Polyps+ : - Thyroid ca - Osteomas - Dental numeracy

Deck 6 Flashcards by K D

Categories of polyps

Non-neoplastic

Neoplastic

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Non-neoplastic polyps

Metaplastic
Hamartomatous
Pseudopolyp

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Neoplastic polyp types

Tubular
Tubulo-villous
Villous

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What is the most frequent neoplastic polyp

Tubular then tubulo-villous, then villous

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Which neoplastic polyp has the most malignant potential

Villous

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FAP genetics

autosomal dominant

Loss of APC tumour supressor gene

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FAP sx

100-1000s of polyps in 20s

100% risk of GI malignancy by 40yo

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Two FAP syndromes

Gardner syndrome

Turcot syndrome

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Gardner syndrome sx

Polyps+ :

Thyroid ca
Osteomas
Dental numeracy

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Turcot syndrome

Polyps +

CNS neoplasm : esp medulloblastomas

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When to do OGD+colonoscopy for FAP FHx

Colonoscopy:

12-13 yo
Every 1-3 years

OGD
- 25 yo

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Prophylactic op for FAP

Total colectomy + ileorectal pouch
or
panproctocolectomy and end lieostomy

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What is the function of PSA (prostate specific antigen)

Produced by epithelial cells of prostate gland

Liquifies semen allowing sperm to move freely dissolving the cervical mucous

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Difference between grading and staging

Stage: size and degree of spread

Grade: how well differentiated a tumour is

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When to check PSA after prostectomy

6 wks after op
Then every 6 months for 2 years
Then every year

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Hormone therapy for prostate cancer

Bicalumetide (antagonist to androgen receptors)

Stops testosterone binding to cancer cells inhibiting their growth

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Voiding sx

Incomplete emptying
Hesitancy
Terminal dribble
Poor flow

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Filling sx

Nocturia
Frequency
Urgency

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Aetiology of BPH

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Unclear, increased ratio of dihydrotestesterone to oestrogen has been suggested

Ix of BPH

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Bedside: urine dip
Bloods: PSA
Imaging: Transrectal USS or IVU
Special tests: uroflowmetry

TURP complications

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Early: bleeding, infection, TUR syndrome
Late: stricture, retrograde ejaculation

How does proteus lead to struvite stone formatio

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Alkalinses the urine (urea ->ammonia)

Reduces solubility of phosphate

RIFlE classification

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R: cr *1.5 or UO< 0.5 6hrs

I: cr * 2 or UO < 0.5 12hrs

F: cr *3 or UO <0.3 ml/kg 24hrs or anuric for 12hrs

Loss: failure for >4 wks
End stage: failure > 3months

RIFlE classification

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R: cr *1.5 or UO< 0.5 6hrs

I: cr * 2 or UO < 0.5 12hrs

F: cr *3 or UO <0.3 ml/kg 24hrs or anuric for 12hrs

Loss: failure for >4 wks
End stage: failure > 3months

Warm ischaemic time

Start: circulation to donor kidney stops End: perfusion solution starts flowing

Cold ischaemic time

Start: cold solution starts flowing End: organ transplanted in recipient Max between 24-48hrs

What is perfusion solution for organ transplant made off

Ice cold solution: - impermeable solutes (minimise swelling) - pH buffer - free radical scavengers - membrane stabilisers - adenosine for ATP synthesis

RFs for undescended testicles

Preterm Low birth weight FH

Teratoma age

20-30

Seminoma age

30-40

Where do testicular tumours mets to

Lung Colon Bladder Pancreas

Where does acral lentigenous affect

Palms and soles, under finger nails

Where is Breslow thickness measured from

From glandular cells of epidermis to deepest point of invasion

Features of BCC

Sun exposed area Slow growing, never metastasise Pearly papule with a rolled edge

Treatment of BCC

Excision or 5 FU cream

What is Bowens skin disease

SSC in situ Could progress to become invasive SSC slow enlarging, red, well demarcated plaque

Cytological signs of malignancy

1. increased mitotic rate 2. hyperchromatism (darkened nuclei due to increased DNA concentration) 3. Pleomorphism (varied size and shape of cell) 4. Increased nuclear to cytoplasmic ratio

What are features of malignancy on histology

Neovascularisation Necrosis Haemorrhage

Negative prognostic markers for melanoma

Nodular | High Breslow thickness

Functions of spleen

1. immune 2. circulatory filteration 3. platelet storage 4. haemopoiesis until birth 5. iron re-utilisation

Functions of spleen

1. immune 2. circulatory filteration 3. platelet storage 4. haemopoiesis until birth 5. iron re-utilisation

Complications of splenectomy

Immediate: haemorrhage Early: - gastric necrosis, - pancreatitis Late: - thrombocytosis - OPSI (overwhelming post splenectomy infection)

Abx post splenectomy

Pen V or erythromycin (pen allergic) in: - the first 2 yrs - <16 yo or >55yo - immunocompromised

Abx post splenectomy

Pen V or erythromycin (pen allergic) in: - the first 2 yrs - <16 yo or >55yo - immunocompromised

Splenectomy vaccination procedure

Either 2 wks before or 2 wks after op 1. Haemphilis influenza 2. Pneumococous 3. Men B, C 4. annual flu jan

Post splenectomy blood film

Increased platelets Howel jolley bodies (RBC with remnants of nuclei which otherwise should have been removed) Pappenheimer bodies (siderocytes containing iron) Target cells

Causes of splenomegally

Infective: EBV, CMV Haematological: leukaemia, lymphoma Systemic: sarcoid, amyloid

Deck 6 Flashcards

(47 cards)