Sunday 15 December 2013

Surgery

SURGERY
1. Least incidence of breast cancer is in the lower inner quadrant (6-8%). Maximum incidence is in the upper outer quadrant 2. Multicentric tumors are contraindications for BC
3. Involvement of supraclavicular lymph nodes in breast cancer makes it Stage III C
4. Tubular cancer has the best prognosis
5. Stent used for esophageal cancers – expandable metallic stents. Names: Choo, Dua 6. Most common tumor of appendix: Mucinous adenocarcinoma
7. Tumor in appendix more than 2cm in size – right hemicolectomy
8. Marion's disease - bladder neck stenosis. given in bailey - prostatism sans prostate - that means symptoms of BPH without enlargement of the gland 9. Intra-op liver laceration, 3 cms, stable vitals: suture. 10. Compressibility of muscle is not a criteria used during debridement of wounds
11. Blunt trauma abdomen with hematuria: IOC – CECT if stable. Single shot IVU if unstable
12. Adder head appearance – ureterocele 13. Peritoneal dialysis is not curative
14. Surg intervention not required in..SDH/EDH/depressed #/ Diffuse axonal injury: NOT required for Diffuse axonal injury.
15. All are complication of bariatic surgery except? Kidney stones Vitamin deficiency GIT disturbances Pulmonary embolism. All are complication but if I have to choose one I will go for pulmonary embolism…as it is not a direct consequence of bariatric surgery
16. Incision preferred in blunt trauma abdomen: Midline
17. Incision preferred in children: Transverse incision..usually infraumblical
18. Units of PSA – nanograms
19. Treatment of primary CBD stones: ERCP with sphincterotomy
20. Extrahepatic choledochal cyst: resection of cyst followed by hepatico-jejunostomy or choledochojejunostomy 21. Site of IM injections in the gluteal region: upper outer quadrant
22. Warm and dry peripheries in Neurogenic shock. In addition – bradycardia and hypotension
23. Tendons and nerves should be repaired immediately following injury
24. Hernia which presents as gastroenteritis – Richeter’s hernia. Portion of bowel gets strangulated and patient initially presents with features of gastroenteritis
25. Young and fit patients- abdominal rectopexy. Abdominal rectopexy has least recurrent rates but complications like constipation and erectile dysfunction. Perineal procedures are more suited for old and frail patients but have a higher recurrence rate
27. Bowel injury while inserting trocar: keep the trocar there and convert to an open procedure. This is because the trocar will have a tamponading effect as there might be vascular injury associated with it as well and secondly it guides you to the site of the surgery 28. Flail chest: IPPV 29. Torsion of testis to be repaired within 6 hours 30. Massive blood transfusion: equivalent of blood volume transfused within 24 hours 31. Parathyromatosis, consisting of hyperfunctioning parathyroid tissues scattered throughout the neck, is a rare cause of recurrent hyperparathyroidism after parathyroidectomy. Medical management of patients with parathyromatosis usually is ineffective. Repeated surgery often is necessary, but generally is unsuccessful.

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