Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery > Surgery Shelf > Flashcards

Surgery Shelf Flashcards

1
Q

What is the ABG consequence of post-op atelectasis?

A

ventilation-perfusion mismatch –> hypoxemia –> increased WOB –> patients hyperventilate –> respiratory alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can be used to rapidly reverse warfarin?

A

fresh frozen plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What factors mitigate hernia formation/enlargement/ recurrence?

A
  • weakened tissue: smoking, age, steroids, immunosuppressive meds, collagen disorders, surgical wounds
  • force applied to tissue: heavy lifting, obesity, constipation, cough, trouble urinating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A ____________ hernia enters through a weak point in the fascia of the abdominal wall and its sac is medial to the inferior epigastric vessels

A

direct hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Hesselbach’s triangle?

A
  • rectus abdominus
  • inguinal ligament
  • inferior epigastric artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Direct inguinal hernias exit through the (superficial/deep) inguinal ring and (can/cannot) extend into the scrotum

A
  • superficial inguinal ring

- cannot extend into the scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A __________ hernia occurs from failure of embryonic closure of the deep inguinal ring after the testicle has passed through

A

indirect hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which type of polyp has a greater risk of becoming colon cancer?
hyperplastic or adenomatous

A

adenomatous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What polyp factors should prompt consideration of total colectomy?

A
  • poorly differentiated histology
  • lymphovascular invasion
  • cancer at the resection or stalk margin or margin <2mm
  • invasion into muscular propia of bowel wall
  • invasive carcinoma in a sessile (flat) polyp
  • invasive carcinoma with incomplete polypectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is used to treat anal fissures and why?

A
  • topical lidocaine: comfort

- nifedipine: vasodilator –> increases blood flow to fissure –> enhances healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Best treatment options for a blunt trauma patient with pneumoperitonium include all of the following except…

  • ABG
  • serum lactate
  • exploratory laparotomy
  • CT CAP
  • exploratory laparoscopy
A

CT chest, abdomen, pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do scaphoid fractures carry a significant risk for?

A

osteonecrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What complication occurs when too much normal saline is given?

A

hyperchloremic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is LR or NS preferred for large-volume resuscitation?

A

LR (because normal saline causes hyperchloremia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What fluids do you give for each of the following Na+ problems?

  • hypernatremia: hypovolemic, euvolemic, hypervolemic
  • hyponatremia: hypovolemic, euvolemic, hypervolemic
A
  • hypernatremia: hypovolemic (NS), euvolemic (water), hypervolemic (lasix)
  • hyponatremia: hypovolemic (NS), euvolemic (water restrict), hypervolemic (water restrict)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a local vascular complication of cardiac catheterization that presents with sudden hemodynamic instability?

A

retroperitoneal hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do you treat hyperkalemia?

A

calcium, glucose + insulin, bicarb, beta-agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

N/V, hyporeflexia, weakness, quadraparesis, coma, bradycardia, and respiratory failure are all signs of what electrolyte disturbance?

A

hypermagnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How does hyperphosphatemia present?

A

seizures and tetany from low calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the effect of the following receptors?

  • alpha 1
  • beta 1
  • beta 2
A
  • alpha 1: peripheral squeeze
  • beta 1: cardiac contractility
  • beta 2: peripheral dilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What receptors does epinephrine act on?

A

alpha 1 and beta 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What receptors does phenylephrine act on?

A

pure alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What receptors does milrinone act on?

A

PDE inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What antibiotics should be given for a patient with epididymitis?

A

CTX, doxycycline, FQs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does a CT scan with diffuse blurring of the gray-white matter interface and multiple small punctate hemorrhages suggest?

A

diffuse axonal injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Trauma –> deteriorating blood gases, “white out” of the lungs on CXR

A

pulmonary contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If a patient undergoes splenectomy, what vaccines must be given postoperatively?

A
  • pneumococcus
  • H influenza B
  • meningococcus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the standard topical agent used to treat patients with burns?

A

silver sulfadiazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does rabies prophylaxis consist of?

A

immunoglobulin + vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the antidote for a black widow spider bite?

A

IV calcium gluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is Ogilvie syndrome?

A

paralytic ileum of the colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

From where do each of the following originate?

  • epithelial tumor
  • sarcoma
  • adenocarcinoma
A
  • epithelial tumor: ectoderm
  • sarcoma: mesoderm
  • adenocarcinoma: endoderm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Severe migratory necrolytic dermatitis, DM, anemia, glossitis, and stomatitis are suggestive of…

A

glucagonoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In a baby, green vomiting and a “double-bubble” picture in x-rays (large air-fluid level in stomach, smaller one to its right in 1st portion of duodenum) are found in…

A
  • duodenal atresia
  • annular pancreas
  • malrotation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What should a patient receive for antibiotics who has been bitten by a cat?

A

amoxicillin-clavulonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the difference between treatment for subdural and epidural hematoma?

A
  • epidural: emergency craniotomy

- subdural: ICP monitoring, elevate head of bed, hyperventilate, avoid fluid overload, give mannitol or furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Failure to thrive in an infant, pansystolic murmur best heard at L sternal border, and increased pulmonary vascular markings on CXR are suggestive of…

A

VSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does development of diplopia (from paralysis of extrinsic eye muscles) in a patient suffering from frontal or ethmoid sinusitis suggest?

A

cavernous sinus thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What should be the urgent treatment for pituitary apoplexy?

A

steroid replacement (eventually other hormones will need to be replaced)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What it the utility of IVP (intravenous pyelogram)?

A
  • excellent view of kidneys, collecting system, ureters, bladder
  • provides help with idea of function of renal parenchyma and for ureters and bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Only _____________ can look at the bladder mucosa in detail and aid in detecting early cancers

A

cystoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What causes pneumaturia?

A

fistulization between the bladder and GI track, most commonly the sigmoid colon, and most commonly from diverticulitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Vascular thrombosis that occurs within minutes of re-establishing blood supply to a transplanted organ is a…

A

hyperacute rejection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What causes hyper acute rejection?

A

preformed antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What suggests acute organ rejection and when does it occur?

A
  • liver function deterioration (rising GGT, alk phase, bilirubin)
  • 5 days to 3 months post-transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is first line therapy for acute organ rejection?

A

steroid bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What type of fluid resuscitation should patients with burns get?

A

LR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the worry if a BUN is >100?

A

increased risk of post-op bleeding 2/2 uremic platelet dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are the most common causes of a non-anion gap metabolic acidosis?

A

diarrhea, diurectic, renal tubular acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

A metabolic alkalosis with a low urine chloride is caused by…

A

vomiting/NG, antacids, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

A metabolic alkalosis with a high urine chloride is caused by…

A

Barreter’s, Gittleman’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Paralysis, ileus, ST depression, and U waves are suggestive of…

A

hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How do you treat a circumferential burn?

A

escharotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What should you think of when you see a post-op patient with decreased platelets and clots?

A

HIT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

A patient has confusion, a petechial rash in the chest, axilla, and neck, and acute SOB. Dx?

A

fat embolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

When a patient presents with muffled heart sounds, JVD, electrical alternans, and pulses paradoxus, what is the confirmatory test for the diagnosis?

A
  • pericardial tamponade

- FAST scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What test should be done if blood is seen at the urethral meatus and patient has a high-riding prostate?

A

retrograde urethrogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How do you treat lung abscesses?

A

IV clinda or PCN

59
Q

Patients with constipation, kidney stones, malaise, low PTH, and central lung mass

A

squamous cell carcinoma (paraneoplastic syndrome)

60
Q

CXR showing peripheral cavitation and CT showing distant mets

A

large cell carcinoma

61
Q

Elevated AFP is associated with what type of cancer?

A

hepatocellular carcinoma

62
Q

Carcinoid tumor occurs most commonly at __________ and presents w/ sxs of…

A
  • appendix

- diarrhea, wheezing

63
Q

When should a hemicolectomy be done for a patient with carcinoid tumor?

A
  • > 2cm
  • at base of appendix
  • with +nodes
64
Q

What test is done to work up the following…?

  • pheochromocytoma
  • primary aldosteronism
  • adrenocortical carcinoma
  • cushing
A
  • pheochromocytoma: urine or plasma-free metanephrines
  • primary aldosteronism: plasma aldo to renin ratio
  • adrenocortical carcinoma: urine 17-ketosteroids
  • cushing: overnight dexamethasone suppression test
65
Q

A systolic-diastolic abdominal bruit is specific for…

A

renovascular HTN

66
Q

What type of shock affects vagal tone and what type affects cardiac afterload?

A
  • vagal tone: neurogenic shock

- cardiac afterload: septic shock

67
Q

________ cysts are located on the midline, at the level of the hyoid bone, and seem somehow connected to the tongue

A

thyroglossal duct cysts

68
Q

________ cysts occur along the anterior edge of the sternomastoid muscle

A

brachial cleft cysts

69
Q

How should adrenal insufficiency be worked up?

A

8am cortisol and plasma ACTH

70
Q

What further workup should be done for a simple renal cyst?

A

none

71
Q

How do you distinguish between painless thyroiditis and Graves disease?

A
  • painless thyroiditis has decreased radioiodine uptake, suggesting release of preformed thyroid hormone
  • Graves has increased radioiodine uptake, suggesting increased synthesis of thyroid hormone
72
Q

What is the primary screening test for hyperaldosteronism?

A

plasma aldo:renin ratio

73
Q

An elderly, sedentary, immobilized person with abdominal distension and a dilated colon

A

ogilvie syndrome

74
Q

Young patient with HTN in the arms w/ normal pressure in the lower extremities and scalloping of the ribs

A

coarctation of the aorta

-spiral CT is diagnostic

75
Q

HIV+ patient with perforated cecum and CD4 <200. What bug caused the bloody diarrhea and perforated cecum?

A

CMV

76
Q

What is the difference between a paraesophageal and sliding hiatal hernia?

A
  • paraesophageal: defect in diaphragm, normal GE junction

- sliding: dilation of the hiatus, associated with GERD

77
Q

What lab abnormality can be seen with fibromuscular dysplasia?

A

increased serum aldosterone concentration

78
Q

Young woman with headaches, hypertension, and hypokalemia

A

aldosteronoma

79
Q

What is the most common hip disorder in adolescence?

A

slipped capital femoral epiphysis

80
Q

What artery do nosebleeds come from?

A

sphenopalatine artery

81
Q

What study is most appropriate to predict a patient’s risk for preoperative MI?

A

radionuclide scan with thallium and dipyridamole

82
Q

How do you confirm carpal tunnel?

A

nerve conduction studies

83
Q

What is the difference in RAIU between Graves and a toxic thyroid adenoma?

A
  • Graves: diffuse uptake

- toxic thyroid adenoma: uptake in only one spot

84
Q

Apocrine glands are found in the…

A

skin, breast, eyelid, ear

85
Q

Sebaceous glands are found in the…

A

skin, hair

86
Q

A rapid and significant increase in transaminases is the hallmark of…

A

ischemic hepatopathy

87
Q

_________ should be considered in a patient with hemolytic anemia, cytopenia, and a hypercoagulable state

A

paroxysmal nocturnal hemoglobinuria

88
Q

What acid-base disturbance can be seen with atelectasis?

A

respiratory alkalosis

89
Q

The most common cause of painless bleeding associated with lightheadedness and hemodynamic instability is…

A

diverticular hemorrhage

90
Q

transudate = ______ SAAG

A

-high SAAG (hydrostatic pressure)

91
Q

exudate = ______ SAAG

A

-low SAAG

92
Q

Anti-thyroid peroxidase and antithyroglobulin are 90% specific for…

A

Hashimoto’s thyroiditis

93
Q

How do you treat hospital-acquired PNA?

A

vancomycin, pip/tazo

94
Q

How do you treat a catheter-associated UTI?

A

CTX

95
Q

What two cardiac risk factors are absolute contraindications to (non-cardiac) surgery?

A
  • EF <35%

- MI within the last 6 months

96
Q

MRCP with “beads on a string” and ERCP with “onion-skin fibrosis” are suggestive of…

A

PSC

97
Q

Patients with a puncture would to the foot are at risk for…

A

pseudomonas

98
Q

A baby with bilious emesis and a “double bubble” sign likely has _________ based on…

  • normal gas distally
  • no gas
  • multiple air-fluid levels
A
  • normal gas distally: malrotation
  • no gas: duodenal atresia, annular pancreas
  • multiple air-fluid levels: intestinal atresia
99
Q

How is diverticulitis diagnosed?

A

CT

100
Q

A coiled GI tube with normal gas below is suggestive of…

A

esophageal atresia with fistula

101
Q

What is the murmur of endocarditis?

A

mitral regurg or aortic regurg

102
Q

What is the murmur of rheumatic fever?

A

mitral stenosis

103
Q

How is a seminoma treated?

A

platinum-based chemo

104
Q

What is the first thing to do when someone has a chemical burn?

A

wash it

105
Q

A double bubble sign with otherwise normal gas pattern is suggestive of…

A

malrotation

106
Q

How should BRBPR be worked up in a child?

A

radioactively-labeled technetium scam

107
Q

HTN and rib scalloping are suggestive of ________ and the next step in the workup includes __________

A
  • coarctation of the aorta

- CT angio

108
Q

Diffuse thyroid uptake from radioactive iodine scan suggests…

A

hyperthyroidism

109
Q

A chest tube with a persistent air leak may be caused by…

A

ruptured bronchus

110
Q

A reaction two hours after a blood transfusion is due to…

A

preformed Abs to leukocyte antigens

111
Q

A child with black, shiny stools and an abdominal mass has…

A

meckel diverticulum

112
Q

What is biliary atresia and how does the patient present?

A
  • abnormally narrow, blocked, or absent bile ducts in a child
  • child with jaundice (~3 weeks of life)
113
Q

What is the next step when someone has non-palpable pedal pulses?

A

arteriography

114
Q

Dense hemiparesis and early decerebrate posturing is suggestive of…

A

a ruptured intracerebral aneurysm

115
Q

Anti-thyroid peroxidase and thyroglobulin antibodies are suggestive of…

A

Hashimoto’s thyroiditis

116
Q

What are the EKG findings associated with hyperkalemia?

A
  • gradual prolongation of PR interval
  • prolonged QRS complex
  • ST segment elevations
  • peaked T waves
117
Q

In what patient population is calculus cholecystitis seen?

A

severely ill patients in the ICU with multigrain failure, severe trauma, surgery, burns, sepsis, or prolonged TPN

118
Q

How do you work up Hirschsprung’s disease?

A

biopsy the rectal mucosa

119
Q

If a patient has an esophageal tear, what is the next step?

A

exploratory thoracotomy

120
Q

What is the fluid replacement equation?

A

4mL x kg x %body burned

121
Q

What artery is affected with a temporal bone fracture?

A

middle meningeal artery

122
Q

How do you manage acute kidney rejection?

A

antithymocyte serum and steroid bolus

123
Q

An acute drop in Na+ after surgery is likely due to…

A

water retention

124
Q

How do you treat paralytic ileum of the colon?

A

1st: fluid and electrolyte correction
2nd: colonoscopy (suck out all the air) and rectal tube

125
Q

What type of cancer causes multiple pelvic masses, ascites, and omental masses?

A

ovarian adenocarcinoma

126
Q

What is the most commonly found organism causing ascending cholangitis?

A

e coli

127
Q

How do you manage esophageal perforation?

A

exploratory thoracotomy

128
Q

How do you treat H. pylori?

A
  • PPI
  • amoxicillin
  • clarithromycin
129
Q

Which describes ileum and which describes abdominal obstruction?

  • post-op day 1-2: no stool or flatus
  • post-op day 5: no stool or flatus
A
  • ileus: post-op day 1-2, no stool or flatus

- obstruction: post-op day 5, no stool or flatus

130
Q

Migratory thrombophlebitis is characteristic of…

A

pancreatic cancer

131
Q

What is important about antitrypsin III deficiency?

A

heparin won’t work

132
Q

What are the most common bugs causing necrotizing fasciitis?

A
  • group A beta hemolytic strep

- clostridium perfringens

133
Q

blowing diastolic murmur

A

aortic regurg

134
Q

wide, fixed, split S2

A

ASD

135
Q

Patient with bleeding gums, petechiae, nosebleeds, decreased platelet count, increased megakaryocytes; no splenomegaly

A

1st time: steroids for ITP

relapse: splenectomy

136
Q

What is the mainstay of treatment for squamous cell anal cancer?

A

chemo

137
Q

Bleeding + isolated decrease in platelets…

A

ITP

138
Q

Normal platelets but increased bleeding time and PTT…

A

vWD

139
Q

Low platelets, increased PT, PTT, bleeding time, fibrinogen, d-dimer, schistocytes…

A

DIC (caused by gram- sepsis)

140
Q

What is the first step in treating an electrical burn?

A

EKG

141
Q

Alcoholic –> big meal –> vomiting = ?

A

edematous pancreatitis

142
Q

If blood at the urethral meatus and a high-riding prostate, consider…

A

pelvic fracture w/ urethral or bladder injury

143
Q

Patient with shoulder pain, ptosis, constricted pupil, and facial edema has…

A

superior sulcus syndrome from small cell cancer of the lung

Surgery (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions