Surgical Recall

Question 1

Beck’s triad

Answer 1

JVD
Muffed heart sounds
Hypotension

Question 2

Blumer’s shelf

Answer 2

Metastatic dz to pouch of Douglas or rectovesicular pouch that creates a palpable “shelf” on rectal exam

Question 3

Carcinoid triad (FDR)

Answer 3

Flushing
Diarrhea
R heart failure

Question 4

Charcot’s triad

Answer 4

Fever
Jaundice
RUQ pain

Question 5

Chvostek’s sign

Answer 5

Twitching facial nerves after tapping on pts with hypocalcemia

Question 6

Courvosier’s law

Answer 6

Enlarged nontender gallbladder seen with obstruction of CBD, usually d/t pancreatic cancer

Question 7

Cullen’s sign

Answer 7

Periumbilical blue d/t retroperitoneal hemorrhage through facial planes –> acute hemorrhagic pancreatitis

Question 8

Cushing’s triad

Answer 8

hypertension
Bradycardia
Irregular respirations

Question 9

Goodsall’s rule

Answer 9

Anal fisutales course in a straight path anteriorly and curved path posteriorly

Question 10

Howship-Romberg sign

Answer 10

Pain along inner aspect of thigh d/t obturator hernia and nerve compression

Question 11

Meckel’s diverticulum rule of 2s

Answer 11

2% have it, 2% are symptomatic, occur within 2 feet of ileocecal valve

Question 12

Pheochrromocytoma sx (PHE)

Answer 12

Palpitations
HA
Episodic diaphoresis

Question 13

Reynold’s pentad

Answer 13

Fever
Jaundice
RUQ pain
AMS
shock/sepsis

Question 14

Virchow’s node

Answer 14

metastatic tumor to left supraclavicular node often d/t gastric cancer

Question 15

Virchow’s triad - risk for thrombosis

Answer 15

Stasis
Abnormal endothelium
Hypercoaguablity

Question 16

Trousseau’s sign

Answer 16

Carpal spasm after occlusion of blood with BP cuff in pts with hypocalcemia

Question 17

Valentino’ sign

Answer 17

RLQ pain d/t perf peptic ulcer

Question 18

Whipple’s triad

Answer 18

Hypoglycemia
CNS sx
Relief of sx with glucose admin

Question 19

Budd-Chiari syndrome

Answer 19

thrombosis of hepatic veins

Question 20

Dumping syndrome

Answer 20

Large amount of hyperosmolar chyme into SB, usually after surgery –> autonomic inability, abdominal pain and diarrhea

Question 21

HITT syndrome

Answer 21

Heparin induced thrombocytopenia thrombosis syndrome – heparin induced platelet antibodies cause platelets to thrombosed vessels

Question 22

Mirizzi’s syndrome

Answer 22

extrinsic obstruction of the common hepatic bile duct from a gallstone in the GB or cystic duct

Question 23

Ogilvie’s syndrome

Answer 23

massive nonobstructive colonic dilation

Question 24

Refeeding syndrome

Answer 24

Hypokalemia, hypomagnesmia, and hypophosphatemia after refeeding a starved pt

Question 25

Short gut syndrome

Answer 25

Malnutrition d/t <200 cm of viable small bowel

Question 26

M/c vessel involved with bleeding duodenal ulcer

Answer 26

Gastroduodenal artery

Question 27

M/c electrolyte deficiency that causes ileus

Answer 27

Hypokalemia

Question 28

M/c cause of large bowel obstruction

Answer 28

Colon cancer

Question 29

M/c cause of free peritoneal air

Answer 29

perforated PUD

Question 30

Complete absorption time for PDS

Answer 30

6 months

Question 31

What is pre-op bowel prep?

Answer 31

Colon cathartic
Oral abx
IV abx before incision

Question 32

How long until a sutured wound epitheializes?

Answer 32

24-48 h

Question 33

Calot’s triangle

Answer 33

area bordered by cystic duct, common hepatic duct, and cystic artery. Lund’s node contained within

Question 34

How do you find the appendix after you find the cecum?

Answer 34

Trace the taeniae back as they converge on the origin of the appendix

Question 35

What are the white lines of Toldt?

Answer 35

lateral peritoneal reflections of the ascending and descending colon

Question 36

Structural difference between jejunum and ileum

Answer 36

J: long vasa rectae, thicker wall
I: shorter vasa rectae, thinner wall

Question 37

Major anatomic difference between colon and SB

Answer 37

Colon: taeniae coli, haustra, and appendices epiploicae
SB: smooth

Question 38

Which dermatome is at the umbilicus

Answer 38

T10