Surgery Practice Test Handouts

Comprehensive vocabulary flashcards covering surgery board prep practice tests, including classifications, eponyms, trauma zones, and surgical procedures.

Fine Needle Aspiration Biopsy (FNAB)

The primary diagnostic tool used for thyroid masses to determine if they are benign or malignant.

Papillary Thyroid Carcinoma

The most common histologic type of thyroid cancer, accounting for approximately $80\%$ of all thyroid malignancies.

Modified Radical Neck Dissection (MRND)

Removal of lymph nodes from levels II–V while preserving the spinal accessory nerve, internal jugular vein, and sternocleidomastoid muscle.

Nissen Fundoplication

A $360^{\circ}$ antireflux surgical procedure that wraps the fundus of the stomach completely around the lower esophagus.

Toupet Fundoplication

A $270^{\circ}$ posterior partial fundoplication wrap used as an alternative to reduce postoperative dysphagia.

Dor Fundoplication

A $180^{\circ}$ anterior fundoplication of the distal esophagus.

Littre’s Hernia

A hernia sac that contains a Meckel’s diverticulum.

Spigelian Hernia

A hernia occurring through the linea semilunaris, typically near the level of the arcuate line; also called a lateral ventral hernia.

Richter’s Hernia

The herniation of only the antimesenteric portion of the bowel wall through a fascial defect.

Amyand’s Hernia

The presence of the vermiform appendix within an inguinal hernia sac.

Pantaloon Hernia

A condition involving simultaneous ipsilateral direct and indirect inguinal herniation.

Maydl Hernia

A hernia containing two loops of bowel within the sac.

Inhalation Injury

A burn complication caused by combustion products that causes airway edema, mucosal sloughing, and increased metabolic demand.

Ophthalmia Neonatorum

A purulent conjunctivitis in newborns most commonly caused by Chlamydia trachomatis acquired during passage through the birth canal.

Hypothermia (Surgical)

A drop in body temperature below $35^{\circ}\text{C}$ ($95^{\circ}\text{F}$) during surgery, which can cause arrhythmias and respiratory acidosis.

Helical Non-contrast CT Scan

The standard imaging gold standard for detecting renal and ureteral stones of any size.

Hemiarthroplasty

A surgical procedure replacing only the femoral head while preserving the acetabulum, often preferred for elderly hip fracture patients.

Kosher Sign

The migration of abdominal pain from the umbilical area to the right lower quadrant, characteristic of acute appendicitis.

Recurrent Laryngeal Nerve

The nerve most at risk during the surgical repair of a patent ductus arteriosus and thyroidectomies.

Whipple Procedure

A pancreaticoduodenectomy involving the resection of the duodenum, head of the pancreas, and distal common bile duct.

Halo Vest

An orthotic device consisting of a metal ring secured to the skull that provides the greatest degree of external cervical stabilization.

MammaPrint

A genomic test designed to identify the risk of recurrence in ER-positive, HER2-negative early-stage breast cancer.

Hypovolemic Shock

A condition resulting from a severe decrease in circulating blood volume, characterized by tachycardia, cold extremities, and low blood pressure.

Pneumoperitoneum

The presence of free air under the right hemidiaphragm on an upright abdominal X-ray, suggesting a perforated peptic ulcer.

Glasgow Coma Scale (GCS)

A standardized system for assessing level of consciousness based on eye, verbal, and motor responses; a primary predictor of outcome in TBI.

Fothergill’s Sign

A diagnostic sign for rectus sheath hematoma where an abdominal wall mass remains palpable when the rectus muscles are tensed.

Testicular Dysgenesis Syndrome Triad

A developmental disorder consisting of cryptorchidism, hypospadias, and impaired spermatogenesis.

Mycophenolate

A renal transplant medication that is teratogenic and associated with characteristic embryopathy, making it unsafe for pregnancy.

Spina Bifida Occulta

The mildest form of neural tube defect characterized by failure of fusion of the posterior vertebral elements, often marked by a tuft of hair.

Secondary Intention

A method of wound healing where the wound is left open to heal spontaneously by granulation, contraction, and epithelialization.

Refeeding Syndrome

A complex complication characterized by hypophosphatemia, hypokalemia, and hypomagnesemia after reintroducing nutrition to a malnourished patient.

Arrowhead Sign

A CT scan finding for appendicitis where thickened cecum funnels contrast toward the appendiceal orifice.

Achalasia

A primary motility disorder defined by a hypertensive lower esophageal sphincter, absent peristalsis, and failure of the LES to relax.

Mirizzi Syndrome

Extrinsic compression of the common hepatic duct by a stone impacted in the cystic duct or Hartmann’s pouch.

Triangle of Doom

A laparoscopic anatomical landmark bounded by the vas deferens and testicular vessels containing the external iliac artery and vein.

Gastroschisis

A full-thickness abdominal wall defect, usually to the right of the umbilicus, through which intestines protrude without a covering sac.

Omphalocele

A midline abdominal wall defect in which the herniated bowel and viscera are covered by a peritoneal sac and amniotic membrane.

Billroth II

A gastrojejunostomy reconstruction that can be complicated by alkaline reflux gastritis or afferent loop syndrome.

Type II Hiatal Hernia

A paraesophageal hernia involving the herniation of the gastric fundus alongside a normally positioned GE junction.

Ranula

A mucous retention cyst involving the sublingual gland.

Epulis

Granulomatous lesions of the oral cavity due to exaggerated inflammation; the pregnancy type often resolves spontaneously.

Pemberton Sign

A sign of substernal goiter where facial flushing and venous dilatation occur when the patient raises both arms.

Selective Neck Dissection

A procedure that removes specific lymph node levels based on tumor location, such as a supraomohyoid dissection for oral tongue cancer.

Secondary Hypothyroidism

A condition characterized by low TSH and low Free T4, indicating a pituitary or hypothalamic cause.

Significant Weight Loss (3 months)

A weight loss categorized as $7.5\%$ of baseline body weight over a 90-day period.

Severe Weight Loss (3 months)

A weight loss categorized as greater than $7.5\%$ of baseline body weight over a 90-day period.

Basal Caloric Requirement

The daily caloric intake recommended for a normal healthy adult, typically $25\text{--}30\,kcal/kg$ per day.

Primary Energy Source (Short-term Fasting)

Glycogen stored in the liver, which is broken down to maintain blood glucose.

Primary Energy Source (Prolonged Fasting)

Fat and ketones mobilized after glycogen stores are depleted.

ERAS Principle

Early Recovery After Surgery; core principles include early mobilization and early oral feeding postoperatively.

Tetanus-Prone Wound

A wound that is deep ($>1\,cm$), contaminated (soil, saliva), or contains devitalized tissue.

Operative Wound Class II

Clean-contaminated; involves controlled entry into a colonized viscus (e.g., elective cholecystectomy or appendectomy).

Operative Wound Class III

Contaminated; includes fresh, open traumatic wounds or gross spillage from the GI tract.

Operative Wound Class IV

Dirty; involves existing infection, devitalized tissue, or perforated viscera present before the operation.

Primary Intention

Wound healing used for clean, well-approximated surgical incisions closed immediately with sutures.

qSOFA Criteria

A bedside tool for sepsis consisting of respiratory rate $\ge 22\,bpm$, altered mentation ($GCS < 15$), and systolic blood pressure $\le 100\,mmHg$.

Superficial Surgical Site Infection

An infection involving only the skin and subcutaneous tissue of the incision occurring within 30 days post-surgery.

Standard Prophylactic Antibiotic Timing

Administration of antibiotics within $60\,minutes$ before the surgical incision.

Post-operative Fever: Wind

Fever occurring within $<48\,hours$ post-surgery, classically attributed to atelectasis.

Mohs Surgery (CCPDMA)

Complete circumferential and peripheral deep margin assessment with intraoperative frozen section; preferred for facial basal cell carcinoma.

Coffee-Bean Appearance

A classic abdominal X-ray finding pointing toward the right upper quadrant, pathognomonic for sigmoid volvulus.

Ligament of Treitz

The anatomical landmark separating upper gastrointestinal bleeding (proximal) from lower gastrointestinal bleeding (distal).

Crohn’s Disease

An inflammatory bowel disease characterized by transmural inflammation, skip lesions, granulomas, and a 'cobblestone' appearance.

Uric Acid Stone Environment

Stones that typically form when the urine $\text{pH}$ is consistently $\le 5.5$.

Calcium Phosphate Stone Environment

Stones that form in a slightly alkaline environment with a urine $\text{pH} \ge 6.5$.

Primary Spontaneous Pneumothorax

Pneumothorax occurring without underlying lung disease, most commonly due to the rupture of apical subpleural blebs.

TURP Absolute Indications

Refractory urinary retention, recurrent UTIs, bladder stones, or renal insufficiency from outlet obstruction.

Free Flap

A tissue flap completely detached from the body and reimplanted using microvascular anastomosis at the recipient site.

Orofacial Clefting

The most common birth defect in the world, with family history being the strongest predictive factor.

Latissimus Dorsi Flap

The most common musculocutaneous transfer used in combination with breast implants for reconstruction.

Retinal Detachment

A condition causing sudden, painless visual loss often described as a 'curtain coming down' without associated redness.

Exenteration

The surgical removal of the entire globe and all orbital contents, typically done for malignant orbital tumors.

Anisocoria

The ocular hallmark sign of uncal herniation, caused by compression of the ipsilateral oculomotor nerve (CN III).

Incentive Spirometer

A device used post-operatively to encourage deep inspiration and prevent atelectasis.

Esophageal Varices

Cause of massive upper GI bleeding due to portal hypertension, requiring emergency management with octreotide and band ligation.

Massive Hemoptysis

The expectoration of more than $600\,mL$ of blood within a $24\text{-hour}$ period.

Surgical Stress Response Hormones

Includes elevated cortisol, epinephrine, and glucagon; insulin levels are typically decreased or its effects blunted.

Hypertrophic Pyloric Stenosis (HPS)

Condition characterized by non-bilious projectile vomiting in infants aged 3-6 weeks and a palpable 'olive' mass.

Hypoplastic Left Heart Syndrome

The most common congenital heart defect requiring cardiac transplantation during infancy.

Anterior Compartment Syndrome

Traumatic emergency characterized by pain on passive dorsiflexion and numbness between the first and second toes.

Insensible Water Loss

Non-measurable fluid losses occurring through the skin ($75\%$) and lungs ($25\%$).

Earliest Sign of Volume Overload

Rapid weight gain.

Primary Hemostasis Component

Platelet plug formation.

Fibroblastic Phase

The stage of wound healing (days 4-12) focused on establishing tissue continuity, characterized by collagen deposition.

Total Body Water (Adult Male)

Approximately $60\%$ of total body mass.

Extracellular Fluid (ECF)

Fluid compartment accounting for $20\%$ of body weight, consisting of interstitial fluid ($15\%$) and plasma ($5\%$).

Intracellular Fluid (ICF)

Fluid compartment accounting for $40\%$ of body weight, rich in potassium and phosphate.

Holliday-Segar Method

A standard calculation for maintenance fluid: $100\,mL/kg$ for first $10\,kg$, $50\,mL/kg$ for next $10\,kg$, and $20\,mL/kg$ thereafter.

DIC Laboratory Findings

Elevated D-dimer, prolonged PT/aPTT, low fibrinogen, and decreased platelet count.

Type III Collagen

The most important initial collagen type laid down during the proliferative phase of wound healing.

Type I Collagen

The most abundant collagen in the body, providing tensile strength to skin and bone; replaces Type III during maturation.

Target Glucose for SSI Prevention

$<200\,mg/dL$ in perioperative patients.

Class II Hemorrhagic Shock

Blood loss of $750\text{--}1500\,mL$ ($15\text{--}30\%$), characterized by tachycardia ($>100\,bpm$) and narrow pulse pressure.

Class III Hemorrhagic Shock

Blood loss of $1500\text{--}2000\,mL$ ($30\text{--}40\%$), characterized by decreased blood pressure and confusion.

Class IV Hemorrhagic Shock

Blood loss $>2000\,mL$ ($>40\%$), characterized by lethargy and negligible urine output.

Middle Meningeal Artery

The structure most commonly disrupted in an acute epidural hematoma.

Dural Bridging Veins

The structures most commonly disrupted in an acute subdural hematoma.

Le Fort I Fracture

A horizontal fracture through the maxilla superior to the teeth, resulting in a mobile hard palate.

Le Fort II Fracture

A pyramidal maxillary fracture extending through the medial orbital wall and infraorbital rim.

Le Fort III Fracture

A complete craniofacial separation involving the zygomatic and nasal suture lines.