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  1. number 1 limiting factor prior to surgery
    cardiovascular disease
  2. after an mi, when can u do surgery?
    at 6 months if the pass the stress test
  3. pts with chf, must be managed how prior to surgery?
    must be medically optimized with bb, acei, and spironolactone to decrease mortality
  4. risk factors for surgery?
    • male over 45
    • anything that causes artherosclerosis
    • htn, dm, cholesterol
  5. a patient with heart disease needs what 3 tgests prior to surgery?
    • ekg
    • stress test
    • echo
  6. under 35, no history of dz, what is the only test?
  7. pts with lung disease need to have done what prior to surgery?
    • pft
    • need to quit smoking 8 weeks prior
  8. how is kidney dz managed prior to surgery?
    • hydration
    • dialysis 24 hrs prior
  9. best way to maintain an airway with no facial trauma?
    facial trauma?
    • orotracheal
    • cricothyroidotomy
  10. how do u maintain an airway with a cervical spine injury?>
    orotracheal tube wtih flexible bronchoscopy
  11. if suspecting a perforation, best initial test?
    upright chest xray
  12. URETHRAL trauma, next best step?
    • kub xray
    • retrograde urethrogram
  13. best initial test for acute mesenteric ischema?
    most accurate?
    • ct
    • angiography
    • surgery
  14. what 2 abdominal conditions give pneumatosis intestinalis?
    • necrotizing enterocolitis
    • acute mesenteric enterocholitis
  15. subcutaneous emphesema wchich is cracking and poppin on paplation of clavicles is seen in what condition?
    boerhaave syndrome
  16. most accurate test for a boerhaaves?
  17. most common cause of esophageal perforation?
  18. most common cause of gastric perforation?
  19. PUD occur due to whta?
    • h pylori
    • nsaid
    • stress ucers--cushings or curlings
  20. best initial test for perforation?
    most accurate?
    • xray
    • ct
  21. 2 emergent conditions that have pain that radiates to the back?
    • pancreatitis
    • abdominal aortic aneurystm dissection
  22. what diagnostic tests are avoided in a pregnant woman?
    • xray
    • ct
  23. diagnostic testst for a woman of childbearing age with lower quadrant pain?
    pelvic sono
  24. best and most accurate test for diverticulitis?
  25. rx of diverticulitis?
    • 1st ---antibitocs and bowel rest
    • recurs--resection
  26. most accurate test for appenditicis, pancreatitis, diverticultis?
  27. most accurate test for cholecystitis?
    hida scan
  28. best test for abscess?
  29. distribution of bone tumors from proximal to distal bone?
    • MODE
    • metaphysis--osteo
    • Diaphysis--ewings
  30. best initial test for small bowel obstruction?
    most accurate?
    • xray-fluid air levels and dilated loops
    • ct--dilated parts with contrast
  31. best therapy for trigger finger?
  32. most common type of shoulder dislocatioin?
  33. rx for scaphoid fracture?
    thumb spica cast
  34. rx for dequervian tenosynovitis?
    steroids and a splint
  35. rx for cauda equina?
    surgical decompression
  36. pad vs venous ulcers?
    • pad ulcers--below the ankle
    • venous ulcers--above the ankle
  37. ulcer that appears repeatedly after years of a draining sinus or a burn?
    sqaumous cell carcinoma
  38. management of spinal cord compression?
    steroids and decompression
  39. rx for femur midshaft fracture?
    intermedullary shaft fixation
  40. 4 places where you can loose enough blood to go into a hypovolemic shock?
    • thorax
    • abdomen
    • pelvis
    • femur when it is broken
  41. dyspnea, petechiae around the neck, low po2
    fat embolism
  42. clicking and locking of the knee on flexion and extension?
    meniscal tear
  43. rx for compartment syndrome?
  44. colles fracture?
    distal radial fracture
  45. simple fractures that can be manipulated back into place, this is called?
    closed reduction
  46. shortened leg after a fall?
    broken femur
  47. femoral neck fracture vs intertrochanteric fracture,management?
    • femoral neck--prosthesis
    • intertrochanteric--pinning
  48. primary bone tumors tend to occur in what age group?
  49. therapy for mm?>
    • steroids
    • lanolidomide
  50. rx for clavicle fracture?
  51. posterior shoulder dislocations tend to occur when?
    when all muscle contract as in a seizure
  52. what kind of shoulder dislocation it is when the arm is held medial to the body?
    posterior shoulder disloaction
  53. volkman contracture is caused by what fracture?
    supracondylar fracture--radial artery
  54. name for a fracture involving the growth plate?
    salter harris
  55. genu varum and genu valgum at an early age?
    no problem
  56. club foot rx?
    plaster cast
  57. with supracondylar fractures you need what studies to check for patency of the radial artery/
  58. in kids, hip pathologies may present with what pain?
    knee pain
  59. rx of slipped femoral capital epiphyses?
  60. toddler with fever and hip pain?
    septic arthriis--aspirate and culture
  61. which of these is an surgical emergency?
    congenital hip dysplasia?
    leg parthe calve
    slipped capital femoral epiphyses?
    slipped capital femoral epiphysese
  62. supracondylar fracture of humerous can lead to ?
    avascular necrosis
  63. rx of black widow spider bite vs brown recluse bite?
    • black widow--iv calcium gluconate and antispasmodics
    • brown recluse--resect necrotic tissue
  64. dx of congenital hip dyslpac?
    • ultrasound
    • 3 diapers
    • pavlik harness
  65. blunt trauma to the neck or head?
    ct of head and neck
  66. imaging of spinal cord?
  67. best initial rx for spinal cord injury?
  68. rx for rib fracture/.
    topical anestethic block
  69. rx of tension pneumo?
    rx of spontaneous pneumo?
    • chest tube
    • xray to confirm
  70. rx for hemothorax?
    chest tube to drain blood
  71. 3 bones that are hard to break and only break with bad trauma?
    • 1st rib
    • scapula
    • sternum
  72. injury to trachea or bronchus require intubation how?
    with a bronchoscope
  73. gunshots and stab wounds below where are considered abdominal?
    nipple line
  74. maanagemetn of apatient who is stable with a stab wound?
    put a finger through the whole and see if the peritoneum is intact
  75. blunt trauma to abdomen, next best step when pt is stable?
    not stable?
    • stable--ct of abdomen
    • not stable--ultrasound or peritoneal lavage
  76. patient is schock with broken bones and not responding to fluids?
    immobilize the bones
  77. blunt trauma and hematuria?
    • look at what bones are associated with it
    • if ribs---ct of kidneys
    • if pelvis--retrograe urethrogram for males
    • cystagram for females
  78. complications of kidney blunt trauma?
    • av fistula with heart failure
    • renal stenosis
  79. when do you worry about a bullet in the thigh?
    if its antero-medial in location
  80. crushing injuries of the arm or leg may develop into what?
    compartment syndrome
  81. rx of a chemical burn?
    washi it out
  82. dx of an inhalational injury?
    how do you decide if to treat?
    • bronchoscope
    • looks at abg
  83. circumferential skin burns require wht to allow blood flow?
    surgical echarotomy
  84. urine output in a burn patient per hour?
    1cc/kg /hr
  85. burns require topical?
    silver sulfadiaziene
  86. when are early excision grafts done?
    if a small area is invovled?
  87. if a bit from a dog is provovoked, do you give rabies ivig if the bite is on the hand?
    • hand--observe the dog
    • face--give ivig
  88. management of a bite from a coyote?
    kill the coyote and examine th ebrain from rabies
  89. all bites need at least?
    • cleaning
    • tetanus
  90. rx of snake bite?
    • observe the skin with the bite to see if there is a reaction
    • at the same time five tetanus

    • blood matching on hold
    • venom on hold
  91. can you have pulses in compartment syndrme?
  92. most sensitive test for compartment syndrome?
    pain on extension of wrist or foot
  93. posterior dislocation of humerous and femur has the humeour and femur internally or externally rotated?
    internally rotated
  94. posterior dislocation of the knee poses what problem/
    occlusion of the popliteal artery
  95. most accurate test for carpal tunnel?
  96. best initial therapy ofr carpal tunnel?
    • nsaids
    • splint
  97. when do you not do the surgery when the ef is what?
  98. time from an MI to surgery ideally?
    6 months
  99. with copd , the pft look at what?
  100. rx for malignant hyperthermia?
    • dantrolene
    • cooling blankets
    • hydration
  101. imaging for an abscess?
  102. most MI occur when?
    during or 1 day after surgery
  103. rx of a post srugery mi cannot include what?
  104. when do you put in an ivc filter?
    • if pt is on heparin and the clot reoccurs
    • or if anticoagulation is contraindicated bc of increased bleeding
  105. when is the last time a pt can eat b4 surgery?
    midnight before the surgery or 8 hours before
  106. post up coma and diffusion with not other risks, check what?
  107. rx for ards?
  108. rx for delirium tremens?

    iv etoh
  109. urine output is 0, next best step?
    change catherer
  110. low urine, how to work it up?
  111. electrolyte disorder causing ileus?
  112. what is ogilvie syndrome?
    ileus of the large colon
  113. ogilvie syndrome occurs secondary to what?
    • joint replacement and cabg
    • colonoscopy
  114. wound dehisence?
    close it more securely
  115. rx for an infected wound absecc?
  116. rx for siadh?
    water restriction
  117. what kind of fluid replaces water quickly?
  118. fluids that replace water lost over several days?
  119. rx for hyponatremia?
    • if water gained quickly
    • hypertonic fluid
    • if gained over days?
    • isotonic fluids
    • if gained over weeks?
    • water restriction
  120. rx of dka?
    • fluids and insuling
    • once urinary output is normal, iv K
  121. bile and pancreatic juices are rich in what ?
  122. rx of hypochloremic, hypokalmeic metabolic alkalosis due to loss of h?
  123. most accurate test for gerd?
    24 ph monitoring
  124. difficulty swallowing, best initial test?
    barium swallow
  125. most accurate for esophagus cancer?
  126. best initial test for difficulty swallowing?
    barium swallow--then manometry or endoscoy
  127. choice of test for stomach.?
  128. rx of sbo and lbo?
    • sbo--partial--wait and fluid
    • sbo--complete--surgery
    • lbo--colonoscopy
  129. when do you do ct for appendiciti?
    if the case isnt classic
  130. which polyps are malignant potential?
    • fap--gardners, turcots
    • villous
    • adenomatous polyps
  131. indications for colectomy for uc?
    • long time
    • toxic megacolon
  132. next step in management after a history?
  133. rx of anal fissure?
    dilation of the sphincter--botulinum, nitroglycerin
  134. rx of sqamous cell carcinoma of the rectum?
  135. 75% of gi bleeds occur from?
    upper gi
  136. how do you work up a gi bleed?
    1st rule out an UGIB
  137. diagnosis of lower gi bleed?
    • colonoscopy
    • tagged rbc
    • arteriogram
Card Set:
2013-03-10 23:18:57

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