PGIM CSE Surgical Specialties flashcards

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

Alvarado score

Clinical scoring system for acute appendicitis using migration of pain, anorexia, nausea, tenderness, rebound, fever, and leukocytosis; scores ≥7 support operative management.

Graham patch

Omental plug used to repair a perforated peptic ulcer; covers the defect after peritoneal lavage and is combined with antisecretory therapy and Helicobacter pylori eradication.

Damage control laparotomy

Staged surgical strategy for unstable trauma patients: control hemorrhage and contamination, temporary abdominal closure, then definitive repair after correction of hypothermia, acidosis, and coagulopathy.

Reynolds pentad

Charcot triad plus hypotension and confusion, indicating severe ascending cholangitis with sepsis; requires urgent resuscitation and biliary drainage.

Revised Atlanta classification

Grades acute pancreatitis as mild, moderately severe, or severe based on organ failure and local complications; guides fluid resuscitation, nutrition, and intervention timing.

Post-ERCP pancreatitis prophylaxis

Rectal NSAIDs and periprocedural hydration reduce risk in high-risk patients; pancreatic stent placement may be used in selected cases.

Total mesorectal excision

Sharp dissection of the rectum with intact mesorectum along the mesorectal fascia; standard for rectal cancer and reduces local recurrence.

Hinchey classification

Stages complicated diverticulitis from pericolic abscess to fecal peritonitis; guides percutaneous drainage versus emergency resection.

Goodsall rule

Predicts fistula-in-ano tract course: anterior tracts run radially, posterior tracts curve to the posterior midline; exceptions occur with complex or recurrent disease.

Sentinel lymph node biopsy

Identifies the first draining node using blue dye or radiotracer; used in clinically node-negative breast cancer to stage the axilla and avoid unnecessary dissection.

Bethesda thyroid categories

Six-tier cytology classification from nondiagnostic to malignant; higher categories guide need for surgery and extent of thyroidectomy.

Pheochromocytoma blockade

Alpha-blockade precedes beta-blockade to avoid unopposed vasoconstriction and hypertensive crisis; biochemical screening uses plasma metanephrines.

EVAR

Endovascular aneurysm repair of abdominal aortic aneurysm using stent grafts; lower early mortality than open repair but requires surveillance for endoleak.

ABPI

Ankle-brachial pressure index; values below 0.9 suggest peripheral arterial disease, and values below 0.4 suggest critical limb ischemia.

Carotid endarterectomy indication

Benefit is greatest for symptomatic stenosis ≥70%; surgery should be performed within two weeks of the index event after multidisciplinary assessment.

Compartment syndrome

Elevated fascial compartment pressure causing ischemia; pain out of proportion and pain on passive stretch are early signs; fasciotomy is emergency treatment.

Gustilo-Anderson classification

Grades open fractures by soft tissue injury and contamination; higher grades require urgent debridement, antibiotics, and stable fixation.

Lachman test

Most sensitive clinical test for anterior cruciate ligament rupture; performed with knee flexed 20-30 degrees and anterior tibial translation assessed.

Extradural hematoma

Lens-shaped collection from middle meningeal artery injury; expanding or symptomatic lesions require urgent craniotomy and evacuation.

Nimodipine

Calcium channel blocker used after aneurysmal subarachnoid hemorrhage to reduce delayed ischemic deficits from vasospasm.

MGMT promoter methylation

Epigenetic silencing of DNA repair gene in glioblastoma; predicts benefit from temozolomide and is used in treatment planning.

Beck triad

Hypotension, distended neck veins, and muffled heart sounds in cardiac tamponade; requires urgent pericardiocentesis or surgical drainage.

Massive hemothorax

More than 1500 mL blood in the chest or more than 200 mL per hour; requires urgent thoracotomy and blood product resuscitation.

TAVI

Transcatheter aortic valve implantation; preferred for severe symptomatic aortic stenosis in patients at high or prohibitive surgical risk.

Testicular torsion

Acute scrotal pain with high-riding testis; immediate exploration and bilateral orchidopexy if viable, without delaying for imaging.

Hyperacute rejection

Antibody-mediated graft destruction within minutes to hours due to preformed antibodies; prevented by crossmatching before transplantation.

Parkland formula

Burn resuscitation using 4 mL/kg per percent total body surface area crystalloid in 24 hours; half given in first 8 hours from injury.

Cleft palate repair timing

Palate repair typically around 9-12 months of age to support speech development; lip repair around 3 months.

Pyloric stenosis

Non-bilious projectile vomiting in infants at 3-6 weeks; ultrasound shows thickened pylorus; correct electrolytes before pyloromyotomy.

Necrotizing enterocolitis

Preterm intestinal inflammation with feeding intolerance, distension, and pneumatosis; bowel rest and antibiotics, surgery for perforation.

Enhanced recovery after surgery

Multimodal perioperative pathway using carbohydrate loading, opioid-sparing analgesia, early feeding, and early mobilization to reduce complications and length of stay.

WHO surgical safety checklist

Three-phase checklist with sign in, time out, and sign out; improves team communication and reduces surgical morbidity and mortality.

Duty of candour

Professional obligation to disclose harm promptly and honestly, apologize, explain what happened, and document the discussion with the patient.