surgery EOR questions with 100% correct answers

surgery EOR questions with 100% correct answers peripheral artery disease intervention - Answer- first line = exercise/walking program and lifestyle changes + aspirin second = pentoxifylline 3rd = percutaneous angioplasty/stenting if it is critical you need to bypass it how to prevent post op a-fib - Answer- a beta blocker!!! patient has mesenteric ischemia, history of pain after eating, poorly localized or diffuse pain out of proportion to physical exam with weight loss and possibly bloody stool - what caused this - Answer- likely A fib, bc MC source is embolus cellulitis treatment if they have a sulfa allergy so cannot use bactrim, and need to save linezolid and vanc for most severe cases - Answer- doxycycline or clindamycin hyperparathyroidism - Answer- stones bones and abdominal groans primary = excessive PTH from the gland and is associated with MENI and II - will have fatigue, depression, memory impairment, sleep disturbances, elevated calcium secondary is due to renal failure or vit. D deficiency - will have hypocalcemia tx of choice for liver cancer - Answer- resection of solitary lesions transplant for unresectable lesions without mets. resection of mets from colon cancer mc type is hepatocellular carcinoma sigmoid volvulus - Answer- pt has abdominal distention, cramps abdominal pain, obstipation, prior occurrence usually have chronic constipation too may see a coffee bean sign on Xray may be an older patient that is bed-ridden (especially if they have dementia or neuropsychiatric impairment) tx is endoscopic detorsion!!! if they have cecal volvulus then tx is emergent resection SBO tx - Answer- if incomplete mechanical obstruction, do NPO, IV ABX for 24 hours if complete do NG decompression or resection if bowel is strangulated bowel wall thickening - Answer- what you see on CT for diverticular abscess on PE of pt with an anal fissure, what else may you see? - Answer- skin tag or sphincter muscle incarcerated hernia - Answer- painful bulge in stomach that will not reduce pt. has nausea, vomiting, may have an obstruction strangulated hernia - Answer- the hernia will be incarcerated and the patient will appear toxic there will be ischemia bowl and severe pain, tenderness, redness of the area with fever wound dehiscence - Answer- separation of the layers of a surgical wound; may be partial, or superficial only, or complete, with disruption of all layers seroma - Answer- accumulation of serum beneath the surgical incision best way to access a pt. receiving dialysis - Answer- AV fistula - take a piece of vein from arm or leg and sew to an artery and allow it to become larger and thicker peritoneal dialysis can be used too subclavian steal syndrome - Answer- pathophys: arm fatigue and vertebrobasilar insufficiency due to obstruction of the subclavian artery - moving that left arm will increase blood flow demand which is met by retrograde flow from the vertebral artery thereby stealing from the vertebrobasilar arteries hx: upper extremity claudication and muscle cramping in the arm due to ischemia, dizzy, vertigo, syncopal attacks, dysarthria, nystagmus, diplopia, blindness (due to vertebrobasialar insufficiency) PE: difference in upper extremity pulses and brachial systolic BP