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SURG TESTS > Chapter 20 > Flashcards

Chapter 20 Flashcards

genitourinary (77 cards)

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1
Q

what is a PSA test

A

prostate specific antigen
see if cancerous

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2
Q

what do elevated levels of PSA indicated

A
  • indicate a biopsy is necessary*
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3
Q

what is the best diagnostic for GU procedures

A

urine

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4
Q

what does Dx MIBG detect

A

peochromocytoma
- tumor of adrenal medulla
- for epi and norepi production

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5
Q

what is the only accurate way to diagnose cancer in GU

A

Bx

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6
Q

what is a cysto room

A

drain in the floor
mesh bag at bottom of table

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7
Q

incision options for GU

A

inguinal
scrotal
abdominal
lumbar
flank
gibson

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8
Q

what is gibson incision for

A

allows access to lower part of ureter

implantation of donor kidney in adults

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9
Q

what is a flank incision

A

lateral side of pt, cutting through muscle

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10
Q

what layers do you need to go through for a subcostal incision

A

lat dorsi, internal and external oblique

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11
Q

what do you need to go through for transcostal incision

A

11th or 12th rib removed (chest tube available)

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12
Q

what do you need to do for intercostal incision

A

seperate 11th and 12th rib

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13
Q

what incisions do you use to get to the adrenal gland or kidney

A

transcostal, intercostal

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14
Q

what incision is for just the kidney not adrenal gland

A

subcostal

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15
Q

what is hte most common abdominal tumor found in children

A

wilms tumor- kidney cancer

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16
Q

what age has wilms tumors

A

3-8 years old

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17
Q

why is wilms tumor bad

A

asymptomatic until late stages
- hard to tell symptoms in little kids

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18
Q

what is renal cell carcinoma

A

most common adult kidney cancer

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19
Q

what is renal cell carcinoma from

A

direct link to smoking and hereditary
- metastasizes direct to lungs

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20
Q

what is the treatment for any kind of renal cancer

A

simple to radical nephrectomy
- depending on how far along it is

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21
Q

3 types of polycistic kidney disease*

A

*autosomal dominant
- inherited, adults

autosoman ressessive
- very rare, young kids

acquired
- long term kidney disorders*

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22
Q

what is polycystic kidney disease

A

PKD
multiple fluid filled cysts ( benign)

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23
Q

symptoms of PKD

A

flank pain
hypertension
chronic UTI

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24
Q

treatments for PKD

A

dialysis

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25
what is diabetic nephropathy
uncontrolled diabetes - body cant filter blood
26
symptoms of diabetic nephropathy
thirst + edema hypertension protein in urine chronic renal failure 2-6 years
27
*what is kidney failure determined by*
*both kidneys functioning at less than 10%*
28
who mostly has renal failure
diabetic- ½ cases
29
*treatment of renal failure*
*dialysis or transplant*
30
what is a nephrectomy
removal of all or part of the kidney subtotal- upper part only simple- all of kidney radical
31
what is a radical nephrectomy
kidney adrenal gland perineal fat upper ureter en bloc done for cancer
32
what is renal cooling
done if artery will be occluded for a long time reduced metabolic requirements of kidney reduces possibility of tubular necrosis
33
steps for a partial nephrecotmy
- flank incision - gerotas capsule entered - dissection of kideny - control renal artery - ligate segmental artery + remove - close capsule - incision layer closed
34
what incision is done for a simple nephrectomy
flank subcostal
35
steps of simple nephrectomy
gerotas fascia opened isolate + ligate ureter expose + ligate renal artery + vein remove kidney drain close capsule close
36
*what comes first, renal artery or vein ligating*
*artery*
37
*how many ties when ligating the renal arteries and veins*
*3 for artery, 3 for vein*
38
*what do you do for a removed kidney for protection*
*place in a woven stockinette (for donor kidneys)*
39
what type of suture do you ligate the renal artery and vein with
heavy: 2-0 to 1 nonabsorbable
40
*what is the positioning and incision for radical nephrectomy*
*abdominal incision, supine*
41
steps of a radical nephrectomy
incision moist sponge placed over tumor vein ligated colon dissected if needed renal artery ligated geroats capsule dissected adrenal artery + vein ligated ureters dissected lymph nodes dissected closure in layers
42
*what is mannitol*
*a diuretic that forces urine production for people with kidney failure*
43
*what does anesthesia administer prior to clamping renal vessels in a transplant*
*heprain, mannitol, and lasiks* *promotes diuresis and prevents clotting of donor kidney*
44
*what is given to a donor patient to reverse heparinization*
*protamine sulfate*
45
what is the anesthesias job during kidney transplant
maintain heart and lungs
46
what is removed en bloc during kideny transplant
kidneys, ureters, renal vesesls, parts of abd aorta and IVC
47
*what is used to preserve transplant kidneys*
*collins solution and iced slush* *(up to 24 hours, 30 hours with pump)*
48
what is the vascular supply to kidney for adults
internal illiac artery and external illiac vein
49
what is the vascular blood supply to kidney for peds
aorta and IVC
50
what instruments for you need for kidney transplant
potts scissors and 11 blade
51
*what suture do you use for vascular anastomosis for transplanting kidney*
*fine (5-0 - 8-0) nonabsorbable, double armed*
52
*what is polypropolene for*
*wet surgeons hands to prevent friction when tying*
53
what is an ureterineocystostomy
anastomosis of the ureter to the bladder
54
what kind of procedure is a cystoscopy
transurethral
55
*what kind of stent is placed to maintain patency of ureters*
*double J or pigtail stent*
56
what procedures are done with cystoscopy
retrograde urogram visual Dx Bx prostate tissue removal removal of small bladder tumors ureteral stent placement calculi removal urethral enlargement
57
stsr responsibility with cystoscopy
lube may assist circulating duties dont forget specimen
58
what fluids do you use when doing a cystoscopy
water, sorbitol, glycine
59
*what fluids do you not use when doing a cystoscopy*
*NS*
60
what is the recurrence rate for kidney stones
50%
61
steps for male ureteroscopy
dialte urethra obturator placed bladder disetneded stone captured with basket stent placed
62
*what is a pyelolithotomy
*open stone removal- invasive intervention for complicated stones in the calyx*
63
what are the possible open incisons for pyelolithotomy
flank gibson suprapubic/ pfannesteal
64
steps for a pyelolithotomy with flank incision
flank incision vessel loops placed renal pelvis incised stone forceps remove stone close renal pelvis close incision
65
what is hte main symptom for a bladder tumor
hematuria
66
characteristics of a benign bladder tumor
called papillomas occur in young adults
67
characteristics of malignant bladder tumor
arise from epithelial lining men over 50
68
*what is water used for in bladder distnetions*
*used for cancer cell lysis after the procedure*
69
what is a cystectomy for
removal of a single invasive tumor in the dome of the bladder
70
what do cystectomies require
diversion of the urine from the kidneys to outside the body
71
*what is a koch pounch*
*continent resvoir* means it can hold urine in body
72
what is the neobladder
where they take a new bladder from the intestines and connect it to the urethras
73
*what is the official name for an ileal conduit*
*uteroileocutaneous diversion*
74
steps of radical cystectomy with ileal conduit
midline abd incision expose bladder lymph nodes incised dissect bladder from wall ligate vas dissect bladder from peritoneum ureter exposed and ligated ileal conduit made
75
*what do you do with the urachus during a radical cystectomy with ileal conduit*
*clamped, transected, and distal end is used for traction*
76
*what do you do with bilateral proximal ends of ureters during radical cystectomy with ileal conduit*
*send frozen section for assurance of clear margins*
77
how do you make an ileal conduit
divide 20 cm iluem with mesentary anastomos remaining ends implant ureters into ileum make stoma

SURG TESTS (27 decks)

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