Файл: Kaplan USMLE - Step 2 CK Lecture Notes 2017- Surgery.pdf

postoperative, 37 strangulated, 167 Bow-legs. See Genu varum

Brain

abscess of, 85, 219

breast cancer metastasis to, 186 tumors of, 87, 216

dizziness and, 86

in children, 82, 85, 217

Breast

abscesses of, 54, 177 diseases of, 54–56, 175–180

Breast cancer, 60–61, 186–189 peau d’orange appearance in, 62 ruling out, 59

Breathing, in trauma assessment, 3. See also Airway, in trauma assessment

Bronchial injury

in chest trauma assessment, 109 traumatic rupture, 8

Brown recluse spider bites

assessment and management of, 120 assessment of, 17

Brown-Séquard syndrome, 7, 109

Burn injuries, 123–126. See also Chemical burns, assessment of circumferential, 15, 124–125

in adult patients, 16

in pediatric patients. See under Pediatric patients to eye, 74

C

Calcifications, in breas, 62

Calcium gluconate, for black widow spider bites, 17 Cancer

anorectal, 49–50, 169 back pain and, 30 esophageal, 41, 156

in children and young adults, 15–16 metastatic, to liver, 49

obstructive jaundice with, 57 of bile ducts, 171–172

of brain, 82, 213–214

of breast, 54–55, 178–181 ruling out, 59

of colon, 45, 160 of liver, 169

of lung, 65, 197–198 of stomach, 43, 158

of urogenital system, 85–86, 224–225 pancreatic, 52, 173

testicular, 91, 229 Capital femoral epiphysis

avascular necrosis of, 15 slipped, 19, 122

Carbon monoxide poisoning, in burn victim, 124 Carcinoembryonic antigen (CEA), in liver disease, 176 Carcinoid syndrome, 167

Cardiac index, 195

Index

Cardiac risk, preoperative assessment of, 23, 35 Cardiology

cardiac evaluations, 3–4, 19–20, 35–36, 45–46, 65–66, 71–72, 75–76, 79–80, 81–82, 83–84, 87–88, 91–92, 95–96

Cardiothoracic surgery

for acquired heart disease, 72–73, 195–196 for congenital heart problems, 63–64, 193–194 of lung, 65, 197–198

Cardiovascular system, preoperative assessment of, 146–147, 149–150. See also Coronary disease; Vascular occlusive disease

Carpal navicular fracture, 23 Carpal tunnel syndrome, 28, 141

thenar atrophy, 28 Casts, pain under, 20 Cataracts, in children, 211 Catheterization

in acquired heart disease, 196 in urologic conditions, 226

for postoperative complications, 36, 136 Cauda equina syndrome, 29, 143

Causalgia, 90, 227

Cavernous sinus thrombosis, 85, 219

Celiac artery, abdominal aortic aneurysm involving, 76 Cellulitis, orbital. See Orbital cellulitis

Central cord syndrome, 7, 110 Central venous pressure (CVP)

in abdominal trauma assessment, 8, 111 in myocardial infarction, 99

in shock assessment, 4, 95 in vasomotor shock, 4

Cervical spine injury airway assessment in, 3

in neck trauma assessment, 103 Chemical burns, assessment of, 14, 124

with eye involvement, 206

Chemotherapy, in breast cancer management, 61, 189–190 Chest

postoperative pain in, 36, 152

trauma to, assessment of, 6–7, 104–109 Child abuse, injury assessment in, 51, 184 Children. See Pediatric patients Cholangiocarcinoma, 179

Cholangitis, 54, 177

obstructive jaundice without, 57 Cholecystectomy, cardiac risk in, 149 Cholecystitis. See Acute cholecystitis

Chronic obstructive pulmonary disease (COPD) management of, 197

preoperative risk assessment in, 146, 149 Chronic pancreatitis, 57, 183

Chronic rejection, of transplanted organ, 95, 232 Chronic ulcerative colitis (CUC), 48 Circumferential burns, 15, 124–125

Cirrhosis

acute abdomen and, 173

preoperative risk assessment in, 146–147, 149–150 Claudication

disabling intermittent, 204

241

USMLE Step 2 CK λ Surgery

in subclavian steal syndrome, 67, 199 neurogenic, 226

Clavicular fractures, 22, 115

Closed reduction, of fractures, 122, 134 Clostridium difficile infection

in colon, 45

pseudomembranous colitis and, 169

Clostridium perfringens infection, gas gangrene from, 27 Club foot. See Talipes equinovarus

Coagulopathy, in abdominal trauma, 118 Coarctation of aorta, 64, 194

Coin lesions

in lung cancer assessment, 197, 206 Colic

biliary, 52 ureteral, 175

Collateral ligament injuries, 24, 137 Colles fracture, 22, 22

Colon

cancer of, 159

preoperative risk assessment in, 146, 149 diseases of, 45

polyps in, 48, 168

Colonoscopy, in Ogilvie syndrome, 157 Colostomy, in abdominal trauma management, 115 Coma

diabetic, preoperative risk assessment in, 30, 144 head trauma and, 105–106

postoperative, 36, 152–153 Common bile duct, cancer of, 170–171 Compartment syndrome

abdominal, 9, 113–114 leg fractures and, 28, 132

orthopedic emergencies and, 26, 139 Computed tomography (CT)

in abdominal trauma, 111–112, 235 intraabdominal bleeding, 10

in aortic rupture, 108

in head trauma, 4–5, 99–101 in jaundice diagnosis, 50

in lung cancer, 197, 198 in neck trauma, 5–6

in orthopedic injuries, 19 Congenital anomalies

annular/malrotated pancreas, 66, 196–198 diaphragmatic hernia, 66, 195

duodenal atresia, 66 heart problems, 45, 201 neck masses, 75

urologic disease, 86, 222–223 VACTER constellation of, 65, 195

Contralateral hemiparesis, epidural hematoma and, 106 Contusions, myocardial and pulmonary, 8, 112 Coronary disease

acquired, 203–204

bypass surgery indications in, 208 cardiothoracic surgery and, 65 congenital anomalies, 195–196

preoperative risk assessment in, 146–147, 149–150

242

Coronary revascularization, 204 Corpora cavernosa, fracture of, 122 Courvoisier-Terrier sign, 55 Craniopharyngioma, 89, 223

Craniotomy, in head trauma management, 105 Cricothyroidotomy, airway assessment and, 3 CROFAB, for snakebites, 17

Crohn disease, 49, 170 Crush injuries

causalgia following, 90 compartment syndrome and, 20 of extremities, 10–11, 117, 153 pelvic fractures and, 117

Cushing disease, 63–64, 192, 224

Cystic fibrosis, meconium ileus in, 60, 185 Cystic hygroma, 67

Cystic mastitis, 185

Cystitis, as urologic emergency, 91 Cystosarcoma phyllodes, of breast, 60, 185

D

Dapsone, for brown recluse spider bites, 17 Dehiscence, postoperative wound, 42, 157 Dehydration, postoperative, 159

Delirium tremens (DTs), postoperative, in alcoholics, 40, 152–153 De Quervain tenosynovitis, 28, 142

Developmental dysplasia, of hip, 19

Dexamethasone suppression test, in Cushing diagnosis, 192 Diabetes mellitus

leg ulcers in, 30, 31 ophthalmologic evaluation in, 82

postoperative fluid and electrolyte replacement in, 152–153 preoperative risk assessment in, 146, 149

retinal complications in, 212

Diabetic ketoacidotic coma, preoperative risk assessment in, 30, 151 Diaphragm

traumatic rupture of, 8, 39, 113. See also Hernia Digits, traumatic injuries to, 29, 143 “Dinner-fork” deformity, 22

Disabling intermittent claudication, workup of, 72–73 Disk herniation, lumbar spine, 29, 143, 226 Dislocation injury, of shoulder, 22

Disorientation, postoperative, 40, 155–156 Diverticular disease

acute diverticulitis, 52, 175 cardiac risk in, 149

postoperative complications in, 152 preoperative assessment in, 146–147, 149–150

Dizziness, as ENT emergency, 86, 220 Dog bites, 16

Double bubble sign, in pediatric vomiting, 67, 196 Drug abuse, epistaxis with, 220

Ductal carcinoma in situ, 61 Duodenum. See also Small intestine

pediatric

atresia of, 67, 196 stenosis of, 197

ulcers of, 170

Dupuytren contracture, 29, 142 Dysplasia

developmental, of hip, 19 fibromuscular, 194 mammary, 60

Dysreflexia, autonomic, 226

E

Ears, nose and throat (ENT). See Otolaryngology (ENT) Ecchymosis, head trauma and, 106–107

Ejection fraction, in cardiac risk assessment, 35, 149 Electrical burns, 14, 124

Electrolyte replacement, postoperative, 37–38, 152–155 Electromyography, in carpal tunnel syndrome, 28, 141 Embolism

in chest trauma assessment, 7 pulmonary. See Pulmonary embolus (PE) retinal artery, 69, 213

Embolization

angiographic, for epistaxis, 220 in neck trauma, 102

Endocarditis

antibiotic prophylaxis for, 197 aortic insufficiency, 203

Endocrine system

diseases of, 55–56, 182–184 neurological disorders and, 223

Endoscopic retrograde cholangiopancreatography (ERCP) in acute ascending cholangitis, 175

in bile duct, 171–172

in jaundice diagnosis, 50, 171 in pancreatic disease

chronic pancreatitis, 183 pancreatic cancer, 173

Endoscopy

in esophageal disease, 158

in gastrointestinal bleeding, 165 in neck mass, 208

in volvulus of sigmoid, 168 Envenomation, snake bites and, 16, 128 Epidural hematoma, head trauma and, 5, 103 Epistaxis, 85

drug abuse and, 220

in pediatric patient, 211 secondary to hypertension, 220

Escharotomy, for burn injuries, 124 Esophageal pH monitoring, 156 Esophagitis, 163–164

Esophagus

atresia of, pediatric surgery and, 67 cancer of, 156–157

diseases of, 42–43, 157–159 perforation of, 165

Evisceration, postoperative wound, 42, 158

Ewing sarcoma, in children and young adults, 33, 123 Explosion injuries, in chest trauma assessment, 112 Extremities. See also Foot and ankle; Hand and wrist

crush injuries of, 14–15, 119, 160

Index

fractures of

ankle, 20, 133–134 arm, 20, 129

lower

fractures of, 23, 133–135 peripheral vascular disease of, 77 ulcers of, 30, 136–137

trauma assessment in, 10–11, 115–116

F

Facial fractures, 28, 141 Facial nerve

injuries of, 69 paralysis of, 218

Fasciotomy

for burn injuries, 119

in compartment syndrome, 134

in extremity trauma management, 10–11, 117 Fat embolism

chest trauma and, 7, 110 femoral fractures and, 131

Fat embolism syndrome, 115 Feeding

cardiac evaluation and, 3, 19, 35, 45, 65, 71, 75, 79, 81, 83, 87, 91, 95

Felon abscess, 29, 142–143 Femoral fractures, 19, 131–132

femur head, 134 femur neck, , 23 in adult, 126

Fever, postoperative, 29–30, 142–144 Fibroadenoma, of breast, 60, 185 Fibrocystic disease, of breast, 185 Fibromuscular dysplasia, 194 Fibula, fractures of, 25, 138 Fine-needle aspiration (FNA)

in breast disease assessment, 176–177 of neck masses, 208

of thyroid nodules, 55, 182 Fistula in ano, 49, 170 Fistulas

fecal, postoperative, 158

of gastrointestinal tract, 37, 153–154 perianal, 169

renal, 118

tracheoesophageal, in pediatric patient, 195 urologic, 227

Flail chest, 8–9, 112 Fluid infusion

postoperative complications and, 36–37, 152–155 rate determination, for burn injuries, 10

in adult, 16

in babies, 13–14 Fluid resuscitation

for burn injuries, 20–22 in trauma setting, 4

Foot and ankle

fractures of, 20, 133–134

243

USMLE Step 2 CK λ Surgery

pain in, 29, 137–138 ulcers of, 30, 136–137

Foreign bodies

detection and evaluation of, 77 in airway, 85

Foster-Kennedy syndrome, 223 Fractures. See also specific bones

bone angulation and, 123, 132, 133 facial. See Facial fractures

hidden, 27 in adults, 22

in pediatric patients, 17, 127–128 of bone

angulation and, 133 in adults, 22

in children, 15, 126–127 open, 22, 134

Salter Harris Grade III, 21 Frontal lobe brain tumor, 81, 219

Fundoplication, in esophageal disease, 164

G

Galeazzi fracture, 23 Gallbladder

thickened wall of, 56 thin-walled, 179

Gallbladder disease, 55–56, 179–180 obstructive jaundice and, 55, 178

Gallstones, 56

diagnosis and management of, 51–52, 172–173 obstructive jaundice with, 57, 178

Gamekeeper’s thumb, 29, 142

Gangrene, of toes, 26. See also Gas gangrene Gas gangrene, 26, 134–135

from C. perfringens infection, 27 Gastric adenocarcinoma, 44

Gastric lymphoma, 44

Gastric ulcers, postoperative complications in, 158 Gastrinoma, 64, 192

Gastroesophageal reflux disease (GERD), 163 Gastrografin swallow

in esophageal disease, 158 in meconium ileus, 189

Gastrointestinal tract. See also Acute abdomen; specific organs, e.g. Stomach

bleeding in, 50–51, 165–167 diseases of

lower GI tract, 166

upper GI tract, 42–43, 158–160 fistulas of, 42, 158–159

Gastroschisis, in pediatric patient, 66, 196 Genu valgus (knock-knee), in children, 15, 126 Genu varum (bow-legs), in children, 15, 126 Giant juvenile fibroadenoma, of breast, 60, 185 Glaucoma

as ophthalmologic emergency, 206 Glucagonoma, 64, 193

Goldman’s index of cardiac risk, 35, 149–150

Gout, 32

foot pain in, 32, 145

Green vomiting, in pediatric patient, 50, 196–197 Grey-Turner sign, 57

Growth plate, fractures of, 14, 124 Gunshot wounds

abdominal, 9, 113

disorientation/coma following, 155–156 in extremities, 11, 116–117

in neck trauma, 5, 102–103

in urologic injury assessment, 114 pulmonary aspiration with, 150

H

Hand and wrist

common problems of, 24–25 fractures of, 20

Headache, in breast cancer metastasis, 62, 190

Head-on automobile collisions, hidden fracture injuries in, 28 Head trauma

assessment of, 3–4 closed injuries in, 22

Heart disease. See Coronary disease Heart murmur, in pediatric patient, 201 Hematomas

epidural, 5, 103

of penile shaft, 116

pelvic fracture and, 12, 117 scrotal, 13, 120

subdural, 5, 103 Hematuria, 92

urologic injury and, 119 urologic tumors and, 86, 223–224

Hemisection, in spinal cord injury, 7, 109 Hemodynamic instability

in pelvic fracture assessment, 113 intraabdominal bleeding and, 10

Hemolytic jaundice, 54, 178 Hemoperitoneum, 12 Hemopneumothorax, 112 Hemorrhagic pancreatitis, 173 Hemorrhagic shock, treatment of, 4 Hemorrhagic stroke, neurosurgery in, 88 Hemorrhoids, 49, 169–170 Hemothorax, 8, 111–112

Hepatic system. See Liver Hepatitis, jaundice with, 178 Hepatocellular jaundice, 54, 178 Hernia

abdominal, 52

congenital diaphragmatic, 66 in pediatric patients, 59, 187

incarcerated, 184

in young adult, 175–176 strangulated, 184 umbilical, , 59

in pediatric patient, 175 Herniation, lumbar disk, 29, 143, 30