Surgery Onlinemeded

Front 1

Next step when you see old guy with anemia & BRBPR

Back 1

TRANSFUSE (then, EGD/Colonoscopy)

-most likely R colon CA

Front 2

if patient had a polyp removed and it was carcinoma in situ or dysplastic (but NO LN***) then what happens?

Back 2

just follow up 3-5 years with colonoscopy

Front 3

patient has bloody diarrhea & THICK BOWEL WALL on CT. usually after AAA surgery:

Back 3

ischemic colitis (decreased blood flow through IMA to left colon). you will see hemorrhagic ulcers on colonoscopy

Front 4

ulcerative colitis

Back 4

rectal & superficial

Front 5

when to do surgery for ulcerative colitis

Back 5

fail medical treatment or greater than 10 years with dz

Front 6

SCC secondary to HPV infection

Back 6

anal cancer: Dx with anal Pap smear and biopsy if it's positive for HPV

Front 7

Juvenile

Peutz-Jeger

hyperplastic

Back 7

non-malignant colonic polyps

Front 8

patient has high output from ostomy/diarrhea/malabsorption. what is the tx?

Back 8

PPI/Octreotide to decrease gastric secretions

Front 9

patient is super tender on the butt, has fevers, doesn't even want to sit down. If they have diabetes what are you worried about?

Back 9

ischiorectal abscess can lead to necrotizing infection!!!

Front 10

how long does it take to get c. dif pseudomembranous colitis?

Back 10

like a week. WATERY diarrhea

Front 11

Dx for c. dif colitis

Back 11

do a stool cx

Front 12

if you see liver mets/malignancy on CT, what's the next step

Back 12

no need to biopsy, go straight to surgery

Front 13

only reason to biopsy liver lesion?

Back 13

if patient is NOT a surgical candidate and could benefit instead from chemo/radiation

Front 14

patient recently had gastric bypass, now gets sweaty, dizzy, and crampy after eating:

Back 14

DUMPING SYNDROME: hypertonic gastric contents empty quickly into the duodenum/s.b. and fluid shifts too quickly and you release vasoactive polypeptides

Front 15

treatment of dumping syndrome

Back 15

high fat, low carb diet

Front 16

stone lodged in common duct causes EVERYTHING (including gallbladder & liver) to have trouble

Back 16

AST/ALT

Alk Phos

BILI

JAUNDICE!!!!

Front 17

treatment for choledocolithiasis

Back 17

supportive + ERCP

Front 18

enlarging the opening of the ampulla of vater

Back 18

sphincterotomy

Front 19

ERCP is to remove stones that are LODGED, then what?

Back 19

then do cholecystectomy to remove the entire thing so that it never happens again!

Front 20

super sick sepsis/trauma/MODS patient has RUQ colicky pain, WBC, Fever but NO GALLSTONES:

Back 20

Acalculous cholecystis: gallbladder is static and ischemic, making perfect environment for enteric organisms to INFECT and cause edema/necrosis

Front 21

tx for acalculous cholecystitis

Back 21

percutaneous cholecystectomy + supportive care

Front 22

what Abx to give in cholecystisi?

Back 22

metro/cipro

Front 23

obstructive jaundice is post-hepatic

Back 23

conjugated: dark urine, pale stools

Front 24

why don't you have a +Murphy's sign in a patient with gallbladder CA (thin/distended gallbladder & painless jaundice)?

Back 24

because it's not inflamed, it's just cancerous

Front 25

how to find a pancreatic tumor

Back 25

endoscopic u/s

Front 26

migratory thrombophlebitis

Back 26

could be pancreatic CA

Front 27

how to find ampullary cancer?

Back 27

CT, do ERCP to Bx

Front 28

which cancer will usually be FOBT+?

Back 28

ampullary because bleeds into the lumen

Front 29

Dx of cholangioCA?

Back 29

ERCP to bx