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General Surgery > Subspecialty > Flashcards

Subspecialty Flashcards

1
Q

Avulsion

A

flap of skin

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2
Q

abrasion

A

superficial loss of dermis with lower components intact

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3
Q

What imaging is done for a fracture?

A

two X-rays perpendicular to each other

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4
Q

What are treatment options for fracture?

A
  • Open reduction internal fixation: if fracture is open, angular, or comminuted
  • casting if fracture is closed and approximated
  • Open fracture means emergency washout
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5
Q

What can cause anteiror dislocation of shoulder?

A

any trauma (FOOSH, anteiror trauma)

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6
Q

What is the appearance of an anterior shoulder dislocation?

A

Abduction externally “shaking hands”

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7
Q

What nerve damage can occur in anterior shoulder dislocation?

A
  • axillary artery and axillary nerve (C5,C6)(37%) results in a weakened or paralyzed deltoid muscle and as the deltoid atrophies unilaterally, the normal rounded contour of the shoulder is lost. difficulty abducting greater than 15 degrees.
  • suprascapular nerve (29%)
  • radial nerve (22%)
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8
Q

What can cause a posterior shoulder dislocation?

A

Massive trauma: seizures, lightning, electric shock

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9
Q

what is the appearance of a posterior shoulder dislocation?

A

Adducted and internally rotated, like arm is hurt. anterior shoulder is flattened with prominent coracoid process.

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10
Q

Imaging for dislocated shoulder?

A

X-ray

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11
Q

Treatment for anterior/posterior shoulder dislocaitons?

A

Relocate, sling. X-ray can confirm reduction

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12
Q

What is a Colle’s fracture?

A

-a fracture of the distal radius in the forearm with dorsal (posterior) and radial displacement of the wrist and hand

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13
Q

Who typically gets Colle’s fractures?

A

Old woman with osetoporosis who falls

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14
Q

Management for Colle’s?

A

X-ray, treat

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15
Q

What is a Monetggia fracture?

A
  • fracture of the proximal third of the ulna with dislocation of the head of the radius.
  • Caused by fall on outstretch arm or a blow to outer arm (upward block)
  • open reduction internal fixation is typically performed
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16
Q

What is a Galeazzi fracture?

A
  • a fracture of the radius with dislocation of the distal radioulnar joint.
  • “downward block”
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17
Q

susepcted scaphoid fracture management

A

X-ray, cast regardless, x-ray again in 7-10 days

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18
Q

Boxer’s fx

A

Punch against wall, fourth, fifth digits break

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19
Q

If the knee hurts and is not swollen, it’s probably the _____

A

hip (referred pain)

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20
Q

Hip fracture characteristics

A
  • Lots of trauma

- Leg is shortened an externally rotated

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21
Q

Hip fracture management for varying locations

A

-Femoral head = prosthesis (poor vascular supply)
-Intratrochanteric fx = plates
-shaft = rods
open = emergency washout with traction to stop bones form sliding against each other

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22
Q

posterior knee trauma

A

ACL tear with anteiror drawer sign

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23
Q

Anterior knee trauma

A

PCL with posteiror drawer sign

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24
Q

Cruciate ligamaent tear management

A

MRI
Surgery (athletes)
Casting (everybody else)

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25
Q

Valgus stress causes what tear?

A

vaLgus - Lateral - MCL tear

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26
Q

Vargus stress causes

A

medial - LCL tear

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27
Q

MCL/LCL management

A

MRI
Surgery (athletes)
Hinge cast

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28
Q

Meniscus signs

A

Knee pain and a click on extension

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29
Q

Meniscus management

A

MRI, arthroscopic surgery to remove torn portion.

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30
Q

Stress fx managmeent

A

Weekend warriors
X-ray:
Normal: cast anyway, redo in a few days. Crutches.

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31
Q

An ankle patient in ortho doesnt need n x-ray if ________

A

they can walk on it

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32
Q

Who gets carpal tunnel most often?

A

Those with hypothyroidism and diabetes

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33
Q

What is the pathology of Carpel tunnel syndrome?

A

Compression of median nerve, inflammatory

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34
Q

What is the progression of Carpel tunnel?

A

Pain ->parasthesias->paralysis of first three digits

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35
Q

Phalen test

A

Carpel tunnel: flexion of both hands

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36
Q

Tinel’s test

A

Carpel tunnel: tap median nerve

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37
Q

What is a high yeild physical exam finding for carpel tunnel?

A

Thenar atrophy

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38
Q

Diagnosis of Carpel tunnel

A

EMG: decreased conduction through the median nerve.
An electromyograph detects the electric potential generated by muscle cellswhen these cells are electrically or neurologically activated.

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39
Q

Carpel Tunnel Treatment

A
  1. Splinting _ NSAIDs
  2. Steroids
  3. Surgery
    f/u: RA assessment
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40
Q

Jersey finger

A
  • Tearing of flexor tendon when grabbing jersey
  • patient cannot flex digit
  • Clinical diagnosis
  • Standard treatment
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41
Q

Mallet finger

A

Tearing of extensor tendon

  • Cannot extend digit
  • Clinical diagnosis
  • Standard treatment
42
Q

Trigger finger

A
  • Stenosing tensynovitus of extensor
  • cannot extend, when they do there is a pop
  • treatment: standard
43
Q

Dequervains tensynovitis

A
  • Path: tendonitis of the tendons of extensor pollicis brevis and abductor pollicis longus muscles. CHRNOIC DEGENERATIVE, not inflammation.
  • Seen in mother holding a baby or man doing overhead lifts.
  • diagnosis: you know
  • Tx: NSAIDs, splinting, No surgery
44
Q

Who does Dupuytren’s occur in typcially?

A

Alcoholics and scandinavian men

45
Q

What are the characteristics of Dupuytren’s

A

Fascia balls up in hand, causes inability to extend fingers, they are clawed.
findings:
-cannot extend fingers
-fascial nodules
Treatment: surgical, no NSAIDs (not inflammatory)

46
Q

Felon

A
  • Abscess of pulp of finger
  • Pain, penetrating injury, fever, leukocytosis
  • Dx: clinical
  • Tx: I+D
47
Q

In what age does developmental dysplasia of the hip occur?

A

Newborn

48
Q

What is the PE finding of Developmental dysplasia of the hip?

A

Clicky hip

49
Q

What is Tx for Developmental dysplasia of the hip?

A

Harness

50
Q

In what age does Legg-Calve-Perthe disease occur?

A

6

51
Q

What are the H&P/PE findings of Legg-Calve-Perthe disease?

A
  • Insidious onset

- antalagic gait

52
Q

What is Dx for Legg-Calve-Perthe disease?

A

X-ray

53
Q

What is Tx for Legg-Calve-Perthe disease?

A

Cast

54
Q

What is age of slipped-capital femoral epiphysis?

A

13

55
Q

What are findings for slipped-capital femoral epiphysis??

A

Fat kid
Growth spurt
nontraumatic
knee pain

56
Q

What is Dx for slipped-capital femoral epiphysis?

A

Frog-leg X-ray

57
Q

What is Tx for slipped-capital femoral epiphysis?

A

Surgery

58
Q

What age does septic hip occur in?

A

any age

59
Q

What are findings for septic hip

A

Fever+joint pain

60
Q

What is diagnosis for spetic hip?

A

Arthrocentesis

61
Q

What is treatment for septic hip?

A

I&D

62
Q

What is the typcial presentation of Osgood-schlatter disease?

A

Teenage athlete

Knee pain+swelling

63
Q

What is the diagnosis of Osgood-schlatter disease?

A

clinical

64
Q

What is the Tx of Osgood-schlatter disease?

A
  1. Work through it which could result in palpable nodule that does not go away
  2. Cast + rest, which is curative
65
Q

Scoliosis is usually on the _______ side

A

right

66
Q

What is scoliosis?

A

Deformity of spine

67
Q

What patient is scoliosis seen in?

A

Teenage girl
moderate: cosmetic
Severe: SOB

68
Q

What is the Diagnosis for scoliosis?

A
  • Adam’s (she bends forward, look at back)

- X-ray

69
Q

What is Tx for scoliosis?

A

Brace

70
Q

Ewing sarcoma is translocation of ______

A

11,22 (11+22 was patrick ewings jersey)

71
Q

Ewing sarcoma locaiton

A

midshaft

72
Q

Appearance of Ewing’s on X-ray?

A

-onion skinning

73
Q

Osteosarcoma is associated with what gene?

A

retinoblastoma gene (people who had an eye taken out as a child)

74
Q

Osteosarcoma x-ray appearance?

A

sunburst

75
Q

Presentation of bone tumors

A

Bone pain, atraumatic focal pain with no other symptoms

76
Q

Diagnosis of bone tumors

A
  • X-ray
  • MRI
  • Biopsy
77
Q

Tx of bone tumors

A

Resection

78
Q

what do you do for a fracture in kids that involves the growth plate?

A

Open reduction with internal fixation (no involvement is standard care)

79
Q

Aortic stenosis murmur

A
  • Systolic crescendo-decrescendo murmur

- left sternal border

80
Q

Mitral regurgitation murmur

A
  • holosystolic
  • occludes S1 and S2
  • cardiac apex radiate to axilla
81
Q

Aortic insufficiency murmur

A
  • High pitched, blowing
  • decrescendo
  • diastole at 4th intervostal space left sternal border
82
Q

Mitral stenosis murmur

A

rumbling diastolic murmur with OPENING SNAP

83
Q

Atrial myxoma murmur

A

-An atrial myxoma may create an extra heart sound, audible to auscultation just after S2 It is most seen on echocardiography

84
Q

Elderly, dehydrated post-op patient with fever, leukocytosis, and parotid inflammation has….

A
  • acute bacterial parotitis
  • Staph aureus most ocmmon cause
  • prevented by adequate hydration and oral hygiene
85
Q

What is suggested by terminal hematuria?

A
  • prostate bleeding

- with clots, suggests urothelial cancer

86
Q

urothelial cancer risk factors

A
  • Age >40
  • Smoke!
  • Male sex
87
Q

What do you evaluate urothelial cancer with?

A

Cystoscopy

88
Q

Old Asian with bleeding from nose and EBV history

A

Nasopharyngeal carcinoma (NPC)

89
Q

Nasopharyngeal carcinoma

A
  • recurrent otitis media, epistaxis, nasal obstruction, asian, old, smoking, nitrosamine consumption (fish) EBV
  • Track with EBV titer levels
90
Q

Whistling in nose after rhinoplasty

A

nasal septal perforation

91
Q

Causative organism of prosthetic joint infection

A

Staph aureus or pseudmonas in first 3 months (late is propionibacterium or coagulase negative staph like epididermis after 3 months)

92
Q

PEEP is used for what?

A

Increase oxygenation

93
Q

What do you do to a bleeding lung after stabilization?

A

CT +/- bronchoscopy

94
Q

Cusingoid features + hypotension

A

Adrenal insufficiency from chronic cortisol suppresion

95
Q

Treatment for adrenal crisis

A

hydrocortosone or dexamethasone with aggressive fluid support

96
Q

diaphragmatic rupture after trauma management

A

X-ray -> CT+/- bronchoscopy

97
Q

most effective postop pneumonia prophylaxis

A

incentive spirometry

98
Q

What do you suspect in patient with reperfusion surgery?

A 
Compartment syndrome (reperfusion syndrome)
-Pain out of proportion to injury
-PAIN INCREASE ON PASSIVE STRETCH
-Rapidly increasing and tense swelling
Parasthesia (early)
99
Q

Difference between arterial embolus and arterial thrombosis

A

embolus is sudden, thrombosis is slow

100
Q

Bilateral lower extremity edema and stasis dermatitis

A

Venous hypertension

101
Q

AAA repair colonic complication?

A

Ischemia of the bowel

102
Q

Fast MVA trauma increases risk for

A

aortic injury

General Surgery (3 decks)

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