ABS 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 acute appendicitis using migration of pain, anorexia, nausea/vomiting, right lower quadrant tenderness, rebound tenderness, fever, and leukocytosis with left shift.

Forrest classification

Endoscopic classification of peptic ulcer bleeding stigmata; Forrest Ia spurting and Ib oozing carry highest rebleeding risk and require endoscopic hemostasis plus PPI infusion.

Strangulated bowel obstruction

Small bowel obstruction complicated by ischemia; suggested by fever, tachycardia, constant pain, peritoneal signs, or closed-loop configuration, and requires urgent laparotomy.

Hesselbach triangle

Boundaries are the inferior epigastric vessels laterally, rectus sheath medially, and inguinal ligament inferiorly; direct inguinal hernias protrude through this triangle.

Femoral hernia anatomy

Hernia through the femoral canal, below and lateral to the pubic tubercle and medial to the femoral vein; narrow neck confers high strangulation risk requiring prompt repair.

Abdominal compartment syndrome

Sustained intra-abdominal pressure above 20 mmHg with new organ dysfunction; bladder pressure monitoring is standard and decompressive laparotomy is definitive treatment.

Charcot triad

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

Triple assessment

Combined clinical examination, imaging with mammography and ultrasound, and tissue sampling by core needle biopsy used to evaluate a suspicious breast mass.

BI-RADS 4

Mammographic category for suspicious findings with a 2-95% likelihood of malignancy; mandates tissue sampling, usually image-guided core needle biopsy.

Sentinel lymph node biopsy

Technique using blue dye and radiotracer to identify the first draining lymph node; standard for clinically node-negative breast cancer and melanoma above threshold thickness.

Inflammatory breast cancer

Aggressive breast cancer with diffuse erythema, edema, and peau d'orange from dermal lymphatic invasion; treated with neoadjuvant chemotherapy followed by mastectomy and radiation.

Breslow thickness

Measurement of melanoma invasion depth in millimeters from the granular layer; determines prognosis, surgical margin width, and eligibility for sentinel lymph node biopsy.

LRINEC score

Laboratory risk indicator for necrotizing fasciitis using CRP, WBC, hemoglobin, sodium, creatinine, and glucose; a score of 6 or more suggests higher risk.

Parkland formula

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

Mohs micrographic surgery

Staged excision with intraoperative frozen-section margin assessment, tissue-sparing and preferred for high-risk basal cell and squamous cell carcinomas of the face.

Bethesda system

Cytopathology reporting categories for thyroid fine-needle aspiration, ranging from nondiagnostic to malignant, each linked to a malignancy risk and management recommendation.

Medullary thyroid carcinoma

Neuroendocrine thyroid tumor arising from parafollicular C cells, marked by elevated calcitonin and CEA; associated with RET mutations and treated by total thyroidectomy with neck dissection.

Primary hyperparathyroidism

Elevated calcium with inappropriately normal or high parathyroid hormone; most often a single adenoma, treated by focused parathyroidectomy with intraoperative PTH monitoring.

Pheochromocytoma blockade

Preoperative alpha-adrenergic blockade, typically with phenoxybenzamine, must precede any beta-blockade to prevent unopposed alpha stimulation and hypertensive crisis.

qSOFA

Bedside sepsis screen scoring one point each for respiratory rate 22 or higher, systolic blood pressure 100 mmHg or lower, and altered mentation.

Septic shock criteria

Sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure of 65 mmHg or higher and lactate above 2 mmol/L despite fluid resuscitation.

ARDS Berlin criteria

Acute onset hypoxemia with PaO2/FiO2 of 300 or less on PEEP of at least 5, bilateral opacities, and respiratory failure not fully explained by cardiac failure.

KDIGO AKI staging

Staging of acute kidney injury by serum creatinine rise and urine output thresholds; stage 3 includes creatinine 3 times baseline or urine output below 0.3 mL/kg/h.

Restrictive transfusion threshold

Transfusion of packed red cells at hemoglobin of 7 g/dL for most patients, with 8 g/dL considered for cardiac surgery or active coronary disease.

R0 resection

Surgical removal of a tumor with microscopically negative margins; a key oncologic quality measure associated with improved local control and survival.

GIST and imatinib

Gastrointestinal stromal tumors are driven by KIT or PDGFRA mutations; imatinib is used adjuvantly after resection and neoadjuvantly to shrink large tumors.

Colorectal liver metastases

Resectable hepatic metastases from colorectal cancer can achieve 40-50% five-year survival; RAS and BRAF testing guide systemic therapy selection.

Neoadjuvant therapy

Systemic or radiation treatment given before surgery to downstage locally advanced tumors and improve resectability, used in rectal, esophageal, breast, and pancreatic cancer.

ATLS primary survey

Sequential assessment of Airway with cervical spine protection, Breathing, Circulation with hemorrhage control, Disability, and Exposure with environmental control in trauma patients.

Tension pneumothorax

Clinical diagnosis of obstructive shock from trapped intrathoracic air; requires immediate needle decompression followed by tube thoracostomy without waiting for imaging.

Massive transfusion protocol

Balanced resuscitation with packed red cells, fresh frozen plasma, and platelets in roughly equal ratios, plus tranexamic acid within three hours of severe injury.

FAST examination

Focused assessment with sonography for trauma, detecting free fluid in pericardial, perihepatic, perisplenic, and pelvic windows in hemodynamically unstable trauma patients.