PIMP Surgery Flashcards
criteria for abdominal compartment syndrome?
Controversial, but:
- intra abdominal pressure > 20 mmHg
- evidence of abdominal organ failure, such a AKI progessing to renal failure, hepatic dysfunction
how to read an xray
A: airway, check for midline, masses, etc.
B: Bones, check for fractures, fat padding, alignment, joint spaced, etc.
C: Cardiac, check size of silhouette, mediastinal widening, ventricle enlargement, etc.
D: Diaphragm, look specifically for flattening, effusion obscuring the costophrenic angles, position
E: Effusion
F: Fields, check for infiltrates, consolidation, etc.
G: Gastric buble
H: Hilum
What is a JP drain?
Jackson-Pratt drain, placed to suction using a suction bulb for post operative management of wounds and fluid collections.
what treatments exist besides ERCP for bilar decompression?
- Percutaneous transhepatic cholangiography, where interventional radiology placed a drain through liver bile duct
- percutaneous cholecystostomy, where percutaneous drain is placed in the gall bladder
what vascular acess for patient with hematochezia?
Usually has a gastric ulcer or esophageal variceal bleed which can lead to blood loss very quickly. Obtain vascular access x2 large bore neeles for transfusion protocol
risk factors for cholecystitis or cholelithiasis
Fat, Female, Forties, and whore Fertile (pregnancy induced)
First line treatment for peripheral arterial disease?
Walking, smoking cessation, diabetes control, lipid control, blood pressure control
- walking and smoking cessation most important
- walking creates collateral circulation
most common hernia?
indirect inguinal hernia
-hernia goes through the superficial inguinal canal thus it does NOT go directly through the abdominal wall
most serious complication of cholecystectomy
(Apart from serious bleeding) is injury to the common bile duct
-duct is especially prone to stricturing, which leads to recurrent or persistent bile obstruction
diagnostic test for suspected extremity arterial embolism
Duplex ultrasound of the extremity. Cold standard is contrast arteriography
Other ways to diagnose include ABI and MRI
type of lung cancer associated with hypercalcemia?
squamous cell carcinoma
Mechanism: parathyroid hormone related peptide
symptoms of an acute ischemic limb
6 P’s
Pain, pallor, pulseless, paresthesia, poikilothermia, paralysis
main causes of fever post op
Day 1-2: Wind: atelectasis, pneumonia
Day 3-5: Water: UTI
Day 4-6: Walking: Deep Venous Thrombosis
Day 5-7: Wound: infection
Day 7+: Wonder drug: antipsychotics, lamictal, amphetamines, blood product reactions
what structures are in the portal triad?
proper hepatic artery
hepatic portal vein
common bile duct
Significance and treatment of percelain gallbladder
Caused by excessive calcium deposits in the gallbladder. Unknown exact cause.
Has an increase risk of cancer and a cholecystectomy is recommended
