Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
254 Cards in this Set
- Front
- Back
|
Standard biochemical parameters that indicate impairment in the visceral protein mass include a serum albumin of ____ or a serum transferrin of ___
|
less than 3 g/dL or a serum transferrin of less than 150 mg/dL.
|
|
|
What should you do with Ace inhibitors for surgery?
|
should be continued except day of operation
|
|
|
What should you do with Aspirin or clopidogrel (Plavix)?
|
Should be discontinued at least 1 week prior to the planned operation if bleeding is a significant risk or concern; may be continued usually at the discretion of the surgeon
|
|
|
What should you do with Oral anticoagulants (warfarin, coumadin)?
|
Should be discontinued at least 5 days prior
|
|
|
What should you do with diuretics?
|
discontinued day of operation
|
|
|
What should you do with cholesterol lowering meds?
|
discontinued day of operation
|
|
|
what gas is used to sterilize?
|
ethylene oxid
|
|
|
how do you treat diabetics during surgery?
|
Administer subcutaneously, on the morning of the operation, one-third to one-half the patient’s usual dose of long-acting insulin plus one-third to one-half the usual dose of short-acting insulin. This is followed by intravenous infusion of 5% or even 10% glucose at a rate of 100 mL/h preoperatively and intraoperatively. If the operation is prolonged, potassium chloride should be added at a rate of 20 meq/h.
|
|
|
Dressings over closed wounds should be removed on ___
|
the third or fourth postoperative day
|
|
|
Generally, skin sutures or skin staples may be removed by ___
|
the fifth postoperative day and replaced by tapes
|
|
|
What does Cryoprecipitate do?
|
improves platelet aggregation and adhesion and decreases bleeding in uremic patients.
|
|
|
When are Granulocyte transfusions indicated?
|
in severely neutropenic (absolute neutrophil count < 0.5 × 103/μL) patients with bacterial sepsis who have not responded to optimum antibiotic therapy after 48–72 hours
|
|
|
What is a seroma?
|
a fluid collection in the wound other than pus or blood.
|
|
|
Sutures must be placed ___from the wound edge and about ___ apart.
|
2–3 cm. 1 cm
|
|
|
Although wound dehiscence may occur at any time following wound closure, it is most commonly observed between___
|
the fifth and eighth postoperative days,
|
|
|
Atelectasis is usually manifested by ____
|
fever (pathogenesis unknown), tachypnea, and tachycardia.
|
|
|
If needed, heparin can be restarted ___after surgery along with oral anticoagulation.
|
36–48 hours
|
|
|
Ventricular dysrhythmias should be immediately treated with ___
|
lidocaine 1mg/kg
|
|
|
When does postoperative parotitis occur?
|
Second week post op
|
|
|
most postoperative intussusceptions are ____
|
ileoileal or jejunojejunal.
|
|
|
patients with ulcerative colitis and Crohn disease are peculiarly susceptible to ___
|
seizures with loss of consciousness after surgery.
|
|
|
Most overt psychiatric derangements are observed after the ___ postoperative day.
|
third
|
|
|
___is one of the most common causes of fever after the third postoperative day.what are the symptoms?
|
Phlebitis. The symptomatic triad of induration, edema, and tenderness is characteristic.
|
|
|
Fever within 48 hours after surgery is usually caused by ___
|
atelectasis.
|
|
|
Secondary healing occurs in wounds left open through___
|
the formation of granulation tissue and eventual coverage of the defect by migration of epithelial cells.
|
|
|
Intracellular water represents about ___ of total body water.
|
two-thirds
|
|
|
ECF is divided into two compartments:_____ and ___
|
(1) plasma water, comprising approximately 25% of ECF, or 5% of body weight; and (2) interstitial fluid, comprising 75% of ECF
|
|
|
About ___of esophagus are normally below the diaphragm
|
2-4cm
|
|
|
The musculature of the pharynx and upper third of the esophagus is ____the remainder is ___.
|
skeletal in type (striated muscle); smooth muscle
|
|
|
the upper end of esophagus is supplied by ___
|
branches from the inferior thyroid arteries.
|
|
|
The thoracic portion of the esophagus receives blood from the ____
|
bronchial arteries and from esophageal branches originating directly from the aorta.
|
|
|
The mucosal lining of the esophagus consists of ___
|
stratified squamous epithelium that contains scattered mucous glands throughout.
|
|
|
The esophagus has no ___and, for this reason, does not heal as readily after injury
|
serosal layer
|
|
|
What is the gold standard for diagnosing GERD?
|
Ambulatory 24-Hour pH Monitoring=
|
|
|
Esophageal achalasia is a primary esophageal motility disorder characterized by ___
|
the absence of esophageal peristalsis.
|
|
|
What is the primary treatment modality for esophageal achalasia?
|
laparoscopic Heller myotomy and partial fundoplication
|
|
|
What has Radiologic evidence of tertiary contractions (corkscrew esophagus)?
|
Esophageal spasm
|
|
|
___ is the only test that distinguishes diffuse esophageal spasm from other primary esophageal motor disorders.
|
Esophageal manometry
|
|
|
what is the most common symptom of nutcrackers esophagus?
|
Chest pain
|
|
|
what is characteristic of nutcrackers esophagus?
|
Normal peristalsis but high amplitude and duration
|
|
|
___are the most common benign tumors of the esophagus.
|
Esophageal leiomyomas
|
|
|
On barium swallow, leiomyomas appear as _____
|
a smooth filling defect within the esophageal lumen
|
|
|
The treatment of choice for symptomatic esophageal leiomyomas is
|
laproscopic enucleation.
|
|
|
What is boerhaave syndrome?
|
Spontaneous esophageal perforation
|
|
|
___produces “liquefaction necrosis,” ___produce a “coagulation necrosis”
|
Strong alkali. Acids
|
|
|
Aorta hiatus lies at ___
|
T12
|
|
|
Esophageal hiatus lies at ___
|
T10
|
|
|
Pleuroperitoneal Hernia is ___ hernia
|
Foramen of Bochdalek
|
|
|
Parasternal or Retrosternal is ___ hernia
|
Foramen of Morgagni
|
|
|
What is gas stoppage sign?
|
visceral sensation due to reflex ileus induced by an inflammatory lesion walled off from the free peritoneal cavity, as in retrocecal or retroileal appendicitis. Feeling of fullness that would be relieved by BM
|
|
|
The absence of bile in the vomitus is a feature of ___
|
pyloric stenosis.
|
|
|
What is obstipation?
|
the absence of passage of both stool and flatus
|
|
|
A raised ___level corroborates a clinical diagnosis of acute pancreatitis.
|
serum amylase
|
|
|
Thumbprint” impressions on the colonic wall are noted in about half of patients with ___
|
ischemic colitis
|
|
|
Which ulcer has Epigastric pain relieved by food or antacids?
|
Duodenal
|
|
|
How do you treat ulcers surgically?
|
Vagotomy
|
|
|
What is Billroth I resection versues Billroth II resection?
|
In 1, he proximal remnant may be reanastomosed to the duodenum. In 2, to the side of the proximal jejunum
|
|
|
What is SUBTOTAL GASTRECTOMY?
|
resection of two thirds to three fourths of the distal stomach.
|
|
|
Most gastric ulcers are located ___
|
lesser curvature (most within 6 cm of pyloris)
|
|
|
What are type 1 gastric ulcers?
|
Most common. No evidence of duodenal ulcers.
|
|
|
What are type 2 gastric ulcers?
|
Often with duodenal ulcers. Very close to pyloris. Low association with cancer.
|
|
|
What are type 3 gastric ulcers?
|
Associated with NSAIDs
|
|
|
Hematemesis of either bright-red or dark blood indicates that the source is ___
|
proximal to the ligament of Treitz.
|
|
|
Coffee-ground vomitus is due to ___
|
vomiting of blood that has been in the stomach long enough for gastric acid to convert hemoglobin to methemoglobin.
|
|
|
Most patients with melena (passage of black or tarry stools) are bleeding from ___
|
the upper gastrointestinal tract
|
|
|
What is Hematochezia?
|
passage of bright-red blood from the rectum.
|
|
|
What is early symptom of gastric cancer?
|
vague postprandial abdominal heaviness that the patient does not identify as a pain.
|
|
|
What is diagnostic triad for volvus?
|
1) vomiting followed by retching and then inability to vomit, (2) epi-gastric distention, and (3) inability to pass a nasogastric tube.
|
|
|
___ is a relative contraindication for partial hepatectomy
|
cirrhosis
|
|
|
what is the most common cause of prehepatic jaundice?
|
Hemolysis
|
|
|
what is elevated in acute pancreatitis?
|
Amylase
|
|
|
what is a pancreatic psuedocyst?
|
Pancreatic pseudocysts are encapsulated collections of fluid with high enzyme concentrations that arise from the pancreas. They are usually located either within or adjacent to the pancreas in the lesser sac. Don’t have an epithelial lining (thus called pseudo)
|
|
|
what is diagnostic study of choice for pancreatic psudeocyst?
|
CT
|
|
|
Where does Primary Adenocarcinoma of small bowel usually occur?
|
in proximal jeunum
|
|
|
What are contributing factors for toxic megacolon?
|
inflammation involving the muscular coats, hypokalemia, opioid use, anticholinergic use, or barium enema examination.
|
|
|
How do you diagnose toxic megacolon?
|
Plain abdominal x ray or barium enema
|
|
|
What is Charots triad and what does it help diagnose?
|
ascending cholangitis fever, RUQ pain, and jaundice
|
|
|
What is Reynolds pentad?
|
hypotension and mental status changes in addition to charots triad
|
|
|
What is child turcotte pugh classification used for?
|
Liver failure
|
|
|
what does ransons criteria tell you about?
|
Severity of pancreatitis
|
|
|
what is courvoisier’s sign?
|
Palpable non rtender gallbladder in patient with jaundice. Pancreatic carcinoma
|
|
|
what helps distinguish between small nad large bowel obstructions?
|
Large have haustral markings
|
|
|
what is most common site for volvus?
|
Sigmoid colon
|
|
|
what is most common lung cancer seen in non smokers?
|
Adenocarcinoma
|
|
|
lead pipe deformity= ___
|
ulcerative colitis
|
|
|
bird beak deformity= ___
|
achalasia
|
|
|
most common cause of incisional hernia?
|
Deep wound infections
|
|
|
what is triad for reactive arthritis?
|
Urethritis, arthritis, and conjunctivitis
|
|
|
what is the primary source for metastatic bone disease in men?
|
Prostate cancer
|
|
|
___released during anesthesia and surgical stress, promotes ___.
|
ADH, water conservation by the kidneys
|
|
|
Barrats esophagus is the Replacement of normal ___ with ___.
|
squamous epithelium. intestinal columnar epithelium.
|
|
|
Barrets predisposes to development of ___
|
adenocarcinoma
|
|
|
What is Achalasia?
|
degeneration of the intramural myenteric plexus neurons by an unknown etiology
|
|
|
What does Esophageal manometry with achalasia show?
|
elevated LES pressure, incomplete relaxation of LES with swallowing.
|
|
|
Mallory wise tear is Post retching, post emesis longitudinal mucosal tear of the ____ near the ___
|
stomach near the GE junction.
|
|
|
Of Mallory wise tears, half are caused by ___ and the other half ___
|
alcoholics and hiatal hernias
|
|
|
balloon devices are only used in ___ which are ___
|
esophageal varices which are painless
|
|
|
what will stop a majority of the bleeding with Mallory weise tears?
|
Water lavage
|
|
|
what is Boerhaave’s Syndrome?
|
Postemetic esophageal rupture from increased intraluminal pressure.
|
|
|
Esophagus doesn’t have ___ so it is more ___
|
serosa so is more likely to perforate
|
|
|
Where is boerhaave’s syndrome most commonly seen?
|
posterolateral aspect of the esophagus above the GE junction.
|
|
|
What are symptoms of borhaave’s?
|
pain postemesis which may radiate to the back. May see L pneumothorax, L pleural effusion, fever, tachypnea, widened mediastinum on CXR, Hammans sign
|
|
|
What is hammans sign?
|
mediastinal crunch- heart beating against air filled tissues
|
|
|
How do you treat boerhaave’s?
|
surgery w/i 24 hours to drain the mediastinum, close the perf, and place a patch. IVabx
|
|
|
What is calots node?
|
part of Calots triangle. Important site of metastasis.
|
|
|
Need to be aware of the ___as it is often mistaken for the ___because of its proximity to Calot’s triangle
|
R hepatic artery. cystic artery
|
|
|
What is calot’s triangle?
|
Cystic duct, Common hepatic duct and Cystic artery.
|
|
|
What are Ducts of Luschka?
|
small ducts which drain bile directly into GB from liver
|
|
|
What is bile?
|
mix of cholesterol, lecithin, bile acids and bilirubin.
|
|
|
Where is bile reabsorbed?
|
ileum
|
|
|
What is Cholecystokinin (CCK)?
|
It stimulates GB to empty, opens ampulla of vater, relaxes sphincter of Oddi, slows gastric emptying.
|
|
|
What makes cholecystokinin?
|
duodenal mucosal cells
|
|
|
At what level do you see jaundice?
|
Billiruben over 2.5
|
|
|
Where is jaundice first seen?
|
Under tongue
|
|
|
What are symptoms of obstructive jaundice?
|
jaundice, dark urine, clay colored stools, itching (bile salts attempting to be excreted through skin), loss of appetite and nausea.
|
|
|
What makes pigmented stones more common?
|
seen more often in cirrhosis and hemolysis
|
|
|
What is Choledocholithiasis?
|
gallstones in CBD
|
|
|
What is Cholangitis?
|
inf of biliary tract
|
|
|
What are symptoms of cholangitis?
|
Charcot’s Triangle
|
|
|
What is charcot’s triangle?
|
Jaundice, Fever, Chills (“shivering”)
|
|
|
What do you add to charcot’s triangle to make pentad?
|
Confusion and Hypotension
|
|
|
What is biliary obstruction?
|
Intrahepatic usually from stasis as bile excretion
|
|
|
What is extrahepatic obstruction?
|
occurs within the ducts or secondary to external compression. Gallstones are most common
|
|
|
What does extrahepatic obstruction cause?
|
eventual conjugated hyperbilirubinemia
|
|
|
What does primary sclerosing cholangitis cause?
|
Intrahepatic obstruction
|
|
|
What is extraductal obstruction?
|
compression of ducts
|
|
|
What is courvosier sign?
|
Palpable gallbladder
|
|
|
What are labs for extrahepatic and intrahepatic?
|
bilirubin, alk phos (extrahep increased 3x beyond normal, intrahep just elevated)
|
|
|
What is ERCP?
|
endoscopic Retrograde ChoangioPancreatography
|
|
|
What is MRCP?
|
Magnetic resonance cholangiopancreatography is a noninvasive way to visualize the hepatobiliary tree. It takes advantage of the fact that fluid (eg, that found in the biliary tree) is hyperintense on T2-weighted images
|
|
|
What incision is used for lap chole?
|
Kochlar incision
|
|
|
What is clipped in lap chole?
|
Cystic artery and cystic duct
|
|
|
What are some Indications for a cholangiogram in lap chole procedure?
|
Jaundice, Pancreatitis, Dilated cystic duct, Ductal Injury, Many small stones
|
|
|
What is elevated with pancreatitis?
|
Elevated amylase/lipase
|
|
|
What causes pacreatitis?
|
I GET SMASHED: Idiopathic, Gallstones, EtOH, Trauma, Scorpion bite (!!), Mumps, Autoimmune, Steroids, Hyperlipidemia, ERCP, Drugs (HCTZ)
|
|
|
What is a pancreatic psuedocyst?
|
localized fluid collections that are rich in amylase and other pancreatic enzymes, that have a nonepithelialized wall consisting of fibrous and granulation tissue, and that usually appear several weeks after the onset of pancreatitis.
|
|
|
How do you treat pancreatic psuedocysts?
|
Need 6 weeks to mature from a phlegmon to gain a wall thick enough to manipulate. Need to watch for 6 weeks, about 50% will spontaneously resolve. In large pseudocysts (>6cm open operative drain). May then need pancreatic cyst-jejunostomy roux en y, pancreatic cyst-gastrostomy all with a CCY in all operations.
|
|
|
What are symptoms of pancreatic psuedocyst?
|
continuous abdominal pain following pancreatitis, may see jaundice.
|
|
|
What is Roux-En-Y?
|
Limb of jejunum that is used to drain bile, the pancreas or the stomach.
|
|
|
What is test of choice and can determine resectability of a adenocarcinoma of pancreas?
|
endoscopic ultrasound
|
|
|
What do all diagnostic modalities do with adenocarcinoma of pancreas?
|
Underestimate extent of disease
|
|
|
What is Whipple?
|
Pancreaticoduodenectomy
|
|
|
What is symptom of pancreatic fistula?
|
Sterrorhea bc there are no enzymes to break down fats
|
|
|
What is main cause of bowel obstruction?
|
Adhesions
|
|
|
What is a gallstone ileus?
|
large gallstone eats though gb and into duodenum where it travels and eventually gets stuck
|
|
|
How is SBO different than ileus?
|
ileus is lack of peristalsis
|
|
|
What is the most common cause of small bowel ileus?
|
Post surgical
|
|
|
Where is most common area for diverticultis?
|
Sigmoid colon
|
|
|
What is false diverticulum?
|
does not contain all three layers, missing the outer serosal layer
|
|
|
How do you treat diverticulitis?
|
initially abx to cover E.coli and bacteroides = Cipro+Flagyl. Clear liquids. If present again, similar treatment until healthy, then resection.
|
|
|
Where do upper GI bleeds occur?
|
Proximal to ligament of treitz
|
|
|
Right colon cancer causes ___ whereas left colon cancer causes ___
|
right= anemia. Left=obstruction
|
|
|
What type of Volvulus is most common?
|
Sigmoid
|
|
|
Describe CT for colonic volvus.
|
Beak sign
|
|
|
How do you treat colonic volvus?
|
Need to resect because there is a high likelihood of another recurrence.
|
|
|
How do you treat cecal volvus?
|
CANNOT decompress. Can resect with an anastomosis or perform a cecopexy in which the cecum is sutured down, or the appendix is removed and the associated scarring will tie down the cecum in place.
|
|
|
Who gets colonic volvus versus cecal volvus?
|
Colonic= usully older. Cecal= middl aged
|
|
|
What is The most common type of hernia in both men and women?
|
Inguinal hernia
|
|
|
__ inguinal hernias are usually large, located often in the scrotum and can sometimes be asociated with a hydrocele
|
indirect
|
|
|
what is an indirect hernia?
|
always congenital! appear in young children, often Inguinal. Hernia is lateral to epigastric vessel. Seen in women (because of the wider pelvis). Passes through inguinal ring
|
|
|
what is a direct hernia?
|
acquired from muscle weakening. Inguinal is most common. Hernia is medial to epigastric vessel. Pass through Hesselbach’s triangle.
|
|
|
What is hesselbach’s triangle?
|
: inferior epigastric vessels, inguinal ligaments and rectus abdominis.
|
|
|
What are borders for femoral hernia?
|
boundaries include the superior inguinal ligament, coopers ligament with the vein being the lateral border (NAVHernia going lat-med).
|
|
|
Who gets femoral hernias more?
|
Women
|
|
|
Which do women get more: femoral or inguinal?
|
Inguinal
|
|
|
A bulge felt below the ___is consistent with a femoral hernia
|
inguinal ligament
|
|
|
__ is the most common cancer in the intestinal tract
|
Adenocarcinoma
|
|
|
where is adenocarcinoma most commonly seen?
|
ileus and in the appendix.
|
|
|
Where is most common sites for mets for adenocarcinoma of intestinal tract?
|
Liver
|
|
|
What are the three symptoms of adenocarcinoma of intestinal tract?
|
FDR. Flushing, Diarrhea, Respiratory
|
|
|
Antrum/Duodenal Ulcers that perforate anteriorly → cause ___
|
air in the abdomen
|
|
|
Antrum/Duodenal Ulcers that perforate posteriorly → cause ___
|
bleeding (close to vessels)
|
|
|
What is Bilroth I?
|
the pylorus is removed and the proximal stomach is anastomosed directly to the duodenum
|
|
|
What is Bilroth II?
|
Indicated in refractory PUD. The greater curvature of the stomach is connected to the first part of the jejunum in a side-to-side manner.
|
|
|
Where do gastrinomas usually occur?
|
duodenum or pancreas
|
|
|
What is Esophageal Atresia?
|
a congenitally interrupted esophagus.
|
|
|
What are symptoms of esophageal atresia en utero?
|
Polyhydraminos
|
|
|
What is Omphalocele?
|
an anterior abdominal wall defect at the base of the umbilical cord, with herniation of the abdominal contents.
|
|
|
What is Gastroschisis?
|
Most cases of gastroschisis involve the intestine and other abdominal organs herniating through an opening in the abdominal wall and spilling out into the amniotic fluid around the fetus.
|
|
|
Where are most gastroschisis found?
|
To right of umbilicus
|
|
|
How is gastroschisis different than omphalocele?
|
Differentiated from an omphalocele in that is does not have a peritoneum covering.
|
|
|
How do you treat gastroschisis?
|
Cillenti bag placed over the herniated contents.This is a spring-loaded silastic (silicone plastic) pouch which slowly and gently pushed back down into the abdomen
|
|
|
Describe Chromic sutures.
|
Absorbable in about 2 weeks
|
|
|
Describe vicryl sutures
|
Absorbable in appx one month. The longer time frame allows for the tissue surrounding to heal naturally by the time the sutures dissolve.
|
|
|
Describe silk sutures
|
Nonabsorbable. Not used in sites of active infection or possible infection as they can frequently cause stitch granuloma.
|
|
|
Describe nylon sutures
|
Nonabsorbable. Used for superficial lacerations- ie face, fingers, etc.
|
|
|
Usually inner serosa=___ sutures, then outer=___ sutures
|
inner=chromic/vicryl, then outer- silk/nylon
|
|
|
When do you see toxic megacolon?
|
in UC of Cdiff colitis
|
|
|
What is most vulnerable to perforation with toxic megacolon?
|
Cecum
|
|
|
How do you treat toxic megacolon?
|
Antibiotics and if unresponsive, total colectomy
|
|
|
What is wilms tumor?
|
a tumor affecting a kidney (unilateral) seen primarily in children
|
|
|
What are symptoms of wilms tumor?
|
dull back ache,ascities, F/N/V, hematuria usually present.
|
|
|
How do you diagnose wilms tumor?
|
Lump felt on PE. Biopsy is typically NOT done as it risks a spread
|
|
|
What is in the epidermis?
|
mostly keratinocytes: T-B stratum, basale, sinous, granular, corneum
|
|
|
What is in the dermis?
|
fibroblasts, collagen and elastin, blood, lymph, nerves
|
|
|
What is in the Sub Q?
|
fat
|
|
|
How much fluids do you give?
|
1st 10kg=100ml/kg, next 10=50ml/kg, rest=20ml/kg
|
|
|
Any volume excess is typically in ____
|
the 3rd space seen in PO day 3 as pulmonary edema (s3 gallop)
|
|
|
Most common fevers in first week are
|
1)Inf (40%) 2) UTI (30%) 3) Pneumonia (12%)
|
|
|
When does wound infection as cuase of fever usually occur?
|
POD5
|
|
|
What causes necrotizing fasciitis?
|
Clostridium perfringens, Group A Hemolytic Strep
|
|
|
When do you most often see malignant hyperthermia?
|
in inhaled anesthetics
|
|
|
How do you treat malignant hyperthermia?
|
Dantrolene (Dantrum)
|
|
|
When should you use Transfusions in attempts to raise hematocrit levels or to replace after acute blood loss?
|
In postoperative patients Hgb<8 or Hgb<10 but symptomatic.
|
|
|
Portal vein is formed by ___
|
splenic and SMveins
|
|
|
IMV drains into ___and the left gastic drains into___. ___supplies the liver
|
the splenic vein. the portal vein. The portal vein divided into R and L
|
|
|
What causes prehepatic hypertension?
|
splenic thrombosis (avm of spleen)
|
|
|
What causes intrahepatic hypertension?
|
presinusoidal (viral hepatitis, primary biliary cirrhosis) sinusidal (alcoholic cirrhosis) post sinusoidal (veno-occlusive disease)
|
|
|
What causes extrahepatic hypertension?
|
budd chiari, pericarditis, tricuspid insufficiency
|
|
|
What Accounts for ⅓ of all cirrhosis deaths and mostly likely cause of upper GI bleed in cirrhotic patients?
|
Variceal Bleed
|
|
|
Where is most common location of undescended testicle?
|
Inguinal canal
|
|
|
What is most common renal mass in infancy?
|
Congenital mesoblastic nephroma
|
|
|
What is the most common renal tumor of childhood?
|
Wilms tumor
|
|
|
What is Ogilvie’s syndrome?
|
Acute massive dilation of cecum and ascending and transverse colon without organic obstruction
|
|
|
What is the most common stologic type of bladder cancer?
|
Transitional cell carcinoma
|
|
|
How do you best treat carcinoma in situ of the bladder?
|
Immunotherapy with intravesical bacillius calmee Guerin
|
|
|
What is most common cause of male infertility?
|
Varicocele
|
|
|
What is the most common non bacterial cause of pneumonia in transplant patient?
|
CMV
|
|
|
__ is leukocyte sharing between graft and the recipient so that the graft becomes a genetic composite of both the donor and the recipient
|
chimerism
|
|
|
what is the most common disease requiring a liver transplant?
|
Hepatitis C
|
|
|
what is cystic hygroma?
|
Congenital malformation with a predilection for the neck. Benign lesion that usually presents as soft mass in lateral neck
|
|
|
what is type A aortic dissection versus type B?
|
type A begins in ascending aorta and may continue to descending. Type B only occurs in descending
|
|
|
what are the most common causes of aortic stenosis?
|
Congenital abnromalites and calcific (degenerative) disease
|
|
|
what is surgical treatment for UC?
|
Total colectomy with ilioanal pouch anestomosis
|
|
|
what is chvostek’s sign?
|
Spasm of facial muscles caused by tapping of facial nerve trunk
|
|
|
what is trousseaus sign?
|
Carpal spasm elicited by occlusion of brachial artery for 3 mins with blood pressure cuff
|
|
|
what od chvosteks sign and trousseaus sign indicate?
|
Hypocalcemia
|
|
|
what are the surgical correctable causes of hypertension?
|
1)renovascular HTN 2) pheochromocytoma 3) cushings 4)primary hyperaldosteronism 5) coartation of aorta 6) unilateral renal parenchymal disease
|
|
|
what is the most commonly injured facial nerve branch during parotidectomy?
|
Ramus marginalis mandibularis
|
|
|
what are the micororganisms for artherosclerosis?
|
Chlamydia pneumonia, h pylori, strep, and bacillisu typhosus
|
|
|
what is average expansion rate for abdominal aorta?
|
0.4cm/yr
|
|
|
how does heparin work?
|
Binds to antithrombibn III making it more active
|
|
|
what has the highest potassium concentration?
|
Saliva
|
|
|
basic caloric expenditure equals ____
|
25 kilocalories/kg/day with at least 1 g protein/kg/day
|
|
|
maximal glucose infusion rates in parenteral formulas should not exceed ___
|
5 mg/kg/min
|
|
|
refeeding syndrome causes decreased ___ levels
|
serum phosphorus, potassium, calcium, and magnesium
|
|
|
___ is most common amino acid found in muscle and plasma
|
glutamine
|
|
|
what is formula for cardiac output?
|
HR X SV
|
|
|
what is normal cardiac output?
|
5-6 L/min
|
|
|
what is kehr’s sign?
|
Concurrent left upper quadrant and left shoulder pain. Indicates diaphragmatic irritation from a ruptured spleen or subdiaphragmatic abcess
|
|
|
rebound tenderness implies ___
|
peritoneal inflammation
|
|
|
what are clinical indicators for baillar skull facture?
|
Periorbital ecchymosis and battles sign (mastoid ecchymosis)
|
|
|
what defines a penetrating neck wound?
|
Violation of the platysma
|
|
|
what is the most common manifestation of blunt myocardial injury?
|
Arrhythmia
|
|
|
what is becks triad?
|
Hypotension, distended neck veins, and muffled heart sounds
|
|
|
what supplies blood flow to liver?
|
Hepatic artery (30%) and portal vein (70%)
|
|
|
what is pringles maneuver?
|
Used to reduce liver hemmorage. Manual occlusion of hepatoduodenal ligament to interrupt blood flow to liver
|
|
|
splenectomy significantly decreases ___
|
igM
|
|
|
90% of trauma fatalitesresulting from pelvic fractures are the result of ___
|
venus bleeding and bone oozing
|
|
|
posterior knee dislocations are associated with ___ injuries and are indications of ___
|
popliteal artery injuries. Angiography
|
|
|
___ indicate splenic vein thrombosis and are indication for ___
|
isolated gastric varices with hypersplenism. Splenectomy
|
|
|
what is curshings ulcer?
|
Stress ulcer found in critically ill patients with CNS injury. Typically single and deep and have tendency to perforate.
|
|
|
What is curlings ulcer?
|
Stress ulcer found in critically ill patient with burn injuries
|
|
|
What is a marginal ulcer?
|
Ulcer found near the margin of gastroenteric anastomsosi. Usually on small bowel side.
|
