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Clerkships-SURGERY Flashcards

(63 cards)

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1
Q

How does PEEP increase oxygenation?

A

Increases FRC

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2
Q

First step in HIT, second step

A

Stop heparin

  1. Give a direct thrombin inhibitor such as

Argatroban, lepirudin

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3
Q

Progression of retinal detachment

A

First 20 question

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4
Q

NBT pancreatic adenoca

A

Ultrasound guided endoscopic biopsy

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5
Q

Wallenberg

A

PICA

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6
Q

Comminuted occipital condyle fracture

A

Hypoglossal palsy

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7
Q

kyphoplasty

A

puts cement in the vertebra to offer compression fracture relief

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8
Q

first step in treating PE

A

IVC filter (not heparinization, not thombolytic)

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9
Q

tx for biliary atresia

And PSC

A

liver transplant

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10
Q

Gallbladder path assoc. w UC

A

Primary sclerosis cholangitis

Pbc is only medium sized

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11
Q

Fibromuscular dysplasia

A

Renal artery stenosis/htn
Carotid dissection
“String of beads”

tx: stent and angioplasty

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12
Q

Amarousis fugax

A

?

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13
Q

“Salty” found in csf

A

Tau protein (beta-2 transferrin)

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14
Q

Cilostazol used only for

A

Peripheral artery disease

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15
Q

ABSOLUTE contraindication to surgery

A

DKA

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16
Q

Surgical abx ppx timing?

Choice of abx and target?

A

1 hour prior to surgical incision
+intra-operative dose for 6+ hr surgeries

cefazolin (kefzol) for GRAM+ COCCI (staph, etc., skin flora)

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17
Q

Which abx is the culprit in causing infectious colitis

A

clindamycin (kills “good” flora)

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18
Q

NBS in anuric kidney transplant patient

A

biopsy the allograft (suspect acute graft rejection)

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19
Q

next best step in TIA?

A

aspirin 1300mg/day

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20
Q

What to look for in munchhausen’s/factitious hyperinsulinemia

A

NORMAL C-peptide. remember, it would be elevated in real insulinoma

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21
Q

Tumor marker in pancreatic cancer

GIST?
MEN2A/B, medullary thyroid 
Small cell lung 
Burkitts
Neurofibromatosis 
Schwannoma 
Hepatocellular
Colorectal
A

k-ras, CA19-9

C-kit
ret
L-myc, neuron specific enolase
C-myc
Nf1
Nf2
AFP, ferritin
CEA
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22
Q

NBS in pyelonephritis

A

foley

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23
Q

Indications for hemodialysis

A

AEIOU

acidemia, electrolyte disorder, intoxication (lithium, ethylene glycol), overload of fluid (Pleural effusion periph edema, pulmonary edema) , uremia

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24
Q

Tx for benign essential tremor

A

Deep brain stim of thalamus

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25
Uremic coagulopathy Nephrotic syndrome?
Look for elevated bun/cr and that might lead to platelet dysfunction Hypercoaguable! Lose ATIII in proteinuria
26
Hyperextention neck injury in the setting of stenosis
Central cord syndrome Loss of UL motor, preservation of LL motor
27
BBS in gross hematuria
CT a/pelvis with contrast for suspected bladder cancer
28
Protamine FFP Cryoprecipitate
Heparin reversal Warfarin reversal When fibrinogen is low/massive transfusions/ tPA admin.
29
DVTs happen most commonly where
Femoral v
30
Which clotting factor is not made by the liver
VIII
31
Cauda equina syndrome
Saddle anesthesia Urinary retention Weakness
32
Alpha 1 antitripsin liver characteristics
Intracellular red hyaline globules on PAS
33
Hepatic Adenoma
Likely to rupture and bleed Assoc with oral contraceptives
34
Post splenectomy sepsis
Strep pneumo
35
Preferred way to get someone's nutritional status up?
Enteral Feeds
36
Biggest predictor of peri-operative mortality? How to evaluate? Cutoff?
CHF; measure EF w/ echo; <35% postpone surgery
37
NBS for all three neck zone trauma
Zone II always surgery Zone I esophagram Zone III arteriogram
38
If a patient has had LOC at ANY POINT, NBS
CT head (after airway, etc. )
39
Cushing's treflex triad
Bradycardia, widened pulse pressure, irregular breathing in the setting of elevated ICP
40
What to do if someone has trouble voiding after surgery
Slow the rate of fluid admin intraoperatively
41
In addition to abx what do you give for meningitis
steroids
42
Broca's area/expressive aphasia what area of the brain?
Inferior frontal gyrus
43
Low urine output in elderly? Workup?
Renal ultrasound (but fluid bolus for younger people/prerenal) Not fluids in this case bc of risk of CHF exacerbation, etc.
44
RCC is assoc. with what syndrome
VHL
45
Most common cause of death following myocardial contusion
Vfib
46
NBS for blunt trauma to kidney
CT
47
Priority of limb injury
1) bone 2) vessel (delay causes compartment) 3) nerve
48
A-V fistulas are assoc. with what cardiac abn.
high output cardiac failure
49
Cavernous malformation on MRI
popcorn lesion
50
Confirmatory test for "echinococcal/hydatid cyst"
ELISA
51
Temporal lobe hernia Subfalcine Hernia
3rd nerve palsy anterior cerebral artery occlusion
52
Short and externally rotated leg vs internally rotated leg
EXternally rotated, femoral hEad fracture Internally rotated, posterior dislocation of the hip
53
What condition classically resolves when leaning forward (using a cans or pushing a cart etc)
Lumbar stenosis (don't confuse with PVD)
54
Transfusion related acute lung injury
Too much transfusion. White out. Looks like ards.
55
Arm symptoms normally, but also dizziness/speech issues when exercising that arm. Path? Dx? Tx?
Subclavian steal syndrome, athero of the sublavian before it gives off the vertebral a. Reversal of flow thru vertebral. dx- arteriogram tx - surg bypass
56
Wealthy man who is retired has claudication after walking 15 blocks. NBS?
nothing. Only workup if it affects the person's life
57
IVF maintenance of choice? When to use other stuff?
D5 1/2 normal saline Extremes: hypertonic and hypotonic (D5W) in acute hyponatremia and acute hypernatremia, respectively. Fluid restriction for chronic hyponatremia. Isotonic-normal saline for alkalotic "natremia." Isotonic-LR for acidotic "natremia."
58
What to check in CO poisoning?
CARBOXYHEMOGLOBIN (not pulse ox; worthless because it's an unloading issue)
59
NBS in electrical burn
EKG
60
how do you treat flail chest
nerve block
61
Contraindications to FNA? | Drainage of abcess?
Liver hemangioma, scrotal mass (could spread the SSC) Lung abcess, liver (amoebic) abscess. note: echinococcal cyst (tx with albendazole/etOH then surgery)
62
tx for incisional infection?
NO ABX.
63
Vitamin deficiency w/ carcinoid?
Niacin. (serotonin/tryptophan derivative). Diarrhea, dermatitis, dementia

Qoy (16 decks)

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