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Surgery shelf > Surgery general > Flashcards

Surgery general Flashcards

1
Q

Signs of cardiogenic shock

A

JVP, crackles, EKG changes

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2
Q

findings fat embolism

A

petechiae

respiratory distress

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3
Q

Legg Calve Perthes

A

avascular necrosis of femoral head causing deformity
intermittent pain causing antalgic gait
young children who are short in stature confirmed with xray

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4
Q

Malignant pleural effusion

A

Fluid buildup between parietal and visceral pleura due to cancer
Decreased pulse ox
Friction rub over the lungs
Dullness to percussion

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5
Q

Signs of atrial myxoma

A

weight loss,
Majority in LA
Tumor “plop” and mid diastolic rumble that change when patient changes position

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6
Q

Paraneoplastic syndromes associated with lung cancers

A

Small cell: SIADH, Lambert Eaton

SCC: PTHrP

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7
Q

ITP

A

anti-platelet antibiodies

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8
Q

hiatal hernias

A
  1. sliding: displacement of GE junction above the diaphragm; asx or GERD; Tx is mx of GERD
  2. paraesophageal: true hernia with a hernia sac and is characterized by an upward dislocation of the gastric fundus through a defect in the phrenoesophageal membrane; tx is surgery in sx pts
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9
Q

Sx VIPoma

A

tumor in pancreas
flushing, weight loss, loose stools
arises in young children of adults

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10
Q

Sx testicular tumor

A

does not transilluminate
firm nodule
grows with time
painless

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11
Q

Sx lymphoma

A

B sx

chylothorax

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12
Q

labs nephrolithiasis

A

gross or microscopic hematuria

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13
Q

Diabetic joint

A

Charcot neuropathy loss of sensation to a joint may result in a chronic, progressive, and destructive arthropathy
Causes change in foot architecture

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14
Q

Sx ovarian cancer

A

advanced disease can spread to omentum or bowel, leading to abdominal distension, nausea, early satiety, ascites (+fluid wave)

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15
Q

Slipped capital femoral epiphysis

A 
obese teens
displacement of femoral neck causes fx at epiphysis 
knee or hip pain; limping
dx: xray
tx: surgery; fixation
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16
Q

mechanism of AV fistula causing high output heart failure

A

acute decrease in systemic vascular resistance and a secondary increase in cardiac output
tachycardia, edema, JVD, wide PP, an enlarged apical impulse, a midsystolic murmur (caused by increased ventricular filling), S3 and S4, pulmonary crackles, peripheral edema, and warm extremities as a result of low systemic vascular resistance

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17
Q

Bloody nipple discharge in premenopausal woman

A

Intraductal papilloma

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18
Q

most common premenopausal breast mass

A

fibrocystic change; benign

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19
Q

fibroadenoma

A

most common benign tumor; well circumscribed rubbery

estrogen sensitive–grows during pregnancy

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20
Q

DCIS

A

incidental microcalcifications on mammogram
malignant cells that have not yet invaded BM
not usually palpable on PE

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21
Q

Invasive ductal carcinoma

A

firm, immobile, discrete mass with nipple retraction

malignant cells with stromal invasion and microcalcifications

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22
Q

invasive lobular carcinoma

A

malignant cells infiltrating breast lobules; sensitive to hormonal therapy

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23
Q

nipple retraction cause

A

suspensory ligaments are infiltrated by cancer cells.

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24
Q

test used to determine perioperative cardiac risk

A

dipyridamole thallium imaging

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25
Q

varicocele

A

dilatation of pampiform plexus causing bag of worms feel; more common on left; associated with male infertility; does not transilluminate

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26
Q

ovarian torsion

A

acute onset of severe pain, adnexal mass, h/o cysts

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27
Q

toxic adenoma

A

solitary nodule on thyroid that overproduces T4
Usually benign
Looks hot on thyroid scintigraphy

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28
Q

cerebral hyperperfusion

A

risk of CEA in which severe post-op HTN causes headaches, neuro defects, or seizures leading to intraparenchymal hemorrhage

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29
Q

Post-op risk CEA

A

cerebral hyperperfusion (HTN) causing intraparenchymal hemorrhage

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30
Q

Drugs that reduce stroke in patients undergoing CEA

A

statin and ASA

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31
Q

Unhappy triad

A

medial meniscus, ACL, MCL

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32
Q

presentation meniscal tear

A

clicking/locking of knee especially with extension, delayed swelling, pain along medial joint line
Can’t see on X-ray; do MRI

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33
Q

diverticulitis signs

A

fever, leukocytosis, peritoneal irritation in LLQ, sometimes palpable mass
middle age

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34
Q

sx insulinoma

A

SNS activation sweating, nervousness, tremors, tachycardia, hunger
worse w fasting

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35
Q

gallstone ileus CT

A

Gallbladder wall thickening
Pneumobilia
Intestinal obstruction
Obstructing gallstone

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36
Q

mesenteric ischemia risk factors

A

source of clot: afib, recent MI

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37
Q

mesenteric ischemia presentation

A

old person w/ acute abdomen with GI bleed

very old may not present until acidotic and septic

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38
Q

signs of hemolytic transfusion reaction

A

fever, flank pain, and red or brown urine

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39
Q

detecting adequate resuscitation

A

best indicated by urine output of > 0.5 to 1 mL/kg/h. (30-40 mL/hr)

40
Q

basal cell carcinoma of skin characteristics

A

upper lip
waxy, pearly, raised
does not metastasize
excision

41
Q

squamous cell carcinoma of skin characteristics

A

lower lip and rest of body
metastasis to lymph nodes
excision; radiation sometimes

42
Q

torus platinus

A

bony benign mass on hard palate of mouth most frequently found in women of Asian descent.
tx is obs unless it is symptomatic inwhich it can be surgically removed

43
Q

complications of parotidectomy

A

injury to CN VII causing facial droop or cervical plexus causing numbness around earlobe

44
Q

most common salivary gland tumor

A

pleiomorphic adenoma

45
Q

Screening guidelines for child born with APC

A

flexible sigmoidoscopy beginning at 10.

46
Q

colon cancer screening guidelines for UC patient

A

screen 8 years after disease onset and every 1-2 years after. Do random biopsies.

47
Q

Ogilvie’s syndrome

A

pseudoobstruction of colon associated with bedridden, neurologically impaired or older patients, opiate use, surgery, trauma, or infection.

48
Q

findings on laparoscopy with normal appendix on pathology

A

Crohn’s (regional enteritis)–mimic’s appendicitis

49
Q

factors that prevent fistulas from spontaneously closing

A 
High output
Inflammation
Short
Foreign body
Radiation
Infection
Epithelialization
Neoplasm
Distal obstruction
50
Q

signs of sigmoid volvulus

A

bent inner tube

coffee bean

51
Q

triad epidural abscess

A

focal back pain, abnormal inflammatory markers, neurologic deficits

52
Q

slipped capital femoral epiphysis

A

obese teenage males

Trendelenberg sign due to gluteus muscle weakness

53
Q

signs of suppurative tenosynovitis

A

flexor tendon sheath tenderness, sausage shaped fingers, pain w passive extension, semi flexed posture of digit

54
Q

legg calve perthes disease

A

avascular necrosis of the hip causing pain most commonly in children between 4-10

55
Q

drop arm test

A

evaluate a tear in supraspinatus muscle. shoulder to 90 and flex to 30 while keeping thumb pointed down.

56
Q

most commonly injured rotator cuff muscle

A

supraspinatus

57
Q

Tinel sign

A

for carpel tunnel: percuss over median nerve and feel tingling in first 3 digits

58
Q

Phalen sign

A

for carpel tunnel: placing elbow on table and flexing wrist for 60s causes numbness in first three digits

59
Q

imaging posterior dislocation of shoulder

A

axillary and lateral view radiographs. if equivocal, then CT.

60
Q

signs of biliary atresia

A

6-8 wk old babies with worsening juandice

61
Q

dx biliary atresia

A

HIDA with phenobarbital to look if bile reaches duodenum

62
Q

febrile non-hemolytic transfusion rxn

A

fever and chills within 1-6 hours of transfusion caused by cytokine accumulation in blood storage

63
Q

acute hemolytic transfusion rxn

A

fever, flank pain, hematuria, renal failure, DIC within an hour of transfusion caused by ABO incompatibility

64
Q

delayed hemolytic transfusion rxn

A

mild fever within 2-10 days caused by Ab response; postive direct coombs testa and positive new ab screening test

65
Q

anaphylactic transfusion rxn

A

rapid onset of shock, angioedema, urticaria within a few seconds of transfusion due to anti IgA Abs

66
Q

urticarial transfusion rxn

A

flushing, angioedema, pruritis within 2-3 hours of transfusion caused by recipient IgE abs and mast cell activations

67
Q

transfusion related acute lung injury

A

respiratory distress and signs of noncardiogenic pulmonary edema within 6 hours of transfusion caused by donor anti leukocyte Abs

68
Q

silver sulfadiazine SE

A

leukocytosis

69
Q

mafenide acetate SE

A

acidosis

70
Q

silver nitrate SE

A

methemoglobinemia

71
Q

clinical picture intussusception

A

squatting kid 6-12 mo. with vague R mass, current jelly stool

72
Q

surgical candidate for lobectomy must have

A

FEV1>800

73
Q

findings on barium enema for Crohn’s

A

string sign

74
Q

presentation ATN

A

recent surgery, hypotension, sepsis, necrosis

NSAIDs, aminoglycosides, cisplatin

75
Q

central venous catheter complications

A 
infection
thrombosis
stenosis
vascular injury
PE
air embolus
76
Q

presentation ruptured trachea or bronchus

A

subq emphysema in chest, neck, face and air leak from chest tube

77
Q

dd of subq emphysema

A

ruptured trachea or bronchus, tension pneumo, ruptured esophagus

78
Q

PE developmental dysplasia of hip

A

uneven gluteal folds, easily dislocated hips with jerk and clip

79
Q

septic hip

A

toddlers post febrile illness who refuse to move hip

dx is aspiration

80
Q

presentation of osgood schlattter

A

persistent pain over tibial tubercle without swelling; aggravated with quad contraction

81
Q

risk following tx supracondylar fx of humerus in child

A

Volkmann contracture (claw like deformity)

82
Q

osteogenic sarcoma on xray

A

sunburst

83
Q

multiple myeloma imaging

A

multiple punched out lesion on Xray

84
Q

rules for xrays

A

2 views 90 degrees from one another of one joint above and one below

85
Q

presentation anterior shoulder dislocation

A

holding arm close to body and rotated outward

86
Q

xray views to see posterior shoulder dislocation

A

axillary and scapular lateral

87
Q

colles fx is of

A

distal radius

88
Q

presentation of posterior hip dislocation

A

leg is shortened, adducted, and internally rotated

89
Q

presentation of broken hp

A

leg is shorted and externally rotated

90
Q

assessing hepatic risk in surgery

A

encephalopathy, ascites, serum albumin, INR, bilirubin

91
Q

blood gases PE`

A

hypoxemia and hypocapnia

92
Q

sx PE

A 
sudden pleuritic pain
SOB
anxiety and diaphoresis
JVP
tachycardic
93
Q

presentation of air embolus

A

sudden death while on ventilator and respirator

94
Q

distinguishing between adrenal hyperplasia vs adrenal adenoma

A

postural change response: hyperplasia adjusts to lying down by secreting more aldosterone where adenoma does not

95
Q

causes of intracranial hemorrhage in children, adults, and elderly

A

children: AV malformation
adults: hypertension
elderly: amyloid angiopathy

Surgery shelf (2 decks)

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