Iran General Surgery Board Exam flashcards

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

Anion gap formula

Anion gap equals sodium minus the sum of chloride and bicarbonate, normally 8–12 mEq/L; an elevated gap with metabolic acidosis suggests lactate, ketones, uremia, or toxins.

4-2-1 maintenance fluid rule

Hourly maintenance fluid is 4 mL/kg for the first 10 kg, 2 mL/kg for the next 10 kg, and 1 mL/kg for each kilogram thereafter; deficits are replaced separately based on volume status.

Parkland burn formula

For burns, give 4 mL/kg per percent total body surface area of lactated Ringer's in the first 24 hours, with half in the first 8 hours; estimate surface area by the rule of nines.

Damage control laparotomy

A staged surgical strategy that stops hemorrhage and controls contamination, uses temporary abdominal closure, and returns for definitive repair after intensive care resuscitation and correction of physiology.

Revised Cardiac Risk Index

A preoperative tool scoring ischemic heart disease, heart failure, cerebrovascular disease, insulin-treated diabetes, renal impairment, and high-risk surgery to estimate perioperative cardiac risk.

ERAS core elements

Enhanced recovery after surgery combines early oral intake, multimodal opioid-sparing analgesia, early ambulation, and avoidance of routine nasogastric tubes to shorten hospital stay.

Child–Pugh classification

A liver disease severity score using bilirubin, albumin, INR, ascites, and encephalopathy; class C indicates poor hepatic reserve and prohibitive risk for major hepatic resection.

Murphy sign

A physical finding in acute cholecystitis in which palpation of the right upper quadrant during inspiration causes the patient to arrest breathing because of pain.

Bethesda thyroid categories

A cytologic reporting system for thyroid fine-needle aspiration, ranging from benign to malignant, that guides decisions about observation versus surgical resection.

Pheochromocytoma blockade order

Alpha-adrenergic blockade is started before beta-blockade in pheochromocytoma to avoid unopposed vasoconstriction and hypertensive crisis during surgery.

Abdominal aortic aneurysm repair threshold

Elective repair is considered when the aneurysm reaches 5.5 cm in diameter, grows more than 1 cm per year, or becomes symptomatic; endovascular repair is preferred when anatomy permits.

Ankle-brachial index

The ratio of ankle to brachial systolic pressure; a value below 0.9 supports peripheral arterial disease, while values below 0.4 suggest critical limb ischemia.

Rule of sixes for fistula

A mature arteriovenous fistula for hemodialysis should have flow above 600 mL/min, diameter above 6 mm, and depth less than 6 mm from the skin.

Pyloric stenosis metabolic picture

Hypertrophic pyloric stenosis causes projectile nonbilious vomiting with hypochloremic, hypokalemic metabolic alkalosis; correct electrolytes before performing pyloromyotomy.

Intussusception first-line therapy

In children without peritonitis, pneumatic or hydrostatic reduction under imaging is first-line for intussusception; surgery is reserved for failure, perforation, or peritonitis.

Kasai portoenterostomy timing

Surgery for biliary atresia should be performed before 60 days of age to improve native liver survival; later presentation carries a higher risk of cirrhosis and transplant need.

Hyperacute rejection

Rejection occurring within minutes to hours after transplant, caused by preformed recipient antibodies against donor antigens, leading to immediate graft thrombosis and failure.

Milan criteria

Liver transplant criteria for hepatocellular carcinoma: a single tumor up to 5 cm or up to three tumors each up to 3 cm, without vascular invasion or extrahepatic spread.

Critical view of safety

During laparoscopic cholecystectomy, the gallbladder neck is cleared so only two structures enter it, confirming the cystic duct and artery before clipping.

Pneumoperitoneum physiology

Carbon dioxide insufflation at 12–15 mmHg causes hypercapnia, reduced venous return, and vagal bradycardia; physiologic effects are greater in patients with cardiopulmonary disease.

Informed consent elements

Valid consent requires patient capacity, disclosure of risks, benefits, and alternatives, and voluntary agreement; emergency treatment may proceed when delay would risk death.

Surgical safety checklist

A structured three-phase checklist (sign in, time out, sign out) confirming patient identity, procedure, allergies, antibiotic prophylaxis, and instrument counts reduces preventable surgical harm.

FAST examination

Focused assessment with sonography for trauma detects free intraperitoneal fluid in dependent areas; it is less sensitive for retroperitoneal, hollow viscus, and pelvic injuries.

Tension pneumothorax treatment

A clinical diagnosis treated with immediate needle decompression followed by tube thoracostomy; waiting for imaging risks cardiac arrest from impaired venous return.

MELD score components

The Model for End-Stage Liver Disease uses bilirubin, INR, and creatinine, with sodium added in MELD-Na, to predict mortality and prioritize liver transplant candidates.

Insulinoma diagnostic triad

Whipple triad: symptoms of hypoglycemia, documented low glucose, and relief after glucose administration; elevated insulin and C-peptide during hypoglycemia confirm the diagnosis.

Sentinel lymph node biopsy

A staging procedure in clinically node-negative breast cancer that identifies the first draining node using blue dye or radiotracer to avoid unnecessary axillary dissection.

Carotid endarterectomy indications

Surgery is indicated for symptomatic carotid stenosis of 70–99% and selected asymptomatic stenosis of 60% or more in patients with acceptable surgical risk.

Flail chest management

Paradoxical chest wall motion after multiple rib fractures is managed with analgesia and ventilation; rib fixation is considered for severe displacement or failure to wean.

Empyema stages

Pleural infection progresses from exudative to fibrinopurulent to organizing stages; early drainage and antibiotics are used, with decortication for loculated or organizing disease.

Oncologic R0 resection

An R0 resection removes the tumor en bloc with microscopically negative margins, which is a key determinant of local control and survival in solid tumor surgery.

SBAR handover

A structured communication format covering situation, background, assessment, and recommendation; it improves handover accuracy and reduces patient safety events.