UKOM Sp.B flashcards

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

Alvarado score

A 10-point clinical scoring system for acute appendicitis based on migration of pain, anorexia, nausea, tenderness, rebound, fever, leukocytosis, and left shift; ≥7 supports operative management.

Tokyo Guidelines severity grading

Grades acute cholecystitis as I (mild), II (moderate, elevated WBC or palpable mass), and III (organ dysfunction); Grade III requires urgent biliary drainage before cholecystectomy.

Hartmann procedure

Resection of the rectosigmoid with closure of the rectal stump and end colostomy, used for perforated left-sided diverticulitis or obstruction in unstable patients with fecal peritonitis.

Sentinel lymph node biopsy

Injection of blue dye or radiotracer to identify the first draining lymph node; standard for clinically node-negative breast cancer to avoid unnecessary axillary dissection.

Milan criteria

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

D2 lymphadenectomy

Removal of perigastric nodes plus nodes along the celiac, splenic, and hepatic arteries; standard for resectable gastric cancer and associated with improved staging accuracy.

ATLS primary survey

Sequential assessment of airway with cervical spine protection, breathing, circulation with hemorrhage control, disability (GCS), and exposure, repeated whenever the patient deteriorates.

REBOA

Resuscitative endovascular balloon occlusion of the aorta; a temporizing catheter-based measure for non-compressible torso hemorrhage, with Zone I for abdominal and Zone III for pelvic bleeding.

Damage-control laparotomy

An abbreviated operation to control hemorrhage and contamination with temporary abdominal closure, followed by ICU resuscitation and planned re-look within 24–48 hours.

Ankle-brachial index

Ratio of ankle to brachial systolic pressure; 0.9–1.3 is normal, below 0.9 indicates peripheral arterial disease, and above 1.3 suggests non-compressible calcified vessels.

Rutherford category IIb

Acute limb ischemia with sensory loss and muscle weakness but no frank paralysis; requires urgent surgical revascularization because limb viability is immediately threatened.

NASCET criteria

Angiographic measurement of internal carotid stenosis comparing the narrowest residual lumen to the normal distal internal carotid; ≥70% symptomatic stenosis benefits from endarterectomy.

Pyloric stenosis

Hypertrophy of the pyloric muscle causing non-bilious projectile vomiting at 3–6 weeks, with hypochloremic hypokalemic metabolic alkalosis; treated by pyloromyotomy after correction.

Intussusception

Telescoping of proximal bowel into distal bowel causing colicky pain, red currant jelly stool, and a sausage-shaped mass; air or contrast enema is diagnostic and therapeutic.

Kasai portoenterostomy

Hepatoportoenterostomy for biliary atresia, excising the fibrotic extrahepatic bile duct and anastomosing a jejunal loop to the porta hepatis; most effective before 60 days of age.

Parkland formula

Burn resuscitation formula giving 4 mL of Ringer's lactate per kilogram per percent total body surface area in 24 hours, with half administered in the first 8 hours.

Kanavel signs

Four signs of flexor tenosynovitis: fusiform finger swelling, tenderness along the sheath, pain on passive extension, and a flexed resting posture; require urgent drainage.

Rule of nines

Adult burn surface estimate: head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, perineum 1%; used to calculate resuscitation fluids.

Garden classification

Grades femoral neck fractures I–IV by displacement; Garden I–II are undisplaced or minimally displaced, while Garden III–IV are displaced and often treated with arthroplasty in the elderly.

Compartment syndrome

Elevated fascial compartment pressure causing pain out of proportion and pain on passive stretch; pressure within 30 mmHg of diastolic pressure or above 30 mmHg warrants fasciotomy.

Gustilo-Anderson classification

Grades open fractures I–III by wound size, soft tissue injury, and vascular injury; Type IIIB needs flap coverage and Type IIIC requires vascular repair.

Cushing triad

Hypertension with widened pulse pressure, bradycardia, and irregular respiration, indicating raised intracranial pressure and impending brain herniation; requires urgent decompression.

Epidural hematoma

Lens-shaped extra-axial hemorrhage from middle meningeal artery injury, often with a lucid interval; requires urgent craniotomy and evacuation before herniation occurs.

Cauda equina syndrome

Compression of the lumbosacral nerve roots causing saddle anesthesia, bladder and bowel dysfunction, and bilateral leg weakness; a surgical emergency requiring urgent decompression.

Testicular torsion

Twisting of the spermatic cord causing acute scrotal pain with absent cremasteric reflex and reduced Doppler flow; detorsion and bilateral orchiopexy within 6 hours preserve the testis.

Pyonephrosis

Infected obstructed kidney with pus in the collecting system; a urologic emergency requiring urgent drainage by ureteral stent or percutaneous nephrostomy in addition to antibiotics.

Gleason grade group

Prostate cancer grading system combining Gleason patterns into Grade Groups 1–5; higher groups indicate higher risk and guide treatment selection and prognosis.

Sepsis-3 definition

Life-threatening organ dysfunction from a dysregulated host response to infection, defined by a SOFA score increase of at least 2 points; septic shock adds vasopressor need and lactate above 2.

Malignant hyperthermia

Pharmacogenetic reaction to volatile anesthetics or succinylcholine causing hyperthermia, rigidity, and acidosis; treated with dantrolene 2.5 mg/kg IV and aggressive cooling.

Berlin ARDS criteria

Acute onset within one week, bilateral opacities not fully explained by cardiac failure, and PaO2/FiO2 ≤300 mmHg with PEEP ≥5 cmH2O; managed with lung-protective ventilation.

Informed consent elements

Capacity, disclosure of material risks and alternatives, comprehension, and voluntariness; the discussion and the patient's decision must be documented in the medical record.

Negligence four elements

Duty of care, breach of the standard of care, causation, and damages; all four must be proven for a malpractice claim to succeed.

Number needed to treat

The reciprocal of the absolute risk reduction; it estimates how many patients must receive an intervention for one additional patient to benefit.