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1
Q 
proto-oncogene associations
c-myc: 
c-kit: 
N-myc 
k-ras 
CD117
A 
c-myc: Burkitt's lymphoma
c-kit: GIST (tyrosine kinase)
N-myc - neuroblastoma
k-ras - colorectal cancer
CD117: GIST
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2
Q

Tumor suppressor genes:

  • APC:
  • BRCA-2:
  • DCC -
  • p16 -
  • p53 -
  • VHL -
  • WT-1 -
  • MSH2, MLH1 -
A
  • APC: FAP
  • BRCA-2: breast cancer (men and women), pancreatic cancer, ovarian cancer, prostate cancer
  • DCC - colorectal cancer
  • p16 - familial melanoma, pancreatic cancer (DCKN2A)
  • p53 - Li-Farumeni
  • VHL - kindey cancer, reitinal cancer, brain cancer
  • WT-1 - Wilm’s tumor
  • MSH2, MLH1 - DNA mismatch repair, Lynch syndrome
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3
Q

cell type: recognize cells lacking self MHC1, triggers APC death apoptosis

A

NK cells

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4
Q

cell type: recognize (D) PAMPs

A

TLR

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5
Q

cell type: opsonizes foreign antigens

A

complement cascade

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6
Q 
IL-1
IL-2
IL-4
IL-6
TNFa
Interferons
A 
IL-1 - fevere
IL-2 - matures T cells
IL-4 - IgE, matures B cells into plasma cells
IL-6 - fever and acute phase reactants
TNFa - septic shock
Interferons - secreted by NK cells
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7
Q

cell type: release, IL-2, IL-4, IFN-G. involved in type IV hypersensitivity

A

helper T cells (CD4

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8
Q

cell type: CD8 , regulate CD4, CD8

A

suppressor T cells

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9
Q

cell type: CD8, recognize and attack non-self antigens attached to MHC

A

cytotoxic T cells

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10
Q

cell type: IL-4 stimulates this, 10% become memory

A

B cells

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11
Q

MHC

  1. which chromosome?
  2. expressed by all nucleated cells?
  3. HLA type for MHC I?
  4. expressed on thymic epithelium and APC
  5. HLA type for MHC II?
A
  1. chromosome 6
  2. MHC I
  3. A, B, C
  4. MHC II
  5. DP, DQ, DR* most important
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12
Q

cell type: highly phagocytic APC, expresses MHC II

A

dendritic

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13
Q

Hypersensitivity Reaction: Anaphylaxis, Atopic, Allergic

A

I

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14
Q

Hypersensitivity Reaction: IgE mediated, release of histamine

A

I

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15
Q

Hypersensitivity Reaction: antibody mediated

A

II

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16
Q

Hypersensitivity Reaction: Rh incompatibility

A

II

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17
Q

Hypersensitivity Reaction: myasthenia gravis, hyperacute reaction

A

II

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18
Q

Hypersensitivity Reaction: cytotoxic

A

II

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19
Q

Hypersensitivity Reaction: rheumatoid arthritis, lupus, serum sickness

A

III

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20
Q

Hypersensitivity Reaction: immune complex deposition

A

III

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21
Q

Hypersensitivity Reaction: delayed

A

IV

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22
Q

Hypersensitivity Reaction: antigen stimulated by prior sensitized T cells

A

IV

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23
Q

Hypersensitivity Reaction: transplant rejection

A

IV

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24
Q

transfusion reaction: fevers, chills, DIC due to a release of cytokines from donor

A

acute hemolytic reaction

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25
transfusion reaction: respiratory distress
TRALI
26
transfusion reaction: circulatory overload
TACO
27
Transplant induction medications
thymoglobulin, basilizimab, alemutuxumab
28
drug: rabbit immunized with human thymocytes. T cells bound by antibody, osponized
Thymoglobulin
29
drug: anti-IL-2 receptor
Basiliximab
30
drug: recombinant IgG1 monocolona, CD52 (on T and B lymphocytes)
Alemtuzumab
31
Anti-metabolite drugs
MMF, Azathioprine
32
drug: inhibits purine (guanine) synthesis by inhibiting IMPDH
MMF
33
MMF AE
GI symptoms, myelosuppression
34
drug: metabolized to 6-MP (purine antagonist) incorporated into DNA and blocks replication, RNA transcription
Azathioprine
35
Azathioprine AE
malignancy, hepatitis, myelosuppressio, pancreatitis, alopecia. reserved for patients intolerant of MMF
36
Calcineurin inhibitors
cyclosporine, tacrolimus
37
drug: binds to cyclophilin-A, inhibits calcineurin, downregulates IL-2 expression
cyclosporin
38
immunosuppression drug secreted in bile
cyclosporine
39
drug: binds FKBP, complex inhibits calcineurin, IL-2, IL-3, IL-4, IFN-G
tacrolimus
40
tacrolimus AE
nephrotoxicity, HTN, hyper K, hypoMg, tremors/seizures, AMS
41
mTOR inhibitors
sirolimus, everolimus
42
drug: binds FKBP, and inhibits mTOR
sirolimus or everolimus
43
sirolimus AE
less nephrotoxic than tacrolimus, pneumonitis, wound healing effects
44
glucocorticoid MOA
inhibits COX2 and decreases prostaglandin synthesis, inhibits NFkB
45
how do hyperacute rejections occur?
preformed antibodies (type II hypersensitivity)
46
how to prevent hyperacute rejection?
test PRA assay - serum IgG and IgM to HLA haplotypes
47
what is cross matching:
serum IgG.igM antibodies for binding to donor lymphocytes. mixes serum of recipent with donor lymphocytes
48
what is acute cellular rejection? how do you treat it?
cytotoxic and helper T cells agains donor HLA | - immunosuppression, pulse steroids
49
what is chronic rejection? how do you treat?
partially type IV hypersensitivity + antibody formation | - retransplant
50
MCC of chronic rejection?
HLA incompatibility
51
PRA panel to not transplant?
>50%
52
owl eyes after transplant? treatment?
CMV, gancyclovier
53
Virus to cause ureteral obstruction or fibrosis after kidney transplant? tx?
BK virus. decrease immunosuppression
54
virus that causes B cell proliferation and SBO
EBV
55
makes up MELD
Cr, INR, bilirubin
56
Milan criteria
singe lesion <5cm, 3 lesions < 3cm, no macrovascular invision or mets
57
anesthesia drug: hepatitis, eosinophilia
Halothane
58
anesthesia drug: low mac
halothane
59
anesthesia drug: fast onset, less laryngospasm
sevoflurane
60
anesthesia drug: used in neurosurgery
isoflurane
61
anesthesia drug: least myocardial depressino, high MAC
nitrous oxide
62
what does it mean to be a high MAC?
less lipid soluble, fast onset, less potent
63
anesthesia drug: AE: bradycardia, hypoTN, hypertriglyceridmia, rhabdomyolysis
propofol
64
anesthesia drug: gaba agonist
propofol
65
anesthesia drug: can cause adrenocorticosuppression
etomidate
66
anesthesia drug: induction that is fast acting and has the least changes in hemodynamics
etomidate
67
anesthesia drug: inc secretions and cardiopulmonary demand. Dosage in the ED for procedures?
ketamine - .5-1mg/kg
68
anesthesia drug: depolarizing agent
succinylcholine
69
anesthesia drug: hoffman elimination
cisatracurium, slow onset
70
rapid anesthesia reversal
sugammadex
71
lidocaine toxicity
wo epi - 5mg/kg
72
bupivicaine toxicity
2mg/kg
73
ASA classification
I - nomral II - pregnancy, smoker, social ETOH, BMI <40, DM controlled III - ESRD, BMI >40, hepatitis, premature infant, old CVA or MI IV- new ESRD, spepsi, ARD, CHFrEF, new CVA or MI V- patient not expecting to survive VI - dead
74
MC congenital heart defect
VSD
75
Tetralogy of Fallot? which shunt?
pulmonary stenosis, RVH, overriding aorta, VSD (boot shaped heart). R to L shunt
76
what med to give for cyanotic children to keep the PDA open for lung oxygenation?
PGE-1 (prostaglandin)
77
which nerve runs anterior to the pulmonary hilum? posterior?
anterior - phrenic, posterior- vagus
78
which type of pneumocyte helps with gas exchange? surfactant?
I | II
79
thoracic lymph node stations?
``` 1-9 = mediastinal 10-11 = hilar ```
80
Thoracic outlet anatomy (start with clavicle)
clavicle --> subclavian vein --> phrenic nerve --> anterior scalene --> subclavian artery --> brachial plexus --> middle scalene
81
Lung volume and capacity: what makes of the: - FRC? - vital capicity
- expiratory reserve volume and residual volume | - inspiratory, TV, expiratory
82
how does the FRC increase in aging?
inc residual volume
83
need post op FEV1 to be what to do well postoperatively?
FEV1 >0.8 or >40%
84
causes of decreased DCLO
lowered capillary surface area, low Hgb, increased dead space, pulmonary HTN, low CO
85
no lung resection if:
- pCO2>50 or O2<60 - VO2 max <15 - DCLO <60% - FEV1 < 2L for pneumonectomy, <1.5 for lobectomy, or <0.8 for wedge resection - VQ scan < 40%
86
lung cancer staging: mediastinoscopy/EBUS for what?
centrally located tumor, LN stations 1-4, 7, 10-12
87
lung cancer staging: chamberlain procedure for which LN?
5+6
88
lung cancer treatment: - < 5cm - >5 and resectable - not resectable
- < 5cm --> VATS - >5 and resectable --> neoadjuvant chemo + resect - not resectable --> definitive chemotherapy
89
popcorn lesion in the lung
harmartoma
90
small cell lung cancer | - tx?
``` neuroendocrine tumor (+kulchitsky cells) - chemoXRT ```
91
what does small cell lung cancers release?
inc ACTH, inc ADH --> cushing disease
92
what does SCC of the lung release?
PTH
93
is a pancoast tumor usually small cell or nonsmall cell?
non small cell
94
is SVC syndrome usually small cell or non small cell?
small cell
95
Lights criteria
LDH >0.6 protein >0.5 pleural LDH > 2/3
96
if need to feeds chylothorax, which FA can they have?
medium chain. LCFA are directly absorbed
97
anterior mediastinal tumor
thymoma (and other terrible Ts)
98
MC mediastinal tumor
neurogenic tumor
99
subclavian v thrombosis?
thrombolytics or thrombectomy if acute
100
tuboovarian abscess cut off for surgery?
<7cm will resorb - only need antibiotics
101
Meig's syndrome
ovarian fibroma --> ascites and hyrothorax (inc VEGF)
102
which serum markers for testicular cancers? what for prognosis?
- AFP, b HCG | - LDH
103
do you bx testicular cancer?
never
104
seminoma tx
XRT (radiosensitive). chemo reserved for metastatic disease
105
elevated AFP in testicular cancer?
non-seminomatous
106
nonseminomatous testicular cancer tx:
orchiectomy and LN dissection, >stage II get chemotherapy (BEP)
107
L varicocele
RCC on the left
108
femur fx tx | - children
ORIF - careful of fat embolism | - reduction only
109
posterior knee injury
popliteal artery injury
110
shoulder dislocation
most anterior --> axillary nerve injruy
111
midshaft humerus fx
radial nerve injury (wrist drop)
112
Volkmann contracture
supracondylar humerus fx : anterior interosseus artery or brachial artery
113
ewing sarcoma | - tx
onion skinning, pseurorosettes | - chemo THEN xrt and surgery
114
osteogenic sarcoma | - tx
sunburst pattern, codman triangle | - doxyrubicin chemo
115
hyperparathyroidism mutation
PRAD oncogene
116
pubic symphysis sensation
iliohypograstric
117
tPA reversal
aminocaproic acid
118
brown recluse bite tx
dapsone
119
echinococcus tx
albendazole
120
cranial nerve injured in temporal bone fx
VII
121
cushing triad
kussmal respirations, HTN, bradycardia
122
source of histamine in the blood
basophils
123
antibiotic after a human bite and allergic to PCN
doxycycline
124
Sipple syndrome
MEN 2A
125
hereditary pancreatitis
PRSS1, PRSS2, CFTR, SPINK1
126
most common nerve injured in parotidectomy
greater auricular
127
upper lip cancer
basal cell
128
radical neck dissection includes what?
spnal accessory nerve, SCM, IJ
129
pharyngeal cancer tx
XRT
130
nasopharyngeal CA associated with?
EBV
131
salivary gland cancer --> large salivary gland
benign
132
dx for salivary gland CA
superficial parotidectomy
133
MC malignant salivary gland tumor
mucoepidermoid
134
second MC malignant salivary gland tumor
adenoid cystic tumor
135
tx for salivary gland tumor
total parotidectomy, MRND and post op XRT
136
MC benign salivary gland tumor. Second MC?
pleomorphic adneoma. warthins tumor
137
sensation: - great auricular nerve (C2-3) - lesser occipital nerve (C2) - auriculotemporal nerve (CN V3)
- great auricular nerve (C2-3) - lower ear, skin over parotid - lesser occipital nerve (C2) - upper posterior ear - auriculotemporal nerve (CN V3) - anterior upper ear --> Freys
138
when to perform esophagectomy?
t1b
139
when to perform esophagectomy + chemoXRT
T2 (muscularis propria)
140
Stewart classification. how to tx?
I - 1-5cm above GE junction (tx like esophageal ca) II - 1cm above to 2cm below the GE junction (tx like esophageal ca) III - 2-5 cm below the GE junction (tx like gastric cancer)
141
chemo regimen for esophagus
paclitaxel, carboplatin, or flurouriacil and oxiplatin
142
primary blood supple to stomach after resection for esophagectomy?
R gastroepiploic
143
margins for gastric cancer?
4cm
144
signet ring cells --> tx?
total gastrectomy
145
gastric cancer tx?
- T1b surgery | - >T2 tx like esophageal cancer --> ECF (3 and 3) or FLOT (4 and 4)
146
how many LN for gastric cancer?
15
147
mutations in gastric cancer for young people?
CDH1 and e-cadherin (also inc lobular carinoma of the breast)
148
tx for hereditary diffuse gastric cancer?
prophylactic gastrectomy between 18-40yrs
149
most common gastric lymphoma?
B cell (nonhodkins)
150
tx of gastric lymphoma?
chemo XRT --> risk of perforation
151
GIST tumor cells
interstitial cells of Cajal
152
spindle cells
GIST tumor
153
LND for GIST? margins for GIST?
no - mets to liver, negative microscopic margins
154
GIST tx:
imatinib and surgery
155
``` Pancreatic cells Alpha cells Beta cells (at center of islets) Delta cells PP or F cells Islet cells ```
Alpha cells – glucagon Beta cells (at center of islets) – insulin Delta cells – somatostatin PP or F cells – pancreatic polypeptide Islet cells – also produce vasoactive intestinal peptide (VIP), serotonin
156
when to give chemotherapy to whipple patient?
pre and post surgery
157
when to give chemotherapy to whipple patient?
pre and post surgery
158
colonoscopy screening recommendations - first degree relative with CA or adenoma <60yr or 2 first degree relatives with CA at any age - first degree after 60 or 2 second degree at any age
- average risk 45 q10 yrs - first degree relative with CA or adenoma <60yr or 2 first degree relatives with CA at any age --> 40 q 5 yrs - first degree after 60 or 2 second degree at any age --> 40 q 10 yrs
159
polyp screening recommendations - FAP - HNPCC - personal hx of 1-2 small andeomas - 3+ adenomas - advanced adenomas (>1cm, high grade, dysplasia, villous elements)
- FAP: 10-12yrs q 1 yr - HNPCC: 20-25 (or 10 years prior) q 1-2 yrs - personal hx of 1-2 small andeomas - 5 yrs - 3+ adenomas - 3 yrs - advanced adenomas (>1cm, high grade, dysplasia, villous elements) - 1-3 years
160
HNPCC inheritance
autosomal dominant
161
HNPCC defect
DNA mismatch repair (dMMR)
162
rectal cancer tx:
TIII+ (muscularis propria) - chemoXRT (capecitabine or 5-FU + 5000 cGy)
163
Anal cancer HPV
16 + 18
164
MC soft tissue sarcoma
undifferentiated pleomorphic sarcoma
165
MC soft tissue sarcoma of the extermity
malignant fibrous histiosarcoma
166
soft tissue sarcomas spread LN vs hemoatgenous?
hemotogenous
167
which soft tissue sarcomas spread via LN?
rhambdomyosarcoma, epitheliod, clear cell, synovial, angiosarcoma
168
stewart treves syndroem
lymphangiosarcoma
169
inc risk for sarcomas
- irradiation, phenoxyacetic acid, chlorophenols
170
thorium oxide, vinyl chloride, arsenic exposure?
hepatic angiosarcoma
171
most important prognostic factor for retroperitoneal sarcomas?
resectibility
172
MC soft tissue sarcoma in kids? worst prognosis subtype?
rhabdomyosarcoma. alveolar
173
rhabdomyosarcoma tx?
VAC neoadjuvant --> surgery --> RT for positive margins
174
how to tx kaposi sarcoma?
HAART, XRT for local disease, interferon alpha for disseminated disease. surgery for intestinal hemorrhage
175
Soft tissue sarcoma: CNS tumors, peripheral sheath tumor, pheochromocytoma
Neuofibromatosis
176
Soft tissue sarcoma: sarcoma, bone, brain, breasst, leukoema, lung, adrenal cancer
LI-Fraumeni (p53)
177
Soft tissue sarcoma: FAP, desmoid tumors
Gardners
178
best chemotherapy for soft tissue sarcoma
doxyrubicin
179
histology stains for melanoma
S100, HMB-45, tyrosine
180
Melanoma staging
``` T1- <1mm T2 - 1-2mm T3 = 2-4mm T4 - >4mm stage IIC T4, N0 stage III = +N ```
181
immunotherapy for melanoma
ipilimumab (CTL4 inhibitor) - upregulate CD4, blocks T cell upregulation Nivolumab) - (PD1 inhbitor) - upregulatd CD4 MEK/BRAF inhibitors - MAP kinase pathway (V600 protein kinase)
182
boundaries of the femoral triangle for lymphadenectomy
superior - inguinal ligament lateral - sartorius medial - adductor longus * start at the ASIS and come down
183
tumor markers: - AFP - CA125 - Beta HCG - Chromogranin A - Ret oncogene - NSE
- AFP: liver CA - CA125: ovarian cancer - Beta HCG: testicular cancer, choriocarcinoma - Chromogranin A: carcinoid (HIAA seritonin) - Ret oncogene: medullary thyroid - NSE: small cell cancer, neuroblastoma
184
``` chemoman: cisplatin carboplatin oxaloplatin vincristine vinblastine cyclophosphamide taxol ```
cisplatin: nephrotoxic, neurotoxic, ototoxic carboplatin: mylosuppression oxaloplatin: same as cisplatin vincristine: peripheral neuropathy vinblastine: mylosuppresion cyclophosphamide; SIADH, hemorrhagic cystitis taxol: neuropathy
185
dx for SBP - PMNs: tx?
PNMs >250 | tx: 3rd gen cephalosporin
186
Antibiotic MOA - vancomycin, bacitracin - clindamycin, linezolid, macrolide - aminoglycosides, tetracycline
- vancomycin, bacitracin: blocks cell wall synthesis - clindamycin, linezolid, macrolide: 50S subunite - aminoglycosides(bacteriocidal - irreversible binding), tetracycline(bacteriostatic): inhibits 30S subunit
187
how does aminoglycoside resistance work?
decreased active transport
188
AE: zosyn
platelet dysfunction, high salt load
189
AE: ceftriaxone
cholestasis
190
AE: carbapenem
seizures
191
Antibiotic MOA - Rifampin - Sulfonamides: - Trimethoprim: - daptomycin, polymyxin
- Rifampin: mRNA polymerase inhibitor - Sulfonamides: PABA analogue, inhibits purine synthesis - trimethoprim: block folic acid synthesis and purine synthesis - daptomycin, polymyxin: membrane integrity
192
Bactrim AE:
SJS and nephrotoxicity
193
lateral pectoral nerve innervates?
pectoralis major
194
BIRADs
``` 0 - need additional imaging I - negative II- benign III - probably benign - rpt 6 mo IV - suspicious - tissue diagnosis V - highly suspicious - tissue diagnosis VI - known biopsy proven malignancy ```
195
hemorrhagic shock - HR>100 - decreased BP - dec UOP - anxious - HR>140 - negligible UOP - confused
- HR>100: II - decreased BP: III - dec UOP: III - anxious: III - HR>140: IV - negligible UOP: IV - confused: IV
196
CPP - goal CPP - normal ICP
CPP=MAP-ICP - goal CPP >60 - normal ICP = 10
197
AA to embolize in a posterior nose bleed
internal maxillary artery
198
best exposure for L carotid injury
L anterolateral thoracotomy, median sternotomy (Cristiano care)
199
Blunt cerebrovascular injury grading
``` 25-POT I- <25 II ->25 III - pseudoaneursym IV - vessel occlusion V - vessel transection ```
200
which side for thoracostomy? - trachea - proximal L mainstem - distal L mainstem
- trachea - R - proximal L - R - distal L - R
201
best exposure for: - innominant A - proximal R subclavian A - proximal R common carotid A
all: median sternotomy
202
best exposure for: | aortic transection
L thoracotomy
203
pancreatic trauma tx: - L of SMV: - R of SMV:
- L of SMV: distal panc | - R of SMV - closed suction
204
nonop splenic injuries
<50% destruction, 1-3cm lac
205
delta pressure less than ___ is indicative of compartment syndrome - compartment pressure > ____ is indicative of compartment syndrome
- 30 | - 20
206
hand flexors - PIP - DIP
- PIP: flexor digitorum superficialis | - DIP - profundus
207
MC infection in burn
psuedomonas
208
contracture (primary or secondary) - FTSG - STSG
- FTSG= primary contracture | - STSG = secondary contracture
209
silvadene AE
neutropenia, agranulocytosis
210
silver nitrate AE
hypo Na/Cl/K/Ca, methemaglobinemia
211
sulfamylon (mafenide sodium) AE
metabolic acidosis
212
hypthermia
mild = <35 modereate = 28-32 severe =20-28 profound < 20
213
how to measure fetal maturity?
lecithin:sphingomyelin ratio >2:1, phosphatidylcholine in the amniotic fluid
214
SMA exposure
L visceral rotation or pull colon caudad
215
SNL for phyllodes?
no - hematogenous spread. do not need axillary staging
216
breast ca: clear cytoplasm and large nucleus
pagets disease
217
how to manage pleomorphic LCIS?
mangae like DCIA
218
how to tx inflammatory breast ca
neoadjuvant chemotherapy, MRM, XRT
219
breast cancer staging
``` T1: < 2cm t2: 2-5 T3 >5 T4: invasion N1: 1-3 notes N3; >10 nodes Stage II = T2N1, T3N0 stage III = T3N1, T4N0 ```
220
when to consider neoadjuvant chemo?
>5cm tumor
221
BRCA1 - chromosome, gene type
17, suppressor gene
222
BRCA2 - chromosome, gene type
13, suppressor gene, DNA repair
223
neck LN V
posterior neck - spinal accessory nerve injury
224
antibody development when have HIT
platelet factor 4
225
ileal brake during fatty foods
peptide YY
226
first branch off the ICA
opthalmaic A
227
MC nerve iinjured in CEA
vagus
228
debakey classifications
I - both II - ascending III descending
229
indications for AAA
sypmtomatic, >5.5 or 5.0 in marfans, rapidly increasing >0.5 per year - repair open if >6.5 cm
230
``` criteria for endovascular repair - neck length - neck diameter - neck angulation - common iliac artery length common iliac artery diameter otehr ```
- neck length - 15 - neck diameter - <30 - neck angulation <60 - common iliac artery length >10 - common iliac artery diameter 8-18 otehr
231
Endoleaks
``` I above and belo II - retrograde flow from lumbars III - defect in graft IV wall porostoy V - inc in aneursym * repair I and III ```
232
renin in Conn's syndrome (hyperaldosteronemia)
decreased
233
how to diagnose hyperaldosteronism
salt load suppressio tesdt: urine aldosterone will remain high, aldosterone:renin ratio >20
234
localizing studies for hyperaldosteronism
NP-59 scintigraphy, CT scan
235
metabolic change in hyperaldosteronism
hypernatremia, hypokalemia, alkalosis
236
how to test for hypocortisolism
cosyntropin test
237
adrenal hyperplasia tx:
metyrapone and aminogluthemide
238
antithyroid antibodies/thyroglobulin antibodies
hashimotos
239
TSH receptor antibodies
graves
240
bestheda
``` I nondiagnostic II benign III FNA IV lobectomy V thyroidectomy VI malignant ```
241
sulfur colloid scan in hepatic adenoma
will not see kupffer cels
242
central stellate scar in the liver. kupffer cells?
FNH - yes kupffer cells
243
varient for HCC in kids
fibrollamellar variant
244
tx: of HCC | drug in HCC
depends - surgery (1cm margins), ablation, arterial directed theray, radiation, transplant sorafenib
245
dermatitis, Dm, depression, DVT
glucagonoma
246
watery diarrhea, hypokalemia, achlorhydria
VIPoma
247
TEG | prolonged K
clot strength - cyro ("kryo")
248
TEG | R time
"reaction time" for clotting factors - FFP
249
TEG | angle
platelets
250
TEG | - MA
maximum amplitude - platelets
251
TEG | - ly
lysis time - TXA
252
most common extracranial solid tumor in peds
neuroblastoma
253
peds: | increased catecholamines, VMA, HVA
neuroblastoma
254
neuroblastoma tx
doxyrubicin
255
best prognosis in hepatoblastoma
pure fetal histology
256
hepatoblastoma tx
doxyrubicin and resection
257
MC TE fistula
C - air in the stomach
258
gasless stomach
A (blind ending) and B
259
thoracic duct leak approach
from the R side

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