Surgery Rapid Fire Review Flashcards by Carlos Altamirano

Elderly woman, SBO, and air in biliary tract.

Gallstone ileus

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Elderly woman with pain down inner aspect of thigh.

Obturator hernia (howship romberg sign)

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Abdominal pain, hypotension, and abdominal pulsatile mass.

Ruptured abdominal aortic aneurysm

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Abdominal pain “out of proportion” to abdominal exam.

Mesenteric ischemia

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Arm pain and syncope with arm movement.

subclavian steal syndrome

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Increasing creatinine on ACE inhibitor.

Renal artery stenosis

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Child with midline neck mass.

Thyroglossal duct cyst

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Child with lateral neck mass.

Branchial cleft cyst

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Crush injury and dark urine.

Myoglobinuria

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Emesis, chest pain radiating to back, and mediastinal air.

Boerhaave’s

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Lower GI bleed + technetium pertechnetate scan.

Meckel’s diverticulum

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Flushing, diarrhea, and right sided heart failure.

Carcinoid

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Pneumoaturia and LLW pain.

Colovesicular fistula

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Desmoid tumor, osteoma, and colon cancer.

Gardner’s syndrome

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Epigastric pain radiating to back and flank ecchymosis.

Hemorrhagic pancreatitis

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Pancreatitis and palpable epigastric mass.

Pancreatic pseudocyst

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Liver abscess with “anchovy paste”.

Amebic abscess

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RUQ pain, travel, and exposure to sheep.

Hydatid cyst

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Caput medusa

Portal hypertension

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45 year old woman with RUQ pain for 12 hours, fever and leukocytosis.

Acute cholecystitis

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Elderly man with large nontender palpable gallbladder

Pancreatic cancer (Courvoisier’s sign)

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Female taking birth control pills with liver mass.

Hepatic adenoma

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Liver tumor with “central scar”.

Focal nodular hyperplasia

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Pancreatic mass, gallstones, diabetes and diarrhea.

Somatostatinoma

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RUQ bruit and CHF in young adult.

Liver hemangioma

Excruciating pain with bowel movement.

Anal fissure

Abdominal pain, diarrhea, and anal fistulae.

Crohn's disease

ECG with peaked T waves

Hyperkalemia

Buccal mucosa with pigmentation

Peutz-Jeghers syndrome

LLQ pain, fever, and change in bowel habits.

Diverticulitis

Elevated urine 5-HIAA

carcinoid

Institutionalized, abdominal pain, vomiting and distention, with proximal colonic dilation.

Sigmoid volvulus

Infant with projectile vomiting.

Pyloric stenosis

Newborn with failure to pass meconium in first 24 hours.

Hirschsprung's disease

Infant with bilious vomiting

malrotation

Newborn with abdominal defect and umbilical cord on sac.

Omphalocele

Teenager with knee pain and "onion skinning" on X-Ray.

Ewing's sarcoma

Pulmonary capillary wedge pressure less than 8, CXR with bilateral pulmonary infiltrates, and PaO2:FiO2 ratio less than 200

Acute respiratory distress syndrome (ARDS)

Increased peak airway pressure, low urine output, and urinary bladder >25mmHg.

Abdominal compartment syndrome

Newborn with inability to pass an NGT.

esophageal atresia

Traumatic bliding in one eye followed by blindness in the contralateral eye 2 weeks later.

Sympathetic ophthalmia

Mitotic pupil, ptosis, and anhydrosis.

Horner's syndrome

Traumatic head injury, conscious in ER followed by unconsciousness.

Epidural hematoma ("lucid interval")

Worst headache of my life

Subarachnoid hemorrhage

Hematuria, flank pain, and abdominal mass (palpable).

Renal cell carcinoma

60 year old white man with painless hematuria.

bladder cancer

RUQ pain, jaundice and fever.

Cholangitis

Epigastric pain radiating to back, with nausea and vomiting.

Pancreatitis

Chest pain radiating to back and described as a tearing pain.

Aortic dissection

40 year old man with tachycardia, hypotension and confusion on postoperative day 2.

Alcohol withdrawal

Marfanoid body habitus and mucosal neuromas.

MEN II-B

Psammoma bodies

Papillary thyroid cancer

Sulphur granules

actinomyces infection

Thyroid tumor with amyloid tissue

Thyroid medullary cancer

Palpable neck tumor and hypercalcemia

parathyroid cancer

Hypertension, diaphoresis (episodic), and palpitations.

Pheochromocytoma

Jejunal ulcers

Zollinger-Ellison syndrome

Pituitary tumor, pancreatic tumor, and parathyroid tumor

MEN-I

Necrotizing migratory erythema

Glocagonomoa

Medullary thyroid cancer, pheochromocytoma, and hyperparathyroidism.

MEN-IIa

Hypokalemia refractory to IV potassium asupplementation.

Hypomagnesemia

Newborn with pneumatosis

Necrotizing enterocolitis (NEC)

Child with abdominal mass that crosses midline

Neuroblastoma

Child less than 4 years of age with abdominal tumor that does not cross midline

Wilms tumor

Currant jelly stools and abdominal colic.

Intussusception

Femur fracture, respiratory failure, petechiae, and mental status changes

Fat embolism

Hearing loss, tinnitus, and vertigo

Meniere's disease

Adolescent boy with nasal obstruction and recurrent epistaxis.

Juvenile nasopharyngeal angiofibroma

Child less than 5 years of age sitting upright and drooling with "hot potato" voice

Epiglottitis

Angina, syncope, and CHF.

Aortic stenosis

Tobacco use, asbestos exposure, and pleuritic chest pain.

Mesothelioma

Supracondylar fracture and contracture of forearm flexors.

Volkmann's contracture

Tibia fracture, "pain out of proportion", pain on passive foot movement, and palpable pulses.

Compartment syndrome

25 year old man with liver mass with fibrous septae and NO history of cirrhosis or hepatitis.

Fibrolamellar hepatocellular carcinoma

EKG with flattening of T waves and U waves.

Hypokalemia

Central pontine myelinosis.

Too rapid correction of hyponatremia

Polydipsia, polyuria, and constipation.

Hypercalcemia

Factor VIII deficiency.

Hemophilia A

Abdominal pain, fever, hypotension, hyperkalemia and hyponatremia.

Adrenal insufficiency (Addisonian crisis)

Massive urine output and hypernatremia.

Diabetes insipidus

Increased urine osmolality, hyponatremia, and low serum osmolality.

SIADH

IV antibiotics, fever, diarrhea

C. diff. pseudomembranous colitis

Bleeding gums and wound dehiscence

Vitamin C deficiency

Fever, central line, and hyperglycemia.

central line infection

Appendectomy followed by fever and abdominal pain on postoperative day #7.

Peritoneal abscess

Advancing crepitus, fever, and blood blisters.

Necrotizing fasciitis

High intraoperative fever.

Malignant hyperthermia

Confusion, ataxia, and ophthalmoplegia

Wernicke's encephalopathy

Tracheal deviation, decreased breath sounds, and hyperresonance.

Tension pneumothorax

Hypotension, decreased heart sounds, and JVD

Pericardial tamponade

Four ribs broken in two places and pulmonary contusion.

Flail chest

Otorrhea (clear) and Battle's sign.

Basilar skull fracture

Ulcer decreased pain with food.

Duodenal ulcer

Vomiting, retching, and epigastric pain

Mallory-Weiss tear

Fever on postoperative day #1, with "bronze" weeping, tender wound.

Clostridial wound infection

Hematochezia and tenesmus

Rectal cancer

Upper GI bleed, jaundice, and RUQ pain

Hemobilia

Gallstones, epigastric pain radiating to back, and nausea.

Gallstone pancreatitis

18 year old woman with bloody nipple discharge

Ductal papilloma

Irritability, diaphoresis, weakness, tremulousness, and palpitations.

Insulinoma