hyperventilation --> Co2 removal leads to vasoconstriction - elevate head of bed --> venous outflow - sedatoin --> dec metabolic demand - mannitol

surgery Flashcards by Peter Klauck

signs to progress to ex lap from conservative measures in SBO

fever, hemodynamic instability, luekocytosis, metabolic acidosis

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“pain out of proportion to exam findings”

acute mesenteric ischemia

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peritonsalar abcess sx

fever, pharyngeal pain, earache

saliva pooling, deviated uvula,

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tertiary hyperparathyroid

renal transplant

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femoral nerve

innervates muscles of anterior thigh –> flexion of hip and extension of knee

sensation to medial thigh/medial leg via saphenous

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tibial nerve

posterior compartment of thigh/leg

flexion at knee, digits and foot

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scaphoid fracture

FOOSH
pain over snuff box
avascular necrosis –> radial artery goes distal pole to proximal pole

does not show up on xray immediately –> thumb spica splint, relook in 2 weeks

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clinical triad of fat embolism syndrome

petechiae
neurologic dysfunction
respiratory distress

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patchy alveolar infiltrates not restricted by anatomic borders after trauam

pulmonary contusion

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leriche syndrome

arterial occlusion at bifurcation of common iliac

–>chronic glute, thigh, hip pain and impotence

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ways to decrease ICP

hyperventilation –> Co2 removal leads to vasoconstriction

elevate head of bed –> venous outflow
sedatoin –> dec metabolic demand
mannitol

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atelectasis is most common _____ post op

day 2-3

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bloody/ painful diarrhea after AAA repair

ischemic bowel due to loss of IMA after graft placement

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retrograde urethrogram

used in suspected urethral injury

penile fracture
urinary retention
blood at meatus
dysuria, hematuria

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presentations of pancreatic cancer (besides weight loss/fatigue)

migratory thrombophlebitis (trouseau’s sign)
painless jaundice –> panc head, jaundice may come later if at tail
gnawing epigastric pain that is worse at night

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4T’s of mediastinal mass

thymoma
teratoma
thyroid neoplasm
terrible lymphoma

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hypocalcemia, hyperphosphatemia, normal renal fx

hypoparathyroid

post surgical
autoimmune
digeorge
non autoimmune

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reversal of warfarin for emergency ex lap vs non emergent

FFP, vit k

FFP will instantly normalize PT time with vit k dependent clotting factors

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obstructive sx 24-36 hours after blunt abdominal trauma

duodenal hematoma

req NGT decompression, parenteral nutrition until resolve

flail chest

> 3 contiguos ribs in >2 locations

causes paradoxical movement of chest on inpiration

diagnostic characteristics of meningiomas

extra axial, dural based, partially classified

pathologic nipple discharge

unilateral, spontaneous, single duct

persistent pneumo despite chest tube with addition of pneumomediastinum

tracheobronchial rupture (after blunt chest trauma)
most common in R bronchus

risk factors for post op PNA

age >50
thoraco/ abdominal surgery
surgery >3hrs
preexisting lung dz
poor health

IS!!!

Scurvy

cutaneous manifestations ( petechiae, coild hairs, follicular hyperkeratosis - bleeding gingiva - impaired wound healing - arthralgias, malaise alcoholics!!!

complicated diverticulosis + management

assoc with abcess, perf, fistula <3= abx >3= percutaneous drainage persist for 5 days --> lap drainage/debridement

wound infections in burn patients (>20%)

- first 5 days= gram + - >5 days= gram - (PSA), fungi (candida) - CHANGE IN APPEARANCE (partial thickness to full thickness) - unexplained hyperglycemia - oliguria

evaluation of posterior urethral injury

retrograde urethrogram

QT prolongation after thyroidectomy?

hypocalcemia

patient on longterm GC therapy with cushingoid feature at high risk for....... with surgery

acute adrenal crisis hypotn, n/v, hyponatremia, hypoglycemia

how do you prevent acute adrenal crisis

stress dose anyone on >20mg pred for 3 weeks

which side of the diaphragm is "weaker"? What is it prone to in BAT

L detachment hiatal hernia!!!

head injury, loc, lucid interval

EPIdural hematoma | does not cross suture lines

which side is varicocele more common?

L | "nutcracker effect" (l spermatic --> l renal passes under SMA)

what pH is indication for bicarb in severe acidosis

<7.2

marjolin ulcer

SCC arising in burn wound

PPV in tension pneumo?

BAD, increases insult of one wayvalve of air out of lung into pleural thatcannot escape

nerve injured in anterior shoulder dislocation

axillary, weakend deltoid abduction

spinal cord injury during repair of TAA

anterior cord syndrome (radicular arteries supply anterior spinal artery,artery of Adamkeweitz) loss of movement, pain, temp (spinothalamic) maintain position/vib

loss of ventricular preload after PPV?

hypovolemia --> dec CVP --> PPV --> dec venous return --> collapse capacitance

CI to LMWH after surg provoked Dvt?

ESRD use unfractionated and bridge to warf for 3months

post op bacterial parotitis

who: dehydrated, elderly post, post op prevention: hydration/oral hygeine what: staph a

compensatyory mechanisms of hypovolemic shock

inc SVR, HR, EF

extraperitoneal bladder injury vs intra

EPBI- pelvic fracture | IPBI- rupture of dome --> intraper leakage --> chemical peritonitis

lab measurement assoc with gallstone panc?

ALT>150

common EARLY sx of compartment syndrome?

pain with passive motion, parasthesas uncommon= pallor and lossofpulses

common path after distal gastrostomy (hypotn n/v aftereating)

dumping syndrome-->no pyloric regulation