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ZZ Notes Surgery > Breast, Lung, Heart, Vascular > Flashcards

Breast, Lung, Heart, Vascular Flashcards

1
Q

Principal sources of blood of the breast

A

Internal mammary
Posterior intercostal arteries
Axillary artery

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2
Q

Level I, II, III nodes are located:

A

I - Lateral to pectoralis minor
II - Under pectoralis minor
III - Medial to pectoralis minor

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3
Q

Gynecomastia not associated with an increased risk of breast CA in males except in:

A

Kleinfelter syndrome

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4
Q

Treatment for extensive DCIS (>4mm or disease in more than one quadrant)

A

Mastectomy

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5
Q

Sentinel LN biopsy is NOT suitable for the following:

A

Inflammatory breast CA
Palpable axillary lymphadenopathy and biopsy-proven metastasis
DCIS without mastectomy
Prior axillary surgery

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6
Q

Most common pattern of calcification in hamartomas

A

Popcorn calcification

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7
Q

NSCLC patient with a potentially resectable tumor:

If the patient can walk on a flat surface indefinitely, without oxygen and without having to stop and rest secondary to dyspnea, he will be very likely to tolerate:

A

Lobectomy

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8
Q

NSCLC patient with a potentially resectable tumor:

If the patient can walk up two flights of stairs (up two standard levels), without having to stop and rest secondary to dyspnea, he will likely tolerate:

A

Pneumonectomy

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9
Q

The most likely bacterial cause of aspiration pneumonia is:

A

Anaerobic organisms ONLY (50% of cases)

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10
Q

Chest wall mass with elevated ESR may indicate which disease?

A

Ewing sarcoma

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11
Q

Most common benign chest wall tumor

A

Chondroma

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12
Q

Primary site for female patients with malignant pleural effusion is most commonly:

A

Breast CA

Males: Lung CA

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13
Q

Eosinophilic granulomas are associated with which disease?

A

Langerhans Cell Histiocytosis

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14
Q

Chylothorax is likely to be present with a triglyceride level of ____ in the pleural fluid:

A

Greater than 110 mg/100 mL

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15
Q

Causative agent and treatment for epidemic puepural mastitis:

A

MRSA

Tx: STOP breastfeeding, give antibiotics, and I&D

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16
Q

Recurrent periductal mastitis is also known as

A

Zuska’s disease

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17
Q

Baseline mammography should be done at

A

Age 35

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18
Q

Annual mammography should start at:

A

Age 40

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19
Q

Most important prognostic correlate of disease-free and overall survival in breast CA:

A

Axillary LN status

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20
Q

DCIS comedo type has a _____ risk for recurrence

A

High

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21
Q

Treatment options for LCIS

A

Observation
Tamoxifen chemoprevention
Bilateral total mastectomy

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22
Q

Treatment options for DCIS and early invasive breast CA (St I, II)

A

Mastectomy/lumpectomy + RT

SAME mortality rate, but recurrence is more common in lumpectomy

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23
Q

Large, pale, vacuolated cells in the rete

pegs of the epithelium is pathognomonic for:

A

Paget’s disease of the nipple

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24
Q

Treatment for Breast CA St. IIIa, IIIb

A

Neoadjuvant CT + MRM + adjuvant RT

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25
Q

Removed in simple mastectomy

A

Breast tissue
Skin, nipple-areola complex
Level I LN

26
Q

Removed in MRM

A

Breast tissue
Skin, nipple-areola complex
Level I and II LN
(Patey removes pectoralis minor)

27
Q

Most frequent MRM complication

A

Seromas beneath skin flaps or axilla

28
Q

Structures removed in Halsted Radical Mastectomy that are preserved in MRM

A

Pectoralis major
Pectoralis minor
LN III

29
Q

Breast discharge characteristics that are associated with benign disease:

A

Milky or blue-green

30
Q

Breast characteristics that are associated with malignant disease:

A

Serous, bloody, clear

31
Q

Most common age to close asymptomatic ASDs

A

4-5 years old

32
Q

Bidirectional glenn procedure is used to correct

A

Tricuspid atresia (First stage of Fontan repair)

33
Q

Norwood procedure is used for

A

Hypoplastic left heart syndrome

34
Q

Arterial switch for TGA is best performed within:

A

2 weeks of birth

35
Q

Most common VSD requiring surgical correction:

A

Perimembranous

36
Q

Best predictor of spontaneous closure of VSD:

A

Age at diagnosis

37
Q

Major determinant of operability of VSD is:

A

Degree of pulmonary vascular resistance

38
Q

Most common cause of thoracic aortic aneurysms

A

Nonspecific medial degeneration

39
Q

Most common cause of death in type IV Ehlers Danlos

A

Ruptured visceral artery

40
Q

Most common complication of extensive repair of distal aortic aneurysms

A

Pulmonary dysfunction

41
Q

Most common presenting symptom in patients with ascending aortic aneurysm

A

Anterior chest pain

42
Q

Risk for rupture of AAA is exponentially increased above the size of:

A

5.5 cm

43
Q

Most commonly affected compartment in a lower leg compartment syndrome is:

A

Anterior compartment

44
Q

Most common cause of ischemic stroke

A

Emboli

45
Q

Hollenhorst plaque is found within the:

A

Retinal vessels

46
Q

Best diagnostic image modality for lower extremity occlusive disease

A

Contrast angiography

47
Q

Most common source of distal emboli

A

The heart

48
Q

A syndrome were there is increased DVT formation, characterized by narrowing of the left iliac vein where the right iliac artery crosses over it

A

May-Thurner Syndrome

49
Q

Extensive DVT of the major axial deep venous channels of the lower extremity with relative sparing of collateral veins causes a condition called:

A

Phlegmasia cerulea dolens

50
Q

According to the American College of Chest Physicians, the recommended duration of long-term antithrombotic therapy after provoked DVT is:

A

3 months

51
Q

Heparin-induced thrombocytopenia is characterized by:
Previous exposure to heparin
Platelet count

A

PC <100,000

Decline of >50% following exposure

52
Q

Solitary pulmonary nodule should at least be _ cm in size

A

3 cm

53
Q

Only true surgical emergency among all congenital heart diseases

A

TAPVC

54
Q

Hallmark finding of TAPVC

A

Equalization of O2 sat in all chambers

55
Q

Percentage of chest wall masses that are considered malignant:

A

50-80%

56
Q

Most commonly recommended age of correction of TOF is:

A

Younger than 3 months

57
Q

Aneurysm is the increase in size of the abdominal aorta to greater than __cm in diameter

A

3.0cm

58
Q

Percent of chest wall masses that are malignant (range)

A

50-80%

59
Q

A patient presenting with a history and findings of dyspnea, wheezing, hemoptysis, and a mediastinal mass in the visceral compartment yields a diagnosis of:

A

Mediastinal granuloma

60
Q

A patient with an anterior mediastinal mass and elevated serum α-fetoprotein (AFP) most likely has

A

A nonseminomatous germ cell tumor

ZZ Notes Surgery (6 decks)

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