GenSurgQuestions Flashcards
AAA is atleasts what measurement
> 3cm
Most AAA are in what location
infrarenal
What is used to dx AAA and what is used to characterize and measure
US for dx, then CT
Who gets screenings for AAA
men 65-75 hx smoking
When is surgical repair indicated for AAA
5cm or larger
Ascending thoracic AA usually dt
elastin degradation
Descending thoracic AA usually dt
atherosclerosis
Arch aneurysm seen in
trauma or deceleration injuries
What is the TOC to characterize thoracic AA
MRI or CT, often discovered on CXR
Surgical repair indicated for thoracic AA that are
6cm, rapid expansion, of symptomatic
AAA or thoracic AA- which is more likely to sponatenous rupture?
AAA
Varicose veins usually occur where
in the saphenous vein
Aortic dissection usually occurs
in ascending aorta
Typical pt for aortic dissection
men 60-70, HTN or connective tissue disorders
Majority aortic dissections are what type
Proximal (Stnadord A), DeBakey I
ripping retrosternal back pain, pulse discrepancies, HTN w/o
CXR, CT or TEE
What kinds of aortic dissections must receive surgcal repair?
Stanford type A/Proximal
DVT management
Anticoag with heparin, LMWH, or fondaparinux
some cases lytics or thrombectomy
3m anticoagulation, consider IVC filter if not a good candidate
What lung cancer is NOT associated with smoking
Adenocarcinoma
MC type of thyroid CA
papillary adenocarcinoma
Bariatric sx limited to pts with BMI
> 40 or >35 if complications are present
opacification of the eye lens is called
cataract
gallstone that has traveled to the common bile duct
cholecocholithiasis
fever, RUQ pain, jaundice
Charcot’s triad- ascending cholangitis
fever, RUQ pain, jaundice, confusion, HoTN
Reynold’s pentad- ascending cholangitis
Tx for ascending cholangitis
Zosyn or Cef + Flagyl
biliar drainage via ERCP
Toxic megacolon is a dilation of greater than
6cm
MC hernia is
indirect inguinal
what esophageal neoplasm is associated with Barrett’s esophagus
Adenocarcinoma
What esophageal neoplasm is associated with alcohol and tobacco use
Squamous cell carcinoma
Benign tumors of the esophagus include
Leiomyoma
Adenoma
Esophageal papilloma (can transform to SCC)
small bowel neoplasms usally located in
the ileum
MC primary colorectal CA
Adenocarcinoma
MC benign liver tumor
hemangioma
what benign liver tumor is associated with long term estrogen use
Hepatic adenoma
hepatocellular carcinoma usually occurs with
chornic liver diseas or cirrhosis
Who/how gets screened for liver CA
High risk pts (chronic liver dis, cirrhosis) screened q6m via US
What lab value rises in malignant hepatocellualr carcinoma
AFP
extraintestinal manifestations of inflammatory bowel disease
Uveitis, erythema nodosum, pyoderma, liver, joints
Who should get screenings for Barrett’s esophagus
EGD for aduts 50 with 5-10 yr hx GERD, and EGD q3y for pts with known Barret
MC breast CA
Invasive ductal carcinoma
MC skin CA
Basal Cell Carcinoma
MC renal CA
renal cell carcinoma
Courvoisier’s Sign
palpable gallbladder due to compression of bile duct
dt tumors of biliary tree or pancreatic head tumors
BMI to dx obesity
> 30 kg/m2
BMI to dx morbid obesity
> 40 kg/m2
BMI to dx overwt
25.0-29.9
Normal BMI
18.5-24.9
What type of closure is best for pilondial cysts
delayed closure has lower likelihood of recurrence
work up for post menopausal bleeding
To r/o endometrial neoplasm
transvag US assess endometrial stripe, >5mm warrants bx
Bx
Colorectal Sx recommended abx
cefoxitin
preop neomycin + erythromycin
Cardiac sx recommended abx
Cefazolin
GU sx recommended abx
Cefazolin
Non perforated appendectomy recommended abx
cefoxitin + metronidazole
Things that keep fistulas open
Fb Radiation Inflamm (Chrons)/ Infec Epithelization Neoplasm Distal obstruction Sepsis
What are the indications for dialysis?
(AEIOU)
Acidosis, electrolytes, ingestions, overload, uremia
Causes of AG metabolic acidosis
Methanol Uremia DKA, AKA, SKA Paraldehyde INH Lactic acidosis Ethanol Salicylates
MCC SBO in virgin belly
indirect inguinal hernia
Tx of hyperkalemia
CBIGK- die calcium gluconate bicarb insulin and glucose kayexalate
dialysis
ACUTE tx of AMS
DONT dextrose oxygen naloxone thiamine
rule of 10s for pheochromocytoma
10% bilat
10% malignant
10% extra-adrenal
Fever on POD 2 consider
atelectasis, pna
peripheral smear showing microangiopathy hemolytic anemia
DIC
Abx for breast abscess
dicloxacillin, cephalexin, or clindamycin
Solid rubbery round movable breast mass
Likely fibroadenoma
US to determine if solid
-needle bx/monitor and regular exms
increased risk breast CA
phyllodes tumor tx
Require excision
if malignant wider margins/mastectomy
Where do phyllodes tumors mets to?
Lungs NOT LN
tx mastitis in breast feeding mother
Augmentin
or cephalexin, dicloxacillin
MRSA- clindamycin or cipro
2 MCC nipple discharge
w/o
intraductal papilloma
mammary duct ectasia
w/o- diagnostic mammogram is first step
mammography screenings MUST start at what age
50 q1yr till 65
then q2yr till 75
What does a BIRADS score of 0 mean?
insufficient exam, may need repeat or additional views
What does a BIRADS score of 3 mean?
most likely nl-2% chance CA
What does a BIRADS score of 6 mean?
known CA, already confirmed by pathologist
ER+ therapies include
a SERM- Tamoxifen
an aromatase inhibitor- not in premenopausal
