Breast
What are the anatomic borders of the breast?
Superior: clavicle/second rib
Inferior: inframammary fold/sixth rib
Medial: sternal border
Lateral: mid-axillary line
What are the three zones of the retroperitoneum?
I: aortic hiatus to sacral promontory (supramesocolic and inframesocolic zones)
II: pericolic gutters (right and left)
III: begins at the sacral promontory and encompasses the pelvis
What are the basic maneuvers to manage an acute increase in ICP?
Elevate HOB 30-45
Hyperventilate to keep CO2 < 25
Hypertonic/Hyperosmolar therapy
You see "string of beads" on a renal angiogram, what is the treatment?
What are the histologic zones of a full-thickness burn injury?
Hyperemia
Stasis
Coagulation
0: incomplete
1: negative
2: benign
3: probably benign
4: suspicious
5: highly suggestive of malignancy
6: bx proven malignancy
Brachial
Median
What constitues the "coma cocktail?"
_____ of tendons leads to diminished elasticity in diabetic feet.
Glycosylation
What % TBSA burn does a patient with all extremities 2nd degree burn have?
54%
What is the appropriate imaging for a patient with spontaneous bloody nipple discharge?
Mammogram +/- ultrasonography
Ductography
List four hard signs of vascular trauma.
Absent distal pulse
Thrill or buit
Expanding hematoma
Active pulsatile bleeding
Describe the GCS scoring system components.
Eye opening (1: none, 2: pain, 3: speech, 4: spontaneously)
Verbal (1: none, 2: incomprehensible sounds, 3: inappropriate words, 4: confused, 5: oriented)
Motor (1: none, 2: decerebrate, 3: decorticate, 4: withdrawal from pain, 5: localizes to pain, 6: obeys commands)
Where is the medial incision for a lower leg fasciotomy?
One fingerbreadth below the tibia
What is a normal carboxyhemoglobin?
5% nonsmoker
10% smoker
When does USPSTF recommend to start screening mammograpgy?
ACOG?
ACS?
USPSTF: 50y
ACS: 45y
ACOG: 40y
List four soft signs of vascular trauma.
Hx of significant bleeding
Proximity to named vessel
Diminished pulse, ABI < 0.9
Neurological deficit
Acute stressors (sx, infection)
Deficits (hearing, glasses, dentures)
Environmental factors (rest, stim control, lighting)
Longevity (age > 70)
Impaired functional status (early mobilization, PT/OT)
Restraints (avoid along with other tethers (catheter/IV))
Intellect (CNS function)
Uncomfortable (pain management)
Medications (anesthetic agents)
How much of the circumference of the leg does the anterior flap encompass in a BKA?
2/3
What are four clinical features of a marjolin ulcer?
Ulcerated growth with rolled-up edges
Aggresive but slow-growing lesion
Well-differentiated growth
No lymphatic spreading beacause of desctruction of lymph channels
Decrease estrogen levels
Tamoxifen, Danazol, OCP, or bromocriptine
Describe the steps for optimal control, exposure and repair of the supraceliac aorta.
Approach midline through the right diaphragmatic crus, via a left thoracotomy, or via a left medial visceral rotation.
Define acute liver failure.
INR >/= 1.5
Acute liver injury (transaminitis/ hyperbilirubinemia)
Encephalopathy
No cirrhosis or prior liver disease by hx/PE/imaging
<26 weeks since symptom onset
Describe the Rutherford Classification of acute limb ischemia.
IIa: marginally threatened and salvageable limb if promptly treated
IIb: immediately threatened limb that is slavageable only with immediate revascularization
III: irreversibly damaged limb with major tissue loss or permanent nerve damage
What is the difference between a STSG and FTSG?
STSG: epidermis and part of the dermis
FTSG: epidermis and entire dermis