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Surgery JB > Pestana's Questions > Flashcards

Pestana's Questions Flashcards

1
Q

Air Embolism

A

Intubated and on Respirator

Air in Subclavian vein (Supravicular node biopsy, central venous line placement, CVP line disconnected)

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2
Q

Fat Embolism

A 
Petechial Rash in Axilla and neck
Fever 
Tachycardia
low Platelet Count
Star field pattern on brain
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3
Q

Jersey Finger

A

Flexed finger is extended

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4
Q

Mallet Finger

A

Forcefully Flexed

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5
Q

Marjolin Ulcer

A

Squamous Cell carcinoma after chronic leg ulcer, many years of healing and breakdown such as 3rd degree burns

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6
Q

Ammonium Intoxication

A

Coma in cirrhotic patient with bleeding esophageal varices.

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7
Q

Metabolic Alkalosis

A

(Vomiting)
pH>7.4 Bicarb >25
KCl to correct problem

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8
Q

Metabolic Acidosis

A

pH<7.4 Bicarb <25
Replace bicarb, lactate or acetate
Replace K+ as part of therapy

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9
Q

Longstanding GERD

A

GI Study and biopsy

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10
Q

Rectal Bleeding

A

NG:
Green Bile - Stomach to ligament of treitz
Clear: - Nose to Pyloris

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11
Q

Acute Edematous Pancreatitis

A

Alcoholic or patient with gallstones
Pain after heavy meal, radiates to back
Elevated Serum amylase or lipase

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12
Q

Fibroadenoma

A

Firm rubbery mass that moves easily with palpation

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13
Q

Primary Hyperaldosterone

A

Adenoma or hyperplasia
Hypokalemia and Hypertension

Aldosterone levels high, renin levels low.
Response to postural changes = Hyperplasia
Lack of response = Adenoma

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14
Q

Meconium Ileus

A

Cystic Fibrosis
Bilious VOmiting, Dilated loops of small bowel
Gastrografin enema diagnostic and therapeutic

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15
Q

Vascular Ring

A

Congenital Anomaly in which trachea and esophagus are encircled by abnormal blood vessels

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16
Q

Fogerty Catheter

A

Removes Emboli

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17
Q

Basal Cell Carcinoma

A

Waxy Raised Lesion - Excise
Ulcer - Biopsy at edge

Upper part of face LIP
Does not metastasize
Requires 1mm Margin

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18
Q

Squamous Cell Carcinoma

A

Metastasize to lymph nodes
Surgical Margins 0.5-2cm
Radiation therapy

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19
Q

Melanoma

A

ABCDE

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20
Q

Right Colon Cancer

A

Bleeds

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21
Q

Left Colon Cancer

A

Obstructs

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22
Q

Amblyopia

A

Vision impairment resulting from interference with processing images

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23
Q

Strabismus

A

Correct to prevent amblyopia

Correct with glasses if later in infancy

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24
Q

Thyroglossal Duct Cyst

A

Connection between Hyoid Bone and Tongue

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25
Q

Squamous Cell Carcinoma of Mucosae

A

Old men who smoke and drink and have rotten teeth
Metastatic node in neck
Dx: Triple endoscopy looking for primary tumors (Panendoscopy)
Sx: Persistent Hoarseness, Painless ulcer in floor of mouth, unilateral earache

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26
Q

Facial nerve injury

A

Swelling will resolve spontaneously

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27
Q

Rheumatic Fever

A

Dyspnea, Orthopnea, low pitched rumbling diastolic apical heart murmur

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28
Q

Dissecting aneurysm of the thoracic aorta

A

Tearing chest pain radiates to the back
MRI Angiogram
CT Angiogram
Transesophageal Echo

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29
Q

Brachial Cleft Cyst

A

Anterior edge of sternomastoid muscle

Little opening with blind tract in skin

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30
Q

Acoustic Neuroma

A

Sensory hearing loss in one ear but not the other

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31
Q

Trigeminal Neuralgia

A

Tx with Anticonvulsants (carbamazapine) or Radiofrequency ablation

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32
Q

Acute Epididymitis

A

Severe testicular pain with sudden onset

lifting testicle helps pain

33
Q

hidradenitis

A

Debilitating chronic suppurative process involving skin and subcutaneous tissue.
Follicular occlusion & secondary rupture of sebofollicular junction
(skin to skin acne..)

34
Q

Ureteropelvic Junction Dysfunction

A

Colickly flank pain if large diuresis occurs (binge drinking) because it cannot handle large urinary output to flow

35
Q

Middle zone of neck gsw

A

Surgical Exploration

36
Q

Upper zone of neck gsw

A

arteriographic diagnosis and management

37
Q

Base of Neck GSW

A

arteriography, esophagogram (water soluable followed by barium) esophagoscoy and bronchoscopy

38
Q

Pediatric Malignant Liver Tumor

A

Mass moves up and down with inspiration

39
Q

Fluid Replacement

A

Aim for 1-2mL/kg/h

40
Q

Blount Disease

A

Tibia growth disorder causing leg to angle inward (bowleged) African American

41
Q

Pathologic Fracture

A

Suspect Malignant Bone Tumor

42
Q

Dupuytren contracture

A

Norwegian ancestry

Contracture of the palm of the hand, palmar fascia nodule

43
Q

Posterior Dislocation of the hip

A

Femur is driven backward such as knee hitting dashboard
Leg shortened, adducted, internally rotated
Can lead to avascular necrosis

44
Q

ARDS

A

Stormy complicated course, bilateral pulmonary infiltrates, no evidence of CHF.
Treat with PEEP

45
Q

Mallory Weiss

A

Prolonged forceful vomiting

Normal vomiting followed by bright red emesis

46
Q

Boerhaave

A

Forceful vomiting leading to esophageal perforation

47
Q

Squamous Cell Carcinoma of Anus

A

HIV+ Fungating mass out of anus,

Metastatic hard inguinal lymph nodes

48
Q

Infiltrating Ductal Carcinoma

A

Stage I, II: Lumpectomy with sentinel node biopsy, axillary lymph node dissection with post op radiation
Stage III+: Modified radical mastectomy with Lymph node biopsy + Sentinel node biopsy

49
Q

Malrotation

A

Double bubble + gas beyond

50
Q

Duodenal Atresia/Annular Pancreas

A

Double bubble no gas beyond

51
Q

Metastatic Malignant Melanoma

A

Bizarre unpredictable metastasis

52
Q

posterior Urethral Valves

A

newborn no urine
Voiding Cystourethrogram
tx: Endoscopic Fulguration or Resection

53
Q

Ureteral Stones

A

3mm or less will pass 70%

7mm 5% of passing - lithotripsy

54
Q

Chronic Subdural

A

Tearing venous Sinuses

Over weeks - mental status changes & hematoma forms

55
Q

Epidural

A

Uncomcios with a lucid interval
Fixed Dilated Pupils
Uncal Herniation
Lens Shaped

56
Q

Anterior Cord

A

Burst Fracture

loss of pain & temp

57
Q

Central Cord

A

Forced Hyperextension

Paralysis & Burning in Upper

58
Q

Hemi Section

A

paralysis & loss of proprioception distal

contralateral loss of pain

59
Q

Slipped Capital Femoral Epiphysis

A

Chubby kid groin or knee pain limping, sole of foot points towards the other foot

60
Q

Developmental Dysplasia

A

Uneven gluteal folds, hips show easily dislocated.

61
Q

Anterior dislocation of shoulder

A

Hold arm close to body rotated outward

AP & Lateral XR

62
Q

Posterior dislocation of shoulder

A

Epileptic seizures
Hold arm close to body internally rotated
Axillary view or scapular lateral

63
Q

Ankle Fractures

A

Open reduction and internal fixation

64
Q

Lumbar Disc Herniation

A

Discogenic: Vague Achy (Anterior spinal ligament)
Neurogenic: Electric Shock to leg

65
Q

Morton Neuroma

A

Inflammation of common digital nerve at 3rd interspace
Pointed shoes
Tx: Indomethacin, Colchicine, Allopurinol, probenicid

66
Q

Malignant Hyperthermia

A

After Halothane or succinylcholine
Tx: Dantrolene O2,
Watch for Myoglobinuria

67
Q

Hypernatremia

A

3mEq/L above 140 = 1L water loss

D5 1/2 NS or D5W

68
Q

Meckel Diverticulum

A

Technetium scan looking for ectopic gastric mucosa

Blood per rectum in child

69
Q

Cystosarcoma Phyllodes

A

Late 20’s
Grow very large replacing entire breast
Fibroepithelial Tumor

70
Q

Necrotizing Enterocolitis

A

Premature infants with feeding intolerance, abdominal distention, dropping platelet counts
Tx: Surgical if abdominal wall erythemia or pneumatosis

71
Q

Eye Burn

A

triple antibiotic ointment

72
Q

Hemodynamically stable abdominal wound

73
Q

Acute Kidney Rejection

A

First line: steroid boluses, antilymphocytic agents (OKT3)

74
Q

Ogilvie

A

Paralytic ileus of colon
Abdominal distention, dilated colon,
Tx: Fluid and electrolyte & Colonoscopy to remove air

75
Q

Hirschprung

A

Chronic constipation in a child
Distended proximal colon,
Dx with full thickness biopsy of rectal mucosa.

76
Q

Atrial Septal Defect

A

Pulmonary flow, fixed split

Frequent colds

77
Q

Ependymoma

A

Pediatric brain tumor

Children assume knee chest position to open flow to CSF to relieve their headache

78
Q

Cystic Hygroma

A

CT scan to see how deep

79
Q

Branchial Cleft Cyst

A

Mushy Fluid filled mass at base of neck

Surgery JB (6 decks)

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