surgery devirgilio- pediatric, trauma, complications

Question 1

gastroschisis associations in utero

Answer 1

young moms who smoke with elevated AFP

Question 2

bilious emesis, landmark?

Answer 2

distal to ampulla of vater

Question 3

evaluation of sizeable melanoma concern on face?

Answer 3

punch bx to dermis to calculate breslow score

Question 4

fevers in first 24 hours after surgery? Worry or not?

Answer 4

cytokines!

But, if dishwater discharge= GAS and clostridium within hours

Question 5

mechanism behind warf induced skin necrosis

Answer 5

prot C deficiency –>hyerpcoagulable, thrombosis at cutaneous vessels

Question 6

pressor of choice in septic shock?

Answer 6

norepi

GIVE FLUIDS!!

Question 7

order of tx in ITP

Answer 7

steroids –> IVIG –> splenectomy

Question 8

response to HIT?

Answer 8

stop heparin and start direct thrombin inhibitor (argatriban)

Question 9

first sign of cardiac tamponade?

Answer 9

impaired diastolic filling

Question 10

managment of blunt carotid injuries

Answer 10

anticoagulation (heparin)

Question 11

GSW to abd with stable vitals. Ex lap, CT or FAST?

Answer 11

CT

FAST for blunt trauma

Question 12

acute limb ischemia followed by reperfusion is riskfor…..

Answer 12

compartment syndrome

(interstitial edema)–> ischemia reperfusion leads to vascular permeability

Question 13

peaked T waves on EKG after saturday night palsy

Answer 13

compartment syndrome–> muscle necrosis–> CPK –> hyperkalemia

give Ca first!!!!

Question 14

order of ischemic tissue damage

Answer 14

muscle
nerve
fat
skin
bone

Question 15

management of tension pneumo

Answer 15

needle decompression –> tube thoracostomy

no imaging, no OR.

Question 16

underlying condition assoc with flail chest that should be managed?

Answer 16

pulmonary contusion –> secure the airway

Question 17

numbness in the first web space?

Answer 17

compartment syndrome involving deep peroneal nerve

Question 18

electrical burns are assoicated with compartment syndomre

Answer 18

do a fasciotomy!!