Surgery

Question 1

Which direction does the trachea deviate in a tension pneumothorax?

Answer 1

Away from the pneumothorax

Question 2

What neurosurgical emergency is associated with battle’s sign (ecchymosis behind the ear)?

Answer 2

basilar skull fracture

Question 3

What is the rule of 9s with regard to burn injuries - what are the divisions of the body that each account for 9%? (11)

Answer 3

head, each arm, anterior/posterior of each leg, torso is 18% anterior and 18% posterior

Question 4

What is the antidote to a white phosphorus burn?

Answer 4

1% copper sulfate and calcium gluconate injection

Question 5

What is the antidote to a hydrofluoric acid burn?

Answer 5

lavage for > 30 minutes then application of calcium gluconate gel to affected areas

Question 6

What is the formula for fluid resuscitation in burn patients?

Answer 6

% burn area x body weight (kg) x 4 = total needed in first 24 hours. Half given in first 8 hours then remainder over the next 16. All crystalloid - LR recommended.

Question 7

What is a curling ulcer?

Answer 7

an ulcer associated with burn victims in the stomach or duodenum

Question 8

What kind of cancer is associated with healed/healing burns?

Answer 8

SCC (marjolin ulcer transformation)

Question 9

What is the timeline for atelectatic induced post operative fever?

Answer 9

24-48 hours

Question 10

What is the timeline for post operative fever induced by UTI?

Answer 10

48-72 hours

Question 11

What is the timeline for post operative fever induced by wound infection?

Answer 11

> 72 hours

Question 12

What treatment has been proven to improve keloid scaring?

Answer 12

kenalog injection (triamcinolone)

Question 13

How do you properly identify an organism in a pressure ulcer?

Answer 13

biopsy

Question 14

In a patient with cellulitis, what triad of test results increases your index of suspicion for necrotizing fasciitis?

Answer 14

WBCs > 14k, BUN > 15, Na < 135

Question 15

What is the initial antibiotic management for necrotizing fascitis?

Answer 15

Carbapanem + Clinda + MRSA coverage (vanc/dapto/zyvox) alternate agents: aminoglycoside/fq + flagyl

Question 16

What is the impact of insuflation and pneumoperitoneum on cardiac function?

Answer 16

Decreases CO by as much as 30%

Question 17

What is the most common complication of appendectomy?

Answer 17

Open: wound infection, Lap: abscess

Question 18

What vitamin deficiencies are typical of bariatric surgery patients? resulting disorders?

Answer 18

Vitamin B12, Calcium, Vitamin D causing anemia, renal stones and osteopenia/porosis