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
