10/31/18 Flashcards
what does Lynch syndrome type 1 get?
colon cancer
AD inheritance but 20% are sporadic
What does Lynch syndrome type 2 get?
colon cancer + endometrial, ovarian, gastric cancers (ie: small bowel adenocarcinoma)
Surveillance and prophylaxis for Lynch syndrome?
Surveillance
Colonoscopy @ 20 yo every 1-3 years
Transvaginal US @ 20-25 every year
Prophylactic resection includes total abdominal colectomy with ileorectal anastomosis + TAH + BSO
Best imaging study for detecting a colovesicular fistula?
CT
Approach for orchiectomy for mass?
the surgery should be performed by an inguinal approach, NOT scrotal!
If the scrotum is surgically violated, metastatic spread to both the retroperitoneal and the inguinal nodes becomes possible. Also, exposes the immune system to the haploid cells of the testes.
MCC of catheter related infections after E Coli?
Enterococcus
MCC of community acquired UTI after E Coli?
Staph spp
What does IgA do and how does it work?
Unlike IgG, IgA does not activate complement and it does not lead to the destruction of its antigens. Instead it prevents adherence of antigens to the intestinal lumen forcing it to be excreted.
Treatments for CMV infection?
Severe CMV infection approved treatments - ganciclovir, foscarnet, cidofovir - these inhibit DNA polymerase
For mild infections valganciclovir is acceptable
Vitamin K MoA?
Vitamin K activates the clotting factors via gamma CARBOXYLATION (not decarb) of glutamate residues 2, 7, 9, 10, protein C and S.
Warfarin inhibits the reduction of vitamin K.
Treatment of most RCC?
RCC = nephrectomy
If in the IVC then remove tumor from IVC as well
Responds poorly to chemoradiation
After hysterectomy for resection of a uterine fibroid the path comes back as leiomyosarcoma. What is the next step?
No further surgery is needed.
Removal of ovaries can be considered but not required.
