Pestana Errata Thread

[superduperman]

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Below is what i think is right. Take from it what you will. Feel free to add your own. These corrections are only for the free pestana notes online. Feel free to dispute what im adding.

8. not sure if pericardial window and pericardiocentesis are the same thing but uptodate seems to favor the latter
20. pulmonary contusion treatment: uptodate says "crystalloid is appropriate"
though opinions vary
23. correct answer: chest CT. angio is reserved for equivocal CTs only.
44. early larygnoscopy should be done if patient had smoke inhalation signs and respiratory distress. i'm think the diagnosis is essentially a clinical one though.
sk 4. melanoma. just some clarification. excisional biopsy is done for basal, squamous and melanoma. <1mm invasion = done after 1mm margins. 1-4mm invasion = 2-3mm margins and sentinel nodes, 4+mm invasion on pathology means full metastatic w/u
breast 1. if clinical suspicion is low, US for masses in age <45. mammo to eval>45. if high i think it's just tissue biopsy.
breast 17. i think it should be lumpectomy with radiation with sentinel node. if sentinel node is + then proceed to full dissection. sentinel node prevents lymphedema.
G 1.1. GERD is treated by medical management only. If PPI daily doesnot work go to BID. endoscopy for failure of medical management or dysphagia. if scope is normal go to manomatry.
G 1.13. 24 hour urine HIAA not serum.
G1.19. endoscopy is contraindicated in patients with classical c diff due to risk of perf. confirm w/ stool toxin.

stay tuned...

 

[superduperman]

G.1.30 lower GI bleeding: colonoscopy first. if heavy

bleeding, proceed to angio
G.1.39. CT is test of choice. not KUB.
G.1.41. surgery of choice is sigmoid resection w/

anastomosis
EN.1. management of thyroid nodule begins with TSH.

if normal TSH then US. if low TSH then thyroid scan.

US determines whether FNA is warranted.
EN.2. US not FNA is the first test
EN.3. radioiodine ablation is preferred as

hyperfunctioning nodules preferentially accumulate

radioiodine and are destroyed rendering patient

euthyroid. radioiodine is also prefered over surgery

for graves.
PD.5. Omphalocele assoc with cardiac defects (#1), GI

defects, beckwith wiedeman
PD12. Upper GI series not contrast enema.
PD14. biliary atresia w/u. 1. r/o other causes: abd

US, HIDA, liver biopsy. 2. intraoperative

cholangiogram 3. treat with Kasai procedure

hepatoportoenterostomy.
OT 5. open lymph node excisional biopsy provides

architecture info. FNA is not recommended due to

significant chance of false negative and lack of

architecture info.
OT 19. test of choice in epiglottitis is direct

visualization in the OR with the ability to secure

airway if needed. lateral x ray is not needed to

establish dx and is only done if dx is uncertain by

hx and other dx are likely.

 

[Mr Cookie Pants]

Pestana is old. The Surgery shelf thread says MANY places do not use it for management plans, but more vignette identification.