Pre-Test (Skin and friends, Trauma, Transplant/Immunology/Oncology) Flashcards Preview

Surgery > Pre-Test (Skin and friends, Trauma, Transplant/Immunology/Oncology) > Flashcards

Flashcards in Pre-Test (Skin and friends, Trauma, Transplant/Immunology/Oncology) Deck (55):
1

Nerve that innervates most of the intrinsic muscles of the hand

Ulnar nerve

2

Nerve involved with extension of wrist

Radial

3

Margins of excisions for melanoma

4 mm- 3 cm margin

4

Frostbite tx

Rapidly warming by immersion in water slightly above normal body temp (40-44 c)

5

Another name for SCC form chronic skin wound

Marjolin ulcer

6

Silver nitrate AE

Hyponatremia and hypokalemia

7

Silver sulfa AE

Neutropenia

8

Most common malignant tumor of the lip

SCC (esp lower)

9

What do composite tissue grafts contain

Tissue in addition to dermis/epidermis

10

How long should a clean would be present before it should no longer be closed

6 hours

11

Tx for a trauma pt with a seatbelt sign

Worried for enteric or mesenteric injury, the patient should be held and observed regardless of test results

12

Surgical treatment of choice for a ruptured vein in an unstable patient

Ligation, rather than repair

13

CT scan sensitivity for penetrating abdominal trauma

Low, good for blunt abdominal trauma

14

Insulin levels after acute trauma? BS levels?

Shot drop in insulin followed by a significant rise
Still hyperglycemia due to elevated insulin resistance

15

Best surgery for common bile duct transection in stable patient? Unstable?

Stable: Roux-en-Y choledochojejunostomy
Unstable: T tube placement

16

Absolute indications for surgical neck exploration

Acute signs of airway distress (stridor, hoarseness, dysphonia)
Visceral injury (sub-q air, dysphagia, hemoptysis)
Hemorrhage
Neuro signs referable to carotid injury (stroke, AMS)

17

Duodenal obstruction following BAT likely? Management?

Likely a duodenal hematoma
Mgt conservative: NG tube and observation

18

Blunt carotid artery injuries should be treated with?

Full systemic anticoagulation in the absence to any contraindications to prevent stroke

19

Cushing triad in inc ICP

Hypertension
Bradycardia
Irregular respirations

20

What nerve innervates most of the flexors of the hand? What else does it get

Medinan nerve, also gets pronator muscles of forearm and lots of hand sensation

21

Two good ionotropes for cariogenic shock

Dobutamine and Dopamine

22

Why are popliteal artery injuries associated with knee dislocations?

Extreme force required to dislocate the joint

23

Nitrogen balance in sepsis

Negative, due to breakdown and increased urinary loss

24

What should be requested for suspected colonic perf?

CT abdomen

25

When is surgery indicated in orbital trauma

Enopthalmos greater than 2mm
Diplopia on primary or inferior gaze
Entrapment of EOM
Fracture greater than 50% of orbital floor

26

What happens to the Lactate in LR solutions

Metabolized to HCO3 in the liver --> helps correct metabolic acidosis

27

Mgmt of low grade renal injuries

Strict bed rest for 24-72 hours with serial Hgb levels

28

Tx for injury of major pancreatic duct to left left of the mesenteric vessels

Distal prancreatectomy

29

In absence of sepsis, management of patients with enterocutaneous fistulas

Bowel rest, TPN, and correction of electrolyte abnormalities

30

initial management of extraperitoneal bladder injuries

Initial catheter drainage followed by repeat imaging to confirm healing

31

Pos DPL criteria

10cc gross blood
> than 100,000 ul RBC
> 500 uL WBC
Elevated amylase, bili, or alk phos

32

First step in treating neurogenic shock? Then?

Restore volume (Normal CP is 2-6)
Then vasoconstrictors

33

Ideal tx of pericardial tamponade from trauma

Pericardiocentesis under local anesthesia in the OR (that way able to surgically explore after)

34

Guidelines for thoracotomy in hemothorax patients

> 1500 mL of immediate drainage or >200 mL/h for several hours after

35

Pulmonary contusion def

hemorrhage and edema of the lung parenchyma without parenchymal disruption

36

Initial tx of open tension pneumothorax

Place occlusive dressing over the defect

37

What makes TNF

Monocytes/macrophages

38

Chronic liver transplant rejection characterized by

Paucity of bile ducts on biopsy due to immune-mediated injury to biliary epithelium

39

What is the cross match done before transplant

Donor lymphocytes with recipient serum and compliments

40

Tumor lysis syndrome is mediated by?

Cytotoxic T cells

41

Cyclosporin inhibits?

IL-2

42

Acute kidney rejection mgmt

Renal biopsy, steroid boost, and immunoglobulin therapy

43

Most common post transplant infections

Viral (CMV, EBV, HSV, VSV)

44

Best drug for severe acute rejection that does not respond to steroid tx

Muromonab-CD3

45

Wilms tumor ass w/

Aniridia, GU abnormalities, MR

46

Tx for early stage seminoma

Orchiectomy and external beam radiation

47

Who should get sentinel node biopsies in breast Ca

Pt's who do not have clinically positive lymph node disease

48

How are cardiac allografts matched

Only by size and ABO type

49

GIST drug

Imatinib (TKI)

50

Mammogram rec for BRCA1 carriers

Once every 6 months (biannual) starting at age 25

51

BRCA1 vs BRCA2

BRCA1: likely ER neg, colon and prostate ca in males
BRCA2: likely ER+, also GI cancers

52

Post transplant lymphoproliferative disorder ass w/?

EBV

53

What is tertiary hyperparathyroidism? Tx?

Persistant hypercalcemia 2/2 autonomous parathyroid function after renal transplant
Tx: total parathyroidectomy

54

Neg margin for colon cancer should be

5cm

55

Azothioprine AE

Bone marrow suppression