(Miami Dade College) SURGERY - NMS/Pestana/pretest/lange/uworld study guide Solved and Verified

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-1. signs of a base of the skull fracture 2. cardiac tamponade dx/tx {{Correct Ans- 1. raccoon sign, battles sign, CNS otorrhea, CNS rhinorrhea (CSF fluid can enter mastoid air cells and middle ear/... eustachian tube to nasopharynx) 2. echocardiography**** , tx = pericardial window, pericardiocentesis -blunt aortic tears/great vessel injury 1. CXR 2. dx/tx {{Correct Ans- 1. widened mediastinum, deviated NG tube, depressed left mainstem bronchus, blurring of aortic knob 2. CXR, transesophageal echocardiography, angiography -abdominal trauma assessment1. diagnostic peritoneal lavage - also do ultrasound, CT, {{Correct Ans- 1.1L of saline into the abdominal cavity, positive if >100k RBCs, and >500 wbcs -1. evaluation of urethral injury 2. what is the risk of an unsplinted fracture {{Correct Ans- 1. retrograde urethrography , DON'T PUT IN A FOLEY ***** 2. fat embolization syndrome -revised trauma score components 2. Injury severity score {{Correct Ans- 1. GCS, systolic BP, RR range is 1-8, >40 = 60% survival 2. sum of the squares of 3 highest AIS scores -1. first degree burns 2. second degree burns 3. third degree burns 4. when to hospitalize patients for burns {{Correct Ans- 1. epidermis 2. superficial involves papillary dermis, deep involves reticular dermis 3. involves entire dermis 4. 3rd degree >2% of BSA, partial thickness >10%, or 2nd/third degree on face, hands, feet, genetalia, or major flexion cresases -1. fluid resuscitation by BSA burned 2. required urine output in adults 3. when should burn patient get NG tube {{Correct Ans- 1. % BSA burned * kg * 2-4ml electrolyte-give half the volume over first 8 hours and remaining over second 16 hours 2. 30-50ml/hour--- adjust fluids accordingly 3. burns >25%, BSA or if patient has N/V -1. histology of spleen 2. which diseases involve abnormal splenic sequestration 3. what does the spleen clear from the blood 4. what kind of immunoglobulins are produced by the spleen {{Correct Ans- 1. white pulp - lymphocytes, macrophages, plasma cells red pulp - cords of reticular cells 2. autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura 3. clears cells that have IgG on their surface, and aged/abnormal RBCs 4. IgM in teh white pulp -1. hypersplenism 2. clinical presentation of hypersplenism3. what CBC/bone marrow finding indicates hypersplenism 4. dx of hypersplenism - spleen filters opsonized bacteria {{Correct Ans- 1. exaggerated destruction of rbc/wbc/platelets 2. either anemia (pallor fatigue dyspnea), leukopenia (inc. susceptibility to infection), thrombocytopenia (bruising epistaxis) 3. increased reticulocytes, bone marrow aspirate shows inc. megakaryocytes 4. ultrasound/CT shows size of spleen, + lab findings -1. indications for splenectomy {{Correct Ans- 1. splenic cyst, varicies, spherocytosis, splenic abscess, echinococcal cyst, spleen tumors, -1. primary hyperslenism 2. tx {{Correct Ans- 1. very rare, sequestration of blood elements, may be associated with fevers/infection 2. splenectomy -1. splenic cysts patho 2. tx {{Correct Ans- 1. usually from previous trauma , 2. surgery if they cause pain -1. most common cause of hypersplenism - usually clinically insignificant hypersplenism {{Correct Ans- 1. portal hypertension (2/2 hypertension, cirrhosis, budd chiari, congestive heart failure) -splenic vein thrombosis 1. patho 2. tx {{Correct Ans- 1. pancraetitis --> splenic vein thormbosis --> significant bleedintg from esophageal/gastric varicies 2. splenectomy [Show More]

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