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MS3 > Surgery Rotation 15 > Flashcards

Surgery Rotation 15 Flashcards

1
Q

Pre-op management of pt with high risk of coagulation

A

Prophylactic low-dose heparin

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2
Q

Hormones that can be produced by squamous cell carcinoma of the lung

A

PTH = hypercalcemia

THINK: s(Ca)mous cell

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3
Q

Hormones that can be produced by small cell carcinoma of the lung

A

ADH, ACTH (Cushings), antibodies against post-synaptic Ca2+ channels (Lambert Eaton)

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4
Q

Tx of acute pancreatitis

A

Fluid resuscitation

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5
Q

What causes flank pain that radiates to the groin?

A

Kidney stones

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6
Q

Ddx of LLQ pain in old men

A

Sigmoid volvulus

Mesenteric ischemia

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7
Q

Biliary disease associated with ulcerative colitis

A

Primary sclerosing cholangitis

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8
Q

Antibody associated with primary sclerosing cholangitis

A

p-ANCA

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9
Q

Antibody associated with primary biliary cirrhosis

A

anti-mitochondiral antibodies

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10
Q

Classic imaging associated with PSC

A

“beaded” appearance due to contrasting dilation and narrowing

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11
Q

Diagnose: episodes of dysphagia, regurgitation, and/or chest pain precipitated by emotional stress and hot/cold foods

A

Diffuse esophageal spasm

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12
Q

Test used to diagnose diffuse esophageal spasm

A

Manometry

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13
Q

What will you see on endoscopy with a gastrinoma

A

Multiple ulcers and thickened gastric folds

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14
Q

Presentation of colovesical fistula

A

Connection between colon and bladder

Presents with pneumaturia (air in urine), fecaluria (stool in urine), recurrent UTI (mixed flora)

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15
Q

How do you diagnose colovesical fistula

A

Abd CT with oral or rectal (not IV) contrast - will show contrast in the bladder

Colonoscopy to exclude colonic malignancy

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16
Q

Describe management of dysphagia when it is difficulty initiating swallowing; with cough, choking or nasal regurg

A

Probably oropharyngeal dysphagia

Evaluation with barium swallow

17
Q

Evaluation of dysphagia with solids progressing to liquids

A

Mechanical obstruction

Barium swallow or upper GI

18
Q

Evaluation of dysphagia with solids and liquids at onset

A

Motility disorder

Barium swallow followed by manometry

19
Q

Next step in management after US if suspected cancer causing biliary obstruction?

A

Abd CT

Do not do ERCP immediately because it is invasive

20
Q

Diagnose: bleeding in women on long term OCP

A

Hepatic adenoma

21
Q

Most common cause of liver mass

A

Metastatic disease

22
Q

Tx of acute pancreatitis

A

Supportive (fluids, bowel rest)

23
Q

Diagnosis of chronic pancreatitis

A

CT

24
Q

Tx of acute ascending cholangitis

A

Emergency ERCP to drain duct. Or can use percutaneous transhepatic drainage

Fluids, abx

25
Q

Tx of pulmonary contusion

A

Fluid restriction and diuretics

Contused lungs are sensitive to fluid overload

26
Q

Cause and presentation of primary biliary cirrhosis

A

Autoimmune destruction of intra-hepatic bile ducts
–Associated with other autoimmune conditions
Presentation:
–Cholestasis – due to destruction of bile ducts
–Jaundince, hepatomegaly, steatorhhea, portal HTN
–Hyperlipidemia (with xanthelasma)
–Metaboalic bone disease
- Lymphocytic infiltrate + -
granulomas
- Mostly occurs in women around age 40
- (+) anti-mitochondrial antibody (AMA)
- Cirrhosis is a late complication

27
Q

Cause and presentation of primary sclerosing cholangitis

A
  • Unknown cause
  • Concentric fibrosis of the intra- and extra-hepatic bile ducts
  • Contrast imaging will show “beaded” appearance due to alternating fibrotic and dilated regions
  • Mostly occurs in men around age 40
  • Associated with (+) pANCA and Ulcerative colitis
  • Increased risk for cholangiocarcinoma
28
Q

Tx of sigmoid volvulus

A

sigmoidoscopy-guided placement of rectal tube

29
Q

Ulcers associated with autoimmune disorders such as IBD

A

Pyoderma gangrenosum

30
Q

What are the effects of hypomagnesemia on calcium?

A

Mg is needed for the production and release of PTH. So low Mg = low PTH = hypocalcemia

31
Q

Contraindications to mammography

A

Age < 20. Breast tissue too dense

Lactating women

NO contraindication in pregnancy

32
Q

Tx of sigmoid volvulus

A

sigmoidoscopy-guided placement of rectal tube

33
Q

Ulcers associated with autoimmune disorders such as IBD

A

Pyoderma gangrenosum

34
Q

What are the effects of hypomagnesemia on calcium?

A

Mg is needed for the production and release of PTH. So low Mg = low PTH = hypocalcemia

35
Q

What is decerebrate posturing?

A

Causes hyper extension (away from core, vs. decorticate posturing)

Caused by ICP

MS3 (88 decks)

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