Surgery Flashcards
first sign of hypovolaemia
tachycardoa
respiratory quotient:
6CO2/ O2= 1
NB when assessing weaning patients from mechanical ventilation
normal RQ= 0.8
RQ greater than 1
XS carbs
RA= 0.7
fat
nasal furunculosis can lead to
cavernous sinus thrombosis
ERCP can be used for
acute/ ascending cholangitis
Hx RTA, and CXR= patchy alveolar infiltrate within 24hrs
pulmonary contusion
Sx workup haemoptysis
- intubate
2. bronchoscopy– if adequately haemo stable
complication of thoracic abdominal aorta repair
spinal cord infarction
- spinal shock= paralysis and UMN (days-weeks)
NORMAL proprioception and vibration
spinal cord infarction
burn patients need
escharotomy
torus palatinus
fleshy immobile mass in midline of hard palate;
young person
mgmt torus palatinus=
NO SURGERY, unless symptomatic
risk factors for post-op cholestasis
hypotension
XS blood loss and replacement
dumping syndrome post-gastrectomy, treatment resistant cases–>
OCTREOTIDE
complication acutely post op AAA
BOWEL ISCHAEMIA
complication of cardiac catheterization
retroperitoneal haematoma-CT
PC:
- fever
- chest pain
- increase WBC
- mediastinal widening on CXR
ACUTE MEDIASTINITIS
PC:
- respiratory distress
- shift–> opposite side
- elevated of hemi diaphragm
- CXR with NG tube in pulmonary cavity
diaphragmatic hernia
flail chest
3+ rib fractures in 2 places
BULGE out on inspiration
RETRACTS on expiration
PC:
- early paraesthesia
- increase pain with passive stretch
- soft tissue swelling
- exclusively tender
compartment syndrome; can happen post- femoral artery embolectomy
laparotomy hemodynamically stable–
FAST
diagnostic peritoneal lavage—blood–> Sx
amputated finger
- saline gauze
- bag on bed of ice
other causes of gastric outlet obstruction
- crohns
- gastric cancer
- STRICTURES
- ACID INGESTION
retropharyngeal abscess, can spread and cause
mediastinitis
imaging for blunt abdo trauma
abdo CT
splenic injury and haemostable
US–> CT
diaphragmatic rupture with RTA, next best step
CT abdomen and chest
pneumomediastinum
subutaneous emphysema
= persistent pneumothorax
tracheo bronchial rupture
pulsatile mass in groin
femoral artery aneurysm
anterior mediastinal mass
4T's Thymoma Teratoma/GCTs Thyroid neoplasm Terrible lymphoma
2 causes of blunt aortic injury
RTA
Fall from height
DDx widening mediastinum
- AD
- Acute mediastinhtis
- Boerhaave
- Blunt aortic injury
PC: wide mediastinum + hypotensive/ bp difference
AD
PC: wide mediastinum + fever + increase WCC
acute medastinitis
PC: wide mediastinum + pleural effusion with amylase + subcutaneous emphysema
boerhaave
PC: wide mediastinum + L sided haemothorax
blunt aortic injury
Ddx umbilical hernia
- blacks– resolve spontaneously
- preme
- beckwidth
- hypothyroidism
penile fracture, most vulnerable when…
man is hard, and woman on top;
PC: snapping sound
what next, penile fracture
retrograde urethrogram and surgical exploration of penis
pain when sleeping on side
trochanteric bursitis
when can a syringomyelia present
POST-trauma— 3-4% post-spinal cord injuries
- whiplash
- YEARS-MONTHS later
constant/ gnawing epigastric pain
pancreatic cancer
KEHR sign a/w
peritonitis
isolated duodenal haematoma
NG tube and TPN