ABSITE Flashcards
TEG: R
Greater 10 min
FFP
TEG: K
Greater 3 min
Cryo
TEG: α Angle
Less 53
Cryo & Plt
TEG: MA
Less 50 mm
Plts
TEG: LY30
Greater 3%
TXA
BIRADS 0
Incomplete
Repeat Mammo or U/S
BIRADS1
Negative
Routine screening
BIRADS 2
Benign
Routine Screening
BIRADS 3
Probably Benign
6 Month follow up
BIRADS 4
Suspicious
Tissue Diagnosis
BIRADS 5
High likelihood of malignancy
Tissue diagnosis
BIRADS 6
Biopsy proven malignancy
Excision
Bethesda I
Nondiagnostic
Repeat FNA
Bethesda II
Benign
Clinical or U/S follow up
Bethesda III
AUS/FLUS
Repeat FNA
Lobectomy/Molecular testing
Bethesda IV
Follicular Neoplasm (FN)/SFN
Molecular testing/Lobectomy
Bethesda V
Suspicious for Malignancy
Total/Lobectomy
Bethesda VI
Biopsy proven malignancy
Total/Lobectomy
Male Breast Cancer
MRM
Aromatase inhibitor
Inflammatory Breast Cancer
Neoadjuvant CT -> MRM -> ALND -> Adjuvant XRT
Paget Breast
MRM, Nipple-Areolar Complex
Invasive ductal carcinoma borders
No ink on tumor
DCIS Borders
2 mm
Her2neu (+)
Neoadjuvant (Traszumemab) + BCT
DCIS Treatment (Female vs Male)
Female: BCT + Endocrine + Radiation
Sentinel lymph node is not recommended for DCIS unless the following apply: lesion>4 cm, palpable mass, mastectomy, and microinvasion.
Male: Mastectomy
Li Fraumeni
p53
Leukemia
Sarcoma
Adenocarcinoma
Breast
PCI Scoring
T1 is a PCI score 1-10,
T2 is a PCI score 11-20
T3 is a PCI score 21-30
T4 is a PCI score 31-39
LS0: No tumor; LS1: Tumor up to 0.5 cm; LS2: Tumor b/w 0.5 - 5.0 cm; LS3: Tumor >5 cm or confluent tumor
When primary Esophagus can be repaired primary in TEF
Gap is <2 vertebral bones
Compartment syndrome
12 mm Hg (Increase pressure)
20 mm Hg (Organ failure)
High risk IPMN
- jaundice
- enhancing solid component
- MD >1 cm
Worrisome IPMN
- Size >3 cm
- Thickened enhancing cyst walls
- MD 5 - 9 mm
- Nonenhancing mural nodules
- Abrupt caliber change
- Lymphadenopathy
- Pancreatitis
Contraindication to total or head pancreatic resection
Splenic or portal vein thrombosis
(Casuses significant operative bleeding due to recanalization)
Long term Blind loop sydrome
Due to B2
Medium chain Triglycerides + B12
Muir-Torre syndrome
- GI
- GU
- Breast
(MLH1, MSH2)
Cowden syndrome
- Mucocutaneous
- Endometrial
- Thyroid
- Breast
(PTEN)
Gastrectomy margins
Proximal 6 cm
Distal 2 cm
Triple negative Breast CA
Lumpectomy + Adjuvant XT + Radiation
Time span anal nodule needs to be present before biopsy
6 Months
Papillary Thyroid Ca Stage III or IV
Age >55 yrs
Size of thyroide nodule not needing FNA
<1 c m(10 mm)
Desmoplastic melanoma
Resection + Adjuvant radiation
Lidocaine dosing
w/ Epi 7 mg/Kg
w/o Epi 5 mg/Kg
Bupivicaine Dosing
2.5 mg/kg
Pancreatitis Surgery: Head
- Frey
- Berger
- Whipple
Pancreatitis Surgery: Enlarged duct
Peustow
Side Effect: Etomidate
Adrenal Supression
Hoffman Elimination Nondepolarizing agents
Atracurium
Cisatracurium
(Hoffman elimination)
Baitracin
Partial thickness burns
Nephrotoxic
Mupirocin
MRSA
Silvadene (Sulfadiazie)
Does not penetrate eschar
Prophylaxis
Neutropenia
Mafenide acetate
Fullthickness burns
Penetrates eschar
Metaboli aidosis (carbonic anhydrase inhibotor)
Silver nitrate
Hyponatremia
Contraindication to lumpectomy
- prior irradiation
- pos margins
- inflammatory
- pregnancy (unless 3rd trimester)
Breast: what are the axillary node levels (1-3, and one more category)?
1 - lateral to pec minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter’s Nodes - between pec major and pec minor
Breast: what do you do if you can’t find radiotracer dye in SNLB?
ALND
Breast: what patient would get only mastectomy/BCT + tamoxifen for 5 years (4 characteristics)?
(-) SLN
old
ER+
tumor <2 cm
Breast: what patient would get mastectomy/BCT + tamoxifen for 5 years plus chemo (4 characteristics)?
(-) SLN, young, ER+, and tumor >1cm
Liver: in what population should giant liver hemangioma be resected, how can it present in this population (name of syndrome and its 2 problems, other possible problem)?
pediatric population – kasabach-merit syndrome = hepatic sequestration and thrombocytopenia, also can present with AV shunting and heart failure
Colorectal: when is transanal excision OK (T stage, circumference, location, 2 criteria if invasive)?
stage - polyp or T1
circumference - <40%
location - within 8-10cm of anal verge
if invasive must be: 1) no lymphovascular invasion; 2) not poorly differentiated
Colorectal: coloncyte fuel, and derived from where?
butyric acid
GIST Treatment
R0 resection
Indications for adjuvant Gleeve
- Ruptured GIST
- > 10 cm
- Mitotic rate > 10/50
- Tumor size >5cm & 5 mitosis/HPF
Nejoadjuvant therapy for GIST
Duodenal GIST
Rectal GIST
GEJ GIST
Colon Ca Tx
Stage I: Resection
Stage II (T1-3, N0): Resection
Stage II (T3, <12 nodes in specimen, poorly differentiated, lymphovascular invasion): Resection -> Adjuvant XT
Rectal CA Tx
CIS, T1: TEM (up to 15 cm)
T2-3, N1-2: Neoadjuvant XRT
Rectal Ca < 5cm from dentate line
LAR with total mesorectal excision
Anal Ca Tx
AIN: Resection/Ablation
T1, N0 (welll differentiated): Resection, Inadequate margins- Observe vs XRT
Any T, N0, N+
X (chi squared)
Categorical
>2 groups
Cox proportional hazards regression
Variables affecting survival
Paired t test
two groups: Before & After
Mann Whitney (Wilcoxon)
Two independent groups with ranks
EVAR Indications
External iliac: 7-16 mm
Length of aorta: >15 mm
Diameter of aneurysm: <26 mm
Zenker Diverticulum
< 3 cm: Open myotomy with diverticulopexy
Stitch Trial
5 mm from incision
5 mm vertcical distance
No muscle
2-0 PDS, 31 mm needle
Papillary cystadenoma lymphomatosum (Warthin tumor)
Bilateral parotid masses
Bilateral superficial parotidectomy
