Test Q's Flashcards
You find a small lipoma on your pt. You are working at a small aid station. What can you do?
You can remove a small lipoma
- be careful they can be icebergs
- can be vascular
3-0 vs 2-0?
0.001 vs 0.01
3-0 is smaller than 2-0
2 is rope (chest tubes)
High spine injury can lead to
PE 2/2 immobilization
Spinal vs epidural anesthesia where does the anesthetic go?
Spinal (suparachnoid block) - into the subarachnoid space (CSF)
Epidural - into the epidural space
Spinal vs epidural anesthesia who administers?
Spinal - anesthesiology service
Epidural - can be don by others
Spinal vs epidural anesthesia uses?
Spinal - lower abd, lower extremity, GU and GYN procedures
Epidural - rib fractures
Spinal vs epidural anesthesia volume of anesthesia?
Spinal - small amount of fluid
Epidural - continuous drip
Spinal vs epidural anesthesia each block?
Spinal - sympathetic, sensory AND motor
Epidural - sensory BUT NOT motor
Post op pt who is oliguric or anuric (MC complication of central nerve block)
You find >1L of fluid in the bladder, what do they need?
Foley catheter
- they DO NOT need superpubic or a diuretic
Reversal agents
Narcotic:
Benzodiazepine:
Narcotic: naloxone
Benzo: flumazenil
Be able to differentiate
- Pulmonary edema
- atalectisis
- ARDS
Pulmonary edema
- volume overload (CHF etc)
ARDS
- interstitial fluid
- doesnt respond to diuretics
- must intubate
Atalectisis
- collapsed alveoli from not coughing
Presentation of fat emboli vs pulmonary emboli
Fat
- 6-24hrs pst injury
- petechiae
- normal D dimer
Pulmonary embolus
- time: whenever (prob DVT)
- pos D dimer
- verchow’s triad (high spine inj)
Pt was in a car/motorcycle crash not wearing a helmet. Suffered a high spinal injury. What is the concern?
They can’t move so they get a PE
- stasis
What are the MC causes of post operative oliguria?
BPH
Dehydration
Post operative oliguria with BPH as the cause. What is the tx?
1st thing to try is to cannulate the bladder
- NOT SUPRAPUBIC DRAIN
MC nosocomial infection?
Surgical site infections
- 36%
Post op pt with small fever , x ray has streaky lines
Atalectasis
- not pneumonia (that would have higher fever)
“On my exam” Pleural effusion pt will have ___ fluid caused by ____?
Exudative fluid
Pneumonia
AAA’s are at an increased risk for rupture if?
> 6cm in size
Expansion >0.6cm/yr
Elective AAA repair?
Misnomer, >5.5cm and asymptomatic; you must get it repaired
- elective means its not an emergency and you can get it repaired with a scheduled surgery not an emergent one
Not mentioned specifically as a test q but he keeps saying it:
How to avoid the MC 5 causes of death with trauma pts?
- Talk to the pt
- Get them naked
- Roll them over and shoot a side CXR
Chronic Mesenteric ischemia pts will present w?
- Food fear - post prandial abdominal pain
- weight loss
- diarrhea
- N/V
Pt with low(ish) ABI
Smoker
Pain when walking
Atherosclerotic peripheral disease
- stop smoking
- increase exercise
Hard signs for surgery with a vessel injury?
Pulsatile bleed Expanding hematoma Bruit/thrill Pulseless/cool extremity Sensory deficit
Penetrating injuries in the extremities can be observed (not surgerized) if?
Hemodynamically stable
No fx
No hard signs of arterial injury
ABI >0.9
MC hernia?
Inguinal
Femoral is most commonly found in women but the MC in women is still inguinal
Men MC = inguinal
(Endo lecture)
B blockers treat?
A blockers treat?
B-blocker - thyrotoxicosis
- prevent thyroid storm
A-blocker - pheochromocytoma (adrenals)
MEN 1
Werner’s syndrome
- hyperparathyroidism
Men 2
Sipples syndrome
- medullary thyroid ca
- pheochromocytoma
Pheochromocytoma tx?
Control HTN w A-blocker then a B-blocker (in this order)
Type of surgeon for the following:
- Pituitary adenoma
- SC lung ca
- Carcinoid tumor (gut)
- Medullary carcinoid (thyroid)
- Pituitary adenoma
- neurosurgeon - SC lung ca
- thoracic surgeon - Carcinoid tumor (gut)
- anybody - Medullary carcinoid (thyroid)
- head/neck
Management of hormonally inactive adrenal mass?
> 5 cm - adrenalectomy
<5 cm - confirmed benign
- repeat CT in 3-6 mo
Differentiate acute mastitis from breast abscess
Mastitis:
- no organization or mass (abscess)
- continue to breast feed
Abscess (cellulitis)
- definite mass, organizing infection
- systemic symptoms
- stop nursing
Risk factor for breast cancer?
Female Age 1st degree relative Bx w atypia High fat diet BRCA 1 - 50-70% risk BRCA 2 - 40% risk
Not risk factors for breast cancer?
Breast feeding FMHx (not 1st degree) OCPs Breast augmentation Mastitis hx Fibrocystis
Which pathology results have the worst prognosis?
Triple negative breast cancer
Eczematoid/crusted lesion on the nipple or areola that is refractory to steroids >1 week
Paget’s disease (breast cancer)
BAD sign
When i sentinel node BX is done and found to have spread what is a treatment that will be done after removing the node?
External beam radiation
