Uworld Surgery Flashcards
Nasopharyngeal carcinoma is associated with what virus
EBV
Nasopharyngeal carcinoma is endemic to where
sourthern china (and parts of Africa and the Middle East)
Aflatoxin B1 is a mycotoxin that often contaminates agricultural products and is associated with an increased risk of what?
hepatocellular carcinoma
Recent cardiac cath, anticoagulation with heparin, sudden onset of hypotension, tachycardia, flat neck veins, and back pain is consistent with what?
-retroperitoneal hematoma due to bleeding from the arterial access site (with retroperitoneal extension . . . . .Non contrast CT scan of abdomen and pelvis or abdominal US confirms . . . treatment supportive
This causes chronic anterior knee pain and is most common in women. It presents with peripatellar pain worsened by activity or prolonged sitting
Patellofemoral pain syndrome
Patient in MVA with persistent pneumothorax despite chest tube placement and pneumomediastinum, and has subcutaneous emphysema on PE . . cause?
- Tracheobronchial perforation secondary to blunt thoracic trauma (bronchial rupture)
- The right main bronchus is most commonly injured in these cases. Dx confirmed with high-resolution CT scanning, bronchoscopy, or surgical exploration
This is a common complication of vascular surgery, as patients are often older and have extensive underlying atherosclerosis. CT imaging can show thickening of the bowel wall. Colonoscopy shows cyanotic mucosa and hemorrhagic ulcerations
Ischemic colitis
In burn victims, clinical indicators of thermal inhalation injury to the upper airway and/or smoke inhalation injury to the lungs include burns on the face, singing of the eyebrows, oropharyngeal inflammation/blistering, oropharyngeal carbon deposits, carbonaceous sputum, stridor, carboxyhemoglobin level >10%, or history of confinement in a burning building. The presence of one or ore of these indicators warrants what?
early intubation to prevent upper airway obstruction by edema
Stress fractures of the 2nd, 3rd, and 4th metatarsals are managed how and why?
- conservatively . . initial interventions include rest and simple analgesics (e.g. acetaminophen)
- The surrounding metatarsals act as splints and nonunion is uncommon
Stress fractures of the 5th metatarsals are at increased risk for nonunion and are usually managed how?
with casting or internal fixation
A patient with stuttering episodes of nausea and vomiting, pneumobilia (air in the biliary tree), hyperactive bowel sounds, and dilated loops of bowels likely has what?
A gallstone ileus, a form of mechanical small bowel obstruction
Gallstone ileus occurs when what happens
A gallstone passes through a biliary enteric fistula into the small bowel. As the stone advances it may cause intermittent “tumbling” obstruction with diffuse abdominal pain and vomiting until finally lodging in the ileum
Dislocation of this carpal bone following a fall on an outstretched hand can cause compressive neuropathy of the median nerve?
Lunate
Describe the extension and complications potentially of a retropharyngeal abscess
- drains inferiorly to the superior mediastinum
- Spread to the carotid sheath can cause thrombosis of the internal jugular vein and deficits in cranial nerves IX, X, XI, and XII
- Extension through the alar fascia into the “danger space” (between the alar and prevertebral fascia) can rapidly transmit infection into the posterior mediastinum to the level of the diaphragm
- Acute necrotizing mediastinitis is a life-threatening complication characterized by fever, chest pain, dyspnea, and odynophagia, and requires urgen surgical intervention
Ludwig angina is a rapidly progressive bilateral cellulitis of the submandibular and sublingual spaces, most often arising from what?
an infected mandibular molar
Acalcujlous cholecystitis is a serious condition that can lead to sepsis and death if undetected. Most often seen in SEVERELY ILL patients in the ICU with multiorgan failure, severe trauma, surgery, burns, sepsis, or prolonged. The immediate treatment in critically ill patients includes what?
-antibiotics followed by percutaneous cholecystostomy under radiologic guidance
Sphincter of Oddi dysfunction is a functional biliary disorder due to dyskinesia or stenosis of the sphincter of Oddi. Patients experience recurrent, episodic pain in the RUQ or epigastric region, with corresponding elevations in aminotransferases and alk phos. What meds may cause sphincter contraction and precipitate symptoms?
-Opioid analgesics (e.g. morphine)
most common cause of primary hypoparathyroidism
post surgical
All trauma patients should be triaged using the Glasgow coma scale, which can predict the severity and prognosis of coma, during the primary survey. The GCS assesses what?
- Ability to open his/her eye
- motor response
- Verbal response
The most rapid means of normalizing the prothrombin time (INR) is restoration of the vitamin K-dependent clotting factors through what?
an infusion of FFP
This is given pre-operatively to patients with mild hemophilia A in order to prevent excessive bleeding. It directly increases factor VIII levels by causing vWF release from endothelial cells
Desmopressin (DDAVP)
Medial tibial stress syndrome (shin splints) causes anterior leg pain resembling that of a stress fracture. It is usually seen in casual runners and is characterized by what?
- diffuse area of tenderness (not point tenderness, as seen in stress fracture)
- Shin splints are more common in overweight than underweight individuals
Gastric outlet obstruction can be caused by many disease processes and is characterized by early satiety, nausea, nonbilious vomiting, and weight loss. In a patient with a history of acid ingestion, what is the most likely cause?
Pyloric stricture
A patient with blunt abdominal trauma, hypotension, right chest/abdominal wall injury, and free intraperitoneal fluid most likely has what?
A hepatic laceration, one of the most common solid organ injuries, along with splenic lacerations
