Surgery Flashcards by Ena Wong

Perineal or scrotal hematoma

Destot sign

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Diagnostic test done to rule our urinary extravasation in trauma patients

Retrogade urethrogram

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5 hard signs for vascular Injury; indications for operative intervention

1) ALI
2) Pulsatile bleeding
3) Audible bruit
4) Expanding hematoma
5) Palpable thrill

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Contraindications for emergency department thoracotomy

Penetrating trauma: CPR > 15 min with no signs of life

Blunt trauma: CPR >10min with no signs of life

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Lethal triad of the bloody vicious cycle

1) hypothermia (<35 C)
2) acidosis (pH < 7.2 or base deficit <15mmol/L)
3) refractory coagulopathy

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Differential capillary action of CSF and blood on an absorptive surface used to diagnose CSF rhinorrhea or CSF leak from trauma

Halo sign

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Confirmatory test for CSF leak

B2 transferrin test

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Treatment of thyroglossal duct cyst

Sistrunk Procedure

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Treatment of cystic hygromas

Intra-lesional injection of OK-432 or Bleomycin (Complete surgical Tx is preferred)

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Mucous retention cyst of the sublingual gland

Ranula

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Benign tumor of the tongue derived from Schwann cells

Abrikoss tumor

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End organ resistance to T4 wherein free T4 are increased and TSH are normal

Refetoff Syndrome

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Most important serologic marker for monitoring of differentiated thyroid cancer recurrence after total thyroidectomy and RAI ablation

Serum thyroglobulin

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Sensitive marker for medullary thyroid cancer

Serum calcitonin

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Medication given 7-10 days pre-op to decrease vascularity of thyroid and lessen risk of thyroid storm

Potassium iodide saturated solution

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Painless hard, woody thyroid gland associated with auto-immune diseases and other focal sclerosing syndromes

Reidel Thyroiditis

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The ratio of the largest to smallest diameter of a lymph node used in describing lymph node involvement

Solbiati index

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Thyroid disorder with chief cell hyperplasia and shows amyloid on pathology

Medullary Thyroid Carcinoma

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Most common malignancy which metastizes tot he thyroud

Renal cell cancer

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Diagnostic test performed to localize parathyroid lesions pre-operatively

Sestamibi scan

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Hypoplasia or complete absence of the breast with hypoplasia of chest wall

Poland Syndrome

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Most common route of hematogenous breast cancer metastases

Batson Plexus

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Ovarian metastasis associated with gastric adenocardinoma

Krukenberg tumor

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Tumor markers for GIST

c-KIT (CD117) and CD 34

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Tumor markers for gastric carcinoid tumors

Chromogranin A and NSE

Antrum-sparing hypertrophy of rugal folds associated with protein loss and hypochlorydia

Menetier Disease

Treatment for watermelon stomach a.k.a. gastric antral vascular ectasia

Endoscopic Nd: YAG laser or argon plasma coagulator

Congenital AV malformation of a submucosal vessel presenting as pulsating blood from a normal-appearing gastric mucosa on endoscopy

Dieulafoy lesion

Plane from the gallbladder fossa to the IVC separating the true left and right lobes of the liver

Cantlie's line

Structure which separates the left lateral and left medial segments of the liver

Falciform ligament

Structure clamped in the Pringle Maneuver

Hepatoduodenal ligament (Portal vein, hepatic artery, CBD)

Epigastric vascular murmur due to shunting from the portal vein to the umbilical branches

Cruveilhier- Baumgarten Syndrome

Obstruction in hepatic venous outflow causing congestive hepatopathy

Budd-Chiari Syndrome

Normal portal venous pressure

12 mmHg

Organism causing hydatid cyst

Echinococcus granulosus

Classic appearance of the pus from amebic liver abscess due to necrotic central portion

Anchovy paste

Clearest risk factor for hepatic adenoma

OCP use

Most common location of the cystic artery

``` Budde triangle Borders: R: cystic duct L: common hepatic duct S: margin of the right lobe of the liver ```

Lymph node most commonly enlarged in patients with cholecystitis or cholangitis

Calot node

Circular area which fits into the hepatocystic duct angle containing hepatic pedicle variations

Moosman Area

Primary bile salts(2)

Cholate and chenodeoxycholate

Amino acids conjugated with the primary bile salts(2)

Taurine and Glycine

Nerve responsible for GB contraction

Vagus nerve

Substance which inhibits GB contraction (2)

VIP, Somatostatin

Substance which stimulates liver ductal secretion

Secretin

Basal pressure at the Sphincter of Oddi

13mmHg above duodenal pressure

Infection of the gallbladder by gas-forming aerobes most commonly C. perfringens

Emphysematous gallbladder

Gallstone ileus of the duodenum

Bouveret Syndrome

Genetic mutation which predisposes towards chronic pancreatitis through the inactivation of trypsinogen

PRSSI

Surgical procedure indicated for the treatment of symptomatic chronic pancreatitis with ductal obstruction and a main pancreatic duct dilatation

Puestow procedure (Pancreaticojeunostomy)

Whipple Triad of insulinoma

1) Fasting hypoglycemia 2) Glucose < 50mg/dL 3) Relief of symptoms with glucose administration

Gall bladder Ca with best prognosis

Periampullary Gall bladder Ca

Anatomic region consisting of the head of the pancreas, duodenum, and lymphatic bed posterior and superior to the duondenum where a gastrinoma is usually found

Passaro's triangle

Type of pancreatic tumor often found at the tail

VIPoma

Age of gestation where: 1) extracoelomic herniation 2) retraction into the abdominal cavity

1) 5th week | 2) 10th week

Triad of radiographic findings in SBO:

1) Dilated bowel loops 2) Air-fluid levels 3) Paucity of air in the colon

The double bubble sign in radiographs is often seen in:

Duodenal obstruction

The coiled spring sign seen in contrast enema is often seen in:

Intussusception

The coffee bean sign in radiographs is often seen in:

Volvulus

Normal small bowel length in children

200-250cm

Most intestinotrophic hormone

GLP-2

What does the GALT secrete

IgA

Most common position of the appendix

Retrocecal

Cut-off for a right hemicolectomy in an appediceal carcinoid tumor

>2cm

RLQ pain on dropping from standing on toes to heels

Markle sign

RLQ pain upon manipulation of the uterus

Bryan sign

Pain caused by traction on the spermatic cord

Ten Horn sign

Diagnosis of colonic diverticulitis (3)

1) LLQ pain 2) bowel habit alterations 3) tenderness on palpation

Structure which divides the upper and lower GI tract

Ligament of Treitz

Subtype of FAP associated with CNS tumors

Turcot Syndrome

Subtype of FAP associated with epidermoid cysts, dermoid tumors of the abdominal wall, and skull osteomas

Gardner Syndrome

Disorder characterized by the development of benign hamartomas in the GIT with hyperpigmented macules

Peutz-Jeghers Syndromes

Separates the anterior rectum from the vagina in females, prostate and seminal vesicles in males

Denonvilliers fascia

Fascial condensation between the fascia propria and the presacral fascia

Waldeyer fascia

Idiopathic asymmetric thigh atrophy related to avascular necrosis of the femoral head

Legg-Calve-Perthes Disease

Ossification of distal patellar tendon at the point of tibial insertion common among athletes

Osgood-Schlatter Disease

Most common cause of shoulder pain

Supraspinatus tendinitis

Anterior diaphragmatic hernia

Morgagni hernia

Posterolateral diaphragmatic hernia

Bochdalek hernia

Syndrome of sternal cleft, ectopia cordis, supraumbilical omphalocele, anterior midline diaphragmatic defect and intra- cardiac anomalies

Pentralogy of Cantrell

Syndrome of arthritis, conjunctivitis, and non-gonococcal urethritis

Reiter's syndrome

Gerstmann's syndrome

1) R-L dissociation 2) Agraphia 3) Finger agnosia 4) Acalculia

Lesion for motor/expressive aphasia

Broca's area

Lesion for sensory/ receotive aphasia

Wernicke's area

Lesion for apraxia

Supramarginal gyrus