surgery-amboss Flashcards
dysphagia in Rhematic heart pt?
enlarged LA from prolonged mitral stenosis
seemingly signs of tension pneumo BUT dull to percussion with depression of left main bronchus?
thoracic aortic rupture
proph managmenet of bleeding esoph varices
- band, beta blocker
- band ligatation q1-2 weeks
**70% will recur in two years after bleed without proph
tx for recurrent varices that fail medical managment?
TIPS –>chance for encephalopathy because diverts blood away from liver
splenorenal shunt –> same as above, major abd surgery
mech of octerotide in esophageal bleed
splanchinic vasoconstriction gets blood out of portal system
-develop a tolerance quickly!! so effect is transient
6 P’s of acute limb ischemia
Pain pallor parasthesia poikilothermia paralysis pulselessness
proph in patients with PAD?
antiplatelet therapy reduces M&M!!
EKG changes in severe mitral stenosis?
R axis deviation due to PVR
afib due to inc size LA
first line (conservative) for PAD without critical limb ischemia?
graded exercise therapy
modify other risk factors too
acute prostehtic valve endocarditis vs subacute
staph epi
viridans
lab prognostic predictors of pancreatitis
Hct –> dec suggest hemodilution and third spacing of fluids
inc suggests hemorragic panc
can you use amylase and lipase as prognostic indicators of pancreatitis?
no
sliding hernia
more common on left
form of inguinal where post wall is organ/ colon
repair risk injury to colon
femoral hernias are most common hernia in women or cause by multigravida
multip
**most common hernia in men/women is inguinal hernia
what is a Richter’s hernia
only antimesenteric wall of intestine involved
causes strangulation without the warning signs