General Surgery Rotation

What rating system puts pts into risk categories based on cardiac disease? What factors does it include? – ANS Detsky's Modified Cardiac Risk Index - age >70 - MI - Unstable angina - Pulmonary edema - Aortic stenosis - Arrhythmia - Emergency operation - Poor general medical status Detsky's Modified Cardiac Risk Index – ANS **Look at pg 294 in Babcock** I = 0-15 pts (low) II = 15-30 pts (intermediate) III = 31+ pts (high) What rating system determines chance of car...

what are the 2 conditions under the inflammatory bowel disease umbrella? - 1. ulcerative colitis 2. crohn's dz in comparing ulcerative colitis and crohn's dz, which is: -limited to the colon w/ rectum always involved *VS* mouth to anus -transmural *VS* mucosa/submucosa involved -LLQ *VS* RLQ pain -bloody diarrhea *VS* non -complications of perianal dz, strictures, fistulas & granulomas *VS* colon cancer & toxic megacolon -colonoscopy showing "skip lesions" & cobblestoning *VS* ulce...

Definition of Gastroesophageal reflux disease - Transient relaxation of the LES, leading to gastric acid reflux which causes esophageal mucosal injury Complications of GERD - Esophagitis, esophagus stricture, Barrett's esophagus, esophageal adenocarcinoma Definition of Barrett's esophagus - Esophageal squamous epithelium replaced by precancerous metaplastic columnar cells Clinical Manifestation of GERD - Heartburn (pyrosis) is hallmark, often restrosternal and postprandial; dyphagia; ...

Aortic Aneurysm - Weakness and subsequent dilation of the vessel wall, usually caused by genetic defect or atherosclerotic damage to the intima. Weakness and subsequent dilation of the vessel wall, usually caused by genetic defect or atherosclerotic damage to the intima. - Describe Aortic Aneurysm 1. Atherosclerosis damage to intima 2. Genetic defect - What typically causes an aortic aneurysm? Atherosclerosis - This is the most common cause of Aortic Aneurysm? 1. Congenital 2. Syp...

When can a patient eat prior to a major surgery? - NPO after midnight or at least 8 hours What risks should be discussed with all patients and documented on the consent form for a surgical procedure? - Risk: Bleeding, infection, anesthesia, scars If a patient is on anti-HTN meds should the patient take them on the day of the procedure? - Yes Should a patient who smokes cigarettes stop before an operation? - Yes - improvement is seen in just 2-4 weeks of smoking cessation What lab tes...

what is the most common type of liver cancer? - hepatocellular carcinoma tx for hemochromatosis (excessive iron loading) - deferoxamine chelation HBsAg - acute/chronic infection HBeAg - VERY INFECTIOUS acute/chronic infection infectivity wild type viral infection anti-HBc - marker of exposure persists indefinitely anti-HBe - low infectivity Anti-HBs - marker of immunity VACCINATION what can cause false + for hemoccult? - grapefruit, red meat, turnips radishes, horserad...

Where do aortic aneurysms most commonly occur? - ANS Below the kidney What is a pseudoaneurism? - ANS A collection of blood and connective tissue located outside the vessel wall What is the normal measurement of the abdominal aorta? - ANS 2cm At how many centimeters does the abdominal aorta become aneurismal? - ANS 3 cm At how many centimeters would an abdominal aortic aneurysm need surgical repair? - ANS 5 cm What is the initial test for a suspected AAA? - ANS Abdomin...

_______is the most important anesthetic complication. Anesthesia causes an uncontrolled increase in skeletal muscle oxidative metabolism, which overwhelms the body's capacity to supply oxygen, remove CO2, and regulative body temperature. - Ans Malignant hyperthermia If patient is hyperkalemic (normal range 3.8-5.0), how should you treat the patient? - Ans treat with glucose/insulin, and calcium +/-bicarb _______is the reversing agent for opiods. - Ans Naloxone _______is the rever...