Surgery Flashcards
Post Carotid Endarterectomy, on the left, the patient’s tongue deviates to the left, what nerve was cut?
Left Hypoglossal nerve
What post angioplasty complication has pain out of proportion to injury, passive stretch pain, rapid and intense swelling, and paresthesia (early), what is this?
Sometimes described as ants crawling on the skin and burning sensation
Compartment syndrome
Pyloric Sphincter Bypass or resection can result in what?
Rapid emptying of stomach contents after a meal
Colonic Ischemic will have what type of diarrhea?
Bloody
Small Intestine overgrowth can cause abdominal discomfort and watery diarrhea, and what else?
A non-tender abdomen
Blind Pouch from abdominal surgery can cause increase bacteria growth
Leukoreduction of the blood can help prevent a transfusion reaction how long after a transfusion start?
1-6 hours
Multiple Blood Transfusions in a car accident victim can cause what electrolyte abnormality?
Low Calcium
Renal transplant, successful, has tacrolimus, steroids, elevated BMI, what is the most likely long complication in the next few months?
Diabetes Mellitus onset, steroids plus impaired insulin sensitivity
Young military recruit, bilateral leg pain, worse with exercise, better with rest, negative X-ray, what could it be?
Chronic exertional compartment syndrome
Stress fractures are worse with ADLs, sensitive to touch at the tibial plateau
Teardrop pupil, post injury, what do you think the patient has?
Open Globe injury, call an eye doctor
Large Pituitary macroadenoma, what is the next best step, elevated prolactin and impaired vision?
Give oral Dopamine, not surgery first, even with the vision problems, I know
If an uncomplicated surgery has hypoxemia in the first hour, what is the first assumption to make?
Residual Anesthesia has hit the patient
If a burn victim has burned face and beard hair, but is saturating well on room air, what is the next best step?
Fiberoptic Laryngoscopy
What is the most common TURP procedure complication?
Retrograde Ejaculation
What is the drug of choice for an emergency awake intubation?
Ketamine
Shallow respirations, tachycardia, recent car accident, no trachea deviation, what should be evaluated?
Physical chest for flail chest
Drug of Choice for a pregnant manic patient?
Haloperidol is ok given the circumstance
Carbamazepine and Valproate are not safe in the 1st trimester
What is the best sensitive and specific test for a pneumothorax?
Bedside Ultrasound
Fat Embolism has a triad of what three things?
Resp. Insufficiency
Neurological Impairment
Petechial Rash
Limb ischemia pain improves with what maneuver?
Compartment syndrome pain is worse with what maneuver?
Limb ischemia pain is improved when the limb is hanging off the bed
Compartment syndrome is worse with passive stretching
If there is a dirty wound and you have not received 3 tetanus immunizations/not immunized, what is the next thing that should be ordered?
Tetanus Immunoglobulin, only if the criteria are met and the wound is severe and dirty
If there is a dirty wound and you have not received 3 tetanus immunizations/not immunized, what is the next thing that should be ordered?
Tetanus Immunoglobulin, only if the criteria are met and the wound is severe and dirty.
With young babies and undescended testicles, how long should parents wait before having orchipexy done?
6 months, if testicle does not descend, need surgery
If a patient drops a lung 2/2 barotrauma, what is the next best step?
Insert a chest tube, a needle compression can be helpful, but definitive management is a chest tube.
How do you differentiate between a flail chest and a cardiac contusion?
Flail chest has rapid/shallow breathing and cardiac contusion does not have poor breathing.
LCIS, lobular carcinoma in-situ, what is the best treatment once found?
Excisional Biopsy
Vertebral Compression Fracture, what is the best treatment?
Physical activity as soon as tolerated
Increased resp. work post surgery, what is the best tx a patient can receive?
Give chest physiotherapy, not duonebs (duonebs are needed for wheezing)
Teardrop pupil is most concerning for what? What needs to happen?
Open Globe laceration, an emergent opthalmology consultation
Teardrop pupil is most concerning for what? What needs to happen?
Open Globe laceration, an emergent ophthalmology consultation
An amputated digit is recovered, what is the best way to transport it?
Ice mixed with saline
As long as patient’s are not heart failure, what medication can be held right before surgery?
ACE inhibitors
What medication should be held 4 weeks before surgery, it can cause venous thromboembolism?
Raloxifene
Supracondylar fracture, xray with a posterior fat pad, what should be done?
Place splint for immobilization
Female, Fat, and Fertile patient has gallstones. The patient is stable, and her liver enzymes have decreased. She is at her baseline. When should she have her surgery done?
Surgery during that hospital admission
Diabetic foot injury has foot erythema, warmth, and edema. Xray shows “sucked candy”. What am I?
What is the treatment?
Diabetic Peripheral Neuropathy, Charcot (neuropathic arthropathy)
Foot Casting and weight reduction
New AMS, spinal tenderness, fever, and elevated WBC. Where should we start looking?
Spinal Epidural Abscess
Scrotal Trauma, bilateral scrotal reflex is intact, what is the next best step?
Scrotal Ultrasound
Can you do hyperventilation therapy with a traumatic brain patient?
No
Roux en Y bariatric surgery, watery diarrhea day and night, patient gets better after a course of amoxicillin-clavulanic acid. What is the most likely diagnosis?
Maldigestion in the intestinal Lumen
