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PANCE > Surgery > Flashcards

Surgery Flashcards

1
Q

alcohol, NSAIDs, chemotherapeutic agents, and a/b all cause ?

A

increased bleeding tendencies… also herbal meds

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2
Q

most important preoperative evaluations

A

history and physical

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3
Q

preoperative creatinine levels in all patients ?

A

over 40 years old

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4
Q

bypass grafting for peripheral vascular disease, abdominal aortic aneurysm repair, or coronary artery bypass grafting all need ?

A

blood glucose obtained

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5
Q

coagulation factors may be abnormal in severe ? or ? dysfunction

A

hepatic, biliary

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6
Q

EKG recommended in all older than ?

A

40 years old

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7
Q

silent MI more common in ? 2

A

elderly, diabetics

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8
Q

CXR indicated in all w/ heart or pulmonary dz; all patients older than ?

A

60 y.o.

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9
Q

spirometry for pts evaluated for ? surgery or history of smoking or dyspnea

A

thoracic or abdominal

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10
Q

Virchow’s triad? (DVT)

A

stasis, intimal damage, hypercoagulability

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11
Q

DVT prophylaxis ?

A

unfractionated heparin 5,000 units sQ q 8 or 12 hours until patient fully ambulatory or enoxaprin (LMWH) 40mg sQ 12 hrs before or soon after surgery up to 14 days after

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12
Q

? associated with lower incidence of DVT in hip surgery; blocks activated factor X

A

fondaparinux, 2.5mg sQ starting 6h post-op

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13
Q

preferred DVT prophylaxis for trauma pts or those w/ abdominal/pelvic cancer

A

enoxaprin (LMWH)

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14
Q

? are not recommended in DVT prophy and can actually promote a tourniquet effect

A

non fitted thromboembolic stockings

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15
Q

? devices are beneficial in all pt populations for DVT trophy from on way to OR until fully ambulatory

A

sequential compression devices

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16
Q

prophy of clots only from lower extremities, for CI to other prophy or undergoing CNS procedures

A

Greenfield filter insertion

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17
Q

prophy DVT not associated with sig decreases in incidence of DVT but associated with heart failure, renal failure and difficulty in cross-matching blood

A

dextran

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18
Q

malnourished pt- lost more than ? and no adequate nutritional intake for more than 7 days

A

10% body weight

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19
Q

occurrence of bacterial translocation from gut linked with depletion of ?

A

amino acid glutamine

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20
Q

w/ severe malnutrition ? or ? may develop

A

marasmus, kwashiorkor

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21
Q

basal energy expenditure calculated using ?

A

Harris-Benedict equation

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22
Q

pts who are elderly, have marasmus, kwashiorkor, anorexia nervosa, or undergoing chemotherapy at risk for development of?

A

refeeding syndrome

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23
Q

abnormal glucose and lipid metabolism, thiamine deficiency, hypophosphatemia, hypomagnesemia, and hypokalemia

A

refeeding syndrome

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24
Q

? probs include air embolus, sepsis, pneumothorax, hemothorax, hydrothorax, and cardiac rupture

A

catheter-related problems

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25
Q

leading cause of death between ages 1 and 44

A

unintentional and violence related injuries

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26
Q

leading cause of accidental deaths in US

A

motor vehicle accidents

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27
Q

permissive hypotension prevents the ? and further exsanguination

A

dislodgment of ‘fresh clot’

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28
Q

MC indication for intubation?

A

AMS

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29
Q

? intubation requires the patient be awake

A

nasotracheal

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30
Q

cricothyroidotomy only by experienced operators and not under ? bc of risk of developing ?

A

12 yo, subglottic stenosis

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31
Q

paradoxical breathing

A

flail chest

32
Q

open chest wounds- never be completely occluded with dressing because this may confer the wound into a ?

A

tension pneumothorax

33
Q

each liter of ringer’s lactate solution contains ?

A

4 mEq of potassium

34
Q

high riding prostate in association with blood in urinary meatus may imply ?

A

pelvic fracture

35
Q

trauma eval not complete until ?

A

finger or tube inserted in every orifice

36
Q

cribiform plate injury suspected- avoid ? and use ?

A

nasogastric tube, orogastric tube

37
Q

? largely replaced diagnostic peritoneal lavage as diagnostic test of choice for intra-abdominal injury

A

FAST- focused assessment with sonography for trauma

38
Q

? indicated if a patient exhibits any signs of shock, peritoneal irritation, or evisceration

A

immediate laparotomy

39
Q

FAST reveals free intraperitoneal air or fluid- ? is indicated

A

laparotomy

40
Q

Glascow Coma score

  • intubate at ?
  • normal?
  • mild head injury?
  • moderate?
  • severe?
A 
less than or equal to 8
15
13-15
9-12
less than 9
41
Q

rhinorrhea, otorrhea, raccoon eyes, battle’s sign

A

basilar skull fracture

42
Q

ecchymosis of lids?

A

raccoon eyes

43
Q

ecchymosis behind the ear?

A

battle’s sign

44
Q

epidural hematoma

  • usually injury to ?
  • herniation triad ?
  • Dx w/ CT, require ?
A

middle meningeal artery
fixed/dilated pupils, coma, decerebrate posturing
emergent craniotomy

45
Q

subdural hematoma

  • usually injury to ?
  • chronic more common in ?
A

bridging veins

elderly, alcoholics

46
Q

burns

  • first degree?
  • second degree?
  • third degree?
  • fourth degree?
A
  • only epidermis
  • superficial partial thickness extends into papillary dermis; deep superficial extend into reticular dermis
  • full thickness (epidermis and dermis)
  • skin and sQ, further involves fascia, muscle, bone, or other structures
47
Q

most common type of burns

A

scald burns

48
Q

characteristics
first degree- absence of ?
second degree- ? walled, fluid filled blisters, pain?
third degree- appearance ?, dry skin without presence of ?
fourth degree- significant charring, exposure of muscle, fascia, tendons and pigs, extensive damage to nerves results in?

A
  • blisters
  • thin-walled, painful
  • white, leathery, or charred, no sensation
  • loss of sensation
49
Q

fifth degree burns- for coding purposes, result in ?

A

amputation or loss of body part

50
Q

findings on skin do not correlate with extent of burns when caused by ?

A

electrical energy

51
Q

if chemical burn, don’t use ? but use

A

water (may cause further burn damage), powder

52
Q

burns caused by white phosphorus may require neutralization with ? and ? to address concomitant hypocalcemia

A

copper sulfate, calcium gluconate

53
Q

hydrofluoric acid burns- ? for at least 30 min with concomitant application of ? to affected area

A

copious lavage, calcium gluconate gel

54
Q

parkland formula? (for burns)

A

percentage of burn area x weight (kg) x 4ml/hr

55
Q

foley catheter & burns

  • maintained urine output in adult
  • child
A

0.5 mL/kg/hr in adult

1 mL/kg/hr

56
Q

MC used topical burn ointment

A

sulfadiazine (silvadene)

57
Q

deep dermal burns/full-thickness burns best covered by ?

A

autograph

58
Q

severe burns - gastric or duodenal ulcerations aka?

A

curling ulcers

59
Q

most common complication of burns?

A

infections

60
Q

chrnoic healing burn wounds- transformation into SCC aka?

A

Marjolin ulcer

61
Q

five Ws in determining cause of post-op fever

A 
Wind- atelectasis (MC) (24-48h post-op)
Water- UTI (48-72h)
Wound- infection (MC fever after 72h)
Wondering drugs/Whopper
Walking- thrombophlebitis (after 72h)
62
Q

thrombophlebitis in post-op fever can be associated with ? (MC), indwelling central lines, or DVT

A

IV catheters

63
Q

post-op fever… whopper = ?

A

post-op abscess

64
Q

shifting of mediastinum TOWARD affected side, loss of lung volume on affected side

A

atelectasis (tension PTX opposite)

65
Q

MC nosocomially acquired infection

A

UTIs

66
Q

hypertrophic tissue usually regresses without intervention; keloid?

A

usually requires intervention

67
Q

pts w/ ? are at greatest risk of developing decubitus ulcers

A

spinal cord injury

68
Q

standard in differentiating between colonization and true infection in ulcers?

A

deep tissue biopsy/deep tissue cultures

69
Q

char. by rapidly progressing erythema, tissue crepitus, marked tissue tenderness, high temperatures, tachycardia, hypotension, and AMS

A

necrotizing fasciitis

70
Q

triad of necrotizing fasciitis?

A
  • elevated WBC (15 mg/mL)

- hyponatremia (<135 mmol/L)

71
Q

mainstay of therapy in necrotizing fasciitis

A

surgical debridement

72
Q

? of anterior chest wall may be seen post-op as a normal variant

A

subQ emphysema

73
Q

MC method of repair for inguinal surgery

A

TAPP- TransAbdominal PrePeritoneal Herniorrhaphy

74
Q

MC complication of open appendectomy

A

wound infection

75
Q

MC complication of laparascopic appendectomy

A

intra-abdominal abscess

PANCE (6 decks)

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