GI
fuel source for colonocytes
fuel source for enterocytes
SCFA
glutamine
A 55-year-old male with history of total parathyroidectomy is now being evaluated for symptomatic hyperthyroidism. Ultrasound reveals a singular thyroid nodule on the left inferior thyroid lobe. Other than labwork, as part of his preoperative workup, which of the following tests should be ordered?
laryngoscopy
Patients with signs of recurrent laryngeal nerve injury such as stridor, dysphagia, and hoarseness preoperatively, or who had surgery that placed the recurrent laryngeal nerve at risk, should have direct or indirect laryngoscopy
8yo boy presents with midline neck mass that moves with swallowing. It is nontender without signs of infection, what is it and how do you treat it?
thyroglossal duct cyst
cistrunk procedure - resection of cyst and mid portion of the hyoid bone
40 yo F with no PMH, no tobacco or drug use presents for elective lipoma resection, what preop testing does she need?
none!
where are G cells located? what do they secrete
antrum, gastrin
The mechanism by which C difficile causes the characteristic diarrhea is
toxins A and B, which directly injure colonic mucosa and cause increased fluid secretion into the colonic lumen
what are the borders for a central neck dissection
hyoid superiorly
carotids laterally
innominate inferiorly
prevertebral fascia posteriorly
duodenal vs jejunal atresia: which is associated with Down syndrome and congenital abnormalities and which is thought to be due to an in utero vascular accident?
duodenal = down syndrome
jejunal = in utero vascular
Pt with GSW to the head on hospital day 1 starts putting out > 400 mL/h of clear urine. His urine and serum sodium/Osm values reveal elevated serum sodium and osmolality with minimally concentrated urine. What condition is this presentation concerning for?
central DI
what is the mechanism of how a marginal ulcer forms
After gastric bypass surgery, the jejunum does not have the mucosal barriers of the stomach to protect itself from continuous acid secretion
the treatment for intestinal malrotation
Ladd's procedure - divide abnormal peritoneal attachments and place the SB in the R abdomen, LB in the L abdomen, appendectomy
what is a marjolin ulcer and what is its treatment?
squamous cell cancer in the setting of a chronic wound/scar/burn
WLE with 1 cm margins
at what age do you repair symptomatic, reducible pediatric umbilical hernias?
at what age do you repair symptomatic, reducible pediatric inguinal hernias?
if it persists past 4-5 years (may spontaneously close around 4)
schedule electively as soon as possible
name the hard signs of vascular injury
Pulsatile Hemorrhage
Expanding Hematoma
Absent Distal Pulses
Thrill or Bruit
what are daily protein requirements for:
1 healthy individual
2 sepsis or metabolic stress
3 burn patients
healthy individuals who are not malnourished require approximately 0.8 g/kg/day of protein in their diet.
Patients with metabolic stress or sepsis require 1.5 to 2.0 g/kg/day of protein
Patients with burn injuries may require up to 2 to 2.5 g/kg/day of protein.
after a stab wound, a patient is found to have a 60% circumferential esophageal injury without major tissue loss. describe your management.
2-layer primary repair with muscle flap and local drainage
A 52-year-old woman is found to have a 1.5-cm thyroid nodule on ultrasound. FNA is performed, and the results show a "follicular neoplasm." She undergoes a thyroid lobectomy, and the final pathology reveals a widely angioinvasive follicular carcinoma with invasion by more than four vessels. What is the best next step?
Completion thyroidectomy would be required to facilitate RAI ablation
A 23-year-old woman who is 38 weeks pregnant is brought to the ED after a high-speed MVC. She is hypotensive, and despite aggressive resuscitation and uterine displacement to the left, she goes into cardiac arrest. There is no return of circulation with the usual resuscitative measures. What is the next step?
C section
what do you do for for zone III hematomas?
explore all penetrating hematomas
explore blunt if expanding
what are the following deficiencies associated with:
- selenium
- copper
- fatty acids (name 2)
- cardiomyopathy
- pancytopenia
- waxy skin, thrombocytopenia, alopecia, impaired growth, cognitive and visual dysfunction
name 3 things you would do after a CT scan shows pseudmyxoma peritonei
upper and lower scope
diagnostic lap with peritoneal biopsies
hipec and cytoreductive surgery
You are reviewing a 67-year-old woman’s imaging studies after she was diagnosed with a thymoma. Her thymoma does have capsular invasion into the adjacent mediastinal fat but not into other mediastinal structures. What is the best course of treatment?
surgical resection
Masoaka stage II
what is the operative incision for repairing a tracheoesophageal fistula
Right thoracic approach, via thoracotomy or thoracoscopy
usually performed on the opposite side of the aortic arch direction as determined by a chest radiograph or echocardiogram
what other injuries are Chance fractures associated with
hollow viscus, mesenteric, and solid organ injuries
when doing a pancreaticoduodenectomy, to create the transection plane at the neck of the pancreas, you develop a tunnel anterior to this vessel
the SMV