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Surgery > Surgery EOR Exam > Flashcards

Surgery EOR Exam Flashcards

1
Q

What are the 5 W’s for post op fever?

A

Wind, water, walking, wound, wonder drugs

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2
Q

Atelectasis/Pneumonia is which of the five W’s, and occurs on what day?

A

WIND; POD 1-2

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3
Q

Pneumonia usually occurs after how many hours post op?

A

48

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4
Q

UTI is which of the 5 W’s and occurs on what days?

A

WATER; POD 3-5

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5
Q

DVT is which of the 5 W’s and occurs on what days?

A

WALKING; POD 4-6

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6
Q

Infection is which of the 5 W’s and occurs on what days?

A

WOUND; POD 5-7

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7
Q

Drugs is the cause of which of the 5 W’s and occurs on what days?

A

WONDER DRUGS; POD 7+

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8
Q

Stone formation in the gallbladder

A

Cholelithiasis

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9
Q

Infrequent episodes of steady, severe pain in the epigastrium or RUQ with radiation to the right scapula that can sometimes be brought on my eating a large or fatty meal is a sx of?

A

Cholelithiasis

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10
Q

How do you diagnose cholelithiasis?

A

RUQ US

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11
Q

Surgical tx of choice for cholelithiasis?

A

Laparoscopic cholecystectomy

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12
Q

Cholecystitis is typically caused by a stone lodged where?

A

Cystic duct

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13
Q

If there isn’t a stone causing cholecystitis, what could the cause be?

A

Klebsiella or e coli

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14
Q

N/V, fever, murphys sign (positive), guarding, rebound tenderness, jaundice are signs and sxs of?

A

Cholecystitis or choledocholithiasis

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15
Q

Initial test of choice for cholecystitis?

A

US, but can use a HIDA scan if you think it is acalculous

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16
Q

Test of choice for choledocholithiasis?

A

Endoscopic US or MRCP; ERCP in high risk patients

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17
Q

Treatment of of cholecystitis or choledocholithiasis?

A

Removal of the stone endoscopically or surgically; ERCP

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18
Q

Choledocholithiasis is a stone in the ??

A

Common bile duct

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19
Q

Charcot’s triad

A

Fever, RUQ pain, jaundice

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20
Q

Reynold’s pentad

A

Charcot’s triad + confusion and hypotension

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21
Q

Reynold’s pentad and chariot’s triad are characteristic symptoms of ??

A

Ascending cholangitis

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22
Q

What is ascending cholangitis?

A

When choledocholithiasis proceeds to infection

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23
Q

How do you diagnose ascending cholangitis?

A

ERCP or abdominal US will show common bile duct dilation

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24
Q

Treatment for ascending cholangitis?

A

ERCP to help w biliary drainage; Zosyn or ceftriaxone + metronidazole

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25
Q

Acute cholecystitis that progresses to suppurative infection in which the gallbladder fills with purulent material

A

Gallbladder empyema

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26
Q

Most common pathogens that cause gallbladder empyema?

A

Klebsiella, e coli, strep faecalis

27
Q

How do you treat gallbladder empyema?

A

Antibiotics & immediate drainage or resection of gallbladder to prevent perforation

28
Q

Uninfected with no inflammation surgical classification

  • Resp, GI, GU tracts NOT entered
  • Closed primarily
A

Clean

29
Q

Exploratory laparotomy, mastectomy, neck dissection, thyroid, vascular, hernia, splenectomy are what type of surgical procedures?

A

Clean

30
Q

Resp, GI, GU tracts entered in a controlled environment

- No unusual contamination

A

Clean contaminated

31
Q

Chole, SBR, Whipple, liver txp, gastric surgery, bronch, colon surgery are examples of what type of surgical procedures

A

Clean contaminated

32
Q

Open, fresh, accidental wounds, major break in sterile technique, gross Spillage from GI tract, acute nonpurulent inflammation

A

Contaminated

33
Q

Inflamed appendectomy, bile spillage in chole, diverticulitis, Rectal surgery, penetrating wounds are what type of surgical classification?

A

Contaminated

34
Q
  • Old traumatic wounds, devitalized tissue
  • Existing infection or perforation
  • Organisms present BEFORE procedure
A

Dirty

35
Q

Abscess I&D, perforated bowel, peritonitis, wound debridement, positive cultures pre-op are examples of what type of surgical classification?

A

Dirty

36
Q

This occurs where the tissue surfaces have been approximated (closed). This can be with stitches, or staples, or skin glue (like Derma bond), or even with tapes (like steri-strips). This kind of closure is used when there has been very little tissue loss.

A

First intention healing

37
Q

Example of first intention healing

A

Surgical incision

38
Q

A wound that is extensive and involves considerable tissue loss, and in which the edges cannot be brought together heals in this manner. This is how pressure ulcers heal.

A

Secondary intention healing

39
Q

Three differences between primary and secondary intention healing

A
  • Wound takes longer to heal
  • More scarring
  • Higher chance of infection
40
Q

This type of wound healing is indicated where there is a reason to delay suturing or closing a wound some other way, for example when there is poor circulation to the injured area. These wounds are closed later. Require more connective tissue (scar tissue) than wounds that heal by secondary intention.

A

Tertiary intention healing or secondary closure

41
Q

Abdominal wound that is initially left open to allow for drainage but then closed

A

Tertiary healing or secondary closure

42
Q

The partial or total rupture of a wound

A

Dehiscence

43
Q

Protrusion of internal viscera through an incision

A

Evisceration

44
Q

Obesity, poor nutrition, multiple trauma, failure of sutures, excessive coughing, vomiting, and dehydration all increase risk for ???

A

Dehiscence

45
Q

A noticeable increase in serosanguineous drainage on POD 6 should cause concern for what?

A

Dehiscence or wound infection

46
Q

4 Phases of healing

A

Hemostasis, inflammation, granulation, remodeling

47
Q

Appendicitis is usually caused by?

A

Fecolith

48
Q
  • Dull periumbilical pain that progresses to focal sharp pain with RLQ radiation
  • Anorexia, n/v -Low grade fever
A

Appendicitis

49
Q

Positive:

  • McBurney’s point tenderness -Obturator sign
  • Psoas sign
  • Rovsing’s sign
A

Appendicitis

50
Q

Abdominal CT is preferred in which populations to diagnose appendicitis?

A

Adults and nonpregnant women

51
Q

Abdominal US is preferred in which populations to diagnose appendicitis?

A

Children and pregnant women

52
Q

Treatment for appendicitis

A

Appendectomy; If abscess or rupture may need cipro or zosyn treatment first

53
Q

What comes first with appendicitis, N/V or abdominal pain?

A

Abdominal pain

54
Q

Most common type of hernia

A

Indirect

55
Q

When hernia goes through hole in inguinal canal; Patent processus vaginalis

A

Indirect

56
Q

Bulge in scrotum due to herniation through inguinal canal

A

Indirect hernia

57
Q

Surgery is usually indicated for an indirect hernia, why?

A

Risk of strangulation is higher

58
Q

When intestinal tissue breaks through hole in weak abdominal muscle in hasselbach’s triangle; DOES NOT GO THROUGH INGUINAL CANAL

A

Direct hernia

59
Q

Treatment for direct hernia

A

Watch and wait if mild/not strangulated

Surgery if symptomatic

60
Q

Surgical risk factors

A 
History of CAD
History of heart failure
History of cerebrovascular disease
Diabetes requiring treatment with insulin
Serum creatinine (2.0 mg/dL)
61
Q

When does a patient need prophylactic antibiotic before a dental procedure?

A
  • With an artificial heart valve
  • Previous infective endocarditis
  • A previous heart transplant when there are problems with a heart valve
  • Certain heart defects, such as unrepaired cyanotic congenital heart disease
  • Joint replacement hip or knee
62
Q

When is the only time you need to prophylactically treat with antibiotics prior to a dental procedure (or after if not given prophylaxis before)

A
  • During dental procedures that involve manipulation of gingival tissue (around bone and teeth) or the periapical region of teeth (tip of the tooth root)
  • When the inside lining of the mouth is perforated
63
Q

Which bacteria is found in the mouth that can cause infective endocarditis?

A

Strep viridans

Surgery (2 decks)

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