Pearls 2 Flashcards by Aloha Lopez

X ray apperance of ameloblastoma

Soap bubble sign

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Butterlfy ulcer involving the hard palate

Necrotizing sialonetaplasia

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Areas for blind biopsy

Base of tongue, tonsillar fossa, nasopharynx, pyriform sinus

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Mc malinant tumor of the parotid gland

Mucoepidermoid carcinoma

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Most common malignant tumor of minor salivary glands

Adenoid cystic carcinoma

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Only tumor restricted to the Parotid gland

Warthin’s tumor (papillary cystaedoma lymphomatosum)

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Mc primary tumor of the middle ear

Glomus jugular/glomus tympanicum

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Most potent inhibitor of gastrin release

Luminal acid

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Ulcer tx associated with the least recurrence and highest mortality

Antrectomy+ bilateral truncal vagotomy

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Truncal vagotomy is always accompanied by

Drainage procedure

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In highly selective vagotomy wc is the part denervated

Corpus

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Standar operation for gastric Ca

Radical subtotal gastrectomy

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Diagnostic for SBO

CT scan

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Post op ileus is said to be prolonged when duration exceeds

3 days

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Differentiates post op ileus from post op SBO

CT Scab

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Spontaneous closure of fistulas occur within how many months

2-3

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Management for embolus/thrombus induced AMI

Surgical revascularizatiom; <12 hrs- thrombolytics

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Mngmt for NOMI

Vasodilator- papaverine

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Most common cause of obscure GI bleeding in adults

Smal intestinal dysplasia

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Earliest lesion characteristic of Crohn’s disease

Aphthous ulcer

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Focal transmural inflammation

Crohn’s disease

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Only segment not affected by Crohn’s

Rectun

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Safest procedure in unstable patients with St IV diverticulitis

Hartmann’s procedure(sigmoid colectomy with end colostomy)

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Most common complication of colostomy

Parastromal hernia

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Lead pipe colon

Advanced ulcerative colitis

Surgical procedure of choice for chronic ulcerative colitis

Total proctocolectomy with end ileostomy

Colorectal carcinomas commonly metastasize to the

Liver

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

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

Keyhole deformity is a complication of?

Posterior internal sphincterotomy

First line tx for anal epidermoid carcinona

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

1st line tx for primary peritonitis

Cefotaxime

Arro head sign

Appendicitis (CT scan)

Mgmt for appendiceal carcinoid <1cm

Appendectomy

Mgmt for appendiceal carcinoud >1- <2cm

Tip or mid- appendectomy | Base-right hemicolectomy

>2cm appendiceal carcinoid

Right hemicolectony

Most common type of adenocarcinoma? Mgmt?

Mucous; right hemicolectomy

Single most sensitive test of liver function

INR/FVII/F5 coagulation function

Hepatic vein thrombosis mgnt?

Budd Chiari syndrome; anticoagulation

Most critical tx of acute variceal bleeding

Promot endoscopic intervention

Selective shut contraindicated in patients with ascites

Distal splenorenal shunt(warren shunt)

SMV and IVC shunt

Drapanas

Hassabs procedure

Devascularizatiob

Sugiura's procedure

Esophageal transection

Management of the mc benign tumor pf the liver

PAIR(simple hepatic cyst)

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

Focal nodular hyperplasia; often asymtpomatic

Tx for the hepatocellular variant with best prognosis?

Resection (Fibrolamellar variant)

Maximum amount of diseased liver transected

60%

Echogenic focus with posterior shadow;(+) pericholecystic fluid

Acute calculous cholecystitis ; halo sign

Asymypomatic GB stones that are surgically managed

Elderly; diabetic, porcelein GB, chronic typhoid carrier

A dilated CBD is approximately

8mm

CBD stone diagnosed 1yr after cholecystectomy; mgmt?

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

External impingement of CBD

Mirizzi syndrome

Most dreaded complication of lap cholecystectomy

CBD injury

Tx of CBD injury

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

Mgmt for acute acalculous cholecystitis

Percutaneous US/CT guided cholecystectomy

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

Duodenoduodenostomy (annular pancreas)

Mc cause of death in pancreatitis?

Infection

Mc complication of chronic pancreatitis

Pseudocyat

Tx for the mc complication of chronic pancreatitits

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

Palpable nontender GB seen in patients with periampullary tumor

Courvossier's GB

Diagnostic and staging test of choice for pancreatic CA

Spiral CT scan with contrast

Etiology of severe pain experienced by patients with pancreatic CA

Invasion of retroperitoneal nerve

Drug for palliative tx of advanced pancreatic CA

Gemcitabine

Most dreaded complication of whipples

Disruption of pancreatico jejunistomy

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

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

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

VIPoma/ verner morrison syndrome; so debulking as palliative tx

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

Glucagonoma; debulking

Mcc anomaly of the spleen

Accessory spleen

Process by wc spleen removes intracellular substances

Pitting

Removal of the spleen of rbcs with less deformable membrane

Culling

Intracellular altered hgb

Heinz

Nuclear remnant (rbc)

Howell jolly body

Pappenheiner bodies

Sideroblast

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

Oral prednisone

First line therapy for TTP

Plasma exchange

1st line therapy for TTP

Plasma exhange

Most common etiology for splenic cysts

Parasitic(echinococcal)

Mc complication of splenectomy

Left lower lobe atelectasis

Fothergil sign

Rectus sheath hematoma

Cogenital umbilical hernia allowed for spontanoues closure up to

5 years

Tillaux sign

Mesenteric cyst

Drug with strongest causal relationship to retroperitoneal fibrosis

Methysergide

Idiopathic retroperitoneal fibrosis

Ormond's dae

Mgmt for retriperitoneal fibrosis

Steroids as mainstay, debulking, ureterolysis

Inguinal hernia repair with least recurrence

Shouldice

Direct+indirect hernia

Pantaloon

2 loops in same ring

Maydl's hernia

Hernia at superior lumbar triangle

Grynfeltt's hernia

Hernia at inferior lumbar triangle

Petit's

Hernia of anterior diaphragm

Morgagni's

Hernia of posterior diaphragm

Bochdaleck's

Hernia lateral to rectus muscle

Spigelian

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

Lingual nerve