ABPS General Surgery flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Alvarado score

Clinical scoring system for appendicitis using migration of pain, anorexia, nausea and vomiting, tenderness, rebound, fever, and leukocytosis; scores of 7 or more indicate high probability.

Glasgow-Blatchford score

Risk score for upper gastrointestinal bleeding using urea, hemoglobin, systolic blood pressure, heart rate, melena, syncope, hepatic disease, and cardiac failure; a score of 0 to 1 identifies very low risk.

Water-soluble contrast challenge

In adhesive small bowel obstruction, oral water-soluble contrast followed by imaging; contrast reaching the colon predicts resolution and reduces the need for surgery.

Graham patch

Omental patch repair of a perforated peptic ulcer, closing the perforation and securing a vascularized omental plug; definitive management includes H. pylori eradication and a proton pump inhibitor.

Sentinel lymph node biopsy

Breast cancer staging technique using radioisotope and blue dye to identify the first draining axillary node; indicated for clinically node-negative invasive cancer.

Z0011 criteria

For early breast cancer treated with breast conservation and whole-breast radiation, one or two positive sentinel nodes may be managed without completion axillary lymph node dissection.

Bethesda system

Six-tier cytologic classification of thyroid fine-needle aspiration specimens, from benign to malignant, guiding molecular testing and the extent of thyroidectomy.

Intraoperative PTH

During parathyroidectomy, a fall of more than 50 percent in parathyroid hormone ten minutes after excision of the abnormal gland predicts cure of primary hyperparathyroidism.

Permissive hypotension

In trauma with hemorrhagic shock, limiting crystalloid to a systolic pressure near 90 mmHg until hemorrhage control, avoiding clot disruption and hypothermia; contraindicated in traumatic brain injury.

FAST exam

Bedside ultrasound evaluating pericardial, perihepatic, perisplenic, and pelvic windows for free fluid after trauma; a positive result in an unstable patient prompts laparotomy.

REBOA

Resuscitative endovascular balloon occlusion of the aorta, a catheter-based aortic occlusion providing temporary hemorrhage control in non-compressible truncal or junctional trauma.

Parkland formula

Burn resuscitation estimating 4 mL/kg body weight per percent total body surface area of lactated Ringer solution in the first 24 hours, with half given in the first 8 hours.

Sepsis-3 definition

Sepsis is life-threatening organ dysfunction from infection, defined as a SOFA score increase of 2 or more; septic shock adds vasopressor requirement and lactate above 2 mmol/L.

Berlin ARDS criteria

Acute hypoxemia with PaO2/FiO2 of 300 or less, bilateral opacities, and positive end-expiratory pressure of at least 5 cm H2O, not fully explained by cardiac failure.

Lung-protective ventilation

Mechanical ventilation with tidal volumes of 6 mL/kg predicted body weight and plateau pressure of 30 cm H2O or less, reducing mortality in acute respiratory distress syndrome.

Abdominal compartment syndrome

Sustained intra-abdominal pressure above 20 mmHg with new organ dysfunction; treatment is decompressive laparotomy, often with temporary abdominal closure.

Rutherford classification

Staging of acute limb ischemia from viable to irreversible, based on sensory and motor deficit, Doppler arterial and venous signals, and muscle weakness, guiding urgency of revascularization.

Ankle-brachial index

Ratio of ankle systolic pressure to brachial systolic pressure; values below 0.90 suggest peripheral artery disease, and values below 0.40 suggest critical limb ischemia.

Tension pneumothorax

Air trapping under pressure causing hypotension and tracheal deviation; immediate needle decompression is required before confirmatory imaging.

Carotid endarterectomy indications

Carotid endarterectomy is indicated for symptomatic 70 to 99 percent stenosis and selected symptomatic 50 to 69 percent stenosis, plus asymptomatic stenosis in selected patients with acceptable surgical risk.

Revised Cardiac Risk Index

Revised Cardiac Risk Index predicting perioperative major cardiac events using ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, renal impairment, and high-risk surgery.

Malignant hyperthermia treatment

Stop triggering agents, give intravenous dantrolene 2.5 mg/kg, hyperventilate with 100 percent oxygen, cool the patient, and treat hyperkalemia and arrhythmias.

Lipid rescue

Intravenous lipid emulsion therapy for local anesthetic systemic toxicity, given as a 1.5 mL/kg bolus of 20 percent emulsion followed by infusion, alongside airway and seizure management.

Milan criteria

Liver transplantation criteria for hepatocellular carcinoma: one lesion up to 5 cm, or up to three lesions each 3 cm or less, without vascular invasion or extrahepatic disease.

Charcot triad

Fever, right upper quadrant pain, and jaundice in ascending cholangitis; the Reynolds pentad adds hypotension and altered mental status, indicating suppurative cholangitis requiring urgent biliary drainage.

Whipple procedure

Pancreaticoduodenectomy removing the pancreatic head, duodenum, distal stomach or pylorus, common bile duct, and gallbladder, with reconstruction by pancreaticojejunostomy, hepaticojejunostomy, and gastrojejunostomy.

Pyloric stenosis metabolic

Hypertrophic pyloric stenosis causes nonbilious projectile vomiting, leading to hypochloremic, hypokalemic metabolic alkalosis with paradoxical aciduria; correct fluids and electrolytes before pyloromyotomy.

Intussusception management

Ileocolic intussusception in children is diagnosed by ultrasound and treated with air or contrast enema reduction when there is no peritonitis or perforation; surgery is reserved for failure or complications.

Split-thickness skin graft

A graft containing epidermis and part of the dermis, used to cover burns and wounds; it requires a vascularized bed and contracts more than a full-thickness graft.

Surgical safety checklist

A WHO-derived three-phase checklist completed before induction, before skin incision, and before the patient leaves the operating room to reduce errors and improve team communication.

Informed consent elements

Disclosure of diagnosis, proposed treatment, material risks and benefits, alternatives including no treatment, and confirmation of patient understanding and voluntary decision-making capacity.

Morbidity and mortality conference

A confidential peer-review forum where surgical complications and deaths are analyzed for systems causes, supporting quality improvement and education rather than individual blame.