nir hus md, phd., absite review q13
DESCRIPTION
Slides with topics that are covered and were tested in the recent Absite exams.Nir Hus MD., PhD.http://www.nirhus.comTRANSCRIPT
Absite Topic Review General Surgery
Nir Hus, MD, PhD. Mount Sinai Medical Center Miami Beach
Topics
1) BRCA-1,2. 2) Rx Postop Parotitis. 3) Rx Non-healing burn wound.
Nir Hus
Predict Increased risk BRCA-1,2 mutation
BRCA I Ovarian CA – 40% lifetime risk Male Breast CA – 1% lifetime risk
BRCA II Ovarian CA – 10% lifetime risk Male Breast CA – 10% lifetime risk
Nir Hus
BRCA cont.
BRCA gene + family Hx = 60% lifetime risk of breast CA (autosomal dominant)
Bi prophylactic mastectomy w/ BRCA gene results in decreased risk of breast CA by 90% Add TAH & BSO decrease risk 95%
CA in a person w/ BRCA I,II carries a 50% risk of developing CA in contralateral breast.
Nir Hus
Parotitis Can occur in the surgical patient and identified during the
postoperative period. Particularly in elderly Dehydrated individuals.
Therapy should be directed toward Rehydration Enhancing salivation Ensuring that no mechanical obstruction of the duct of Stensen
is present Obtaining stains and cultures Administering antibiotics directed against S. aureus, which is the
most common offending organism. In ICU patients who are often colonized with gram-negative
bacteria, the possibility of gram-negative bacterial parotitis should be considered and appropriate empiric therapy used.
I&D Nir Hus
Rx Non-healing burn wound.
Q: 30 y.o veteran suffered a burn wound to arm 2nd or 3rd degree over one year ago and the wound is ulcerated. What to do next. A: Marjolin’s tumor – need Bx
Nir Hus
Ulcers associated with burns
Curling’s ulcer – gastric ulcer that is associated with burns.
Marjolin’s ulcer – highly malignant squamous cell CA.
Nir Hus