Pre-Test (Endocrine/Breast, GI) Flashcards Preview

Surgery > Pre-Test (Endocrine/Breast, GI) > Flashcards

Flashcards in Pre-Test (Endocrine/Breast, GI) Deck (53):
1

Isolated focus of increased uptake on a thyroid scan virtually diagnostic of

Hyperfunctioning adenoma

2

Multifocal breast Ca means

Multiple tumors w/in 1 quadrant of the breast

3

Important prognostic factor in papillary and follicular thyroid Ca

Age (>45 years worse prognosis)

4

Papillary Ca thyroid description on path

Calcified clumps of sloughed cells

5

LCIS work up

Frequent self breast exams and yearly screening mammograms (LCIS considered risk factor for cancer development, not precursor)

6

Acute management of hypercalcemia

Vigorous hydration to restore intravascular volume and Lasix
*Thiazides contra b/c they increase Ca*

7

Cushing's dz tumor

Pituitary tumor

8

Pre surgery pheo tx

Pre-op w/ alpha blockade (phenoxybenzamine) 1-3 weeks before
*can add b-blockers*

9

Tx of breast cancer in pregnant woman

Immediate surgery, chemo after 1st trimester
Radiation absolutely contraindicated

10

Workup for suspected Paget's

Mammogram and biopsy of the affected area

11

Secretin test results for ZE syndrome

Rise in Gastrin

12

tx to prevent thyroid storm after thyroid removal in graves

10 days pre-op w/ Drops of Lugol iodide solution
*B-blocker is tx for thyroid storm*

13

Tx of single PTH adenoma

Removal of that adenoma

14

Tx for Hurtle cell thyroid tumor? What is it?

Surgery followed by radioiodine ablation
Is a type of follicular cancer, but is more often multifocal and bilateral

15

When is thyroid lobectomy ok

for single adenomas less than 4cm size

16

Most common cause of cushing syndrome

Iatrogenic

17

Indication for radical mastectomy

Locally advanced breast cancer with wide invasion of pec major muscle in pt who can handle surgery

18

Omeprazole MOA

Inhibits H+-K+ ATPase in secretory canaliculus of the gastric parietal cell

19

Platelet transfusions in ITP reserved for? Otherwise tx?

Acute bleeders
Otherwise (30k-50k) tx w/ steroids and IV-IG

20

Tx for adenocarcinoma of the spleen

Right hemicolectomy

21

Safest and most effective tx of achlasia

Esophagomyomyotomy (modified heller myotomy --> cutting LES)

22

Most frequent complication of end colostomies

Parastomal herniation --> commonly when stoma is placed lateral to, rather than through, rectus muscle

23

When do the majority of dumping syndrome cases resolve

Within 3 months

24

Medical mgmt of bleeding varices

Octreotide or vasopressin (balloon tamponade if those don't work)
*Don't forget crystalloids*

25

Lesions of Peutz-Jagers? Other things seen?

Hamartomas
Also melanin spots on oral mucosa

26

Indications for surgical intervention in dirverticular disease

Hemorrhage secondary to diverticulosis, recurrent episodes of diverticulitis, intractability to medical therapy, complicated (perforations with or w/out abscess and/or fistula)

27

When can gallbladder polyps be measured w/ serial CT's? Sx for gall bladder cancer

when they are less than 1cm
Do radical cholecystectomy for gall bladder cancer

28

Tx for Entamoeba histolytica liver abscess

metronidazole

29

Important step prior to undergoing operative intervention for GERD

Endoscopy

30

Mgmt for non-necrotic chronic ischemic colitis

Expectant mgmt

31

Bowel Habits after colonic resection

Relatively normal

32

What part of the colon absorbs more salt and water

Right

33

When do you take out hepatic andenomas

When greater than 4cm (risk for rupture and risk for malignant transformation)

34

If performing appendectomy, Chron's is noted, what do you do

Take out appendix as normal (90% who present like this will not progress to full blown disease)

35

Tx for biliary stricture? most likely cause?

End-to-side choledochojejunostomy (Roux-en-Y)
Most likely iatrogenic

36

90% of gastrinoma's located where?

"gastrinoma triangle" - junction of 2nd and 3rd portions of duodenum, junction of neck and body of pancreas, and junction of cystic and common bile duct

37

Tx for insulinoma

Simple excision of the tumor

38

Apple core lesion on colon tx

Bowel prep followed by removal of area (obstructing)

39

Most likely dx in older person with markedly distended colon? Workup?

Cecal or sigmoid volvulus --> dx w/ sigmoidoscopy (also can be therapeutic) --> If neg think cecal location (do emergent celiotomy)

40

Procedure of choice for cecal volvulus

Right hemicolectomy

41

Kidney bean vs Coffee bean sign

Kidney bean - cecal volvulus
Coffee bean - sigmoid volvulus

42

Most common non-OB related surgical condition in pregnant women

Appendicitis

43

Paraesophageal vs Sliding hernia worse?

Paraesophageal (sliding hernia contained by intact pleura)

44

Olgivie's syndrome tx

Bowel rest and NG tube (Unless >10 cm dilated)

45

First line tx for major hematobilia

Transarterial embolization

46

Crypt abscesses and superficial ulcerations in what bowel dz

UC

47

Test for small bowel bleeding in people under 30?

Tech 99 pertechnetate scan -- Looking for Meckels (MCC of small bowel bleeding under 30)

48

Colectomy vs Simple appendix removal in carcinoid of appendix

Less than 1 cm just take appendix
1-2 based on location
>2 Right hemicolectomy

49

Where are stress ulcers usually found

Usually involve lower body and funds
*Spare antrum*

50

Tx for cholecystitis in critically ill

Tube cholecystostomy

51

How long until therapy for pancreatic pseudocysts

At least 6 weeks**

52

Where do carcinoid tumors originate? What do they look like in rectum

Crypts of Leiberkuhn

53

Definitive operation of choice for patients with UC

Total proctocolectomy w/ end ileostomy or illegal J-pouch anastomosis