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Surgery Clerkship > Surgery Clerkship 4 > Flashcards

Surgery Clerkship 4 Flashcards

1
Q

What vessel provides blood supply to the appendix?

A

Appendiceal artery

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2
Q

Can you have abnormal urinalysis with appendicitis?

A

Yes; mild hematuria and pyuria are common in appendicitis with pelvic inflammation, resulting in inflammation of the ureter

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3
Q

Appendicitis imaging studies

A
  • Spiral CT
  • U/S
  • AXR
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4
Q

What is the pathology?

  • Viral or bacterial infection of the GI tract, usually with vomiting and diarrhea
  • If pain is present, it’s usually after vomiting
A

Gastroenteritis

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5
Q

Difference between pain experienced in appendicitis and gastroenteritis

A
  • Gastroenteritis: Pain usually after vomiting

- Appendicitis: Pain usually before vomiting

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6
Q

Why is glucose-containing IVF contraindicated in burn patients in the first 24 hours?

A

Patient’s serum glucose will elevate on its own because of the stress response

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7
Q

Minimal urine output for adult burn patients

A

30 cc per hour

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8
Q

Ways to monitor volume status

A
  • Urine output
  • Blood pressure
  • Heart rate
  • Peripheral perfusion
  • Mental status
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9
Q

MC sign of burn wound infection

A

Discoloration of burn eschar

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10
Q

Is tetanus prophylaxis required in burn patients?

A

YES - unless they’ve been immunized within 12 months

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11
Q

What electrolyte must be closely followed acutely after a burn?

A

Na

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12
Q

Name of the gastric/duodenal ulcer associated with burn injury

A

Curling’s ulcer

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13
Q

Diagnostic test of choice for UGI bleed

A

EGD

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14
Q

What test may help identify the site of a MASSIVE UGI bleed when EGD fails to diagnose the cause?

A

Selective mesenteric angiography

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15
Q

H. Pylori tx regimens

A
  • MOC: Metronidazole, Omeprazole, Clarithromycin

- ACO: Ampicilin, Omeprazole, Clarithromycin

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16
Q

Age group in which duodenal ulcers are most common

A

40-65 years (younger than gastric ulcer)

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17
Q

Zollinger-Ellison syndrome

A

Gastrinoma and PUD (Peptic Ulcer Disease)

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18
Q

Artery involved with bleeding duodenal ulcers

A

Gastroduodenal artery

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19
Q

Are gastric or duodenal ulcers more common?

A

Duodenal (more than twice as common)

20
Q

PUD or gastritis associated with neurologic trauma or tumor

A

Cushing’s ulcer

21
Q

Ulcer at the margin of a GI anastomosis (name)

A

Marginal ulcer

22
Q

Pinprick gastric mucosal defect bleeding from an underlying vascular malformation

A

Dieulafoy’s ulcer

23
Q

Is anterior or posterior duodenal ulcer perforation more common?

A

Anterior

24
Q

What would you see with posterior and anterior perforation of a duodenal ulcer?

A

Posterior - Bleeding from the gastroduodenal artery and possibly acute pancreatitis
Anterior - Free air

25
Q

“Rule of two thirds” of esophageal varceal hemorrhage

A
  • 2/3 of patients with portal HTN develop esophageal varices

- 2/3 of patients with esophageal varices bleed

26
Q

Postemetic esophageal rupture (name of syndrome)

A

Boerhaave’s syndrome

27
Q

MC location of Boerhaave’s perforation

A

Posterolateral aspect of the esophagus, 3-5 cm above the GE junction

28
Q

Hamman’s sign

A

“Crunching” sound in the mediastinum due to escaped air from an esophageal rupture (associated with Boerhaave’s syndrome)

29
Q 
Associated with Boerhaave's syndrome:
-Emesis
-Lower chest pain
-Cervical empysema
(name of triad)
A

Mackler’s triad

30
Q

MCC of esophageal perforation

A

Iatrogenic

31
Q

Name of the space that lies behind the stomach

A

Lesser sac

32
Q

Name of the opening into the lesser sac

A

Foramen of Winslow

33
Q

What do gastric parietal cells secrete?

A

HCl

Intrinsic factor

34
Q

What do chief cells secrete?

A

Pepsinogen

35
Q

What do mucous neck cells secrete?

A

Bicarbonate

Mucus

36
Q

What do G cells secrete?

A

Gastrin

37
Q

What is gas-bloat syndrome?

A

Inability to burp or vomit

38
Q

Where is a gastrointestinal stromal tumor (GIST) most commonly found?

A

Stomach

39
Q

Action of heparin

A

Binds to and activates antithrombin III

40
Q

What reverses the effects of heparin?

A

Protamine

41
Q

What lab test follows the effects of Warfarin?

A

PT

42
Q

Classic therapeutic INR

A

2-3

43
Q

What happens when Warfarin therapy is initiated?

A

Proteins C and S are initially depressed, leading to a hypercoagulable state

44
Q

Why should Carafate not be given with H2 blockers?

A

Because it needs acid to activate it

45
Q

Drug classically associated with mesenteric ischemia

A

Digitalis

46
Q

Meds used to stop seizures

A
  • Benzodiazepines

- Phenytoin

Surgery Clerkship (4 decks)

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