COMLEX 3 > Surg > Flashcards

Surg Flashcards

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1
Q

pre-op eval: what are 2 cardiac contraindications for surg?

A
  • EF <35%

- MI in past 6mo

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2
Q

pre-op eval: what classification can be used to determine cardiac risk?

A

Goldman Index

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3
Q

pre-op eval: what 5 systems are reviewed?

A
  • cardiac
  • pulm
  • hepatic
  • nutrition
  • metabolic
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4
Q

pre-op eval –> pulm risk: when should pt undergoing surg stop smoking?

A

8wk

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5
Q

pre-op eval: how determine hepatic risk?

A

Child-Pugh score:

  • bili
  • albumin
  • PT/INR
  • encephalopathy
  • ascites
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6
Q

definition of malnutrition

A
  • weight loss >20% in past few mo
  • albumin <3
  • anergy to skin antigens
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7
Q

pre-op eval –> malnutrition: when start vigorous nutritional support?

A

10 days

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8
Q

pregnant patient –> trauma –> what position?

A

left lat decubitus

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9
Q

2nd-3rd trimester pregnant patient –> trauma –> what position?

A

left lat decubitus

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10
Q

2nd-3rd trimester pregnant patient –> trauma –> should be placed in left lat decubitus –> why?

A

to prevent positional hypotension from aortocaval compression from enlarged uterus

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11
Q

epidural hematoma –> MC mechanism of injury?

A

trauma to side of head

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12
Q

epidural hematoma –> presentation

A

LOC –> lucid interval –> general decreasing mental function –> coma

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13
Q

epidural hematoma –> possible complication

A

uncal herniation

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14
Q

epidural hematoma –> uncal herniation –> presentation

A
  • ipsilat fixed dilated pupil

- contralat hemiparesis

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15
Q

what kind of intracranial bleed is more commonly found in elderly?

A

subdural hematoma

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16
Q

epidural hematoma –> shape on CT?

A

football

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17
Q

subdural hematoma –> acute –> no midline shift –> tx?

A

decrease ICP

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18
Q

epidural hematoma –> tx?

A

craniotomy

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19
Q

subdural hematoma –> tx: decrease ICP –> how?

A
  • elevation
  • hyperventilation
  • mannitol
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20
Q

subdural hematoma –> shape on CT?

A

crescent

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21
Q

MVA –> car struck at angle –> car spin –> patient in coma –> what condition?

A

diffuse axonal injury

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22
Q

diffuse axonal injury –> pathophys?

A

angular trauma –> shear axon fibers

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23
Q

diffuse axonal injury –> what is seen on MRI?

A

blurring of grey-white matter

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24
Q

playing sports –> head trauma –> LOC & retrograde amnesia –> what condition?

A

concussion

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25
subdural hematoma --> chronic --> tx?
craniotomy
26
ant vs posterior shoulder dislocation --> which is more common?
ant
27
ant shoulder dislocation --> presentation
- shoulder pain | - arm: slight abduct, ext rot
28
ant shoulder dislocation --> can injure what nerve
axillary N
29
ant shoulder dislocation --> axillary N injury --> presentation
loss of sensation in shoulder badge distribution
30
posterior shoulder dislocation --> can injure what vessels?
axillary & subclavian arteries
31
mid-shaft fx of humerus --> can injure what nerve?
radial N
32
low serum ceruloplasmin --> found in what condition
Wilson's disease
33
Wilson's disease --> TX? MOA?
penicillamine --> complex w copper --> excrete in urine --> stop progression of disease
34
43F --> total abd hysterectomy --> several hours later --> R eye --> photophobia, conjunctival injection, small watery discharge --> vision intact what condition
corneal abrasion
35
corneal abrasion after surgery --> pathophys
- intraoperative: something brush the open eye | - postoperative: patient rub eye when awaken from anesthesia
36
corneal abrasion after surgery --> tx
prophylaxis w broad-spectrum abx drop
37
corneal abrasion after surgery --> dx
slit lamp
38
AAA --> 3.8cm --> next step
monitor yearly with US
39
AAA --> recommend surgery at what diameter?
>5.5cm
40
AAA --> what diameter can be monitored yearly with US?
3-4cm
41
AAA --> 4 to 5.5cm --> next step
monitor q6month with US
42
patient undergoing TAH+BSO --> during operation, how can assess for damage to ureters?
IV indigo carmine injection
43
4vessel CABG --> 2wk f/u visit --> c/o LLE swelling --> no fever, SOB, ambulating well what condition?
harvest greater saphenous vein for CABG --> decreased venous return --> unilat leg swell
44
burn to head total surface body area?
9%
45
burn to arm total surface body area?
9%
46
burn to chest total surface body area?
18%
47
burn to back total surface body area?
18%
48
burn to leg total surface body area?
18%
49
burn to head (infant) total surface body area?
18%
50
burn to arm (infant) total surface body area?
9%
51
burn to chest (infant) total surface body area?
18%
52
burn to back (infant) total surface body area?
18%
53
burn to leg (infant) total surface body area?
13.5%
54
burn patient --> how calculate maintenance fluids?
Parkland formula: total fluids for 24hr = 4ml x kg x TBSA% first 8 hr: administer half total next 16hr: administer rest
55
closed angle glaucoma --> dilated pupil --> reactive or nonreactive?
nonreactive
56
closed angle glaucoma --> tx
- relieve pressure: laser --> hole in eye | - constrict pupil: a-agonist + BB
57
closed angle glaucoma --> what medication is contraindicated?
atropine
58
periorbital cellulitis vs orbital cellulitis --> differentiate in presentation
periorbital --> can mv eye orbital --> cannot move eye
59
eye inflamed and swollen --> cannot move eye --> next step
CT
60
"curtain" over vision --> dx?
- retinal detachment | - retinal artery occlusion (amaurosis fugax)
61
what typically causes retinal detachment?
- trauma (MVA) | - HTN crisis
62
retinal detachment --> tx
spot-weld laser
63
retinal artery occlusion --> pathognomonic finding on fundoscopy?
cherry red spots on fovea
64
retinal artery occlusion --> tx
intra-arterial TPA
65
retinal artery occlusion --> alternate tx
if can't TPA --> vasodilation: - global pressure - hyperventilation
66
chronic progress loss of central vision --> peripheral vision intact dx?
macular degeneration
67
posterior epistaxis --> what blood vessel?
maxillary A --> sphenopalatine A
68
POD#1-2 --> fever dx?
PNA
69
POD#3-5 --> fever dx?
UTI
70
POD#5-7 --> fever dx?
surgical site infect
71
POD#4-6 --> fever dx?
DVT/PE
72
POD#7+ --> fever dx?
medication
73
burn patient --> what IVF?
LR
COMLEX 3
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