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Surgery > Pre-Test (Skin and friends, Trauma, Transplant/Immunology/Oncology) > Flashcards

Pre-Test (Skin and friends, Trauma, Transplant/Immunology/Oncology) Flashcards

1
Q

Nerve that innervates most of the intrinsic muscles of the hand

A

Ulnar nerve

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2
Q

Nerve involved with extension of wrist

A

Radial

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3
Q

Margins of excisions for melanoma

A

4 mm- 3 cm margin

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4
Q

Frostbite tx

A

Rapidly warming by immersion in water slightly above normal body temp (40-44 c)

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5
Q

Another name for SCC form chronic skin wound

A

Marjolin ulcer

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6
Q

Silver nitrate AE

A

Hyponatremia and hypokalemia

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7
Q

Silver sulfa AE

A

Neutropenia

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8
Q

Most common malignant tumor of the lip

A

SCC (esp lower)

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9
Q

What do composite tissue grafts contain

A

Tissue in addition to dermis/epidermis

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10
Q

How long should a clean would be present before it should no longer be closed

A

6 hours

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11
Q

Tx for a trauma pt with a seatbelt sign

A

Worried for enteric or mesenteric injury, the patient should be held and observed regardless of test results

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12
Q

Surgical treatment of choice for a ruptured vein in an unstable patient

A

Ligation, rather than repair

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13
Q

CT scan sensitivity for penetrating abdominal trauma

A

Low, good for blunt abdominal trauma

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14
Q

Insulin levels after acute trauma? BS levels?

A

Shot drop in insulin followed by a significant rise

Still hyperglycemia due to elevated insulin resistance

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15
Q

Best surgery for common bile duct transection in stable patient? Unstable?

A

Stable: Roux-en-Y choledochojejunostomy
Unstable: T tube placement

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16
Q

Absolute indications for surgical neck exploration

A

Acute signs of airway distress (stridor, hoarseness, dysphonia)
Visceral injury (sub-q air, dysphagia, hemoptysis)
Hemorrhage
Neuro signs referable to carotid injury (stroke, AMS)

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17
Q

Duodenal obstruction following BAT likely? Management?

A

Likely a duodenal hematoma

Mgt conservative: NG tube and observation

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18
Q

Blunt carotid artery injuries should be treated with?

A

Full systemic anticoagulation in the absence to any contraindications to prevent stroke

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19
Q

Cushing triad in inc ICP

A

Hypertension
Bradycardia
Irregular respirations

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20
Q

What nerve innervates most of the flexors of the hand? What else does it get

A

Medinan nerve, also gets pronator muscles of forearm and lots of hand sensation

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21
Q

Two good ionotropes for cariogenic shock

A

Dobutamine and Dopamine

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22
Q

Why are popliteal artery injuries associated with knee dislocations?

A

Extreme force required to dislocate the joint

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23
Q

Nitrogen balance in sepsis

A

Negative, due to breakdown and increased urinary loss

24
Q

What should be requested for suspected colonic perf?

A

CT abdomen

25
Q

When is surgery indicated in orbital trauma

A

Enopthalmos greater than 2mm
Diplopia on primary or inferior gaze
Entrapment of EOM
Fracture greater than 50% of orbital floor

26
Q

What happens to the Lactate in LR solutions

A

Metabolized to HCO3 in the liver –> helps correct metabolic acidosis

27
Q

Mgmt of low grade renal injuries

A

Strict bed rest for 24-72 hours with serial Hgb levels

28
Q

Tx for injury of major pancreatic duct to left left of the mesenteric vessels

A

Distal prancreatectomy

29
Q

In absence of sepsis, management of patients with enterocutaneous fistulas

A

Bowel rest, TPN, and correction of electrolyte abnormalities

30
Q

initial management of extraperitoneal bladder injuries

A

Initial catheter drainage followed by repeat imaging to confirm healing

31
Q

Pos DPL criteria

A

10cc gross blood
> than 100,000 ul RBC
> 500 uL WBC
Elevated amylase, bili, or alk phos

32
Q

First step in treating neurogenic shock? Then?

A 
Restore volume (Normal CP is 2-6)
Then vasoconstrictors
33
Q

Ideal tx of pericardial tamponade from trauma

A

Pericardiocentesis under local anesthesia in the OR (that way able to surgically explore after)

34
Q

Guidelines for thoracotomy in hemothorax patients

A

> 1500 mL of immediate drainage or >200 mL/h for several hours after

35
Q

Pulmonary contusion def

A

hemorrhage and edema of the lung parenchyma without parenchymal disruption

36
Q

Initial tx of open tension pneumothorax

A

Place occlusive dressing over the defect

37
Q

What makes TNF

A

Monocytes/macrophages

38
Q

Chronic liver transplant rejection characterized by

A

Paucity of bile ducts on biopsy due to immune-mediated injury to biliary epithelium

39
Q

What is the cross match done before transplant

A

Donor lymphocytes with recipient serum and compliments

40
Q

Tumor lysis syndrome is mediated by?

A

Cytotoxic T cells

41
Q

Cyclosporin inhibits?

A

IL-2

42
Q

Acute kidney rejection mgmt

A

Renal biopsy, steroid boost, and immunoglobulin therapy

43
Q

Most common post transplant infections

A

Viral (CMV, EBV, HSV, VSV)

44
Q

Best drug for severe acute rejection that does not respond to steroid tx

A

Muromonab-CD3

45
Q

Wilms tumor ass w/

A

Aniridia, GU abnormalities, MR

46
Q

Tx for early stage seminoma

A

Orchiectomy and external beam radiation

47
Q

Who should get sentinel node biopsies in breast Ca

A

Pt’s who do not have clinically positive lymph node disease

48
Q

How are cardiac allografts matched

A

Only by size and ABO type

49
Q

GIST drug

A

Imatinib (TKI)

50
Q

Mammogram rec for BRCA1 carriers

A

Once every 6 months (biannual) starting at age 25

51
Q

BRCA1 vs BRCA2

A

BRCA1: likely ER neg, colon and prostate ca in males
BRCA2: likely ER+, also GI cancers

52
Q

Post transplant lymphoproliferative disorder ass w/?

A

EBV

53
Q

What is tertiary hyperparathyroidism? Tx?

A

Persistant hypercalcemia 2/2 autonomous parathyroid function after renal transplant
Tx: total parathyroidectomy

54
Q

Neg margin for colon cancer should be

A

5cm

55
Q

Azothioprine AE

A

Bone marrow suppression

Surgery (8 decks)

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