Surgery Flashcards
An amputated digit should be brought to hospital how?
Wrapped in saline moisturized gauze placed in sealed sterile bag and the bag placed in chilled container with ice mixed in saline/sterile water.
High suspicion for scaphoid fx should get what imgs?
xray, if neg get mri since it can up to two wks to show up
If xray neg need mri before u cast them bc casting nonfracture can impede function
Risk of intreated scaphoid fracture
Nonunion and AVN
Calcification of right hypochondrium on xray should be confirmed with what? What does it mean and what should u do?
Ct of the abd
Porcelain gallbladder. Even if asymp need to do elective cholecystectomy
Unilateral testicular pain with normal cremaster reflex and +prehn sign (relief with elevation) is? What are next tests to do?
Epididymitis- ua, urethral swab
Kid who had appendectomy now presented 2-3 wks after with r shoulder pain, f, cough, high wbc due to
Subphrenic abscess
Get abd u/s to diagnose
Pt with multiple fx experiences sob, ams, petechiae rash. What is it and how to prevent it from occurring?
Fat embolization
Petechiae due to occlusion of dermal capillaries leading toe extravasation if erythrocytes
No evidence that heparin reduces risk
How soon should u dc raloxiFENE before surgery?
1 month bc incr risk of dvt
Raloxifene is a Selective estrogen modulator for preventing OP and br ca chemoprevention
Osteonecrosis of femur- what is best test to diagnose?
Mri!! Xray may miss it
Stage 4 osteonecrosis should get total hip replacement
Should u get anymore preop workup for pt getting ortho procedure who has slowly worsening sob but still can climb flight of stairs? (4 mets)
Nope. Dont even need cardiopulm or pft workup.
What is most common complication from anal abscess? Skin inf/fistula/fecal impaction?
Fistula in 50%!!
Baby w cleft lip- how did they inherit and when to fix?
Many modes of inheritance- ar, ad, x linked
Tx in 10 WEEKS at 10 lbs
Arterial thrombus followed by thrombectomy. Man gets excruciating pain after and tingling/ant crawling sensation/burning has…
Compartment syn!!
Phantom pain only refers to amputated legs
How much vit d does a roux en y gastric bypass pt need daily??
2-3000 iu/day
Horizontal laceration to upper eyelid and see orbital fat means what kind of injury?
Levator muscle
What is side effect of compartment syndrome?
Renal failure
Pe
Renal failure from rhabdo and muscle necrosis
Athlete training for marathon now w pain in lower leg and tibial tenderness has what? What would u see in xray?
Stress fx. See nothing in first month!!!
Once it shows something u find bonescletosis, cortical thicekning, fracture, periosteal elevation
Displaced fracture of clavicle management?
Orif!!! Bc displaced and have shortening
Vs nondisplaced can manage conservatively w ice, figure 8, mobility as tol, sling
Pt w PAD in legs- ie claudication. Tx?
Asa or plavix, control bp and dm2, give statin
Dont give pentoxifylline which is second line and not always effective
Next try supervised exercise program!! If that fails then surgery- per or surgical revas
Head or neck cancer in pt should be treated w
combined CRT!!!! Superior to either alone
Elderly w hip fx should get surgery within how long? Even if dmx htn 160/68
2 days decr mortality
2 yo aa baby w genu varum (10 deg) should have fu how?
No tx
Unless >15 deg
Which opioid best for elderly lady w hip f
Hydrocodone!!!!!!
Not even fentanyl
