Surgery Ck

mikenakhla's version from 2016-05-21 23:46



Question Answer
• High riding prostate, blood at urethral meatus, inability to void. What is this and what is the first step?posterior urethral injury. Do a retrograde urethrogram
• Isolated duodenal hematoma is seen in kids followingblunt abdominal trauma
• How do you treat isolated duodenal hematomas?conservative tx with NG suction and PTN
• Any penetrating wound below what level is considered to involve the abdomen? What do you do?nipple level (4th intercostal space). Exploratory laparotomy in unstable patients
• Immediate postoperative fever in patient who got transfusion, think thisfebrile nonhemolytic transfusion reaction
• SIRS criteriaTemp over 101.3, pulse over 90, respiratorions over 20, wbc > 12000
• Most common type of hernia overall? Lateral to inferior epigastric vessels and into the scrotum or labiaindirect. Pathophys is patent processus vaginalis defect
• Weakness in abdominal musculature of Hesselbach's triangle cause these herniasdirect, medial to inferior epigastric vessels
• These hernias are more common in women and are more susceptible to strangulationfemoral hernias.
• Symptoms of small bowel obstruction and shock, what do you think of?strangulated hernia causing obstruction and getting necrotic
• Massively distended colon loop under left hemidiaphragm?sigmoid volvulus
• Prevent and treat atelectasis withearly ambulation, incentive spirometry and proper pain control
• Daily fever spikes patient after surgery that doesn't respond to antibiotics?abscess, get a CT then drain it
• Bird's beak on barium enema?volvulus!
• Any gunshot wound through peritoneal cavity? How about wound from sharp instrument?laparotomy. If stable, CT scan, if unstable laparotomy
• Most common cause of immediate death after car accident or a fall from a great height? What does this look like on chest X ray?aortic rupture, widened mediastinum. Do an angiogram or CT scan if they're still alive
• Patients with this infection and splenomegaly should avoid contact sports?EBV
• Management of different neck zone injuries?1 and 3, arteriogram then OR. 2 is immediate OR. If bleeding in neck, all immediately to OR
• What should you do if a tooth is knocked out?put it back and stabilize it, don't clean it. Better prognosis the sooner it's done
• Post op patient with hypotension, jVD, and new onset RBBB and is basically dyingmassive PE
• Impaired cough, shallow breathing, decreased breath sounds at lung bases 2-3 days after surgeryatelectasis
• Abdominal surgery then nausea vomiting, abdominal distention, can't fart or poop and absent bowel sounds on physical exam? What can make this worse?this is a post operative ileus, motile dysfunction basically. IV morphine or other opiates can make it worse because it decreases GI motility
• Treatment of penile fracturesurgical emergency, surgical repair and retrograde urethrogram
• Treatment for urinary retention in the hospital?short term indwelling catheter
• Indications for carotid endarterectomy?if symptomatic, 50-70% stenosis. If asymptomatic, 60 or greater. In women, 70 or greater regardless of symptoms
• Intense pain in surgical wound, decreased sensation at edges of the wound, cloudy/gray discharge, what is this and how do you treatnecrotizing surgical infection, surgical exploration

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