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Step 2 CK > Surgery > Flashcards

Surgery Flashcards

1
Q

ABCDES

Airway

Breathing

Circulation

D ______

Environment

A

Disability (Brain)

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2
Q

Best type of intubation:

A

Oral endotracheal intubation

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3
Q

Nasotracheal intubation (temporary or permanent)

A

Temporary

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4
Q

Patient with altered mental status, is this indication for intubation?

A

Yes

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5
Q

Cervical spine injury, still intubate?

A

Yes

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6
Q

Initial surgical airway is _______.

A

Cricothyroidotomy

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7
Q

Cricothyroidotomy is permanent/temporary?

A

Temporary

Convert to tracheostomy within a day.

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8
Q

Most common type of shock in trauma:

A

Hypovolemic shock

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9
Q

Which comes first tachycardia or hypotension?

A

Tachy

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10
Q

The best access to address shock: (what type of veins)

A

Short and Fat

  1. Antecubitals - best
  2. Saphenous
  3. Femoral (dirty)
  4. Central line
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11
Q

What is the risk when putting central line in kids?

A

Pneumothorax

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12
Q

Interosseous line start with what bone?

A

Tibia… then femur

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13
Q

Intraosseous line permanent or temp?

A

Temporary

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14
Q

Risk for prolonged intraosseous line placement.

A

Osteomyelitis

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15
Q

5 areas where you can lose blood in the body:

A

C - Chest

A - Abdomen

R - Retroperitoneum

P - Pelvis

T - Thigh

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16
Q

What happens to mediastinum in the tension pneumothorax?

A

Mediastinum shifts and kinks blood vessels

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17
Q

Why is patient hypotensive and tachycardic in tension pneumo?

A

Heart cannot fill

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18
Q

Where do you insert needle to relieve tension pneumo?

A

2nd ICS

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19
Q

How to manage recurrent cardiac tamponade?

A

Pericardial window.

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20
Q

How to differentiate between cardiac tamp or pneumothorax?

A

Breath sounds (no breath sounds means tension pneumo)

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21
Q

Patient comes with MI and hypotensive and tachy, what shock?

A

Cardiogenic shock

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22
Q

What type of shock is anaphylaxis?

A

Vasomotor shock

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23
Q

Treatment of vasomotor shock?

A

Fluids and pressors

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24
Q

Difference in vasomotor and cardiogenic shock.

A

Patient is pale in hypovolemic. Patient is red is vasomotor.

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25
Q

Systems you always evaluate in neck trauma:

V______ system. Use _________ to evaluate.

A

V ________ . Use CT Angio.

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26
Q

Systems you always evaluate in neck trauma:

R______ system. Use _________ to evaluate.

A

Respiratory system. Use bronchoscopy to evaluate.

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27
Q

Systems you always evaluate in neck trauma:

G______ system. Use _________ to evaluate.

A

GastroIntenstinal system. Use gastrografin swallow (water soluble) to evaluate.

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28
Q

What to do in gunshot wound to the angle of the jaw?

A

Call interventional radio and have them do an angiographic embolization.

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29
Q

Most common complication to a flail chest:

A

ARDS

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30
Q

Why is there ARDS in flail chest?

A

Vasoactive amines secreted during trauma cause surfactant to decrease resulting in ARDS

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31
Q

How to address ARDS in flail chest?

A

PEEP

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32
Q

What do you think about when you see a sternum fracture?

A

Cardiac contusion

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33
Q

What to do in sternum fracture?

A

Check heart:

  1. EKG
  2. Troponins
  3. Echo
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34
Q

What labs are to be done in a sternum fracture?

  1. E___
  2. T___
  3. Echo
A

EKG

Troponin

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35
Q

Most common site of aortic rupture?

A

Just distal to the left subclavian artery

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36
Q

2nd most common site of aortic rupture?

A

Aortic root

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37
Q

Patient experienced head-on collision. X-ray taken showed this. Patient asymptomatic. Dx?

A

Aortic rupture

(Widened mediastinum)

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38
Q

How to diagnose aortic rupture?

A

CT angiography

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39
Q

What does a non-expanding lung after chest tube insertion mean?

A

Bronchial injury

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40
Q

Patient with multiple fractures,

hypoxic, thrombocytopenic, petechiae.

Dx?

A

Fat embolism

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41
Q

What parts are done in FAST scan?

A

RUQ

LUQ

Pericardium

Pelvis

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42
Q

Most common solid organ injured is the ______?

A

Spleen

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43
Q

Most common organ injured in the infant?

A

Liver

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44
Q

Most common cause of oozing in the OR while transfusion is

A

dilutional thrombocytopenia

45
Q

Which is more important? Platelets or Factors?

A

Platelets

46
Q

What do you do in pelvic bleeder?

A

stabilize the pelvis

47
Q

Do you operate on pelvic bleeding?

A

no

48
Q

2nd line management of pelvic bleeding?

(if pelvic stabilization does not work)

A

Angiographic embolization of the hypogastric (internal iliac) artery

49
Q

Which do you embolize in pelvic bleeding?

A

Internal iliac artery

50
Q

Other name for hypogastric artery?

A

Internal iliac artery

51
Q

Gunshot wound with gross hematuria, wound in the right flank, which do you inspect? Bladder or Kidney?

A

Both

52
Q

What does high riding prostatet mean?

A

Urethral injury

53
Q

If adult has microscopic hematuria after sports, do you follow up?

A

no

54
Q

If child has microscopic hematuria after fall, do you follow up?

A

Yes (after 1 week)

Check for congenital abnormality

55
Q

What is main tx for chemical burns?

A

Irrigation

56
Q

What chemicals are released in a crush injury?

A

Acid, potassium, and myoglobin

57
Q

Tx for crush injuries?

A

Hydrate, diurese, alkalinize the urine

58
Q

Intubate right away in inhalational burns?

A

yes

59
Q

What layer affected in 1st degree burn?

A

Epidermis

60
Q

%regeneration in 1st deg burn?

A

100%

61
Q

2nd degree burn looks like

A

blister

62
Q

What layer affected in 2nd degree burn?

A

dermis

63
Q

%regeneration in 2nd deg burn?

A

100%

64
Q

3rd deg burns look like

A

white/char

65
Q

What layer affected in 3rd deg burn?

A

full thickness

66
Q

Pain in 3rd deg burn?

A

none

67
Q

%regeneration in 3rd deg burn?

A

0%

68
Q

pain in 2nd degree burn?

A

yes but less than 1st deg

69
Q

Most common systemic complication of skin burns is

A

hypovolemic shock

70
Q

1st line treatment of burns:

A

hydrate

71
Q

What is the parkland formula for burns

A

4cc/kg/%burn

72
Q

Fill blanks

A
73
Q

How do you determine the adequacy of fluid resuscitation?

A

urine output

74
Q

How to infuse fluids?

A

1st half in 8 hours, 2nd half in 16 hours

75
Q

What is the late complication in burns?

A

Gram neg infection

76
Q

What degree of burn?

A

full thickness

77
Q

What to do when you see an eschar?

A

Take it out - escharotomy

78
Q

Amount of antivenom depends on…

A

amount of venom injected

79
Q

Falling with outstretched arm in kids results in what fracture?

A

Supracondylar fracture

80
Q

What is a common complication of supracondylar fracture?

A

compartment syndrome

81
Q

Falling with outstretched arm in adults results in what fracture?

A

Colle’s fracture

82
Q

What bones are involved in a Colle’s fracture?

A

distal radius and styloid process

83
Q

Fall with associated pain in the snuffbox:

A

carpal navicular fracture (scaphoid fracture)

84
Q

Repeat x-ray if fracture unclear after 2 weeks. Why?

A

Osteoclasts make the fracture visible

85
Q

Venous stasis ulcer caused by what?

A

Incompetent valves

86
Q

Best test for osteomyelitis?

A

MRI

87
Q

Most common site of diabetic ulcer?

A

first metatarsal-phalengeal joint

88
Q

How long does treatment for osteomyelitis last?

A

6 weeks

89
Q

Most common complication for diabetic foot ulcer

A

osteomyelitis

90
Q

2nd most common site of diabetic foot ulcer?

A

calcaneus

91
Q

Ulcer from squamous cell carcinoma?

A

Marjolin’s Ulcer

92
Q

What is this? Dx?

43 y/o woman wearing heels with pain in this area.

A

Morton’s Neuroma

93
Q

Child’s x-ray showed this? Most likely..

A

Osteogenic sarcoma

94
Q

Child 6 y/o with bone pain on x-ray. Dx?

A

Ewing sarcoma

(5-15 y/o)

95
Q

Most common cause of pathologic fracture in women?

A

Breast CA

96
Q

Most common cause of pathologic fracture in men?

A

Lung CA

97
Q

Most common cause of any bone metastasis in men?

A

Prostate CA

98
Q

Lung CA in men with lets to where?

A

Long bones

99
Q

3 contraindications to elective general anesthesia:

  1. ________ Heart failure
  2. A____________
  3. MI within ___________.
A
  1. Congestive heart failure
  2. Arrhythmia
  3. MI within 6 months
100
Q

5 medical conditions that defer general anesthesia surgery that have to do with the liver.

A
  1. encephalopathy
  2. ascites
  3. inc bilirubin
  4. dec albumin
  5. coagulopathy
101
Q

Best test for malnutrition:

A

Skin test anergy

102
Q

What fo general anesthetics do to the heart?

A

Decrease inotropy

Increase ectopy

103
Q

Malnourishment decreased what kind of immunity?

A

Cell-mediated immunity

104
Q

Patient acquires fever after day 1-2 of post-op… most likely due to…

A

Pneumonia caused by atelectasis

105
Q

Patient has fever after day 3-5 post-op.. cause?

A

UTI

(usually caused by catheter)

(but also due to increased urine stasis)

106
Q

Most common cause of post op fever on day 6-7?

A

Wound infection

107
Q

Dx test for pulmonary embolism?

A

Spiral CTA

108
Q
A

Step 2 CK (2 decks)

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