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, DDAVP]
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
Palpable:MRM
Nonpalpable: Lumpectomy w/ Nipple-Areolar complex + Radiation
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
Male: Mastectomy
No ALDN unless:
>4 cm
Palpable mass
Prior Mastectomy
Microinvasion
Li Fraumeni
[p53]
Leukemia
Breast
Adenocarcinoma
Sarcoma
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
(Causes 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 thyroid nodule not needing FNA
<1 cm(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
Puestow
Frey
Side Effect: Etomidate
Adrenal Supression
Hoffman Elimination Nondepolarizing agents
Atracurium
Cisatracurium
(Hoffman elimination)
Bacitracin
Partial thickness burns
Nephrotoxic
Mupirocin
MRSA
Silvadene (Sulfadiazine)
Does not penetrate eschar
Prophylaxis
Neutropenia & Thrombocytopenia
Mafenide acetate
Full thickness burns
Penetrates eschar
Metaboli aidosis (carbonic anhydrase inhibitor)
Silver nitrate
Hyponatremia
Contraindication to lumpectomy
- prior irradiation
- pos margins
- inflammatory
- pregnancy (unless 3rd trimester)
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
What do you do if you can’t find radiotracer dye in SNLB?
ALND
What patient would get only mastectomy/BCT + tamoxifen for 5 years (4 characteristics)?
- (-) SLN
- old
- ER+
- tumor <2 cm
What patient would get mastectomy/BCT + tamoxifen for 5 years plus chemo (4 characteristics)?
- (-) SLN
- young
- ER+
- tumor >1cm
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, AV shunting and heart failure
Indication for transanal excision (T stage, circumference, location, 2 criteria if invasive)?
stage I: polyp or T1
circumference: <40%
Location: within 8-10cm of anal verge
if invasive must be: 1) no lymphovascular invasion; 2) not poorly differentiated
Coloncyte fuel, and derived from where?
butyric acid
Short fatty acids
Carcinoid tumor rectum - Tx?
Transanal excision
Treatment for FAP?
- TAC
- Mucosal proctectomy
- Pouch
MALToma - when is surgery first line treatment?
gastric outlet obstruction
MALTOMA: 1st, 2nd, 3rd line treatment?
- Eradicate H pylori
- Chemo/xrt
- surgery