Surgery

Question 1

Indications for urgent exploratory lap

Answer 1

• hemodynamic instability
• peritonitis (rebound tenderness, guarding)
• evisceration (externally exposed intestines)
• blood from NG tube or on rectal exam

Question 2

Most common complication after thyroidectomy

Answer 2

hypocalcemia from hypoparathyroidism

• tetany and seizures
• QT prolongation

Question 3

Pt statbalized after an MVA develops RUQ pain and is minimally responsive on the 5th day of his hospital stay. Abdominal CT shows distension of small and large bowel with no air fluid levels. Gallbladder is distended with minimal pericholecystic fluid

Answer 3

Acalculous cholecystitis

Question 4

Pt presents 15 min after surgery with temp of 100, tachycardia, dyspnea, muscle rigidity and brown colored urine

Answer 4

Malignant hyperthermia

- following exposure to succinylcholine or volatile anesthetic

Question 5

PT in an MVA with blood in the urethra, unable to void, huigh riding prostate, and perineal hematoma. Next step?

Answer 5

Retrograde urethrogram

- posterior urethral injury from pelvic fracture

Question 6

Tx for anal fissures

Answer 6

increase fiber and fluid, sitz baths, stool softeners, and topical anesthetics and vasoldilators (nifedipine, NTG)

Question 7

What do you have to watch for in a patient with alcohol and polysubstance abuse coming out of surgery

Answer 7

delayed emergence from anesthesia due to alcohol/substances interacting with anesthesia medications

Question 8

Any sx of elevated ICP with hyponatremia give

Answer 8

hypertonic 3% saline to correct cerebral edema

Question 9

dantrolene moa

Answer 9

ryanodine receptor antagonist

Question 10

liver lesion with central scarring

Answer 10

focal nodular hyperplasia

• due to abberant congenital artery
• usually in young women

Question 11

Benign bony growth located midline on the hard palate. Pt has had the mass for many years and it has not grown or changed

Answer 11

torus palatinus

- can be congenital or develop later in life

Question 12

Young male with mediastinal mass and elevayed AFP and bHCG

Answer 12

nonseminomatous germ cell tumor

Question 13

Rising thyroglobulin level after thyroidectomy for papillary cancer is indicitive of

Answer 13

recurrent malignancy

-Tg is the precursor to T3 and T4 and made my thyroid tissue

Question 14

Post op patient with hypotension, JVD, and new onset RBBB

Answer 14

PE