Cuba General Surgery Specialty State Exam 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, tenderness, rebound, fever, leukocytosis, and left shift; score ≥7 suggests appendicitis.

Rutherford classification

Staging system for acute limb ischemia based on sensory and motor deficits and Doppler findings; categories I-IIa are viable, IIb threatened, III irreversible.

Milan criteria

Selection criteria for liver transplantation in hepatocellular carcinoma: single tumor ≤5 cm or up to three tumors each ≤3 cm, without vascular invasion or extrahepatic spread.

Charcot triad

Fever, jaundice, and right upper quadrant pain indicating ascending cholangitis; Reynolds pentad adds hypotension and altered mental status.

Beck triad

Hypotension, distended neck veins, and muffled heart sounds suggesting cardiac tamponade; treat with pericardiocentesis or thoracotomy.

Howship-Romberg sign

Medial thigh pain on hip extension caused by obturator hernia compressing the obturator nerve; seen in elderly emaciated women.

Sistrunk procedure

Surgical excision of a thyroglossal duct cyst including the central portion of the hyoid bone to reduce recurrence.

Kasai portoenterostomy

Hepatic portoenterostomy for biliary atresia, connecting jejunum to porta hepatis; best outcomes when performed before 60 days of life.

Ladd procedure

Surgical treatment for malrotation: counterclockwise detorsion, division of Ladd bands, widening of mesentery, and placement of bowel in nonrotated position.

Parkland formula

Burn resuscitation formula: 4 mL/kg per percent total body surface area of lactated Ringer solution in first 24 hours, half in first 8 hours.

Berlin criteria

Acute respiratory distress syndrome definition: onset within 1 week, bilateral opacities, and PaO2/FiO2 ≤300 on positive end-expiratory pressure ≥5 cmH2O.

Apfel score

Postoperative nausea and vomiting risk score based on female sex, nonsmoking status, history of nausea, and postoperative opioids.

Rapid shallow breathing index

Ratio of respiratory rate to tidal volume in liters; value <105 predicts successful weaning from mechanical ventilation.

Hinchey classification

Staging of diverticulitis: I pericolic abscess, II pelvic abscess, III purulent peritonitis, IV fecal peritonitis.

Rigler triad

Pneumobilia, small bowel obstruction, and ectopic gallstone on imaging, indicating gallstone ileus.

Whipple triad

Symptoms of hypoglycemia, documented low blood glucose, and relief with glucose administration; suggests insulinoma.

Zollinger-Ellison syndrome

Gastrinoma causing severe peptic ulcer disease and diarrhea due to excessive gastrin secretion; treated with proton pump inhibitors and resection.

MEN2 syndrome

Multiple endocrine neoplasia type 2 with medullary thyroid carcinoma, pheochromocytoma, and hyperparathyroidism; associated with RET proto-oncogene mutation.

Pringle maneuver

Compression of the hepatoduodenal ligament to control hepatic arterial and portal venous bleeding during liver surgery or trauma.

Damage control surgery

Staged approach for severely injured patients: hemorrhage and contamination control, temporary closure, then definitive repair after correction of hypothermia, acidosis, and coagulopathy.

Sentinel lymph node biopsy

Injection of blue dye and radiolabeled colloid to identify the first draining lymph node; used for staging breast cancer and melanoma.

Breslow thickness

Depth of melanoma invasion in millimeters from the granular layer; strongest prognostic factor and guides wide excision margins and sentinel node biopsy.

Mismatch repair deficiency

Loss of DNA mismatch repair proteins causing microsatellite instability; predicts response to immunotherapy and suggests Lynch syndrome.

Mallampati classification

Airway assessment based on visibility of oropharyngeal structures with mouth open and tongue protruded; class III-IV predicts difficult laryngoscopy.

Malignant hyperthermia

Hypermetabolic crisis triggered by volatile anesthetics or succinylcholine; treated with dantrolene, cooling, and treatment of hyperkalemia.

Sugammadex

Selective relaxant binding agent that reverses rocuronium and vecuronium neuromuscular blockade by encapsulation.

Strasberg classification

Classification of bile duct injuries during cholecystectomy, from cystic duct leak (A) to complete transection with loss of continuity (E).

Hesselbach triangle

Boundaries: inguinal ligament inferiorly, inferior epigastric vessels laterally, rectus abdominis medially; site of direct inguinal hernia.

Spigelian hernia

Hernia through the semilunar line lateral to the rectus abdominis, often interparietal and difficult to palpate; confirmed by ultrasound or CT.

Pheochromocytoma

Catecholamine-secreting adrenal tumor causing episodic hypertension; preoperative alpha blockade with phenoxybenzamine is required before surgery.

Inflammatory breast cancer

Aggressive breast cancer with diffuse erythema and peau d'orange; treated with neoadjuvant chemotherapy, mastectomy, and radiation rather than immediate surgery.

Phyllodes tumor

Fibroepithelial breast tumor with leaf-like architecture; treated with wide local excision with margins ≥1 cm; axillary staging not routinely needed.