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shelf surgery > VI > Flashcards

VI Flashcards

1
Q

SIRS criteria

A

at least 2 of:

  • temp >101.3
  • pulse>90
  • respirations>20
  • WBC>12,000
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2
Q

what occurs in first week after patient with severe burns

A

hyperglycemia, muscle wasting, protein loss, hyperthermia and increased energy expenditure

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3
Q

main causes of infection after burns

A

staph aureus and pseudomonas aeruginosa

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4
Q

criteria that indicate sepsis

A

worsening hyperglycemia, leukocytosis, thrombocytopenia, mild hypothermia, tachypnea and tachycardia

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5
Q

characteristics of serum sickness

A

fever, urticaria, arthritis, and nephritis

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6
Q

treatment for cardiac tamponade from pericardial fluid

A

pericardiocentesis or surgical pericardiotomy

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7
Q

first step with variceal bleeding

A

inserting two large bore IV needles

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8
Q

medical control of bleeding varices

A

vasoconstrictors like terlipressin, octreotide, or somatostatin

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9
Q

what space in the neck is most dangerous to have an infection

A

retropharyngeal space because spreads to posterior mediastinum resulting in acute necrotizing mediastinitis

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10
Q

ludwigs angina

A

infection in submandibular space

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11
Q

how do sedative medications worsen hypovolemia

A

relax the venous capacitance vessels and cause circulatory failure by decreasing venous return

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12
Q

what indicates need for escahrotmoy

A

when pressure is 25-40 mmHg

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13
Q

test to determine if eschar from burn is constricting

A

doppler US

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14
Q

what is postoperative cholestasis

A

benign condition that develops after a major surgery with hypotension, extensive blood loss into tissues, massive blood replacement

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15
Q

why are you jaundiced with postoperative cholestasis

A

increased pigment load, decreased liver funtionality and decreased bilirubin excretion

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16
Q

treatment for penile fracture

A

emergent urethrogram to assess for urethral injury and emergent surgery to evacuate hematoma and to mend tunica albuginea

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17
Q

components of glascow coma scale

A

eye opening, verbal response, motor response

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18
Q

cushingnoid features

A

buffalo hump, central obesity, moon facies, weight gain

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19
Q

what should be avoided in patients taking chronic glucocorticoids prior to surgery

A

etomidate because can inhibit steroid synthesis and cause acute adrenal crisis

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20
Q

clinical signs of perioperative adrenal insufficiency

A

unexplained nausea, vomiting, abdominal pain, hyponatremia, hyperkalemia, hypoglycemia, hypotension

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21
Q

insulin induced hypoglycemia signs after surgery

A

dizziness, diaphoresis and fatigue

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22
Q

man with abdominal pain. no guarding or rebound, bowel sends present with increased intensity at peak of pain, mild fever and abdomina XR how multiple air fluid levels

A

Small bowel obstruction

need immediate surgical obstruction if suspect strangulation

23
Q

findings to suspect strangulation of small bowel

A

fever, tachycardia and leukocytosis and metabolic acidosis

24
Q

anterior spinal cord syndrome

A

lose motor, and pain and temp to lower limbs because lost supply from anterior spinal artery

25
Q

see air under diaphgrams or pneumoperitoneum

A

need to immediately surgically explore. could be perforated ulcer or viscous organ

26
Q

presentation of mediastinitis

A

post op 2 weeks with fever, tachycardia, chest pain, leukocytosis, and sternal wound drainage or purulent discharge

27
Q

CX mediastinitis

A

widened mediastinitis

28
Q

how to Tx postop mediastinitis

A

drainage, surgical debridement with immediate closure, and prolonged antibiotic therapy

29
Q

best control for afib

A

beta blockers or amiodarone

30
Q

signs of postpericardiotomy syndrome and Tx

A

fever, leukocytosis, tachycardia and chest pain

NSAIDS or steroids treat the inflammation

31
Q

triad of leriche syndrome

A

bilateral hip, thigh and buttock claudication, impotence and symmetric atrophy of bilateral lower extremities due to chronic ischemia

32
Q

what nerve can be damaged to remove a parotid tumor

A

facial nerve, will get facial droop

33
Q

tic douloreux

A

trigeminal neuralgia, short bursts excrutiating, lancinating pain lasting from minutes to second. from 2nd and 3rd branches trigeminal

34
Q

when do you give the tetanus vaccine AND the imunoglobulin

A

if the wound is dirty or severe AND uncertain if completed tetanus childhood vaccines

35
Q

fever within first week of surgery is usually from what

A

nosocomial infections like pneumonia UTIs

36
Q

presentation malignant hyperthermia

A

high fever, muscle rigidity, rhabdomyolysis, metabolic acidosis, hemodynamically instability

37
Q

likely cause of prosthetic joint infection if within 3 mo of the arthroplasty

A

staph aureus

38
Q

likely cause of delayed onset prosthetic joint infection

A

staph, proprionibacterium spcies, enterococci

39
Q

urethritis/enteritis, arthritis, conjunctivitis

A

chlamydia or salmonella causing reactive arthritis

40
Q

if patients arm is abducted passively then asked to slowly lower and arm drops

A

supraspinatus tear

41
Q

popeye sign

A

biceps muscle belly prominent in mid upper arm because long head biceps ruptured

42
Q

what muscle causes winged scapula

A

paralysis serratus anterior

43
Q

klumpkes palsy is damage to what

A

inferior trunk of the brachial plexus originating from C8 and T1 cervical roots

44
Q

describe klumkes palsy

A

weakness and atrophy of the hypothenar and interosseous muscles characterize this palsy

45
Q

pilonidal disease

A

infection in hair follicles that form abscesses and rupture forming tracts
midline post sacral intergluteal region
need to drain

46
Q

suppurative hidradenitis

A

multiple painful nodules and pustules of axillae and groin

47
Q

bowens disease

A

squamous cell carcinoma of skin

48
Q

pagets bone disease

A

osteitis deformans
osteolast activity increased
woven bone at many sites and bowing with fractures

49
Q

most common presentation of pagets disease of bone

A

pain of long bones that may result in arthritis of hip or knee

50
Q

lab findings in pagets disease of bone

A

increased alk phos and normal Ca and phosphorus levels

51
Q

XR pagets disease of bone

A

enlargement of the bones of the skull– frontal bossing

52
Q

how can pagets disease of bone lead to hearing loss

A

from the cochlear nerve being impinged by the enlarging temporal bone

53
Q

what syndrome predisposes to renal cell carcinoma

A

von hippel lindau

54
Q

what syndrome predisposes to pulmonary hemorrhage

A

goodpastures

shelf surgery (7 decks)

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