Surgery

Question 1

Gunshot wounds to the abdomen require

Answer 1

exploratory laparotomy

Question 2

Penetrating stab wounds to the abdomen require

Answer 2

exploratory laparotomy

Question 3

Penetrating stab wounds to the abdomen diagnostic study

Answer 3

CT

Question 4

Sign of internal bleeding/shock (25-30% blood loss)

Answer 4

drop in BP, fast thready pulse, low CVP, low UO, cold, pale, anxious, shivering, thirsty, perspiring

Question 5

Site where major bleed can hide

Answer 5

Abd, thighs (femur), and pelvis (pelvic fracture)

Question 6

Dx of intraabd bleeding (hemodynamically stable pt)

Answer 6

CT

Question 7

Dx of intraabd bleeding (hemodynamically unstable pt)

Answer 7

Sonogram (FAST exam) or time-honored diagnostic peritoneal lavage

Question 8

Most frequent cause of abdominal bleed

Answer 8

ruptured spleen or liver

Question 9

Intraoperative coagulopathy

Answer 9

Give platelets and fresh frozen plasma (terminate procedure if pt becomes hypothermic and acidotic)

Question 10

DVT management

Answer 10

Unfractionated heparin-bridged to warfarin

Question 11

Necrotizing surgical site infection

Answer 11

Pain, edema, erythema
Systemic signs (fever, hypoT, tachy)
Paresthesia
Purulent, cloudy discharge (dishwater)
Gas or crepitus

Question 12

Pilondial Disease

Answer 12

Young, obese, males, sedentary
Flactuant Mass (cephalad to anus) in intergluteal regions
Mucoid, bloody, purulent
Infected hair follicle

Question 13

Folliculitis

Answer 13

multiple small, puritic pustules (not a tender mass)

Question 14

Hidradenitis suppurative

Answer 14

multiple painful recurrent nodules

Question 15

Peritonsillar abscess

Answer 15

Fever
Pharyngeal pain
Earache
Trismus, pooling of saliva, uvular deviation

Question 16

Herpangina

Answer 16

Coxsackie A virus (fever, sore throat, odynophagia)