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Flashcards in 15 Special surg Deck (65)
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1

when is conjunctivitis an emergency?

varicella, shingles

-vesicles present
can lead to blindness

2

Testicular CA tumor markers and blood tests

Seminoma--LDH
Endodermal sinus--AFP
CC--B HCG
teratoma--malignant! (but not in females)

3

Scaphoid fx
-how tx (2)
-when to recheck xr

Clinical dx
-XR shows nothing, then cast. Recheck XR in 3 wks
-XR shows damage (bad enough to show), then ORIF

4

Long bone fx in child, cross growth plate
-tx

requires ORaIF to ensure growth plate realigned

5

Hip fx:
-what different txs? (4 to know)

Head: femoral prosthesis (risk avascular necrosis)
Intertrochanteric: Plates ORIF
Shaft: rods
Open: Emergent washout

6

newborn male with low/no urine output. Cr up.
-think what, do what

Posterior Urethral Valves (blockage)

-cath, relieve bladder pressure
-confirm dx with voiding cystourethrogram
-ablation/surgery of valves

7

retinoblastoma
-how dx
-what to be careful about
-assoc

-white reflex instead of red
-no radiation! 2nd hit.
-osteosarcoma, age 10

8

hypspadias and epispadias, what to remember

no circumcision

9

Child bone cancers to know: 3
-how to diff

1. Ewing's sarcoma--midshaft. Possible F/C/night sweats
2. osteosarcoma--prox/distal long bone, painful

3. osteochondroma--at growth plate, benign. Usu painless

10

Peds VSD
-when to do surgery
-why do surgery

-if asx, give 1 yr to allow closure
-Surgery if sx(CHF) or persistent to 1yr of age

-risk of Eisenmenger's later in life

11

Coarctation of aorta
-diff in dx between babies/adults

babies: echo
adults: CXR to see rib notching

12

premature baby with growths seen on retina
-think what

retinopathy of prematurity.

Also look for:
necrotizing enterocolitis
bronchopulm dysplasia
intraventricular hem

13

Peds brain tumor with cord lesions, think what

medulloblastoma

14

lesion suspicious for Melanoma:
how to dx

1. suspicion low: punch bx
2. small, or high suspicion: wide excisional bx

Looking for Breslow's depth

always check for lymph nodes

15

central retinal a occlusion
-tx (3)

painless unilat vision loss in elderly

-hyperventilate in bag (vasodilate)
-push on eye to move clot downstream (compromise smaller area of vision)
-intraarterial tpa possible

16

-most common cyanotic defect of newborn
-most common cyanotic defect of children

-Transposition
-Tet Fallot

17

Cyanotic heart diseases

which ones important?

Truncus arteriosus
Transposition of great arteries
Tricuspid atresia
Tet Fallot
TAPVR

Transposition and Tet-Fallot are the 2 important ones

18

dupuytren's contracture
-presentation
-pop (2)
-tx

can't extend hand flat, fasica tight
1. etoh
2. scandinavian

surgery

19

BCC and SCC skin CA:
-mets?

BCC: no mets
SCC: rare mets

20

SCC and BCC skin CA:
what tx (4)

small, not on face: excisional
large, not on face: wide excision
large aggresive, extremity: amputation
face: Mohs

21

When to suspect VUR (vesicoureteral reflux)

dx, tx?

Kid with
1. pyelo
2. recurrent UTI

Do a voiding cystourethrogram (dye should not enter ureters)

surgery or 'grow out of it' with empiric abx

22

SCC and BCC skin CA: what bx to do? (3)

small, not on face: excisional
large, not on face: incisional
on face: incisional

incisional: punch full thickness at ulcer edge

23

orbital vs periorbital cellulitis

extra-ocular paralysis,
get CT to confirm

24

amblyopia vs strabismus
-how to dx
-tx

amblyopia: permanent lazy eye
strabismus: lazy eye.

strabismus: light reflection is separate both eyes

If present at birth, surgery
If acquired, do glasses/patch.
Prevent amylopia!

25

Tet Fallot

Pulmonic stenosis
Overiding aorta
R Ventricle hypertrophy
VSD

26

Pt with painless vision loss, describes "veil/cloud" in vision. Think what?

Retinal detachment
Amaurosis fugax (if comes/goes)

27

corneal abrasion
-dx

fluorescein dye

28

Cushings reflex

HTN
bradycardia
irregular breathing

29

chalazion vs hordeolum

hordeolum: infection of eyelid gland, painful.

chalazion: sterile, chronic inflamm from blocked gland
"Chill" usu not painful.

hordeolum that heals can become chalazion

30

what is pink eye

conjunctivitis, viral. nonpurulent
usu adenovirus

make sure no vesicles, not varicella conjunctivitis