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General Surgery > Set 3 (10/8) > Flashcards

Set 3 (10/8) Flashcards

1
Q

Antibiotic associated with cholestasis

A

ceftriaxone (Rocephin)

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2
Q

What reverses effects of heparin?

A

Protamine IV

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3
Q

When to d/c heparin before surgery

A

4-6 hours before surgery (90min half-life)

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4
Q

Causes of hypotension

A
  • hypovolemia
  • sepsis
  • MI/ cardiac dysrhythmia
  • hypoxia
  • pneumothorax
  • PE
  • cardiac tamponade
  • meds (eg: morphine)
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5
Q

Causes of Mental Status Changes

A
  • hypoxia (assume its hypoxia until ruled out)
  • hypotension
  • hypovolemia
  • drug reaction/ drug or EtOH withdrawal
  • seizure
  • ICU psychosis
  • CVA
  • sepsis
  • urinary retention in elderly
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6
Q

SIRS Criteria

A

2+ of these = sepsis:

  • temp <36C or >38C
  • Tachypnea >20 bpm
  • Tachycardia >90bpm
  • Leukocytes <4k or >12k
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7
Q

Septic shock

A

sepsis + hypotension

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8
Q

Most common bacteria in post-op wound infections

A

Staph aureus, E coli, Enterococcus

Clostridium if bronze-brown and weeping

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9
Q

When do you get CT looking for PO abscess

A

after post-op day 7

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10
Q

Meds that protect from post-op bleeding

A

H2 blockers & PPIs

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11
Q

Protection against wound infection

A

do not use razor for hair removal (electric shavers only), adequate skin prep in OR, do not close skin on contaminated case, pre-op Abx before incision

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12
Q

Types of Shock

A

hypovolemic, spetic, cardiogenic, neurogenic, anaphylactic

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13
Q

First vital sign to change in hypovolemic shock

A

tachycardia

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14
Q

Indications for dialysis

A

AEIOU: Acidosis, Electrolytes, Intoxication, volume Overload, Uremic complication

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15
Q

CCK

A
  • Source: duodenum mucosal cells
  • stimulated by fat, protein, amino acids
  • Inhibited by trypsin and chymotrypsin
  • Actions: empties gallbladder, opens ampulla of Vater, slows gastric emptying, release of exocrine pancreas products
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16
Q

Secretin

A
  • Source: duodenal cells
  • Stimulated by pH <4.5, fat in duodenum
  • Inhibited by high pH in duodenum
  • Actions: releases bicarb, enzymes, & H2O; releases bile; ↓LES tone; ↓release of gastric acid
17
Q

Somatostatin

A
  • Source: pancreatic D cells
  • Stimulated by food
  • Actions: globally inhibits GI function
18
Q

RUQ Pain Differential

A

Cholecystitis, hepatitis, PUD, perforated ulcer, pancreatitis, choledocholithiasis, cholangitis, pyelonephritis, nephrolithiasis, appendicitis (esp w/ pregnancy), pneumonia, PE, MI, pericarditis

19
Q

LUQ

A

PUD, perforated ulcer, gastritis, splenic injury, abscess, reflux, dissecting aortic aneurys,, thoracic causes, pyelonephritis, nephrolithiasis, hiatal hernia, Boerhaave’s, Mallory-Weiss tear, splenic artery aneurysm

20
Q

LLQ Pain Differential

A

Diverticulitis, sigmoid volvus, perforated colon, colon cancer, UTI, SBO, IBD, nephrolithiasis, pyelonephritis, referred hip pain, gynecologic problems

21
Q

RLQ Differential

A

appenidicitis, diverticulitis, perforated colon, Meckel’s diverticulum, intussusception, colon cancer, UTI, SBO, IBD, nephrolithiasis, pyelonephritis, referred hip pain, gynecologic problems

22
Q

CO2 gas embolus findings

A

hypotension, ↓end tidal CO2, mill-wheel murmur

23
Q

When to operate w/ duodenal ulcers

A

Intractability, Hemorrhage, Obstruction, Perforation

24
Q

Artery involved in bleeding duodenal ulcers

A

gastroduodenal artery

25
Q

Risks for gstric cancer

A

smoked meats, high nitrates, low fruits & veggies, EtOH, tobacco, poor SES, atrophic gastritis, male, blood type A, pernicious anemia, H pylori

26
Q

Virchow’s Node

A

metastatic gastric cancer to nodes in left supraclavicular fossa

27
Q

Work-up for gastric cancer

A

EGD w/ Bx, endoscopic US, CT of abd/ pelvis for mets, CXR, labs

28
Q

Linitis plastica

A

“leather bottle” gastric cancer involving the entire stomach

29
Q

Genetic alteration in most gastric cancers

A

p53 mutation

30
Q

GIST

A

Gastrointestinal Stromal Tumor

originates from interstitial cells of Cajal; found anywhere in GI tract

Sx: GI bleed, occult GI bleed, abd pain, abd mass, nausea, distention

Marker: C-KIT

31
Q

Most common sign of anastomtoci leak after gastric bypass

A

tachycardia

32
Q
A

General Surgery (6 decks)

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