Surgery UWorld

Question 1

CT findings ischemic colitis

Answer 1

thickened bowel

Question 2

Colonoscopy ischemic colitis

Answer 2

cyanotic mucosa/ hemorrhagic ulcers

Question 3

Pt with ruptured AAA too unstable to have a CT can confirm AAA with?

Answer 3

bedside ultrasound. Urgent surgery required

Question 4

Whistle noise following rhinoplastie

Answer 4

nasal septum perforation from septal hematoma

Question 5

Dumping syndrome

Answer 5

• postgastrectomy complication
• pyloric sphincter rapid emptying leading to nausea, diarrhea, diaphoresis, AMS
• caused by fluid shifts

Question 6

pulmonary contusion

Answer 6

• complication of blunt thoracic trauma
• ↑ RR, ↑ HR, hypoxic
• cxr: patchy alveolar infiltrate from hemorrhage
• may –> ARDS

Question 7

Pneumothorax

Answer 7

• blunt force trauma
• CP, ↓ breath sounds, sub-q emphysema
• cxr: area without lung markings

Question 8

hemothorax on cxr

Answer 8

plural effusion

Question 9

flail chest caused by

Answer 9

> 3 ribs broken–> detachment

chest wall moves paradoxically

Question 10

cardiac contusion s/s

Answer 10

usually asymptomatic

can cause ↓ BP, ↑ HR, heart failure if severe

Question 11

absent bowel sounds

dilated gas filled loops of bowel with no transition point

Answer 11

paralytic ileus- common after surgery but sometimes even trauma

Question 12

BUN: Cr ratio for pre-renal failure

Answer 12

> 20: 1

Question 13

extraparitoneal bladder injury

Answer 13

pelvic fx
localized pain
gross hematuria

Question 14

intraperitoneal bladder rupture

Answer 14

damage to dome
s/s of chemical peritonitis
pelvic fx often present

Question 15

children with traumatic diaphragmatic injury

Answer 15

delayed presentation (months/years) 
herniation of bowel into lung fields (usually left side)

Question 16

Conservative anal fissure treatment

Answer 16

stool softener
sitz bath
lidocain- topical
vasodilator- ↑ blood flow–> better healing

Surgery only if refractory

Question 17

Anterior mediastinal mass differential

Answer 17

4 Ts

thymoma
teratoma
thyroid neoplasms
terrible lymphoma

Question 18

Burn sepsis criteria

Answer 18

Temp- under 36, over 39
HR- > 90
RR- > 30
BP- < 90

also common 
oliguria
AMS
↑ glucose 
↓ plts

Question 19

Hemodynamically unstable GSW below the nipple line

Answer 19

if unstable w/ + fast –> immediate x- lap

inconclusive fast- consider DPL

below nipple= could involve abdominal cavity

Question 20

Nec Fash on CT

Answer 20

gas in deep tissue

Question 21

Appendicitis > 5 days after onset usually have

Answer 21

Perforation/ abscess formation