Brainscape's Knowledge GenomeTM

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


See full index

SHELF EXAMS > Surgery > Flashcards

Surgery Flashcards

1
Q

Recommendations for lung cancer screening

A

Annual chest CT for all current & former smokers who:

  • Are age 55-79
  • Quit <15 years ago
  • Have >30 pack years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Histologic type for Pancoast tumor

A

Squamous cell CA

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

DDx: Adult, jaundice, elevated LFT’s vs Adult, jaundice, elevated Alk Phos

A

LFT: Hepatitis; Hemochromatosis

ALK PHOS: Cancer; PBC/PSC; Gallstones

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

Hearing loss:

TM with red blush vs with white horseshoe

A

Red blush = otosclerosis (AD)

White horseshoe = tympanosclerosis (chronic OM)

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

Interpretation of Weber/Rinne tests

A

Weber –> + is conductive (ips) or sensory (cont)

Rinne –> + is normal or sensory, - is conductive

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

Difference between Dix Hallpike and Epley

A 
DH = diagnostic
Epley = treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mutation, Wilsons disease

A

ATP7B

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

ENT complication of gout

A

Higher incidence of salivary stones

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

Acute vs chronic management of gout

A

Acute: NSAIDS or colchicine (if no NSAID)
Chronic: Allopurinol – will trigger acute attack!

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

Best imaging for toxic megacolon

A

AXR – no Barium!

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

Treatment for toxic megacolon

A

NGT, IVF

Steroids if IBD e/o

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

Presentation of toxic megacolon

A
  • Hx of abx use or IBD
  • bloody diarrhea
  • peritonitis with SIRS criteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Appropriate workup for primary lung cancer

A
  1. CXR & CCT
  2. Small nodule <8mm : follow serial CCT
  3. Likely malignancy: Bx and/or VATS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Appropriate imaging for aspiration foreign body

A
  1. XR

2. CT if XR is neg (non radio opaque objects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

4 drug classes most likely to cause pill esophagitis

A
  1. Tetracyclines
  2. NSAID’s
  3. Bisphosphonates
  4. Vitamin supplements (Fe esp)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment for bony mets from prostate primary

A

– If SC compression –> emergency steroids

External beam radiation

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

Best Antibiotics for bacterial prostatitis

A

Bactrim or Keflex

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

Treatment: infantile hemangioma

A

Watchful waiting

If ulcerated –> propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Required vax in burn patients

A

Tetanus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Appropriate tetanus prophylaxis:

Clean wound, up to date on shots (3 or more) vs dirty wound, up to date on shots

A

Clean: TT only if last dose >10 years
Dirty: TT only if last dose >5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Appropriate tetanus prophylaxis:

Clean vs dirty wound, <3 prior shots (inadequate)

A

Clean: TT
Dirty: TT & TG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

CA-125 vs CEA?

A 
CA-125 = ovary
CEA = colon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Best imaging to assess for metastatic disease

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treatment: giant cell arteritis

A

Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Treatment: Buergers disease

A

Quit smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Predisposing conditions for SIBO

A

Gastric motility impairment – diabetes, IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Workup for dyspepsia in young vs old patient

A

Young?

  1. Trial PPI
  2. ? H. pylori testing
  3. Barium swallow if no improvement

Old/alarm symptoms?

  1. UGI w Bx
  2. CT if Bx +
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

E/o : popliteal Baker cyst

A

DJD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Treatment: hypertensive emergency in pregnant and non pregnant adult

A

Pregnant? Hydralazine

Not pregnant? Sodium nitroprusside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Diagnosis? Infant with weak abdominal muscles, dilated ureters, undescended testes

Most likely COD?

A 
Dx = prune belly (Eagle Barrett syndrome)
COD = pulmonary hypoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Best imaging for bone mets

A

Technetium 99 bone scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Contraindications for immunomodulators:
Prednisone?
Azathioprine?
Cyclosporine?

A

P - diabetes
A - cirrhosis
C - renal dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Crypt abscesses are seen in

A

UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is IRIS?

A

Immune Reconstitution Inflammatory Syndrome – the reason not to start (or restart) HAART in an acutely ill AIDS patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

A deformity in which body system causes oligohydramnios vs polyhydramnios?

A

Oligo – renal (can’t produce urine)

Poly – GI (can’t swallow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Leslar-Trélat sign

A

Acute eruption of sebhorreic keratoses; suggestive of gastric cancer

Justifies ordering an ACT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Treatment for keratoacanthoma

A

A low grade SCC; should be excised completely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Anatomic site for foreign body impaction in infants vs children

A

Baby: larynx
Kid: R main bronchus or trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Is blood hyper or hypo dense on CT?

A

Hyper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Diagnosis: head CT shows hyperdense fluid in ventricles

A

SAH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

1 most common brain tumor

A

Metastatic lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Most likely diagnosis: newborn with difficulty breathing and CXR showing diffuse interstitial/alveolar edema

What’s the treatment?

A

Transient tachypnea of the newborn

Self resolving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is a normal value for CVP? Which values would suggest fluid overload?

A

Normal: 0-5

Fluid overload: >12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Under which criteria can a pregnant trauma patient be d/c home?

If they can’t be d/c home, what test should you order?

A
  1. Fetal nonstress test shows no acute distress
  2. No contractions > q10m
  3. No abdominal pain
  4. Normal fetal heart tracing

First test if patient fails these criteria: Biophysical profiling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Treatment: Warthin tumor

A

Superficial parotidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Biggest risk factor: Warthin tumor

A

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Best imaging: renal artery stenosis

A

Renal arteriogrhaphy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Screening guidelines: AAA

A

Men >age 50 with significant smoking history

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Most common location of a peripheral aneurysm

A

Popliteal; often b/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Imaging for intact vs stable ruptured AAA

A

Intact: US
Ruptured: CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Treatment: ruptured AAA

A

Morphine and propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Prenatal US finding (and its significance): Gastroschisis

A

Polyhydramnios (concomitant intestinal atresia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Infants with omphalocele should be screened for these three genetic syndromes

A
  1. Trisomy 13
  2. Trisomy 18
  3. Beckwith-Wiedemann (macroglossia, microcephaly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Treatment, according to Cobb angle: Scoliosis

A

> 20 needs a brace

>50 needs surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Workup for dysphagia

A
  1. Barium swallow to r/o Zenker
  2. Manometry to r/o achalasia

No UGI until Zenker has been r/o (risk of perf)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

MOA of these drugs for acute angle closure glaucoma:
PO Carbonic anhydrase inhibitors
Topical beta blockers and alpha 2 agonists

A

CAI: decreases intraocular pressure
Symps: induces pupil constriction (miosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Treatment: acute adrenal insufficiency

A

Corticosteroids and IVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Pharmaceutical treatment for anal fissure – what are they and why do they work? Side effects?

A

Vasodilators – nifedipine, nitroglycerin

Increased bloodflow improves healing

Nitro can cause headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Imaging for aortic dissection stable vs unstable

A

Stable: CT
Unstableish: TEE
Unstable: emergent thoracotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

When would a dissection of the descending aorta necessitate surgical repair?

A

Signs of end organ or limb ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Best drug treatment for dissection of descending aorta?

A

Labetalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Aortic transection: finding on CXR

A

Left hemothorax with widened mediastinum and deviation of trachea to the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

3 diseases that predispose to angiodysplasia

A
  1. Renal disease
  2. Aortic stenosis esp when associated w VWD
  3. VWD alone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Preferred drug treatment for:
Dog bite
Black widow bite
Brown recluse bite

A

Dog: Amox/Clav
Black widow: Calcium gluconate
Brown recluse: Dapsone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Deadliest animal injury

A

Bee sting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Prophylaxis for post op atelectasis in smokers

A

Stop smoking at least 8 weeks prior to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Common e/o organism: bacterial parotitis

A

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Common e/o organism: Septic arthritis

A

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Most common appendiceal tumor

A

Mucinous adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Diagnosis: “lead pipe” appearance of colon on AXR

A

UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Initial imaging: basilar skull fracture

A

Head CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Treatment: Bell’s palsy

A

PO corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Definitive diagnostic test for biliary atresia

A

HIDA scan with Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Imaging: Bladder dome rupture

A

Retrograde cystogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the clinical indication for aminocaproic acid? How does it work?

A

Pre-operative for severe (transfusion-dependent) Hemophilia A

Decreases fibrinolysis by binding to plasminogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Mechanism of action for each of these anticoagulants?

Fondaparinux (Arixtra)
Bivalrudin
Argatroban 
Rivaroxaban (Xarelto)
Apixaban
A

Direct thrombin inhibitors:

  • Bivalrudin
  • Argatroban

Direct Xa inhibitors:

  • Rivaroxaban
  • Apixaban

Indirect Xa inhibitors (anti-thrombin binding)
- Fondaparinux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Mechanism of action for each of these anti-platelet agents?

Aspirin 
Clopidogrel (Plavix)
Cilostazole
Dipyridamole
Abciximab (Reopro)
A

ADP receptor blockers:
- Clopidogrel

PDE inhibtors:

  • Cilostazole
  • Dipyridamole

Platelet GP receptor blockers:
- Abciximab

78
Q

Presentation for Blount’s disease

A

Persistent bowleggedness (genu varum) in an older child; requires surgical correction

79
Q

Brachial plexus: nerve roots for superior vs inferior trunk

A

Superior: C5-C6
Inferior: C8-T1

80
Q

Best imaging: brain abscess

A

Head CT

81
Q

Appropriate management for bronchial rupture

A

Intubation with fiberoptic bronchoscopy followed by urgent surgical repair

82
Q

Best imaging: breast abscess

A

US

83
Q

Paget’s disease of the breast is most commonly associated with this pathologic diagnosis

A

DCIS

84
Q

Most common bacteria to infect burn patients:

  • First 5 days
  • > 5 days
  • Overall
A
  • First: MRSA and Group B Strep
  • > 5 days: Gram negative
  • Overall: Pseudomonas
85
Q

What is the rule of 9’s? How is it different in babies?

A

Adults -
Head and each arm 9%
Front, back, and each leg 18%

Babies -
Head, front, and back 18%
Each arm 9%
Each leg 14%

86
Q

Which imaging study would be most appropriate to order in a patient with severe burn injuries?

A

Endotracheal fiberoptic bronchoscopy

87
Q

Appropriate treatment for a burn patient with carboxyhemoglobin > 10%

A

100% O2

88
Q

What is the Parkland Formula for calculation of IVF in a burn patient?

A

TBSA % (2nd and 3rd degree) * Weight kg * 4

usually ~1,000mL/hr in adults or 20mL/hr in babies

89
Q

Which IVF is absolutely contraindicated in a burn patient, and why?

A

Anything with dextrose – sugar can induce osmotic diuresis

90
Q

What are the side effects of silver sulfadiazene and mafenide acetate?

A

Silver –> thrombocytopenia

Mafenide –> severe pain with application; metabolic acidosis

91
Q

Which lab test is fastest for diagnosis of C. diff colitis?

A

Stool toxin

92
Q

What is the antibiotic of choice in C. diff colitis?

A

Vancomycin PO

93
Q

Which vessel is most commonly transplanted to the heart in a CABG?

A

Internal mammary artery

94
Q

What is the most common complication of CABG and which imaging is appropriate to identify it? How is it treated?

A

Retroperitoneal hematoma, less than 12 hrs
A/P CT without contrast
Treatment = supportive only

95
Q

What is the appropriate management for multi-vessel heart disease in patients who are poor surgical candidates for CABG?

A

Balloon angioplasty with stent placement

96
Q

If a patient with recent history of CABG presents with SIRS criteria, what should be your first differential? What’s the treatment?

What is Hamman’s sign?

A

Acute mediastinitis
Tx = surgical debridement and antibiotics

Hamman’s sign = systolic crepitus over mediastinum

97
Q

This finding on cardiac echo justifies performing a CABG

A

EF < 50%

98
Q

Contraindications specific for CABG

A
  • Poor ventricular function

- No distal vessels sufficient for graft

99
Q

CP manifestations of carcinoid syndrome

A

Right valvular disease (ie tricuspid) 2/2 increased JVP

100
Q

Which vitamin deficiency is associated with carcinoid syndrome and why?

A

Pellagra (niacin deficiency) 2/2 depletion of tryptophan

101
Q

Dermatologic manifestation of carcinoid syndrome

A

Cutaneous telangiectasias

102
Q

What is the best imaging test for metastatic carcinoid tumors?

A

OctreoScan (and A/P CT)

103
Q

What is the standard treatment for symptomatic carcinoid tumor?

A

Pre-operative octreotide followed by surgical resection of liver mets

104
Q

Best imaging for cauda equina syndrome

A

MRI

105
Q

Which part of the hand is affected in carpal tunnel?

A

Thumb, 2, 3, and half of 4

NOT THE PALM (palmar cutaneous comes off before the carpal tunnel)

106
Q

Best imaging for carotid artery dissection?

A

MR Angiogram (and usually head CT to r/o stroke in cases of Horner syndrome)

107
Q

Most feared complication of carotid artery dissection?

A

SAH

108
Q

Appropriate management for carotid artery dissection

A

Medical anticoagulation

Stenting increases stroke risk and is therefore reserved for special cases

109
Q

Appropriate management for carotid artery stenosis

A

> 60% and symptomatic (or >80% and asymptomatic): endarterectomy

110
Q

Best initial imaging in C-spine injury

A

CT – then MRI if CT is negative

111
Q

Treatment for cholangitis

A

Decompressive ERCP with elective chole to follow

112
Q

Neoplastic association of porcelain gallbladder

A

Gallbladder cancer

113
Q

Appropriate treatment for chronic symptomatic cholelithiasis in a poor surgical candidate. What is the most common side effect

A

Oral ursodeoxycholic acid; diarrhea

114
Q

Why does Crohn’s disease predispose to cholecystitis?

A

Terminal ileum resection –> loss of bile salts

115
Q

A gallbladder wall beyond a thickness of ___ cm is suggestive of acute cholecystitis

A

4 cm

116
Q

Which organism is usually responsible for emphysematous cholecystitis, and which characteristic laboratory finding does it cause?

A

Clostridium

+ Unconjugated bilirubin (hemolysis)

117
Q

Best antibiotic for clostridial species

A

PCN or Clinda

118
Q

HIDA scan results in acalculous cholecystitis

A

Gallbladder is not visualized at all (may be false +)

119
Q

Appropriate workup and treatment for acute bile duct leak

A
  1. CT –> determines drain placement
  2. HIDA –> tracer in the abdomen is justification for ex lap with hepaticojejunostomy; if tracer is contained, can do an ERCP with stent placement instead
120
Q

What is Mirizzi’s syndrome?

A

A gallstone in the cystic duct compressing the common hepatic duct

121
Q

Appropriate treatment for benign gallbladder cyst

A

Cholecystectomy. Cysts can be premalignant; and they can predispose to cholangitis (especially if the involve the hepatic ducts, as in Caroli’s syndrome)

122
Q

Best pain relieving medication for gallbladder disease

A

Anti-cholinergics

123
Q

Which two vessels are at highest risk for injury in a clavicle fracture?

A

Axillary artery, subclavian artery

124
Q

How does the location of a clavicular fracture change the treatment? Which location is most common?

A

Mid-shaft (most common): ice, rest, bracing

Distal shaft: open reduction and internal fixation

125
Q

How does a person with a clavicle fracture hold the affected arm?

A

Posterior & inferior

126
Q

Which chemotherapeutic agent is most standard in CNS lymphoma?

A

Intrathecal methotrexate

127
Q

What is the appropriate treatment for a cocaine overdose with EKG changes? Which treatment is absolutely contraindicated?

A

PCI!

Never give BB!

128
Q

What are the treatment for acute and chronic cluster headaches?

A

Acute – sumatriptan (5HT agonist) and O2

Chronic – verapamil prophylaxis

129
Q

Which genetic syndrome predisposes to coarctation of the aorta?

A

Turner syndrome

130
Q

Which condition presents with “scalloping” or “notching” of the ribs on CXR? Why?

A

Coarctation of the aorta (erosion from collateral enlargement of intercostal vessels)

131
Q

How is coarctation of the aorta managed in a neonate?

A

Prostaglandin E –> opens the DA

132
Q

What is a Colles fracture, how does it present, and how is it treated?

A

Fracture of the distal radius

Most commonly presents in a little old lady with osteoporosis and a FOOSH injury with a “dinner fork” deformity (the fractured end of the radius is displaced dorsally)

Treated with casting

133
Q

A patient with colon cancer and colonization by Clostridium septicum is at increased risk for these

A

hematologic malignancy; myositis

134
Q

How does R-sided colon cancer present?

A

+FOBT, asymptomatic

135
Q

First site of metastasis for rectal cancer

A

Lungs

136
Q

Which of these polyposis syndromes are benign?

Peutz-Jeghers
Juvenile polyposis
Gardner syndrome

A

Peutz-Jeghers and Juvenile polyposis

137
Q

A patient with UC needs increased screening for colon cancer at 20 years after diagnosis. How often should they get a colonoscopy?

A

Every 1-2 years

138
Q

Which non-malignant etiology can cause false elevations in CEA?

A

Smoking

139
Q

Patients with FAP can usually wait to undergo a total proctocolectomy until their early 20’s, unless …

A

They have HG dysplasia or are symptomatic

140
Q

Children who test positive for the APC (FAP) mutation should undergo this test every year

A

Flexible sigmoidoscopy (since polyps arise on the left)

141
Q

Colon cancer screening protocol in patients with Lynch syndrome

A

Annual flex sig or colonoscopy starting at age 25

142
Q

Female patients with Lynch syndrome need this non-GI screening test

A

Annual endometrial biopsy (or prophylactic hysterectomy)

143
Q

What is the purpose of the GCS? What does a GCS < 8 indicate?

A

PROGNOSTIC rather than diagnostic

<8 justifies intubation

144
Q

What are the three components of the GCS?

A

Eye opening (4), verbal (5), motor (6)

145
Q

Which chemotherapy regimens are most appropriate in colon cancer?

A

FOLFOX (5FU and folinic acid)
or
FOLFIRI (5FU, folinic acid, and irinotecan)

146
Q

Which test can be used to diagnose abdominal compartment syndrome?

A

Bladder pressure test

147
Q

How is abdominal compartment syndrome treated, and how does that vary by etiology?

A

Post-surgical (most common): surgical opening of the wound with placement of temporary cover

Pancreatitis: NG tube placement and paracentesis

148
Q

What is the time scale at which irreversable damage occurs to these structures in a case of limb ischemia?

  • Muscle
  • Nerve
  • Fat
  • Skin
  • Bone
A 
Muscle 4h
Nerve 8h
Fat 13h
Skin 24h
Bone 5d`
149
Q

Which surgical procedure is most likely to lead to extremity compartment syndrome?

A

Femoral artery embolectomy

150
Q

Which vascular symptoms do you expect to see in compartment syndrome of the extremity?

A

NONE. Pulses should be normal

151
Q

Most likely diagnosis in a post-surgical patient with a warm, exquisitely tender limb

A

Warm = fairly specific for cellulitis

152
Q

Top 4 complications of an electrical burn injury

A

1- hyperkalemia
2- compartment syndrome
3- cataracts
4- demyelination syndromes

153
Q

Localizing corticotropic tumors using the 8mg dexamethasone suppression test: After suppression:

High ACTH, low cortisol = ?
High ACTH, high cortisol = ?
Low ACTH, high cortisol = ?

A

High ACTH, low cortisol – pituitary
High ACTH, high cortisol – ectopic (ie lung)
Low ACTH, high cortisol – adrenal

154
Q

DIagnosis: ascites and “square root sign” on Swann Ganz catheter

A

Chronic constrictive pericarditis

155
Q

Treatment for DeQuervain tenosynovitis vs DePuytren contracture

A

DeQuervain: Steroid injections
DePuytren: Surgery eventually

156
Q

A scaphoid (“sucked in”) abdomen may portend this abnormality

A

Diaphragmatic hernia – the abdomen is empty because its contents are in the chest

157
Q

Diaphragmatic hernias may occur in children weeks or months after a BAT, in which case they undergo immediate surgical repair to prevent bowel strangulation. How are they treated differently in infants with congenital disease?

A

Provide ECMO respiratory support and delay surgery until 3-4 days old to allow the displaced little lungs to mature

158
Q

A patient presents with a dislocated shoulder. Explain how you would treat them and how imaging would factor in .

A

1 - start with XR
2 - reduce
3 - re-XR
(4 - concern for vascular injury – CT angio post reduction)

159
Q

How does a patient with an anterior shoulder dislocation hold their arm?

A

AD and ER (like shaking hands)

160
Q

What is the primary long term concern in a patient with anterior shoulder dislocation and how would it manifest?

A

Axillary nerve injury

  • Can’t ABduct (teres minor & deltoid weakness)
  • Numbness in lateral shoulder (deltoid)
161
Q

Posterior shoulder dislocations are rare. Which imaging to they require, and how is that different from an anterior shoulder dislocation?

A

Posterior needs both lateral and axillary views (more than anterior)

162
Q

Is it ever appropriate to order a CT in a shoulder dislocation?

A

Only if the XR is equivocal

163
Q

What is the FIRST test to order in a case of bacterial endocarditis?

A

Blood culture

Not echo

164
Q

A patient has a suspected colovesical fistula which needs to be evaluated by contrast CT. How should the contrast be administered?

A

Rectal or oral – NOT IV

165
Q

What is the pathogenesis of Dumping Syndrome s/p gastric bypass and how is it treated?

A

Excessive release of post-prandial insulin

Dietary modifications & octreotide

166
Q

Appropriate initial imaging in a case of acute diverticulitis

A

ACT with contrast
not colonoscopy – could perforate if you pump air into it

NEVER DO A COLONOSCOPY ON AN ACUTELY ANGRY COLON

167
Q

When does a diverticulitis patient need to be admitted to the hospital? When do they need emergent (non-elective) surgery?

A

Any abscess at all on ACT should be admitted
If the abscess is >3cm it needs to be drained
If it persists after drainage colectomy is required

168
Q

You should have a high index of suspicion for this injury in a child with a recent fall onto their bicycle handlebars

A

Duodenal hematoma

169
Q

Does duodenal hematoma with perforation commonly present with peritonitis?

A

NO – injuries are usually retroperitoneal

170
Q

What is the appropriate treatment for duodenal hematoma with and without extravasation of contrast on CT?

A

With – emergent ex lap

Without – NG decompression, may need I/D if doesn’t improve

171
Q

Treatment: epidural hematoma

A

Emergent craniotomy

172
Q

Neurologic exam findings in epidural hematoma

A

Ipsilateral fixed and dilated pupil

Contralateral hemiparesis

173
Q

Patients with otomycosis (or malignant otitis media) 2/2 aspergillus need to undergo this test

A

Head CT

174
Q

The most common complication of acute otitis media is what? What test is required? What’s the treatment?

A

Mastoiditis
CT
Surgical mastoidectomy with ear tube placement

175
Q

3 most appropriate tests in a baby with esophageal atresia

A

Renal US
Limb (radius) XR
Echo
(for VACTERL)

176
Q

Best pharmacotherapy for esophageal spasms

A

Diltiazem

177
Q

Esophageal varices are treated with vasopressin, nadalol, and this drug, which decreases portal bloodflow

A

Octreotide

178
Q

Patient’s s/P TIPS procedure should limit this in their diets

A

protein

179
Q

The preferred beta blocker in esophageal varicies

A

Nadalol

180
Q

Patients with Plummer Vinson Syndrome need to undergo this screening test

A

annual UGI (high risk of SCC)

181
Q

Appropriate management for empyema

A

thoracentesis, and chest tube

182
Q

CBC finding characteristic of fat embolism syndrome

A

thrombocytopenia

183
Q

What causes a felon, how does it present, and how is it treated?

A

Cause: neglect of penetrating wound

Presentation: abscess in fingertip with fever and severe pain, sometimes meeting SIRS criteria

Treatment: I/D terminal joint space

184
Q

Injury to this nerve causes numbness in the anterior thigh and an inability to extend the knee

A

femoral nerve

185
Q

Injury to this structure needs to be ruled out in cases of flail chest

A

thoracic aorta

186
Q

What is Foster Kennedy syndrome? What are its symptoms?

A

Frontal brain tumor – bizarre behavior, anosmia, C/L papilledema, vomiting

187
Q

Which test is considered definitive for gastroparesis?

A

Scintigraphic emptying study

188
Q

Gamekeeper’s (skiier’s) thumb, jersey finger, and mallet finger are all treated with casting. What is the difference between them?

A

Gamekeeper/skier – forced hyperextension of thumb
- ulnar collateral ligament
Jersey finger – forced hyperextension of finger
- flexor tendon
Mallet finger – forced hyperflexion of finger
- extensor tendon

189
Q

Appropriate treatment for GERD with HG dysplasia

A

NIssen with radiofrequency ablation

190
Q

What is the #1 risk factor for gastric cancer?

A

H pylori

SHELF EXAMS (1 decks)

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