AOBS Surgery flashcards

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

Coronary steal syndrome

Angina after internal mammary artery grafting when the graft supplies collateral flow to an underperfused native territory; treated by reimplanting the graft or relieving the native stenosis.

Pulsus paradoxus

Inspiratory fall in systolic pressure greater than 10 mmHg, classically seen in cardiac tamponade and severe obstructive lung disease.

Esophageal perforation management

Broad-spectrum antibiotics and source control; primary repair is favored within 24 hours, while delayed presentation may require drainage and diversion.

Alvarado score

Clinical scoring for appendicitis using migratory pain, anorexia, nausea, right lower quadrant tenderness, rebound, fever, and leukocytosis.

Pancreatic pseudocyst maturation

A fluid collection requires about four weeks to develop a mature wall before internal drainage; earlier intervention risks leakage.

Sepsis-3 definition

Suspected infection with an acute SOFA increase of 2 or more; septic shock adds vasopressor requirement for MAP 65 mmHg and lactate above 2 mmol/L.

Berlin ARDS criteria

Acute onset within one week, bilateral opacities not explained by cardiac failure, and PaO2/FiO2 ratio of 200-300 mild, 100-200 moderate, below 100 severe.

Abdominal compartment syndrome

Intra-abdominal pressure above 20 mmHg with new organ dysfunction; definitive treatment is decompressive laparotomy.

Propofol infusion syndrome

Metabolic acidosis, rhabdomyolysis, renal failure, and arrhythmia during high-dose prolonged propofol infusion; requires immediate discontinuation.

Ankle-brachial pressure index

Ratio of ankle to brachial systolic pressure; below 0.9 indicates peripheral arterial disease, while above 1.3 suggests noncompressible calcified vessels.

Acute limb ischemia signs

Pulselessness, pallor, pain, paresthesia, paralysis, and poikilothermia; paresthesia and paralysis signal a threatened limb needing emergent revascularization.

Permissive hypotension in rupture

Targeting systolic pressure around 70-90 mmHg during active hemorrhage to limit clot disruption until surgical control is achieved.

Dumping syndrome

Rapid emptying of hyperosmolar contents after gastric bypass causing postprandial sweating, tachycardia, and diarrhea; managed with dietary modification.

Thiamine deficiency after bariatric surgery

Prolonged vomiting after gastric bypass can precipitate Wernicke encephalopathy; treat with parenteral thiamine before glucose administration.

Marginal ulcer

Ulcer at the gastrojejunostomy after gastric bypass, associated with NSAIDs, smoking, and Helicobacter pylori; treated with acid suppression.

Bariatric eligibility criteria

BMI of 40 or greater, or BMI of 35 or greater with an obesity-related comorbidity; some guidelines include BMI 30 with type 2 diabetes.

Epidural hematoma shape

Biconvex or lens-shaped collection that does not cross suture lines, typically from middle meningeal artery injury.

Subdural hematoma shape

Crescent-shaped collection that crosses suture lines, arising from bridging vein injury and often requiring evacuation when symptomatic.

Brain death criteria

Unresponsive coma, absent brainstem reflexes, and positive apnea test with PaCO2 rise, after excluding confounding factors such as sedation or hypothermia.

Cauda equina syndrome

Saddle anesthesia, urinary retention, and lower extremity weakness from lumbar disc herniation; requires emergent decompression.

Status epilepticus sequence

Benzodiazepines first, then levetiracetam, valproate, or fosphenytoin; refractory cases need continuous infusion and EEG monitoring.

Subarachnoid hemorrhage vasospasm

Delayed arterial narrowing peaking days 3-14 after hemorrhage; monitored by transcranial Doppler and treated with nimodipine and euvolemia.

Hyperosmolar therapy targets

Serum sodium of 145-155 mmol/L or osmolality of 300-320 mOsm/kg used to reduce cerebral edema after brain injury.

Neurogenic stunned myocardium

After subarachnoid hemorrhage, troponin elevation with reversible wall motion abnormality and pulmonary edema, managed supportively.

Parkland burn formula

Four mL/kg per percent total body surface area of lactated Ringer's in 24 hours, with half given in the first 8 hours from injury.

Free flap venous congestion

Flap appears dark with brisk capillary refill and congestion; indicates impaired outflow and may require operative revision.

Pressure ulcer stage IV

Full-thickness skin loss with exposed bone, tendon, or muscle; requires debridement and often flap coverage.

Cleft lip rule of tens

Repair timing when weight is 10 lb, hemoglobin 10 g/dL, and age 10 weeks; palate repair is typically at 9-12 months.

Testicular torsion window

Sudden severe scrotal pain with high-riding testis and absent cremasteric reflex; detorsion within 6 hours best preserves viability.

Fournier gangrene

Necrotizing fasciitis of the perineum and genitalia requiring emergent debridement and broad-spectrum antibiotics.

Ureteral stone size rule

Stones under 5 mm usually pass spontaneously; stones over 10 mm rarely pass and often require intervention.

Bladder cancer presentation

Painless gross hematuria is the classic sign; cystoscopy is diagnostic and non-muscle-invasive disease is treated with transurethral resection.