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Step 3 Final > Surgery > Flashcards

Surgery Flashcards

1
Q

Post Carotid Endarterectomy, on the left, the patient’s tongue deviates to the left, what nerve was cut?

A

Left Hypoglossal nerve

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2
Q

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

A

Compartment syndrome

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3
Q

Pyloric Sphincter Bypass or resection can result in what?

A

Rapid emptying of stomach contents after a meal

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4
Q

Colonic Ischemic will have what type of diarrhea?

A

Bloody

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5
Q

Small Intestine overgrowth can cause abdominal discomfort and watery diarrhea, and what else?

A

A non-tender abdomen

Blind Pouch from abdominal surgery can cause increase bacteria growth

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6
Q

Leukoreduction of the blood can help prevent a transfusion reaction how long after a transfusion start?

A

1-6 hours

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7
Q

Multiple Blood Transfusions in a car accident victim can cause what electrolyte abnormality?

A

Low Calcium

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8
Q

Renal transplant, successful, has tacrolimus, steroids, elevated BMI, what is the most likely long complication in the next few months?

A

Diabetes Mellitus onset, steroids plus impaired insulin sensitivity

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9
Q

Young military recruit, bilateral leg pain, worse with exercise, better with rest, negative X-ray, what could it be?

A

Chronic exertional compartment syndrome

Stress fractures are worse with ADLs, sensitive to touch at the tibial plateau

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10
Q

Teardrop pupil, post injury, what do you think the patient has?

A

Open Globe injury, call an eye doctor

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11
Q

Large Pituitary macroadenoma, what is the next best step, elevated prolactin and impaired vision?

A

Give oral Dopamine, not surgery first, even with the vision problems, I know

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12
Q

If an uncomplicated surgery has hypoxemia in the first hour, what is the first assumption to make?

A

Residual Anesthesia has hit the patient

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13
Q

If a burn victim has burned face and beard hair, but is saturating well on room air, what is the next best step?

A

Fiberoptic Laryngoscopy

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14
Q

What is the most common TURP procedure complication?

A

Retrograde Ejaculation

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15
Q

What is the drug of choice for an emergency awake intubation?

A

Ketamine

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16
Q

Shallow respirations, tachycardia, recent car accident, no trachea deviation, what should be evaluated?

A

Physical chest for flail chest

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17
Q

Drug of Choice for a pregnant manic patient?

A

Haloperidol is ok given the circumstance
Carbamazepine and Valproate are not safe in the 1st trimester

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18
Q

What is the best sensitive and specific test for a pneumothorax?

A

Bedside Ultrasound

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19
Q

Fat Embolism has a triad of what three things?

A

Resp. Insufficiency
Neurological Impairment
Petechial Rash

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20
Q

Limb ischemia pain improves with what maneuver?

Compartment syndrome pain is worse with what maneuver?

A

Limb ischemia pain is improved when the limb is hanging off the bed

Compartment syndrome is worse with passive stretching

21
Q

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?

A

Tetanus Immunoglobulin, only if the criteria are met and the wound is severe and dirty

22
Q

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?

A

Tetanus Immunoglobulin, only if the criteria are met and the wound is severe and dirty.

23
Q

With young babies and undescended testicles, how long should parents wait before having orchipexy done?

A

6 months, if testicle does not descend, need surgery

24
Q

If a patient drops a lung 2/2 barotrauma, what is the next best step?

A

Insert a chest tube, a needle compression can be helpful, but definitive management is a chest tube.

25
Q

How do you differentiate between a flail chest and a cardiac contusion?

A

Flail chest has rapid/shallow breathing and cardiac contusion does not have poor breathing.

26
Q

LCIS, lobular carcinoma in-situ, what is the best treatment once found?

A

Excisional Biopsy

27
Q

Vertebral Compression Fracture, what is the best treatment?

A

Physical activity as soon as tolerated

28
Q

Increased resp. work post surgery, what is the best tx a patient can receive?

A

Give chest physiotherapy, not duonebs (duonebs are needed for wheezing)

29
Q

Teardrop pupil is most concerning for what? What needs to happen?

A

Open Globe laceration, an emergent opthalmology consultation

30
Q

Teardrop pupil is most concerning for what? What needs to happen?

A

Open Globe laceration, an emergent ophthalmology consultation

31
Q

An amputated digit is recovered, what is the best way to transport it?

A

Ice mixed with saline

32
Q

As long as patient’s are not heart failure, what medication can be held right before surgery?

A

ACE inhibitors

33
Q

What medication should be held 4 weeks before surgery, it can cause venous thromboembolism?

A

Raloxifene

34
Q

Supracondylar fracture, xray with a posterior fat pad, what should be done?

A

Place splint for immobilization

35
Q

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?

A

Surgery during that hospital admission

36
Q

Diabetic foot injury has foot erythema, warmth, and edema. Xray shows “sucked candy”. What am I?

What is the treatment?

A

Diabetic Peripheral Neuropathy, Charcot (neuropathic arthropathy)

Foot Casting and weight reduction

37
Q

New AMS, spinal tenderness, fever, and elevated WBC. Where should we start looking?

A

Spinal Epidural Abscess

38
Q

Scrotal Trauma, bilateral scrotal reflex is intact, what is the next best step?

A

Scrotal Ultrasound

39
Q

Can you do hyperventilation therapy with a traumatic brain patient?

A

No

40
Q

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?

A

Maldigestion in the intestinal Lumen

41
Q

Dual Chamber PM implant, new onset heart failure, what is the most likely problem?

A

Tricuspid Regurgitation

42
Q

Loss of sensation, difficulty urinating, symmetric upper motor neuron signs, symmetric perianal numbness, what is this?

A

Conus Medullaris Syndrome

43
Q

Severe Radicular Pain, bowel/bladder dysfunction, asymmetric motor weakness, areflexia, and asymmetric saddle numbness that may extend into the legs, what is this?

A

Conus Equina

44
Q

Rheumatoid Arthritis and irregular, violaceous border can cause what wound?

A

Pyoderma Gangrenosum

45
Q

If someone is moving boxes and they have sudden back pain, you are thinking Vertebral Fracture, what could this be due to?

A

Loss of Bone mineral Density

46
Q

Olgive Syndrome usually occurs after an abdominal surgery, what is the most common cause?

A

Electrolyte Imbalance (potassium and magnesium)

47
Q

Cervical Spine Injury, a patient has limited feeling below neck, what is the next best step? Does the patient need steroids?

A

No steroids, do a bladder catheterization

48
Q

A person has a renal transplant 100 days ago, profuse watery diarrhea, CMV and C. Diff are negative. What is the most likely culprit? HIV negative

A

Graft vs. Host disease

49
Q

If hemorrhoids can be pushed back inside rectum, do they need surgery? What are the next steps?

A

No, increase fluid intake and fiber

Step 3 Final (12 decks)

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