MTB - Surgery (Part 1 of)

ash23mandy's version from 2015-09-08 07:23

Section 1

Question Answer
if the pt is under 35 yeas old with NO history of cardiac dz, what pre-op test do you need?EKG only!
if pt has hx of cardiac dz (regardless of age), what pre-op test(s) do they need?1) EKG 2) stress test for ischemic coronary lesions 3) echo to assess EF
how long must pt quit smoking prior to surgery?6-8 weeks (can use nicotine patch to help)
if pt is on dialysis, when should they be dialyzed prior to surgery??24 hours prior to sx
whats the best way to maintain airway in pts with NO facial trauma?orotracheal tubes
whats the best way to maintain airway: in its with facial trauma? cricothyroidotomy
whats the best way to maintain airway: with cervical spine injuryorotrachial tube WITH flex bronchoscopy
name the 4 SIRS criteria (2 or more indicates SIRS)1) body temp <36 or >38 2) HR > 90 bpm 3) RR >20 or PCO2 <32 mmHg 4) WBC <4000 or >12,000
signs and symptoms of: hypovolemic shock and cariogenic shockpale and cool
signs and symptoms of: cariogenic shocjpale and cool
signs and symptoms of: neurogenic shockwarm
signs and symptoms of: septic shockwarm and faint
whats the tx for neurogenic shock?fluids and pressors

Section 2

Question Answer
what are 2 causes of cullers sign (bruising around umbilicus)?1) hemorrhagic pancreatitis 2) ruptured AAA
what is grey turners sign?bruising in flank d/t retroperitoneal hemorrhage
whats kehr sign?pain in left shoulder...caused by splenic rupture
what causes kehr sign?splenic rupture
what causes balance sign (dull percussion on left and shifting dulness on right)?splenic rupture
what does free air under the diaphragm indicate?bowel perforation
EKG shows electrical alternanspericardial tamponade
whats the diagnostic test for pericardial tamponade?echo
whats the tx of ischemic bowel disease?IV NS and sx to remove necrotic boewl

Section 3

Question Answer
site of referred pain from: MIleft chest, jaw, left arm
site of referred pain from: cold foods/ice creambrain freeze 2/2 to rapid temp changes of sinuses
site of referred pain from: gallbladderright shoulder/scapula
site of referred pain from: pancreasback pain
site of referred pain from: pharynxears
site of referred pain from: prostatetip of penis/perineum
site of referred pain from: appendix LLQ
site of referred pain from: esophagussubsternal chest pain
what is harman sign? what is it a/w?harman sign = crunching heard upon palpation of thorax d/t subQ ephysema
full thickness tear thru esophagusBoerhaave syndrome (think of ALCOHOLIC)
MUCOSAL tear in esophagusmallory weiss tear (its NOT a perforation)
difference btw boerhaave syndrome vs. Mallory Weiss tearBoerhaave syndrome: full thick tear thru esophagus. Location is left posteriolateral aspect of distal esophagus. Malloy-Weiss tear: mucosal tear at GE junction
whats the best diagnostic test for boerhaave or mallory weiss?esophogram with gastrografin (NOT barium) = will show leakage of contrast outside of eosphagus
whats a bad complication of esophageal perforation and reason why they need to go to the OR stat!mediastinitis! since has high mortality rate
whats the most common cause of esophageal perforation?upper endoscopy

Section 4

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