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The Great Surgery Deck > The Superlatives of Surgery > Flashcards

The Superlatives of Surgery Flashcards

Most Commons, Pre-malignant lesions Exceptions, ONLY ones, Etc...

1
Q

Only IV NSAID

A

Ketorolac

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2
Q

Most abundant source of energy (fast <5 days)

A

Lipids

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3
Q

Flatus or passage of stool are not prerequisites for enteral feeding EXCEPT IN…

A

Gastroparesis

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4
Q

Most common trace mineral deficiency

A

Zinc

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5
Q

TBW of males versus females

A

Male: 60%
Female: 50%

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6
Q

Most common fluid disorder in surgical patients

A

Extracellular volume deficit

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7
Q

Most common cause of Extracellular volume deficit

A

Loss of GI fluids

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8
Q

Most common abnormality of hemostasis

A

Thrombocytopenia

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9
Q

Most common complication of warfarin therapy

A

Bleeding into the abdominal cavity

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10
Q

Most common cause of abdominal pain in patients undergoing anticoagulation

A

Intramural bowel hematoma

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11
Q

Most common indication for blood transfusion

A

Replacement of volume

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12
Q

TRALI ALWAYS occurs before…

A

6 hours post transfusion

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13
Q

Most common indication for intubation

A

Altered mental status

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14
Q

Most common type of burn admissions

A

Flame burns

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15
Q

Keratinocyte transit time

A

40-56 days

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16
Q

Most common site of extravasation (Adult)

A

Dorsum of the hand

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17
Q

Most common cause of extravasation (Infant)

A

high concentration dextrose, bicarb, Ca, TPN

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18
Q

More sensitive to pressure?

Muscle or Skin?

A

Muscle! Hence necrosis tends to extend deeper than is superficially apparent

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19
Q

Most protective factor from UV-related damage

A

Melanin

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20
Q

Most common form of radiation exposure

A

UV radiation

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21
Q

Pathognomonic for actinomycosis

A

Sulfur granules within purulent specimen

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22
Q

Most common location for a dermoid cyst

A

Eyebrow

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23
Q

Most common cutaneous cyst

A

Epidermal cyst

2nd: Trichilemmal cyst

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24
Q

Most common cutaneous lesion of infancy

A

Hemangioma

90% involute

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25
Q

Most common subcutaneous neoplasm

A

Lipoma

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26
Q

More common location of granular cell tumors

A

Tongue

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27
Q

Most common type of skin cancer

A

BCC

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28
Q

Most frequent from of BCC

A

Nodulocystic / Nodulo ulcerative - RODENT ulcer

Morpheaform - more aggressive

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29
Q

Syndromic malignancies assoc with BCC

A

Gorlin’s syndrome (Basal cell nevus)

Nevus sebaceus of Jadassohn

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30
Q

Syndromic malignancies assoc with SCC

A

Epidermolysis verruciformis
Xeroderma pigmentosum
Epidermolysis bullosa
SLE

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31
Q

Premalignant lesion: Malignant melanoma

A

Dysplastic nevi

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32
Q

Most common type of malignant melanoma

A

Superficial spreading (anywhere EXCEPT hands and feet)

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33
Q

Least common type of malignant melanoma

A

Acral lentiginous (palms, soles, and ungal areas)
Most common: great toe, thumb
More common in dark skinned people

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34
Q

Types of of malignant melanoma with the best and worst prognosis

A

Best: Lentigo maligna
Worst: Acral lentiginous

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35
Q

Most important prognostic factor

A

Breslow thickness

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36
Q

Skin malignancy with worst prognosis

A

Merkel Cell Carcinoma

IHC stain: neuron specific enolase

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37
Q

Most common sites of necrotizing soft tissue infection

A

Ext. genitalia, perineum, abd. wall

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38
Q

Most common site of breast cancer

A

Upper outer quadrant

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39
Q

Most common site of axillary LN mets

A

Lateral (level 1)

Levels reference point: Pectoralis minor!

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40
Q

At what size is gynecomastia considered in men?

A

> /= 2cm

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41
Q

Mammography by age

A

Baseline: 35
Annual: start at 40

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42
Q

Chemopreventive med for Breast CA with a more favorable adverse event profile

A

Raloxifene

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43
Q

Most important prognostic factor of disease free survival in breast CA

A

Axillary LN status

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44
Q

More common in situ breast CA in premenopausal women

A

LCIS

also more common bilateral

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45
Q

True anatomic precursor of Breast CA

A

DCIS

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46
Q

Pathognomic for Paget’s Disease of the Nipple

A

Large, pale, vacuolated cells

Always r/o malignant melanoma

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47
Q

Most frequent complication of MRM

A

Seromas beneath the skin flaps

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48
Q

Most tumors of the oral cavity are of this type

A

SCCA

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49
Q

Most common location of SCCA of the oral cavity

A

Lower lip

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50
Q

Head and Neck CA with best prognosis

A

Cancer of the lip

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51
Q

Lymph drainage of tongue cancer

A

Post 3rd: Deep Cervical LN
Medial ant: inf. deep cervical
Lateral ant: submandibular
Apex: submental

52
Q

Most common nasopharyngeal malignancy in the pediatric age group

53
Q

Most common LN mets from oropharyngeal cancer

A

Subdigastric area (Level II)

54
Q

Most common site of recurrent respiratory papillomatosis

A

Larynx

HPV 6&11

55
Q

Most common site of laryngeal granulomas

A

Posterior larynx, arytenoid fossa

56
Q

Most common cause of vocal cord paralysis

A

iatrogenic (s/p thyroid, carotid, thoracic sx)

L RLN more commonly affected EXCEPT if an anterior cervical approach is done

57
Q

Area where parapharyngeal tumors usually arise

A

Anterior to styloid process

40-50% parotid in origin

58
Q

Most common salivary gland affected

59
Q

Most common tumors of the parotid

A

Benign: pleomorphic adenoma
Malignant: mucoepidermoid
2nd most common malig: Adenoid cystic

60
Q

Risk of malignancy depending on type of salivary gland

A

Minor Salivary Gland > Submandibular, Sublingual > Parotid

61
Q

Most frequently injured nerve in parotidectomy

A

Greater auricular nerve - Frey syndrome

62
Q

Frequently injured nerves in submandibular gland removal

A

Lingual and hypoglossal

63
Q

Weight of thyroid gland

64
Q

RLN innervates all intrinsic laryngeal muscles except

A

Cricothyroid (ELN)

65
Q

Most important lab for monitoring recurrence of thyroid cancer

A

Thyroglobulin

66
Q

Higher risk for malignancy?

Hot or cold thyroid nodules?

67
Q

Most common cause of hyperthyroidsim

A

Graves Disease

68
Q

Most common GI symptom of hyperthy

69
Q

Given pre-operatively to reduce vascularity of the thyroid

70
Q

Common causes of Acute thyroiditis

A

streptococcus and anaerobes

71
Q

Most common presentation of Hashimoto’s thyroiditis

A

Minimal or moderately enlarged firm granular gland

72
Q

Most important test in evaluation of thyroid masses

73
Q

Most common site of mets for papillary thyroid CA

A

lungs
bone
liver
brain

74
Q

Most important prognostic factor for papillary thyroid CA

75
Q

Most common site of mets for follicular thyroid CA

76
Q

Pre-malignant lesion of medullary thyroid CA

A

C Cell hyperplasia

77
Q

Tumor markers for medullary thyroid CA

A

Most sensitive: calcitonin

Better prognostic: CEA

78
Q

Worst prognosis for medullary thyroid CA when…

A

Patient has MEN 2B

79
Q

Characteristic finding in anaplastic CA

A

Giant and multinucleated cells

80
Q

Most common thyroid lymphoma

A

Non-Hodgkins B cell type

81
Q

1st diagnostic test in patients with suspected esophageal disease

A

Barium swallow

82
Q

Essential pre-op eval before anti-reflux surg

83
Q

GOld standard diagnostic for GERD

A

24 hour ambulatory pH monitoring

84
Q

Most specific symptom of foregut disease

85
Q

Most important consideration affecting competence of GEJ

A

Sphincter length (<1cm)

86
Q

Most important factor in predicting failure of medical tx

A

Structurally defective LES

Review the principles of surg therapy of reflux (p. 53)

87
Q

Borchardt’s triad

A

Pain
nausea w/o ability to vomit
inability to pass NGT

88
Q

Classic triad of achalasia

A

Dysphagia
Regurgitation
Weight loss

89
Q

Most common area for Zenker’s diverticulum

A

Killian’s area

90
Q

Most common primary motility disorder of the esophagus

A

Nutcracker esophagus

91
Q

Most common cause of esophageal perforation

92
Q

Best prognosis for esophageal perforation achieved when

A

primary closure is done within 24 hours

93
Q

Phase of caustic injury when esophagus is WEAKEST

A

II: Ulceration and granulation phase

94
Q

Most common symptom of Esophageal SCCA

95
Q

Most radical surgical treatment of esophageal cancer

A

Ivor Lewis procedure

96
Q

Gold standard for H. pylori diagnosis

A

Histologic exam of antral mucosa with special stains

97
Q

Blood types and PUD

A

Type O: duodenal

A: gastric

98
Q

Most common location of gastric ulcer

A

Lesser curvature

99
Q

Most common location for esophageal perforation

A

Left lateral wall, above GEJ

100
Q

Most common cause of ulcer-related death

101
Q

High risk lesions for ulcers

A

Posterior duodenal: near gastroduodenal art

Less curvature: near left gastric art

102
Q

Confirmatory test for gastrinoma

A

Secretin secretion test

First tests: Fasting gastrin and BAO

103
Q

Pre-op imaging of choice prior to gastrinoma resection

A

Ocreotide scan

104
Q

Most common gastric CA

A

AdenoCA 95%
Lymphoma 4%
GIST 1%

105
Q

Most common pre-cancerous lesion of gastric adenoCA

A

atrophic gastritis

106
Q

Most important prognostic factor in gastric adenoCA

A

LN involvement and depth of invasion

107
Q

Most common site of GI lymphoma

108
Q

Most common gastric polyp

A

Hyperplastic / regenerative

109
Q

Strongest layer of the SI

A

Tela submucosa

110
Q

Most specific diagnostic for SBO

A

Abdominal series:
Dilated small bowel loops (>3cm)
Air fluid levels seen
Paucity of air in the colon

111
Q

Indication for sx in partial SBO

A

No improvement of sx in 48 hours

112
Q

Normal pattern of return to GI motility

A

SI: 24 hours
gastric: 48 hours
Colon: 3-5 days

113
Q

Pathognomonic of Crohns

A

Fat wrapping around the serosal surface of the bowel (transmural infarct)

114
Q

Most common cause of enterocutaneous fistulas

A

Iatrogenic

Low output: 500

115
Q

Most useful initial test in intestinal fistula

A

CT scan

Fistulogram better in determining origin of fistula

116
Q

Most common location of SI adenoCA

A

Duodenum

If w/ Crohns: terminal ileum

117
Q

Most common presentation of SI neoplasm

A

Partial SBO

118
Q

Most accurate diagnostic for chronic radiation enteritis

A

Enteroclysis

119
Q

Most prevalent congenital anomaly of the GI tract

A

Meckel’s diverticulum

120
Q

Most common cause of Acute mesenteric ischemia

A

Embolus
Most common source? Heart
Most common location? SMA

121
Q

Golden period for intestinal ischemia

A

3-6 hours

3rd hour: start of cell sloughing

122
Q

Diagnostic of choice for intussusception

A

CT scan: Target sign

123
Q

MC etiology of short bowel syndrome

A

Acute mesenteric ischemia, malignancy, Crohns

Pedia: int. atresia, volvulus, NEC

124
Q

Most common period in pregnancy when appendicitis occurs

A

2nd trim

Also, appendicitis is the most common surgical emergency in preg

125
Q

CT scan use in Colon disease

A

Extraluminal disease

The Great Surgery Deck (5 decks)

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