Surgery p435-447 Flashcards
common cause & site of stress fracture
- repetitive insults to the bone
* metatarsals
common cause & site of compression fracture
- osteoporosis
* most common site is lumbar vertebra
pathologic fracture
fracture that occurs by minimal trauma in a bone that has been weakened by an underlying diseasee
what do we need to rule out in case of anterior shoulder dislocation
axillary nerve and artery injury
type of shoulder dislocation seen as a result of seizure or electrical burn
posterior type
clavicular fracture poses a risk of injury to which neuromuscular structures
subclavian artery and brachial plexus
treatment for scaphoid fracture
thumb spica cast
best imaging modality when suspecting scaphoid fracture
MRI
trigger finger treatment
steroids,
surgery to cut the tendon sheath in cases that don’t respond to steroids
*fracture of long bone,
*dyspnea, petechial rash, confusion
*CXR infiltrates
Diagnosis?
fat embolism
treatment for fat embolism
*Oxygen < maintain PO2 over 95%>
Intubation and mechanical ventilation in severely hypoxic cases.
shopping cart sign is positive in
spinal stenosis
treated with NSAIDS/surgery
*h/o lifting heavy weights
*electric pain with dermatomal distribution
straight leg raise test positive
disc herniation
treated with NSAIDS/activity modification
imaging modality of choice in disc herniation
MRI
best next step when suspecting compartment syndrome
immediate fasciotomy
ligaments affected in unhappy triad of knee injury
a) anterior cruciate ligament
b) medial collateral ligament
c) lateral or medial meniscus
bruit and pulsatile abd mass. Diagnosis?
Abdominal aortic aneurysm
sudden onset tearing chest pain radiating to the back,
Dx and test of choice
aortic dissection
- -> MR angiogram (stable patients), CT angiogram, TEE
- ->TEE is fastest and used if patient is unstable
management of ascending aortic dissection
emergent surgery and bp control
management of descending aortic dissection
medical therapy for bp control
cause of postoperative fever day 1-2 and its prevention
atelectasis or postoperative pneumonia
—>can be prevented by incentive spirometry, vancomycin and tazobactum-piperacillin
cause of postoperative fever day3-5
UTI
causes of postoperative fever day 5-7,
prevention
DVT, thrombophlebitis
|»_space;can be prevented by heparin for 5 days in addition to warfarin 3-6 months
cause of postoperative fever day 7
wound infection
postoperative fever day 8-15
drug fever or deep abscess
imaging modality for pulmonary embolism
spiral CT
next best step if patient has second pulmonary embolism while on coumadin
IVC filter via inguinal catheterization
test of choice for pulmonary embolism in patients with known contrast allergy
V/Q scan
Management guidelines for abdominal aortic aneurysm based on size
Management guidelines for abdominal aortic aneurysm based on size
a)3-4 cm : USG every 2-3 years
b)4-5.4 cm: USG or CT every 6-12 months
C)>= 5.5 cm : surgical repair even if asymptomatic
