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Surgery 1 > S6 > Flashcards

S6 Flashcards

1
Q

Risk factor of upper extremity DVT?

A

Central venous catheter and PICC(peripherally inserted central catheter)
Yong athletic males(spontaneous)
Thoracic outlet obstruction

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2
Q

CM?

A

Unilateral arm or forearm edema
Pain and heavy sensation
Erythema
Dilated subcutaneous Vien

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3
Q

Diagnosis?

A

Compression Doupler U/S

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4
Q

Management?

A

3-month anticoagulation

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5
Q

How to differentiate from venous line infection?

A

Unlike venous line infection, In DVT the venous catheter insertion site is normal.In infection(phlebitis the venous line become red)

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6
Q

Acute epididimitis cause?

A

Age < 35–sexualy transmited(Claymidia and Gonorhia)

Age > 35–Obstraction UT(choliform bacteria)

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7
Q

CM?

A

Unilaterral/Posterior testicular pain
Epididymal edema
Pain improves with elevation
Dysuria and frequency(If due to cholioform)

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8
Q

Diagnosis?

A

NAAT

Urinalysis/culture

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9
Q

Management?

A

Ceftriaxone plus doxycycline or

Levofloxacin

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10
Q

What to do inpatient suspected of VAP?

A

Do C-x-Ray
Take a sample from the lower part of the endotracheal tube
Start empiric therapy(G+.G-,P and MRSA) if abnormal CXR
Then decide on culture result and clinical improvement

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11
Q

Negative culture?

A

Stop antibiotic and search other cause

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12
Q

Positive culture and clinical improvement?

A

Adjust the empiric antibiotic

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13
Q

Positive culture w/o clinical improvement?

A

High likely VAP
Asses for Pneumonia complication
Consider changing AB
Asses other cause

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14
Q

VAP CM?

A 
Develop after >48 hr
Fever
leukocytosis
Infiltration on x-ray
The difficulty of intubation(high RR and Low TV, deteriorating oxygenation)
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15
Q

Cause of nosocomial bloodstream infection inpatient have CVC?

A

Coagulase-negative staphylococci and S.A(Major cause)

Candida in 10 %

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16
Q

CM of colovesical fistula?

A

Pnumaturia
Fecaluria
Recurent UTI

17
Q

Abdominal CT?

A

CT with oral/rectal contrast no Iv contrast(thickened Bw and fistula)
Colonoscopy to r/o colonic ca

18
Q

risk factor?

A

diverticular disease
colonic Ca
chrons

19
Q

Compartment syndrome dx?

A 
Intracompartment Pressure measurement(needle manometry)
Delta pressure (Diastolic blood pressure <30 at lesion site)
20
Q

atelectasis x-ray feature?

A

Lung opacification
Mediastinal shift
Narrow gap b/n ribs

21
Q

Management if due to plugging (mainly post oprative)?

A

Small plug: Pulmonary Exercise

Large: remove with bronchoscopy

22
Q

types and cause of prosthetic valve dysfunction?

A 
Transvalvular regurgitation(cusp degeneration)--commonly affect bioprosthetic valve
Paravalvular leak(annular degeneration/IE--dehiscence)--commonly affect mechanical valve
Valvular stenosis(valve thrombus)
23
Q

diagnosis?

A

echocardiography

do coagulation studies additionally if stenotic

24
Q

a complication of PVD?

A

MA-HA
HF
Thrombocytopnia

25
Q

transportation of amputated extremity for repair?

A

wash with saline
Cover with sterile gauze soaked with saline
seal with a plastic bag
Put on ICE water container(0 degre)

26
Q

what is the cause of Cervical LDP with SCC?

A 
Metastasis from head and neck
Do larengiopharengioscopy(visualize nasal,pharnex,larnex and oral cavity)
27
Q

CM?

A

Patients with smoking or alcoholism

LDP >1.5 and present for > 2 week

28
Q

cause of hypotension while transfusion?

A

Anaphylaxis
TRALI(alcoholic, smoking, and critically ill patient)
Hemolysis
Infection(mainly on platelet transfusion)

29
Q

NF type 2 genetics?

A

AD
usually at age 20-30
defect in NFT2 gene encoding merlin(TSG)

30
Q

CM?

A 
Bilateral vestibular shewanoma
Intracranial meningioma
A spinal tumor (schwannoma, ependymoma)
cataract
Cutaneous tumor/plaque
Peripheral neuropathy
31
Q

Tumour surveillance?

A

Audiogram
Head and spinal MRI
Ophthalmologic evaluasion

32
Q

cause of hypoxia with high A-a gradient does not respond to o2 therapy?

A

Diffuse pulmonary edema
Massive PE
right to left cardiac shunt

33
Q

Grave ophthalmopathy sx?

A

impaired EOM(diplopia and enable convergence)
eye pain, irritation, and redness
proptosis due to orbital tissue expansion

34
Q

what to do imidiateley in varicial heamorage?

A

Place two IV line

35
Q

RIB fracture location and associated injury?

A

1-3–(SCV,BP,Mediasternal vessel)
3-6–CVS
9-12–Intraabdominal(L,S,K(11,12)
Any level–lung

36
Q

Risk factor for VAP?

A 
Acid suppression
Supine position
Pooled subglottic secretion
Paralysis and exessive sedation
excessive pt movt on intubation
Frequent ventilator circulation change
37
Q

prevention?

A 
Minimal antiacide usage
bed elevation 30-45 degrees
Cont/Int subglottic suction
minimize patient transport
Daily sedation break

Surgery 1 (11 decks)

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