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Surgery EOR
| Question | Answer |
|---|---|
| What is the most common type of thyroid nodule? | benign thyroid adenoma |
| Are most thyroid nodules malignant? %? | No; only 5% are malignant |
| Follicular adenoma of thyroid - rare or common? | common |
| What is a rare type of thyroid nodule? | papillary adenoma |
| What specific type of thyroid nodule cell has eosinophilic staining and malignant potential? | Hurtle cell |
| If a solitary thyroid nodule is found, what should be done? | FNA |
| What are the three possible findings with FNA done on a solitary thyroid nodule? | malignant; hypercellular follicular neoplasm, benign |
| Cold nodule vs hot nodule - which is more dangerous? | cold nodule; it's not functioning; requires surgery |
| What can be done to see if a nodule is hot or cold? | RAIU scan |
| What is the most sensitive test to detect thyroid lesions? | high resolution U/S ; |
| Is CT or US preferred when scanning thyroid lesions? | US |
| If a thyroid nodule is specific for malignancy, what test can be performed to biopsy? | US-guided FNA |
| What is the most common solid renal tumor of childhood? | Wilm's tumor |
| What kind of tumor is Wilm's tumor? | nephroblastoma |
| What is the initial study of choice to evaulate abdominal masses in kids? | US |
| If a pt is suspected to have Wilm's tumor, what study is preferred? | abdominal CT; allows assessment of tumor extension and regional lymph spread |
| When is CXR used in Wilm's tumor assessment? | to look for presence of metastases |
| What is the most effective treatment for Wilm's tumor? | surgery, chemo, and sometimes radiation |
| Are Wilm's tumors chemosensitive or resistant? | chemosensitive |
| In what cases is radiation used in Wilm's tumor? | higher staged Wilm's tumor; stage III or IV, or for tumors with focal anaplasion |
| What is the treatment of choice for resectable wilm's tumors? | radical nephrectomy with lymph node sampling |
| If a Wilm's tumor is unresectable, what is the treatment? | pre-op bx followed by tumor |
| If a Wilm's tumor has anaplasia, is this associated with a better or poorer prognosis? | poorer |
| What are common risk factors associated with bladder cancer? | tobacco exposure, occupational carcinogens (rubber, dye), cyclophosphamide |
| What gender is more likely to get bladder carcinoma? What ages? | Males; 40-70 |
| Most common presenting sx of bladder carcinoma? | painless hematuria; also can have bladder irritability and infection |
| If you suspect a patient has bladder carcinoma, what is the definitive diagnostic procedure? What confirms? | cytoscopy; biopsy confirms |
| You do a cytoscopy of a bladder carcinoma and confirm that the patient has superficial lesions; what is the treatment of choice? | endoscopic resection and fulguration; cytoscopy every 3 months |
| In which cases of bladder carcinoma is radical cystectomy the correct treatment? | recurrent cancer, diffuse TCC in situ, muscle-invasive tumors |
| When is external beam radiation used in bladder carcinoma? | individuals who are not surgical candidates due to significant comorbid conditions |
| What are the most common causes of small bowel obstruction | post-op adhesions |
| T/F = in small bowel obstructions, there is a lot of colonic gas | false |
| How is partial small bowel obstruction managed? | IV hydration and NG decompression |
| What childhood history increases the chances of thyroid carcinoma? | childhood radiation to the head and neck |
| Family history of what syndromes increase the risk of thyroid carcinoma? | MEN II, Gardner syndrome |
| What is the most common type of thyroid carcinoma? | Papillary carcinoma |
| Is papillary thyroid carcinoma aggressive or bening? | least aggressive; spreads by local estention |
| What test is usually used to detect thyroid carcinoma? | US |
| What might be useful for residual disease? | RAIU ablation |
| What is the strongest associated risk factor for testicular cancer? | right-sided cryptochidism |
| What is often done as a diagnostic when testicular cancer is suspected? | scrotal u/s |
| What is often high in the blood when a patient has testicular cancer? | alpha fetoprotein |
| Are most testicular cancers radioresistant or radiosensitive? | radioresistant |
| What is done for dx and tx reasons in cases of testicular cancer? | orchiectomy |
| What is the global name for NE, epi, etc.? | catecholamines |
| What is a pheochromoctyoma? | catecholamine-secreting tumors arising from the cells of the adrenal medulla; |
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