CK Flashcards Preview

Surgery > CK > Flashcards

Flashcards in CK Deck (34)
Loading flashcards...
1

pre surgery - cardiovascular RF

1. EF below 35
2. recent MI (must be 6months before, if not, admit to ICU to optimize)
3. CHF (optimize medically)

2

cardiovascular tests needed prior to surgery

1. EKG
2. stress test
3. echo for stractural disease and EF
if under 35 yearsol with no history --> only EKG

3

pre surgery - when PFT

1. known lung disease
2. smoking

4

pre surgery in patients in dyalisis

dialysis 24 hour before

5

intubation in facial trauma

crycothyroidotomy

6

intubation in cervical trauma

with flexible bronchoscopy

7

SIRS criteria

2 or more
1. body Q less than 36 or more than 38
2. HR more than 90
3. tachypena more than 20 or PCO2 less than 32
4. wbc less than 4 or more than 12

8

Barium in esophagus leakage

Never

9

Tests contraindicated in diverticulitis

Barium enema + coloniscopy

10

Most accurate test for cholecystitits

HIDA

11

Methylnatrexone (Relistor)

Alleviate obstruction from stool impaction in patients on chronic opioids

12

Fecal incontinence

Continuous or recurrent uncontrolled passage of fecal material (more than 10 ml) for at least 1 month in an individual older than 3

13

fecal incontinence - diagnosis

- clinical history combined with flexible sigmoidoscopy or anoscopy as the best initial test
- the most accurrate is anorectal manometry
- if history of anatomy injury --> endorectal manometry

14

fecal incontinence - treatment

3 forms
- medical therapy: bulking agents (fibers)
- biofeedback: exercises + muscle strenthening
- if fails: sugery

15

SIRS criteria

2 or more
1. body Q less than 36 or more than 38
2. HR more than 90
3. tachypena more than 20 or PCO2 less than 32
4. wbc less than 4 or more than 12

16

SIRS - interpretation

2 criteria = SIRS
2 criteria + source of infection = sepsis
2 criteria + source + organ dyfunction = severe septis
2 criteria + source + organ dyfunction + hypotension = septic shock

17

shock is not only tachycardia and hypotension

also end organ dysfunction

18

types of shocks (and skin and PCWP)

1. hypovolemic: pale and cool, low
2. cardiogenic: pale + cool, high
3. neurogenic: warm, low
4. septic: warm + faint, no change

19

types of shocks and treatment

1. hypovolemic: fluids + pressors
2. cardiogenic: treat cardiac problem
3. neurogenic: fluids + pressors
4. septic: fluids + pressors + antibiotics

20

how to find the type of shock

skin?
1. pale/cool --> PCWP: elevated: cardiogenic, low: hypovolemic
2. warm/flushed --> CO changes:
- low: neurogenic
- elevated: low PCWP in anaphylaxis, no change in PCWP in septic

21

sings associated with abd trauma and descripion

1. cullen sign: periumbilical
2. grey turner: flank
3. kerh: pain in left shoulder
4. balance sign: dull percussion on the let and shifting dullness on the right
5. seatbelt sign: bruising

22

sings associated with abd trauma and cause

1. cullen sign: retroperitoneal hemor
2. grey turner: retroper hemor
3. kerh: splenic rupture
4. balance sign: splenic ruptur
5. seatbelt sign: deceleration injury

23

balance sign

dull percussion on the let and shifting dullness on the right
- in splenic rupture

24

mallory weiss sybdrine vs Boerhave in diagnosis

gastrografin esophgogram:
leakage onky in boerhave

25

management of AAA

- 3-4 cm: U/S every 2-3 years
- 4-5,4 cm, U/S or CT every 6-12 monhts
- 5,5 or more: surgery

26

general rules in fractures therapy

1. closed reduction: mild without displacement
2. open reduction and internal fixaton: severe with displacement or misalignment of bone pieces
3. open: skin must be closed and bone must be set in the operating room with debridement

27

types of fracture

1. comminuted: multiple pieces (crash injuries)
2. stress
3. compression
4. pathologic: from minimal trauma (metastasis)
5. open (high risk of bacterial infection, SURGERY)

28

shoulder injuries - types + etiology

1. anteriod dislocation: any injury that causes strain (MC)
2. posterior dislocation: seizure or elect burn
3. clavicle fracture: trauma
4. scaphoid fracture: falling on an outstretched hand

29

shoulder injuries - types + treatment

1. anteriod dislocation: shoulder relocation + immobilization
2. posterior dislocation: traction and surgery in pulses or sensation are diminished
3. clavicle fracture: simple arm sling
4. scaphoid fracture: thumb spica cast

30

shoulder injuries - types + sings + symptoms

1. anterior dislocation: externally rotated
2. posterior dislocation: medially rotated
3. clavicle fracture: pain over location
4. scaphoid fracture: pain