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236 Cards in this Set
- Front
- Back
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What is the most common tumor that mets to the intestine
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melanoma
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Pt with a small bowel obstruction due to adhesions from prior surgery. What is your overall mgmt plan?
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rehydration with NG drainage for several days, monitor for marked leukocytosis, fever, acidosis, or localized tenderness, and findings suggestive of closed loop obstruction or perforation
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For an elective procedure, how many days before do you need to stop Aspiring? how about other NSAIDs?
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7-10 days, 2 days
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When should diabetic patients stop oral meds before surgery? how about Insulin?
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no oral meds the morning of surgery.
Check sugar and if >250 give 2/3 morning dose of NPH otherwise give 1/2 normal dose. |
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Perioperative blood glucose levels should be __ - ___
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100-250
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Improvement in postoperative respiratory morbidity in smokers occurs after __ - ___ wks of abstinence
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6-8
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What is the most common cause of early postoperative death following LE revascularization?
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MI
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Which is possibly a normal variant RBBB or LBBB
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RBBB (seen in pts with significant pulmonary dz)
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How to classify liver failure?
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Child's classification: Bilirubin, Albumin, Ascities, Encephalopathy, Nutrition, Mortality
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How does uremia cause intraoperative bleeding?
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platelet dysfunction
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Most common cause of postoperative fever
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atelectasis
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Second most common cause of postoperative fever and which day?
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UTI, 3
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What to do if wound exhibits fluctuance?
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remove staples and drain
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Factors associated with unhealing fistula
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FRIEND
Foreign Body Radiation Infection or inflammatory bowel Epithelialization Neoplasm Distal bowel obstruction |
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Gram positive spore producing rods found in wound, what is it and what to do?
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Clostridium perfingens, look for gas gangrene, high dose PCN G and debridement, hyperbaric oxygen, tetanus shot
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Complete wound remodeling and maturation may take up to __ months
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6
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When should you add abx to tx for a wound infection.
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Only if wound cellulitis appears to be spreading despite wound drainage.
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For a skin graft to attach, the bacterial count on the granulation bed must be less than ___ bacteria per gram of tissue
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10^5
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In wound healing collagen production can first be detected within __ hours and peaks in __-__ days
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10, 5-7
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How do you confirm the dx of a small bowel obstruction without an operation?
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Upper GI series with small bowel follow through
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What segment of the bowel involvement in Crohn's is treated better by 5-ASA
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colon (if limited to the small bowel there is little effect)
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Peak incidence of appendicitis?
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bimodal 25 yrs and 65 yrs
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What is the recommended timing of CEA measurements after CRC? how about colonoscopy?
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CEA every 2-3 months for 2 years (also screen liver function)
colonoscopy 1 year after surgery, screening at 3 years, and then at 5 year intervals |
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Squamous cell carcinoma of the anal verge, which nodes likely involved with mets?
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inguinal lymph nodes most commonly but also to superior rectal lymph nodes in up 50% of patients
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What is Olgilvie's syndrome and what is the tx?
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acute pseudobstruction, if colon diameter exceeds 11-12 cm then attempt endoscopic decompression plus possibly a trial of neostigmine a parasympatholytic, if this fails then attempt surgical decompression with possible colectomy
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What is a potential tx for anal fissure that is deep and chronic
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internal sphincterotomy
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Patient with a thyroid nodule and a hx of radiation exposure, tx?
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proceed directly to thyroidectomy
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Which is a higher risk for thyroid malignancy? a solitary nodule or a dominant nodule in a multinodular gland?
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solitary nodule
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thyroid FNA shows amyloid deposits and calcitonin staining, which type of CA
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medullary
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What two types of cells on thyroid FNA are considered non diagnostic and therefore require lobectomy
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Hurthle and Follicular
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Which type of thyroid CA is found in iodine deficient areas
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follicular carcinoma
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In which type of thyroid CA is tx with 131I not beneficial because it arises from C cells
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Medullary
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Many clinicians recommend exploratory parathyroid surgery if calcium is > ___, even if asymptomatic
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11
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what is the surgical tx for 2ndary hyperparathyroidism?
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remove all but 50mg of glandular tissue, either left in place or implanted into the forearm muscle where it easier to retrieve
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thyroid histology showing giant cell granulomas around degenerating follicles, dx?
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deQuarvains thyroiditis
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whipples triad
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fasting hypoglycemia (<60),
hypoglycemic sx, relieved by glucose (think insulinoma) |
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With malignant melanoma what is the most significant finding in addition to TMN which correlates to reduced survival
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the presence of ulcerations (1/3 reduction in survival)
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no nodes are palpable in resection of a malignant melanoma, what do you do?
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sentinal node bx and resection if positive
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recurrence of sarcoma is one of the few tumors in which excision of ___ mets may result in significant disease free interval
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pulmonary
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which type of hernias is strangulation most common
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femoral (followed by indirect)
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What does the inguinal canal contain in women
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round ligament
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priapism in a trauma pt, what are you thinking?
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spinal cord injury
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Cardiac risk assessment, for a pt < age ___ obtain ecg. For a pt of any age with cardiac hx or an older pt: obtain ecg consider __ and ___
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35, echo, stress
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echo is concerning if evidence of ___ or if EF is < __%, stress is positive if depressions > ___ mV or if inadequate response of hr to stress or ___
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AS, 35, 0.2, hypotension
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up to 35% of postop deaths are due to ___ complications, what 2 types of surgery are of greatest risk?
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pulmonary, upper abdominal or thoracic (major abdominal surgery decreases VC and FRC)
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what is the postoperative mortality of elderly pts with pneumonia?
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50%
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What post op day does fluid mobilization occur?
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2 or 3
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when should dialysis pts be dialyzed pre op?
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within 24hrs to best control creatinine and electrolytes
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intra and postop ___ must be strictly avoided in renal pts.
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hypotension
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risk of bleeding increases in pts with BUN > 100 due to platelet dysfunction, can be corrected with ___
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desmopressin
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one unit of plts raises count by ___ -____
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5,000 - 10,000
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ABX proph:
in general: ___ colorectal surgery, appendectomy: ___ or ___ urologic: ___ head and neck: ___ or ___ and ___ |
cefazolin
cefoxitin, cefotetan ciprofloxacin cefazolin, clinda, gent |
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abx proph given __ before procedure and again 6 hrs later if procedure is ongoing
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30 min
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simple instructions are NPO after midnight but could be no solids __- __ hrs prior and no liquids __ - __ hrs prior
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6-8, 2-3 (bowel prep would include day of clear liquids and prep only prior to NPO after midnight)
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hold ASA for __ days preoperatively and plavix for __ days, give BBs and hold diuretics
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10, 7
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at 1 month wound healing is at ___% of its ultimate cohesive strength
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85
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epithilization of surgical wounds closed primarily is usually complete by __-__ hrs
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24-48
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what is the difference between a contaminated and dirty surgical wound.
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contaminated is gross spillage from the gi or gu (if infected) tracts or there was a major break in aseptic technique or the wound was from trama
dirty means there is already evidence of infection (pus) |
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Surgical site infections that occur in the first 24hrs are usually cause by ___ or ___ (others are usually 4-5 days postop)
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strep, clostridium
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most common cause of free air under diaphragm?
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perforated peptic ulcer
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What condition's signs include: scaphoid, tense abdomen; diminished bowel sounds (late); loss of liver dullness; guarding or rigidity
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perforated viscus
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pts with splenic rupture will have an elevated ___ in the setting of trauma?
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white count
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pts with ___ will initially be able to take in fluids but then vomit a short time afterward
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bowel obstruction
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What test must you perform on all pts presenting with ___ pain
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midepigastric
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rough estimate for total amount of crystalloid volume needed to acutely replace blood loss.
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3-to-1
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Body Water: ___ is intracellular, ___ is extracellular -> of that ___ is intravascular, ___ is extravascular
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2/3, 1/3, 1/4, 3/4
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a "trauma series" consists of radiographs of ___, ___ and ___
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C-spine, chest, pelvis
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Mnemonic for trauma hx
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AMPLE
Allergies Medications/Mechanism of injury Past medical hx/Pregnant Last meal Events surrounding mechanism of injury |
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What separates the zones of the neck?
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angle of mandible between III and II, cricoid cartilage between II and I
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clinically apparent tamponade may result from __-__ cc of blood
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60-100
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kehr's sign?
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left shoulder or neck pain from splenic rupture. Increases with trendelenberg or LUQ palpation
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4 places to look for free fluid in FAST?
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Morrisons pouch (between liver and kidney)
Splenorenal recess (between spleen and kidney) Pouch of Douglas Subxiphoid and parasternal views to look for hemopericardium |
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what must you do before DPL (2 things)
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gastric and urinary decompression
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what is the most sensitive test for retroperitoneal injury?
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CT
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chance fracture? and what other injury is it associated with?
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anterior vertebral body compression (seat belt), look for blunt small bowel injury
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to determine viability of bowel in the OR inject ___ and use a ___ to inspect bowel.
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fluoresein dye IV, Wood's lamp (nonviable bowel will have patch or no fluorescence)
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what is the first sx in hypovolemic shock? also never use ___ containing fluids for resuscitation
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tachycardia, dextrose
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why is LR preferred for large volume replacement
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NS can result in hyperchloremic acidosis, LR contains alternative anions to Cl-
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what is the min. urine output in cc/kg/hr
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0.5 (or 35 cc/hr for average 70 kg person)
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top three g- bugs for causing septic shock?
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e. coli, klebsiella, pseudomonas aeruginosa
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three classic findings in spinal shock?
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hypotension, bradycardia and absence of rectal tone on DRE
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Most useful measure of effective fluid resuscitation is ___
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urine output (renal perfusion)
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what is the pressor of choice in septic shock?
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vasopressin (ADH)
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Two conditions where PEEP is primarily used because it keeps alveoli open allowing for more gas exchange?
What is the main problem with PEEP? |
CHF, ARDS
hypotension due to decreased preload |
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Minute ventilation = ?
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respiratory rate times tidal volume
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Try to titrate down FiO2 on vent to prevent oxygen toxicity. What is ideal?
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<50%
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CXR does not reliably distinguish ARDS from CHF. What does?
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PCWP < 18 in ARDS
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What is the most common cause of ARDS?
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sepsis
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Large amounts of NS may cause ___
Ringer's lactate given when pt is hypovolemic from ___ may worsen alkalosis when the lactate is metabolized. |
NG tube/vomiting (metabolic alkalosis)
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What are 3 colloids?
why are then better than non colloids |
Packed RBCs, FFP, albumin
stay mainly in intravascular space |
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The average 70 kg adult needs about __ L/day of fluid
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2.5 (~100 mL/hr)
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first thing you do before treating pt with hypokalemia
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check Mg level (usually low) and correct before/along with hypokalemia
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first tx of hyperkalemia and how does it work
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calcium gluconate stabilizes the membrane potential of cardiac muscle (doesn't actually affect the amount of K)
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why are esophageal anastomoses prone to leaks
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there is no serosal layer in the esophagus
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gold standard for dx of GERD
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24hr pH probe
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3 mos of early satiety wieght loss and non bilious vomiting, think?
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gastric outlet obstruction
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which wall of duodenum most common location for ulcer
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posterior within 2cm of pylorus
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What is the difference between Mallory-Weiss and Boerhaave
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Boeahaave is a rupture and Mallory-Weiss is just a tear
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indications for Bariatric surgery are BMI > __ with comorbity (HTN, DM) or just BMI > __
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35,40
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___ comprises 95% of malignant gastric cancer
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adenocarcinoma
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What is Blumer's shelf
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gastric ca metatsis to pelvic cul de sac felt on DRE
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What has a less favorable prognosis for gastric ca proximal or distal lesions
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proximal
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what is the role of chemo in gastric ca?
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sometimes used palliatively for non surgical candidates, no role for adjuvant therapy
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imatinib treats which two cancers
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GIST, CML
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what is menetrier's disease
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hypertrophic gastropathy with enlarged gastric rugae benign but there may be an increased incidence of gastric ca
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what is a dieulfoy's lesion
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a large tortuous mucosal end artery that causes pressure necrosis and erodes into stomach and ruptures
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anterior vs. posterior duodenal arteries. Which one tends to perforate? Which one can perforate the gastroduodenal artery causing massive bleeding?
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anterior, posterior
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the entire small bowel blood supply is the ___ except for the first part of the duodenum which is supplied by the ___
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SMA, branches of the celiac trunk
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most common cause of SBO?
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adhesions from previous surgery
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which has fat in mesentary ileum or jejunum?
which one has long vasa recta and thicker wall and more prominent plicae circulares |
ileum
jejunum |
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what is absorbed in the large intestine that can be used as an alternative energy source for persons suffering from carbohydrate malabsorption
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short chain fatty acids
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what is the longest time the kidneys can tolerate ischemia without becoming damaged
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30-90 min
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what electrolyte abnormality can cause paralytic ileus?
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hypokalemia
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what is shock lung? and what is the main pathologic changes in the lung?
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ARDS, low compliance
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which GI secretion has the closest electrolyte composition to serum?
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ileal
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What is the physical exam finding for pyloric obstruction?
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succussion splash
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is magnesium mainly intra or extra cellular
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intra
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ecg changes in hypermagnesmia are similer to what other electrolyte excess
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K
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gap or non gap acidosis is associated with diarrhea
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non gap
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what is a better tx for hemophilia, FFP or factor VIII concentrate
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factor VIII
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What is the cause and tx of excessive bleeding following surgical procedures on the prostate?
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the prostate is rich in urokinase so procedures on it can cause fibrinolysis and aminocaproic acid inhibits plasminogen activation
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Under anesthesia, a hemolytic transfusion sx are more: hyperpyrexia and hypotension or bleeding and hypotension
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bleeding and hypotension (fever if no anesthesia)
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chlorambucil for 6 weeks followed by cholecystectomy is the tx for __
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Polycythemia vera
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soybean oil?
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can be added peripherally in a pt on TPN to increase calories
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stress vs. starvation:
primary fuel? proteolysis? |
primary fuel in stress is mixed, starvation is fat
proteolysis in stress is greatly increased, in starvation it is moderately increased |
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what is the problem with suddenly stopping TPN
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hypoglycemia since islet-cell production has been increased
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Intubated pt on TPN: which is more likely to increase production of CO2 excess glucose or excess fat?
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glucose (respiratory quotient of 1 vs. 0.7 for fat)
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old age does what to the oxy-hemoglobin saturation curve
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left shift
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what is a known complication of PA catheter placement: mural thrombus or RBBB
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RBBB
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Correction of hyponatremia should be done by raising serum sodium by ___ mEq/L/h
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1
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heparin binds to
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AT III
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what three vitamin or mineral deficiencies are associated with retarded wound healing?
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A, C, Zinc
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Pt on TPN experiences hyperglycemia, what two mineral deficiencies could be at fault?
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chromium (insulin cofactor), manganese (cofactor of metabolism)
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phenylephrine stimulates only __ receptors
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alpha
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glascow coma score is made up of motor response, verbal response and ___
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eye opening
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actinic keratosis turns into squamous carcinoma, tx is excision. Do you include radiation, chemo, or just make sure margins are clear
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margins
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Bowen's disease is intraepithelial squamous cell carcinoma. Do excision with clear margins. Then include sentinal node bx?
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nah just good margins
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what is the most common malignancy in caucasians
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basal cell carcinoma
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what is congenital nevocellular nevi?
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found in 1/100 live births and has a 3-5% lifetime risk of undergoing malignant change
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flat ulcer skin lesion with telangiectasias
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basal cell carcinoma
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melanoma with clark level 1 means that it is superficial to the ___
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basement membrane
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chronic draining subcutaneous periareolar abscesses that have been incised and drained many times. What is the tx that will stop them from draining?
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complete excision of the drainage tract
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What is the most common cause of bloody discharge from the nipple?
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intraductal papilloma
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smoking has not been shown to increase the risk for breast cancer?
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true
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breast ca and palpable axillary node, can you do a sentinal node bx?
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no contraindicated
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lumpectomy with a 5 mm tubular cancer, ER and PR positive and a negative sentinel node. What adjuvant tx?
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radiotherapy and hormonal therapy (small lesion less than 1 cm and node negative you can spare chemo)
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2 cm infiltrating carcinoma resected with clear margins, ER and PR positive, 5 of 15 lymph nodes involved? what adjuvant tx?
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chemo, radiation and tamoxifen
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what is usually the ER and PR status in breast ca in preggos
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negative for both
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what is the most common ca in preggos
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breast
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injury to what nerve can cause winged scapula
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long thoracic
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what is the most common distant metastasis site for breast ca?
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bone
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Breast implants in the submuscular plane or the subglandular position have better mammography?
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submuscular
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Breast mass that erodes into skin, which of the following possibilities has the best prognosis after resection:
sarcoma cystosarcoma phyllodes colloid carcinoma infiltrating carcinoma inflammatory carcinoma |
cystosarcoma phyllodes
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If a tracheotomy results in copius amounts of blood, what was most likely transected?
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anterior jugular vein
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pneumonectomy for carcinoma of the lung is contraindicated for which: total atelectasis of the involved lung or PCO2 over 60 mmHg
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hypercarbia
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what is the treatment for tracheal stenosis following prolonged intubation?
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resection of segment of tracheal stenosis
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Pt with MEN has a bone tumor, what is it?
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osteitis fibrosa cystica (brown tumor) from hyperparathyroidism
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lung abscess, what is the first mode of therapy: needle aspiration or abx and vigorous attempts to obtain bronchial drainage
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abx and drainage
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Adenocarcinoma is the predominant malignant lesion in which of the following?
(A) Hard palate (B) Lip (C) Anterior two-thirds of the tongue (D) Larynx (E) Esophagus |
Tumors of the hard palate usually arise from the minor salivary glands. Cancers of the lip, tongue, esophagus, and larynx are often squamous cell carcinoma.
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what would you expect FENa to be if the pt is hypovolemic
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<1%
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how long after an MI should you delay elective surgery?
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6 mos
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what is the biggest risk of surgery in pts with polycythemia vera
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bleeding due to qualitative deficiency of platelets
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what two clotting factors are deficient in banked blood?
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V and VIII
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following abdominal surgery, normal bowel motility returns in the stomach in ___ hrs, small bowel in ___ hrs and the colon in ___
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24 hrs,
4 hrs, 3 days |
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What is the half-life of the most stable clotting factor (VII) and thus the timeframe for FFP for a pt with abnomal coagulation before surgery.
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4-6 hrs
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Dehiscence larger than ___ cm should be re operated on, smaller can be treated with ___
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1-2, abdominal binder
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hemolytic transfusion reaction, tx should include steroids or fluids and mannitol
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fluids and mannitol
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Which enteric fluid is closest to ringers lactate in terms of Na, K, Cl?
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right colon
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what is the pH of lactated ringers? and D5/NS
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6.5, 4.5
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Increased or decreased:
The cardiovascular response to early sepsis is characterized by: ___ cardiac output, ___ systemic vascular resistance, ___ peripheral utilization of oxygen (which yields a ___ arteriovenous oxygen difference). |
increased,
decreased, decreased, decreased |
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Classic clinical criteria for diagnosing ARDS: Hypoxemia that is refractory to oxygen therapy: ratio of PaO2/FIO2 ≤___
Bilateral diffuse pulmonary infiltrates on CXR No evidence of CHF: PCWP ≤__ mm Hg |
200,
18 |
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Crescent-shaped hematoma on head CT is ___
Bi-convex hematoma is ___ If you decided to treat subdural with hyperventilation, diuretics and fluid restriction, why? |
subdural
epidural you are preventing increase in intracranial pressure. you would do evacuation if there was displacement of structures or unequal pupils. |
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trauma pt needs many units of blood. starts bleeding from all sites including IV sites, tx?
what if pt develops hypothermia, coagulopathy and acidosis? |
ffp and platelets
pack bleeding surfaces and close with towel clips |
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"white out" of lung a few days after chest trauma, dx?
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pulmonary contusion
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during a fem-pop bypass a tourniquet is used and some degree of ischemia is expected. what is expected in the patient for several hours after the procedure
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hypotension
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what is the typical transfusion target crit?
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30%
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what would the urine sodium be in a pt with volume depletion?
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< 20 mEq/L
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posterior wall of axillary artery is pierced during placement of axillary block. Which nerve is most likely affected?
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ulnar
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large ill defined epigastric mass that develops several weeks after blunt abdominal trauma and causes early satiety, dx? tx?
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pancreatic pseudocyst, cystograstrostomy
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small caliber gunshot wound to zone III of the neck, small trickle of blood, next step?
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arteriogram
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what is better in postmenopausal women after ER and PR positive tumor resection, estrogen suppression with anastrozole or PR blocking with tamoxifen?
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anastrozole (tamoxifen if premenopausal)
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Sensory fibers of which nerve are in the area of the digastric muscle and can become damaged during manipulation of the area and result in difficulty swallowing due to inhibition of the normal glottal reflex.
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glossopharyngeal (IX)
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which is associated with squamous cell carcinoma of the penis: lack of circumcision or HPV 6?
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lack of circumcision
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what nerve is responsible for winged scapula
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long thoracic
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what is the first dx step in pt with suspected kidney stone, what if stone is suspected to be at the uretovesical junction?
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plain abdominal xray, US (with full bladder)
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hemangioblastomas of the CNS, cysts of the pancreas and kidney and renal cell carcinoma
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Von Hippel Lindau syndrome
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Cavitary lesions in the kidney with history of weight loss and low-grade fever
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secondary TB
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What should be done surgically to a neonate with suspected Hirschsprung's?
|
diverting ileostomy and appendectomy (for tissue to dx aganglionic tissue)
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Pt presents with a solid 3 cm testicular mass that arises from the testical itself, proceed to ___
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radical inguinal orchiectomy (virtually all testicular tumors are malignant)
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clean catch urine in separate alliquots shows blood in first alliquot, suspect ___
|
urethral carcinoma (rare)
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pt develops a fistual after hemigastrectomy and gastroduodenostomy, pt is afebrile with no signs of an acute abdomen, tx should be surgical reconstruction or replace the fluid lost?
|
replace the fluid lost, fistula should close on its own
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pt with a sternal fracture should have what additional study?
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EKG, cardiac contusion
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tx for iliac artery occlusion from a thrombus is which of the following:
dacron proshtetic vascular conduit or fogarty ballon tipped catheter or saphenous vein bypass |
fogarty balloon tipped catheter
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what is first line for mitral stenosis, mitral commisurotomy or replacement
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commisurotomy
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what it is important to do before pneumonectomy for non small cell lung CA
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CT scan of chest and upper abdomen looking for mets
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teenager develops severe colicky left flank pain on first exposure to beer, dx?
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ureteropelvic junction obstruction from congenital narrowing, beer is a diuretic
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what is a more common cause of an intracranial bleed, AVM or berry aneurysm
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berry aneurysm
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Well-contained abscess secondary to ruptured appendix in a stable pt, tx?
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percutaneous drainage, abx, surgery in 6 weeks after risk of infection is reduced
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pt reports swelling and streak of tenderness over left arm, what is this and what CA is associated?
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migratory thrombosis (trousseau's syndrome) pancreatic CA
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colonscopy in toxic mega colon?
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nope (risk of perf)
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Mnemonics for Ranson criteria
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GA LAW at admission
Glucose >200 AST >250 LDH>350 Age>55 WBC>16000 C HOBBS at 48 hrs Calcium <8 Hct drop by > 10% O2 < 60 mmHg BUN > 5 Base deficit >4 Sequestration of fluid >6L |
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CT need bx for pancreatic head mass?
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no needle could seed
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Which is first line for UC, mesalazine or sulfasalazine
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mesalazaine since sulfasalazine has more side effects
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where does urine extravasate in urethral injuries: anterior abdominal wall or perianal region?
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anterior abdominal wall because the fascial layers fuse around the penis and scrotum
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splenic laceration from trauma, mgmt?
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supportive care unless hemodynamically unstable
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Can jaundice develop as a result of cystic duct obstruction?
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yes
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Which has a higher risk of developing colon CA: CA in first degree relative, Gardner's syndrome, Peutz-Jeghers syndrome
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Gardner's
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hot thyroid nodule: FNA or follow
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follow
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What age should pts with FAP and the APC get a colonoscopy and what time interval?
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10, 2-3 years
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Most common causes of lower GI bleeding in descending order are: diverticulosis, ___ and ___
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cancer/polyp, angiodysplasia
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Two things that can cause false negative urease breath test.
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use of PPIs or recent GI bleeding
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what is the typical time frame for drug fever after surgery?
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1-2 weeks
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Pt intubated and tube fills with blood. Next step is: bronchoscopy vs. urgent thoracotomy
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bronchoscopy to visualize and stabilize the bleeding
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When to use DPL vs abdominal CT?
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use DPL for unstable pt
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What increases functional residual capacity more in a postop pt who is desating: inhaled albuterol, elevation of head of bead, decrease opoids?
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elevation of head of bed
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Impaired pain/temp and strength in upper extremities after whiplash, dx?
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syringomyelia (post-traumatic cystic degeneration of spinal cord)
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Three main components of GCS
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eye opening, verbal response, motor response
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solitary pulmonary nodule on CXR: repeat in 2 mos or get chest CT with contrast
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chest CT with contrast
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Nerve in the posterior surface of humerus
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Radial
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Abdominal trauma, CT shows no abnormalities. Pt returns 1 week later with fever, shaking chills, deep abdominal pain.
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Pancreatic laceration not seen on CT develops pancreatic abscess
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Abdominal trauma US shows fluid in spleno-renal angle. Proceed to laparotomy or CT
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CT if hemodynamically stable
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Circumfrential eschar, causes faint pulses and swelling: fasciotomy or escharotomy
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escharotomy and then fasciotomy if no improvement
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volkmann's ischemic contracture is the final sequel of ___
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compartment syndrome (dead tissue replaced by fibrous tissue)
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most likely etiology of fleshy imobile mass of hard palate.
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congenital (torus palatinus) no tx required unless symptomatic
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Traumatic aortic rupture suspected, get: aortogram or spiral CT?
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spiral CT
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Renal failure, respiratory distress and a tight abdomen following abdominal surgery with multiple transfusions, dx?
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abdominal compartment syndrome
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Trigger finger tx other than surgery?
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steroid injections
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impotence after perineal injury is due to: erectile nerve plexus injury or vascular arterial injury
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vascular arterial injury
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Metastatic testicular CA is treated with: antiandrogen meds, radiation or platinum based chemo
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platinum based chemo
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Low implanted ureters seen in girls, uretopelvic junction obstruction is seen with diuretic challenge
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yes
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What size diverticular abscess should be drained percutaneously (CT guided)
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>3cm
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Hypotension and back pain after cardiac cath. Think ___
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retroperitoneal bleeding from an extension of local vascular hematoma is a common iatrogenic complication of cardiac cath. Dx via CT, tx is supportive
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Respiratory quotent is CO2 to O2. The RQ for ___ is around 1.0, ___ is around 0.8 and ___ is around 0.7
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carbs, protein, fat
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Fever, chest pain, leukocytosis and mediastinal widening after cardiac surgery, dx? tx?
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mediastinitis, surgical debridement and abx
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Tx for penile fracture with no blood at urethral meatus?
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retrograde urethrogram followed by surgery
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Tx for non displaced scaphoid bone fracture
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immobilization for 6-10 wks (displaced is surgery)
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