Surgery Flashcards
Most common cause of spontaneous unilateral nipple discharge
Solitary intraductal breast papilloma
Management of breast papilloma
Excision and circumareolar incision
Indications for surgical removal in simple breast cyst
- The cyst recurs multiple times
- If a needle biopsy reveals findings of atypia, incompletely removes the mass
- If the cyst is large and painful for the patient.
Management of breast cyst
Usually conservative by aspiration
Gynecomastia in teenagers
- Occurs between the age of 13 and early adulthood.
- It presents as a tender, firm, smooth mass in the subareolar region.
- Observation is done because it usually regresses within 1 to 2 years.
Gynecomastia in teenagers: surgical incision may be needed if it is
- Unilateral
- Unable to regress in 18 to 24 months,
- Causing cosmetic issues.
Ultrasound findings of malignant lesions
- micro calcifications
- distortion of surrounding breast architecture
- internal echoes
- irregular borders
Ultrasound findings of benign lesions
- Round
- Hypoechoic
- Slightly lobular
- Well-defined mass
Li-Fraumeni syndrome
- Autosomal dominant mutation of the TP53 gene
- High risk for multiple malignancies at a young age (breast cancer, osteosarcoma, leukemia, lymphoma, brain tumors, adrenocortical carcinoma).
Genetic mutations associated with an increased risk for breast cancer:
- BRCA1, BRCA2,
- TP53 (Li-Fraumeni syndrome)
- PTEN (Cowden syndrome)
- Peutz-Jeghers syndrome
- Klinefelter syndrome
Most common breast cancer diagnosed in men
- Invasive ductal carcinomas
- Hormone receptor positive
American Cancer Society has recommended annual MRI screening beginning at age 30 years for women at high lifetime risk for breast cancer development (approximately 20% to 25% or greater), these include:
- Known BRCA1 or BRCA2 gene mutation
- First-degree relative with BRCA1 or BRCA2 gene mutation, but have not had genetic testing themselves
- Radiation therapy to the chest between the ages of 10 and 30
- Lifetime risk of breast cancer >20%
- Li-Fraumeni syndrome or Cowden syndrome or a first-degree relative with one of these syndromes
Women at moderately increased lifetime risk (15% to 20%) should consult with their physicians about the benefits and limitations of adding MRI screening, these include:
- Lifetime risk of breast cancer of 15%-20% according to risk assessment tools based mainly on family history
- Personal history of breast cancer, DCIS, LCIS, atypical ductal hyperplasia, or atypical lobular hyperplasia
- Extremely dense breasts or unevenly dense breasts when viewed by mammograms
Antireflux surgery is more successful in patients who have:
- typical symptoms of GERD
- good response to antireflux therapy
The most common histopathological type of esophageal cancer that arises in the upper portion of the esophagus
Squamous cell carcinoma
The most common type of esophageal cancer which arises in the distal esophagus
Adenocarcinoma
What is the initial choice in treating actively bleeding wounds
- Applying direct pressure
- Tourniquets can be used as an alternative to direct pressure in patients who present with uncontrolled extremity bleeding
most common complication after a laparoscopic sleeve gastrectomy
Staple line leaks
MDM2 and CDK4 markers for
Liposarcoma
