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MTBs Step 3 > Surgery > Flashcards

Surgery Flashcards

1
Q

when do you intubate on the Glasgo Coma scale

A

8

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2
Q

intubation method in pt with extensive facial trauma

A

cricothyroidotomy

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3
Q

intubation method in pt with cervical spine injury

A

flexible bronchoscope

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4
Q

Systemic Inflammatory Response Syndrome(SIRS)

A

2+ of the following criteria needed:

  • Temp <36 or >38
  • HR >90
  • RR>20; PCO2 >32
  • WBC <4K or >12K
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5
Q

Pt with head injury w/scalp laceration and linear skull fraction on CT, no LOC. do they need surgery?

A

nope! asymptomatic head injury w/closed fracture

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6
Q

Pt with head injury, scalp laceration, depressed fracture is seen on CT, denies LOC. surgery?

A

yes! surgery alwasy done due to depressed fracture

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7
Q

Pt with head trauma w/LOC. next step?

A

CT w/o contrast

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8
Q

Pt with ecchymosis around both eyes(racoon eyes) and behind ears(battle’s sign) + leaking CSF. W/U? tx for CSF leak? complications?

A

CT of head and neck = basal skull fracture!

  • CSF leak will stop by itself
  • Neurapraxia/facial paralysis make occur 2-3 days later but will resolve in 8-10 wks
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9
Q

Brain Abscess

sx? dx? tx?

A

sx: Fever, HA, FND
dx: CT scan w/o contrast
tx: IV Abx + Surgical drainage

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10
Q

Epidural Abscess

sx? rf? dx? tx?

A

sx: fever, back/neck pain & TENDERNESS OVER AREA ON THE BACK +/- lower extremity weakness
rf: IVDU
dx: MRI
Tx: Bx + I&D + abx

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11
Q

Anterior Spinal Artery Sydrome

sx? dx? tx?

A

sx: infarction of anterior 2/3rd of SC = loss of motor function below lesion & sensation
dx: MRI
tx: support

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12
Q

Epidural hematoma

A

trauma, LOC, lens-shaped hematoma, arterial blood

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13
Q

Subdural Hematoma

A

venous blood, no LOC, crescent shaped, semilunar

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14
Q

Diffuse Axonal Injury

A

Diffuse axonal injury (DAI) is a prolonged posttraumatic coma that is not due to ischemia or a mass lesion,
Most commonly follows deceleration injuries,
Damage characteristically occurs at grey-white junctions

*bad prognosis

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15
Q

pt presents with sudden on set of severe diffuse abdominal pain. PE is normal. pain is worse with eating. W/U?

A

acute mesenteric ischemia! = angiography or surgery asap

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16
Q

1 risk factor for perioperative complications

A

Cardiac risk = DM

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17
Q

person with chronic renal failure. what do you need to do for them before surgery?

A

aggresive IV hydration 24 hr prior; if on dialysis must be dialyized within 24 hrs of surgery

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18
Q

Post-op fever day 1

A

atelectasis

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19
Q

Post-op fever day 3

A

UTI

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20
Q

Post-op fever day 5

A

DVT

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21
Q

Post-op fever day 7

A

abscess/wound infection

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22
Q

Median Arcuate Ligament Syndrome(MALS)

A

MAL compresses celiac trunk causing ischemia. presents just like chronic mesenteric ischemia but seen in a patient who just recently lost alot of weight

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23
Q

Tx of Gas gangrene

A

IV PCN + Hyperbaric O2

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24
Q

when you suspect a fracture how should you xray?

A

2 views 90 degrees to each other and always include the joints above and below + check xrays in line of force

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25
Q

Fat Embolism

sx? tx?

A

sx: hx of bone fracture, neurologic dysfunction, petechial rash, respiratory distress
tx: supportive w/O2 goal >90%

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26
Q

Compression fracture

presentation? dx? tx?

A

shitty bones/osteoprosis = fracture doing normal shit, often have no trauma hx, + point tenderness over fracture.
dx: XR
tx : ??

27
Q

Pathological Fracture

presentation? dx? tx?

A

fracture due to 2nd dz & often follows minimal trauma

dx: XR
tx: tx fracture & look for cause

28
Q

Stress Fracture

presentation? dx? tx?

A

fracture due to overuse, seen in marathon runners n shit.

dx: usualy not seen on XR may need CT
tx: stop, Anagesia

29
Q

Person with face fracture what else do you need to look at?

A

cervical spine

30
Q

Clavicle Fracture

presentation? dx? tx?

A

sx: shoulder trauma, pain, swelling, misalignment or “step off”
dx: XR + ANGIOGRAM TO ASSESS INJURY TO SUBCLAVIAN A& BRACHIAL PLEXUS
Tx: sling

31
Q

Anterior Shoulder Dislocation

presentation? dx? tx?

A

SX: pain, swelling, arm is EXTERNALLY ROTATED

dx: XR + CHECK FOR AXIALLY A&N INJRUY
tx: reduction + sling

32
Q

Posterior Shoulder Dislocation

presentation? dx? tx?

A

sx: seen wit person who had a seizure, pain, swelling, ARM IS INTERNALLY ROTATED
dx: XR
tx: reduction + sling

33
Q

Colles Fracture

A

pt called on outstreached hand = dinner fork deformity = distal radius moves superioly + posterioly

34
Q

Monteggia Fracture

A

blow to ulnar = fractures ulnar and dislocated radius

35
Q

Galeazzi Fracture

A

blow to radius = fractures radius and dislocated ulnar

36
Q

Scaphoid Fracture

dx? tx?

A

fall on outstretched hand = persistant pain in anatomical snuffbox; takes about 3 weeks to see on XR
tx: thumb spica casts

37
Q

Trigger Finger

tx?

A

idiopathic fibrous band inflammation causing popping sound = tendon popping over inflammation

  • women waks up with weird hand shit
    tx: steroid injection
38
Q

De Quervains Tenosynovitis

tx?

A

tendonitis of thumb + wrist = steroid injection + rest

39
Q

Dupuytren Contraction

tx?

A

thickening of palmer fascia causing perm flexion and decreased extension of hand
tx: surgery

40
Q

MCL or LCL injury

A

caused by blow to the opposite side of knee

tx: surgery

41
Q

ACL or PCL injury

A

positve anterior/post draw sign

tx: surgery; old ppl get rehab

42
Q

Meniscal injury

A

pt complains of a “catching or popping” sesnation in knee

tx: surgery

43
Q

Osteoarthritis of Knee

when do you replace?

A

wear & tear = XR shows narrowing and sclerotic changes
tx: PT, steroids, anaglesia

*replace when pt has trouble walking or inability to perform ADLs or bone on bone

44
Q

What will you see on MRI for disc herniation vs Spinal stenosis?

A

herniation will show bulging at the discs but stensosis will show dipping inward at the discs

45
Q

Spinal Stenosis

sx? dx? tx?

A
  • arthritis changes resultin in a narrowing of the spinal canal = osteophytes form causing pain and weakness. Lumbar > Cervical
    sx: neck/bk pain, bilateral leg/butt pain + numbness(this is bc its in the canal!), pseudoclaudication(worse with walking and improves with flexion/leaning forward)
    dx: MRI = shows dipping at discs
    tx: NSAIDS + Surgery
46
Q

Plantar Fasciitis

sx? dx? tx?

A

sx: overweight pt with sharp heel pain every time their foot strikes the ground
dx: XR shows bone spur + pain on palpation of spur
tx: symptomatic = resolves in 12-18m

47
Q

Morton Neuroma

sx? dx? tx?

A

sx: inflammation of the common digital nerve at the 3rd interspace between the 3rd and 4th toes, caused by wearing pointy-toed shoes
dx: palpable + tender neroma
tx: analgesics + better footwear

48
Q

tx of acute epididymitis

A

ceftriaxone + doxy

49
Q

Subclavian Steal Syndrome

A

plaque at origin o fthe subclavian allows to blood to be stolen from vertebral A for arm.
sx: visual sx, equilibrium probs, claudication in the arm during exercises

dx: angiography
tx: bypass surgery

50
Q

Best thing you can do for a AAA <5cm

A

control BP

51
Q

Pt presents with pain in legs that is relieved by rest dx?

A

Arteriosclerotic Occlusive disease of the lower extremities

52
Q

Arteriosclerotic Occlusive Disease of the Lower Extremity

sx? dx? tx?

A

sx: leg pain with use and relieved by rest
dx: ABI <0.9
tx: #1 = stop smoking, Cilostazol + ASA + start walking to promote colateral circulation

53
Q

Subacromial impingement

A

pain in abduction and interal rotation + overhead activities

tx: steroids

54
Q

Rotator Cuff tear

A

weakness and pain

tx: steroids

55
Q

Biceps tendonitis & rupture

A

if rupture usually have visable bulge, ecchymosis and audiable snap

rupture = surgery tendonitis = steroids

56
Q

Adhesive Capsulitis

A

DECREASED ACTIVE AND PASSIVE ROM

57
Q

Acromiclavicular separation(AC separation)

A

pain over the AC joint(anterior superior lateral shoulder), and pain on adduction of arm, usually caused by tackle

58
Q

Superior Labrium Anterior Posterior Tear(SLAP)

A

shoulder instability = locking and clicking + pain

tx: surgery!

59
Q

Patellar Tendonitis

A

pain INFERIOR to the patella

60
Q

IT band syndrome

A

lateral knee pain

61
Q

Patello-femoral syndrome

A

anterior knee pain under the patella

62
Q

Atlantoaxially instablity

A

seen w/RA & DS = dx w/XR & tx w surgical fusion

63
Q

Osgood Schlayer Disease

A

active kid undergoing growth spurt + anterior knee pain(usually bilateral)

64
Q

Nursemaids Elbow

A

radial head pulled otu of annual ligamanet

MTBs Step 3 (30 decks)

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