Surgery Recall Signs and Triads you should know Flashcards Preview

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Flashcards in Surgery Recall Signs and Triads you should know Deck (35):
1

What are the ABCDs of
melanoma?

Signs of melanoma:
* Asymmetric
* Border irregularities
* Color variation
* Diameter >0.6 cm and Dark color

2

Ballance’s sign

Constant dullness to percussion in the
left flank/LUQ and resonance to
percussion in the right flank seen with
splenic rupture/hematoma

3

Barrett’s esophagus

Columnar metaplasia of the distal
esophagus (GERD related)

4

Battle’s sign

Ecchymosis over the mastoid process in
patients with basilar skull fractures

5

Beck’s triad

Seen in patients with cardiac tamponade:
1. JVD
2. Decreased or muffled heart sounds
3. Decreased blood pressure

6

Bergman’s triad

Seen with fat emboli syndrome:
1. Mental status changes
2. Petechiae (often in the axilla/thorax)
3. Dyspnea

7

Boas’ sign

Right subscapular pain resulting from
cholelithiasis

8

Borchardt’s triad

Seen with gastric volvulus:
1. Emesis followed by retching
2. Epigastric distention
3. Failure to pass an NGT

9

Carcinoid triad

Seen with carcinoid syndrome (Think:
“FDR”):
1. Flushing
2. Diarrhea
3. Right-sided heart failure

10

Cushing’s triad

Signs of increased intracranial pressure:
1. Hypertension
2. Bradycardia
3. Irregular respirations

11

Charcot’s triad

Seen with cholangitis:
1. Fever (chills)
2. Jaundice
3. Right upper quadrant pain
(Pronounced “char-cohs”)

12

Chvostek’s sign

Twitching of facial muscles upon tapping the
facial nerve in patients with hypocalcemia
(Think: CHvostek’s = CHeek)

13

Courvoisier’s law

Enlarged nontender gallbladder seen with
obstruction of the common bile duct,
most commonly with pancreatic cancer
Note: not seen with gallstone obstruction
because the gallbladder is scarred
secondary to chronic cholelithiasis
(Pronounced “koor-vwah-ze-ay”)

14

Cullen’s sign

Bluish discoloration of the periumbilical
area due to retroperitoneal hemorrhage
tracking around to the anterior abdominal
wall through fascial planes (e.g., acute
hemorrhagic pancreatitis)

15

Grey Turner’s sign

Ecchymosis or discoloration of the flank
in patients with retroperitoneal
hemorrhage as a result of dissecting
blood from the retroperitoneum (Think:
TURNer’s = TURN side-to-side = flank)

16

Hamman’s sign/crunch

Crunching sound on auscultation of the
heart resulting from emphysematous
mediastinum; seen with Boerhaave’s
syndrome, pneumomediastinum, etc.

17

Homans’ sign

Calf pain on forced dorsiflexion of the
foot in patients with DVT

18

Kehr’s sign

Severe left shoulder pain in patients
with splenic rupture (as a result of
referred pain from diaphragmatic
irritation)

19

McBurney’s point

One third the distance from the anterior
iliac spine to the umbilicus on a line
connecting the two

20

Meckel’s diverticulum
rule of 2s

2% of the population have a Meckel’s
diverticulum, 2% of those are symptomatic,
and they occur within 2 feet of the
ileocecal valve

21

Murphy’s sign

Cessation of inspiration while palpating
under the right costal margin; the
patient cannot continue to inspire
deeply because it brings an inflamed
gallbladder under pressure (seen in
acute cholecystitis)

22

Obturator sign

Pain upon internal rotation of the leg
with the hip and knee flexed; seen in
patients with appendicitis/pelvic abscess

23

Pheochromocytoma SYMPTOMS triad

Think of the first three letters in the
word pheochromocytoma—“P-H-E”:
Palpitations
Headache
Episodic diaphoresi

24

Pheochromocytoma rule
of 10s

10% bilateral, 10% malignant, 10% in children, 10% extra-adrenal, 10% have multiple tumors

25

Psoas sign

Pain elicited by extending the hip with the knee in full extension, seen with appendicitis and psoas inflammation

26

Raccoon eyes

Bilateral black eyes as a result of basilar
skull fracture

27

Reynold’s pentad

1. Fever
2. Jaundice
3. Right upper quadrant pain
4. Mental status changes
5. Shock/sepsis
Thus, Charcot’s triad plus #4 and #5; seen
in patients with suppurative cholangitis

28

Rovsing’s sign

Palpation of the left lower quadrant
resulting in pain in the right lower
quadrant; seen in appendicitis

29

Silk glove sign

Indirect hernia sac in the pediatric
patient; the sac feels like a finger of a silk
glove when rolled under the examining
finger

30

Sister Mary Joseph’s sign
(a.k.a. Sister Mary
Joseph’s node)

Metastatic tumor to umbilical lymph
node(s)

31

Virchow’s node

Metastatic tumor to left supraclavicular
node (classically due to gastric cancer)

32

Virchow’s triad

Risk factors for thrombosis:
1. Stasis
2. Abnormal endothelium
3. Hypercoagulability

33

Trousseau’s sign

Carpal spasm after occlusion of blood to
the forearm with a BP cuff in patients
with hypocalcemia

34

Westermark’s sign

Decreased pulmonary vascular markings on
CXR in a patient with pulmonary embolus

35

Whipple’s triad

Evidence for insulinoma:
1. Hypoglycemia (50)
2. CNS and vasomotor symptoms
(e.g., syncope, diaphoresis)
3. Relief of symptoms with
administration of glucose