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STEP 2 > Surgery > Flashcards

Surgery Flashcards

1
Q

what amount of prednisone to cause adrenal insufficiency?

A

pred >20mg a day for 3 weeks

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2
Q

Volkmann contracture

A

2/2 compartment syndrome

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3
Q

How does hyperventilation lower ICP

A

causes cerebral vasoconstriction

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4
Q

child with suspected diaphragmatic rupture on KUB, next step in mgmt?

A

CT

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5
Q

Can you see a stress fx on plain film?

A

usually not, sometimes see periosteal reaction

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6
Q

kid with GCS 15 s/p head trauma and LOC for 1 min, mgmt?

A

observe for 4-6 hours or do NCHCT

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7
Q

sub Q emphysema, what kind of intubation

A

fiberoptic bronchoscope

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8
Q

mgmt hemorrhagic shock in non urban setting

A

o Non urban setting: volume resuscitate first, then blood until urinary output is 0.5-2mL/kg/hr while not exceeding CVP of 15mmHg

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9
Q

can hypovolemic shock happen from intracranial bleeding?

A

no, not enough space

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10
Q

topical burn tx

A

silver sulfadiazine

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11
Q

deep burn penetration

A

mafenide acetate

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12
Q

tx burns near eyes

A

trile antibiotic ointment

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13
Q

epinephrine dose for a bee sting

A

0.3-0.5mL 1:1000 IM

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14
Q

tx black widow spider

A

Ca gluconate, muscle relaxants

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15
Q

brown recluse spider bites tx

A

dapsone

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16
Q

human bite mgmt

A

extensive irrigation and debridement in the OR

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17
Q

penetrating wound to extremities with no vascular involvement, mgmt?

A

tetanus prophylaxis and cleaning of the wound

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18
Q

what do you have to worry about in circumferential burns

A

blood supply!

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19
Q

what burn victims are candidates for early excision and grafting

A

limited 3rd degree burns

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20
Q

pt with severe chest pain, SOB and tachycardic: dx on POD 2 vs POD 7

A

POD 2: hypotension, see ST depression and T wave flattening with EKG and troponins
POD 7 : PE (usually don’t get in first few days post op)

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21
Q

DDx and tx for developmental dysplasia of the hip

A

Sonogram

Pavlik harness x 6 months

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22
Q

dx osteo in a kid

A

MRI, tx abx (plain films take weeks to show)

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23
Q

bowlegs are nml until when

A

age 3

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24
Q

genu valgus nml when?

A

4-8 years old, no tx

25
Q

kid with hyperextension of elbow, or FOOSH

what injury at risk for? tx?

A

supracondylar fracture of the humerus
vascular / nerve injury can cause a Volkmann’s contracture

need casting, montior vascular and nerve intregrity, watch out for compartment syndrome

26
Q

tx fx of growth plate

A

closed reduction if epiphyses and growth place are displaced laterally but in 1 piece

if growth plate is in 2 pieces, need precise alignment: ORIF

27
Q

tx metacarpal neck fractures

A

closed reduction and ulnar gutter splint

28
Q

isolated collateral ligament injury tx

A

hinged cast

29
Q

point tenderness over tibia, x rays nml, dx?

A

stress fx

tx cast and repeat x rays in 2 weeks

30
Q

tx open fx

A

cleaning in OR and reduction within 6 hours

31
Q

tx gas gangrene

A

IV PCN, surgical debridement and hyperbaric O2

32
Q

patient who cannot extend finger unless they pull on it, wake up in middle of night with finger flexed

dx, tx

A

dx: trigger finger

ddx: no history of trauma
tx: steroids, then surgery if fails

33
Q

tx de quervain tenosynovitis

A

splint, anti-inflammatories, steroid injection

34
Q

injury from thumb hyperextenion?

A

gamekeeper thumb, cast

35
Q

can’t flex finger, dx

A

Jersey finger

splint

36
Q

can’t extend finger, due to sports , dx, tx

A

dx: mallet finger
tx: split

commonly seen in volleyball

37
Q

finger amputation mgmt

A

clean finger wtih sterile saline, put on plastic bag on ice

38
Q

distended bladder, flaccid rectal sphincter, perineal saddle anesthesia

dx, tx

A

cauda equina syndrome

surgical emergency, needs immediate deompression

39
Q

what EF needed to have surgery?

A

> 35%

40
Q

how soon have surgery s/p MI

A

best to wait 6 months

41
Q

how long stop smoking prior to surgery

A

8 weeks with resp rehab

42
Q

mgmt of deep thrombophlebitis

A

doppler studies of deep leg and pelvic veins. Anticoagulate with heparin

43
Q

FETID mneumonic prevention of wound closure

A 
foreign body
epithelialization
tumor
infection
irradiated tissue
IBD
distal obstruction
44
Q

imaging for obstructive jaundice

A

RUQ US then ERCP

45
Q

what prolongs paralytic ileus

A

hypoK

46
Q

mgmt Ogilvie syndrome

A

KUB
fluid and electrolyte correction
IV neostigmine

47
Q

tx achalasia

A

balloon dilatation by endoscopy

48
Q

dx Carcinoid

A

24 hr urine 5-HIAA

49
Q

tx amebic liver abscess

A

Flagyl

50
Q

venu garum: when nml

A

until age 3

beyond 3 MC Blount dz, distrubance of medial proximal tibial growth plate–> surgery

51
Q

venu valgus: when normal?

A

between ages 4-8, no tx

52
Q

pt with GERD with severe dysplastic changes, what surgery? everyone else with GERD without these changes?

A

Resection

Nissen fundoplication for everyone else

53
Q

Patient with AT III deficiency, what CAN’T you use to anti-coagulate them?

A

heparin

54
Q

urine output goal per hour burn victim?

A

1-2mL/kg/hr

55
Q

mgmt of electrical burn pt

A

48 hours on tele

56
Q

how manage airway of a patient with multiple facial fractures?

A

crichothyroidotomy

57
Q

retroperitoneal fluid found on abdominal CT in a patient who suffered blunt abdominal trauma?

A

duodenal rupture

58
Q

blood at urethral meatus, high riding prostate and scrotal hematoma: what injury?
next best test?

A

consider pelvic fracture with urethral or bladder injury
retrograde urethrogram (not a foley!)
if nml
retrograde cystogram to eval bladder

59
Q

how much fluid do you need to see on lateral decubitus film to do a thoracentesis?

A

> 1cm

STEP 2 (8 decks)

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