surgery 2

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surgery 2
2013-03-21 13:37:41

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  1. acute abdomen
    • inflammation
    • obstruction
    • perforation
    • ischemic
  2. only condition that gives pain and bleeding in gi?
    ischmic process
  3. rx for perforation
    explorative laparatomy
  4. rx for choangitis due to stones?
  5. next step with cancer in the liver?
    ct to see extent of tumor
  6. hepatic adenoma are caused by?
    next step when suspecting?
    • androgens
    • ocp

  7. all absecesses are drained except which one?
    amebic abscess
  8. obstructive jaundice, next step in management?
  9. best initial step for volvulus?
    • xray
    • ultrasound
  10. rx for cholangitis?
  11. rx for gallbladder pancreatitis?
    conservative if doesnt respond, ercp
  12. rx for asymptomatic gallstones?
  13. rx for cholecystitis?
    conservative and the cholecystectomy
  14. do you do cholecystetcomy for cholangitis?
  15. gallblasddr stones cauing any kind of inflammation, must be treated and is cholecystectomy done?
  16. when do you drain a pancreatic pseudocyst?
    • if its larger than 6 cm
    • if its been there for longer than 6 months
  17. when do umbilical hernias close?
    by 2 years of age
  18. rx of hernias in adults?
    elective repair
  19. rx for a newly irreducible hernia
    emergency repair
  20. most accurate test for breast cancer?
  21. tumor in a young woman?
  22. cause of fluid discharge from a nipple?
    intraductal papilloma
  23. rx for cancer in a pregnant woman?
    • no chemo in 1st trimester
    • no radiation at all during pregnancy
  24. best iniitla test for suspecting breast cancer?
  25. how do you proceed with cancers that are operable?
    surgery then chemo and hormonal therapy

    inoperable--chemo and hormone therapy then surgery
  26. how are cancers operated on in a large breast where the cancer is far from the nipple?
    in a small breast with the tumor near the nipple?

    modified mastectomy
  27. what hormones are given post mastectomy if a woman is premenapausal?
    post menapuasal
    • tamoxifen
    • anastrazole
  28. what is anostrozole?
    aromatase inhibitor used in breast cancer in postmenapausal women
  29. most accurate test for ze?
    • high gastrin levels with secretin given
    • high gastrin level with gasric acidity
  30. test to exclude metastasis in ze?
    somatostatin receptor scintigraphy with endoscopic ultrasound
  31. how is local disease of ze treated?
    • surgery
    • metastasis--ppi
  32. gastrinoma--recurrent peptic ulcers
    glucagonoma--migratory necrotizing dermatitis + hyperglycemia
  33. management of a person with dyspepsia who is under 45?over 45?
    • under 45--empiric PPI or h pylori serology
    • over 45--scope them
  34. when do you suspect ze?
    ulcers are large, multiple, in distal duodenum, recurrent after h pylori eradication
  35. how do you detect the location of pheo? if it is outside the adrenals?
    MIBG scanning
  36. excessive salivation and coiling of the ng tube in the esophagus?
    esophageal atresia and tracheoesophageal fistula
  37. rx for meconium ileus?
  38. causes of double bubble sign?
    • duodenal atresia
    • annular pancreas
    • volvulus
  39. dx and rx for intussusspetion?
    barium enema
  40. trouble with swallowing and breathing in (stridor)?
    vascular ring
  41. when do you anticoagulate for valvular af?
    all meaning rheumatic heart valves, prosthetic heart valves, repaired heart valves
  42. best initial test for asd?
    most accurate?
    • echo
    • catheterization
  43. which one presents earlier, tof or togv?
  44. how much fev1 needs to be left after lung surgery for cancer?
    fev1 = 800mL
  45. way to monitor instantaneous blood pressure if a pt is on a pressor?
    arterial line
  46. 6 types of transfusion reactions?
    • febrile nonhemolytic-tylenol
    • acute hemolytic-abo incompatibility
    • delayed hemolytic--rh incompatibility
    • anaphylactic-epinephrine, intubation, fluids
    • urticarial-- benadryl
    • Thrombocytopenic
  47. next step in management
    1-pelvic fracture + DPL showing blood i pelvis?
    2-pelvic fracture + DPL shows urine in pelvis?
    3-pelvic fracture+ DPL shows nothing +hemo instability?
    4-blunt abdo trauma + FAST shows fluid in pelvis and unstable vital signs?
    5-blunt abdo trauma + fast shows no fluid + unstable vital signs?
    6-blunt abdo trauma + unstable vital signs + fast inconclusive?
    7-Blunt abdo trauma + stable vital sign?
    8-Abdo stab wound + hypotensive or signs of peritonitis?
    • 1-emergency laparotomy
    • 2-urgent laparotomy
    • 3-angiogroaphy for retroperitoneal hemorrhage
    • 4-urgen laparatomy
    • 5-angiography for retropeiro
    • 6-dpl
    • 7-ct of abdo and pelvis
    • 8-emergency laparotomy