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Absite Review > Fiser: Subspecialties (urology, ortho, gyn) > Flashcards

Fiser: Subspecialties (urology, ortho, gyn) Flashcards

1
Q

which nerve is most at risk for injury in the lithotomy position?

A

peroneal

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2
Q

anterior to posterior of renal structures?

A 
renal vein (anterior)
renal aa
renal pelvis (posterior)
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3
Q

which renal vein can be ligated?

A

the left can b ligated from the IVC 2/2 increased collaterals

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4
Q

what is the most common type of kidney stone?

A

calcium oxalate

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5
Q

which type of kidney stone do pts get who have had their TI resected?

A

calcium oxalate: due to increased oxalate absorption in colon

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6
Q

what are and what causes struvite stones?

A

magnesium ammonium phosphate stones, cause staghorn calculi, occur w infections (proteus mirabilis) that are urease producing

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7
Q

which kidney stones are radiolucent?

A

uric acid and cysteine

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8
Q

which patients (3) are more at risk for uric acid stones?

A
  • ileostomies, gout and myelopoliferative disorders
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9
Q

what drug is used to prevent cysteine stones?

A

tiopronin

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10
Q

how do you resect testicular cancer?

A

inguinal incision- scrotal incisions will disrupt the lymphatics

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11
Q

what level correlates with testicular ca tumor bulk ?

A

LDH

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12
Q

MC types of testicular ca

A

germ cell: seminoma and non-seminoma (90%)

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13
Q

diagnosis and management of seminoma

A
  • 10% have elevated b-hcg, do NOT hav elevated AFP

ALL get orchiectomy and retroperitoneal XRT

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14
Q

diagnosis and management of non-seminoma testicular ca

A
  • 90% have elevated AFP and B-HCG
    ALL get orchiectomy and RP LN dissection
    Stage 2 or greater: Chemo
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15
Q

what chemotherapy agents do you give in testicular ca?

A

cisplatin, bleomycin, VP-16

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16
Q

how do you proceed when you get stage I prostate ca after a TURP?

A

nothing else

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17
Q

when do you give XRT and androgen ablation in prostate ca?

A

extracapsular invasion (T3+) or metastatic disease

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18
Q

1 primary tumor of the kidney

A

RCC

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19
Q

when can you perform wedge resection of metastatic RCC?

A

isolated lung or colon mets

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20
Q

MC location of RCC mets?

A

lung

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21
Q

1 tumor of the kidney

A

mets from breast ca

22
Q

when do you perform a partial nephrectomy in RCC?

A

in patients who would otherwise require HD after nephrectomy, tumor <4cm and Cr >2.5

23
Q

what is von-hippel lindau syndrome?

A

multifocal and recurrent RCC, renal cysts, CNS tumor and pheochromocytomas

24
Q

risk factors for transitional cell ca of bladder?

A

smoking, aniline dyes, cyclophosphamide

25
Q

what is T2 transitional bladder cancer and how do you manage?

A

T2 invades into muscle wall, manage w cystectomy w ileal conduit, chemo (MVAC: methotrexate, vinblastine, adriamycin, cisplatin) and XRT

26
Q

squamous cell ca of bladder is related to what?

A

schistosomiasis infection

27
Q

what layer hypertrophies in BPH?

A

transitional zone

28
Q

initial therapy of BPH?

A

alpha blockers: terazosin, doxazosin (relax smooth muscle)

5-alpha-reductase inhibitors: finasteride

29
Q

MOA finasteride

A

5-alpha-reductase inhibitors

inhibits conversion of testosterone to dihydrotestosterone, inhibits prostate hypertrophy

30
Q

MC complication of TURP

A

retrograde ejaculation

31
Q

how does left RCC cause a varicocele?

A

left gonadal vein inserts into left renal vein and obstruction of vein by renal tumor can lead to varicocele

32
Q

what is the MC urinary tract abnormality?

A

ureteral duplication

33
Q

what is MC primary cancer of the vagina?

A

squamous cell CA

34
Q

what does diethylstilbestrol cause? (DES)

A

clear cell ca of vagina

35
Q

what is botryoides?

A

rhabdosarcoma that occurs in young girls

36
Q

management of vulvar cancer?

A

MC squamous cell CA
<2cm = stage 1, WLE and ipsilateral node dsxn w 2cm margins
>2cm = stage II or greater, radical vulvectomy w bilateral inguinal node dsxn, post op XRT if margins <1cm

37
Q

which type of ovarian cancer has the worst prognosis?

A

clear cell type

38
Q

stages of ovarian ca?

A

stage I: one or both ovaries only
II: limited to pelvis
III: throughout abdomen
IV: distant

39
Q

what is meige’s syndrome?

A

pelvic ovarian fibroma that causes ascites and hydrothorax (excision of tumor cures syndrome)

40
Q

where does cervical ca mets to first?

A

obturator nodes

41
Q

what is postpartum pelvic thrombophlebitis? tx?

A

can lead to ovarian vein, IVC, and hepatic vein thrombosis
get liver failure w ascites after pregnancy
tx: heparin and abx

42
Q

where does cartilage receive its nutrients from?

A

synovial fluid (osmotic)

43
Q

what is the salter-harris classification?

A

classification of epiphyseal injuries:
type I and II: closed reduction
types III, IV, V: ORIF, cross the epiphyseal plate and can affect the growth

44
Q

whats a jone’s fractue?

A

fx of 5th metatarsal, assoc w nonunion

45
Q

which fx is assoc w avascular necrosis?

A

scaphoid, femoral neck, talus and hip dislocation

46
Q

fx associated w compartment syndrome?

A

supracondylar humerus, tibia, calcaneus

47
Q

biggest risk factor for nonunion?

A

smoking

48
Q

injury assoc w anterior shoulder dislocation?

A

axillary nerve injury (closed reduction)

49
Q

injury assoc w posterior shoulder dislocation?

A

axillary artery injury (seen in seizures and electrocution)

50
Q

management of supracondylar humeral fracture in adults vs children?

A

adults: ORIF
children: nondisplaced = closed reduction, displaced = ORIF

51
Q

what is a colles fracture?

A

fall onto outstretched hand, distal radius fx -> closed reduction

52
Q

what is monteggia’s fx?

A

proximal ulnar fx and radial head dislocation

tx: ORIF

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