Duke PA Surgery Final The Red Stuff
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| where does atherosclerosis and PVD typically occur | at bifurcations
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| diabetics will often have ABI >1 due to __ | calcified noncompressible vessels
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| patients with lower extremity amputations are at high risk of death from __ | MI
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| above the knee amupation is contraindicated if __ | below the knee amputation is possible
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| symptoms that occur with blockage in the vertebrobasilar arterial distribution | diplopia, syncope, vertigo, dizziness
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| symptoms that occur with blockage in the vertebrobasilar arterial distribution do not occur with __ | carotid artery disease
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| the test of choice for carotid artery disease | duplex scanning
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| what is duplex scanning | combination of ultrasound and pulsed wave doppler
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| leading cause of postop death in CEA | cardiac complications
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| indication for AAA repair | any patient with >5cm diameter without increased operative risk or other pathologic process which decreases life expectance
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| five P's of acute arterial occlusion | pain, pallor, pulselessness, poikilothermia, paresthesias/paralysis
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| what is the management of 75% of symptomatic carotid stenosis | CEA (carotid endarterectomy)
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| risk factors for atherosclerosis | smoking, HTN, diabetes
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| cause of amaurosis fugax | embolization via retinal artery
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| is a transient monocular visual loss | amaurosis fugax
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| treatment of AAA rupture | surgery
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| treatment of lower extremity rest pain | angiogram and bypass surgery
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| treatment of stable claudication | lifestyle modification
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| to be considered stable angina it must be unchanged in pattern for __ | four to six weeks
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| to be unstable angina it must be | new onset, angina at rest, crescendo angina, not associated with exertion
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| what do you do if there is left main coronary artery disease | perform a CABG
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| when selecting conduits for CABG remember that the __ is best with 90-95% 10yr patency | internal mammary
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| in aortic stenosis do valve replacement if there are __ | symptoms, gradient >50mm Hg and AVA <.75 cm2, LV function
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| late symptoms of aortic insufficiency | water hammer pulse and widened pulse pressure
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| ausculatory finding in mitral stenosis | opening snap and apical crescendo with diastolic rumble
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| best screening test for aortic dissection | TEE (transesophageal echocardiography)
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| when selecting conduits for CABG __ can be used and has a 54% 10 year patency | saphenous vein
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| 75% of cardiac tumors are benign and diagnosed with | echo
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| pericarditis is diagnosed with | echo
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| MRI's are not best for __ | defining anatomy
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| atrial septal defect may present with __ and have heart failure | systolic murmurs
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| VSD presents with __, heart failure and is frequently seen in infancy | holosystolic murmur
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| AV septal defect can cause right sided congestion which may lead to | hepatomegaly
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| patent ductus arteriosus presents with __ | continuous precordial murmur(machinery)
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| what is truncus arteriosus | when a single trunk form heart supplying systemic and pulmonary circulation as well as a VSD
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| in the case of truncus arteriosus the associated VSD will present with | systolic thrill, and prominent apical pulse
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| what is tetrology of fallot | pulmonary stenosis, VSD, overriding aorta, and RV hypertrophy.
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| how will tetrology of fallot present | a harsh systolic precordial murmur
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| coarctation of the aorta presents with | differential HTN and pulses
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| mitral valve diseases are __ | very rare
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| what can you ad to lidocaine injection to decrease some of the pain | sodium bicarbonate
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| what is the concern when using local anesthetics | neuro and cardio toxicity
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| what is a felon (don't say someone who commits a felony) | an infection of the terminal phalanx
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| what can a felon cause | osteomyelitis
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| what is the most important factor when deciding to close a wound | the age of the wound
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| generally don't close a wound that is >__hours old | 24
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| shoulder pain is commonly caused by impingement of the acromion, coracoacromial ligament, AC joint and the coracoid process on __ | underlying subacromial bursa, rotator cuff, and biceps tendon
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| how do you begin to treat rotator cuff tendonitis | physical therapy and NSAIDS
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| what do you do if you are treating rotator cuff tendonitis with physical therapy and NSAIDS and there is no improvement after 4-6 weeks | consider subacromial cortisone injection
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| what do you do if you have been treating rotator cuff tendonitis with subacromial cortisone injection and there is no improvement after 6 weeks | consider arthroscopy with subacromial decompression
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| what is the single most sensitive and specific exam finding for a rotator cuff tear | weakness with resisted external rotation and or abduction
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| most important divider in the cranium | tentorium
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| supratentorial tumors have __ potential | seizure
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| neurosurgery study of choice for establishing diagnosis | MRI
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| study of choice to check for mets | CT of chest, abdomen, pelvis
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| what is medically intractable epilepsy | requires that a patient has failed two medications
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| surgery offers up to an__% cure rate for epilepsy | 85
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| most common surgery to cure epilepsy | temporal lobectomy (non-dominant lobe)
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| __ test is used to determine risk to language centers when doing brain surgery | WADA
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| what is status epilepticus | an emergency when a seizure is ongoing for thirty minutes without stopping, or has multiple seizures in succession without sensorium returning to normal
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| __ may block arachnoid villi causing hydrocephalus and associated with aneurysm | subarachnoid hemorrhage
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| subarachnoid hemorrhages are classified by __ | fisher and hunter scales
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| growth of teh skull is driven by | growth of the brain
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| myelomeningocele is diagnosed on ultrasound by __ and is best treated by adding oranges, apples, and various other fruits to make a tasty salad | lemon sign, banana sign
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| myelomeningocele is associated with __ and is a surgical emergency best when a planned c-section is done | hydrocephalus
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| one of the most important cytokines is | IL-2
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| what are the two pathways of allogenic recognition | direct and indirect
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| there are different types of drug for __, use a different one in the OR vs what is used for maintenance | immunosuppression
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