Surgery SF

Question 1

preferred primary tretment for GH-secreting microadenomas and macroadenomas

Answer 1

transphenoidal surgery

only prolactinoma has primary treatment of medical

Question 2

signs of impending respiratory compromise in burns

Answer 2

hoarse voice
wheezing
stridor
subjective dyspnea (particularly concerning symptom)

Question 3

type of necrotizing faciitis with a monobicrobial source

Answer 3

type 2
GABHS
MRSA

Question 4

what to do for BIRADS 3

Answer 4

follow up after 6 months

Question 5

% of malignancy for BIRADS 4B

Answer 5

11-50%

Question 6

most robust indicators for burn mortality

Answer 6

AGE
BURN SIZE
INIHALATION INJURY
(REVISED BAUX SCORE)

Question 7

neck zone with highest morbidity and mortality

Answer 7

zone I

Question 8

amino acid most beneficial in the surgical critical patient

Answer 8

GLUTAMINE?
(primary nutrition source of small intestines)
-added in total parenteral nutrition

“With parenteral glutamine, the patients most likely to benefit are the critically ill and those at high risk of gut dysfunction. In such patients, a dose of 15–25 g per day may be sufficient.” (D’Souza & Powell-Tuck, 2004)

however

according to Schwartz (2019):
“Recently reported data from 2 large RCT in which critically ill patients received GLUTAMINE supplementation demonstrated INCREASED 6-MONTH MORTALITY in the patients who received glutamine. Therefore, glutamine supplementation in the critically ill patient is not currently recommended.”

Question 9

best studied immune-nutrients

Answer 9

glutamine
arginine
omega-3 PUFA

Question 10

Most abundant amino acid in the human body

Answer 10

GLUTAMINE (Schwartz)

-comprising nearly 2/3 of the free intracellular amino acid pool

Question 11

preferred intubation for burn patients

Answer 11

orotracheal intubation

if with subjective dyspnea, elective ENDOTRACHEAL intubation?

Question 12

2 large-bore IVs are ideal for burn largern than

Answer 12

40% TBSA

Question 13

burn and prophylactic antibiotics

Answer 13

patients with acute burn injuries shouuld never receive prophylactic antibiotics

Question 14

this acid causes liquefactive necrosis

Answer 14

hydrofluoric acid

• causes hypocalcemia
• topical application of calcium gluconate
• IV calciu gluconate for systemic hypocalcemia symptoms

Question 15

this acid has been known to cause hemolysis and hemoglobinuria

Answer 15

formic acid

Question 16

BRCA1 is located on chromosome

Answer 16

17q

BRCA1
-tumor suppressor gene
-85% lifetime risk for BREAST CANCER
>>invasive ductal CA, poorly differentiated
>>hormone receptor negative (-/-/-)
-40% lifetime risk for OVARIAN CANCER

Question 17

BRCA2’s lifetime ovarian cancer risk

Answer 17

~20%

BRCA2
-chromosome 13q
-tumor suppressor gene
-bears NO homology to BRCA1
-85% breast cancer risk (same with BRCA1)
>>WELL-differentiated
>>express hormone receptors

Question 18

men with germline mutation sin BRCA__ have an estimated breast cancer risk of _____

Answer 18

BRCA 2
breast cancer risk of 6%
which represents a 100-fold increase over the risk in the general male population

Question 19

other assoc’d cancer for BRCA 2

Answer 19

OVARIAN
Colon
Prostate
Pancreatic

Gallbladder
Bile ducct
Stomach
MELANOMA