Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MS3 > Surgery > Flashcards

Surgery Flashcards

1
Q

differential for anterior mediastinal mass

A

4 T’s 1. Thymoma (normal bHCG, AFP)

  1. Teratoma (elevated bHCG, AFP)
  2. Thyroid neoplasm
  3. Terrible Lymphoma (normal bHCG, AFP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

scrotal mass that increases in size with valsalva…what is it and what is tx

A

Varicocele “bag of worms” -presents with subfertility, testicular atrophy -us finding of retrograde venous flow -dilation of pampiniform venous plexus tx: gonadal vein ligation, scrotal support, NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how to confirm presence of peripheral artery disease

A

Ankle-brachial index

<0.9 abnormal (diagnostic of occlusive PAD)

0.91-1.3 normal

>1.3 suggestive of calcified and uncompressible vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

treatment of gallstones

  1. Gallstones without symptoms
  2. Gallstones with typical biliary colic sx
  3. Complicated gallstone dz
A
  1. gallstones w/o sx –> no tx necessary
  2. gallstones with typical biliary colic sx –> elective laparoscopic cholecystectomy
  3. complicated gallstone dz (acute cholecystitis, choledocolithiasis, gallstone pancreatitis) –> surgery within 72 hours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

physical exam findings indicative of a urethral injury

A

blood at the meatus, high riding prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

pubic ramus fx, return of frank blood on foley insertion without resistance and NO blood at meatus

A

EXTRAperitoneal bladder rupture (contusion or rupture of the neck, anterior wall, or anteriorlateral wall of bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

intra vs extra peritoneal rupture of the bladder

A

intra –> rupture of the dome of the bladder resulting in intraperitoneal leakage and presents with signs of chemical peritonitis (guarding, diffuse abd tenderness)

extra –> localized pain in lower abd and pelvis, pelvic fracture almost ALWAYS seen, gross hematuria present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

most critical prognostic indicator of compartment syndrome

A

time to fasciotomy (go to OR right away…NO time for eval or elevation or ice)

-in fact, the leg should be kept at the level of the torso, not higher or lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

retropharyngeal abscess

A

presents with neck pain, odynophagia, and fever following penetrating trauma to the posterior pharynx. This infection can drain into the superior mediastinum. -If it extends through the alar fascia, it can enter the “danger fascia” and transmit infection into the POSTERIOR mediastinum and result in acute nectrotizing mediastinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ludwig angina

A

rapidly progressive bilateral cellulitis of the submandibular and sublingual spaces arising from an infected mandibular molar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

succession splash over the epigastrum and a hx of acid ingestion several months ago in a suicide attempt

A

pyloric stricture = gastric outlet obstruction caused by mechanical obstruction leading to postprandial pain and vomiting and early satiety

-can be caused by gastric malignancy, crohns, PUD, ingestion of caustic agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

timeline of post-op fever

A

0-2 hours: prior trauma/infection, blood products, malignant hyperthermia

24hrs-1 week: nosocomial infection, noninfective (MI, DVT, PE), Group A strep, Clostridium perfringes

1 week-1 month: other bacteria not above, catheter infection, drug fever, dvt, pe

>1 month: viral infections, SSI (indolent organisms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

post-op fever defined as what temp

A

>100.4 = 38

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

tx of anal fissures

A
  • topical anesthetics and nifedipine
  • sitz bath
  • high fiber diet and adequate fluid intake
  • stool softeners
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

paradoxical chest wall movement

A

seen in flail chest with multiple rib fractures. Chest expands when inhales and retracts when exhale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

colonic thickening and fat stranding, think what

A

ischemic colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

persisting pneumo despite bilateral chest tube placement

A

think of tracheobronchial rupture secondary to blunt thoracic trauma. The right main bronchus is most commonly injured in these patients

-also may see pneumomediastinum or subq air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

whistling noise post rhinoplasty, suggests what?

(think Me Myself and Irene)

A

septal perforation likely resulting from a septal hematoma

19
Q

treatment of pancreatic pseudocyst that is symptomatic

A 
endoscopic drainage (these psuedocysts can release amylase into circulation)
-if the patient is asymptomatic, no treatment is needed
20
Q

heparin to use in end stage kidney disease pts

A

use: unfractionated heparin

do NOT use: LMWH (enoxaparin) and rivaroxaban

21
Q

complicated diverticulitis treatment

(you saw this)

A

CT guided percutaneous drainage of abscess

22
Q

acute mesenteric ischemia presentation

A

sudden onset severe, poorly localized mid-abdominal pain accompanied by nausea and vomiting

23
Q

acalculus cholycystitis occurs in what type of pts?

A

occurs in critically ill hospitalized patients. Pts have jaundice in addition to pain/mass in URQ

24
Q

retroperitoneal hematoma dx, presentation, tx

A

non-con abd pelvis CT

presents: as sudden hemodynamic instability and ipsilateral back pain

tx: supportive

25
Q

dx of suspected urethral injury

A

retrograde urethrogram (x-ray of lower GI tract with injection of radiopaque contrast in the urethra)

26
Q

acute bacterial parotidis

A

usually occurs in dehydrated post-op patients with crappy oral hygiene

27
Q

ALT >150 in regards to pancreas

A

95% PPV for gallstone pancreatitis

28
Q

tx of spontaneous pneumo in your tall athletic kiddo with no trauma

A
  1. If small (<2cm), give O2 and supportive
  2. If large, do small needle decompression
29
Q

torus palantinus

A

benign, hard immobile mass on the roof of the mouth

  • the thin epithelium tends to ulcerate and takes a long time to heal given poor vascular supply
  • surgery only indicated if symptomatic
30
Q

anterior cord syndrome is seen with what procedure and presents how?

A

seen in thoracic aortic aneurysm repair

The anterior spinal artery provides blood to the anterior 2/3 of the spinal cord including motor tracks and sensory tracks (spinothalamic)

  • The dorsal column is SPARED (vibration and proprioception)
  • Presents with bilateral flaccid paralysis with UMN signs

**ALSO seen in whiplash injuries in old people

31
Q

the two lobes of the parotid gland are separated by what?

A

the FACIAL nerve

32
Q

chronically wounded, burned, scarred skin predispose to what?

A

Squamous cell carcinoma

-If arise within a burn called a majorlin ulcer

33
Q

what pH is sodium bicarb indicated?

A

<7.2

34
Q

hypocalcemia pt presentation

A

initially nonspecific symptoms such as fatigue anxiety, depression

  • Involuntary contractions involving the lips, face, and extremities are seen when more severe
  • prolonged QT

*surgically this is common in post-thyroidectomy pts

35
Q

ejection fraction in hypovolemic shock

A

INCREASED

The left ventricle is decreased due to decreased filling volume tries to compensate by increasing ejection fraction

  • also see an increase in sympathetic nervous system resulting in an increase in total peripheral resistance and HR
  • presents with, hypotension, tachycardia, cold extremities, and evidence of poor organ perfusion (somnolence, unresponsiveness) and physical exam findings of hypovolemia (flat neck veins)
36
Q

nasopharyngeal carcinoma is associated with reactivation of what?

A

EBV

  • It is especially endemic in China
  • often presents with nasal congesion and epistaxis, HA, CN palsy (facial numbness) and/or serious otitis media
37
Q

Aflatoxin B1

A

mycotoxin that contaminates agricultural products and is associated with an increased risk of Hepatocellular Carcinoma

38
Q

Broken penis, what do ya do?

A
  • First, this is rupture of the corpus cavernosum due to traumatic tear in tunica albuginea
  • MUST do retrograde urethrogram and then take pt to OR for surgery
39
Q

acute adrenal insufficiency (adrenal crisis)

A
  • seen in acute adrenal hemorrhage or infarction or stressors such as surgery
  • presents as hypotension/shock, n/v, abd pain, weakness, fever

occurs in patients with primary adrenal insufficiency (addisons) or suppression of HPA axis due to chronic glucocorticoid use

tx: hydrocortisone or dexamethasone

40
Q

supracondylar fx of the humerus in a child has what common complication

A

entrapment of median nerve or brachial artery

41
Q

acalculus cholycystitis

A

most often seen in severely ill pts in the ICU with multisystem organ failure, severe truama, sepsis…

  • likely due to cholestasis or gallbladder ischemia leading to secondary infection by enteric organisms
  • raise suspicion with gallbladder wall thickening and presence of pericholystic fluid
    tx: abx and cholycystectomy
42
Q

tx meningioma

(think HA clinic pt)

A

surgical resection (dx is confirmed intraoperatively)

43
Q

stasis dermatitis

A

result of lower extremity venous valvular incompetence resulting in pooling of blood and increased pressures in the postcapillary venules

44
Q

leriche syndrome

A

aortoiliac occlusion

Triad:

  1. bilateral hip, thigh, gluteal claudication
  2. impotence
  3. symmetric atrophy of lower extremities due to chronic ischmeia

MS3 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions