Random Surgery Trivia!Surgery

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Complete, transmural rupture of esophagusBoerhaave syndrome

Pre-malignant skin disorder (pigmentation hyperkeratosis ), increasedrisk of Ca in stomach Acanthosis nigricans

Endoscopy reveals a white membrane with a concentric opening ,ring at distalesophagus squamo-columnar junction Schatzki ring

Iron-deficiency anemia,esophageal webs, glossitis increased incidence of esophageal Ca Plummer-Vinson syndrome

Decreased LES pressure, dysphagia to solids > liquids ("steakhouse syndrome") Scleroderma

Increased LES pressure , myotomyAchalasia

It is caused by a non–beta islet cell, gastrin-secreting tumor of the pancreas that stimulates the acid-secreting cells of the stomach to maximal activityZollinger-Ellison syndrome

Describe the findings in this image !

The most feared cause is inflammatory carcinoma, in which the malignant cells plug dermal lymphatics

Peau d’orange or edema -may be due to lymphatic blockage (from surgery or radiation), or mastitis.

Impacted stone in Hartman's pouch or thecystic duct that causes extrinsic compression of the CBD 4.Mirrizzi’s

syndrome

1.Cantlie’s lineLine connecting GB bed to IVC divides

liver into RIGHT and LEFT lobes

2.Calot’s triangle

3. Valves of Heister

Cystic duct Right border of common hepatic duct and right hepatic duct Inferior border of

liver

Spiral mucosal folds in the cystic duct Can prevent the passing of a probe into the CBD

Describe the findings in this image !

Skin dimpling. Traction on Cooper’s ligaments by a scirrhous tumor distorts the surface of the breast

Premalignant lesion which regresses with H.pylori eradicationMALToma

Hypertrophic gastritis , thickening of gastric rugaeMenetriere disease

Cells in fundus + body , HCl (acid) + intrinsic factor Parietal Cells

Cells in Fundus , pepsinogenChief cells

T/F - Sporadic gastrinomas are more often multiple and benign.False

Achalasia is associated with what type of esophageal CASquamous

‘Nodule' in the umbilicus, associated with advanced malignancy Sister Mary Joseph Node

Describe the findings in this image !

Density with spiculated borders and distortion of surrounding breast architecture suggesting a malignancy.

• Broad spectrum antimicrobial, penetrates eschar, painful, metabolic acidosis.

• Sulfamylon

• Indicated for post pump platelet dysfunction and renal failure.• DDAVP

• Glucagonoma rash• Necrolytic erythema migrans

• LaPlace equation?• T=Pr

• Bluish lesion over chronic lymphedema site• Lymphangiosarcoma

• Nigro protocol• 5FU, Mitomycin, Radiation.

• Most common hypercoaguable state• Factor V Leiden

• Fluids, PTU, Lugol’s B blocker,Tylenol, Steroid• Thyroid Storm

• Most active chemo agent for pancreatic cancer.• Gemcitabine

• Popcorn lesion on xray, 10% of pulmonary nodules, wedge resection.

• Hamartoma

• Brain• Muscle• Small Bowel• Colon• Kidney

Glutamine

Glucose and Ketone

Glucose

Glucose and Glutamine

Short chain fatty acids

Main metabolic fuels

Describe the findings in this image !

Clustered microcalcifications

• Associated with FAP , skull osteomas and desmoid tumors

• Gardner's syndrome

• Sometimes overlooked in truncal vagotomy leading to ulcer recurrence

• Criminal nerve of Grassi

• Comes from I cells of duodenum• Cholecystekinin

• Amyand's Hernia• Acute appendicitis in an incarcerated inguinal hernia

• The End