Surgery EOR part 3

Question 1

What is the pathophys behind fibroadenoma?

Answer 1

Hyperproliferation of glandular and stromal cells of the breast

Question 2

What is the surgical criteria for a fibroadenoma?

Answer 2

mass is causing symptoms

mass is larger than 3cm

or rapidly growing to rule out a phyllodes tumor

Question 3

_____ of the breast is a rare type of breast cancer associated with malignant changes in the nipple.

Answer 3

Paget disease

Question 4

How can the dx of Paget’s disease be made? What should you do next?

Answer 4

full-thickness punch or wedge biopsy of the nipple to look for the presence of intraepithelial adenocarcinoma cells

sentinel lymph node bx

Question 5

What surgeries are likely to disrupt the thoracic duct leading to a chylothorax (lymph fluid in the lungs)?

Answer 5

esophagectomy, pulmonary resection with lymph node dissection, and heart-lung transplantation

Question 6

Pleural fluid analysis that reveals lactate dehydrogenase (LDH) level will be low, the glucose, electrolyte, and protein levels will be similar to plasma, and the white blood cell count will show a predominance of lymphocytes. Triglyceride levels > 110 mg/dL and cholesterol levels < 200 mg/dL. What is the fluid?

Answer 6

chyle (lymph fluid)

Question 7

What three receptors are tested for expression in all newly diagnosed patients with breast cancers?

Answer 7

Human epidermal growth factor receptor 2, estrogen receptor, and progesterone receptor.

Question 8

What tissue does an epidermal inclusion cyst arise from?

Answer 8

that arise from the infundibular portion of hair follicles.

Question 9

Upon physical examination, the breast tissue may feel dense on palpation, with a rope-like or cobblestoning texture. What dx?

Answer 9

fibrocystic breast changes

Question 10

pH level < 7.2, a glucose level < 40 mg/dL, a lactate dehydrogenase level > 1,000 IU/L, and a white blood cell count > 50,000 cells/μL. What type of fluid found on thoracentesis?

Answer 10

empyema

Question 11

What are the suturing criteria for the tongue?

Answer 11

laceration is > 2 cm on the dorsum of the tongue and extends into the muscular layer

if the laceration is deep and on the lateral border of the tongue

if it is a large flap or gap

or if there is significant bleeding.

want to use absorbable suture

Question 12

What are three antibiotics that may be used prophylactically for tongue lacerations?

Answer 12

augmentin

cephalexin

clindamycin

Question 13

Which complication is most commonly associated with lumbar puncture procedures?

Answer 13

postdural puncture HA

Question 14

define solitary pulmonary nodule

Answer 14

Solitary pulmonary nodules are defined as < 3 cm opacities surrounded by normal lung tissue.

Question 15

What confirms the dx of catheter associated UTI?

Answer 15

A positive urine culture with ≥ 10^3 CFU/mL of one or more bacterial species confirms the diagnosis.

Question 16

invasive carcinoma with dermal lymphatic invasion. What type of breast cancer? What is the tx?

Answer 16

inflammatory breast cancer

chemo followed by mastectomy

Question 17

What two patient-specific factors are the most significant risk factors for seroma development?

Answer 17

smoking and obesity

Question 18

What respiratory pathogen is rust-colored sputum most often associated with?

Answer 18

strep pneumo

Question 19

_____ is the MC cause of spontaneous bacterial peritonitis

Answer 19

e coli

Question 20

What electrolyte disturbance commonly causes a post-op ileus?

Answer 20

hypokalemia

Question 21

Where is the MC anatomic location of intusseception?

Answer 21

junction of ileum and ascending colon

Question 22

BMI greater than 95th percentile in a kiddo older than 10, what screening labs are indicated?

Answer 22

fasting lipid panel, ALT and fasting glucose

Question 23

What is the most likely cause of the Cullen and Grey Turner signs?

Answer 23

pancreatitis

Question 24

Where is rupture due to Boerhaave syndrome likely to occur?

Answer 24

left posterior distal esophagus

Question 25

______ (initial medication) is recommended for all patients with primary biliary cholangitis because it improves long-term survival, slows disease progression, and improves liver biochemical tests.

Answer 25

Ursodeoxycholic acid

Question 26

What antibody is associated with primary biliary cholangitis?

Answer 26

antimitochondrial antibody (AMA)

Question 27

What autoimmune disorder is associated with primary biliary cholangitis?

Answer 27

Sjögren syndrome

Question 28

What is the most commonly performed surgical procedure to correct a hiatal hernia?

Answer 28

nissen fundoplication