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

Hip

dislocation of, 22–23 fractures of, , 7

orthopedic disorders of, 17, 129–130 posterior dislocation of, 135

septic, 19

Hirschsprung disease, in pediatric patient, 68, 198 Human bites, 17, 129

Humeral fractures neurovascular injury and, 27 supracondylar, 20

Hyperacute rejection, of transplanted organ, 95, 237 Hyperaldosteronism, 64, 193

Hyperbaric oxygen therapy, for gas gangrene, 140 Hypercalcemia, postoperative, 152–153 Hyperkalemia

hypovolemic shock and, 153 postoperative, 37

Hypernatremia, postoperative, 41, 155 Hyperparathyroidism, 63 Hypertension

epistaxis with, 219 renovascular, 64 surgical, 56–57, 184–185

Hyperthermia. See Fever Hyperthyroidism, thyroid nodules in, 63

Hypertrophic pyloric stenosis, in pediatric patient, 68, 198 Hypokalemia

in abdominal distention, 149–150 postoperative, 37

Hyponatremia, postoperative, 40, 155 Hypophysectomy

fluid and electrolyte replacement following, 158 postoperative complications in, 152

Hypospadias, 92, 231

Hypothermia, in abdominal trauma assessment, 107 Hypovolemic shock

criteria for, 112 hyponatremia and, 40 in femoral fracture, 132 in head trauma, 5

in pelvic fracture, 12

Hypoxia, postoperative disorientation and, 40, 155

I

Imperforate anus, in pediatric patient, 65, 195 Impotence, 94, 235–236

Incontinence, urinary, 93–94, 226 Infancy, surgery in, 61, 199

Infants. See also Feeding; Infections, newborn and infant; Maternal disease; Neonatal seizures; Newborns and resuscitation

cardiac evaluation for, 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

Infection

in urologic emergency, 85–86 postoperative, of surgical wounds, 37, 152

Infiltrating ductal carcinoma, of breast, 61, 188–190

Index

Inflammation

abdominal pain caused by, 51 neck masses and, 75–76

Inflammatory breast cancer, 61, 187 Inhalation injuries, 14

Inner ear disease, dizziness and, 86 Insufficiency, arterial, leg ulcers and, 31, 144 Insulin, exogenous administration of, 192 Insulinoma, 64, 192

Internal bleeding, abdominal trauma and, 10 Internal fixation, of fractures, 122, 134 Intertrochanteric fractures, 23, 24

Intestinal atresia, in pediatric patient, 59, 197 Intestinal obstruction

in pediatric patient, 188–189 mechanical, 42

Intoxication, postoperative ammonium, 41

water, 37, 153

Intraabdominal bleeding, 10–11, 119–120 Intracranial bleeding, 103

neurosurgery and, 223

Intracranial pressure (ICP), in head trauma assessment, 103 Intraductal papilloma, 60, 186

Intussusception, in pediatric patient, 69, 199 Invasive cancers, of breast, 190

Invasive melanoma, 205

Ischemia, abdominal pain and, 47, 52 Ischemic stroke, neurosurgery and, 82 Ischiorectal abscess, 49, 170

J

Jaundice, diseases related to, 54, 177–179 Jersey finger, 29, 142

Jugular venous distention, in cardiac risk assessment, 35

K

Ketoacidosis, fluid and electrolyte replacement in, 160–161 Knee. See also Anterior cruciate ligament (ACL) injuries

injuries to, 25, 132–133

pain in, hip disorders and, 123 Knock-knee. See Genu valgus

L

Lachman test, 25, 137

Lactation, breast abscess and, 186 Laparoscopy, for hernia repair, 184 Laparotomy

in acute abdomen diagnosis, 175 in pelvic fracture assessment, 113

Left-to-right shunts, cardiothoracic surgery and, 71 Leg. See Extremities

Legg-Perthes disease, 19

Ligament of Treitz, gastrointestinal bleeding and, 171–172 Liver

abscesses of, 54, 170 diseases of, 50, 169–172

in preoperative risk assessment, 32, 140–141 metastatic cancer to, 54

245

USMLE Step 2 CK λ Surgery

Lobular breast cancer, 188

Lower extremities. See also Extremities Ludwig angina, 72, 219

Lumbar spine

disk herniation in, 29, 143, 226 injury to, as hidden fracture, 137

Lumpectomy, 61, 188–190 Lung cancer, 65, 195–196

Lungs. See also Pulmonary system Lymph nodes

enlarged, in neck, 209

inflammatory vs. neoplastic, 187–189 Lymphomas

breast cancer and, 186 gastric, 44

in neck, 75, 208 Lytic bone, 146–147

M

Mafenide acetate, for burn injuries, 16 Magnetic resonance imaging (MRI)

of ENT tumors, 209–210 of knee injuries, 20

of orthopedic injuries, 19

Malignant hyperthermia, postoperative, 33, 152–153 Malignant melanoma, 205

Malignant obstructive jaundice, 179–180 Mallet finger, 29, 142

Mallory Weiss tear, 165

Malrotation of pancreas, in pediatric patient, 66, 196–198 Mammary dysplasia, 60, 185

Mammography, in breast disease assessment, 60, 185–190 Manometry studies, in achalasia, 164

Marjolin ulcer, 32, 145 Mastitis, 185

Mayo Clinic diagnostic algorithm, in Cushing disease, 55 Meatal stenosis, 230

Meckel diverticulum gastrointestinal bleeding and, 171 in pediatric patient, 61, 191 rectal bleeding and, 48

Meconium ileus

in pediatric patient, 61, 189 with perforation, 68

Megacolon

aganglionic, in pediatric patient, 48 toxic, 48, 159

Melanoma, 79, 210

Melena, GR tract bleeding and, 50 Meniscal tears, assessment of, 25, 138–139 Mesenteric ischemia, 166

in acute abdomen, 50 Metabolic acidosis

fluid and electrolyte replacement in, 158–160 in hemorrhagic pancreatitis, 174 postoperative, 37–38, 152–153, 153–154

Metabolic alkalosis, postoperative, 44, 161 Metabolic risk, in preoperative assessment, 36

246

Metacarpal neck fractures, 23, 136 Metastatic cancer

to jugular chain node, 208 to liver, 49

Metastatic malignant melanoma, 80 Microhematuria, in urologic injury assessment, 119 Mitral regurgitation, 72, 204

Mitral stenosis, 72, 203

Modified radical mastectomy (MRM), 188 Monteggia fracture, 23

Morton neuroma, 32, 145

Motility problems, in upper GI tract, 42 Multiple myeloma, 24, 33

Lytic bone, 146 Myocardial contusion, 112 Myocardial infarction

in preoperative risk assessment, 32, 139–140 perioperative, 38, 149

N

Nasopharyngeal angiofibroma, 220 Neck masses, 75–76, 191–193

congenital, 211 inflammatory, 216–217 neoplastic, 216 squamous cell cancer, 209

Neck trauma, 5–6, 102–103 Necrosectomy, of necrotic pancreas, 58

Necrotizing enterocolitis, in pediatric patient, 67–68, 197 Neonatal patients, surgery in, 61–63, 192–194 Neoplastic masses, in neck, 75–76, 208

Nerves, injuries to, 7 axonal nerve, 6, 107 facial. See Facial nerve radial nerve, 27

Nesidioblastosis, 192 Neurogenic claudication, 226 Neurologic disease/involvement

differential diagnosis in, 87 endocrine system and, 223 in head trauma, 5

in vascular occlusive disease, 81, 212 pain syndromes and, 84

Neuroma, Morton, 32 Neurosurgery

brain tumors and, 81–82, 211–214 differential diagnosis and, 87 intracranial bleeding and, 88–89, 222 pain syndromes and, 84, 218–219 spinal cord and, 225–226

vascular occlusive disease and, 87–88, 221–222 Neurovascular injuries, orthopedic fractures and, 27 Newborns, surgery in, 61–63, 195–198

Nissen fundoplication, in esophageal disease, 164 Nutrition

burn injury support and, 14

in preoperative risk assessment, 32

O

Obstruction

abdominal pain caused by, 51 in urologic emergency, 85

Obstructive jaundice, 55, 178 gallbladder disease and, 55 malignant, 168

Ogilvie syndrome, postoperative, 41, 157 Omphalocele, in pediatric patient, 66, 196

Open fractures, as orthopedic emergencies, 26, 140 Open heart surgery, 204

Open reduction, of fractures, 122, 134 Ophthalmology

in adults, 73–74, 205–206 in children, 73, 205

Orbital cellulitis

as ophthalmologic emergency, 206, 211 Orchiectomy, 93, 233

Organic impotence, 89, 227

Organ transplantation, 89, 237–238 Orthopedics

adult injuries, 20–22 back pain, 26–27

emergency management in, 19–20, 139–140 foot pain, 28–29

hand problems, 25–26 hip disorders, 19

leg ulcers, 30, 136–137 tumors, 33–34

Osgood-Schlatter disease, 20 Osteochondrosis, tibial tubercle, 20

Osteogenic sarcoma, in children and young adults, 33 Osteomyelitis, acute hematogenous, 20 Otolaryngology (ENT)

emergencies and miscellaneous procedures, 75–76, 211–212 in pediatric patients, 76, 210

neck masses, 75–76, 209–210 tumor assessment in, 74, 210

P

Pain

abdominal. See Abdominal pain, acute

at rest, in arteriosclerotic occlusive disease, 68 in chest, postoperatively, 35, 143

in foot and ankle, 27–28, 137–138 in knee, hip disorders and, 125 syndromes of, 227–228

under casts, 19, 132 Pain syndromes

neurologic disease and, 86 neurosurgery for, 223–224

Pancreas

abscesses of, 54, 173

annular/malrotation, in pediatric patient, 66, 196–198 cancer of, 168

jaundice with, 57 diseases of, 52–53, 185–186 pseudocyst of, 57, 183

Index

Pancreatitis acute, 51

Grey-Turner sign in, 57 acute edematous, 58, 174 acute hemorrhagic, 54 acute suppurative, 58 biliary, 52

chronic, 55, 169 hemorrhagic, 173

in acute abdomen, 48, 175 Ranson’s criteria for, 182

Pancreatoduodenectomy, for cholangiocarcinoma, 179 Papilloma, intraductal, 60, 186

Paralytic ileus, postoperative, 41, 157–158 Parathyroid adenoma, 191

Parinaud syndrome, 89, 225–226

Parkland formula for fluid needs assessment, 15, 125–126 Parotid tumors, 80, 218

Patent ductus arteriosus, in premature baby, 72, 197

Patient history, in neurological disease differential diagnosis, 81 Peau d’orange appearance, in breast, 62

Pediatric patients. See also specific conditions bites and stings in, 127

brain tumors in, 81, 86 burn injuries in, 123

fluid needs determination, 11–12, 126 scalding injuries, 15, 125

child abuse in, injury assessment, 51, 184 epistaxis in, 85, 219

orthopedic disorders in, 14–15, 129–130 orthopedic tumors in, 17–18, 129

rectal bleeding in, 48 surgery in, 59–61, 188–192

infants, 72–73, 202

newborns, 66–68, 67–69, 195–198 urologic disease in, 86

Pelvic fractures, 12, 117

injuries associated with, ruling out, 9 Penetrating injuries. See also Gunshot wounds

in abdominal trauma, 8, 110–111 in chest trauma, 6

in head trauma, 4, 99

in neck trauma, 5, 102–103 in urologic trauma, 10

of extremities, 10–11 rib fractures as, 112

Penis, fracture of, 13, 122

Peptic ulcer disease, postoperative complications in, 161 Percutaneous radiologic tube cholecystostomy,

cardiac risk and, 149

Percutaneous transhepatic cholangiogram (PTC), in acute ascending cholangitis, 181

Perforating injuries, in acute abdomen, 51 Perianal fistula, 170

Pericardial tamponade, 4 Pericarditis, chronic constrictive, 73

Peripheral vascular disease, of lower extremities, 77 Peritonitis, acute abdomen with, 47, 173 Pheochromocytoma, 64, 193

247

USMLE Step 2 CK λ Surgery

Pineal gland tumors, 89, 225–226 Pituitary apoplexy, 89–90, 224 Pituitary microadenoma, 192 Plantar fasciitis, 32, 145 Pleomorphic adenoma, 218 Pneumaturia, 235 Pneumonectomy, 206 Pneumonia, postoperative, 37, 154

Pneumothorax. See also Tension pneumothorax in chest trauma assessment, 6, 104 left-sided, 40

Polyps, colonic, 48

Popliteal artery, knee injuries and, 27, 140

Positron emission tomography (PET), in lung cancer assessment, 206 Posterior fossa tumors, in children, 85, 220

Posterior urethral valves, 86 Postoperative complications

abdominal distention, 41, 157–158 chest pain, 38, 153 disorientation/coma, 40, 155–156 fever, 29–30, 142–144

fluid and electrolyte imbalances, 42–43, 158–161 organ transplant rejection, 89

pulmonary, 36, 150

urinary retention, 41, 93, 152 wound healing, 42, 152–153

Pregnancy, in breast cancer/disease, 60, 186 Premature babies

necrotizing enterocolitis in, 49, 197 patent ductus arteriosus in, 72

Preoperative assessment, 35–36 cardiac risk, 149–150 hepatic risk, 150–151 metabolic risk, 151 nutritional risk, 151 pulmonary risk, 150

Primary hyperaldosteronism, 64

Proctosigmoidoscopic examination, of lower GI tract, 169, 169–170 Prolactinomas, 89

Prostatic cancer, 93, 233–234 Prostatitis, acute bacterial, 92, 230 Pseudocyst, pancreatic, 183

Pseudomembranous enterocolitis, 48, 169 Psychogenic impotence, 94, 235 Pulmonary contusion, 8, 112

Pulmonary embolus (PE), 238 postoperative, 36, 152

Pulmonary system

diseases of. See specific diseases

in preoperative risk assessment, 32, 140 Pyelonephritis, 91, 230

Pyloric stenosis, hypertrophic, in pediatric patient, 68, 198 Pyogenic liver abscess, 54, 177

R

Rabies, animal bites and, 16, 127

Radial nerve, injuries to, 27

Radiation therapy, for breast cancer, 51, 188–190

248

Ranson’s criteria for pancreatitis, 182 Rectal bleeding, 48

Reflex sympathetic dystrophy, 90, 227 Rejection, of transplanted organ, 95 Remodeling, in pediatric fractures, 20 Renal cell carcinoma, 92, 232

Renal failure, postoperative, 157

Renal injury, in urologic trauma, 13, 118 Renovascular hypertension, 64, 194 Resectable breast cancer, 61, 146–148

Respiratory acidosis/alkalosis, postoperative, 40 Respiratory burns, 14, 124

Respiratory distress

in fat embolism syndrome, 109 postoperative ARDS, 36, 152 tension pneumothorax and, 100

Rest pain, in arteriosclerotic occlusive disease, 76 Retinal artery embolism, 69, 213

Retinal detachment, as ophthalmologic emergency, 69, 212 Retinoblastoma, 211

Retrograde urethrogram, in urologic injury assessment, 120 Rib fractures, in trauma assessment, 7, 112, 233

as penetrating injury, 107

Right-to-left shunts, cardiothoracic surgery and, 72 “Rule of nines,” 9, 10

in babies, 13–14

S

Scalding burns, 15 Scaphoid fracture, 23 Scoliosis, 20

Scrotal hematomas, 13 Scrotum, hematomas of, 121

Sentinel lymph node dissection (SLND), 190 Septic hip, in child, 15, 126

Shock, 4–5, 94. See also Hypovolemic shock; Pericardial tamponade clinical signs of, 4

in non-trauma setting, 99 Shoulder

fracture/dislocation injuries of, 20 multiple myeloma lesions in, 33

Sigmoid colon

acute diverticulitis of, 53

resection of, cardiac risk and, 149–150 volvulus of, 53–54, 176

Silicon “silo,” in gastroschisis/omphalocele management, 196 Silver sulfadiazine, for burn injuries, 16, 125

Skin surgery

for burn injuries, excision and grafting, 14, 127 indications for, 73, 203–204

Skull fracture, 5–6, 105

Small bowel, obstruction of, 157 Small cell lung cancer, 65

Small intestine. See also Duodenum atresia of, pediatric surgery and, 65 diseases of, 42

Smoke inhalation, 14, 124

Smoking

chronic obstructive pulmonary disease and, 198 in pulmonary preoperative risk assessment, 32, 140 squamous cell cancers of neck and, 79, 209

Snakebites, 16, 128 Soft tissue sarcomas, 33 Spider bites, 17, 129 Spinal cord

injuries to, 6, 103–104 tumors of, 217–218

Spinal stenosis, 226 Spleen, ruptured, 10, 12 Squamous cell carcinoma

Marjolin ulcer, 32, 145

metastatic, to jugular chain node, 216 of anus, 45, 166

of neck mucosae, 76, 209 of skin, 71, 203

Stab wounds

to abdomen, 8, 110–111 to chest, 99, 105

to neck, 103 Sternum, fracture of, 113 Stomach

cancer of, 159 diseases of, 42

Strabismus, in children, 211 Stress fractures, tibial, 25, 138 Stress incontinence, 88, 226 Stress ulcers, 173

Stroke, neurosurgery in, 87, 221–222

Subarachnoid bleeding, from intracranial aneurysms, 88, 222 Subclavian steal syndrome, 75, 207

Subcutaneous emphysema, differential diagnosis in, 9, 114 Subdural hematomas, 5, 103–104

Sucking chest wounds, 8, 112 Supracondylar fractures, of humerus, 20 Surgical hypertension, 56–57, 184–185

T

Talipes equinovarus (club foot), 20 Tamoxifen, in breast cancer management, 190

Technetium scan, in Meckel diverticulum diagnosis, 173 Tension pneumothorax, 4, 100

in chest trauma assessment, 107 intraoperative, 39 postoperative, 152

Testicle, rectractile, 229 Testicular cancer, 93, 233

Testicular torsion, 91, 229. See also Urologic disease Tetanus prophylaxis

for bites and stings, 14 for burn injuries, 14

for extremity injuries, 10 Tetralogy of Fallot, 72, 202 Thenar atrophy, 28

Thoracic needle decompression, in tension pneumothorax, 154 Thoracic spine injury, as hidden fracture, 133

Index

Thoracotomy

in chest trauma management, 109 in hemothorax management, 105 in lung cancer, 197

Thrombophlebitis, postoperative, 37, 153 Thrombosis

intertrochanteric fracture immobilization and, 136 Thyroidectomy, 191

Thyroid nodules, 63, 191

in hyperthyroid patients, 63 Tibia, fractures of, 20, 132

Tic douloureux (trigeminal neuralgia), 83, 218 Toes, gangrene of, 237

Toxic megacolon, 48, 159 Trachea, traumatic rupture of, 6

Tracheoesophageal (TE) fistula, in pediatric patient, 195 Transaminase levels, jaundice and, 177

Transection aortic, 8, 113

of spinal cord, 6

Transient ischemic attacks (TIAs), 87, 221 Transplantation surgery, 95, 238 Transposition of great vessels, 72, 202 Trauma assessment

abdominal trauma, 9–10, 117–120 bites and stings, 16–17, 102

burn injuries, 123–126 chest trauma, 4–5, 104–109 extremities, 7–8, 116–117 facial nerve injuries, 218 femoral fractures, 131–132 head trauma, 5–6, 105–107 hematuria in, 92

initial survey, 4–5

neck trauma, 5–6, 102–103 pelvic fractures, 12, 117

spinal cord injuries, 7, 109–110 urologic injuries, 13, 119–121

Trigeminal neuralgia (tic douloureux), 89, 227 Trigger finger injury, 28, 141

Tumors. See Cancer

Tunica albuginea, fracture of, 122

U

Ulcerative colitis, 48, 168 Ulcers

duodenal, 174

gastric, postoperative complications and, 154 Marjolin, 32, 145

of foot and leg, 27, 136–137, 238 of skin, 27

peptic, postoperative complications in, 161 stress, 173

Umbilical hernia, 59

in pediatric patient, 175

Upper extremities. See also Extremities Ureteral colic, 175

249