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1

What is nodular lymphoid hyperplasia?

numerous polyps in the small and large intestine associated with immunosuppression (tumors, IgA deficiency, HIV)
colorectal- not associated with malignancy
small intestine - associated w increased incidence of lymphoma

2

What are guidelines for placing an ICP monitor w severe brain injury?

- GCS = or <8 who EITHER
1. abnormal CT OR
2. normal CT with >2 of following: age >40yrs, any hx of hypotension, abnormal motor posturing

3

equation for CPP

CPP = MAP - ICP

4

Name 4 etiologies of chylous ascites

1. Malignancy- end stage pancreatic cancer
2. Congenital Lymphangiectasia
3. Thoracic duct obstruction
4. Lymph peritoneal fistula

5

what is the most common causative organism of necrotizing fasciitis?

group A strep

6

What is the indication for a SLN bx in malignant melanoma?

primary melanoma = or >1mmm thickness and clinically negative nodes (for those 0.75 to 1.0mm, consider SLN in younger pts, evidence of ulceration or LVI, extensive dermal regression, or 1 or >mitosis/mm2)

7

tumor lysis syndrome occurs most often in what 2 cancers?

1. Acute leukemia with high WBC counts
2. High grade lymphomas

8

what are 3 patient risk factors for tumor lysis syndrome?

1. Bulky tumors sensitive to chemo
2. Elevated LDH
3. Renal insufficiency

9

what is the most common surgical option for SMA syndrome?

duodenojejunostomy

10

When repairing umbilical hernias, for what size defect do you place a mesh?

>3cm defect

11

MOA of succinylcholine

nicotinic acetylcholine receptor agonist -> depolarization of the motor end plate

12

what are 5 side effects of succinylcholine?

1. Hyperkalemia
2. Muscle pain
3. Transient ocular HTN
4. Anaphylaxis
5. Malignant hyperthermia

13

what are 3 contraindications to use of succinylcholine?

1. Neuromuscular disease
2. Closed head injury
3. Burns

14

treatment of malignant hyperthermia?

dantrolene

15

what are the indications for elective repair of a AAA?

>5.5cm or growing >0.5cm per 6 months

16

what is the most common indication for parotidectomy?

neoplasm

17

what is the problem with an ascending end colostomy?

leaves an end of the colon undrained leading to septic complications or perforation

18

serious side effect of neostigmine

bradycardia

19

Five Types of choledochal cysts

Type I: fusiform/saccular dilation of some or all extrahepatic ducts
Type II: isolated diverticulum protruding from the wall of the CBD
Type III: arises from intraduodenal portion of CBD
Type IV: multiple dilatations of either both the intra and extrahepatic ducts (A) or only the extrahepatic ducts (B)
Type V: Caroli's disease: multiple dilatations limited to the intrahepatic bile ducts

20

treatment of type I choledochal cyst?

excision with roux-Y hepaticojejunostomy

21

treatment of type III choledochal cyst?

marsupialization or excision of the cyst

22

treatment of type II choledochal cyst?

excision and primary closure of the choledochotomy

23

what is thrombotic thrombocytopenia purpura? (classic pentad)

aka moschcowitz syndrome, widespread thrombosis of arterioles, pentad:
1. Thrombocytopenic purpura
2. Neurologic manifestations due to microvascular disease in the brain
3. Kidney injury or hematuria
4. Hemolytic anemia
5. Fever

24

what is immune thrombocytopenia purpura

auto antibodies produced against platelets with resultant platelet destruction and thrombocytopenia

25

what is felty syndrome?

autoimmune neutropenia
triad of: rheumatoid arthritis, neutropenia, splenomegaly

26

what is wiskott-aldrich syndrome? (triad)

hereditary X linked disease
1. Low platelet counts
2. Combined B and T cell deficiency
3. Eczema

27

what is the composition of lactose?

glucose and galactose

28

what is the composition of sucrose?

glucose and fructose

29

what is the composition of maltose?

glucose + glucose

30

what is budd chiari syndrome? how do you diagnose it?

hepatic venous obstruction- can be seen in hyper-coagulable states
diagnose: duplex US