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Topnotch Surgery Pearls > Pearls 2 > Flashcards

Pearls 2 Flashcards

1
Q

X ray apperance of ameloblastoma

A

Soap bubble sign

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2
Q

Butterlfy ulcer involving the hard palate

A

Necrotizing sialonetaplasia

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3
Q

Areas for blind biopsy

A

Base of tongue, tonsillar fossa, nasopharynx, pyriform sinus

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4
Q

Mc malinant tumor of the parotid gland

A

Mucoepidermoid carcinoma

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5
Q

Most common malignant tumor of minor salivary glands

A

Adenoid cystic carcinoma

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6
Q

Only tumor restricted to the Parotid gland

A

Warthin’s tumor (papillary cystaedoma lymphomatosum)

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7
Q

Mc primary tumor of the middle ear

A

Glomus jugular/glomus tympanicum

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8
Q

Most potent inhibitor of gastrin release

A

Luminal acid

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9
Q

Ulcer tx associated with the least recurrence and highest mortality

A

Antrectomy+ bilateral truncal vagotomy

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10
Q

Truncal vagotomy is always accompanied by

A

Drainage procedure

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11
Q

In highly selective vagotomy wc is the part denervated

A

Corpus

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12
Q

Standar operation for gastric Ca

A

Radical subtotal gastrectomy

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13
Q

Diagnostic for SBO

A

CT scan

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14
Q

Post op ileus is said to be prolonged when duration exceeds

A

3 days

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15
Q

Differentiates post op ileus from post op SBO

A

CT Scab

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16
Q

Spontaneous closure of fistulas occur within how many months

A

2-3

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17
Q

Management for embolus/thrombus induced AMI

A

Surgical revascularizatiom; <12 hrs- thrombolytics

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18
Q

Mngmt for NOMI

A

Vasodilator- papaverine

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19
Q

Most common cause of obscure GI bleeding in adults

A

Smal intestinal dysplasia

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20
Q

Earliest lesion characteristic of Crohn’s disease

A

Aphthous ulcer

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21
Q

Focal transmural inflammation

A

Crohn’s disease

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22
Q

Only segment not affected by Crohn’s

A

Rectun

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23
Q

Safest procedure in unstable patients with St IV diverticulitis

A

Hartmann’s procedure(sigmoid colectomy with end colostomy)

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24
Q

Most common complication of colostomy

A

Parastromal hernia

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25
Q

Lead pipe colon

A

Advanced ulcerative colitis

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26
Q

Surgical procedure of choice for chronic ulcerative colitis

A

Total proctocolectomy with end ileostomy

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27
Q

Colorectal carcinomas commonly metastasize to the

A

Liver

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28
Q

Golligher’s triad found in what? Consists of? Management?

A

Hypertrophied papilla, Ulcer, sentinel; chronic anal fissure, lateral internal sphincterotomy

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29
Q

Keyhole deformity is a complication of?

A

Posterior internal sphincterotomy

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30
Q

First line tx for anal epidermoid carcinona

A

Chemoradiotherapy (nigro protocol- 5 FU, mitomycon C, EBRT)

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31
Q

1st line tx for primary peritonitis

A

Cefotaxime

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32
Q

Arro head sign

A

Appendicitis (CT scan)

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33
Q

Mgmt for appendiceal carcinoid <1cm

A

Appendectomy

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34
Q

Mgmt for appendiceal carcinoud >1- <2cm

A

Tip or mid- appendectomy

Base-right hemicolectomy

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35
Q

> 2cm appendiceal carcinoid

A

Right hemicolectony

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36
Q

Most common type of adenocarcinoma? Mgmt?

A

Mucous; right hemicolectomy

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37
Q

Single most sensitive test of liver function

A

INR/FVII/F5 coagulation function

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38
Q

Hepatic vein thrombosis mgnt?

A

Budd Chiari syndrome; anticoagulation

39
Q

Most critical tx of acute variceal bleeding

A

Promot endoscopic intervention

40
Q

Selective shut contraindicated in patients with ascites

A

Distal splenorenal shunt(warren shunt)

41
Q

SMV and IVC shunt

42
Q

Hassabs procedure

A

Devascularizatiob

43
Q

Sugiura’s procedure

A

Esophageal transection

44
Q

Management of the mc benign tumor pf the liver

A

PAIR(simple hepatic cyst)

45
Q

Benign solid tumor associated with a central scar;(+) kuppfer ; sx?

A

Focal nodular hyperplasia; often asymtpomatic

46
Q

Tx for the hepatocellular variant with best prognosis?

A

Resection (Fibrolamellar variant)

47
Q

Maximum amount of diseased liver transected

48
Q

Echogenic focus with posterior shadow;(+) pericholecystic fluid

A

Acute calculous cholecystitis ; halo sign

49
Q

Asymypomatic GB stones that are surgically managed

A

Elderly; diabetic, porcelein GB, chronic typhoid carrier

50
Q

A dilated CBD is approximately

51
Q

CBD stone diagnosed 1yr after cholecystectomy; mgmt?

A

Retained stone; no T tube: ercp+ductal clearance; with T tube: trans T tube extraction

52
Q

External impingement of CBD

A

Mirizzi syndrome

53
Q

Most dreaded complication of lap cholecystectomy

A

CBD injury

54
Q

Tx of CBD injury

A

Early: repair over a stent
Late: biliary reconstruction (hepaticojejunostomy)

55
Q

Mgmt for acute acalculous cholecystitis

A

Percutaneous US/CT guided cholecystectomy

56
Q

2nd rim of duodenum is surrounded by a rim of pancreatic tissue, what is the mgmt?

A

Duodenoduodenostomy (annular pancreas)

57
Q

Mc cause of death in pancreatitis?

58
Q

Mc complication of chronic pancreatitis

A

Pseudocyat

59
Q

Tx for the mc complication of chronic pancreatitits

A

> 6cms or infected warrants surgical mgmt (drainage) otherwise expectant;
Internal drainage is the best tx

60
Q

Palpable nontender GB seen in patients with periampullary tumor

A

Courvossier’s GB

61
Q

Diagnostic and staging test of choice for pancreatic CA

A

Spiral CT scan with contrast

62
Q

Etiology of severe pain experienced by patients with pancreatic CA

A

Invasion of retroperitoneal nerve

63
Q

Drug for palliative tx of advanced pancreatic CA

A

Gemcitabine

64
Q

Most dreaded complication of whipples

A

Disruption of pancreatico jejunistomy

65
Q

Mgmt for insulinoma close to pancreatic duct (>2cm)

A

Whipples, this is the only exception, otherwise just do: Simple enucleation

66
Q

S/sx: watery diarrhea, hypokalemia, achlorydia ; what is the mgmt?

A

VIPoma/ verner morrison syndrome; so debulking as palliative tx

67
Q

(+) tumor with glucagon >500 pg/mL; mgmt?

A

Glucagonoma; debulking

68
Q

Mcc anomaly of the spleen

A

Accessory spleen

69
Q

Process by wc spleen removes intracellular substances

70
Q

Removal of the spleen of rbcs with less deformable membrane

71
Q

Intracellular altered hgb

72
Q

Nuclear remnant (rbc)

A

Howell jolly body

73
Q

Pappenheiner bodies

A

Sideroblast

74
Q

(+)mucocutaneous bleeding and petechial hemorrhages; (+) antiplatelet IgG autoantibodies: mgmt?

A

Oral prednisone

75
Q

First line therapy for TTP

A

Plasma exchange

76
Q

1st line therapy for TTP

A

Plasma exhange

77
Q

Most common etiology for splenic cysts

A

Parasitic(echinococcal)

78
Q

Mc complication of splenectomy

A

Left lower lobe atelectasis

79
Q

Fothergil sign

A

Rectus sheath hematoma

80
Q

Cogenital umbilical hernia allowed for spontanoues closure up to

81
Q

Tillaux sign

A

Mesenteric cyst

82
Q

Drug with strongest causal relationship to retroperitoneal fibrosis

A

Methysergide

83
Q

Idiopathic retroperitoneal fibrosis

A

Ormond’s dae

84
Q

Mgmt for retriperitoneal fibrosis

A

Steroids as mainstay, debulking, ureterolysis

85
Q

Inguinal hernia repair with least recurrence

86
Q

Direct+indirect hernia

87
Q

2 loops in same ring

A

Maydl’s hernia

88
Q

Hernia at superior lumbar triangle

A

Grynfeltt’s hernia

89
Q

Hernia at inferior lumbar triangle

90
Q

Hernia of anterior diaphragm

A

Morgagni’s

91
Q

Hernia of posterior diaphragm

A

Bochdaleck’s

92
Q

Hernia lateral to rectus muscle

93
Q

Nerve closely associated with the submandibular gland, may be damaged during excision of cylindroma

A

Lingual nerve

Topnotch Surgery Pearls (12 decks)

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