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Surgery > Pre-Test (Endocrine/Breast, GI) > Flashcards

Pre-Test (Endocrine/Breast, GI) Flashcards

1
Q

Isolated focus of increased uptake on a thyroid scan virtually diagnostic of

A

Hyperfunctioning adenoma

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2
Q

Multifocal breast Ca means

A

Multiple tumors w/in 1 quadrant of the breast

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3
Q

Important prognostic factor in papillary and follicular thyroid Ca

A

Age (>45 years worse prognosis)

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4
Q

Papillary Ca thyroid description on path

A

Calcified clumps of sloughed cells

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5
Q

LCIS work up

A

Frequent self breast exams and yearly screening mammograms (LCIS considered risk factor for cancer development, not precursor)

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6
Q

Acute management of hypercalcemia

A

Vigorous hydration to restore intravascular volume and Lasix

Thiazides contra b/c they increase Ca

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7
Q

Cushing’s dz tumor

A

Pituitary tumor

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8
Q

Pre surgery pheo tx

A

Pre-op w/ alpha blockade (phenoxybenzamine) 1-3 weeks before

can add b-blockers

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9
Q

Tx of breast cancer in pregnant woman

A

Immediate surgery, chemo after 1st trimester

Radiation absolutely contraindicated

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10
Q

Workup for suspected Paget’s

A

Mammogram and biopsy of the affected area

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11
Q

Secretin test results for ZE syndrome

A

Rise in Gastrin

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12
Q

tx to prevent thyroid storm after thyroid removal in graves

A

10 days pre-op w/ Drops of Lugol iodide solution

B-blocker is tx for thyroid storm

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13
Q

Tx of single PTH adenoma

A

Removal of that adenoma

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14
Q

Tx for Hurtle cell thyroid tumor? What is it?

A

Surgery followed by radioiodine ablation

Is a type of follicular cancer, but is more often multifocal and bilateral

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15
Q

When is thyroid lobectomy ok

A

for single adenomas less than 4cm size

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16
Q

Most common cause of cushing syndrome

A

Iatrogenic

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17
Q

Indication for radical mastectomy

A

Locally advanced breast cancer with wide invasion of pec major muscle in pt who can handle surgery

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18
Q

Omeprazole MOA

A

Inhibits H+-K+ ATPase in secretory canaliculus of the gastric parietal cell

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19
Q

Platelet transfusions in ITP reserved for? Otherwise tx?

A

Acute bleeders

Otherwise (30k-50k) tx w/ steroids and IV-IG

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20
Q

Tx for adenocarcinoma of the spleen

A

Right hemicolectomy

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21
Q

Safest and most effective tx of achlasia

A

Esophagomyomyotomy (modified heller myotomy –> cutting LES)

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22
Q

Most frequent complication of end colostomies

A

Parastomal herniation –> commonly when stoma is placed lateral to, rather than through, rectus muscle

23
Q

When do the majority of dumping syndrome cases resolve

A

Within 3 months

24
Q

Medical mgmt of bleeding varices

A

Octreotide or vasopressin (balloon tamponade if those don’t work)
Don’t forget crystalloids

25
Q

Lesions of Peutz-Jagers? Other things seen?

A

Hamartomas

Also melanin spots on oral mucosa

26
Q

Indications for surgical intervention in dirverticular disease

A

Hemorrhage secondary to diverticulosis, recurrent episodes of diverticulitis, intractability to medical therapy, complicated (perforations with or w/out abscess and/or fistula)

27
Q

When can gallbladder polyps be measured w/ serial CT’s? Sx for gall bladder cancer

A

when they are less than 1cm

Do radical cholecystectomy for gall bladder cancer

28
Q

Tx for Entamoeba histolytica liver abscess

A

metronidazole

29
Q

Important step prior to undergoing operative intervention for GERD

A

Endoscopy

30
Q

Mgmt for non-necrotic chronic ischemic colitis

A

Expectant mgmt

31
Q

Bowel Habits after colonic resection

A

Relatively normal

32
Q

What part of the colon absorbs more salt and water

A

Right

33
Q

When do you take out hepatic andenomas

A

When greater than 4cm (risk for rupture and risk for malignant transformation)

34
Q

If performing appendectomy, Chron’s is noted, what do you do

A

Take out appendix as normal (90% who present like this will not progress to full blown disease)

35
Q

Tx for biliary stricture? most likely cause?

A

End-to-side choledochojejunostomy (Roux-en-Y)

Most likely iatrogenic

36
Q

90% of gastrinoma’s located where?

A

“gastrinoma triangle” - junction of 2nd and 3rd portions of duodenum, junction of neck and body of pancreas, and junction of cystic and common bile duct

37
Q

Tx for insulinoma

A

Simple excision of the tumor

38
Q

Apple core lesion on colon tx

A

Bowel prep followed by removal of area (obstructing)

39
Q

Most likely dx in older person with markedly distended colon? Workup?

A

Cecal or sigmoid volvulus –> dx w/ sigmoidoscopy (also can be therapeutic) –> If neg think cecal location (do emergent celiotomy)

40
Q

Procedure of choice for cecal volvulus

A

Right hemicolectomy

41
Q

Kidney bean vs Coffee bean sign

A

Kidney bean - cecal volvulus

Coffee bean - sigmoid volvulus

42
Q

Most common non-OB related surgical condition in pregnant women

A

Appendicitis

43
Q

Paraesophageal vs Sliding hernia worse?

A

Paraesophageal (sliding hernia contained by intact pleura)

44
Q

Olgivie’s syndrome tx

A

Bowel rest and NG tube (Unless >10 cm dilated)

45
Q

First line tx for major hematobilia

A

Transarterial embolization

46
Q

Crypt abscesses and superficial ulcerations in what bowel dz

A

UC

47
Q

Test for small bowel bleeding in people under 30?

A

Tech 99 pertechnetate scan – Looking for Meckels (MCC of small bowel bleeding under 30)

48
Q

Colectomy vs Simple appendix removal in carcinoid of appendix

A

Less than 1 cm just take appendix
1-2 based on location
>2 Right hemicolectomy

49
Q

Where are stress ulcers usually found

A

Usually involve lower body and funds

Spare antrum

50
Q

Tx for cholecystitis in critically ill

A

Tube cholecystostomy

51
Q

How long until therapy for pancreatic pseudocysts

A

At least 6 weeks**

52
Q

Where do carcinoid tumors originate? What do they look like in rectum

A

Crypts of Leiberkuhn

53
Q

Definitive operation of choice for patients with UC

A

Total proctocolectomy w/ end ileostomy or illegal J-pouch anastomosis

Surgery (8 decks)

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