TrueLearn Flashcards
Explain the maneuver:
Mattox
Cattell Brasch
Mattox: left medial-visceral rotation
Cattell Brasch: right colon mobilization
Amino acid associated with T cell stimulation
Arginine
Radiotracer or methylene blue for SLNB in pregnancy
Radiotracer (meth blue is teratogen)
Dysplastic changes of basal layer of skin, parakeratosis, dermal solar elastosis
Actinic keratosis (pre-SCC)
Dx of biliary dyskinesia on CCK HIDA
EF <35% at 20 min
Central line type associated with lowest DVT and line infection
Subclavian
Intestinal hamartoma
Hyperpigmented oral lesions
Breast, cervical, thyroid, lung ca
Peutz Jeghers
Associated tumor marker:
- Embryonal cell ca, ovarian chorioca, mixed germ cell
- Yolk sac, embryonal cell, immature teratoma
- Dysgerminoma
- Granulosa cell
- Embryonal cell ca, ovarian chorioca, mixed germ cell: HCG
- Yolk sac, embryonal cell, immature teratoma: AFP
- Dysgerminoma: LDH
Gastrinoma: M or F predominant?
Male 2:1
Contraindication to nitrous oxide
SBO (air filled cavities)
Acid-base dx after pancreas txp
Met acidosis from HCO3 losses in pancreatic secretions
When in gestation does alveolar phase of development begin
7 months
Phyllodes margin and recurrence rate
1-2 cm margins
20% recurrence
First step in massive hemoptysis
Rigid bronch and packing
ID the liver lesion:
- Homogenous enhancement of hypodense lesion with central scar
- Heterogenous mass with arterial phase enhancement
- Low density and peripheral nodular enhancement
- Homogenous enhancement of hypodense lesion with central scar: FNH
- Heterogenous mass with arterial phase enhancement: adenoma
- Low density and peripheral nodular enhancement: hemangioma
Child’s scores and corresponding surgery mortality
A: 5-6 points -> 10% mortality
B: 7-9 -> 30%
C: 10-15 -> 80%
Preop medical tx of adrenal aldo-secreting tumor
Spironolactone/eplerenone and K+
Tx of Frey Syndrome
Antiperspirant application to affected skin
If refractory -> tympanic neurectomy
Best route for esophageal substitution
Posterior mediastinum
Reason for urinary retention acutely post-hemorrhoidectomy
Pelvic floor muscle spasm
Mechanism by which hypomagnesemia results in hypocalcemia (2)
- Impaired PTH release
- Impaired PTH receptor sensitivity
Immediate tx for ABO incompatible blood transfusion
Stop transfusion
Large volume fluid resusc
Two genes associated with HNPCC
MSH2, MLH1
Workup of bile reflux gastritis after Billroth
EGD and [bile] in gastric secretions OR HIDA
Minimum roux limb length in ReY gastrojejunostomy to avoid bile reflux
45 cm
Types A and B aneurysm size criteria for repair
Type A: >=5.5 cm
Type B: >=6.5 cm
Most common source of zone III trauma bleeding
Sacral venous plexus
Indications for radical neck dissection for parotid tumours
High grade malignant tumours (mucoepidermoid, squamous cell), even if clinically N0
Antidote for ethylene glycol poisoning
Fomepizole
How to manage clinically positive nodes in melanoma
FNA -> equivocal -> excisional bx
Criteria for surgery for intussusception
Necrotic bowel, 2+ recurrences, incomplete reduction
Squeeze mass distal to proximal
Secretin stimulation study: Total volume Enzyme level HCO3 - ZES, malnutrition, chronic pancreatitis, cancer, end-stage pancreatitis
ZES: High volume; normal enzyme, HCO3
Malnutrition: Decreased enzyme; normal volume, HCO3
Chronic panc: Low HCO3; normal enzyme, volume
Cancer: Low volume; normal enzyme, HCO3
End stage pancreatitis: Low volume, enzyme, HCO3
Most common site of traction esophageal diverticuli
Mid esophagus
How to do a Puestow
Open duct anteriorly, extend medially to level of GDA, and laterally past all strictures
Tx of LCIS
Excisional bx -> close observation, tamoxifen, or prophylactic bilat mastectomy
Most common presentation for lap band erosion
port site infection
RFs for gastric polyps (2)
Atrophic gastritis and H. pylori
TIPS one-year shunt re-stenosis rate
50%
Most common cause of dysphagia immediately s/p Nissen
Edema; should resolve in 6-8 weeks
Three stages of skin graft survival in recipient site
Imbibition -> inosculation -> angiogenesis
Best patency after angioplasty (artery)
iliac
Indication for liver txp for hilar cholangioca
N0 and M0 unresectable dx
Rule of 6s for AVFs
blood flow >600 mL/min
diameter >0.6 cm
depth 0.6 cm
Aberrant anatomy to consider when dividing gastrohepatic ligament in Nissen
Replaced left hepatic coming from L gastric
Most common site of SB lymphoma
Ileum
Splenic laceration grading (AAST)
1: subcapsular hematoma <10% of surface area
parenchymal laceration <1 cm depth
2: subcapsular hematoma 10-50% of surface area
intraparenchymal hematoma <5 cm
parenchymal laceration 1-3 cm in depth
3: subcapsular hematoma >50% of surface area
ruptured subcapsular or intraparenchymal hematoma ≥5 cm
parenchymal laceration >3 cm in depth
4: any injury in the presence of a splenic vascular injury* or active bleeding confined within splenic capsule
parenchymal laceration involving segmental or hilar vessels producing >25% devascularisation
5: shattered spleen
any injury in the presence of splenic vascular injury* with active bleeding extending beyond the spleen into the peritoneum
When to resume physical activity after splenic trauma?
Grade + 2 weeks
Most common cause of AVF thrombosis
Intimal hyperplasia of venous anastomosis
Which component of GCS is most sensitive to neurotrauma
Motor
Type of salivary gland tumor with propensity to metastasize along nerves
Adenoid cystic
Agents that increase or decrease LES tone
Increase LES: gastrin, motilin
Decrease: secretin, CCK, estrogen, progesterone, somatostatin
Most prevalent organism in non-aneurysmal aortic infection
Salmonella
Early vs. interval appy
Early: Early return to work Increased complications (SBO, reoperation, wound infection)
Tx of solitary rectal ulcer syndrome
Conservative: high fiber, biofeedback
Mechanism of diverticular bleed
Rupture of vasa recta
Most devastating cause of PONV following sleeve gastrectomy
Portomesenteric venous thrombosis
Longest phase of the cell cycle
G1 (11 h)
Pharmacokinetics vs. pharmacodynamics
PK: What happens to a drug in the body
PD: What the drug does to the body
Orlistat
Anti-obesity agent that inhibits GI lipases and decreases fat absorption
Cancer associated with vinyl chloride
Hepatic angiosa
When to do classic Whipple (+antrectomy) vs. pylorus-preserving Whipple
Classic when D1 involved
Common burn meds ADR: AgNO3 Ag sulfadiazene Mafenide acetate Neomycin/baci/polymyxin B
AgNO3: hyponatremia
Ag sulfadiazene: neutropenia
Mafenide acetate: met acidosis
Neomycin/baci/polymyxin B: nephrotoxic
Zn deficiency signs (3)
Impaired wound healing
FTT
Rash
Selenium deficiency signs (3)
Cardiomyopathy
Hypothyroidism
Neuro changes
Initial step in improving hypotension in pregnant trauma
Roll to the left (uterus rolls off the IVC)
What group of cells stimulates fibroblasts in wound healing
Macrophages
% weight loss after Lap band Sleeve Bypass Switch
Lap band 40-55%
Sleeve 54-70%
Bypass 60%
Switch 70%
First line tx of stage 4 RCC
Sunitinib, panzopanib
Tx for parotid tumours if
- Benign (warthin, pleomorphic)
- Malignant (mucoepidermoid, adenoid cystic)
- Benign (warthin, pleomorphic): WLE
- Malignant (mucoepidermoid, adenoid cystic): total parotidectomy, MRND, XRT
Melanoma subtypes with worst and best prognosis
Worst: nodular
Best: lentigo maligna
Cationic trypsinogen gene mutation
Hereditary pancreatitis (PRSS1)
High risk features of BCC/SCC warranting Mohs
Poorly differentiated Face, genitalia, hands/feet >=6mm Depth >=4 mm PN invasion Immunosuppression Marjolin ulcer
First step if gastric conduit does not reach esophagus
Kocher
Signs of contrast nephropathy
Normal UOP SCr >25% elevated Muddy brown casts FeNa <1 Mild proteinuria
Most common gene mutation in pancreatic cancer
K-ras
Most common complication of I and D
bleeding
Diagnosis of melanoma (what kind of bx)
Must be full thickness bx
Margins for melanoma WLE
is: 0.5-1 cm
<1 mm: 1 cm
1-2 mm: 1-2 cm
>2 mm: >=2 cm
Where should you not place tacks in IHR
Inferior to iliopubic tract and lateral to epigastrics (neurovascular injury)
Best tx for low grade gastric MALT
Abx for hP
Tx for gastric band slippage
Concern for ischemia so immediately remove saline from band and go to OR for band removal
Only effective chemo for HCC
Sorafenib (VEGF inhibitor)
Milan criteria for resectable HCC (3)
<5 cm lesion
<=3 lesions each smaller than 3 cm
No extrahepatic dx
Tx of asymptomatic histoplasmosis
Nothing
Bx margin for suspected melanoma
Full thickness bx with 1-2 mm margins
Goal lactate in resuscitation of trauma
<2.5
Which organism that causes PID is most associated with infertility
Chlamydia
Size at which adrenal masses should be resected
> 6 cm
Tx for supracondylar humerus fx
Closed reduction with pin fixation
Most common organism in lymphangitis
Group A strep