Surgery Clerkship 4 Flashcards
(46 cards)
What vessel provides blood supply to the appendix?
Appendiceal artery
Can you have abnormal urinalysis with appendicitis?
Yes; mild hematuria and pyuria are common in appendicitis with pelvic inflammation, resulting in inflammation of the ureter
Appendicitis imaging studies
- Spiral CT
- U/S
- AXR
What is the pathology?
- Viral or bacterial infection of the GI tract, usually with vomiting and diarrhea
- If pain is present, it’s usually after vomiting
Gastroenteritis
Difference between pain experienced in appendicitis and gastroenteritis
- Gastroenteritis: Pain usually after vomiting
- Appendicitis: Pain usually before vomiting
Why is glucose-containing IVF contraindicated in burn patients in the first 24 hours?
Patient’s serum glucose will elevate on its own because of the stress response
Minimal urine output for adult burn patients
30 cc per hour
Ways to monitor volume status
- Urine output
- Blood pressure
- Heart rate
- Peripheral perfusion
- Mental status
MC sign of burn wound infection
Discoloration of burn eschar
Is tetanus prophylaxis required in burn patients?
YES - unless they’ve been immunized within 12 months
What electrolyte must be closely followed acutely after a burn?
Na
Name of the gastric/duodenal ulcer associated with burn injury
Curling’s ulcer
Diagnostic test of choice for UGI bleed
EGD
What test may help identify the site of a MASSIVE UGI bleed when EGD fails to diagnose the cause?
Selective mesenteric angiography
H. Pylori tx regimens
- MOC: Metronidazole, Omeprazole, Clarithromycin
- ACO: Ampicilin, Omeprazole, Clarithromycin
Age group in which duodenal ulcers are most common
40-65 years (younger than gastric ulcer)
Zollinger-Ellison syndrome
Gastrinoma and PUD (Peptic Ulcer Disease)
Artery involved with bleeding duodenal ulcers
Gastroduodenal artery
Are gastric or duodenal ulcers more common?
Duodenal (more than twice as common)
PUD or gastritis associated with neurologic trauma or tumor
Cushing’s ulcer
Ulcer at the margin of a GI anastomosis (name)
Marginal ulcer
Pinprick gastric mucosal defect bleeding from an underlying vascular malformation
Dieulafoy’s ulcer
Is anterior or posterior duodenal ulcer perforation more common?
Anterior
What would you see with posterior and anterior perforation of a duodenal ulcer?
Posterior - Bleeding from the gastroduodenal artery and possibly acute pancreatitis
Anterior - Free air
