Complete, transmural rupture of esophagus Boerhaave syndrome Pre-malignant skin disorder (pigmentation hyperkeratosis ), increased risk of Ca in stomach Acanthosis nigricans Endoscopy reveals a white membrane with a concentric opening,ring at distal esophagus 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, myotomy Achalasia 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 activity Zollinger-Ellison syndrome
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 the cystic duct that causes extrinsic compression of the CBD 4.Mirrizzi’s syndrome 1.Cantlie’s line Line 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
Skin dimpling. Traction on Cooper’s ligaments by a scirrhous tumor distorts the surface of the breast
Premalignant lesion which regresses with H.pylori eradication MALToma Hypertrophic gastritis, thickening of gastric rugae Menetriere disease Cells in fundus + body, HCl (acid) + intrinsic factor Parietal Cells Cells in Fundus, pepsinogen Chief cells T/F - Sporadic gastrinomas are more often multiple and benign. False Achalasia is associated with what type of esophageal CA Squamous ‘Nodule' in the umbilicus, associated with advanced malignancy Sister Mary Joseph Node
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
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