Surgery Shelf Flashcards
Hypoparathyroidism is characterized by ???
Hypocalcemia and hyperphosphatemia
Most common cause of primary hypoparathyroidism?
Post-surgical
Most sensitive/specific test for PAD?
Ankle-Brachial Index (arterial dopplers are less sensitive/specific)
ABI of ??? is diagnostic of occlusive PAD
Less than/equal to 0.9
Size dx of acute appendicitis?
> 6 cm
DMILS pneumonic for hernias:
Direct hernias are Medial to epigastric vessels (projects thru ab wall); Indirect hernias are Lateral to epigastric vessels (projects thru ing. ring into Scrotum)
Ab pain, F, leukocytosis, inflammation/ rectal bleeding that is s/p polypectomy, with NO evidence of perforation: Dx?
Post polypectomy electro coagulation syndrome
Acute aortic dissection: DeBakey type 1 and type 2, type 3?
Type 1: ascending, arch, descending
Type 2: ascending. Type 3: descending
Charcot’s triad of cholangitis?
RUQ pain, fever, jaundice
Most accurate method to evaluate a thyroid nodule?
FNA
Common fx with FOOSH injuries?
Scaphoid
Most common surgical cause of ab pain
Appendicitis
Gold standard for Dx imaging of nephrolithiasis?
CT without contrast
Area of thickened mucosa located at distal end of anal fissure?
Sentinel pile
Obstipation definition
Severe constipation, 2/2 obstruction
Cushing’s triad, indicative of increased ICP, consist of:
Bradycardia, HTN, resp. distress
Most likely Post-Op infection: days 3-5? Days 5-7?
UTI. Wound/surgical site
Beck’s triad of pericardial tamponade:
Hypotension, elevated JVP, muffled/distant heart sounds
Reynolds Pentad for cholangitis:
Charcots triad (F/RUQ pain/jaundice) + AMS + shock
Upper GI bleeds are proximal to ???, Lower GI bleeds are distal.
Ligament of Treitz
Peritoneal signs necessitate emergent ???
Exploratory laparotomy
Dx of Boerhaave’s syndrome via ???
Gastrografin esophagram
T or F: femoral hernias, as compared to inguinal hernias, have a higher likelihood of incarceration/strangulation
True
Location of femoral hernias?
In empty space of “NAVeL”
Signs and symptoms of tension pneumothorax?
RDS, hypotension, JVD, tracheal deviation, diminished breath sounds
T or F: asymptomatic gallstones do not require prophylactic cholecystectomy or routine imaging
True
Cholecystectomy is indicated for stones > ???
5 mm
Confirm dx of cholangitis via?
ERCP
Adult burn TBSA: head? Arm? Leg? Trunk?
9%, 9%, 18%, 36%.
Neck midline mass that moves during tongue protrusion?
Thyroglossal Duct Cyst
Benign breast disease, classically presents as intermittent bloody discharge from one nipple. Difficult to palpate
Intraductal papillomas
Hypocalcemia post thyroidectomy, presents with complaints of: MOANS, GROANS, BONES, STONES
{Anxiety, muscle cramps}, {Constipation}, {Osteoporosis}, {Kidney stones}
F/C and deep ab pain suggests?
Retroperitoneal Abscess
Acute pain/swelling in midline sacrococcygeal skin?
Infected Pilonidal Cyst
Functional defect in bowel motility without physical obstruction
Ileus
Acute DVT tx?
Heparin
TOC for diverticulosis? Diverticulitis?
Barium enema. CT with contrast.
Diverticulitis complications?
Fistula, perforation, abscess, obstruction.
GI bleeding is rare in diverticulitis and common in diverticulosis: T or F
True
Radiation therapy is NOT indicated n tx of colon ca, but is indicated in rectal ca: T or F
True
In SBO, initiate care by decompressing bowel with ??!
NG tube
Lung opacification on CXR is generally caused by ??? or ???
Effusion or Atelectasis
Thompson test for Achilles’ tendon tear:
Pt prone, squeeze gastrocnemius and foot should plantar flex
ACS pressure of ??? indicates need for emergent Fasciotomy
Whipple procedure, which organs removed?
Head of pancreas, duodenum, proximal jejunum, GB, distal stomach
Gold standard for dx of aortic dissection?
CT angiography
T or F: there is no benefit of endarterectomy for COMPLETE occlusion of carotid
True
Most common cause of SBO? LBO?
Adhesions. Neoplasms.
The ??? kidney is preferred for living donor transplants bc it has a longer vein
Left
Epididymitis is tx with?
Ceftriaxone and Doxycycline
Epididymitis US findings?
Increased blood flow to affected side (hyperemia)
T or F: cremasteric reflex usually absent in testicular torsion
True
Classic presentation of secondary adrenal insufficiency in a post op pt:
Hypotension, shock, hyperkalemia
Kehrs sign?
L shoulder pain 2/2 traumatic splenic rupture (blood irritates phrenic nerve)
First orders for SBO
NPO, IVF, NG tube
AAA’s > ??? cm require surgery
5
Initial tx for stable pt with sigmoid volvulus?
Sigmoidoscopy for decompression
Cecal Volvulus requires surgical intervention, as it is not amenable to endoscopic insufflation (unlike sigmoid volvulus). T or F
True
Clinical presentation of perioperative adrenal insufficiency:
N/V/Ab pain, hyponatremia, hyperkalemia, hypoglycemia, hypotension
First indicator of hypovolemia?
Tachycardia
First step after placing central venous cath?
Portable CXR to confirm proper placement
Test used in cases of lower GI bleed where the source cannot be found via colonoscopy?
Tech-99 erythrocyte scintigraphy
First step in suspected tension pneumothorax?
Needle thoracostomy in 2nd IC space at midclavicular line
Acute appendicitis is a clinical dx and pts who present classically should have an immediate appendectomy (no imaging) to prevent rupture. T or F?
True
Tx of CO poisoning?
100% oxygen
Any penetrating wound below the ??? is considered to involve the abdomen and requires an ex lap
4th IC space/nipple line
CT scan of ??? shows numerous minute punctuate hemorrhage switch blurring of grey-white interface
Diffuse axonal injury
??? absorption is increased in Crohns pts, causing nephrolithiasis
Oxalate
Hyperventilation decreases ICP by ???
Cerebral vasoconstriction (due to CO2 washout)
Prime objective in rib fractures?
Pain relief, allowing proper ventilation and preventing Atelectasis and PNA
The GCS assesses the pts ability to ???
Open eyes, verbal response, motor response
Mulder sign?
Clicking sensation when squeezing 3/4 metatarsals. Mortons neuroma
Dx AAA with?
CT abdomen. (US is for screening)
