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Phase 2 > Soft > Flashcards

Soft Flashcards

1
Q

What are the causes of acute incisional hernia?

A

IAP
Entrapment of fat in closure
Inappropriate suture material
Infection
Chronic steroids
Poor post care

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2
Q

What the effects of abdominal compartment syndrome?

A

Hypotension
Visceral hypoperfusion
Acidosis
MODs
Inc ICP
Abdominal wall ischemia/necrosis
Hypoxia

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3
Q

What makes up the upper and lower esophageal sphincters?

A

Upper: thyropharyngeus and cricopharyngeus
Lower: thickening of the circumferential layer, diaphragmatic crura, angles of stomach-esophagus Jan, folds of GE mucosa

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4
Q

What are contributing factors to esophageal dehiscence?

A

Segmental blood supply
Lack of serosa
Lack of omentum
Constant motion
Tension

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5
Q

Options for esophageal patching

A

Omentum
Pericardium
Muscle flaps (sternothyroid, longus colli, intercostals, diaphragm)
Gastric/jejunal
(Lung)
Xenogeneic/artificial (PSIS, dura mater, mesh, ePTFE)

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6
Q

Options for esophageal substitution

A

Inverse tubed skin grafts
Muscle grafts
Gastric advancement and EG anastomosis
Isoperistaltic or anti peristaltic gastric tubes
SI or colon graft
Free microvascular small intestinal or colonic graft

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7
Q

Treatment options for esophageal strictures

A

Balloon dilation
Bougienage
Stent
Esophagoplasty
RNA
Patching
Substitution
Esophagocutaneous fistula

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8
Q

Types of hiatal hernias

A

Type 1: sliding hiatal hernia
Type 2: paraesophageal hiatal hernia
Type 3: 1+2
Type 4: other organs herniating

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9
Q

Techniques for pyloric stenosis

A

Fredet-ramstedt pyloromyotomy
Heineken-mikulics pyloroplasty
Y-U pyloroplasty
Billroth I
Billroth II

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10
Q

Flaps that can be used for head/face defects

A

Lip to lid (subdermal plexus)
Lip to nose (subdermal plexus)
Labial transposition (subdermal plexus/superior and inferior transposition flap)
Angularis oris
Superficial temporal
Caudal auricular
Pinna composite

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11
Q

Flaps for the palate defects

A

Buccal transposition/ random mucosal rotating (subdermal plexus)
Angularis oris
Sternohyoideus/sternothyroideus muscle flap
Haired angularis oris
Overlapping flap technique
Medially positioned flap technique
Labial-based mucoperiosteal flap
Split palatal U-flap technique
Tongue flap
Free graft (auricular cartilage, tibial bone graft)
Myoperitoneal microvascular flap (transverse/rectus abdominis)
Prosthesis
Superficial temporal

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12
Q

Flaps for thoracic limb defects

A

Thoracodorsal
Omocervical
Axillary fold
Superficial brachial

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13
Q

Flaps for pelvic limb defects

A

Lateral vehicular
Caudal superficial epigastric
Revers saphenous conduit
Flank fold flap

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14
Q

Flaps for trunk defects

A

Latissimus dorsi myocutaneous
Cranial superficial epigastric
Caudal superficial epigastric
Dorsal deep circumflex iliac
Ventral deep circumflex iliac
Flank fold flap, Elbow fold flap
Lateral caudal

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15
Q

Steps of graft take

A

Adherence
Plasmatic imbibition
Inosculation
Revascularization
Reinnervation

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16
Q

Etiologies of acquired megacolon

A

Extraluminal compression
Intraluminal obstruction
Metabolic (hypoK, hypothyroid)
Neuromuscular (sacral cord, Manx, ileus, dysatuonomia, idiopathic, angangliosis)
Idiopathic (most common)

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17
Q

What are the approaches to the cranial, middle, and caudal rectum?

A

Cranial: ventral midlein + pubic/ischial osteotomy
Middle: Dorsal perineal
Caudal:
Anal
Transcutaneous
Transanal
Combined abdominal + transanal

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18
Q

AGASACA staging

A

Stage 1 (primary tumor < 2.5 cm with no metastasis) MST 40mo
Stage 2 (primary tumor > 2.5 cm with no metastasis) MST 24mo
Stage 3a (lymph node < 4.5 cm) MST 15 mo
Stage 3b (lymph node > 4.5 cm) MST 10 mo
Stage 4 (distant metastasis) MST <3mo

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19
Q

What are proposed etiologies of perineal hernia?

A

Rectal/testicular/prostatic abnormalities
Androgens
Gender differences
Relaxin
Prostatic disease
Neurogenic atrophy of pelvic diaphragm mm

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20
Q

What are surgical options for repair of perineal hernia

A

Neuter PLUS
Traditional
IOMT
Superficial gluteal (new: bilateral for ventral repair)
Semitendinosus (ventral, recurrent)
Mesh
Biomaterials (Xenogenic or Autogenous)
Organopexy
New: Sacrotuberous ligament

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21
Q

What are considered “complicated” perineal hernias?

A

Bilateral
Significant rectal dilatation
Concurent prostatic disease
Retroflexed bladder
Recurrent

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22
Q

Etiologies for GB Mucocele

A

Genetics
Cholestasis
Hyperadenocroticism
Hypothyroid

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23
Q

Causes for acquired extra hepatic shunts

A

Hepatic fibrosis/cirrhosis
PVH with portal hypertension
Hepatic AV malformations
Shunt attenuation

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24
Q

Objective measures of shunt attenuation

A
  1. Maximum portal pressure of 17-24 cm H2O
  2. Maximum increase in portal pressure by 9-10 cm H2O
  3. Maximum decrease in CVP by 1 cm H2O
  4. Maximum decrease in arterial pressure by 5 mm Hg or <15%
  5. Heart rate should not increase dramatically
  6. Ultrasound – shunt and portal vein flow should remain hepatopetal
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25
Q

Types of atresia ani

A

Type 1: stenosis of the anus
Type 2: persistence of anal membrane, rectum ends immediately cranial to this membrane (imperforate anus/dimple)
Type 3: persistence of anal membrane, but rectum ends more cranially
Type 4: anus and terminal rectum develop normally, but cranial rectum ends as a blind pouch

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26
Q

What are the 3 stages of laryngeal collapse

A

Stage I = laryngeal saccule eversion
Stage II = medial displacement of cuneiform processes
Stage III = medial displacement of corniculate processes

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27
Q

Surgical options for LarPar

A

Unilateral cricoarytenoid lateralization
Unilateral thyroaryntenoid lateralization
Transoral partial laryngectomy
Ventral laryngotomy for partial laryngectomy
Castellated Laryngofissure
Permanent tracheotomy

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28
Q

Grades of tracheal collapse

A

I: 25%
II: 50%
III: 75%
IV: 100%

29
Q

Options for a fractured tracheal stent

A

Medical mgmt
New stent within fractured stent
Extraluminal rings
Remove stent vis tracheotomy

30
Q

What causes a rightward shift of the oxygen-hemoglobin dissociation curve?

A

Acidosis
Increased temp
2-3 diphosphoglycerate in RBCs
CO2

(All these things inc with exercise –> better offloading –> happy peripheral tissues)

31
Q

Causes of hypoxemia

A

Hypoventilation
Low fraction of inspired oxygen
diffusion impairment
V/Q mismatch
Shunting (right to left)

32
Q

Muscle flap options for thoracic wall lesions

A

Diaphragmatic advancement, Diaphragm
Latissimus dorsi
External abdominal oblique
Transversus abdominis
Pectoral

33
Q

Chylothorax treatment options

A

Medical: Rutin, low fat diet
TDL ligation or embolization
Cisterna chyli ablation
Pericardectomy
Omentalization
Pleurodesis
Decortication
If recurrent:
Pleural port
Pleuropericardial shunts

34
Q

Options for PDA after rupture

A

Jackson-Henderson
Buttressed mattress sutures
Division between clamps and pledget buttress continuous or interrupted mattres suture + oversew

35
Q

Options for pulmonic stenosis

A

Endovascular balloon valvuloplasty (type A)
Surgical pulmonic dilatation valvuloplasty (type A)
Open patch-graft valvuloplasty (type A or B)

36
Q

Types of Pulmonic stenosis

A

Type A: Normal diameter but fusion or thickened leaflets
Type B: Hypoplastic annulus diameter

37
Q

Components of Tetralogy of Fallot

A

Pulmonic stenosis
Dextropositioned overriding aorta
Perimembranous ventricular septum defect
Secondary right ventricular hypertrophy

38
Q

Medical mgmt of BPH

A

ANtiandrogens (delmadinon acetate, flutamide)
LH inhibitors (megestrol acetate, medroxyprogesterone)
GNRH agonists (Deslorelin acetate, Azagly-nafarelin, Leuprolide)
5-alpha reductase inhibitors (Finasteride)
Estrogens

39
Q

What are the components of Birt-Hogg-Dube in GSD?

A

The disease is characterized by bilateral, multifocal tumors in the kidneys, uterine leiomyomas and nodules in the skin consisting of dense collagen fibers

AKA Hereditary multifocal renal cyystadenocarcinoma and nodular dermatofibrosis

40
Q

What cells produce testosterone, estrogen, and progesterone?

A

Leydig (interstitial) cells, Granulosa cells

41
Q

Treatment options for prostatitis/abscess

A

Castration + finasteride + Abx for 4 wk
US guided drainage
(Marsupialization/prostatocutaneous stoma)
(Passive drainage)
Active drainage
Omentalization
Partial prostatectomy

42
Q

Treatment options for prostatic cysts

A

Neuter +…
US guided drainage
Complete resection
Partial resection + omentalization
(Marsupialization/partial prostatectomy)

43
Q

Phases of IV pyelogram or excretory urogram

A

Phase 1: renal angiogenic phase
Phase 2: renal phase
Phase 3: excretory phase

44
Q

Ways to measure GFR

A

Dynamic renal scintigraphy
Plasma clearance studies

45
Q

Options for kidney stones

A

Extracorporeal shockwave lithotripsy (not cats)
Nephrotomy
Pyelolithotomy
Endoscopic nephrolitotomy
Nephrectomy

46
Q

Kidney Biopsy contraindications, risk factors for complications

A
  • Uncontrolled coagulopathy
  • Uncontrolled hypertension
  • Large/multiple renal cysts/abscesses
  • Extensive pyelonephritis
  • Ureteral obstruction
  • Severe hydronephrosis
  • If biopsy is unlikely to alter disease course (CKD/end-stage renal dz)
  • If owners are unwilling to pursue further treatment
  1. Thrombocytopenia
  2. Prolonged clotting times
  3. Uncontrolled hypertension
  4. NSAIDs within past 5 days
  5. Serum creatinine concentrations >5 mg/dL
  6. Age > 5 yrs
  7. Body weight < 5 kg
  8. Severe hemorrhage (10%): uncontrolled hypertension, NSAIDs w/in past 5 days. Death in 3%
47
Q

Treatment options for ureteral stones

A

Medical mgmt: Diuresis, +/- amitriptyline, glucagon
Lithotripsy (dogs only)
Stent
Ureterotomy
SUBS
Neoureterocystostomy
Intravesicular
Extravehicular
Ureteral RNA
Ureteronephrectomy

48
Q

Cystectomy augmentation techniques

A

o Seromuscular colonic augmentation procedure
o Ileocystoplasty procedure
o Rectus abdominis flap
o Urinary diversion to the prepuce/vagina (colon high morbidity)

49
Q

Options for bladder stone removal

A

Catheter assisted retrieval
Transurethral scope removal
Voiding hydropulsion
Lithotripsy
PCCL/ lap assisted
Cystotomy

50
Q

Options for bladder neoplasia

A

Chemo, NSAIDs
Partial cystectomy (Total and rerouting)
Tube cystostomy
Stent
Cytoscopic laser ablation
Radiation

51
Q

Urethral reinforcement

A

Rectus abdominus
Internal obturator
Omentum
Papers: buccal mucosal graft, PSIS

52
Q

Treatments for urethral stricture

A

RNA
Urethrostomy
Balloon dilation
STent
(Urethral replacement)

53
Q

Etiologies of USMI

A

Congenital abnormalities
Urethral tone and length
Bladder neck position
Body size and breed
Gonadectomy
Hormonal Status
Genital Confformation

54
Q

Treatments for USMI

A

Medications
PPA
Estriol
GnRH analogues
(Androgens)
Increase urethral length/relocate bladder
Colposuspension
Urethropexy/Cystourethropexy
Increase urethral resistance
Transpelvic urethral sling
Transobturator vaginal tape
Bulking agents
Artificial urethral sphincter

55
Q

Complications of renal transplant and the major risk factors for death (*)

A

Renal dysfunction
Acute* or chronic rejection
Hemolytic uremic syndrome
CaOx
Retroperitoneal fibrosis
Ureteral obstruction
Delayed graft function
Allograft rupture
Infection *
DM
Neoplasia

56
Q

Complications with adrenalectomy if cortisol secreting

A

Immunosuppression
Delayed healing
Hypercoagulable (PTE)
Hypertensive
HOC postop
Pancreatitis

57
Q

Pretreatments for Cortisol tumor? Pheochromocytoma?

A

Cortisol: Trilostane, ace-inhibitor or angiotensin receptor blocker
Want ACTH stim 2-5 ug/dL
PCC: phenoxybenzamine

58
Q

Treatment for PTE

A

Oxygen
IVF
Anticoagulant (unfractionated heparin)
Theophylline
SIldenafil

59
Q

Medical mgmt for hyperthyroid

A

Methimazole
Iodine restricted diet
Beta agonist (tachycardia/arrhythmias)

60
Q

Surgical techniques for thyroidectomy

A

Extracapsular
Modified extra capsular
Intracapsular
Modified intra capsular
Parathyroid autotransplant
Staged bilateral ?

61
Q

What can affect scintigraphy uptake in the thyroid gland?

A

Iodinated contrast
thyroid hormone supplementation

62
Q

Complications of thyroidectomy

A

Hemorrhage
Horners
Larpar (bilateral)
Hypothyroid
Dyspnea
MegaE (bilateral)
(HypoCa)(bilateral)

63
Q

Differentials for hypercalcemia

A

H: HyperPTH
A: Addisons
R: Renal disease, raisins
D: Vitamin D
I: Idiopathic, Infectious (granulomatous dz)
O: Osteolytic
N: Neoplasia (HHM), Nutritional

64
Q

When is FNA NOT the answer?

A

Bladder, Ovarian, Thyroid masses

65
Q

Medical mgmt of HyperCa

A

Diuresis
Furosemide
Glucocorticoids
Bisphosphonates
Calcitonin

66
Q

Causes of entropion and treatment

A

Conformational
Cicatricial
Involutional
Spastic

Temporary tacking
Holtz-Celsus procedure (crescent)
Stades procedure (leave strip of granulation tissue)

67
Q

Ectropion treatment

A

Modified Kuhnt-Szymanowski procedure
V-Y PLasty

68
Q

MCT Grading

A

Patnaik
Grade I: well differentiated (20-35%, <10% met)
Grade 2: intermediate (40-65%, <20% met)
Grade 3: undifferentiated (5-25%, 95% met)
Kiupel
Low grade (MST 700-1400d)
High grade (MST 100-200d)

Phase 2 (4 decks)

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