NExT Surgery and Allied Specialties (General Surgery, Orthopedics, Anesthesiology, Radiodiagnosis) Flashcards

24 sample cards from the Surgery and Allied Specialties (General Surgery, Orthopedics, Anesthesiology, Radiodiagnosis) deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What is the Goodsall's rule for anal fistula tracts?

   Fistulas with external opening anterior to the transverse anal line open into the anal canal in a straight radial line; posterior openings curve to open in the posterior midline.

2. In polytrauma, what is the correct ATLS primary survey sequence?

   ABCDE: Airway (with C-spine control), Breathing, Circulation (with hemorrhage control), Disability (GCS/pupils), Exposure/Environment.

3. What is the lethal triad of trauma?

   Hypothermia, acidosis, and coagulopathy — a self-perpetuating cycle worsening hemorrhage and mortality.

4. Which breast quadrant is the most common site for breast carcinoma, and the most common histologic type?

   Upper outer quadrant; invasive ductal carcinoma (NST) is the most common histologic type.

5. What is peau d'orange and what does it signify in breast disease?

   Dimpled, orange-peel skin appearance from dermal lymphatic edema/obstruction; signifies locally advanced or inflammatory breast carcinoma.

6. What nerve injury causes a 'winged scapula' after axillary surgery?

   Injury to the long thoracic nerve (of Bell) supplying serratus anterior.

7. What is the most common cause of hyperthyroidism, and the antibody involved in Graves' disease?

   Graves' disease; caused by TSH receptor-stimulating antibodies (TRAb/thyroid-stimulating immunoglobulin).

8. Which nerve is at risk during thyroidectomy and what is the effect of unilateral injury?

   Recurrent laryngeal nerve; unilateral injury causes hoarseness (paramedian vocal cord); bilateral injury can cause airway obstruction/stridor.

9. What is the most common cause of primary hyperparathyroidism and its classic biochemistry?

   Solitary parathyroid adenoma; high serum calcium with high/inappropriately normal PTH and low phosphate.

10. What is the ankle-brachial pressure index (ABPI) and what value indicates significant peripheral arterial disease?

    ABPI = ankle systolic BP / brachial systolic BP. Normal 0.9-1.3; <0.9 indicates PAD; <0.4 indicates critical limb ischemia.

11. List the '6 Ps' of acute limb ischemia.

    Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Perishing cold (poikilothermia).

12. How is the burn surface area estimated using the Wallace Rule of Nines in adults?

    Head 9%, each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, perineum 1%.

13. State the Parkland formula for burn fluid resuscitation.

    4 mL x body weight (kg) x %TBSA burned of Ringer's lactate over 24h; half given in first 8 hours from time of injury, remainder over next 16 hours.

14. Define Salter-Harris fracture types I-V.

    I: through physis only; II: physis + metaphysis (most common); III: physis + epiphysis (intra-articular); IV: metaphysis + physis + epiphysis; V: crush injury to physis (worst prognosis).

15. What is the difference between a Colles' and a Smith's fracture?

    Colles': distal radius fracture with dorsal angulation/displacement ('dinner fork'). Smith's: distal radius fracture with volar (palmar) angulation ('reverse Colles').

16. What is the most common organism in acute hematogenous osteomyelitis, and in sickle cell patients?

    Staphylococcus aureus overall; Salmonella is characteristically associated with sickle cell disease.

17. Differentiate the typical radiographic features of osteosarcoma vs Ewing sarcoma.

    Osteosarcoma: metaphysis of long bones, sunburst pattern + Codman's triangle, adolescents. Ewing sarcoma: diaphysis, onion-skin/lamellated periosteal reaction, younger children, t(11;22) translocation.

18. What is the most common benign and most common malignant primary bone tumor?

    Most common benign: osteochondroma. Most common primary malignant: osteosarcoma (multiple myeloma is the most common overall malignant bone tumor).

19. Differentiate osteoporosis from osteomalacia biochemically.

    Osteoporosis: normal calcium, phosphate, ALP (reduced bone mass). Osteomalacia: low/normal calcium, low phosphate, high ALP, low vitamin D (defective mineralization).

20. What is the Ortolani and Barlow test used to detect in neonates?

    Developmental dysplasia of the hip (DDH); Ortolani relocates a dislocated hip (clunk in), Barlow dislocates a dislocatable hip (clunk out).

21. What are the three main types of regional anesthesia and the key landmark difference between spinal and epidural?

    Spinal, epidural, and peripheral nerve blocks. Spinal: injected into subarachnoid/CSF space (below L2 to avoid cord), small drug dose, rapid dense block. Epidural: into epidural (potential) space, larger volume, slower onset, catheter for continuous infusion.

22. What is the recommended chest compression rate and depth in adult CPR, and compression-to-ventilation ratio?

    Rate 100-120/min, depth 5-6 cm (at least 2 inches), 30:2 compression-to-ventilation ratio for single/dual rescuer without advanced airway.

23. What contrast agent type is contraindicated in suspected bowel perforation, and which is preferred?

    Barium is contraindicated (causes barium peritonitis); water-soluble iodinated contrast (e.g., Gastrografin) is preferred when perforation is suspected.

24. What imaging modality is the gold standard for soft tissue/spinal cord/ligament evaluation and which uses ionizing radiation: MRI or CT?

    MRI is the gold standard for soft tissue, cord, ligaments and uses NO ionizing radiation (uses magnetic fields). CT uses ionizing radiation and excels at bone and acute hemorrhage.

What this deck covers

Surgery and Allied Specialties (General Surgery, Orthopedics, Anesthesiology, Radiodiagnosis) flashcards FAQ