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Surgery JB > Pestana's Questions > Flashcards

Pestana's Questions Flashcards

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1
Q

Air Embolism

A

Intubated and on Respirator

Air in Subclavian vein (Supravicular node biopsy, central venous line placement, CVP line disconnected)

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2
Q

Fat Embolism

A 
Petechial Rash in Axilla and neck
Fever 
Tachycardia
low Platelet Count
Star field pattern on brain
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3
Q

Jersey Finger

A

Flexed finger is extended

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4
Q

Mallet Finger

A

Forcefully Flexed

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5
Q

Marjolin Ulcer

A

Squamous Cell carcinoma after chronic leg ulcer, many years of healing and breakdown such as 3rd degree burns

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6
Q

Ammonium Intoxication

A

Coma in cirrhotic patient with bleeding esophageal varices.

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7
Q

Metabolic Alkalosis

A

(Vomiting)
pH>7.4 Bicarb >25
KCl to correct problem

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8
Q

Metabolic Acidosis

A

pH<7.4 Bicarb <25
Replace bicarb, lactate or acetate
Replace K+ as part of therapy

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9
Q

Longstanding GERD

A

GI Study and biopsy

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10
Q

Rectal Bleeding

A

NG:
Green Bile - Stomach to ligament of treitz
Clear: - Nose to Pyloris

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11
Q

Acute Edematous Pancreatitis

A

Alcoholic or patient with gallstones
Pain after heavy meal, radiates to back
Elevated Serum amylase or lipase

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12
Q

Fibroadenoma

A

Firm rubbery mass that moves easily with palpation

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13
Q

Primary Hyperaldosterone

A

Adenoma or hyperplasia
Hypokalemia and Hypertension

Aldosterone levels high, renin levels low.
Response to postural changes = Hyperplasia
Lack of response = Adenoma

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14
Q

Meconium Ileus

A

Cystic Fibrosis
Bilious VOmiting, Dilated loops of small bowel
Gastrografin enema diagnostic and therapeutic

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15
Q

Vascular Ring

A

Congenital Anomaly in which trachea and esophagus are encircled by abnormal blood vessels

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16
Q

Fogerty Catheter

A

Removes Emboli

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17
Q

Basal Cell Carcinoma

A

Waxy Raised Lesion - Excise
Ulcer - Biopsy at edge

Upper part of face LIP
Does not metastasize
Requires 1mm Margin

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18
Q

Squamous Cell Carcinoma

A

Metastasize to lymph nodes
Surgical Margins 0.5-2cm
Radiation therapy

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19
Q

Melanoma

A

ABCDE

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20
Q

Right Colon Cancer

A

Bleeds

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21
Q

Left Colon Cancer

A

Obstructs

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22
Q

Amblyopia

A

Vision impairment resulting from interference with processing images

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23
Q

Strabismus

A

Correct to prevent amblyopia

Correct with glasses if later in infancy

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24
Q

Thyroglossal Duct Cyst

A

Connection between Hyoid Bone and Tongue

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25
Squamous Cell Carcinoma of Mucosae
Old men who smoke and drink and have rotten teeth Metastatic node in neck Dx: Triple endoscopy looking for primary tumors (Panendoscopy) Sx: Persistent Hoarseness, Painless ulcer in floor of mouth, unilateral earache
26
Facial nerve injury
Swelling will resolve spontaneously
27
Rheumatic Fever
Dyspnea, Orthopnea, low pitched rumbling diastolic apical heart murmur
28
Dissecting aneurysm of the thoracic aorta
Tearing chest pain radiates to the back MRI Angiogram CT Angiogram Transesophageal Echo
29
Brachial Cleft Cyst
Anterior edge of sternomastoid muscle | Little opening with blind tract in skin
30
Acoustic Neuroma
Sensory hearing loss in one ear but not the other
31
Trigeminal Neuralgia
Tx with Anticonvulsants (carbamazapine) or Radiofrequency ablation
32
Acute Epididymitis
Severe testicular pain with sudden onset | lifting testicle helps pain
33
hidradenitis
Debilitating chronic suppurative process involving skin and subcutaneous tissue. Follicular occlusion & secondary rupture of sebofollicular junction (skin to skin acne..)
34
Ureteropelvic Junction Dysfunction
Colickly flank pain if large diuresis occurs (binge drinking) because it cannot handle large urinary output to flow
35
Middle zone of neck gsw
Surgical Exploration
36
Upper zone of neck gsw
arteriographic diagnosis and management
37
Base of Neck GSW
arteriography, esophagogram (water soluable followed by barium) esophagoscoy and bronchoscopy
38
Pediatric Malignant Liver Tumor
Mass moves up and down with inspiration
39
Fluid Replacement
Aim for 1-2mL/kg/h
40
Blount Disease
Tibia growth disorder causing leg to angle inward (bowleged) African American
41
Pathologic Fracture
Suspect Malignant Bone Tumor
42
Dupuytren contracture
Norwegian ancestry | Contracture of the palm of the hand, palmar fascia nodule
43
Posterior Dislocation of the hip
Femur is driven backward such as knee hitting dashboard Leg shortened, adducted, internally rotated Can lead to avascular necrosis
44
ARDS
Stormy complicated course, bilateral pulmonary infiltrates, no evidence of CHF. Treat with PEEP
45
Mallory Weiss
Prolonged forceful vomiting | Normal vomiting followed by bright red emesis
46
Boerhaave
Forceful vomiting leading to esophageal perforation
47
Squamous Cell Carcinoma of Anus
HIV+ Fungating mass out of anus, | Metastatic hard inguinal lymph nodes
48
Infiltrating Ductal Carcinoma
Stage I, II: Lumpectomy with sentinel node biopsy, axillary lymph node dissection with post op radiation Stage III+: Modified radical mastectomy with Lymph node biopsy + Sentinel node biopsy
49
Malrotation
Double bubble + gas beyond
50
Duodenal Atresia/Annular Pancreas
Double bubble no gas beyond
51
Metastatic Malignant Melanoma
Bizarre unpredictable metastasis
52
posterior Urethral Valves
newborn no urine Voiding Cystourethrogram tx: Endoscopic Fulguration or Resection
53
Ureteral Stones
3mm or less will pass 70% | 7mm 5% of passing - lithotripsy
54
Chronic Subdural
Tearing venous Sinuses | Over weeks - mental status changes & hematoma forms
55
Epidural
Uncomcios with a lucid interval Fixed Dilated Pupils Uncal Herniation Lens Shaped
56
Anterior Cord
Burst Fracture | loss of pain & temp
57
Central Cord
Forced Hyperextension | Paralysis & Burning in Upper
58
Hemi Section
paralysis & loss of proprioception distal | contralateral loss of pain
59
Slipped Capital Femoral Epiphysis
Chubby kid groin or knee pain limping, sole of foot points towards the other foot
60
Developmental Dysplasia
Uneven gluteal folds, hips show easily dislocated.
61
Anterior dislocation of shoulder
Hold arm close to body rotated outward | AP & Lateral XR
62
Posterior dislocation of shoulder
Epileptic seizures Hold arm close to body internally rotated Axillary view or scapular lateral
63
Ankle Fractures
Open reduction and internal fixation
64
Lumbar Disc Herniation
Discogenic: Vague Achy (Anterior spinal ligament) Neurogenic: Electric Shock to leg
65
Morton Neuroma
Inflammation of common digital nerve at 3rd interspace Pointed shoes Tx: Indomethacin, Colchicine, Allopurinol, probenicid
66
Malignant Hyperthermia
After Halothane or succinylcholine Tx: Dantrolene O2, Watch for Myoglobinuria
67
Hypernatremia
3mEq/L above 140 = 1L water loss | D5 1/2 NS or D5W
68
Meckel Diverticulum
Technetium scan looking for ectopic gastric mucosa | Blood per rectum in child
69
Cystosarcoma Phyllodes
Late 20's Grow very large replacing entire breast Fibroepithelial Tumor
70
Necrotizing Enterocolitis
Premature infants with feeding intolerance, abdominal distention, dropping platelet counts Tx: Surgical if abdominal wall erythemia or pneumatosis
71
Eye Burn
triple antibiotic ointment
72
Hemodynamically stable abdominal wound
CT Scan
73
Acute Kidney Rejection
First line: steroid boluses, antilymphocytic agents (OKT3)
74
Ogilvie
Paralytic ileus of colon Abdominal distention, dilated colon, Tx: Fluid and electrolyte & Colonoscopy to remove air
75
Hirschprung
Chronic constipation in a child Distended proximal colon, Dx with full thickness biopsy of rectal mucosa.
76
Atrial Septal Defect
Pulmonary flow, fixed split | Frequent colds
77
Ependymoma
Pediatric brain tumor | Children assume knee chest position to open flow to CSF to relieve their headache
78
Cystic Hygroma
CT scan to see how deep
79
Branchial Cleft Cyst
Mushy Fluid filled mass at base of neck

Surgery JB (6 decks)

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