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Surgery > surgery uworld > Flashcards

surgery uworld Flashcards

1
Q

Characteristics of pain of bursitis

A

shar, swelling, erythema, pain with active but not passive motion

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2
Q

Knee pain associated with repetitive kneeling

A

prepatellar bursitis

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3
Q

patella fracture

A

welling, tenderness, inability to extend knee; caused by sudden forse like falling from a height

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4
Q

Patellar tendinitis

A

episodic pain and tenderness at the inferior patella and patellar tendon; seein athletes in jumping sports

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5
Q

Patellofemoral pain syndrome

A

most common in women; presents with peripatellar pain wosrse with activity or prolonged sitting

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6
Q

Tx of supracondylar fracture

A

analgesia and immobilization

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7
Q

terminal hematuria

A

suggests bleeding form the prostate, bladder or posterior urethra

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8
Q

initial step in workup for bladder cnacer

A

cystoscpy

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9
Q

men with pelvic fractures are at significant risk for

A

posterior urethral injury

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10
Q

First step in patients with suspected urethral injury

A

retrograde urethrogram

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11
Q

Men with straddle injury are at risk for

A

anterior urethral injury

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12
Q

Signs of pelvic fracture, gross hematuria, possibly voiding difficulty; next step

A

retrograde cystogram to assess for bladder rupture

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13
Q

Diffuse axonal injury

A

traumatic acceleration/deceleration -> diffuse damage of axons presenting in coma with CT findings of small bleeds in the grey-white matter jct

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14
Q

uncal hernia

A

ipsilateral hemiparesis; compression of ipsilateral oculomotor nerve (mydraiasis, ptosis and down and out gaze; compresion of ipsilateral posterior cerebral artery (contra homonymous hemianopsia) altered level of consciousness and coma

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15
Q

Cushings triad

A

hypertension, bradycardia and respiratory depression)

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16
Q

Acute popping sensation in knee, catching and locking sensation; how do you dx

A

MRI looking for meniscal tear

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17
Q

short vs long term tx meniscal tear

A

short term NSAIDS and rest; if >3-4 weeks surgical intervention

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18
Q

pain with abduction, external rotation; subacromial tenderness; normal range of motion with positive neer and hawkin signs

A

rotator cuff impingement or tendiopathy

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19
Q

pain with abduction; weakness external rotation age >40

A

rotator cuff tear

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20
Q

anterior shoulder pain; pain with lifting, carrying or overhead reaching, weakness less common

A

biceps tendinopaty/rupture

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21
Q

respirtory distress, neurologic dysfunction and petechial rash

A

fat embolism

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22
Q

recent history of skin infection, fever, abd pain that radiates to groin

A

psoas abscess

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23
Q

abd pain with hip extension

A

psoas sign

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24
Q

tx psoas abscess

A

drainage and blood and abscess cultures

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25
Q

immediate fever post op

A

prior infection, blood products, malignant hyperthermia

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26
Q

post op fever within 1-7 d

A

sirgical site infection, MI, PE< DVT, nosocomial infection

27
Q

post op fever 1-4 wks

A

catheter infection, c diff, drug fever, PE/DVT

28
Q

PE findings pneumothorax

A

hyperresonance over affected side and tracheal deviation to opposite side

29
Q

Signs of tracheobronchial tear

A

dyspnea, hemoptysis, subcut emphysema,, audible crepitus on cardiac auscultation

30
Q

indications for a urgent laparotomy

A

free intraperitoneal fluid in abd of a hemodynamically unstable patient

31
Q

indication for contrast andiography

A

unstable patient with pelvic fracture disrupting pelvic vessels and for patients with hemorrhage d/t spleci or hepatic lacerations

32
Q

signs of myocardial rupture

A

muffled heart sounds, hypotension and distended neck veins

33
Q

Dx of myocardial rupture

A

US with emergent surgical repair

34
Q

preferred wat to establish an airway in a cervical spinal injury if there is no significant facial trauma

A

orotracheal intubation

35
Q

fever, leukocytosis, parotid inflammation

A

bacterial parotitis most commonly cause bby S aureus

36
Q

best way to prevent bacterial parotitis post op

A

adequate fluids and oral hygience

37
Q

extra axial well circumscribed or round homogenously enhancing dural based mass on MRI suggest

A

meningioma

38
Q

tx meningioma

A

resection

39
Q

indications for an airway

A

severe inhalation injury (breathing smoke), cervical spine injury

40
Q

indication for fiberoptic bronchoscope securing of airway

A

subcut emphysema in the neck

41
Q

indication for cricothyroidotomy

A

intubation cannot be done in usual manner and time becomes an issue

42
Q

clinical signs of shock

A

low BP (<90), fast feeble pulse, low UO (<0.5 mL/kg/h), pale, cold sweating, thirsty

43
Q

causes of shock in the trauma setting

A

bleeding (hypovol), pericardial tamponade, tension pneumo

44
Q

trauma with low CVP (empty veins) vs high

A

low-bleeding-> hypovol

high- tamponade or tension pneumo

45
Q

respiratory distress, no breath sounds on right and hyperresonant to percussion and mediastinum displace to left

A

right sided pneumo

46
Q

preferred route of fluid resuscitation in trauma

A

2 16 gauage PIV if not possible femoral vein cath; if under 6 yo intraosseus cannulation of prox tibia

47
Q

management pericardial tamponade

A

clinical dx (no Xray needed maybe sonogram); pericardiocentesis, tube, pericardial window or open thracotomy; fluid and blood

48
Q

management tension pneumo

A

clinical dx; needle or cath into pleural space; follow with chest tube to underwater seal

49
Q

non trauma causes of hypovol shock

A

burns, peritonitis, pancreatitis, massive diarrhea

50
Q

causes of cardiogenic shock

A

massive MI, fulminating myocarditis

51
Q

tx penetrating head trauma

A

surgical intervention

52
Q

tx linear skull fractures

A

closed- leave
open- wound closure
comminuted or depressed- OR

53
Q

Anyone with head trauma who has become unconscious

A

get a CT to look for intracranial hematoma

54
Q

signs of fracture affecting the base of the skull

A

raccoon eyes, rhinorrhea, otorrhea

55
Q

head trauma, unconsciousness, lucid interval and gradual relapse into coma, fixed dilated pupils, and contralateral hemiparesis. CT finding

A

epidural hematoma shows biconvex hematoma

56
Q

tx epidural hematoma

A

emergency craniotomy

57
Q

ICP monitoring

A

elevae head, hyperventilate, avoid fluid overload, and give mannitol or furosemide

58
Q

ALS deficits

A

upper and lower motor neuron with no loss of sensory

59
Q

cervical spondylosis

A

neck pain and stiffness; spinal stenosis-> neuro defects

60
Q

herniated cervical disc

A

unilateral radiculopathy

61
Q

risk factors emphysematous cholecystitis

A

DM, vascular compromise immunosuppression

62
Q

tx emphysematous cholecystitis

A

cholecystectomy emergently and broad spectrum abx

63
Q

Sodium bicarb in the management of metabolic acidosis

A

severe with pH <7.1

Surgery (2 decks)

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