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Surg Exam > Pretest endo/breast > Flashcards

Pretest endo/breast Flashcards

1
Q

hot thyroid nodule?

A

isolated focus of increased uptake on a thyroid scan = Hyperfunctioning adenomas or hot nodules –> hyperthyroidism

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2
Q

diffuse radioactive iodine uptake on thyroid scan?

A

Graves

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3
Q

Diminished radioactive iodine uptake on thyroid scan?

A

cold nodule = carcinoma

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4
Q

various activity of multiple nodules in radioactive iodine uptake on thyroid scan?

A

Multinodular goiter

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5
Q

isolated focus of increased uptake on a thyroid scan

A

Hyperfunctioning adenomas or hot nodules

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6
Q

Addison disease constellation?

A

skin pigmentation, weakness, weight loss, hypotension, nausea, vomiting, abdominal pain, hypoglycemia, hyponatremia, and hyperkalemia.

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7
Q

Tx for wound hematoma?

A

exploration of the wound, drainage of the hematoma, and identification and control of any bleeding vessels

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8
Q

Inflammatory breast ca tx?

A

neoadjuvant chemotherapy, surgery, and radiation

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9
Q

erythema and edema of the right breast with palpable axillary lymphadenopathy with neoplastic cells in the dermal lymphatics. Dx?

A

inflammatory breast CA

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10
Q

What breast CA presents like mastitis?

A

inflammatory

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11
Q

peau d’orange

A

inflammatory breast CA

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12
Q

Tx for prolactinoma?

A

bromocriptine, surgery

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13
Q

What is bromocriptine?

A

Dopamine agonist

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14
Q

Hyperparathyroidism diagnosis?

A

high PTH with high serum Ca++ (>11)

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15
Q

tumor in tail of pancreas + rash = ?

A

glucagonoma.

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16
Q

What is a glucagonoma?

A

tumor of islet alpha cells

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17
Q

syndrome of a characteristic rash, diabetes mellitus, anemia, weight loss, and elevated levels of circulating glucagon

A

glucagonoma

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18
Q

Tx for glucagonoma?

A

TPN + octreotide

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19
Q

tx simple breast cyst?

A

reassurance and reexamination

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20
Q

tx complex breast cyst?

A

aspiration bc risk of malignancy

21
Q

Treatment of high-risk thyroid papillary carcinomas?

A

thyroidectomy +/- nodes, modified radical neck dissection

22
Q

Medullary thyroid carcinoma is associated with?

A

MEN syndrome

23
Q

Lobular carcinoma in situ (LCIS) is a risk factor for?

A

invasive breast carcinoma

24
Q

most common breast tumors between puberty and the early thirties?

A

fibroadenoma

25
Q

breast lesion: characteristic fish flesh texture?

A

Lymphomas

26
Q

breast lesion: bulging, very firm, lobulated surface with a whorl-like pattern?

A

fibroadenoma

27
Q

dx? groans, stones, and bones

A

hyperparathyroidism

28
Q

Tx for hyperparathyroidism?

A

fluids, loop diuretics (furosemide), surgery if stones

29
Q

45-year-old woman presents with hypertension, development of facial hair, and a 7-cm suprarenal mass. Dx?

A

Adrenocortical carcinoma

30
Q

How do you determine malignancy in adrenocortical carcinoma?

A

size of tumor

31
Q

Tx for adrenocortical carcinoma?

A

en bloc resection of the tumor and involved adjacent organs, such as the kidney or the tail of the pancreas

32
Q

Dx? hypertension and symptoms of excessive catecholamine production

A

pheochromocytomas

33
Q

pre-op tx for pheochromocytoma?

A

α-blockade using phenoxybenzamine for 1-3 weeks, +/- beta-blockade; fluids

34
Q

tx? invasive ductal carcinoma in pregnancy

A

modified radical mastectomy

35
Q

dx? 40-year-old woman presents with a rash involving the nipple-areola complex for the last month with associated itching, crusting, and ulceration of the nipple with surrounding erythema involving the areola and surrounding skin

A

Paget disease of the breas

36
Q

Tx Paget disease of the breast?

A

modified radical mastectomy

37
Q

40-year-old woman presents with a rash involving the nipple-areola complex for the last month with associated itching, crusting, and ulceration of the nipple with surrounding erythema involving the areola and surrounding skin. Next step?

A

mammo and biopsy

38
Q

Zollinger-Ellison syndrome diagnosis?

A

very high basal levels of gastric acid (> 35 mEq/h) and serum gastrin (usually > 1000 pg/mL); rise in serum gastrin after giving secretin (>200pg/mL gastrin level increase)

39
Q

presence of hypercalcemia in a patient with ZES should prompt a workup for?

A

MEN1 (multiple endocrine neoplasia type 1)

40
Q

How to reduce the risk of developing thyroid storm in the operating room?

A

Drops of Lugol iodine solution daily beginning 10 days preoperatively

41
Q

hypertension, weakness, bone pain, and a serum calcium level of 15.2 mg/dL. Hand films below show osteitis fibrosa cystica. Dx?

A

Primary hyperparathyroidism

42
Q

tx thyroid storm?

A

rapid fluid replacement, antithyroid medication such as propylthiouracil (PTU), β-blockers, iodine solutions, and steroids

43
Q

Dx? HTN with hypokalemia

A

hyperaldosteronism

44
Q

Hyperaldosteronism test?

A

Plasma renin activity and plasma aldosterone concentration (PAC: PAR ratio of 25 to 30:1 is strongly suggestive of the diagnosis)

45
Q

cystosarcoma phyllodes tx?

A

wide local excision

46
Q

cystosarcoma phyllodes- benign or mal?

A

usu benign

47
Q

follicular thyroid ca tx?

A

lobectomy if small; total thyroidectomy if greater than 4cm

48
Q

Insulinoma findings?

  • glucose level
  • insulin level
  • C-peptide level
A
  • glucose level <50
  • insulin level elevated
  • C-peptide level elevated
49
Q

C-peptide on insulin: endogenous or exogenous?

A

endogenous

Surg Exam (7 decks)

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