Surgery Flashcards
Type of burn that heals in 5-21 days
Second degree superficial burn
Second degree deep dermal burn heals in
3 weeks
Third degree burn heals in
Non-healing
Most common skin malignancy worldwide
Basal Cell Carcinoma
Premalignant lesions of SCC of the skin
Bowen’s disease
Actinic keratosis
Borchardt triad (chest pain, retching and inability to pass NGT) is indicative of
incarcerated intrathoracic stomach
Most effectivd nonsurgical tx of achalasia
Pneumatic dilatation
most common primary esophageal motility disorder
nutcracker esophagus
most common esophageal diverticula
Zenker
gold standard for GERD
24h ambulatory pH monitoring
gold standard for achalasia
manometry
gold standard for gastric CA
upper endoscopy + biopsy
Nerves in the spermatic cord
Autonomic nerves
Genital branch of genitofemoral
Ilioinguinal
Arteries and veins in the spermatic cord
Testicular
Vas deferens
Cremasteric
(TVC)
Tx of high grade dysplasia of esophagus
esophagectomy
Contraindications for curative surgery in esophageal CA
>75 yo >20% weight loss Horner syndrome paralysis of diaphragm malignant pleural eff >9cm length >4 LN involved
maneuver that mobilizes the fixed portions of the duodenum
Kocher maneuver
Nerve at the posterior fundus responsible for ulcer recurrence
Criminal nerve of Grassi (from R vagus)
Most common site of gastric ulcer and gastric adenoCA
Incisura angularis
Standard test to confirm eradication of H. pylori post-treatment
Urease breath test
Most common type of PUD (not associated with increased acid secretion)
Type I
Types of PUD associated with increased acid secretion
Type II and III
Minimum amount of blood for a positive FOBT
20 mL
Minimum amount of blood for the symptom of melena
50 mL
Surgery is indicated for PUD when the location of the ulcer is at the
posterior duodenal bulb
gastric lesser curvature
Truncal vagotomy is always followed by
Gastric drainage
In high selective vagotomy, which GI function is spared?
Motor function to stomach
decreased chance of gastric atony
Nonsurgical mngt for early dumping syndrome
Octreotide (splanchnic vasoconstrictor)
Nonsurgical management of late dumping syndrome
Alpha glucosidase inhibitors
Surgical mngt of dumping syndrome
Roux en Y anastomosis
Diagnostic test to localize gastrinoma
Octreotide scan
Common location of gastrinoma
Passaro’s triangle
Head of pancreas or duodenum
Most common risk factors for gastric adenoCA
H pylori
Autoimmune gastritis
Acillary lymphadenopathy in gastric adenoca
Irish node
dropmets to ovary in gastric adenoca
krukenberg tumor
dropmets to culdesac in gastric adenoca
blumer shelf
gastric lymphoma is associated with which malignancy
B-cell NHL
Mngt of lowgrade gastric lymphoma
H pylori eradication
Mngt of high grade gastric lymphoma
chemoradiation
Malignancy arising from interstitial cells of Cajal
GIST
Tx for unresectable GIST
Imatinib
tyrosine kinase inhibitor
Type of malignancy arising from gastric ECL cells
Gastric carcinoid
gastric lesion characterized by diffuse hyperplasia of surface mucus-secreting cells & decreased parietal cells
assoc with protein-losing enteropathy & hypochlorhydria
Menetrier disease
hypertrophic gastropathy
congenital AVM in stomach
usually with large tortuous submucosal artery
Dieulafoy lesion
Maneuver done to decrease blood supply to the liver
Pringle maneuver
First line treatment for primary SBP
Cefotaxime
Parameters for child-turcotte-pugh scoring (surgical risks / mortality)
Nutritional status Ascites Encephalopathy Serum albumin Serum bilirubin PT or INR
pressure necessary for esophageal barices to form and bleed
> 12 mmHg
Pharmacologic therapy for acute variceal bleed
Octreotide
Vasopressin
Medication given to prevent variceal bleeding and reduce mortality by 50%
Beta blockers
Most consistent symptom of carcinoid
flushing
targeted treatment for HER2-positive breast CA
Trastuzumab (Herceptin)
Most differentiated variant of breast CA with the best prognosis
Tubular CA
Breast CA with a high propensity for bilaterality, multicentricity, multifocality
Lobular CA
Breast CA that carries the worst prognosis
Inflammatory CA
Most common form of liver abscess worldwide
Amebic liver abscess
clearest risk factor for devt of adenoma
OCP use
percutaneous UTZ-guided biopsy is absolutely contraindicated in which 2 conditions of liver
hemangioma and adenoma
most common malignant liver tumor
metastatic
extrahepatic cholangiocarcinoma occuring at the hepatic duct confluence
Klatskin tumor
most common congenital anomaly of pancreas
pancreas divisum
most common peripheral arterial aneurysm
popliteal artery aneurysm
LMWH should be given in DVT patients for how long
3 months
consistently used as a marker of injury response due to its dynamic reflection of inflammation
CRP
potent inducer of acute phase proteins
IL-6
Surgical tx of malrotation
Ladd’s procedure
Most abundant amino acid in the body
Glutamine
characterized by chronic eczematoid eruption of the nipple
Paget’s disease
Paget’s disease presents with elevated level of
CEA
burst fracture of atlas
Jefferson fracture
fracture of pars interarticularis of axis
Hangman fracture
stress fracture of 2nd metatarsal
March fracture
fracture with dislocation of tarsometatarsal joint
Lisfranc fracture dislocation
fracture of the base of 5th metatarsal bone
Jones’ fracture
hip condition with shallow acetabulum resulting in lateral displacement of femoral head
developmental dysplasia of the hip
pediatric conditions presenting with bilious vomiting and minimal distention
Malrotation
Duodenal atresia
anatomical structures preserved in modified radical neck dissection
SCM
spinal accessory nerve
IJV
Mngt of developmental hip dysplasia in a 2-year old
Femoral osteotomy
15 mos to 2 yrs
pediatric orthopedic condition presenting with positive trethowan’s sign
slipped capital femoral epiphysis
EBV is associated with what type of epithelial cancer (2)
Nasopharyngeal carcinoma
Gastric carcinoma
when does epithelialization begin in a superficial cutaneous wound?
within 24 hours
fracture of distal third of humerus entrapping the radial nerve
Holstein-Lewis fracture
fracture of the radial styloid
Hutchinson’s / Chauffeur’s fracture
Mammographic features suggestive of a diagnosis of breast CA
- solid mass with or without stellate features
- asymmetric thickening of breast tissue
- clustered microcalcifications
annual mammogram screening should be started at
age 40
neoadjuvant chemotherapy in breast cancer is started at what stage
stage IIIa
Munro microabscesses (neutrophils in stratum corneum) are seen in
Psoriasis
strongest chemotactic factor for fibroblasts
PDGF
Boas’ sign
referred right subscapular pain of biliary colic
What stage of breast CA? Tx?
T2N1M0
T3N0M0
Stage IIB
BCS +/- adjuvant chemo/RT
ulnar nerve entrapment at the elbow and wrist is called ______ and _______ syndrome respectively
Cubital tunnel syndrome
Tunnel of Guyon syndrome
Hallmarks of hemolytic transfusion reaction in anesthetized patients
Diffuse bleeding and hypotension
Syndrome characterized by dilatation of the colon in the absence of any mechanical obstruction in severely ill patients
Ogilvie syndrome
bird’s beak sign (2)
achalasia
sigmoid volvulus
Felty’s syndrome (3)
Rheumatoid arthritis
Splenomegaly
Neutropenia
bird’s beak sign (2)
achalasia
sigmoid volvulus
bird’s beak sign (2)
achalasia
sigmoid volvulus
bird’s beak sign (2)
achalasia
sigmoid volvulus
most common type of volvulus
sigmoid volvulus
most commonly dislocated joint
glenohumeral joint (anterior > posterior)
most common type of pediatric fracture
Salter-Harris Type II
epiphysis + metaphysis
isolated closed fracture of the radial shaft
Piedmont fracture
most common site of non union
distal tibia
causative agent of hydatid cyst
echinococcus granulosus
most common functional pancreatic endocrine neoplasm
insulinoma
tx of primary SBP
cefotaxime (3rd gen ceph)
most vulnerable segment of colon to obstruction
sigmoid
volvulus, divertic
most vulnerable segment of colon to perforation
cecum
most vulnerable segment of colon to ischemia
splenic flexure
coffee bean sign / bent inner tube sign on radiography is seen in
Sigmoid volvulus
antidote for beta blocker toxicity
glucagon
most common malignancy that metastasize to the thyroid
renal cell CA
treatment of MTC and hurthle cell CA
total / near total thyroidectomy + bilateral central node dissection
FNAB findibg of anaplastic CA of the thyroid
giant multinucleated cells
most common variant of congenital diaphragmatic hernia
posterolateral (Bochdalek)
selective node dissection for thyroid gland malignancies
posterolateral node dissection
tx of inflammatory carcinoma of the breast
neoadjuvant chemotherapy (adriamycin containing)
routine screening mammography for women
> 50 y/o (Schwartz)
> 40 y/o (recent guidelines)
indications for bariatric surgery
BMI >35 with comorbids
>40 without comorbids
most common cause of cataract
aging
sx of acute angle closure glaucoma (3)
mid dilated pupil
ciliary injection
hazy cornea
(+ eye pain)
ophthalmologic diagnostic procedure that can visualize the anterior chamber angle
gonioscopy
events that promote the greatest severity of nitrogen wasting
major burns
severe sepsis
skeletal trauma
elective surgery
GI secretion with the highest potassium content
colon
most common source of fluid loss in a surgical patient
gastrointestinal
IV solution that most commonly approximates ECF
LRS
indications for damage control surgery (lethal triad / bloody vicious cycle)
hypothermia
metab acidosis
coagulopathy
Screening mammography
25 y/o (BRCA gene)
40 y/o (American Cancer Society)
50 y/o (Schwartz)
Tx of toxic MNG / Plummer Disease
Surgery
Modt common type of scoliosis
Adolescent idiopathic scoliosis
Structure involved in Golfer’s elbow? Tennis elbow?
Golfer’s - pronator teres
Tennis - extensor carpi radialis brevis tendon
most common site of hypertensive ICH
putamen
Most common primary brain tumor
astrocytoma
Most common levels of cervical disc syndrome
C5-6, C6-7
Paraneoplastic syndromes of bronchogenic CA
SCLC - hyperCalcemia
Adenoca - pAncoast tumor
Squamous - Svc syndrome
SIADH, Cushings, Lambert Eaton
Neuromuscular paraneoplastic syndrome similar to myasthenia
Laambert Eaton Syndrome
Tx of SCLC / Oat cell CA
Chemoradiation
Preop pulmo function for lobectomy?
pneumonectomy?
FEV 1 > 1.5 L
> 2 L
Most common type of VSD needing surgical intervention
Perimembranous (80%)
Most common type of VSD
Muscular
shunt between subclavian artery and pulmonary artery
Blalock - Taussig shunt
Shunt between SVC and R pulmonary artery
Glenn shunt
most common brain herniation syndrome
subfalcine / cingulate
most dramatic and 2nd most common brain herniation syndrome
uncal transtentorial herniation
most common incomplete SCI
central cord syndrome
incomplete SCI with the worst prognosis
anterior spinal artery syndrome
neurogenic claudication is pathognomonic of
lumbar spinal canal stenosis
conditions assoc w/ cleft lip and palate
maternal DM
rubella
toxoplasmosis
drugs assoc with cleft lip and palate
steroids
anticonvulsants
diazepam