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EORs > Surgery Other Systems > Flashcards

Surgery Other Systems Flashcards

1
Q

tx for cellulitis if we think its MRSA

-outpatient non MRSA

A

IV Vanco or linezolid–> IV ABX is IND if they meet SIRS criteria
-bactrim, clinda, doxy= outpatient

NON MRSA OP–>dicloxacillin, cephalexin** amoxicllin

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2
Q

poorly demarcated boarders of erythema

A

cellulitis

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3
Q

MC pathogens for cellulitis

A

GAS
Strep pyogenes
STaph aureus
MRSA

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4
Q

cat bite abx

A

augmentin or doxy

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5
Q

puncture wound– what abx?

A

ciprofloxacin or ceftazidime to cover pseudomonas

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6
Q

lab values for primary hyperthyroidism aka?

A

Graves Disease

Increased T3 T4
Low TSH

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7
Q

MCC of hyperthyroidism?

-sx?

A

graves

tachycardia, palpiations, afib, PVCs 
anxiety, tremors, insomnia, 
brittle hair, moist and warm skin 
weight loss 
heat intolerance 
exopthalmos, 
pretibila myxedema
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8
Q

stages of pressure ulcers

A
  1. nonblanching erythema, intact skin, may be painful—-only involves epidermis
  2. partial thickness, shallow open ulcer, red/pinnk wound bed
  3. full thickness skin loss, subcu fat may be visible, slough or eschar present, bone muscle tendon not expose, can include tunneing—>through the epidermis
  4. exposed bone, tendon or muscle,
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9
Q

how often to respotion patient to avoid pressure ulcers

A

2 hours

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10
Q

which stage of ulcer is adipose tissue exposed but not bone and tendon

A

3

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11
Q

what is a late sign for acute arterial oclusion

A

loss of motor function

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12
Q

cold leg, weak or loss of pulses—-

A

acute arterial occlusion

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13
Q 
pain out of proportion to exam 
pallor 
pulselessness 
paresthesia 
poikilothermia 
paralysis
A

acute aterial occlusion and acute compartment syndrome

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14
Q

which type of AAA needs immediate surgery

A

type A— a for ASCENDING

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15
Q

tx for type B AAA

A

reduce BP—–IV BBs–>esmolol, labetalol, propranalol (DO NOT GIVE TO PT WITH HX OF ASTHMA)

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16
Q

xanthochromia on LP can indicate

A

early s/s of sub arachnoid hem

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17
Q

pharmalogical management for SAH

A

to reduce BP give Nimodipine—- a DHP CCB
60 mg q4h
this will decrease vasopsasms

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18
Q

if CT scan is negative for a bleed but suspicions are high for a SAH– next test?

A

LP

xanthochromia will show

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19
Q

increased fibrin degradation products and schistocytes on CBC consistent with?

A

DIC

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20
Q

intervention for suspected melanoma

A

excisinoal biopsy with skin margins of at least 2 mm

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21
Q

Pheochromocytoma

  • dx
  • tx
A

DX–urine metanephrines and VMA elevated, CT shows adrenal mass
TX– complete adrenalectomy and PREOP we will give NONSELECTIVE alpha blockers 7-14 days prior to surgery and BBs after surgery

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22
Q

HX of thyroidectomy—- pt will comes in with tinginling aorund mouth, muscle sapsms, numbness and tingling in hands/feet
-hyperactive DTR
DX?

A

primary hyPOparathyroidism

DECR in PTH means DECR in Calcium HIGH phosph

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23
Q
A

epidural

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24
Q

traffic accident, falls, trauma, assualts— MC type of brain bleeed ?

A

epidural

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25
Q

biconvex/lens-shaped bleed

A

epidural

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26
Q

what artery invovled with epidural bleed

A

middle meningeal artery

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27
Q

crescent-shaped bleed

A

subdural

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28
Q

ETOH disorder… older population MC brain bleed?

A

subdural

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29
Q

meds used to reduced ICP

A

Intravenous mannitol and hypertonic solution.

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30
Q

shave biopsy reveals multifocal nests of basophilic staining cells with peripheral palisading nuclei

A

basal cell carcinoma

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31
Q

pearly nodule, telangelic vessels with rolled edgegs

A

BCC

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32
Q

contraindication to sharp debridement of pressure ulcer

A

anticoagualiton therapy

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33
Q

cool, shiny extremitiy with decrease hair

A

PAD

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34
Q

What is the ankle brachial index for PAD

A

ABI <0.9= PAD with >50% stenosis
<0.4=ischemia
OVER 1.4= noncompressilble arteries due to vascular calcification
NORAML = 1-1.4

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35
Q

tx for PADM

A

-ASA, clopidogrel, Cilstazol (vasodilator) for claudication +ACEI +statin
if drugs fail–>revascularization with PTA
or bypass graft or stent or ednarterectomy

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36
Q

next step in intervention for a pt with an ABI of 1.5

A

toe brachial index is needed

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37
Q

MC artery affected in PAD

A

distal superficial femoral artery —-CALF pain

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38
Q

thigh and buttock pain with PAD— what artery affected

A

common iliac artery

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39
Q

ulcer is punched out, deep and irregular shape with +/- necrotic tissue minimal exudate unless infected
-type of uler?

A

arterial

40
Q

shallow and flat margins, moderate to heavy exudate.. slough at the base with granualtino tissue

A

venous ulcer

41
Q

what part of adrenal gland is resp for prod of catecholamines

  • glucocorticoids?
  • androgens?
  • mineralcorticoids
A

adrenal medulla=catecholamines
zona fasiculata= glucos
zona glomerulosa= outermost=mineralcorticoids
-zona reticularias=innermost=androgens

42
Q

what drug can cause itchiness all over body but theres little to no rash

A

morphine or other opioids

43
Q

hypothyroidism does what to DBP

A

raises it

44
Q

lab values for hypothyroidism

A

HIGH tsh and LOW T4 T3

45
Q

AAA with any size + good surigcal candidate=?

A

urgent open or endovadular repair

46
Q

Infrarenal AAA <5.5 cm and pt is asympto?

A

watchful waiting, montior with US

47
Q

> 5.5 cm AAA

A

surgical repair

48
Q

list some factors that would indicate suriglca repair for a AAA < 5.5 cm

A

female
CAD
rapid expansino
coexisting aneurysm

49
Q

NGT post op with ileus– what do we want to give IV

-what do we avoid

A

Potassium!!!!

avoid dextrose containign fluids bc insulin release will shift K back into the cell

50
Q

hemoptysis hematuria— general malaise— CXR pulmonary infiltrates

A

good pastures

51
Q

which thyroid CA assoc with MEN 1 and 2

A

medullary

52
Q

MC type of thyroid CA

A

papillary

53
Q

parkland formula

A

4ml X bodyweight in kg x % TBSA burned

54
Q

compartment pressure over ______ mmhg conssitent with compart syndrome

A

30

55
Q

Necrotizing Fascitis intervention

A

surgical debridement very early— Q1-2 days until nerotic tissue is no longer present
BS abx until wound cultures come back

56
Q

tearing quality abd pain or cp

A

aortic disection

57
Q

initial test OC for aortic dissection for HD:

  • unstable
  • stable
A

UNSTABLE:

  • transesophageal echocardiogram (TEE) ****
  • transthoracic echo

STABLE:

  • CTA
  • MR angio
58
Q

MC abx prescribed for mastitis or breast abscesss

A

Dicloxacillin or cephalexin.

59
Q

how does chronic subdural hematoma show on CT

A

hypodense crescent-shaped……. concave

60
Q

craving ice, koilonychia

low hemoglobin low crit

A

FE def anemia

***total iron binding capacity will be HIGH

61
Q

recent head injury, incr in thirs and incr urination

A

Central DI

62
Q

MC precancerous lesion and precursor for sqaumous cell carcinoma

A

Actinic keratosis

63
Q

irregular, erythematous plaque with hemorrhagic crust

*non healing lesion that bleeds without trauma

A

SCC

64
Q

two viruses assoc with SCC

A

EBV

HPV

65
Q

PT recently took sulfonamides
-developed a rash + fever
Skin BX shws necrotic tissue

A

Erythema Multiforme

66
Q

MCC of TIA

A

carotid artery stenosis

67
Q

Tx for TTP

A

plasma exchange

68
Q

at what threshold do we start giving platlete exchange

A

<50,000

69
Q

post op fever 5-7 days after procedure is MC due to?

A

superficial or deep wound infection

70
Q

post op fever within 48-72 hours MC due to

A

UTI

71
Q

triad for renal cell carcinoma

A

flank pain
hematuria
abdominal pass nontender and palpable

**hx of smoking

72
Q

glossitis

decr DTR

A

pernicious anemia

**hx of bariatric surgery too

73
Q

triad for cardiac tamponade

  • name?
  • list the things
A

BECK TRIAD

hypotension
muffled heart sounds
JVD

**also will see electrical alternans

74
Q

first line med tx for PAD with intermittent claudication

A

Cilostazol

75
Q

threshold for platelet count to be ok for most major surgery

A

50K

76
Q

For nonemergent and elective surgeries, first-line treatment for patients with immune thrombocytopenia is

A

steroids and IVIG

77
Q

tx stepwise for pheochromocytooma

A
  1. control BP BEFORE DOING SURGERY—– alpha blocker (pheonybenzamine) or a ccb—alone or in combo
  2. lap surgical resection

***never give the BB (esp cardioselective… metorpolol) before the alpha or CCB becuse can result in paradoxical worsening HTN due to unopossoed alpha status

78
Q

indication for surgical tx of primary hyperparathyroidism in an asymptomatic pt?

A

presence of kidney stones

79
Q

hemophilia A pt get ____before surgery

A

desmopressin

80
Q

An ___________approach is typically used for resection of any adrenal tumor when malignancy is suspected

A

open transabdominal

81
Q

Classic prodromal symptoms for vasovagal

A

nausea, diaphoresis, a warm or cold sensation, and blurred vision.

82
Q

ost common postsurgical complication experienced by patients undergoing surgical treatment for peptic ulcer disease?

A

wt loss

83
Q

__________is the recommended imaging modality in the assessment of acute arterial embolism that is not immediately limb-threatening,

A

CTA of the pelvis with runoff

84
Q

drug zTreatment of PAD

A

-ASA or clopidogrel (anti-plats) + RF redduction

85
Q

pH: > 7.45; PaCO2: < 35 mm Hg; HCO3: normal

A

resp alkalosis

86
Q

pH: < 7.35; PaCO2: > 45 mm Hg; HCO3: normal

A

resp aciodsis

-hyPOventilation

87
Q

pH: < 7.35; PaCO2: normal; HCO3: < 22 mEq/L

A

met acidosis

88
Q

pH: > 7.45; PaCO2: normal; HCO3: > 26 mEq/L

A

met alkalosis

89
Q

Patients complaining of esophageal dysphagia should undergo

A

upper endoscopy

90
Q

decreased hemoglobin and hematocrit with an elevated mean corpuscular volume.

A

b12 def or folate

91
Q

Intravenous _______ is administered to prevent hypotension secondary to adrenal insufficiency in a patient undergoing unilateral or bilateral adrenalectomy.

A

hydrocortisone (50 to 100 mg)

92
Q

A wide excision with a ____cm wide margin of normal tissue is standard for melanoma that is less than 1 mm in thickness.

A

1 cm

93
Q

A wide excision with a ____ cm wide margin of normal tissue is standard for melanoma that is > than 1 mm in thickness.

A

2 cm

94
Q

Life-long _________ is required for patients who undergo Roux-en-Y gastric bypass

A

micronutrient supplementation

95
Q

Hypoactive bowel sounds are an indicator that

A

perforatoiin occured

96
Q

What are three tumor markers that should be assessed in cases of suspected testicular cancer?

A

Alpha-fetoprotein (AFP), the beta subunit of human chorionic gonadotropin (beta-hCG), and lactate dehydrogenase (LDH).

EORs (15 decks)

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