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Surgery rotation - NMS
questions from the nms casebook for sugery
27
Medical
Professional
03/29/2010

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Cards

Term
Which valves require anticoag?
Definition
Mechanical
Term
When do you have to replace tissue valves?
Definition
7 years
Term
Prognosis for dilated cardiomyopathy?
Definition
1/3 recover
1/3 stay the same with meds
1/3 die
Term
Tx for dilated cardiomyopathy
Definition
immunosuppressives, steroids, diuretics, beta blockers, heart transplant
Term
Dilated cardiomyopathy: improvement with what med?
Definition
Beta blockers
Term
Dilated cardiomyopathy: What is life saving?
Definition
Heart transplant
Term
Heart transplant procedure?
Definition
1. Harvest from brain dead donor
2. Isolated from circulation, perfused with cardioplegia soln, removed
3. Heart kept cold
4. Remove recipient's heart with bypass
5. Donor heart sutured to recipient atria
6. Anastomose pulmonary arts and aorta
7. Re-establish circulation
Term
Zenker diverticulum
Definition
Pharyngeal diverticulum (pulsion diverticulum) between the lower pharyngeal constrictor and cricopharyngeal mm.
Term
Complication of pulsion diverticulum at the distal esophageal gastric junction
Definition
Food gets stuck, regurgitated, and aspirated causing PNA
Term
Bird's beak and poor peristalsis of esophagus on barium swallow
Definition
Achalasia
Term
Loss of smooth mm ganglionic cells of Auerback plexus and neuronal degeneration in the esophagus
Definition
Histopathology of achalasia
Term
Achalasia tx
Definition
Ca channel blockers
Disruption of the loer esophageal high pressure zone --> Heller myotomy (100% pts improve) or transesophageal pneumatic dilation (60% pts improve)
Term
Esophageal cancers: location and id
Definition
top 1/3 = squamous cell ca
bottom 1/3 = more adenoca
Term
Tx: Ca in upper 1/3 esophagus
Definition
Irradiation
Term
Tx: Ca in esophagus middle 1/3
Definition
Irradiation + chemo - need to downsize tumor, may include surgical debulking
Term
Common anterior mediastinum tumors?
Definition
Thymoma, lymphoma, teratoma, Hodgkin's and non-Hodgkins lymphoma
Term
Common middle mediastinum tumors?
Definition
Lymphatic tumors and cysts.
Term
Common poterior mediastinum tumors?
Definition
Neurogenic tumors next to vertebral bodies. Neurilemoma.
Term
Brief neurologic defect that completely resolves in 24 hrs
Definition
TIA
Term
Tx for >70% carotid occlusion
Definition
1. endarterectomy
2. aspirin
endarterectomy is 3x more effective than asa at preventing major strokes in a 2 yr period.
Term
What is important to watch carefully in carotid endarterectomy?
Definition
BP
Term
Amaurosis fugax
Definition
Transient blindness b/c of emboli from the carotid artery bifurcation to the retina (TIA to the ophthalmic artery)
Term
Hollen-horst plaque
Definition
bright shiny spot on a retinal artery - happens with retinal artery embolus
Term
Tx for leg with pain, pallor, pulseless, poikilothermic, paralysis, paresthesias?
Definition
Ballon catheter embolectomy.
Heparin before that.
Hopefully revascularized w/i 6 hrs.
This is iliofemoral artery embolus.
Term
Ischemia-reprofusion injury causing muscle group to stop working
Definition
compartment syndrome
Term
Compartment syndrome: mmHg when irreversible ischemic mm and nn injury occurs
Definition
20-40 mmHg
Term
Compartment syndrome tx
Definition
Fasciotomy
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