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Surgery 1 > S4 > Flashcards

S4 Flashcards

1
Q

Management cerebellar hemorrhage?

A

Reverse anticoagulation
Manage HTN
ICP management
Surgical evacuation

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2
Q

Surgical evacuation?

A

Hemorrhage > 3 CM
Neurologic deterioration
Brainstem Compression
Obstructive hydrocephalus

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3
Q

AAA CM?

A

Upper: Abd/flank/Back pain
Lower: Lower Abd/Groin pain
Calcification X-ray

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4
Q

Management?

A

Hemodynamically stable:CT

Hemodynamically Unstable: Bedside U/S and immediate surgery

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5
Q

MRI indication in back pain?

A

Acute + red flag sign

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6
Q

GB CM?

A

ICP sign and Sx
Personality change
Frontal lobe serpiginous mass

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7
Q

Acute mediastinitis Tx?

A

Wound debridement
Antibiotic Management
10-50% mortality
Complicate 5% of open cardiac surgery

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8
Q

AF after CABG?

A

<24 hr–Beta blocker/amidadrone

last > 24 hr after CABG–Anticoagulation and or Cardioversion

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9
Q

Can SAH patients have FEVER?

A

Yes?But usually low grade

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10
Q

Acute pancreatitis diagnosis algorithm?

A 
>=2 from 3 criteria
1)Abd.Pain that radiates to back
2)Rise in serum amylase/lipase >3
3)Cx imaging finding in CT/MRI or U/S
CT finding may delay 48 hr but amylase and lipase rise within hours(as a result more used)
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11
Q

ERCP complication?

A

Perforation(BW,BD,PD)
Pancreatitis
Ascending cholangitis

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12
Q

Bladder rupture after BAPT CXS?

A

The dome is usually Affected
Intraperitonial fluid/urine
Peritonitis does not develop acutely due to urine is sterilized

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13
Q

CM of bladder rapture?

A

Hematuria (90 %)
Suprapubic tenderness
Difficulty of voiding
Associated with pelvic #

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14
Q

Diagnosis?

A

Retrograde Cystography(water-soluble contrast inflated using catheter then do CT)

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15
Q

Management?

A

Surgical repair if intraperitonial

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16
Q

When considering DPL?

A

Hemodynamically unstable –No time for CT

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17
Q

cause of femoral nerve injury?

A

Hip dislocation
Pelvic #
Illiacus heamatoma
Iatrogenic

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18
Q

Iatrogenic cause of FNI?

A

Prolonged dorsal lithotomy position(Childbirth, pelvic surgery)
Femoral artery/vein procedure

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19
Q

CM?

A

The inability of hip flexion
Knee extension
Loss of sensation in the anterior and medial thigh

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20
Q

Effect of Intubation on Hypovolumic shock patien?

A

HS patients have low CVP–Increase intrathoracic Pressure by positive ventilation—compress veins like IVC—Cardiac arrest/Respiratory failure due to decreased cardiac preload

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21
Q

The only Major modifiable RF associated with Chron’s disease progression and severity?

A

Smoking
Increase hospitalization
Increase need for surgery
Failure of medical treatment

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22
Q

Another risk for severe disease?

A 
Start at a young age<30
High anatomic area involvement
Stricture formation
Fistula
Deep ulceration
Prior need surgery
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23
Q

AAA rapture suspect approach?

A

HS: CT
HU: FAST if have no hx but immediate surgery if already px diagnosis of AA.

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24
Q

Acute Bacterial prostatitis CM?

A 
AUR
Fever
Dysuria
Leukocytosis
Tender Prostate
25
pathogenesis?
Urine reflex--enter to prostate Common etiology are urinary tract pathogen Protus, E.Coli...
26
Management?
6 weeks (TM--CTM and Levofloxacline) Prostate Ab acumulation Urine culture for etiology
27
Chronic bacterial prostatitis epidemiology?
MC in young and middle-aged men | DM, Smoking, and urinary procedure increase the risk
28
Clinical presentation?
Recurrent UTI/Sx of UTI with the same organism Pain during ejaculation Hx of antibiotic use--transient improvement Prostatic swelling and tenderness are usually absent
29
diagnosis?
pyuria/bacteriuria in urinalysis
30
TM?
antibiotic for 6 week
31
what about chronic epididymitis?
N.gonoriha and chlamydia are common etiology tenderness at the upper border of tests may have pain during ejaculation and LUT sx
32
How is muscle exercise is useful in osteoarthritis?
Non-use due to pain mainly at old age---Exacerbate articular degeneration. Exercise prevents this.
33
Blunt orbital trauma pathophysiology?
BOT--Increase IO pressure--# of medial and inferior well--Muscle entrapment--Difficulty/diplopia) in seeing to upward and latteraly.
34
What is CVP indicate?
RAP(2-6 mm Hg)
35
what it helps in identifying the type of shock/
Low CVP--Distributive/hypovolumic | High CVP---Obstructive/cardiogenic
36
cause of cardiac-related shock?
RV injury--Further rise in CVP after fluid LV injury--Refractory shock Cardiac Tamponade---Beck triad
37
extraperitoneal bladder injury CM?
MC associated with pelvic # Like IP heamaturia,AUR and Suprapubic ditension/tenderness More localized symptom Negative FAST/No late peritonitis or ascites
38
Diagnosis and management?
RCU
39
What about ureter injury?
MC associated with penetrating AT/surgery Haematuria Flank/Lower Abd pain depending on location
40
Post BA trauma pan.psudocyst CM?
Occur after weeks epigastric pain/tenderness Bilious vomiting Good differential for duodenal hematoma(DH develop 24-48 hr after trauma)
41
papillary thyroid ca managment?
Surgery The extent of surgery depends on the stage Radioiodine replacement after surgery for patients with a high risk of recurrence Adequate Thyroid supplementation to suppress TSH(TSH increase tumor cell growth)
42
Partial thyroidectomy indication?
Size <1-2 CM | Not involve LN, adjacent tissue, another thyroid lobe(in this case and large do total thyroidectomy)
43
high risk of recurrence?
large size Extratyroid tissue involvement LDN Incomplete resection
44
Post-surgery refractory shock cause in a patient with chronic glucocorticoid usage?
Low HPA--Secondary AI
45
Eye chemical injury CM?
``` Eye pain Blepharospasm Gritty sensation in the eye Eye erythema Severe--ischemia--white conjunctiva ```
46
Path?
Acid: Coagulative Nec.-no further injury Base: Liquifactive Nec--further damage(more severe)
47
Management?
Irrigate with saline until neutral PH(asses using TBT) | we may use Topical Ab
48
etiology for fat embolism syndrome?
of marrow containing bone Orthopedic surgery Pancrititis
49
CM?
``` 24-72 Hr after the event Triads 1-RD(mainly due to ARDS) 2-Neurologic dysfunction(e.g AMS) 3-Petichial rash(<50 %) Thrombocytopenia (PLT attach to fat globule) ```
50
Diagnosis?
Clinical CT may miss b/c of the small size of FAT globule manage by supportive therapy and imobilization
51
How to d/t from aspiration pneumonia with ARDS?
Will have a fever and leukocytosis unkike FES
52
what about DRESS-related ARDS?
Eosinophilia Macular rash Mainly related to CPZ and LMT
53
Paraesophagial hernia pathophysiology?
Diaphragmatic membrane defect--Esophagial fundus herniation/intraabdominal organ herniation--If an advanced respiratory compromise
54
CM?
``` Nausea and vomiting early satiety Epigastric discomfort Dysphagia chest pain ```
55
diagnosis and Management?
Air fluid level cavity on chest(may also be seen in HH) | Mainly need surgical repair, unlike HH which is managed by GERD sx Tx.
56
What about HH?
Mainly asymptomatic May have GERD symptom Cardia will herniate Due to diaphragm mam laxity
57
Catheter-associated UTI inpatient in need of prolonged cath. can be prevented by?
Intermittent catheterization(removal, clean, and reinsert every 4-6 hr)--by a caregiver
58
If unable to do IC?
``` Indwelling catheterization(keep fo month and change)--High risk of CAUTI Suprapubic catheterization ```
59
Hypoxia management in epiglotitis?
1st--Bag-valve-Mask with 100 % ) O2--if archive saturation 2nd-Video-assisted intubation--If fails do not repeat unless Video-assisted did in the previous one If intubation fails--cricothyroidotomy

Surgery 1 (11 decks)

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