Surgery

Question 1

Kehr sign

Answer 1

pain in left shoulder; splenic rupture

Question 2

Balance sign

Answer 2

dull percussion on left side and shifting dullness on right; splenic rupture

Question 3

Ischemic bowel 2 MC complaints

Answer 3

Bloody diarrhea

Abdominal pain after eating

Question 4

best initial test vs most accurate test for chronic ischemic bowel disease

Answer 4

Initial = abd CT
best = angiography

Question 5

best initial vs most accurate test for acute mesenteric ischemia

Answer 5

initial = abd x-ray (air in bowel wall)
best = angiography

Question 6

Location of referred pain from prostate

Answer 6

tip of penis and perineum

Question 7

Hamman sign

Answer 7

crunching in thorax from subQ emphysema

Question 8

location of boerhaave vs mallory weiss

Answer 8

Boer = posterolateral distal esophagus
MW = GE junction

Question 9

Medication for fecal incontinence

Answer 9

Solesta (dextranomer/hyaluronic acid)

Question 10

SIGNS of fat embolism

Answer 10

PO2

Question 11

Spinal stenosis location

Answer 11

C2

L1

Question 12

symptoms of spinal stenosis

Answer 12

Neck/back pain
Bilat leg and buttocks pain/numbness
Pseudoclaudication
Worse with walking, better with final flexion

Question 13

AAA screening

Answer 13

former or current smokers >65yrs; abdominal US

Question 14

AAA rupture rx

Answer 14

desc: medical BP
asc: medical BP + surgery

Medical = b-blockers to slow HR, THEN vasodilators (sodium nitroprusside) [prevent reflex tachycardia]

Question 15

POD fevers:
0-2hrs
1-2d
3-5d
5-7d
7d
8-15d

Answer 15

0-2hrs - old thing, blood products, malignant hyperthermia
1-2d - wind
3-5d - water
5-7d - walking [DVT or IV line thrombophlebitis]
7d - wound
8-15d - weird [drug fever or deep abscess]

Question 16

Management of post-op confusion (5 things)

Answer 16

ABG
CXR
CBC

Blood cultures
Urine cultures