Surgery Medical Board Prep Flashcards Part 1

Comprehensive vocabulary flashcards covering general surgery, trauma, wound care, and specialized surgical systems as per the Topnotch Medical Board Prep handout.

Extracellular volume deficit

The most common fluid disorder in surgical patients, most frequently caused by the loss of GI fluids from nasogastric suction, vomiting, diarrhea, or enterocutaneous fistula.

Basal caloric requirement

For a normal healthy adult, this requirement is estimated at $25-30\,kcal/kg/d$.

Zinc deficiency

The most common trace mineral deficiency manifesting as a diffuse eczematoid rash at intertriginous areas.

Trauma-induced coagulopathy (TIC)

A coagulopathy precipitated by tissue injury and/or hemorrhagic shock with a distinct process from DIC; its frequency is reduced by using Damage Control Resuscitation (DCR).

Massive Transfusion Ratio

The administration of RBC, platelets, and plasma in a ratio of $1:1:1$.

Transfusion associated circulatory overload (TACO)

A transfusion reaction manifesting as pulmonary edema due to large volumes of blood transfused, distinguished from TRALI which is non-cardiogenic.

ERAS Analgesics

The use of non-opioid oral analgesia or NSAIDs as part of Enhanced Recovery After Surgery protocols.

Tetanus-prone wound

A wound characterized by age $>6\,hours$, stellate/avulsion configuration, depth $>1\,cm$, missile/crush/burn mechanism, and the presence of devitalized tissue or contaminants.

Primary Intention

A type of surgical wound healing where clean tissue is approximated by sutures without tension.

Secondary Intention

A type of surgical wound healing where the wound is left open to heal by granulation tissue formation and contraction.

Class III - Contaminated

The operative wound class for an appendectomy performed in the setting of acute appendicitis.

5W’s of postoperative fever

Mnemonic for timing: Wind ($<48\,hrs$), Water ($3-5\,days$), Walk ($4-6\,days$), Wound ($5-7\,days$), and Wonder if drug ($>7\,days$).

Head tilt

An inappropriate airway maneuver in managing a trauma patient with cervical spinal control.

Flail chest

A condition defined by the fracture of $\geq 3$ contiguous ribs in $\geq 2$ locations.

Massive hemothorax

In adults, this is defined by a blood loss of $>1,500\,mL$; in children, it is $>25\%$ of blood volume.

Battle sign

Ecchymosis behind the ear that serves as a sign of a suspected basilar skull fracture.

Middle meningeal artery

The vessel most commonly affected in an acute epidural hematoma.

Brown-Séquard syndrome

A spinal injury characterized by ipsilateral motor weakness, ipsilateral impairment of proprioception/vibration, and contralateral impairment of pain and temperature sense.

Smith’s fracture

A distal radial fracture with volar angulation.

Colles' fracture

A distal radial fracture with dorsal angulation.

Monteggia fracture

A proximal third ulnar fracture associated with dislocation of the radial head.

Galeazzi fracture

A middle-distal third radial fracture associated with dislocation of the radioulnar joint.

Greenstick fracture

An incomplete fracture where the angulating force bends the cortex on the compression side and breaks it on the distraction side.

Rule of 9’s

A system for estimating TBSA: Head ($9\%$), Chest ($9\%$), Abdomen ($9\%$), Upper back ($9\%$), Lower back/buttocks ($9\%$), Arm ($9\%$), Thigh ($9\%$), Leg ($9\%$), and Genitalia ($1\%$).

Mafenide acetate

A topical antimicrobial used in burn care that has the potential to cause metabolic acidosis.

Soap-bubble appearance

The characteristic radiologic finding of an ameloblastoma, a benign but locally aggressive odontogenic tumor.

Ligament of Berry

The ligament that attaches the thyroid gland to the cricoid cartilage.

Delphian nodes

Prelaryngeal lymph nodes that group around the pyramidal lobe of the thyroid.

Sestamibi scan

A technique used for the preoperative localization of the parathyroid glands.

Axillary tail of Spence

The lateral border of the breast found at the anterior axillary line.

Batson vertebral plexus

A venous plexus extending from the base of the skull to the sacrum that provides a route for breast cancer metastases.

Zuska’s Disease

Also known as recurrent periductal mastitis; cigarette smoking is a major risk factor.

Marjolin ulcer

A squamous cell carcinoma of the skin that arises from old scars or burn sites.

Inguinal triangle of Hesselbach

Borders include the rectus abdominis muscle (medial), inferior epigastric vessels (superolateral), and inguinal ligament (inferolateral).

Borchardt Triad

Indicative of an incarcerated intrathoracic stomach: chest pain, retching with inability to vomit, and inability to pass an NGT.

Killian triangle

An area of potential weakness situated behind the esophagus at the level of the cricopharyngeus muscle.

Schatzki ring

A thin submucosal ring located in the lower esophagus.

Dieulafoy lesion

An unusually large tortuous submucosal artery that presents as intermittent upper gastrointestinal bleeding.

Bismuth-Corlette Classification

Method for classifying cholangiocarcinoma; Type IIIB involves the confluence and the left hepatic duct.

Mirizzi syndrome

Common hepatic duct obstruction caused by extrinsic compression from an impacted stone in the cystic duct.

Cullen sign

Periumbilical ecchymosis seen in acute pancreatitis due to blood dissecting the falciform ligament.

Whipple surgery

Also known as pancreaticoduodenectomy; it is the only definitive and potentially curative treatment for periampullary pancreatic carcinoma.

FRIEND

Mnemonic for factors inhibiting spontaneous closure of intestinal fistulas: Foreign body, Radiation, Infection/inflammation, Epithelialization, Neoplasm, and Distal obstruction.

Meckel’s diverticulum Rule of 2’s

Rough guide: $2\%$ of population, $2:1$ male predominance, $2\,feet$ proximal to ileocecal valve, $2\,inches$ long, and $2$ types of mucosae.

Lynch syndrome

Also known as hereditary nonpolyposis colorectal cancer (HNPCC); linked to DNA mismatch repair (MMR) genes.

Nervi erigentes

The parasympathetic fibers originating from $S2-S4$ that innervate the anoderm.

Auerbach plexus

The myenteric plexus that is absent in Hirschsprung’s Disease, resulting in functional obstruction.