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DU PA Surgery Final

Duke PA Surgery Final

divisions of cerebrum frontal, parietal, temporal, occipital
the most important divider in the cranium. lesions above and below this structure; produce distinctive syndromes, require different diagnostic tests, require different treatment strategies, have different prognosis tentorium
concomitant dysphasia, hemianopia, or focal epilepsy is a __ lesion supratentorial
anorexia nervosa is sometimes mistaken for __ wasting
in infants, prominent sutures, wide tight fontanelle, unuusually large head, vomiting, headache in occipital region and neck, squint is very common infratentorial mass
brain tumors seldom__ metastasize outside the CNS
__ spread the soonest with metastatic brain tumors lung and renal cancer cells
mets to the brain in men generally come from __ lung, colon, and renal cancers
mets to the brain in women generally come from __ breast, lung, and melanoma
when you see mets to the brain get a __ to confirm pathology biopsy
epilepsy that has failed two medications is medically intractable epilepsy
Most common form of partial complex epilepsy arises from the mesial temporal lobe. Removal of this region can now be done with up to __% cure rate and minimal morbidity 85
to reduce risk of damaging language and memory , patients can undergo a __ test. WADA
in the __ test you temporarily paralyze that half of the brain into which it is injected. Patients are shown flash cards and stop talkin or remembering when the sodium amytal sets in, indicating that hemisphere is involved in language and memory WADA
is a seizure ongoing for 30 minutes without stopping, or multiple seizures in succession without sensorium returning to normal between them status epilepticus
Sybarachnoid hemorrhage may block __ causing hydrocephalus arachnoid villi
myelomeningocele, ultrasound - findings are two frontal bones appear convex inward lemon sign
myelomeningocele, ultrasound - findings are elongated and curved posterior fossa secondary to Chiari malformation banana sign
if a myelomeningocele is discovered during pregnancy it is a surgical emergency and requires __ planned C section with defect closure within 24hrs
what is the management of 85% symptomatic carotid stenosis carotid endoarterectomy
name 4 primary risk factors for atherosclerosis smoking, hypertension, diabetes mellitus, hypercholesterolemia
true or false diplopia, syncope, dizziness, vertigo, and paresthesia are symptoms of carotid disease false
what is the cause of Amurosis Fugax embolization of retinal arteries
what is the treatment for AAA surgery--repair
name the 5 P's for symptoms of Acute Arterial Occlusion pain, pulselessness, pallor, ploikothermia, paresthesias/paralysis
what is the most effective treatment for stable claudication lifestyle modification, smoking cessation, regimented excercise, and medications (Pletal)
what is the leading cause of death in Western culture atherosclerosis
what is the result of narrowing of lumen in atherosclerotic disease distal ischemia, acute thrombosis, downstream embolization
name the 3 types of lessions associated with atherosclerotic disease fatty streaks, fibrous plaques, complex plaques
the most common location for atherosclerosis at a bifurcation
what are the secondary risk factors for atherosclerosis age, family history, male, obesity
what cuases pain with PVD ischemia of muscle tissue
name the arteries responsible for claudication pain in the buttocks distal aorta/common iliac
name the arteries responsible for claudication pain in the thigh external iliac
name the arteries responsible for claudication pain in the calf superficial femoral
describe typical pain with claudication reproducible, exercise induced pain in foot, calf, or buttock
vascular physical exam assessment includes documented pulses at each level, evaluate each level for signs of ischemia and tissue loss
Is an arteriography is always necessary for diagnosis of claudication? only needed if intervention is planned
a molecule that can interact with the immune system antigen
peptides prouced by B lymphocytes that attach to foreign material and aid in removing it from the body antibody
cells that display foreign antigen complexed with MHC on its surface. antigen presenting cell
these genes are expressed on the surface of cells in all jawed vertebrates, and display fragments of molecules from invading microbes or dysfunctional cells major histocompatibility complex MHC
are encoded by the MHC genes Human Leukocyte Antigens HLA
circulation peptides that influence behavior of the immune system (IL-2) cytokines
a protein complex of T lymphocytes that can identify MHC molecules T-Cell Receptor
interact with APC MHC II molecules via the TCR release cytokines (primarily IL-2) CD4 lymphocyte
interact with MHC class I molcules (that contain foreign peptides) and can directly kill the foreign cell CD8 T lymphocyte
of the same species allogenic
a test for determining tissue compatibility between a transplant donor and the recipient before transplantation, in which the recipient's serum is tested for antibodies that may react with the lymphocytes or other cells of the donor crossmatch
the preexisting antibodies against HLA antigens in the serum of a potential allograft recipient that reacts with a specific antigen in a panel of leukocytes, with a higher percentage indicating a higher risk of a positive crossmatch (listed as % antib) panel reactive antibodies PRA
a state of immune acceptance without immunosuppression tolerance
MHC I goes with __ CD8 T cells (8/1=8)
MHC II goes with __ CD4 T cells (8/2=4)
what are the 2 allogenic recognition pathways direct and indirect
T-cells and their receptors identify allogeneic MHC molecules. This generates CD8 T cells which causes attack on an organ and therefore rejection direct allogenic recognition pathway
velocity of blood in vessels is determined by use of __ duplex ultrasound
antilymphocyte antibodies used to prevent rejection until maintenance suppression is therapeutic induction immunosuppression
what is the normal value of ABI in the normal patient >1
what is the ABI in a patient with intermittent claudication .5-.7
what is the ABI in a patient with claudication type pain at rest <0.3
the important cytokine to remember from the transplant lecture IL-2
the ratio of the blood pressure in the lower legs to the blood pressure in the arms. Compared to the arm, lower blood pressure in the leg is a symptom of blocked arteries (peripheral vascular disease). Ankle Brachial Index (ABI)
drugs that end in "-mab" are __ monoclonal antibodies
what is the common ABI of DM patients >1 due to calcified non-compressible vessels
what is the best test for determination of atherosclerotic disease status arteriography
indications for surgical intervention in PVD lifestyle modifications, rest pain, or tissue loss
one important complication of lower extremity amputation MI
80% of claudication patients have __ claudication stable
essential test to obtain prior to referral of PVD patient NIVT
test of choice for carotid artery disease duplex scan (doppler US)
what is the gold standard for diagnosing lesions of aortic arch, carotid artery, vertebral artery, and intracranial artery four vessel arteriography
leading cause of death CEA cardiac complication
what are the indications for AAA repair >5cm, size increase >0.5cm/yr, symptomatic, rupture
most common post op complication of AAA MI
what is the etiology of acute arterial occlusion thrombosis or embolism
name 2 common sites of AAO lower extremity vessels and diseased vessels
what is the leading cancer killer of women and men lung
what type of cancer is associated with asbestos exposure mesothelioma
what is the most aggressive type of lung cancer and is not surgically treated small cell lung cancer
what type of lung acnacer presents most frequently as systemic disease small cell-highest rate of mets
most common type of lung cancer non-small cell 80%
2 most common types of non-small cell lung cancer squamous, adenocarcinoma
squamous cell lung cancer is usually where in the lung central
adenocarcinoma lung cancer is usually where in the lung peripheral
when a transplanted organ is placed in its normal anatomic location in the recipient orthograft
when a transplanted organ is placed in an area that is not its normal anatomic location in the recipient heterograft
what are the levels for stage 3b (T4 w/ N0-2), and (T1-4 w/ N3)
what are the levels for stage 4 any T or any N with M1
what is the presentation of stage 1 lung cancer predominately asymptomatic while more advanced is symptomatic
what fraction of patients present to PCP with stage 3-4 lung cancer 2/3
what are the most frequent symptoms associated with advanced lung cancer cough, wt loss, dyspnea, chest pain, hemoptosis, bone pain, lymphadenopathy, hepatomegaly, clubbing, horseness, SVC syndrome
Created by: bwyche