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EOR - Surgery > Rosh Material #2 > Flashcards

Rosh Material #2 Flashcards

1
Q

first line pharm for PAD

A

cliostazol

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2
Q

what is this showing

A

midline shift, compressesd lateral ventricle, biconvex lens shaped hematoma -> epidural hematoma

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3
Q

best way to dx a strangulated groin hernia

A

clinical exam

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4
Q

maintenance pharm of choice for mod-severe active UC

A

infliximab -> TNF blocking agent

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5
Q

classification of hemorrhoids

A

1st: do not protrude thru anus
2nd: prolapse but reduce spontaneously
3rd: prolapse and require manual reduction
4th can not be reduced, may strangulate

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6
Q

definitive tx for BPH

A

TURP: transurethral resection of prostate

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7
Q

parkland formula for post burn fluids

A

4 mL/kg x wt in kg x %BSA burned

first half given in the first 8 hr
remaining given over 16 hr

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8
Q

management of pancreatic pseudocyst: early vs late

A

early (< 4 weeks): don’t drain
late (> 4 weeks): drain if symptomatic

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9
Q

cause of pancreatic pseudocysts in kiddos

A

abdominal trauma

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10
Q

what is this showing

A

free abd air -> perforated ulcer

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11
Q

what type of wound care is not recommended for veous stasis ulcers

A

mechanical debridement (wet to dry dressing)

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12
Q

EKG changes of hyperkalemia

A
  1. peaked t waves
  2. dropped p waves
  3. wide QRS
  4. sine wave
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13
Q

management of hyperkalemia

A
  1. calcium gluconate or chloride -> membrane stabilization
  2. insulin, albuterol, sodium bicarb -> redistribution
  3. furosemide -> elimination
  4. hemodialysis -> elimination
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14
Q

first line tx for bcc

A

electrodessication and curettage

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15
Q

what is this

A

btw lower calf and medial malleolus -> venous ulcer

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16
Q

what is this

A

pressure point (toes, feet, lateral malleolus, tibia) -> arterial ulcer

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17
Q

which type of ulcer has moderate to heavy exudate

A

venous

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18
Q

what is this

A

plantar foot, tip of toe, lateral to fifth metatarsal -> neuropathic diabetic ulcer

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19
Q

what is this

A

bony prominence (heel), macerated -> pressure ulcer

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20
Q

mcc of esophageal stricture

A

GERD

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21
Q

initial dx test for esophageal stricture

A

preendoscopy barium esophagram

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22
Q

tx for esophageal stricture

A

dilation
high dose PPI

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23
Q

3 rf for gastric carcinoma

A

male
h.pylori
processed meat

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24
Q

dysphagia to solids AND liquids

A

achalasia

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25
Q

what is this showing

A

coffee bean/comma appearance -> cecal volvulus

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26
Q

what 3 pt pops make you think about small bowel cancer

A

long-standing reginal enteritis
celiac sprue
AIDS

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27
Q

what is this showing

A

zenker diverticulum

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28
Q

older adult w. transient oropharyngeal dysphagia, pulmonary aspiration, halitosis, neck mass

A

zencker diverticulum

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29
Q

moa for roux en y

A

bypasses most of the stomach, duodenum, and proximal jejunum

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30
Q

management of afib: unstable vs stable

A

unstable: cardiovert
stable: diltiazem vs metoprolol

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31
Q

3 rf for afib

A

HTN
CAD
rheumatic heart dz

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32
Q

nonblanchable erythema

A

pressure ulcer

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33
Q

tx for pressure injury must include

A

debridement of necrotic tissue

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34
Q

type of debridement for stage 1 or 2 pressure ulcers that are not infected

A

autolytic

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35
Q

what type of wound care is not recommended for pressure ulcers

A

wet to dry dressings

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36
Q

contraindication for sharp debridement

A

anticoagulation

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37
Q

CA 19-9 is elevated in what cancers (7)

A

gastric
pancreatic
gallbladder
cholangiocarcinoma
ovarian
adenocarcinoma
ampullary

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38
Q

tumor marker that helps determine prognosis in colon ca

A

carcioembryonic antigen (CEA)

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39
Q

managment of renal artery stenosis (large vessel renal artery occlusive dz)

A
  1. ACE/ARB
  2. percutaneous angioplasty +/- stent
  3. revascularization vs resection
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40
Q

what test is used to differentiate pt’s w. gastrinomas from other causes of hypergastrinemia

A

seceretin stimulation test ->
pt’s w. zollinger-ellison tumors have a dramatic rise in serum gastrin after administration of sceretin

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41
Q

indications for lifestyle/H2 blocker/antacid trial for suspected GERD

A

mild/intermittent sx

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42
Q

indications for ppi trial for suspected GERD (3)

A

severe/frequent sx
erosive esophagitis
barretts

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43
Q

cardiac PE finding of hypothyroidism

A

diastolic htn

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44
Q

what is contraindicated in acute diverticulitis due to risk of bowel perf

A

colonoscopy

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45
Q

management of complicated diverticulitis w. pericolonic abscess > 4 cm

A

percutaneous drainage

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46
Q

displacement of the GEJ and herniation of a portion of the fundus into the thoracic cavity

A

paraesophageal hiatus hernia

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47
Q

abx for cellulitis:
simple vs pcn allergy vs MRSA

A

simple: cephalexin, amoxicillin, dicloxacillin
pcn allergy: macrolide, clindamycin
MRSA: bactrin, doxy, clindamycin

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48
Q

what electrolyte abnl is mc associated w. respiratory alkalosis

A

hypokalemia

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49
Q

what type of ABG abnl does severe diarrhea cause

A

metabolic acidosis

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50
Q

what type of hernia runs lateral to the inferior epigastric vessels

A

indirect inguinal

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51
Q

what type of hernia runs medial to the inferior epigastric vessels

A

direct inguinal

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52
Q

which type of inguinal hernia has a greater risk for strangulation

A

indirect

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53
Q

mc site for mesenteric ischemia

A

superior mesenteric a

54
Q

what are the 3 office based procedures for hemorrhoids

A

rubber band ligation
sclerotherapy
excision

55
Q

indication for rubber band ligation for hemorrhoids

A

healthy pt
grade I-III internal

56
Q

indications for sclerotherapy for hemorrhoids

A

pt’s on anticoagulants/antiplatelets
immunocompromised
portal htn

57
Q

indication for hemorrhoid excision

A

actively thrombosed external

58
Q

all pt’s w. venous ulcers should undergo what testing

A

venous duplex US
ABI

59
Q

cardiac functional status

60
Q

LP findings of SAH

A

xanthochromia -> Hgb degradation products

61
Q

what type of ABG abnl does pyloric stenosis cause

A

hypokalemic, hypochloremic metabolic alkalosis

62
Q

what should you order for preop eval of a pt w. worsening COPD symptoms

63
Q

2 rf for toxic megacolon

A

IBD
infectious colitis

64
Q

mcc of sbo in resource rich regions w.o a hx of prior abd surgery

65
Q

what kind of GI bleeding is caused by PUD

A

melena
black stool
FOBT (+)

66
Q

hallmark lab finding of PUD

A

increased BUN:Cr ratio

67
Q

what should everyone get to differentiate syncope from sz

68
Q

san fran syncope rule to identify high risk pt’s

A

chess:
CHF
Hct < 30%
ECG abnl
SOB
systolic BP < 90

69
Q

young woman + abd pain + syncope

70
Q

older man + abd pain/flank pain + syncope

71
Q

woman + prodrome n/v, sweating, warmth + syncope

72
Q

malignancy + SOB + syncope

73
Q

mc visual sx in a pt w. a pituitary mass

A

diminished temporal vision
(bitemporal hemianopsia)

74
Q

lactotroph adenoma is same-same

A

prolactinoma

75
Q

first line tx for prolactinoma/lactotroph adenoma

A

dopamine agonists:
cabergoline
bromocriptine

76
Q

mc pituitary tumor

A

prolactinoma

77
Q

5 types of pituitary tumor

A

prolactinoma
growth hormone secreting
ACTH-secreting
TSH-secreting
nonfunctioning

78
Q

2 mc s.e of dopamine agonists (cabergoline/bromocriptine)

A

nausea
postural hypotn

79
Q

3 indications for I&D of perirectal abscess in the OR

A

ischiorectal
intersphincteric
supralevator

80
Q

5 indications for abx for perianal abscess

A

associated cellulitis
systemic infxn
DM
valvular heart dz
immunosuppression

81
Q

t/f: all perianal abscesses must be drained in the OR

A

f!

simple perianal can be drained in the ED

82
Q

which “p” is a late finding in PAD

83
Q

mcc of early post op fever

A

inflammatory stimulus of surgery

84
Q

mc noninfectious cause of postop fever

85
Q

2 meds mc associated w. postop fever

A

heparin
abx

86
Q

4 mc infectious causes of posop fever

A

pna
infxn
uti
intravascular catheter infxn

87
Q

t/f: atelectasis is a common cause of post op fever

A

f!

i guess it just happens concurrently

88
Q

describe the tremor that occurs w. hyperthyroidism (2)

A

high frequency, low amplitude
present w. action

89
Q

what is this showing

A

bent inner tube: sigmoid volvulus

90
Q

XR sign associated w. cecal volvulus vs sigmoid volvulus

A

cecal: coffee bean/comma
sigmoid: bent inner tube

91
Q

epigastric discomfort w. no apparent e.o organic dz seen on endoscopy x at least 1 mo

A

functional dyspepsia

92
Q

management of functional dyspepsia: < 60 yo vs >/= 60 yo

A

< 60 yo w.o alarming sx: h.pylori testing
< 60 w. alarming sx: endoscopy
>/= 60: endoscopy for all

93
Q

management of a known DVT in a pt w. contraindications to anticoagulation

A

IVC filter

94
Q

indications for IVC filter

A

documented VTE PLUS:
absolute contraindication to anticoags
comlications of anticoags
failure of anticoags
limited cardiac reserve

95
Q

psammoma bodies

A

papillary thyroid ca

96
Q

pre op med for pheo

A

phenoxybenzamine

97
Q

what med should be administered immediately at the time of catheterization for BPH pt

A

alpha 1 adrenergic antagonist (afluzosin/tamsulosin) ->

relax smooth m of bladder neck and prostatic capsule -> prevent early recurrence of retention

98
Q

tx for IDA in a post bariatric surgery pt

99
Q

PE finding most suggestive of a symptomatic abdominal aortic aneurysm

A

abdominal mass

100
Q

cardiac abnl mc seen w. marfans

A

mitral valve prolapse

101
Q

3 major criteria for marfan’s dx

A

ectopica lentis
aortic root dilation
aortic dissection

102
Q

post MI pt w. pansystolic murmur radiating to the axilla, dyspnia, rales thorughout

A

papillary muscle rupture -> MR

103
Q

indication for radioiodine therapy for hyperthyroidism

A

pt’s w.o risk for subsequent thyroid ca, leukemia, or other malignancy

104
Q

a septal hematoma is unlikely if there is

105
Q

which bb’s are beta 1 cardioselective

A

the ones that start with a-n

106
Q

stress test finding of ischemia

A

ST depression during peak exercise

107
Q

tx of choice for symptomatic recurrent arrhythmias

A

radiofrequency ablation of bypass tracts

108
Q

5 indications for CABG

A

> 50% left main CAD
70% LAD w. EF < 50% or e.o ischemia on noninvasive tests
70% LAD/LCX stenosis
asymptomatic 3 vessel dz
DM w. 2 or 3 vessel dz

109
Q

post op increased BUN:Cr and low FEN in an otherwise healthy pt

A

prerenal azotemia

110
Q

mc post op pulmonary complication

A

atelectasis

111
Q

2 rf for atelectasis

A

elderly
overweight

112
Q

mc timeline for post op atelectasis

A

12-24 hr post op

113
Q

tx of choice to preserve vision in a pt w. diabetic retinopathy

A

panretinal laser photocoagulation

114
Q

hallmark PE finding of duodenal ulcer

A

epigastric tenderness

115
Q

barrett’s increases risk for which type of esophageal ca

A

adenocarcinoma

116
Q

main complication of TIPS

A

increased risk of encephalopathy

117
Q

3 structures best visualized w. TEE

A

left atrium
mitral valve
aorta

118
Q

best therapy of choice for long term management of esophageal varices in a pt who can not tolerate bb

A

sclerotherapy

119
Q

fatigue, weight loss, weakness, abd pain, loss of pubic hair, orthostatic hypotn

A

addison’s

120
Q

what is dressler’s syndrome

A

pericarditis and pleuritis several days to weeks post MI

121
Q

2 causes of cavitation on CXR

A

lung abscess
primary TB

122
Q

most reliable site from which to identify the causative organism in osteomyelitis

123
Q

gs dx for thrombophlebitis of the lower leg

A

venography

124
Q

mc site of osteomyelitis in IVDU and adults

A

vertebral spine

125
Q

indication for ORIF

A

angulation > 40 degrees

126
Q

splint of choice for colle’s fx

A

volar forearm

127
Q

fx thru the metaphysis of the distal radius w. dorsal displacement and angulation

128
Q

fracture of the distal radius with volar angulation

129
Q

what test do you order to evaluate a pt following trauma with blood at the meatus

A

urethrogram

only test that won’t damage the urethra 2/2 to pelvic fx

130
Q

abx for bowel perf

A

nafcillin
gentamicin
metronidazole

131
Q

permanent flexion contracture of the hand at the wrist resulting in a claw-like deformity of the hand and fingers

A

volkmann’s contracture

132
Q

2 causes of volkman’s contracture

A

untreated compartment syndrome
arterial injury

EOR - Surgery (13 decks)

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