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Surgery Comat Study Guide for Exam— Success Guaranteed
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Surgery Comat Study Guide for Exam— Success Guaranteed
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Surgery Comat Study Guide for Exam—Success Guaranteed
Spigelian Hernia - ✔✔Arise from a defect in Spigel's fascia, the apoeurotic layer between the
rectus abdominis and external oblique muscle along the linea semilunaris
Presents without bulge but has associated pain
Amyand Hernia - ✔✔An inguinal hernia containing the vermiform appendix (signs and
symptoms of appendicitis may be present)
Littre Hernia - ✔✔Hernia that contains a Meckel's diverticulum
Pantaloon Hernia - ✔✔an inguinal hernia that contains elements of both a direct and an
inguinal hernia
Richter Hernia - ✔✔occurs when only the antimesenteric wall of a hollow abdominal organ
becomes incarcerated in and inguinal hernia.
Sliding Hernia - ✔✔A hernia containing a hollow retroperitoneal organ, most commonly the
bladder or colon
Treatment of hernias - ✔✔Conservative/Observation = Diastasis recti (midline bulge)
Appendectomy = Amyand's hernia
Laparoscopic hernia repair = Ventral, inguinal, hiatal, and incisional hernia
Open hernia repair = most hernias
,Retroperitoneal Organ - ✔✔*SAD PUCKER*
S = Suprarenal (adrenal) glands
A = Aorta/IVC
D = Duodenum (2nd & 3rd segments)
P = Pancreas
U = Ureters
C = Colon
K = Kidneys
E = Esophagus
R = Rectum
Peutz-Jeghers syndrome - ✔✔Autosomal dominant disorder
Two manifestations: Pigmented mucocutaneous macules and multiple hamrtomatous GI polyps
(usu benign)
GI symptom caused by obstruction from *intussusception* or occlusion of bowel obstruction
Paget's Disease of the breast - ✔✔*Hallmark = scaly, raw, vesicular, or ulcerated lesion that
begins on the nipple and then spreads to the areola*
Symptoms = Pain, burring, and/or pruritus
Mammary Paget cells are malignant epithelial cells derived from underlying ductal
adenocarcinoma of the breast that invade into the skin of nipple and areolar
, Acute Hemolytic Transfusion Reaction - ✔✔Classic triad = Fever, flank pain, and red or
brown urine (hemoglobinuria)
The rapid destruction of donor erythrocytes by preformed recipient antibodies. *Due to ABO
incompatibility* > Disseminated Intravascular Coagulation (especially under anesthesia), shock,
and ARF due to Acute tubular necrosis
Inflammatory bowel disease (Crohn's disease and ulcerative colitis) - ✔✔Seen in second
decade of life, more in females
Most commonly affected site Terminal ileum
Symptoms = right lower quadrant pain, weight loss, and diarrhea
Note = Crohn's disease affects the anus and patient will have anal fissures and fistulas.
Colonoscopy: skipped lesions, strictures, and cobblestoning
Treatment of Crohn's - ✔✔Step-wise approach:
1) 1st-line: 5-aminosalicyclic acid (5-ASA): *Sulfasalazine & Mesalamine* for flares
2)Antibiotics: Ciprofloxacin and Metronidazole are good for perianal involvement and fistulas
3) 2nd-line: Corticosteroids for acute flare ups
4) Immunomodulators like 6-Mercaptopurine, Azathioprine (inhibits T-lymphocytes), and &
Infliximab (a monoclonal antibody against anti-TNF) for refractory disease
Treatment of multicentric breast cancer (two or more primary tumors in separate quadrant) -
✔✔Simple or total mastectomy with sentinel node biopsy = removal of entire breast and
preservation of pectoral muscles and axillary contents
Treatment breast cancer in a pt, who have inherited susceptibility with mutation known in
BRCA1 or BRCA2 - ✔✔Bilateral mastectomy
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