Surgery Flashcards
Immediate chest decompression using wide bore cannula in ____ IC space in ____ line in adults and _____ IC space in ____ line in children
- 5th
- Mid axillary line
- 2nd
- Mid clavicular line
Definitive chest tube inserted in ______ IC space for pneumothorax
Left 5th
Parkland formula for burns
4 ml x body wt in kg x % TBSA
Fluid requirement after burns acc to ATLS guidelines for adults
2ml x body wt in kg x % TBSA
Urine output: 0.5 ml/kg/hr
or 30-50ml/hr
Half in first 8 hr next half in next 16 hrs
Fluid requirement after burns acc to ATLS guidelines for children
3 ml x body wt in kg x % TBSA
Urine output: 1 ml/kg/hr
Hepatic adenomas are most exclusively seen in ____ aged ____. They are asso with use of ____. They are detected ____. ____ variant has more malignant potential than ___. Treatment is ____
Females
20-50 y
OCP
incidentally via imaging
Beta catenin mutated variant > Inflammatory type
Excision
Some indications for excision of hepatic adenoma
Males
> 5 cm
Pedunculated
Symptomatic
Beta catenin mutated
FAP is genetic mutation on chromosome ___ where gene _____ gets ____ and _____ gets activated leading to formation of 100s of polyps. Its inheritance is ____
5
APC
deleted
Beta catenin
AD
MELD score includes which variables?
Serum bilirubin
Serum creatinine
Serum Na
INR
Range of MELD score
6-40
higher the score, poorer the outcome
BRCA 1 gene is situated on
BRCA 2 gene is situated on
17
13
Cancers associated with BRCA gene mutation
Breast, Stomach, Pancreatic, Gall baldder, Bile duct, Colon, Prostate, Cervical, Uterine, melanoma
Brawny swelling of submandibular region, rapidly spreading, halitosis with breathing difficulty. Diagnosis?
Ludwig’s angina
Ludwig’s angina involves ___ compartment. MC organisms implicated are _____. There is no ____ involvement. First step of treatment is ____ f/b ____.
all compartments– submental, sublingual, submandibular
Mixed infection– beta hemolytic strept, anerobic peptostrept, bacteriodes
Lymphatic
Insure airway f/b I and D
Anterior approach for hernia repair
Most open surgeries are anterior approaches
Bassini, Shouldice, MacVay, Desarda, Liechtenstein
STOPA (type of open surgery) is posterior approach
Posterior approach of hernia surgery
TEP, TAPP
Classification of endovascular leak
Type 1: Leak proximal or distal to stent
Type 2: Side branches patent
Type 3: Tear in the Stent
Type 4: Stent becomes porous
Type 5: Site unknown
Type 1 and 3 requires repair
MC site of subependymal giant cell astrocytoma?
Foramen of monro (causing Hydrocephalus)
Asso with Tuberous sclerosis
Vogt’s triad
‘Epiloa’
1. Epilepsy
2. Low Iq
3. Adenoma sebaceum
Asso with Tuberous sclerosis
Female
Hyperparathyroid
Cystic parathyroid
Renal hamartoma
Hyperthyroid Jaw tumor syndrome
Hyperthyroid Jaw tumor syndrome
1. Inheritance
2. Gene mutation
3. Clinical features
- AD
- CDC73/ HRPT2 gene on Ch1
- Facial disfigurement (ossifying fibroma of jaw), Hypercalcemia (d/t hyperPT), Malignancy, Kidney cysts, Hamartomas, Wilms tumor
Amsterdam criteria for HNPCC
- At least 3 relatives with HNPCC related cancer of which 2 should be first degree relative
- AGe < 50
- At least 2 successive generation affected
- FAP should be excluded
Oncotype Dx
predicts benefit of adding chemo to endocrine therapy in patient of breast cancer who are-
Anatomic stage 1, 2, 3a
HR+, HER2-
It is gene expression of 21 genes (16 cancer related genes and 5 reference genes) genes using RTPCR
Oncotype Dx
Which women are indicated to undergo chemo?
> 20 y/o
25 recurrence score
