…)

A

EKG, enzymes –> Morphine, O2, Nitroglycerin sublingual, Aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Vasomotor shock (anaphylaxis)

A

Clinical dx –> vasopressors, fluids, (Histamine blockers?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Flail chest (broken ribs)

A

Paradoxical breathing –> R/o other injuries, treat w/ fluids & support to heal the lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pulmonary contusion

A

CXR initially clear, then whites out –> colloid fluid rescusitation, respiratory support & PEEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sternal fracture

A

CXR, then EKG and transesophageal echo to r/u aorta tear –> if isolated finding, pain support only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

(Occult) hematoma

A

CT; hypvolemic shock if >25% volume loss –> Ex Lap & repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Penetrating abdominal trauma wound

A

Diagnose and treat w/ Ex Lap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pelvic fracture w/ urethra or ureter damage

A

Retrograde urethrogram (NO foley!) –> surgical repair later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Posterior urethral injury

A

Clinically, a high-riding prostrate + retrograde urethrogram –> suprapubic catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Small, 3rd degree burn

A

Clinical dx –> early excision and grafting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Human bite

A

Clinical dx –> surgical exploration, washout, Abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fibroadenoma (18yo F w/ firm, rubbery mass)

A

FNA, Sonogram –> If positive for Fibroadenoma, reassure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cystosarcoma phyllodes (young F, slow-growing)

A

Incisional Bx –> margin-free resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Fibrocystic disease (lumps which come and go)

A

Cyst aspiration Bx –> resect if symptomatic and recurring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Intraductal papilloma (34yo F w/ bloody discharge)

A

Mammogram (if large) or Galactogram (if small) and Bx –> Resect if cancer ?or symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

DCIS (69yo F w/ solitary mass)

A

Calcifications on radiography, Bx –> Excision, axillary dissection, potential systematic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

LCIS (69yo F w/ solitary mass)

A

No calcifications on radiography, Bx –> Excision (possibly bilateral), axillary dissection, potential systemic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Congential glaucoma (baby with big, shiny eyes)

A

Clinical dx first –> trabeculotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Acute glaucoma

A

Clinical dx (severe HA, pupils non-reactive), IOP measurement –> Diamox, Mannitol, Pilocarpin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Orbital cellulitis

A

CT scan –> I&D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Chemical contamination of eye

A

Clincal dx (rapid!) –> immediate irrigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Barrett’s esophagus

A

Endoscopy, Bx –> Surgical correction (Nissen Fundoplication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Esophageal carcinoma

A

Barium swallow, Bx –> Surgical resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Achalasia

A

Barium swallow, Manometry study –> Nifedipine and/or botulism toxin (to relax LES)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Mallory-Weiss tear (mucusal tear at GEJ)

A

Endoscopy –> usually self-limiting bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Boerhaave’s syndrome (full-thickness tear)

A

CXR and/or CT … OR Gastrographin swallow –>

stat surgical repair! ;
prognosis depends on timing; mortality w/o repair is 100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Bladder injury

A

Blood on foley insertion (therefore injury above urethra) –> Retrograde cystogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Ruptured testicle (zounds!!)

A

Sonogram dx –> surgery if ruptured, symptomatic treatment if not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Penile fracture (receptive partner on top)

A

Clinical dx w/ penis deviating to one side –> surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Chemical spill on skin (e.g. Drano)

A

Immediate irrigation (don’t wait to arrive at the ER!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Extremity electric burn

A

Clinical dx;
deep tissue destruction –> surgical debridement
myoglobinuria causing renal dmg –> mannitol, IV fluids

39
Q

Respiratory burn

A

Bronchoscopy dx –> Respiratory support

40
Q

Cutaneous thermal burn causing eschar

A

Clinical dx w/ decreased perfusion distal to eschar –>

escharotomy

41
Q

Carcinoid syndrome

[Wheezing, flushing, diarrhea]

A

Increased urinary 5-HIAA (serotonin) –>

Somatostatin (to decrease 5-HT secretion)
Cyproheptadine (antihistamine w/ antiserotonin side effects)

42
Q

Toxic megacolon

A

Xray showing a big, darn colon!, increased Temp, increased WBC –>

decompression early, else surgical removal

43
Q

Internal hemorrhoids (bleeding)

A

Proctosigmoidoscopic examination… to r/o cancer

44
Q

External hemorrhoids (itching)

A

Proctosigmoidoscopic examination… to r/o cancer

45
Q

Perianal fissure (bright red bleeding)

A

Diagnosed usually under anesthesia –>

Sphincterotomy… but also r/o cancer

46
Q

Perianal abcess

A

Clinical dx: fluctuance, fever, high WBC –>

I&D… but also r/o cancer

47
Q

Distal small bowel bleed

A

CT angiogram b/c endoscope likely won’t reach

48
Q

Meckel diverticulum

[7yo w/ bloody bowel movements]

A

Radiolabeled Technetium scan –>

surgical correction

49
Q

Diverticulitis

A

CT scan dx –>

Bowel rest

50
Q

Acute abdomen

A

Clinical dx w/ extreme, diffuse peritoneal signs –>

Ex Lap

51
Q

Acute pancreatitis

A

Epigastric & back pain, N/V, elevated lipase/amylase –>

NPO, NG suction, IV fluids

52
Q

Acute cholecystitis

A

RUQ pain, fever, high WBC… Sonogram 1st, possible HIDA scan –>

Lap CCY

53
Q

Hepatic adenoma

[Girl on OCPs forever]

A

CT scan –>

Surgical resection

54
Q

Ascending cholangitis

A

Fever, jaundice, RUQ pain (Charcot’s triad) + CT scan (or U/S) –>

Radiological percutaneous I&D
ERCP
Abx Cipro, Metronidazole

55
Q

Aomebic abcess

A

CT scan –>

Metronidazole

56
Q

Sigmoid volvulus

A

Xray showing distended loops & obstruction –>

Proctosigmoidoscopy or rectal tube

57
Q

Congenital diaphragmatic hernia

A

Xray showing bowel in thorax –>

Wait 36-48h for neonatal circulation to improve, then perform diaphragm repair

58
Q

Meconium ileus

[3d old infant]

A

Xray shows dilated bowel loops –>

Gastrografin enema; test for CF

59
Q

Acute epiglottitis

A

Lateral xrays showing a big epiglottis! –>

Bag & mask, naso-tracheal intubation, Abx for H.flu

60
Q

Cardio: ASD

[Systolic murmur, fixed & split S2]

A

Echocardiogram –>

Surgical closure

61
Q

Cardio: VSD

[Loud systolic murmur at lower left sternal border]

A

Echocardiogram –>

Surgical closure

62
Q

Cardio: PDA

[Machine-like murmur]

A

Echocardiogram –>

Indomethacin 1st line
Surgical closure if refractory

63
Q

Cardio: Tetrology of Fallot

[Blue baby, toddler relieved by squatting]

A

Echocardiogram –>

Surgical correction

64
Q

Cardio: Aortic stenosis

[Harsh, mid-systolic murmur]

A

Echocardiogram –>

Surgical valve replacement if gradient >50mm Hg

65
Q

Cardio: Aortic regurgitation

[Diastolic murmur at lower left sternal border]

A

Echocardiogram showing LV dilation –>

Surgical valve replacement

66
Q

Cardio: Mitral stenosis

[Atrial dilation –> Afib]

A

Echocardiogram –>

Surgical repair

67
Q

Cardio: unstable angina

A

Clinical hx, coronary angiogram –>

Coronary revascularization; CABG or stents

68
Q

Pulm: non-small cell lung cancer

[Adenocarcinoma of the lung]

A

Xray for initial dx, comparing with old films if possible, then need biopsy via bronchoscopy –>

Thoracotomy/wedge resection if no mets;
FEV1 > 800 to survive post-op

69
Q

Pulm: small cell lung cancer

A

CXR, Cushing’s symptoms, biopsy via bronchoscopy –>

NO surgery; chemo & radiation

70
Q

Subclavian steal syndrome

A

Arm claudication & cerebellar symptoms; angiogram shows retrograde flow in vertebral artery –>

Vascular surgery

71
Q

Abdominal aortic aneurysm

A

> 6cm pulsatile mass, CT w/ contrast –> vascular surgery

72
Q

Transient ischemic attack

A

Angiogram or U/S –>

Carotid endarterectomy

73
Q

Ischemic stroke

A

MRI –>

tPA, thrombolytics

74
Q

Hemorrhagic stroke

A

CT –>

Surgery to clip aneurysm if present

75
Q

Brain tumor/mass

[Slow-growing, morning headaches]

A

MRI 1st choice, CT 2nd choice –>

Short-term mgmt: decrease ICP w/ mannitol and hyperventilation

Long-term mgmt: surgical correction and/or chemotherapy

76
Q

Prolactinoma

A

1st measure prolactin, 2nd do MRI –>

Bromocriptine

77
Q

Acromegaly

A

1st measure GH, 2nd do MRI –>

Surgical resection

78
Q

Pituitary Cushing’s

A

Measure 24hr urine cortisol, MRI –>

Dexamethasone suppression, surgical resection

79
Q

Foster-Kennedy syndrome (Frontal lobe mass)

[Anosmia, weird behavior]

A

MRI –>

Surgical resection

80
Q

Pineal gland tumor

[Sunset gaze]

A

MRI –>

Surgical resection

81
Q

Developmental hip dysplasia

[Baby with clicking hip on exam]

A

Physical exam (Xrays useless) –>

Abduction splinting

82
Q

Slipped femoral epiphysis (Legg-Calve-Perthes)

A

Xrays, PE showing tenderness on weight bearing –>

Casting and crutches if epiphysis has not slipped, pinning plus crutches if it has

83
Q

Septic joint

A

Tap that joint! (Aspirate); increased ESR and WBC –>

Arthrotomy to drain, Abx

84
Q

Osteomyelitis

A

Bone can (X-rays will not demonstrate for ~2 weeks) –>

Abx

85
Q

Compartment syndrome

A

PE showing pain and weak distal pulses –>

Stat fasciotomy

86
Q

Anterior shoulder dislocation

[External rotation, axial nerve damage]

A

Xrays –>

Reduce

87
Q

Posterior shoulder dislocation

A

Xrays and PE –>

Reduce

88
Q

Stress fracture

A

Clinical diagnosis only –>

Fix and wait 2 weeks

89
Q

Testicular torsion

A

PE showing tender testicle but NON-tender cord; Sonogram –>

Stat surgical correction

90
Q

Epididymitis

A

PE showing tender testicle and tender cord; Sonogram –>

Abx

91
Q

Urinary obstruction & infection

A

Clinic dx of painful urination w/ low flow; Sonogram –>

Percutaneous nephrostomy/stent, high-dose Abx

92
Q

Pyelonephritis

A

Clinical dx of fever, flank pain, dysuria –>

Abx, sonogram to r/o obstruction

93
Q

Testicular cancer

A

Clinical dx only… no need to biopsy –>

Inguinal orchiectomy

Surgery Shelf (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions