surgery signs, triads, etc.

Question 1

test for potency of ulnar artery prior to placing radial artery line or performing an ABG.

occlude both ulnar and radial arteries with fingers as patient makes a fist, patient opens while examiner releases ulnar artery occlusion to assess blood flow to hand

Answer 1

allen’s test

Question 2

constant dullness to percussion in the left flank/LLQ and RESONANCE to percussion in the right flank seen with splenic rupture/splenic hematoma

Answer 2

Ballance’s sign

Question 3

What is Beck’s triad?

Patient’s with ______ have Beck’s triad

Answer 3

JVD
decreased or muffled heart sounds
decreased BP

cardiac tamponade

Question 4

metastatic dz to the rectouterine pouch (pouch of Douglas) or rectovesicular pouch creating a shelf that is palpable on rectal exam

Answer 4

Blumer’s shelf

Question 5

what is the carcinoid triad?

Answer 5

FDR
flushing
diarrhea
R sided heart failure

Question 6

What is charcot’s triad and what is it seen with?

Answer 6

seen with cholangitis
fever
jaundice
RUQ pain

Question 7

twitching of facial muscles upon tapping the facial nerve in patients with hypocalcemia

Answer 7

chvostek’s sign

Question 8

enlarged but contender gall bladder seen with obstruction of common bile duct, most commonly seen with ______

Answer 8

Courvoisier’s law

most commonly seen with pancreatic cancer

Question 9

bluish discoloration around umbilicus (periumbilicus) due to retroperitoneal hemorrhage

Answer 9

Cullen’s sign

Question 10

what is cushing’s triad and what is it a sign of?

Answer 10

sign of increased ICP
hypertension
bradycardia
irregular respirations
think of the 3 main vital signs!

Question 11

in goodsall’s rule, _____ course in a straight path anteriorly, but what happen posteriorly

Answer 11

anal fistulae

posterior= curved path

Question 12

crunching sound on auscultation of the heart resulting from ______

Answer 12

Hamman’s crunch

results from pneumomediastinum, Boerhaave’s

Question 13

Pain along the inner aspect of the thigh indicating an obturator hernia that is compression a nerve

Answer 13

Howship-Romberg sign

Question 14

Where is mcBurney’s point

Answer 14

1/3 of the distance from the ASIS to the umbilicus

Question 15

What is Meckel’s diverticulum rule of 2’s?

What is the difference between regular diverticulum and Meckel’s

Answer 15

Meckel diverticulum rule of 2’s:
2% of the population has Meckel diverticulum, of that 2%, 2% are symptomatic and they occur within 2 feet of the ileocecal valve

Diverticulum= out-touching of intestines that an happen randomly with age
Meckel diverticulum: outpouching or bulge in the lower part of the small intestine. The bulge is congenital (present at birth) and is a leftover of the umbilical cord

Question 16

Cessation of inspiration while palpating under the right costal margin. Pt cannot continue to inspire deeply because the gall bladder is under pressure

Answer 16

Murphys stine= acute cholecystitis

Question 17

What is the obturator sign?

Answer 17

pain when you try and internally rotate the leg with the hip and knee flexed
appendicitis or pelvic abscess

Question 18

what are the symptoms of pheochromocytoma?

Answer 18

think PHE
palpitations
headache
episodic diaphoresis

Question 19

What is the psoas sign

Answer 19

pain illicited by extending the hip with the knee fully extended (straight)

appendicitis/psoas inflammation

Question 20

bilateral black eyes = result of _____

Answer 20

raccoon eyes

basilar skull fx

Question 21

What is Reynold’s pentad? What is it similar to?

Answer 21

1. fever
   2.jaundice
2. RUQ pain
   this is all chariot’s triad so far
   then 2 more make it Reynold’s pentad
3. altered mental status
4. shock/sepsis

Question 22

Palpation of the LLQ resulting in pain in the RLQ

Answer 22

Rovsing’s sign

appendicitis

Question 23

What is virchow’s node

Answer 23

metastatic tumor to L supraclavicular node (classically due to gastric cancer)

Question 24

What is virchow’s triad?

Answer 24

stasis
hypercoagulability
abnormal endothelium

Question 25

Carpal spasm after occlusion of blood to the forearm with a BP cuff in its with hypocalcemia

Answer 25

trousseau’s sign

Question 26

RLQ pain from perforated peptic ulcer due to pus draining into RLQ

Answer 26

Valentino’s sign

Question 27

What is whipple’s triad? What is it evidence for?

Answer 27

1. hypoglycemia (<50)
2. CNS and vasomotor symptoms
3. relief of symptoms with admin of glucose

evidence for insulinoma