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Surgery > Surgery PEARLS > Flashcards

Surgery PEARLS Flashcards

1
Q

Stress induced hyperglycemia is primarily due to

A

Peripheral resistance to insulin

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2
Q

Basal caloric requirement in mild stress

A

25-30 kcal/kg/day

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3
Q

Basal caloric requirement in moderate stress

A

30 kcal/kg/day

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4
Q

Basal caloric requirement in severe stress

A

30-35 kcal/kg/day

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5
Q

Cancer + severe malnutrition

A

30 kcal/kg/day

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6
Q

Phase of surgical metabolism/injury with reduced REE

A

EBB phase

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7
Q

Primary source of energy during stress

A

Fat

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8
Q

Systemic proteolysis following injury is mediated primarily by

A

Glucocorticoids

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9
Q

% protein catabolised per day

A

1.5%

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10
Q

Dry, scaly dermatitis following prolonged parenteral treatment

A

Essential fatty acid (EFA) deficiency

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11
Q

MC fluid disorder in surgical patients

A

Extracellular, mainly GI

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12
Q

Source of HCO3 in plain LR

A

Lactate

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13
Q

Dextrose in D5-containing IVFs

A

50 g/L

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14
Q

What to request in patients with persistent hypocalcemia/hypokalemia

A

Serum magnesium

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15
Q

Most important treatment of metabolic acidosis

A

Volume resuscitation, NOT bicarbonate

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16
Q

Early acid-base picture of sepsis

A

Respiratory alkalosis

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17
Q

Criteria for SIRS

A

1) Temp 36C or less OR 38 or more 2) HR 90 or more 3) RR 20 or more 4) WBC 4000 or less OR 12000 or more or 10% or more bands

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18
Q

MC organism isolated in G- septicemia

A

E.coli

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19
Q

Adverse changes in G- septicemia is due to

A

Lipid A release

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20
Q

Earliest stage of hemostasis

A

Vascular constriction (> platelet plug > fibrin > fibrinolysis)

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21
Q

Average life span of platelets

A

7-10 days

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22
Q

Inherited disorder of platelet disorder due to lack of gpIIb/IIIa

A

Glanzmann thrombasthenia

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23
Q

Inherited disorder of platelet disorder due to lack of gpIb/IX/V

A

Bernard-Soulier syndrome

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24
Q

MC abnormality of homeostasis in surgical patients

A

Thrombocytopenia

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25
Q

Platelet level when there is spontaneous hemorrhage

A
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26
Q

Treatment of choice in patients with von Willebrand disease

A

Intermediate purity factor 8/DDAVP

27
Q

Best method of identifying a potential bleeder

A

Complete history and PE

28
Q

MC indication for blood transfusion in surgical patients

A

Volume replacement

29
Q

Treatment for bleeding due to fibrinolysis

A

Aminocaproic acid aka tranexamic acid

30
Q

Most important management for DIC

A

Treat underlying cause

31
Q

Mechanism of DIC

A

Excessive plasminogen activator

32
Q

Differentiates DIC from primary fibrinolysis

A

Protamine test (+) in DIC

33
Q

Diffuse oozing of blood from SSI is most likely due to

A

Platelet deficiency

34
Q

Most important management of immediate transfusion reaction

A

Stop the transfusion

35
Q

Delayed transfusion reaction usually occurs within how many days post-transfusion

A

2-10 days

36
Q

Differentiate delayed from immediate transfusion reaction

A

Delayed is d/t EXTRAVASCULAR hemolysis and no specific intervention is needed

37
Q

Shock in a setting of adequate intravascular volume

A

Cardiogenic shock

38
Q

Preferred test in the diagnosis of cardiac tamponade

A

Echocardiography

39
Q

Immediate step after 2D echo-confirmed cardiac tamponade

A

Pericardiocentesis

40
Q

Sign seen in echocardiography of patient with cardiac tamponade

A

Halo sign

41
Q

Persistently elevated base deficit in a trauma patient is usually due to

A

Ongoing bleeding

42
Q

Caloric content of 1L D5LR

A

180

43
Q

MCC of death of all individuals aged 1-44

A

Trauma

44
Q

Widened mediastinum

A

Aortic dissection

45
Q

Gold standard for determining blunt descending torn aortic injury

A

CT scan

46
Q

MC indication for intubation

A

Altered mental status

47
Q

Preferred technique used in establishing a definitive airway

A

Orotracheal intubation

48
Q

Main difference between tension pneumothorax and simple pneumothorax

A

Hypotension

49
Q

Multiple sta wounds on right chest, awake, normotensive, tachypneic, tachycardic, absent breath sounds on right. Next best step.

A

CXR

50
Q

3 contiguous ribs fractured on both right and left hemithorax

A

Flail chest

51
Q

Lethargic, arousable, palpable femoral pulse. SBP is at least

A

70 mmHg

52
Q

Cutoff blood volume in a massive hemothorax

A

1500mL

53
Q

Blood volume that may cause cardiac tamponade

A

Less than 100 mL

54
Q

Most reliable indicator of organ perfusion

A

UO

55
Q

Adequate UO in adult

A

0.5cc/kg/hr

56
Q

Adequate UO in child

A

1cc/kg/hr

57
Q

Adequate UO in infant

A

2cc/kg/hr

58
Q

Hypotensive, tachycardic, tachhypneic, anxious, confused. Class of shock

A

3

59
Q

Estimated blood loss in a class 3 shock

A

At least 30%

60
Q

Fracture of 3 ribs can result to approximately how much blood loss

A

300-600

61
Q

Most important radiograph to obtain in the setting of a blunt trauma or motor vehicular accident

A

1) Cervical 2) Chest 3) Pelvic (SFA NOT included)

62
Q

MC organ injured in blunt trauma

A

Spleen

63
Q

Next best step in management of symptomatic neck injuries

A

CT angio of neck and chest

Surgery (33 decks)

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