Surgery

Question 1

Boarders of retropharyngeal space

Answer 1

Anterior: buccopharyngeal fascia and pharynx constrictor muscles
Posterior: alar fascia

Question 2

Risk in retropharyngeal abscess

Answer 2

• Infection of mediastinum d/t inferior drainage
• Carotid sheath -> thrombosis IJV and CN IX-XII
• Alar fascia -> danger space -> posterior mediastinum

Question 3

Extension of infection from paranasal sinuses can lead to what?

Answer 3

Subdural empyema

Sx: fever, HA, mass effect

Question 4

Ludwig angina

Answer 4

Progressive b/l cellulitis of submandibular and sublingual spaces
D/t infected mandibular molar
Sx: fever, dysphagia, odonyphagia, drooling

Question 5

Spread of infection from medial 3rd of face, sinuses, or teeth would cause?

Answer 5

Cavernous sinus thrombosis

Sx: HA, fever, CN and proptosis

Question 6

Causes of epidural abscess

Answer 6

Hematogenous dissemination, spread from vertebral osteomyelitis, direct inoculation

Question 7

Radionuclide scan with thallium and dipyridamole is also called?

Answer 7

Stress test

Question 8

Ropey, uneven, irregular etc in the scrotum

Answer 8

Varicocele

Does not transilluminate, increases in size with valsalva

Question 9

Signs of cariogenic shock

Answer 9

Decreased cardiac index, increased capillary wedge pressure, hypotension, tachycardia

Question 10

Leriche syndrome

Answer 10

B/l hip, thigh and buttock claudication
Decreased femoral pulses
Impotence
Cause by occlusion of aorta into iliac arteries

Question 11

Signs of necrotizing wound and treatment

Answer 11

Pain/redness etc beyond the surgical site, systemic symptoms, paresthesia at the wound edge, dishwater drainage, crepitus
Abx and debridement

Question 12

Next step in blunt trauma with normal mental status?

Answer 12

FAST

Question 13

Hard signs of vascular trauma and next step

Answer 13

Pulsatile bleeding, bruit/thrill, expanding hematoma, distal ischemia
Surgical exploration

Question 14

Torus paltinus

Answer 14

Benign bony growth on midline suture of hard palate

Congenital

Question 15

Dumping syndrome

Answer 15

Abd pain, diarrhea, nausea, hypotension/tachy, palpitations, diaphoresis
15-30 mins after a meal
Common postgastrectomy
Dietary modification

Question 16

Pathophysiology of dumping syndrome

Answer 16

Loss of pyloric sphincter -> rapid emptying of hypertonic contents into duodenum -> hypotension, stimulation of autonomics, release of vasoactive peptides

Question 17

Anal fissures

Answer 17

Trauma, IBD, Cancer
Pain, BRBPR, posterior midline
Treat w/ high fiber, stool softeners, sitz, anesthetics and vasodilators (nifedipine or NTG)

Question 18

Risk of injury in supracondylar fracture of the humerus

Answer 18

Brachial artery, median nerve, compartment syndrome/volkmann contracture

Question 19

Next step in clavicle fracture

Answer 19

Angiogram (when bruit is heard)