10/20/2018 Flashcards
TIPS shunt stenosis / thrombosis rates in the first year
50%
Tx by balloon dilation of shunt or place a second shunt
What keep Ductus Arteriosus open after birth?
Prostaglandins (PGE1)
Gold standard imaging for Choledochal cysts
MRCP
Type 1 Choledochal cyst and treatment?
MOST common choledochal cyst.
fusiform dilation of whole CBD
Tx: resection and hepaticojejunostomy
Type 2 Choledochal cyst and treatment?
true diverticulum
Tx: resection and primary repair, possible hepaticojejunostomy
Type 3 Choledochal cyst and treatment?
cyst in distal CBD (normal duodenal mucosa)
Tx: local resection or marsupialization
Type 4 Choledochal cyst and treatment?
multiple cysts intra and extra hepatic
Tx: resection, possible lobectomy, possible Txp
Type 5 Choledochal cyst and treatment?
Caroli’s disease, intrahepatic cysts and hepatic fibrosis (maybe assoc. with medullary sponge kidney)
Tx: resection, possible lobectomy, possible Txp
H. Pylori binds what cells in the stomach?
Can only bind cells that have undergone metaplasia
Greatest risk factor for developing gastric adenocarcinoma?
H. Pylori
Treatment for H. Pylori?
PPI (blocks H+/K+ ATPase pump) and BAM/BAT
Bismuth salts, Amoxicillin, Metronidazole/Tetracycline
Follow-up breath test
Tx for low grade gastric MALT lymphomas?
Antibiotics, treat the H. Pylori
Tx for high grade gastric MALT lymphomas?
Chemo and radiation
only surgery if perforation or uncontrolled bleeding
Gardner’s Syndrome
Colon cancers
GI polyposis, osteomas, epidermal cysts
Sebaceous cyst pathophysiology? Filled with?
implantation of epidermal components into the dermis.
They are filled with keratin.
Preferred grafts for CABG?
Internal thoracic artery preferred over other grafts.
Left ITA - LAD (left to left)
Right ITA - RCA, PDA, or branches of LCA
copper deficiency Sx’s?
Pancytopenia, skin pigmentation changes, arrhythmia
Selenium deficiency sx’s?
cardiomyopathy, weakness, growth retardation
Chromium deficiency sx’s?
hyperglycemia, confusion, neuropathy
Niacin deficiency sx’s?
Pellagra - 3D’s - Dementia, diarrhea, dermatitis
Which pancreatic enzymes are secreted in their active form? (list 3)
Amylase, ribonuclease, lipase
lipase technically active by still needs Co-lipase to function properly
Seminoma characteristics and Tx?
MC testicular tumor. NO AFP elevation.
Tx: All get orchiectomy and XRT. Chemo if mets.
(VERY sensitive to radiation)
Non-seminomatous characteristics and Tx?
(Embryonal, teratoma, choriocarcinoma, yolk sac)
Yes to AFP elevation.
Tx: All get orchiectomy and retroperitoneal dissection. Stage 2 or more get chemo.
(Teratomas more likely to metastasize and not respond to chemo)
Vinyl chloride is a risk factor for what?
Angiosarcoma
Inhibin is a tumor marker for what cancers?
Epithelial stromal tumors such as:
sex cord stromal tumors - Granulosa cell and Sertoli-Leydig cell
mucinous and endometrial cancers
What is the most potent stimulator of pancreatic enzyme secretion?
CCK
What is the most potent stimulator of bicarb secretion from pancreas?
Secretin
What is the most potent stimulator of bile secretion?
Secretin
Most common location of small bowel lymphomas?
ileum
due to higher amount of lymphoid tissue here versus other parts of small bowel
Symptoms of Beri-Beri
(Thiamine deficiency)
anion gap metabolic acidosis, AMS, hyperbilirubinemia, diabetes insipidus, and thrombocytopenia
