Arab Board Surgery Clinical flashcards

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

Alvarado score

A 10-point clinical score for acute appendicitis using migration of pain, anorexia, nausea, right lower quadrant tenderness, rebound, fever, leukocytosis, and left shift; ≥7 supports surgery.

Ranson criteria

A scoring system for acute pancreatitis using admission and 48-hour laboratory values; higher scores correlate with severe disease, necrosis, and mortality, guiding intensive care.

Child-Pugh classification

A scoring system for cirrhosis using bilirubin, albumin, INR, ascites, and encephalopathy; class C indicates decompensated disease and contraindicates major hepatic resection.

Mirizzi syndrome

Obstruction of the common hepatic duct by a stone impacted in the cystic duct or gallbladder neck, causing jaundice; MRCP or ERCP defines the anatomy before surgery.

Whipple procedure

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

Permissive hypotension

Deliberate limitation of fluid resuscitation to a lower systolic pressure in uncontrolled torso hemorrhage to avoid clot disruption; contraindicated in traumatic brain injury.

FAST examination

Focused assessment with sonography for trauma, imaging pericardial, perihepatic, perisplenic, and pelvic windows; positive in an unstable patient prompts immediate laparotomy.

Beck triad

Hypotension, distended neck veins, and muffled heart sounds indicating cardiac tamponade; requires urgent pericardiocentesis or thoracotomy for decompression.

Ankle-brachial index

Ratio of ankle to brachial systolic pressure; ≤0.90 indicates peripheral arterial disease, ≤0.40 critical limb ischemia, and >1.3 suggests noncompressible calcified vessels.

Virchow triad

The three factors predisposing to thrombosis: venous stasis, endothelial injury, and hypercoagulability; used to explain deep vein thrombosis and pulmonary embolism risk.

Abdominal aortic aneurysm threshold

Elective repair is indicated when aneurysm diameter reaches 5.5 cm in men or 5.0 cm in women, or grows more than 1 cm per year.

Bethesda system

A cytopathology reporting system for thyroid fine-needle aspiration; categories III–VI carry increasing malignancy risk and guide repeat sampling or surgical resection.

Primary hyperparathyroidism

Elevated calcium with inappropriately normal or high parathyroid hormone, usually from a single adenoma; localized by sestamibi or 4D-CT and treated by focused parathyroidectomy.

Pheochromocytoma blockade

Alpha-adrenergic blockade with phenoxybenzamine is started before beta blockade to prevent unopposed vasoconstriction and hypertensive crisis during resection.

BI-RADS categories

A standardized breast imaging lexicon: 0 incomplete, 1–2 benign, 3 probably benign with follow-up, 4 suspicious requiring biopsy, 5 highly suggestive of malignancy.

Sentinel lymph node biopsy

Identification and removal of the first draining lymph node using blue dye or radiolabeled colloid; used in clinically node-negative breast cancer and melanoma for staging.

Inflammatory breast cancer

An aggressive breast cancer with erythema, edema, and peau d'orange from dermal lymphatic invasion; treated with neoadjuvant chemotherapy then mastectomy, not breast conservation.

R0 resection

Surgical removal of a tumor with microscopically negative margins; R1 indicates microscopic and R2 macroscopic residual disease, and R0 improves survival.

Breslow thickness

Depth of melanoma invasion in millimeters from the granular layer; with ulceration it determines sentinel lymph node biopsy indication and prognosis.

D2 lymphadenectomy

Gastric cancer resection removing perigastric nodes plus nodes along the celiac, splenic, and hepatic arteries; improves staging accuracy and survival in resectable disease.

Hypertrophic pyloric stenosis

Nonbilious projectile vomiting at 3–6 weeks with an olive-shaped mass and hypochloremic hypokalemic metabolic alkalosis; treated by Ramstedt pyloromyotomy.

Intussusception

Telescoping of proximal bowel into distal bowel causing colicky pain, currant-jelly stool, and a sausage mass; air or contrast enema is diagnostic and therapeutic if no peritonitis.

Biliary atresia

Neonatal obliteration of extrahepatic bile ducts causing persistent jaundice with acholic stools; Kasai portoenterostomy before 60 days improves bile drainage and outcome.

Midgut volvulus

Twisting of the midgut on its mesentery from malrotation, causing bilious vomiting in a neonate; upper GI contrast shows a corkscrew and urgent Ladd procedure is required.

Testicular torsion

Twisting of the spermatic cord causing acute scrotal pain with an absent cremasteric reflex; surgical exploration within 6 hours is required and should not await imaging.

Renal transplant rejection types

Hyperacute rejection from preformed antibodies occurs immediately; acute rejection occurs days to weeks; chronic rejection causes graft vasculopathy over months to years.

Sepsis-3 definition

Suspected infection with a SOFA score increase of at least 2 points; septic shock adds vasopressor requirement for MAP ≥65 with lactate >2 mmol/L.

Informed consent elements

Valid consent requires patient capacity, disclosure of material risks and alternatives, patient understanding, and voluntariness; emergency exception applies when life is threatened.

Caprini score

A risk assessment model for perioperative venous thromboembolism using patient and surgical factors; the score determines need for pharmacologic and mechanical prophylaxis.

Lateral internal sphincterotomy

Surgical division of the internal anal sphincter for chronic anal fissure unresponsive to medical therapy; risk of incontinence is low but higher in multiparous women.

Fournier gangrene

Necrotizing fasciitis of the perineum and genitalia requiring urgent surgical debridement, broad-spectrum antibiotics, and critical care support; often associated with diabetes.

Low anterior resection syndrome

A constellation of frequency, urgency, and fecal incontinence after sphincter-preserving rectal surgery; managed with dietary modification, biofeedback, and antidiarrheal medication.