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General Surgery Rotation exam with correct solutions
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General Surgery Rotation exam with correct solutions
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General Surgery Rotation exam withcorrect solutions
5 W's for postop complicaitons - .......🔷ANSWERS🔶......✔✔ Wind, water, wound, walking,
whooper/wonder drugs
wind (alelectasis) timing and findings - .......🔷ANSWERS🔶......✔✔ FIRST 24-48 hrs postop.
PE: bronchial breathing and shift of trachea toward affected side
water (UTI) timing and findings - .......🔷ANSWERS🔶......✔✔ 48-72 hrs postop
PE: UTI sx, fever, hx of indwelling catheter
wound (infection) timing and findings - .......🔷ANSWERS🔶......✔✔ >72 hrs postop
MC cause of fever during this time pd!
PE: pain at wound site, drainage, erythema, elevation of vitals
walking (thrombophlebitis) timing and findings - .......🔷ANSWERS🔶......✔✔ > 72 hrs post op
PE: indwelling catheters, cellulitic streaking= strep infection; local abscess= staph infection
wonder drugs/whooper (drug fever/abscess) timing and findings - .......🔷ANSWERS🔶......✔✔ > 7
days
PE: persistent fever with neg cultures= drug fever
abdominal abscess= culture that is polymicrobial
STOP questions for obstructive sleep apnea (inc risk of pulmonary comp)
- .......🔷ANSWERS🔶......✔✔ S- snoring
T- tiredness during the day
O- observed apnea
, P- high blood Pressure
Aortic aneurysm/dissection dx - .......🔷ANSWERS🔶......✔✔ U/S is study of choice for AA and for
screening
CT will show bleeding
Thoracic aneurysms may require CT or MRI
Arterial embolism/thrombosis (MC cause and MC location) - .......🔷ANSWERS🔶......✔✔ MC cause
of embolic cerebrovascular accidents= A.fib (80%)
MC location is femoral artery others (iliac arteries, mesenteric arteries, popliteal)
PAD (cause, sx, dx, tx) - .......🔷ANSWERS🔶......✔✔ MC results from atherosclerosis
Sx: weak femoral and distal pulses; claudication, dependent elevation, pain with walking,dependent
rubor, shiny atrophic skin, loss of hair
Dx: angiography is GOLDSTANDARD; doppler or ABI (<.9=significant dz)
Tx: antiplatelet (aspirin, clopidogrel), sx relief use Cilostazol (vasodilatory effect)
Peripheral vascular disorders - .......🔷ANSWERS🔶......✔✔ peripheral arterial disease
varicose veins
thrombophlebitis/ DVT
chronic venous insufficiency
Acute arterial occulusion sx (PAD) - .......🔷ANSWERS🔶......✔✔ pain, pallor, pulselessness,
paresthesias, poikilothermia, and paralysis
vericose veins tx - .......🔷ANSWERS🔶......✔✔ compresssion sclerotherapy for smaller vessels
surgical stripping for larger vessles (saphenous)
Venous stasis ulcers (location and tx) - .......🔷ANSWERS🔶......✔✔ MC location= just above ankle
Tx: stockings and skin grafting
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