Truelearn Flashcards
criteria for transanal excision for anal cancer
T1 <3cm <30% circum <8cm from anal verge no lymphovascular invasion, no mucin
MC abberant left and right hepatic arteries
left- from LGA (in hepatogastric ligament)
right- from SMA (will be posterior to cystic duct)
radioactive iodine treatment indications in thyroidectomy
tumor 2-4cm
vascular invasion
anti TG antibodies
TG <5
AV fistula preferences
1 auto radiocephalic (forearm)
2 auto brachiocephalic
3 auto brachiobasilic
4 brachiocephalic prosthetic
Rule of 6 for fistulas
1 blood flow >600cc/min
2 diameter >0.6cm (for easy cannulation)
3 depth ~0.6cm from skin
benign and malignant parotid tumors
benign - pleomorphic adenomas and warthin
malignant- mucoepidermoid or adenoid cystic carcinomas
fistula in ano management
intersphincteric- fistulotomy
transphincteric- seton
gastric adenocarcinoma management
5cm margins always
total gastrectomy for proximal tumors (in order to get margins)
chemo for T2 and above
Number of lymph nodes in gastric node dissection
15lymph nodes
thoracic outlet: anterior to posterior
subclavian v phrenic n ant scalene subclavian a brachial plexus
liver lesion imaging
heterogeneous enhancing - adenoma
peripheral cetripetal enhancement- hemangioma
stellate scar- FNH
pseudocyst management
conservative if <6wks, <6cm
Milan criteria for liver transplantation
1 lesion <5cm
up to 3 lesions, each <3 cm
no extrahepatic dz
signs of air embolus and management
drop in ET CO2
place Tberg, left lateral decub
early vs late dumping syndrome
early (within 30 min) - hyperosmotic load
late (2-3 hrs) - hypoglycemia
succinylcholine- characteristics, side effects, contraindications
fast on/off
pseudocholinesterase elimination
hyperkalemia, malignant hyperthermia
contraindicated in SCI, burns, renal failure, immobility
isolated gastric varices
think splenic vein thrombosis
cordlike breast mass
mondors (superficial thrombophlebitis)
NSAIDs
melanoma margins
in situ - 0.5 -1cm
<1mm - 1cm
1-2mm - 1-2cm
>2mm - 2cm
bismuth corlette classification of cholangiocarcinoma
I- common hepatic
II- bifurcation
III- unilateral 2ndary hepatic ducts
IV- bilateral 2ndary hepatic ducts
types of melanoma and characteristics
acral lentiginous- AA
nodular- worst prognosis
superficial spreading- most common
lentigo maligna- old sun exposed, best prognosis
anal adenomcarcinoma management
transanal excision if <3cm or <40% circumference, limited to submucosa
otherwise, APR
nerve injury in thyroidectomy
superior laryngeal nerve- (cricothyroid) loss of projection and fatigability
recurrent laryngeal nerve- (all other laryngeal mm)- hoarsenss, bilateral –> airway obstruction
incidental adrenal mass
observation if benign characteristics <4cm nonfunctioning <10 HF units rapid washout >50%
anal fissure usual location
usu posterior midline
if lateral, consider workup for etiology (crohns sti hidraadenitis)
gastrinoma dx
gastrin >1000
basal acid >15
secretin stim test >200 increase in gastrin (not necessary to dx)
management thrombosed hemorrhoids
<4 days- excise
>4days conservative
predictors of successful antireflux surgery
1 typical symptoms
2 abnormal 24hr pH monitoring
3 improvement w PPI
Term ileum resection complications
B12 megaloastic anemia Gallstones Steatorrhea from bile acid loss Oxalate kidney stones Fat vit malabsorb
Innervation epiglottis and larynx
Epiglottis- cn 9 (gag) and sup laryngeal
Above vocal cord - sup laryngeal (cough)
Below - RLN
Innervation epiglottis and larynx
Epiglottis- cn 9 (gag) and sup laryngeal
Above vocal cord - sup laryngeal (cough)
Below - RLN
Fibrolamellar HCC
Well circumscribed, central scar
Elevated neurotensin
Fibrolamellar HCC
Well circumscribed, central scar
Elevated neurotensin
