Lynelle/Willard Notes

Question 1

Polypectomy only

Answer 1

benign adenomas, carcinoma in situ only

Question 2

Scattered mets throughout the peritoneum?

Answer 2

carcinomatosis

Question 3

How does 5-FU work?

Answer 3

pyrimidine analog- antimetabolite- blocks DNA/RNA synthesis

Question 4

When is neoadjuvant therapy used?

Answer 4

T2-T3, or node + RECTAL CA

Question 5

When is adjuvant therapy used?

Answer 5

stage 3, node + disease

Question 6

mucosa - submucosa - muscularis propria - serosa

Answer 6

yup

Question 7

What wall of bowel triggers chemo?

Answer 7

serosa

Question 8

Where will mets from a tumor at 2cm from the anus occur?

Answer 8

lungs

Question 9

Where will mets from a tumor at 7cm from the anus occur?

Answer 9

x

Question 10

total mesorectal incision (TME)

Answer 10

takes every possible node in colorectal CA

Question 11

More than one tumor found on initial workup?

Answer 11

total colectomy

Question 12

Hartmans pouch

Answer 12

x

Question 13

What contrast if you’re looking for lymph nodes?

Answer 13

IV

Question 14

Tumor staging: anything perforated is always stage ___.

Answer 14

4

Question 15

To serosa = what stage?

Answer 15

3

Question 16

Through serosa = what stage?

Answer 16

4

Question 17

s/s retroperitoneal hematoma?

Answer 17

recent cardiac cath
heparin
sudden onset hypotension, tachycardia, flat neck veins
back pain

Question 18

What is found in the submucosa?

Answer 18

BVs

Question 19

What is the tx plan for a T1 colon CA lesion? Why?

Answer 19

hemicolectomy bc of the microvascular invasion

Question 20

If an arterial puncture site is above the inguinal ligament, a hematoma can extend into the ____.

Answer 20

retroperitoneal space

Question 21

How will a retroperitoneal bleed present?

Answer 21

sudden hemodynamic instability

ipsi flank or back pain

Question 22

How is a retroperitoneal bleed diagnosis confirmed?

Answer 22

non-contrast CT

Question 23

What cancers are involved in Lynch syndrome?

Answer 23

ovarian
endometrial
colon

Question 24

What are common organisms causing emphysematous cholycystitis?

Answer 24

Clostridium

some e. coli

Question 25

What is Charcot’s triad?

Answer 25

high fever
RUQ pain
jaundice

Question 26

What abnormal labs are seen in acute cholangitis?

Answer 26

high alk phos

high conj bili

Question 27

What abnormal imaging is seen in acute cholangitis?

Answer 27

bile duct dilation w/o gas

Question 28

What is Fitz-Hugh Curtis syndrome?

Answer 28

perihepatitis in the setting of PID

Question 29

What will imaging show in peptic ulcer perf?

Answer 29

free air under the diaphragm

Question 30

Choledocal cyst plan?

Answer 30

operate

Question 31

choledocolithiasis plan?

Answer 31

ERCP, then cholecystectomy

Question 32

choledocal fistula plan?

Answer 32

relieve the obstruction, then take down fistula

Question 33

pancreatic cancer (if no mets) plan?

Answer 33

whipple or panc/splenectomy

Question 34

neuroendocrine-oma

Answer 34

x

Question 35

Burn percentages and then fluids

Answer 35

half over first 8h, rest over next 16h

Question 36

antidotes

Answer 36

x

Question 37

s/s of dumping syndrome?

Answer 37

ab pain, N/D occurring 15-30mins post-prandial

Question 38

What causes dumping syndrome?

Answer 38

rapid emptyin of hypertonic gastric contents (usu. post-gastrectomy) d/t loss of pyloric sphincter fxn

Question 39

How do you treat dumping syndrome?

Answer 39

small, freq meals

add complex carbs, high fiber, protein-rich foods