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Surgery Midpoint > Surgery Midpoint > Flashcards

Surgery Midpoint Flashcards

1
Q

Crohn’s Clinical Presentation

A
  1. Age
  2. Chronic worsening abd pain
  3. non-bloody diarrhea
  4. malnutrition/wt loss
  5. barium enema findings
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2
Q

Crohn’s Characteristics

A
  1. Transmural inflammation
  2. Skip Lesions
  3. Granulomas
  4. Distribution in GI Tract- Mouth to Anus
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3
Q

Crohn’s cause

A

unknown

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4
Q

Crohn’s Radiographic Features

A
  1. Thumb Printing
  2. String Sign
  3. Ulcers/Fistulas/Fissures
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5
Q

Crohn’s Indications for Surgery

A
  1. Intestinal Obstruction
  2. Symptomatic Fistulas/Disabling Perianal Disease
  3. GI Perforation/Abscess
  4. Intestinal Hemorrhage
  5. Intestinal Carcinoma
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6
Q

UC Clinical Presentation

A
  1. Frequent Diarrheal Stools
  2. Defecation Urgency
  3. Tenesmus
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7
Q

UC Characteristics

A
  1. Limited distribution (colon, rectum)
  2. Superficial
  3. No granulomas
  4. Rectal involvement almost 100% of time
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8
Q

UC Radiographic Features

A
  1. loss of Haustra
  2. Pseudopolyposis
  3. Lead Pipe appearance
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9
Q

UC indications for surgery

A
  1. Toxic Megacolon
  2. Intestinal Obstruction
  3. Hemorrhage
  4. Perforation
  5. Colorectal Carcinomas
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10
Q

Pancreatitis Etiology

A
  1. Gallstones
  2. Alcohol
  3. Trauma
  4. Hypercalcemia
  5. hyperlipidemia
  6. drugs
  7. tumor, anatomic abnormalities
  8. infection
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11
Q

Pancreatitis Ranson’s criteria( determines prognosis/severity): At admission

A
  1. Age >55
  2. WBC >16000
  3. Glucose >200mg/100ml
  4. LDH >350
  5. SGOT >250
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12
Q

Pancreatitis Ranson’s criteria( determines prognosis/severity): During 48hr after admission

A
  1. HCT >10 point decrease
  2. BUN >5mg/100ml increase
  3. Calcium <8
  4. PO2<60mmHg on RA
  5. Base Excess >4mEq/L
  6. Estimated Fluid Sequestration >6000ml
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13
Q

Pancreatitis Complications

A
  1. Pseudocyst
  2. Pancreatic Ascites
  3. Hemorrhage
  4. Necrosis/Infection/Abscess
  5. Respiratory Failure/ARDS/MSOF
  6. Splenic Vein Thrombosis
  7. GI tract obstruction
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14
Q

Pancreatitis Initial Management

A
  1. IV hydration
  2. NPO/NGT
  3. Analgesia
  4. Foley
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15
Q

Bowel Ob Physical Findings

A
  1. Abdominal Distention
  2. Tenderness to Palp with possible guarding
  3. High pitched bowel sound
  4. R/o possible hernia
  5. empty rectal visit
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16
Q

Bowel Ob Etiologies

A
  1. Adhesions from prior surgery
  2. Hernia, inguinal/abdominal wall
  3. Carcinomas
  4. Colonic volvulus
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17
Q

Bowel Ob Associated Lab Abnormalities

A
  1. Elevated WBC
  2. Hemoconcentration
  3. Hyponatremia
  4. Hypokalemia
  5. Elevated BUN, Cr, and urine specific gravity
18
Q

Bowel ob radiographic studies

A
  1. flat and upright abdomen
  2. Chest x-ray
  3. CT scan/contrast studies
19
Q

Bowel ob appropriate fluid for resuscitation

A

NS or LR

20
Q

Bowel ob complications

A
  1. strangulation with intestinal necrosis

2. perforation

21
Q

Breast Cancer Eval

A
  1. history
  2. mammography
  3. FNA
  4. open biopsy
22
Q

Breast Cancer tx options for breast carcinoma

A
  1. Segmental mastectomy with axillary node dissection and radiation
  2. modified radical mastectomy
  3. radical mastectomy
  4. simple mastectomy
23
Q

breast cancer axillary node dissection

A

precise pathological staging

24
Q

breast cancer TNM Staging (staging determines prognosis and need for adjunctive therapy)

A
  1. size of lesion
  2. axillary LN status
  3. distant metastasis
25
Q

Breast cancer physical exam finding indicating poor prognosis

A
  1. edema of skin of the breast
  2. skin ulceration
  3. Tumor fixed to chest wall
  4. massive axillary LN enlargement
  5. Supraclavicular LN
  6. satellite skin nodules
  7. arm edema
  8. inflammatory carcinoma
  9. size
26
Q

Breast cancer DCIS

A

Ductal carcinoma in situ

Treatment options include lumpectomy with radiation and simple mastectomy

27
Q

UGI bleed

A

occurs from lesion of the GI tract located from the oropharynx to the ligament of Treitz

28
Q

UGI bleed causes

A
  1. Gastritis
  2. Duodenal Ulcers
  3. Gastric Ulcers
  4. Mallory Weiss
  5. Hemobilia
  6. Esophagitis
  7. Varices
  8. Tumor
29
Q

Differential Dx of Epigastric Pain

A
  1. Peptic Ulcer
  2. GERD
  3. Gastritis
  4. Cholelithiasis
  5. Ischemic Heart Disease
  6. Pancreatitis
30
Q

UGI dx procedures

A
  1. EGD (sensitivity, specificity, biopsy can be obtained)

2. Contrast Study

31
Q

UGI/PUD medical therapy

A
  1. PPI
  2. H2 blockers
  3. Sucralfate
  4. Non-prescription Antacids
  5. Lifestyle modification
32
Q

Complication of Duodenal Ulcer disease

A
  1. bleeding
  2. perforation
  3. gastric outlet obstruction
  4. intractability
33
Q

Signs/symptoms of Perforated Peptic Ulcer

A
  1. Sudden Onset of Severe Abd pain
  2. Abd rigidity
  3. ABSENT bowel sounds
34
Q

Dx of Perforated peptic ulcer

A

upright CXR/CT scan

35
Q

Preop Eval Organ Systems

A
  1. Cardio
  2. Pulm
  3. Renal
36
Q

Preop eval Cardiac Hx

A
  1. past MI
  2. age of MI
  3. prior ACB
  4. Cardiac meds
  5. Chest pain
  6. hx of Rheumatic fever
  7. arrhythmias
  8. CHF
  9. murmur
  10. HTN
37
Q

Preop eval Pulm hx

A
  1. smoking
  2. asthma
  3. obesity
  4. chronic bronchitis
  5. COPD
  6. Occupational Lung dx
  7. Cough
  8. Wheeze
  9. Exertional dyspnea
38
Q

Preop eval Metabolic/endocrine abn

A
  1. DM
  2. Thyroid
  3. Liver dysfunction
  4. adrenal insufficiency
  5. malnutrition
39
Q

Preop eval Renal hx

A
  1. HTN
  2. Leg edema
  3. stones
  4. DM
40
Q

Preop eval Bleeding tendency

A
  1. Anticoag
  2. ASA
  3. Chronic Alcohol use
  4. Severe Malnutrition

Surgery Midpoint (1 decks)

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