Surgery Flashcards
Best treatment for patient with subdural hematoma without midline shift?
Hyperventilation, Diuretics, Fluid restriction
Post-traumatic HA is more common in patients with HX of …
Depression
NML intracranial pressure?
< 15
When do symptoms of elevated intracranial pressure develop?
> 20
Which CN is most commonly affected by elevated intracranial pressure?
CN 6
Why is CN 6 most commonly affected by elevated intracranial pressure?
Long intracranial course
DOC for prevention of cerebral vascular spasm following SAH?
Nimodipine
Zone 1 of neck trauma?
Thoracic outlet»_space; Cricoid cartilage
Zone 2 of neck trauma?
Cricoid cartilage»_space; Angle of mandible
Zone 3 of neck trauma?
Angle of mandible»_space; Skull base
Best management of neck trauma to Zone 1?
Conservative
Best management of neck trauma to Zone 2?
Surgical
Best management of neck trauma to Zone 3?
Conservative
32 yo male presents with R chest pain after MVC; L hemithorax is hyper-resonant to percussion, without breath sounds; Pulse Ox shows O2 sat = 88%; Vitals are otherwise NML - diagnosis?
Simple PNX
32 yo male presents with R chest pain after MVC; L hemithorax is hyper-resonant to percussion, without breath sounds; Pulse Ox shows O2 sat = 88% - best initial treatment?
CXR + chest tube placement
Which tendon flexes the DIP?
Flexor digitorum profundus
Which tendon flexes the PIP?
Flexor digitorum superficialis
Which muscles flex the MCP joints?
Lumbricals + interossei
Most common fatal complications of acute compartment syndrome?
Rhabdomyolysis, Renal failure
Best next step of management for patient who sustains 3rd degree burn?
Monitor peripheral pulses and capillary refill
According to Rule of 9s – surface area of head?
9%
According to Rule of 9s – surface area of each arm?
9%
According to Rule of 9s – surface area of each leg?
18%
According to Rule of 9s – surface area of anterior torso?
18%
According to Rule of 9s – surface area of posterior torso?
18%
According to Rule of 9s – surface area of perineum?
1%
Parkland formula?
(4 mL) * (% of body surface) * (kg)
How quickly should fluid be replaced in Parkland formula?
Half of fluid in first 8 hours; Half of fluid in first 16 hours
6 criteria for transferring burn patients to burn center?
Electric burn, Respiratory injury, Circumferential burn, Genital + Face involvement. Partial thickness > 10%, Full thickness > 5%
Etiology of J waves on EKG?
Hypothermia
Appearance of J waves on EKG?
Camel’s hump following QRS complex in V2-V6
Which 2 post-exposure prophylactic vaccines should be given to patients after sexual assault?
HIV, Hepatitis B
Best treatment for black widow spider bite?
Antivenin
Diagnostic test for Pseudotumor Cerebri?
Head CT or MRI … (to rule out other cause of elevated ICP)
70 yo male with T2DM presents with sudden R eye vision loss; Eye exam shows train-tracking of retinal arteries, very pale, except for 1 focal area of redness (cherry red spot)?
Central Retinal Artery Occlusion
Next step in CRAO?
Carotid Duplex US
Quality of vision loss in CRAO?
Painless vision loss
Difference between CRAO and Retinal Vein Occlusion?
RVO = polycythemia (causing vein thrombosis), fundoscopy also looks much angrier than CRAO train-tracking
Clinical presentation of retinal detachment?
Brief flashes of light in peripheral eye fields + floaters + night shade
Next step of management for retinal detachment?
Urgent ophthalmology consult
59 yo female presents for HTN follow-up; Reports blurry vision R>L; Fundoscopic exam shows increased optic disk ratio – diagnosis?
Glaucoma
Which type of glaucoma is associated with painful red eye?
Closed angle
Appearance of macular degeneration on fundoscopic exam?
Yellow drusen spots
Pattern of vision loss in macular degeneration?
Loss of CENTRAL vision
Painful sudden vision loss that presents with decreased red reflex?
Endophthalmitis
Painful sudden vision loss that presents with NML red reflex?
Retrobulbar neuritis
Condition associated with Retrobulbar neuritis?
MS
26 yo HIV patient presents with floaters in visual therapy; CD4 count is 26 – diagnosis?
CMV retinitis
Most common ocular infection in HIV patients?
CMV retinitis
CD4 count associated with increased risk for CMV retinitis?
CD4 < 50
45 yo male presents with unilateral ocular pain, redness, vomiting; Reports blurry vision with halos around lights – diagnosis?
Closed angle glaucoma
Most common ocular manifestation of RA?
Scleritis
38 yo male presents with personality changes, jaundice, joint pain; PE shows Kiser-Fleischer ring – diagnosis?
Wilson Disease
Inheritance pattern of Wilson Disease?
AR
Value of D-penicillamine in treatment of Wilson Disease?
Increases excretion of copper in urine
Value of zinc in treatment of Wilson Disease?
Inhibits intestinal copper absorption
Colles fracture affects which bone?
Radius
Direction of distal radius displacement in Colles fracture?
Dorsal
Best management of suspected scaphoid fracture, even if initial XR shows no fracture?
Casting
Boxer’s fracture affects which bone?
5th metacarpal