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CREOGS > High Yield (crush creogs) > Flashcards

High Yield (crush creogs) Flashcards

1
Q

bladder injury incidence

A

0.05-0.66%

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2
Q

how large of bladder injury requires 2 layer closure

A

> 2cm defect

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3
Q

polyglactin suture brand name

A

Vicryl

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4
Q

polyglactin suture characteristics

A

absorbable
braided
multifilament
dyed vs undyed

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5
Q

polyglactin suture uses

A

skin, soft tissue, ligation vessels, repair bladder/bowel

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6
Q

polyglactin suture loses tensile strength …

A

lose 50% tensile strength in 3wk
- complete absorption in 60 days

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7
Q

silk suture characteristics

A

non-absorbable
braided - multifilament
very secure knots
significant inflammatory reaction

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8
Q

silk suture loses tensile strength …

A

1yr

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9
Q

poliglecaprone suture brand name

A

monocryl

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10
Q

poliglecaprone suture completely absorbs in

A

~100 days

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11
Q

polydioxanone suture name

A

PDS

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12
Q

PDS suture completely absorbs in

A

~200 days

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13
Q

PDS suture characteristics

A

absorbable
monofilament

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14
Q

poliglecaprone suture characteristics

A

absorbable
monofilament

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15
Q

polypropylene suture characteristics

A

non-absorbable
monofilament
dyed vs undyed

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16
Q

polypropylene suture name

A

prolene

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17
Q

when does organogenesis occur

A

weeks 6-8

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18
Q

what is gastrulation

A

establishes 3 germ cell layers (ectoderm, endoderm, mesoderm)

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19
Q

when does gastrulation occur

A

week 3

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20
Q

what does endoderm form

A

bladder & urethra
GI tract
resp system
thymus
parathyroid

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21
Q

what does mesoderm form

A

circulatory system
lymphatic system
connective tissue (bone, cartilage, vessels)
muscles
many internal organs (kidney, ureters, adrenal cortex, spleen)

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22
Q

what does ectoderm form

A

skin
mucosal linings
nervous system (brain, spinal cord)
portions of sensory organs

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23
Q

What is Class I surgical ound

A

Clean

uninfected operative wound
No entry into respiratory, alimentary, genital, or urinary tracts

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24
Q

What is class II wound

A

clean-contaminated

controlled entry into respiratory, alimentary, genital, or urinary tracts
No major contamination or infection

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25
Q

What is class III wound

A

contaminated

open, fresh accidental wounds.
Gross spillage from GI tract or nonpurulent inflammation

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26
Q

What is class IV wound

A

dirty or infected

Old traumatic wounds with devitalized tissue or clinical infection.
Involvement of perforated viscera

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27
Q

Only GYN procedures where abx are recommended

A
  • hyst
  • D&C, D&E
  • colporrhaphy
    +/- laparotomy without hyst
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28
Q

When do you increase abx dose

A

Obese patients (increase if >120kg)
Procedure >4hrs (redose)
EBL >1500mL

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29
Q

bowel injury incidence in GYN

A

0.10-0.50%

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30
Q

most common time for bowel injury

A

30-55% during entry
40% during adhesiolysis

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31
Q

when do most postop bowel injuries present

A

5-10 days postop

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32
Q

suture/stitch type for bowel injury

A

interrupted 3-0 delayed absorbable suture

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33
Q

when does bowel injury need 2 layer closure

A

if full thickness

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34
Q

which way do you throw stitch on bowel

A

“sutures throw the way the poop goes”

  • perpendicular to the longitudinal plane of the bowel (so don’t decrease diameter of lumen)
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35
Q

for what population do you use T-score to interpret DEXA

A

postmenopausal

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36
Q

what does T-score compare

A

individual’s BMD measurements with peak mean BMD in healthy, young-adult reference population

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37
Q

what population do you use Z-score to interpret DEXA

A

usually premenopausal

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38
Q

What does Z-score compare

A

number of standard deviations beteen an individual’s BMD and the mean BMD of a reference population of the same sex, age

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39
Q

what T-score is diagnostic of osteoporosis

A

-2.5 or lower in femoral neck, total hip, L spine, or distal 1/3 radius

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40
Q

what T-score is osteopenia

A

-1.0 to -2.5

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41
Q

recommended daily intake calcium

A

1000mg/day 19-50y
1200 mg/day >50y

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42
Q

recommended daily Vit D intake

A

600 IU/day up to age 70y
800 IU/day >70y

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43
Q

hemorrhagic cyst US description

A

lace-like reticular echoes
or an intracystic solid structure (clot)
acoustic enhancement
no internal blood flow

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44
Q

endometrioma US description

A

round, homogenous appearing
low-level echoes
acoustic enhancement with diffuse ground glass echoes

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45
Q

mature teratoma US description

A

hypoechoic attenuating component with multiple small homogenous interfaces.
Echogenic sebaceous material and calcification

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46
Q

epithelial ovarian tumor markers

A

CA125
CEA
CA 19-9

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47
Q

types of epithelial ovarian tumors

A

high grade serous (most common)
low grade serous
endometrioid
clear cell
mucinous
carcinosarcoma

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48
Q

germ cell tumors come from

A

primordial cells (become sperm and eggs)

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49
Q

types of germ cell tumors

A

teratoma
dysgerminoma
yolk sac
embryonal
mixed
choriocarinoma
polyembryoma

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50
Q

germ cell tumor markers (general)

A

AFP, LDH, HCG

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51
Q

chance of malignant transformation of teratoma

A

0.2-2% into squamous cell carcinoma (b/c ectoderm)

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52
Q

LDH tumor marker for (most commonly)

A

dysgerminoma

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53
Q

notable characteristic of sex cord stromal tumors

A

produce hormones - androgen or estrogen excess

often solid masses

Don’t need to do LND

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54
Q

types of sex cord stromal tumors

A

granulosa tumor
sertoli-leydig

55
Q

most common tumor marker for granulosa cell tumor

A

inhibin

56
Q

identifying characteristic of granulosa cell tumor

A

produces estrogen
- must do EMB when diagnosed

57
Q

identifying characteristic of sertoli leydig tumor

A

can secrete testosterone
- see androgenic effects

58
Q

buzzword for sertoli leydig tumor

A

cells of reinke

59
Q

four assumptions of trauma informed care

A

Realize
Recognize
Respond
Re-traumatization

60
Q

four assumptions of trauma informed care: realize

A

realize the widespread effect of trauma and understand potential paths for recovery

61
Q

four assumptions of trauma informed care: recognize

A

s/sx of trauma in clients, families, staff, and others involved with the system

62
Q

four assumptions of trauma informed care: respond

A

Respond by fully integrating knowledge about trauma into policies, procedures, and practices

63
Q

four assumptions of trauma informed care: re-traumatization

A

seek to actively resist re-traumatization

64
Q

when does HPV vax switch from recommended to shared decision making

A

27

65
Q

HPV vax timing <15yo

A

2 doses
@ 0 and 6-12mo
(if too soon recc 3rd dose)

66
Q

HPV vax timing 15-26yo

A

3 doses
@ 0, 1-2mo, 6mo

67
Q

HPV vax recc for CIN

A

adjuvant (postop) HPV vax in surgically-managed CIN 2-3 in previously unvaccinated individuals reduces recurrence of cervical dysplasia
(65% overall risk reduction)

68
Q

lichen simplex chronicus presentation

A

skin thickening (leathery, bark-like)

itch-scratch cycle

69
Q

lichen sclerosus presentation

A

porcelain-white papules and plaques
“cigarette paper”
classic “figure of 8” shape vulva
fusion of labia minora and fissures

vulvar pruritus, irritation, burning

70
Q

lichen planus presentation

A

Classical: white, lacy, Wickham striae

hypertrophic: white, thick, warty plaques

erosive: erythematous erosions extend to labia

71
Q

identifying characteristic of lichen planus

A

oral involvement is common if erosive lichen planus

72
Q

recommended positioning for suspected air embolus

A

L lateral decubitus with trendelenberg (aka Durant’s maneuver)

encourages air to move out of RVOF and into R atrium

73
Q

s/sx of air embolus

A

“mill wheel” murmur

74
Q

earliest indicator of air embolus

A

reduced end tidal CO2

(also see reduced O2 sat, hypotension, tachycardia, R heart strain on echo)

75
Q

most common locations of ureteral injury

A
  1. near IP (ureter crosses over bifurcation of iliacs)
  2. cardinal ligament (ureter under uterine artery)
  3. where ureter enters bladder
  4. lateral border of USLS
76
Q

recommended repair for upper 1/3 ureteral injury

A

uretero-ureterostomy

77
Q

recommended repair for middle 1/3 ureteral injury

A

uretero-ureterostomy
- can consider Boari flap

78
Q

recommended repair for lower 1/3 ureteral injury

A

direct reimplantation
+/- psoas hitch

(within 6cm of bladder)

79
Q

AIDET

A

5 fundamentals of patient communication
Acknowledge
Introduce
Duration
Explanation
Thank you

80
Q

RESPECT model

A

Rapport
Empathy
Support
Partnership
Explanations
Culture competence
Trust

81
Q

Cisplatin/carboplatin toxicity

A

ototoxicity (cisplatin)
nephrotoxicity (both)

82
Q

Bleomycin toxicity

A

pulmonary fibrosis

83
Q

doxorubicin toxicity

A

cardiotoxicity

84
Q

trastuzumab toxicity

A

cardiotoxicity

85
Q

cyclophosphamide toxicity

A

hemorrhagic cystitis

86
Q

vincristine toxicity

A

peripheral neuropathy

87
Q

paclitaxel toxicity

A

peripheral neuropathy

88
Q

clues to hereditary cancer syndrome

A

age <50
multiple cancers in one individual
close relatives with same cancer type
unusual cancer presentation

skin growths, skeletal abnormalities, or other specific benign conditions linked to inherited syndromes

89
Q

high-risk cancers for a hereditary syndrome (need genetics workup)

A

triple neg breast CA
epithelial ovarian CA
colorectal CA with DNA MMR deficiency
endometrial CA with DNA MMR deficiency

90
Q

BRCA1 risk of ovarian cancer

A

40%

91
Q

BRCA2 risk of ovarian cancer

A

15%

92
Q

BRCA risk of breast cancer

A

70%

93
Q

BRCA-like genes

A

ATM
BRIP1
CHEK2
NF1
PALB2
RAD51C
RAD51D

94
Q

Lynch syndrome characteristics

A

autosomal dominant
colon, uterine, ovarian CA
3-5% of uterine cancer

95
Q

DNA Mismatch repair genes!!

A

MLH1
MSH2
MSH6
PMS2
EPCAM

96
Q

Li-fraumeni syndrome associated with mutation in

A

TP53
(tumor suppressor gene)

97
Q

Li-fraumeni syndrome characteristics

A

autosomal dominant

osteosarcoma, breast, colon, leukemia, lymphoma, brain CA

98
Q

Cowden syndrome characteristics

A

autosomal dominant

thyroid, breast, and endometrial cancers

99
Q

Cowden syndrome gene abnormality

A

PTEN
- pathogenic variant in phospatase and tensin (PTEN) gene

100
Q

mnemonic for Cowden syndrome

A

Pettin (PTEN) my COW BETty (breast, endometrial, thyroid)

101
Q

peutz-jeghers syndrome characteristics

A

autosomal dominant

breast (50% lifetime risk), sex cord stromal, cervical, uterine, GI, pancreatic, lung

102
Q

peutz-jeghers syndrome gene

A

serine/threonine kinase 11 (STK11) gene

103
Q

how to dx peutz-jeghers syndrome

A

2 criteria of:

  1. hamartomatous polyps throughout GI tract
  2. mucocutaneous hyperpigmentation
  3. FHX same
104
Q

para/mesonephric ducts give rise to which sex

A

Mesonephric = Male genital ducts
Paramesonephric = Female

105
Q

when does sex differentiation occur

A

7 weeks development

106
Q

what gene determines sex & how

A

SRY (on Y chromosome)

SRY+ = Males
(Males are SORRY)

107
Q

ureteric bud becomes

A

ureter

108
Q

mesonephric ducts become

A

all parts of testes/sperm tract (male)
trigone of bladder

109
Q

urogenital sinus becomes

A

bladder (except trigone)
prostate gland vs lower 2/3 of vagina
bulbourethral gland
urethra

110
Q

paramesonephric duct becomes

A

oviduct
uterus
upper 1/3 of vagina

111
Q

what does absence of MIF do

A

no testosterone
mesonephric ducts regress (no male parts)

112
Q

genital tubercle becomes

A

Male body/glans of penis, corpus cavernosum & spongiosum

Female body/glans of clitoris

113
Q

genital folds become

A

male ventral aspect of penile and penile raphe

female labia minora

114
Q

genital swellings become

A

male scrotum and scrotal raphe

female labia majorum, mons pubis

115
Q

parvovirus in pregnancy

A

most lethal virus to fetus

slapped cheek

116
Q

CMV in pregnancy

A

most common
hearing loss
blueberry muffin baby

117
Q

toxoplasmosis in pregnancy comes from

A

undercooked meats
(cats litter more rare)

118
Q

order of secondary sex characteristics

A
  1. growth spurt prior to breast buds
  2. thelarche - breast buds
  3. pubarche - pubic hairs
  4. adrenarche - axillary hair
  5. MAX growth spurt
  6. Menarche
  7. bone closure of epiphyseal plates
119
Q

longest diameter of fetal head

A

supra-occipital mentum (12.5cm)

120
Q

occiput posterior associated with shich type of pelvis

A

anthrOPoid

121
Q

lemon sign on US indicative of

A

spina bifida

122
Q

banana sign on US indicative of

A

arnold chiari malformation

123
Q

most common causes of primary amenorrhea

A
  1. gonadal failure
  2. congenital absence of uterus (uterine agenesis, MRKH)
124
Q

most common GYN cancer dx in pregnancy

A

cervical

125
Q

low-risk score for GTN

A

WHO score <7
(>= 7 is high risk)

126
Q

tx low-risk GTN

A

single agent chemo
- MTX vs Dactinomycin

127
Q

tx high-risk GTN

A

combo chemo
- EMACO

128
Q

EMACO

A

Etoposide
MTX
Actinomycin-D
cyclophosphamide
Vincristine

129
Q

mnemonic for categories of points for GTN

A

PIMPBAT

of mets
Prior pregnancy
Interval
Mets site
Prior chemo
BHCG pretreatment
Age
Tumor size

130
Q

sensitivity

A

TP / (TP+FN)

131
Q

specificity

A

TN / (TN+FP)

132
Q

PPV

A

TP / (TP+FP)

133
Q

NPV

A

TN / (FN+TN)

134
Q

cardinal movements of labor

A

ED FIrE REx

engagement,
descent,
flexion,
internal rotation,
extension,
Restitution (external rotation),
expulsion.

CREOGS (12 decks)

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