Simulación Examen EFISER: Cirugía General 2

Case Clinical 1: Burn Patient

• Patient is a 55-year-old male with significant history of smoking and chronic alcoholism.

• Suffers from deep second-degree burns covering 30% of total body surface area, affecting face, neck, anterior chest, and hands.

• Most likely cause of burns: Flame exposure.

• Initial management priorities:

  • Ensure airway and adequate ventilation.
  • Initiate aggressive fluid resuscitation with crystalloids.
  • Immediate debridement of all burned areas is NOT prioritized.
  • Evaluate and treat associated injuries is also crucial.

• Factors increasing complication risks:

  • Age, smoking, and alcoholism contribute significantly; all are risk factors.

• Long-term complication prevention is critical:

  • Aim to prevent contractures and hypertrophic scars.
  • Other concerns include wound infections, renal failure, and pulmonary thromboembolism.

• Criteria for transfer to specialized burn center include:

  • Deep second-degree burns covering more than 10% of body surface.
  • Any percentage of third-degree burns.
  • Burns affecting face, hands, feet, or genital areas.

Case Clinical 2: Breast Cancer Patient

• Patient is a 30-year-old female presenting with a 2 cm, mobile, and painless right breast nodule.

• Diagnosis confirmed via mammography and biopsy revealing infiltrating ductal carcinoma.

• Next step in evaluation:

  • Tumor staging with imaging studies and sentinel lymph node biopsy.
  • Other options like radical mastectomy or neoadjuvant chemotherapy are not immediate steps.

• Prognostic factors for this patient include:

  • Tumor size, lymph node involvement, and hormone receptor status.
  • Tumor lateralization (right vs left) does NOT influence prognosis.

• Most appropriate treatment option:

  • Treatment should be individualized based on patient preferences and tumor characteristics.
  • Options include segmental mastectomy with radiotherapy, modified radical mastectomy followed by adjuvant chemotherapy, or neoadjuvant chemotherapy.

• Adjuvant systemic therapy purpose:

  • Designed to prevent cancer recurrence.
  • It does NOT primarily treat metastatic cancer, nor does it reduce tumor size prior to surgery.

Case Clinical 3: Alcohol and Pancreatitis Study

• Case-control study design investigating the link between alcohol consumption and acute pancreatitis.

• Involved 100 patients with acute pancreatitis and 200 healthy controls.

• Of the study subjects, 60 cases (patients with pancreatitis) and 50 controls (healthy) reported excessive alcohol use.

• Appropriate measure of association in this study:

  • Odds ratio (OR) is used to compare the odds of exposure (alcohol consumption) between cases and controls.

Prepare for the EFISER exam with this simulation focused on surgical specialties. It includes clinical cases and research methodology questions to test your knowledge effectively. Engage with 15 clinical cases and multiple-choice questions to solidify your understanding.