Surgical management decisions for common solid tumor resections and margin concepts tested on USMLE Step 2 CK.
35 cards · basic cards · AI-written, checked twice. Edit anything.
- What excision margin is recommended for melanoma in situ?
- 0.5 to 1 cm
- What excision margin is recommended for a melanoma with Breslow thickness of 1 mm or less?
- 1 cm
- What excision margin is recommended for a melanoma with Breslow thickness between 1.01 mm and 2 mm?
- 1 to 2 cm
- What excision margin is recommended for a melanoma thicker than 2 mm?
- 2 cm
- At what Breslow thickness is sentinel lymph node biopsy generally considered for melanoma?
- 1 mm or greater (or thinner with ulceration or a high mitotic rate)
- In breast conserving surgery for invasive cancer, an adequate margin is defined as ____.
- no ink on tumor
- What is the standard next step when a lumpectomy specimen shows a positive margin?
- Re-excision to obtain a clear margin
- What is the standard surgical treatment for ductal carcinoma in situ (DCIS)?
- Lumpectomy with radiation, or mastectomy for extensive disease
- In breast cancer surgery, when is sentinel lymph node biopsy used instead of full axillary lymph node dissection?
- When the axilla is clinically node negative before surgery
- What is the primary indication for a Whipple procedure (pancreaticoduodenectomy)?
- Resectable adenocarcinoma of the head of the pancreas
- Which structures are removed en bloc in a classic Whipple procedure?
- Head of pancreas, duodenum, distal common bile duct, gallbladder, and gastric antrum
- What is the surgical procedure of choice for a resectable tumor of the pancreatic body or tail?
- Distal pancreatectomy, often with splenectomy
- What imaging finding generally makes a pancreatic head tumor unresectable?
- Encasement of the superior mesenteric artery (greater than 180 degrees of contact)
- What margin of grossly normal bowel is generally required on each side of a colon cancer resection?
- At least 5 cm
- What is the minimum number of lymph nodes that should be examined for adequate staging after colon cancer resection?
- 12 lymph nodes