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Surgery > Surgery III > Flashcards

Surgery III Flashcards

1
Q

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. […]
  2. Teratoma (and other germ cell tumors)
  3. Thyroid neoplasm
  4. Terrible lymphoma
A

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. Thymoma
  2. Teratoma (and other germ cell tumors)
  3. Thyroid neoplasm
  4. Terrible lymphoma
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2
Q

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. Thymoma
  2. […]
  3. Thyroid neoplasm
  4. Terrible lymphoma
A

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. Thymoma
  2. Teratoma (and other germ cell tumors)
  3. Thyroid neoplasm
  4. Terrible lymphoma
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3
Q

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. Thymoma
  2. Teratoma (and other germ cell tumors)
  3. […]
  4. Terrible lymphoma
A

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. Thymoma
  2. Teratoma (and other germ cell tumors)
  3. Thyroid neoplasm
  4. Terrible lymphoma
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4
Q

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. Thymoma
  2. Teratoma (and other germ cell tumors)
  3. Thyroid neoplasm
  4. […]
A

The differential diagnosis for an anterior mediastinal mass includes the “4 T’s”:

  1. Thymoma
  2. Teratoma (and other germ cell tumors)
  3. Thyroid neoplasm
  4. Terrible lymphoma
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5
Q

The lateral border of the “anatomic snuffbox” is bounded by the […] and the abductor pollicis longus.

A

The lateral border of the “anatomic snuffbox” is bounded by the extensor pollicis brevis and the abductor pollicis longus.

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6
Q

The medial border of the “anatomic snuffbox” is bounded by the […].

A

The medial border of the “anatomic snuffbox” is bounded by the extensor pollicis longus.

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7
Q

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: […]

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

A

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

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8
Q

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: […]

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

A

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

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9
Q

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: […]

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

A

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

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10
Q

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: […]

POD 8-15: Wonder drugs (drug fever)

A

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

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11
Q

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: […]

A

The most common causes of post-operative fever may be remembered with the “5 W’s”:

POD 2-3: Wind (atelectasis)

POD 3-5: Water (UTI)

POD 5+: Walking (DVT/PE)

POD 7: Wound infection

POD 8-15: Wonder drugs (drug fever)

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12
Q

The Parkland formula is an estimate of the total fluid requirement in the first 24 hours for burn victims and is calculated as total fluids = […].

A

The Parkland formula is an estimate of the total fluid requirement in the first 24 hours for burn victims and is calculated as total fluids = 4 mL * TBSA% x body weight (kg).

50% is given in the first eight hours and 50% is given in the next 16 hours; total body surface area (TBSA) may be estimated using the imaging below

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13
Q

The three components of the Glasgow coma scale (GCS) are […], […], and […].

A

The three components of the Glasgow coma scale (GCS) are eye opening, verbal response, and motor response.

useful for predicting the prognosis of coma and other medical conditions (e.g. traumatic brain injury, bacterial meningitis, etc.)

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14
Q

Total hematuria is suggestive of […] or ureter damage.

A

Total hematuria is suggestive of kidney or ureter damage.

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15
Q

Treatment of acute adrenal insufficiency includes […] or […] with aggressive fluid support.

A

Treatment of acute adrenal insufficiency includes hydrocortisone or dexamethasone with aggressive fluid support.

may be triggered in susceptible patients following acute illness or surgery

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16
Q

Varicoceles are due to tortuous dilation of the […] of veins surrounding the spermatic cord and testis.

A

Varicoceles are due to tortuous dilation of the pampiniform plexus of veins surrounding the spermatic cord and testis.

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17
Q

Varicoceles […] in size with standing and Valsalva maneuvers.

A

Varicoceles increase in size with standing and Valsalva maneuvers.

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18
Q

What abdominal aortic aneurysm repair complication results in progressive abdominal pain and bloody diarrhea?

A

Bowel ischemia/infarction

due to inadequate perfusion after loss of IMA during aortic graft placement

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19
Q

What abdominal mass presents in newborns as a soft, moist, pink, pedunculated lesion after the umbilical cord has separated?

A

Umbilical granuloma

20
Q

What acid-base disturbance is expected in patients with atelectasis?

A

Respiratory alkalosis

due to hyperventilation to compensate for hypoxemia

21
Q

What acid-base disturbance typically occurs with acute mesenteric ischemia?

A

Metabolic acidosis (elevated lactate)

22
Q

What agents (2) may be used to rapidly reverse the effects of warfarin?

A

fresh frozen plasma (FFP) or prothrombin complex concentrate (PCC)

23
Q

What anatomical landmark separates the upper and lower GI tracts?

A

ligament of Treitz

thus, this is useful for separating upper GI bleeds (e.g. melena) versus lower GI bleeds (e.g. hematochezia)

24
Q

What anesthetic is associated with adrenal insufficiency, especially in elderly and critically ill patients?

A

Etomidate

due to inhibition of 11β-hydroxylase

25
Q

What anesthetic is associated with neurotoxicity in patients with vitamin B12 deficiency?

A

Nitrous oxide

N2O inactivates vitamin B12, resulting in inhibition of methionine synthase

26
Q

What are the most common peripheral artery aneurysms?

[…] (#1) and […] (#2)

A

popliteal (#1) and femoral (#2)

frequently associated with abdominal aortic aneurysms

27
Q

What are the most important early steps (2) for managing flail chest?

A

pain control and supplemental O2

28
Q

What areas (2) of the colon are most commonly effected by ischemic colitis?

A

splenic flexure and rectosigmoid junction

watershed areas

29
Q

What artery is at risk for injury with supracondylar fracture of the humerus?

A

Brachial artery

30
Q

What bacteria is the most common cause of acute bacterial parotitis?

A

Staphylococcus aureus

31
Q

What bacteria is the most frequent cause of nosocomial bloodstream infection in patients with intravascular devices?

A

Coagulase-negative staphylococci (e.g. S. epidermidis)

32
Q

What bacteria is typically responsible for acute prepatellar bursitis?

A

Staphylococcus aureus

33
Q

What blunt chest trauma complication is characterized by unilateral decreased breath sounds and patchy, irregular alveolar infiltrate on imaging < 24 hours after the injury?

A

Pulmonary contusion

**the infiltrate is NOT restricted by anatomical borders; other clinical features include tachypnea, tachycardia, and hypoxia, which may be worsened by intravascular volume expansion, as well as chest wall bruising

34
Q

What blunt chest trauma complication presents with a triad of hypotension, distended neck veins, and distant heart sounds?

A

Cardiac tamponade (“Beck’s triad”)

35
Q

What brain injury typically occurs from traumatic acceleration/deceleration shearing forces?

A

Diffuse axonal injury

patients typically have coma with head CT showing diffuse small bleeds at the gray-white junction

36
Q

What breathing instrument is useful for preventing post-operative atelectasis?

A

Incentive spirometer

37
Q

What BUN:creatinine ratio is indicative of prerenal acute kidney injury?

A

> 20:1

other characteristic symptoms include oliguria and unremarkable urine sediment

38
Q

What cardiac catheterization complication presents with sudden hemodynamic instability and ipsilateral flank/back pain?

A

Retroperitoneal hematoma

typically occurs within 12 hours of catheterization; treatment is supportive

39
Q

What cardiac complication is associated with succinylcholine in patients with skeletal muscle trauma?

A

Cardiac arrhythmia

secondary to hyperkalemia due to efflux of K+ ions following binding of succinylcholine to post-synaptic ACh receptors; also may occur in patients with burn injury and stroke

40
Q

What class of analgesics may contribute to prolonged post-operative ileus?

A

Opiates

41
Q

What class of drugs may precipitate symptoms of sphincter of Oddi dysfunction?

A

Opioid analgesics (e.g. morphine)

42
Q

What demographic is most commonly associated with umbilical hernia?

A

African-American infants

43
Q

What diagnosis is suggested by the CT image below?

A

Ruptured AAA

symptoms include hypotension and abdominal or back pain

44
Q

What digestive enzyme may be elevated in patients with acute mesenteric ischemia?

A

Amylase

45
Q

What disease often manifests in young males as a painful, fluctuant mass above the anus in the intergluteal region with associated discharge?

A

Pilonidal disease

due to an occluded, infected hair follicle; most frequently affects males age 15-30, obese individuals, those with sedentary lifestyles, and those with deep gluteal clefts

46
Q

What does the drop arm test test for?

A

Rotator cuff tears (particularly the supraspinatus tendon)

47
Q

What drug classes (2) are useful for the management of anal fissures?

A

topical anesthetics and vasodilators

e.g. lidocaine and nifedipine; initial management of anal fissures should include a high-fiber diet, stool softeners, and sitz baths

Surgery (7 decks)

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