PESTANA3 et al Flashcards
How do you treat a rectal CA less than 5 cm from the anal verge?
Abdominoperineal Resection with end colostomy
What can be given preoperatively to a pt with hemophilia A?
DDAVP (increases vWF which increases the likelihood of binding factor VIII which is deficient- i.e. makes the most out of what you have)
What is the typical progression of sx of a brain tumor
Starts out with months (usually) of headache often worse in morning assoc with nausea or projectile vomiting that may eventually develop focal neurologic deficits
How would you tx a pt s/p CABG with fever, tachy, leukocytosis, and purulent drainage in JP’s?
Surgical debridment of mediastinum with immediate closure and prolonged abx; Acute mediastinitis
What is the most important aspect of managing fat embolus syndrome? How can you technically confirm the dx?
Respiratory support; Fat globules in urine (come on)
What is the cause of elevated PT in pancreatic cancer? What mood abnormality can pancreatic CA cause directly?
Malabsorption of vitamin K due to blockage of the CBD; depression
Name 2 adjuvant therapies for metastatic melanoma
Interferon, Vemurafenib
What problem in the post-op period can masquerade as urinary incontinence?
Urinary retention with overflow incontinence; you should palpate the bladder (bladder scan)
What must be done for a pt with ckd on dialysis preoperatively?
Dialyze 24 hours pre-op
What is the Parkland formula for adults? Kids?
Kg x %BSA x 3-4; Kg x % BSA x 2-3; Give half over the first 8 hours and the rest over the next 16
What is the most likely cause of death in a massive hemoptysis?
i.e. > 600 ml; asphyxiation > exsanguination
What is the deal with perforated diverticulitis mgmt?
If < 3 cm abscess can manage with IV abx and observation; if > 3 cm then CT-guided drainage by IR
What is done if those who wish to become pregnant with h/o prolactinoma fail bromocriptine therapy?
Transnasal transphenoidal surical removal of the prolactinoma
What is the most important diagnostic test in chest trauma after the ABC’s are done?
CXR!
CXR with NGT in pulmonary cavity following trauma
Traumatic rupture of the diaphgragm
What is the treatment for chronic rejection?
There is none it is irreversible (although I’d imagine there is some form of symptomatic mgmt, i.e. inotropes for the heart etc)
What medications must be stopped prior to surgery?
Aspirin, NSAIDs, clopidogrel, vitamin E (2 weeks before surgery); Warfarin 5 days before get INR below 1.5
Colonoscopy shows cyanotic mucosa with sharp transition points?
Ischemic colitis
What is the mgmt of duodenal hematomas?
If obstructing - TPN and NGT until resolve; if do not resolve surgical removal may be needed
What is the timing of fluids that should be given to a burn pt after calculating how much they need via the Parkland formula?
Half over the first 8 hours and the second half over the next 16 (cut the rate of the first half in half)
Where is the AS murmur best heard
Harsh midsystolic in R second IC space
What should you do when there is a large stone (i.e. 7mm or more at the UPJ )?
Extra-Corporeal Shockwave Lithotripsy (ESWL) – if not then basket extraction, laser, sonic probe, or even open surgery
What is the minimum FEV1 needed in order for a non-small cell CA to be operated on with pneumonectomy?
800 ml (that is if there is less than 800 predicted after surgery they are not a surgical candidate and need chemoradiation instead)
What is the appropriate way to excise a parotid tumor
Never open biopsy always do either a superficial parotidectomy if superficial to facial nerve or deep parotidectomy if deep to it