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DU PA Surg final red
Duke PA Surgery Final The Red Stuff
| Question | Answer |
|---|---|
| where does atherosclerosis and PVD typically occur | at bifurcations |
| diabetics will often have ABI >1 due to __ | calcified noncompressible vessels |
| patients with lower extremity amputations are at high risk of death from __ | MI |
| above the knee amupation is contraindicated if __ | below the knee amputation is possible |
| symptoms that occur with blockage in the vertebrobasilar arterial distribution | diplopia, syncope, vertigo, dizziness |
| symptoms that occur with blockage in the vertebrobasilar arterial distribution do not occur with __ | carotid artery disease |
| the test of choice for carotid artery disease | duplex scanning |
| what is duplex scanning | combination of ultrasound and pulsed wave doppler |
| leading cause of postop death in CEA | cardiac complications |
| indication for AAA repair | any patient with >5cm diameter without increased operative risk or other pathologic process which decreases life expectance |
| five P's of acute arterial occlusion | pain, pallor, pulselessness, poikilothermia, paresthesias/paralysis |
| what is the management of 75% of symptomatic carotid stenosis | CEA (carotid endarterectomy) |
| risk factors for atherosclerosis | smoking, HTN, diabetes |
| cause of amaurosis fugax | embolization via retinal artery |
| is a transient monocular visual loss | amaurosis fugax |
| treatment of AAA rupture | surgery |
| treatment of lower extremity rest pain | angiogram and bypass surgery |
| treatment of stable claudication | lifestyle modification |
| to be considered stable angina it must be unchanged in pattern for __ | four to six weeks |
| to be unstable angina it must be | new onset, angina at rest, crescendo angina, not associated with exertion |
| what do you do if there is left main coronary artery disease | perform a CABG |
| when selecting conduits for CABG remember that the __ is best with 90-95% 10yr patency | internal mammary |
| in aortic stenosis do valve replacement if there are __ | symptoms, gradient >50mm Hg and AVA <.75 cm2, LV function |
| late symptoms of aortic insufficiency | water hammer pulse and widened pulse pressure |
| ausculatory finding in mitral stenosis | opening snap and apical crescendo with diastolic rumble |
| best screening test for aortic dissection | TEE (transesophageal echocardiography) |
| when selecting conduits for CABG __ can be used and has a 54% 10 year patency | saphenous vein |
| 75% of cardiac tumors are benign and diagnosed with | echo |
| pericarditis is diagnosed with | echo |
| MRI's are not best for __ | defining anatomy |
| atrial septal defect may present with __ and have heart failure | systolic murmurs |
| VSD presents with __, heart failure and is frequently seen in infancy | holosystolic murmur |
| AV septal defect can cause right sided congestion which may lead to | hepatomegaly |
| patent ductus arteriosus presents with __ | continuous precordial murmur(machinery) |
| what is truncus arteriosus | when a single trunk form heart supplying systemic and pulmonary circulation as well as a VSD |
| in the case of truncus arteriosus the associated VSD will present with | systolic thrill, and prominent apical pulse |
| what is tetrology of fallot | pulmonary stenosis, VSD, overriding aorta, and RV hypertrophy. |
| how will tetrology of fallot present | a harsh systolic precordial murmur |
| coarctation of the aorta presents with | differential HTN and pulses |
| mitral valve diseases are __ | very rare |
| what can you ad to lidocaine injection to decrease some of the pain | sodium bicarbonate |
| what is the concern when using local anesthetics | neuro and cardio toxicity |
| what is a felon (don't say someone who commits a felony) | an infection of the terminal phalanx |
| what can a felon cause | osteomyelitis |
| what is the most important factor when deciding to close a wound | the age of the wound |
| generally don't close a wound that is >__hours old | 24 |
| 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 |
| how do you begin to treat rotator cuff tendonitis | physical therapy and NSAIDS |
| 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 |
| 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 |
| what is the single most sensitive and specific exam finding for a rotator cuff tear | weakness with resisted external rotation and or abduction |
| most important divider in the cranium | tentorium |
| supratentorial tumors have __ potential | seizure |
| neurosurgery study of choice for establishing diagnosis | MRI |
| study of choice to check for mets | CT of chest, abdomen, pelvis |
| what is medically intractable epilepsy | requires that a patient has failed two medications |
| surgery offers up to an__% cure rate for epilepsy | 85 |
| most common surgery to cure epilepsy | temporal lobectomy (non-dominant lobe) |
| __ test is used to determine risk to language centers when doing brain surgery | WADA |
| 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 |
| __ may block arachnoid villi causing hydrocephalus and associated with aneurysm | subarachnoid hemorrhage |
| subarachnoid hemorrhages are classified by __ | fisher and hunter scales |
| growth of teh skull is driven by | growth of the brain |
| 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 |
| myelomeningocele is associated with __ and is a surgical emergency best when a planned c-section is done | hydrocephalus |
| one of the most important cytokines is | IL-2 |
| what are the two pathways of allogenic recognition | direct and indirect |
| there are different types of drug for __, use a different one in the OR vs what is used for maintenance | immunosuppression |
Created by:
bwyche
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