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MS3 > Surgery Rotation 4 > Flashcards

Surgery Rotation 4 Flashcards

1
Q

Treatment of hypernatremia

A

D5 1/2 NS - for slow development

D5 1/3 NS - for rapid development

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2
Q

Treatment of hyponatremia

A

Water restriction - for slow developing

NS or Ringers lactate - for rapid developing

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3
Q

Treatment for hypo and hyperkalemia

A

Hypo - IV potassium

Hyper - hemodialysis, insulin

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4
Q

What is in cryoprecipitate

A

Used in coagulopathies

Fibrinogen, factor 8 and 13, fibronectin, VWF

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5
Q

What does pronator drift test for

A

o Test:
♣ Patient outstretches the arms with palms up and eyes closed so that only proprioception is used to maintain arm position
♣ UMN lesions cause more weakness in supinator muscles compared to pronator muscles of the upper limb – so affected arm drifts downward and the palm turns (pronates) toward the floor

o Positive in UMN or Pyramidal/Corticospinal tract disease
♣ E.g. Multiple Sclerosis

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6
Q

Initial management of patient with unprovoked first seizure

A

CT without contrast to rule out acute neuro problems (e.g. intracranial or subarachnoid bleed)

MRI is better than CT to identify structural causes of epilepsy in non-emergent situations

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7
Q

Treatment of gas gangrene

A

Penicillin
Debridement
Hyperbaric chamber

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8
Q

Review bone breaks and associated nerve/artery damage

A

Do it!!

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9
Q

Artery damaged in posterior dislocation of knee

A

Popliteal artery

Important because there is very little collateral arteries back there

Must check if there is good blood supply to lower leg

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10
Q

Management of carpal tunnel syndrome

A

Wrist xray
Splint and anti-inflammatories
If it needs surgery - precede by electromyography

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11
Q

Management of trigger finger

A

Steroid injections

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12
Q

Management of uncomplicated SBO

A

Bowen rest, NG tube suction, fluids

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13
Q

Signs of complicated SBO

A

Changes in pain, fever, hemodynamic instability (tachycardia, hypotension), guarding, leukocytosis, metabolic acidosis

Increased risk of ischemia, strangulation, and necrosis

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14
Q

Management of complicated SBO

A

Emergency exploratory laparotomy

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15
Q

Management of acute mesenteric ischemia

A

Angiography of mesenteric vessels

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16
Q

Ddx for anterior mediastinal mass

A

4 Ts

Thymoma, teratoma (and other germ cell tumors), thyroid neoplasm, terrible lymphoma

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17
Q

Management of small and uncomplicated pneumothorax

A

Observation and O2

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18
Q

Treatment of large but stable pneumothorax

A

Needle aspiration or chest tube

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19
Q

Management of unstable pneumothorax

A

Chest tube or urgent needle decompression

20
Q

Management of uncomplicated diverticulitis

A

Bowel rest, oral abx, observation

21
Q

What is complicated diverticulitis

A

Diverticulitis associated with Abscess, perforation, obstruction, fistula

22
Q

Management of complicated diverticulitis with abscess

A

Percutaneous drainage guided by CT for fluid > 3

Surgical drainage if percutaneous drainage fails

23
Q

Most common organ injuries in blunt abd trauma

A

Hepatic and splenic laceration

24
Q

Major risk factor for pancreatic cancer

A

Smoking

25
Q

Presentation of pancreatic cancer

A

Systemic sx (weight loss), abd/back pain, jaundice, migratory thrombophlebitis, recent onset DM

26
Q

Test for MCL injury

A

Valgus stress test - one hand on medial leg and one on lateral thigh. Push lateral thigh inwards. Laxity indicates MCL injury

27
Q

Test for meniscal tear

A

McMurray test - passive knee flexion and extension while holding the knee in internal or external rotation. Pain, clicking, or catching indicates meniscal tear

28
Q

Causes of pre-renal AKI

A
  • Decreased renal perfusion:
  • true volume depletion
  • decreased EABV (e.g. HF, cirrhosis)
  • displacement of IV fluid (e.g. sepsis, pancreatitis)
  • renal artery stenosis
  • afferent arteriole vasoconstriction (e.g. NSAID)
29
Q

How do you treat pre-renal AKI

A

Restoration of renal perfusion

30
Q

Management for fx of metatarsal

A

Middle metatarsals (2, 3, 4) - can usually heal with rest and analgesics

5th metatarsal has increased risk for nonunion - managed with casting or internal fixation

31
Q

Management of peritonsillar abscess

A

Needle aspiration or incision and drainage + abx

32
Q

Causes of post-op fever

A 
Malignant hyperthermia (immediate)
Bacteremia
Atelectasis
Pneumonia 
UTI (3 days later)
DVT (5 days later)
Wound infection 
Remember: 4 Ws for timing
Wind - atelectasis 
Water - UTI
Walking - DVT 
Wound - infection 
Wonder where - abscess
33
Q

What is dumping syndrome

A

Result of rapid emptying of food into the small bowel

Hyperosmolality of food causes rapid fl ruin shifts from plasma into bowel, resulting in hypotension and sympathetic nervous system response

Presentation = colicky abd pain, diarrhea, nausea, tachycardia

34
Q

Causes of severe post-op chest pain

A

MI or PE

35
Q

How soon after surgery will post-op MI occur

A

1-3 days

36
Q

How soon after surgery will post op PE occur

A

5-7 days

37
Q

In PE will you see hyper/hypxemia and hyper/hypocapnea

A

Hypoxia and hypocapnea

Vs. respiratory failure which has hypercapnea because pt cannot blow off CO2

38
Q

What is the name of internal hernia after Roux-en-Y with small bowel herniating through mesenteric defect?

A

Petersen’s hernia

39
Q

Contents of inguinal canal

A

Spermatic cord or round ligament
Blood vessels
Lymphatic vessels
Ilioinguinal nerve

40
Q

Contents of the spermatic cord

A 
Ductus deferens
Testicular artery
Pampiniform plexus
Genital branch of genitofemoral nerve
Cremasteric muscle
41
Q

What is Cooper’s ligament?

A

Aka pectineal ligament

Extension of the lacunar ligament that runs on the pectineal line of the pubic bone

42
Q

Boundaries of the femoral canal

A
  1. Cooper’s ligament posteriorly
  2. Inguinal ligament anteriorly
  3. Femoral vein laterally
  4. Lacunar ligament medially
43
Q

What does TURP stand for?

A

Transurethral resection of the prostate

44
Q

What is the referred subscapular pain from gallstones called?

A

Boas sign

45
Q

What is Charcot’s triad

A

For cholangitis

Jaundice, fever, RUQ pain

46
Q

What is the pentad of sx associated with cholangitis

A

Reynold’s pentad

jaundice, fever, RUQ pain, hypotension, AMS

MS3 (88 decks)

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