Pestana Surgery Review Flashcards
(130 cards)
1
Q
epidural hematoma (hemorrhage)
A
lucid interval
CT scan
emergency surgical decompression (craniotomy)
2
Q
acute epidural hematoma
A
high speed automobile collision
CT scan
emergency craniotomy
3
Q
chronic subdural hematoma
A
elderly becomes progressively senile over weeks
CT scan
craniotomy
4
Q
base of skull fracture
A
raccoon eyes/clear fluid dripping from nose/clear fluid dripping from ear/ecchymosis behind the car
CT scan an cervical spine Xrays
Mx: neurosurgical consult and abx
5
Q
High speed MVA with fixed dilated pupils, BP of 70/50 and HR of 130. What is the reason for low BP and high pulse rate?
A
NOT neurological injury b/c not enough room in the head for blood loss to cause shock.
Look for other significant blood loss outside or inside.
6
Q
Hypovolemic shock
A
Management:
- big bore IV needles
- Foley catheter
- IV antibiotics
- ideally exploratory lap immediately then fluid and blood administration but give fluids if waiting for OR
7
Q
pericardial tamponade management
A
Mx: no x-rays needed (clinical diagnosis!)
Do thoracotomy then exploratory lap (if trauma)
8
Q
tension pneumothorax management
A
Mx: immediate big bore IV catheter placed into the right pleural space, followed by chest tube placement
Do NOT send to Xray right away
9
Q
massive MI symptoms and management
A
Sx: cold, diaphoretic and low BP, irregular feeble pulse, distended neck and SOB
Mx: EKG, cardiac enzymes, cardiac care unit, possible thrombolytics, do NOT drown pt with fluids
10
Q
vasomotor shock symptoms and management
A
Sx: low BP, high pulse, “warm and flushed” CVP low
Mx: vasoconstrictors, volume replacement can’t hurt
11
Q
plain pneumothorax management
A
Mx: chest tube to underwater seal and suction (HIGH in pleural cavity)
12
Q
hemothorax management
A
Mx: chest tube at BASE of pleural cavity
13
Q
indications for a thoracotomy to ligate a vessel
A
initial blood retrieved from a hemothorax is >1500 cc or > 600 in the next 6 hours
14
Q
25 y.o. man stabbed in R chest. Moderately SOB, stable VS. No breath sounds on the right. Resonant to percussion at apex on the R chest, dull at the base. CSR shows one single, large air-fluid level. What is the dx?
A
hemo-pneumothorax
Mx: chest tube, surgery only if bleeding a lot
15
Q
“white-out” of lungs are x-ray
A
pulmonary contusion
sometimes doesn’t show up until 1-2 days after trauma
Mx: fluid restriction, diuretics, respiratory support (latter is key)
16
Q
sternal fracture
A
increased risk for myocardial contusion and traumatic rupture of the aorta
17
Q
symptoms of a diaphragmatic rupture
A
- moderate respiratory distress
- no breath sounds over the entire side (always on LEFT)
- percussion unremarkable
- CXR shows air fluid levels in the left chest
- nasogastric tube curling up into the left chest
Mx: surgical repair
18
Q
symptoms and management of rupture of the aorta
A
Sx: severe trauma (breaking bones that are hard to break like first rib, scapula, or sternum)
Dx by arteriorgram
Tx: emergent surgery
19
Q
symptoms and management of traumatic rupture of the trachea or major bronchus
A
- chest trauma
- developing progressive subcutaneous emphysema all over upper chest and lower neck
- CXR shows presence of air in the tissues
Mx: fiberoptic bronchoscopy to confirm dx and level of injury and to secure airway. Then surgery.
20
Q
Management for penetrating wound to the abdomen PRIOR to surgery
A
- indwelling bladder catheter
- big bore IV needle
- broad spectrum abx
21
Q
where are the boundaries for an abdomen wound? A chest wound?
A
- the belly begins at the nipple line
- the chest does not end at the nipple line though
*belly and chest are separated by a dome so if a person has a wound 2 inches below the nipple need to work up for chest AND abd wounds
22
Q
which solid organ gives the most clinically significant bleeding?
A
spleen
23
Q
which solid organ is likely to bleed the most (but less likely to be clinically significant)?
A
liver
24
Q
which immunizations are needed for an asplenic patient?
A
- pneumovax
- homophilus influenza B
- meningococcus
25
MVA. Multiple upper and lower extremity injuries. BP is 75/55 and HR 110. PE shows tender abd with guarding and rebound in all quadrants.
What to do next?
exploratory lap
Of course, gives fluids too.
26
MVA + pelvic fracture + blood in the meatus
What to do next?
1st - retrograde urethrogram
b/c urethral injury would be compounded by insertion of a Foley catheter
27
MVA + pelvic fracture + blood in meatus + scrotal hematoma + "high riding prostate"
posterior urethral injury
28
What is the difference between a posterior urethral injury and an anterior urethral injury?
Anterior injury - repaired right away
Posterior injury - repair delayed 6 months
29
no blood at meatus + gross hematuria after insertion of Foley catheter + pelvic fracture from MVA
What to do next?
Likely a bladder injury
1st - retrograde cystogram
30
MVA + rib fractures and abdominal contusions + insertion of foley catheter shows gross hematuria + retrograde cystogram normal
What to do next?
Likely a kidney injury
1st - CT scan
31
Microscopic hematuria after a traumatic
not a big deal
32
microhematuria in kids
What to do next?
ALWAYS investigate
33
ruptured testicle diagnosis, symptoms, and and management
symptoms: scrotal hematoma d/t traumatic event
diagnosis: sonogram
management: if ruptured --> surgery. If intact --> symptomatic treatment
34
fracture of the penis management
emergent surgery
35
alkaline burn initial management
lots of water irrigation then rush to ER
36
electrical burn management
these burns are much deeper and bigger than appear
1st - extensive surgical debridement
2nd - think about myoglobinuria and renal failure --> give lots of IV fluids, diuretics (e.g. mannitol), and maybe alkalinize the urine
37
inhalation burn diagnosis and management
diagnosis: bronchoscopy
management: respiratory support
38
circumferential burn management
1st - compulsive monitoring of peripheral pulses and capillary filling
2nd - escharotomies at the bedside at the first sign of compromised circulation
39
third degree burn cream
silver sulphadiazine (silvadene)q
40
fluid resuscitation rate in adult
4 cc per kg of body weight per percentage of burn
- try to give LR, and give half of calculated dose in the first 8 hours
- give colloids on the 2nd day (not the first)
41
Monitoring for calculation of fluid resuscitation in a burn victim
CVP - keep below 15 to 20 mmHg
hourly urinary output - aim for 1 cc per kg body weight per hour
42
circumstances where additional fluid is needed (aiming for urinary output of 2 cc per kg per hour)
- electrical burn
| - patients who get an escharotomy
43
Patient is well resuscitated, had good hemodynamic parameters, but required a lot of fluid. On 3rd day he pees out a storm. What should you be concerned of?
Nothing. The fluid from the burn edema is coming back into the circulation. You should expect this.
44
Topical treatments for burns (most areas, where deep penetration needed, near eyes)
most areas - silvadene
where deep penetration is needed - sulphamyelon
around eyes - triple antibiotic ointment
45
When should rehabilitation for burn patients start?
day 1
46
For a very small and clearly third degree burn...
What to do next?
excise and graft on day 1
47
human bite management
surgical exploration and irrigation pronto
48
Farmer. Swedish ancestors. Raised waxy 1.2 cm skin mass on bridge of nose growing for past 3 years. No lymph nodes in next.
What is it?
How is it diagnosed?
Treatment?
What is it - basal cell carcinoma
How is it diagnosed? full thickness biopsy at the edge of the lesion (punch or knife)
Treatment: surgical excision with clear margins but conservative width
49
Farmer. Irish descent. Non-healing, indolent, punched out, clean looking 2 cm ulcer over the temple. Slow growing for past 3 years.
What is it?
How is it diagnosed?
Treatment?
What is it - basal cell carcinoma
How is it diagnosed? full thickness biopsy at the edge of the lesion (punch or knife)
Treatment: surgical excision with clear margins but conservative width
50
Blonde, blue eyed, 69 year old sailor with non-healing indolent 1.5 cm ulcer on lower lip. Slowly enlarging for past 8 months.
What is it?
How is it diagnosed?
Treatment?
What is it - squamous cell carcinoma
How is it diagnosed - biopsy
Treatment - excision (wider margins) or local radiation
51
Red head who loves to sun bake. Pigmented lesion that is asymmetrical, irregular borders, different colors, measuring 1.8 cms.
What is it?
How is it diagnosed?
Treatment?
What is it - likely melanoma
How is it diagnosed - full thickness biopsy at edge of lesion
Treatment - margin free excision if superficial (
52
What to be concerned about with deep melanoma...
metastasis to weird places:
- left ventricle
- duodenum
- ischiorectal area
- weird timing
53
18 year old with firm, rubbery mass in left breast that moves easily with palpation.
What is it?
How is the diagnosis made?
What is it - fibroadenoma
How is the diagnosis made - FNA and UA (mammogram not suitable for young breasts)
54
Immigrant from Latin country. Large breast mass present for several years. Slow growing. Mass is firm, rubbery, completely movable. No palpable axillary nodes.
What is it?
How is the diagnosis made?
What is it - cystosarcoma phyllodes
How is the diagnosis made - tissue diagnosis. Margin free resection will follow.
55
35 year old female with history of tender breasts with menstrual cycles. Now she has a lump that has not gone away for 6 weeks.
What is it?
Management?
What is it - fibrocystic disease
Management - aspiration of the cyst. If mass goes away after aspiration, then no more follow up. If fluid is bloody it will go to cytology. If mass does not go away or recurs after biopsy, then further testing needed.
56
Bloody discharge for past several months. No palpable masses.
What is it?
Management?
What is it - intraductal papilloma
Management - mammogram and probably resection
57
lactating mother with cracks in nipple, fluctuating red, hot, tender mass in the breast along with fever and leukocytosis.
What is it?
Management?
What is it - possibly an abscess
Management - incision and drainage
58
Eczematous lesion in the areola, present for 3 months, not gone away with a variety of lotion and ointments.
What is it?
Management?
Likely cancer. A better answer is Paget's disease of the breast (a cancer under the areola)
Management - core biopsy or incisional biopsy of the tissue underneath
59
classic findings of cancer on a mammogram
irregular area of increased density with fine micro calcifications that were not found on prior imaging
60
When should you do a lumpectomy vs. a modified radical mastectomy?
Lumpectomy - small tumor where most of breast can be spared
Modified radical mastectomy - larger tumors
61
Adjuvant systemic therapy for breast cancer in women. Which ones get chemotherapy and which ones get hormonal therapy?
Chemotherapy - premenopausal women
Hormonal therapy (tamoxifen) - postmenopausal women
62
If the numbers of TNM are not 1 for the tumor and zero for the nodes and met....
the tumor is bad news bears.
63
Causes of amblyopia...
1. child has a huge, pedunculate lipoma hanging from the right upper eyelid and obstructing vision on that eye
2. child suspected of having strabismus
Management: surgically correction ASAP
64
Causes of white pupil (leukocoria)
cataract or retinoblastoma (emergency!)
65
"huge, shiny eyes in a baby"
congenital glaucoma --> if undiagnosed, blindness ensues
66
Symptoms of acute angle glaucoma
- severe frontal HA
- starts after sitting in dark (e.g. watching a movie in the dark)
- seeing halos
- pupils mid-dilated and do not react to light
- corneas are cloudy with greenish hue
- eyes feel "hard as rock"
67
Acute angle glaucoma management
Diomox, pilocarpine drops or mannitol
68
symptoms and management of orbital cellulitis
Symptoms
- swollen, red, tender eyelids of one eye
- fever and leukocytosis
Management - immediate ophthalmologic consult. Do CT and then surgical drainage will follow
69
Chemical burn of the eye
Copious water irrigation for 30 minutes BEFORE bringing person to ED
70
symptoms and management of retinal detachment
Symptoms
- seeing more than a dozen floaters
- a "cloud" at the top of the visual field
Management - ophthalmologic emergency. Surgery is key.
71
elderly pt suddenly loses sight from whole eye without any other neurological signs
what is it?
management?
what is it - embolic occlusion of the retinal artery
management - ophthalmologic emergency.
*have him breath into a paper bag en route and have someone press hard on eye and release repeatedly to try and make embolism move further down stream.
72
Management of GERD...
In the clinic?
On exam questions?
in the clinic - symptomatic medication with no fancy work up
on exam questions - recommend endoscopy and biopsies to assess the extend of esophagitis and potential complications
73
management of Barrett's esophagus
surgery - probably a Nissen fundoplication
74
progressive dysphasia over several months starting with solids and progressing to liquids. Likely diagnosis and management?
diagnosis - carcinoma of the esophagus
management - barium swallow first, then endoscopy and biopsies. CT scan next
75
Women with difficulty swallowing for many years. Liquids more difficult to swallow than solids. Occasional regurgitation of large amounts of undigested food.
Diagnosis and management?
diagnosis - likely achalasia
management - manometry studies
76
Person who drank heavily and vomits. Eventually vomits bright red blood.
Diagnosis and management?
diagnosis - Mallory Weiss tear
management - endoscopy. Bleeding usually self-limiting. Photocoagulation may be used if needed.
77
Person who drank heavily and vomits. After violent episode of vomiting feels a severe, wrenching epigastric and low sternal pain. Develops fever and leukocytosis. Looks ill.
Diagnosis and management?
diagnosis - Boerhave's syndrome
management - gastrographin swallow (for diagnosis) then emergent surgical repair
78
Colicky abdominal pain and protracted vomiting for several days. Progressive abdominal distention, no BMs or passed gas for 5 days, high pitched loud bowel sounds that coincide with colicky pain. X-rays show distended loops of small bowel and air fluid levels. Hx of exploratory laparotomy for gunshot wound of abd.
What is it?
Management?
What is it - mechanical intestinal obstruction due to adhesions
Management - NG suction, IV fluids, careful obs
79
Colicky abdominal pain and protracted vomiting for several days. Progressive abdominal distention, no BMs or passed gas for 5 days, high pitched loud bowel sounds that coincide with colicky pain. X-rays show distended loops of small bowel and air fluid levels. Hx of exploratory laparotomy for gunshot wound of abd.
DEVELOPED FEVER, LEUKOCYTOSIS, ABD TENDERNESS, AND REBOUND TENDERNESS after conservative treatment
What is it?
Management?
What is it - strangulation obstruction from compression of mesenteric blood supply
Management - emergency surgery
80
Protracted diarrhea. Flushing of face. Expiratory wheezing. Prominent jugular venous pulse on neck.
What is it?
How to diagnose?
What is it - carcinoid syndrome
Diagnose - serum determinations of 5 - HT
81
Differences between right and left sided colon cancer
Right side - 4+ occult blood in stool, anemia
Left side - blood coats outside of the stool, constipated, stools have become narrow caliber
82
patient suffering from chronic ulcerative colitis. Now has severe abdominal pain, temperature of 104, leukocytosis, looks "toxic"
What is it?
Management?
What is it - toxic megacolon
Management - emergent surgery (always includes removing the rectum)
83
Management of internal hemorrhoids with bright red blood in toilet paper after BM
cancer of the rectum has to be ruled out.
Correct answer - proctosigmoidoscopic exam
84
Management of external hemorrhoids with anal itching and discomfort, very painful
cancer of the rectum has to be ruled out.
Correct answer - proctosigmoidoscopic exam
85
Exquisite pain with defecation and blood streaks on the outside of stools. Refusing for anyone to "spread her cheeks"
What is it?
Management?
What is it - anal fissure
Management - still need to r/u cancer. Correct answer is examination under anesthesia.
After examination - surgical approach would be lateral internal sphincterotomy
86
non-healing wounds around the anus should make you think of....
Crohn's disease
Management: biopsies ot r/o cancer and diagnose Crohn's
87
Treatment for all abscesses
incision and drainage
88
hx of perirectal abscess that was drained surgically. Cord-like tract palpated from opening towards the inside of the anal canal. Brownish purulent discharge expressed from tract.
What is it?
Management?
What is it - fistula in uno
Management - r/o cancer with proctosigmoidoscopy. 2nd is to do elective fistulotomy
89
HIV + patient with fun gating mass growing out of anus
What is it?
How to diagnose?
Management?
What is it - squamous cell carcinoma of the anus
Diagnose - bx of fungating mass
Management - Nigro protocol of pre-operative chemo and radiation
90
Patient with upper GI bleeding > 2 cc per minute.
Management?
emergency angiogram
91
3 large bowel movements of dark red blood. Looks pale, diaphoretic, with BP 90/70 and HR of 110. NG tube shows clear, green fluid without blood.
What to do next?
He is bleeding from somewhere DISTAL to the ligament of Treitz.
92
When is an angiography not the first choice of management for a GI bleed?
a slow bleed or bleeding that has stopped
93
7 year old boy with large bloody bowel movement
What is it?
Diagnosis?
What is it - likely Meckel's diverticulum
Diagnosis - radioactively labeled technetium scan (identifies gastric mucosa)
94
Patient that has been in and out of septic shock. Had hemorrhagic pancreatitis with several percutaneous drainage procedures for abscesses. Starts to vomit bright red blood.
What is it?
Management?
What is it - stress ulcer
Management - angiographic embolization of left gastric artery. Should have been prevented with antacids.
Diagnosis - made by endoscopy
95
Cirrhotic liver with ascites presents with generalized abdominal pain that started 12 hours ago. Mild fever and leukocytosis.
What is it?
How to diagnose?
Treatment?
What is it - peritonitis
How to diagnose - cultures of the ascitic fluid
Treatment - abx per cultures
96
Pt with excruciating pain, very sharp time of onset, rigid abdomen, no bowel sounds, severe constant pain. Xray shows free air under the diaphragms.
What is it?
Management?
What is it - perforated viscus (perforated duodenal ulcer in most cases)
Management - emergency exploratory lap
97
59 year old lady with hx of prior episodes of diverticulitis. Now having left lower quadrant pain, tenderness, and vague palpable mass. Has fever and leukocytosis.
What is it?
How to diagnose?
Treatment?
What is it - acute diverticulitis
Diagnosis - CT scan
Treatment - medical for acute attacks (abx and NPO) but elective sigmoid resection for recurrent disease. Emergency surgery may be needed if she gets worse.
98
elderly man with severe abdominal distention, nausea, vomiting, and colicky pain. Hyperactive bowel sounds. X-rays show distended loops of small and large bowel and a very large gas shadow located in RUQ and tapers towards the left lower quadrant with the shape of a parrot's beak.
What is it?
Management?
What is it - volvulus of the sigmoid
Management - proctosigmoidoscopy should relieve the obstruction. Rectal tube is another option.
Survey to prevent recurrence should be considered.
99
elderly with a. fib who comes in with diffuse tenderness and mild rebound of the abdomen. X-rays show distended small bowel and colon.
What is it?
Management?
What is it - embolic occlusion of the mesenteric vessels
Management - not much can be done as bowel is usually dead
100
total bilirubin of 6. Unconjugated, indirect bilirubin is 6 while direct, conjugated bilirubin is zero.
What is it?
What to do next?
What is it - hemolysis
What to do next - figure out what's chewing up her red cells
101
slightly elevated direct and indirect bilirubin, minimally elevated SGOT, super elevated alkaline phosphatase
What is it?
What to do next?
What is it - "generic" example of obstructive jaundice
What to do next - sonogram
102
Most common cause of death in a patient with hemorrhagic pancreatitis?
pancreatic abscess
103
Alcoholic with ill-defined upper abdominal discomfort and early satiety. Has a large epigastric mass that is deep within the abdomen and hard to define. He was discharged from the hospital 5 weeks ago after successful treatment of acute pancreatitis.
What is it?
Management?
What is it - pancreatic pseudocyst
Management - US but CT is best option. Needs to be drained by CT guidance.
104
POD 1 fever
What is it?
Management?
What is it - atelectasis
Management - listen to the chest, CXR, encourage deep breathing and coughing.
105
POD 3 fever
What is it?
Management?
What is it - UTI
Management - UA, urinary culture, antibiotics
106
POD 7 fever with red, hot, tender wound
What is it?
Management?
What is it - wound infection
Management - open the wound, drain, and pack open
107
2 weeks post-op with fever and leukocytosis with good healing wound that does not appear to be infected.
What is it?
Management?
What is it - deep abscess (commonly subphrenic and sub hepatic)
Management - CT to find abscess and guide percutaneous drainage
108
Pink, clear salmon-colored fluid from incision around POD 5
What is it?
Management?
What is it - wound dehiscence
Management - keep patient in bed, tape belly together, and schedule surgery for re-closure of the wound if patient can take re-operate
109
worrisome features of thyroid nodules
- young
- male
- single nodule
- history of radiation to neck
- solid mass on US or cold nodule on scan
110
What is the management for a patient with a "hot" adenoma who has lost weight despite a ravenous appetite, moist skin with a high pulse?
1st - confirm hyperthyroidism by measuring free T4
2nd - confirm source of the excessive hormone with radioactive iodine scan
3rd - do surgery after using a beta blocker
111
Patient with virulent peptic ulcer disease. Eradicating H. Pylori fails to heal her ulcers. Several duodenal ulcers in first and second portions of duodenum. Watery diarrhea.
What is it?
What is the diagnosis?
What is it - gastronoma (Zollinger-Ellison)
Diagnosis
1st - measure serum gastrin
2nd - CT scans or MRI of pancreas to remove the tumor for surgery
112
48 year old lady. Severe, migratory necrolytic dermatitis for several years that is unresponsive to any treatments. Thin, mild stomatitis, and mild diabetes mellitus.
What is it?
What is the diagnosis?
What is it - glucagonoma
Diagnosis - Determine glucagon levels. Eventual CT scan or MRI looking for the tumor then surgery.
113
Management of hyperaldosteronism due to an adenoma?
Imaging studies then surgery
114
Management of hyperaldosteronism due to hyperplasia?
Non-surgical. Treat with aldactone.
115
Diagnosis of pheochromocytoma
1st - 24 hour urinary determination of metanephrine and VMA
2nd - CT scan of adrenal glands
3rd - surgery
116
Young female with severe hypertension that doesn't respond to normal anti-hypertensives. Has a faint bruit over her upper abdomen.
What is it?
Management?
What is it - renovascular hypertension due to fibromuscular dysplasia
Management - arteriogram then surgery (balloon dilatation)
117
Two concerning conditions from infants who initially vomit green bile
1. duodenal atresia
| 2. annular pancreas
118
3 day old infant, feeding intolerance and bilious vomiting, X-rays show dilated loops of small bowel and "ground glass" appearance in lower abdomen. Mom has CF.
What is it?
Management?
What is it - meconium ileum
Management - gastrografin enema may be diagnostic and therapeutic
119
8 week old baby with persistent, progressively increasing jaundice. Bilirubin is ⅔ conjugated, direct. US rules out extra hepatic masses, serology negative for hepatitis and sweat test normal.
What is it?
Management?
What is it - biliary atresia
Management - HIDA scan, percutaneous liver biopsy and exploratory laparotomy
120
Management for intussusception
Barium enema - both diagnostic and therapeutic in most cases.
121
supraclavicular node, non-tender, present for 3 months. 20 pound weight loss in past 2 months but otherwise asymptomatic.
What is it?
How do we diagnose?
What is it - malignant mets to a supraclavicular node from a primary tumor below the neck
How do we diagnose - look for the obvious primary tumors: lung, stomach, colon, pancreas, kidney then eventually biopsy the node
122
Unilateral sensory hearing loss in adult. Did not engage in any activity that would subject patient to hearing loss on that side.
What is it?
How to diagnose?
What is it - acoustic nerve neuroma
How to diagnose - MRI
123
Gradual, unilateral nerve paralysis suggests a neoplastic process.
What is it?
How to diagnose?
What is it - neoplastic process
How do diagnose - gadolinium enhanced MRI
124
What is important to remember about parotid masses and diagnosis?
Parotid masses are NEVER BIOPSIED in the office or under local anesthesia.
Need referral to a head and neck surgeon for formal superficial parotidectomy.
125
kid sitting up, leaning forward, drooling at the mouth, and looking very sick
what is it?
management?
what is it - acute epiglottis
management - diagnose with lateral X-rays of the neck and then off to OR for nasotracheal intubation
on the way start IV antibiotics for H. influenzae
126
what are symptoms of a brain tumor?
- neurological process that develop over a few months
- increased intracranial pressure
- morning headaches
- sometimes N/V
127
Ways to decrease intracranial pressure
- mannitol
- high dose steroids (decadron)
- hyperventilation
128
Febrile child with no history of trauma has persistent, severe localized pain in bone.
What is it?
Management?
What is it - acute hematogenous osteomyelitis
Management - do NOT fall for the X-ray choice (X-ray won't show anything for 2 weeks...)
Choose "bone scan"
129
Management of gas gangrene
- IV penicillin
- immediate surgical debridement of dead tissue
- hyperbaric O2 treatment
130
what is the treatment of an 86 year old man with asymptomatic prostate cancer?
Nothing!
Prostatic cancer is typically not treated after age 75 because they'll die of something else first.
