ABSITE True Learn Questions 2 And Answers
Graded A
Management of knee dislocation from a vascular perspective Correct Answer: Fizer says all patient
should get CTA
TrueLearn says if normal ABI, can observe 12-24hrs
Pathophysiology of infra-inguinal pseudoaneurysms after LE bypass surgery Correct Answer: Usually
due to progressive degeneration of recipient artery but must rule out graft infection as cause (culture
the excised graft)
MCC of upper vs lower extremity amputations Correct Answer: Upper: trauma
Lower: PVD
As anesthesiology, management of sudden increase in end tidal Correct Answer: Sign of atelectasis
and hypoventilation, increase TV or RR
**First step: make sure circuit isn't disconnected**
How should ICD/PPM's be managed before surgery? Correct Answer: ICD turned off
PPM in demand mode at a fixed rate
Inheritance pattern of malignant hyperthermia Correct Answer: AD
What should insulin dependent patient's do the AM of surgery? Correct Answer: Take 1/2 dose of
short acting insulin
Do not take daily dose of long acting insulin
Most common anesthesia complication leading to unplanned admission? Correct Answer: Nausea
and vomiting (PONV)
Anesthesia agent that can cause seizures Correct Answer: Meperidine
Anesthesia agent that can cause methemoglobinemia Correct Answer: Any local anesthesia
(lidocaine, cetacaine), especially when injected during endoscopic procedures
When is EKG indicated as part of regular pre-op workup? Correct Answer: Hx CAD or arrhythmia
NOT just based on age
Biggest RF for cardiac complications after any surgery Correct Answer: CHF
Feared complication of ileoinguinal nerve block Correct Answer: Femoral nerve palsy (usually
because too much local is injected)
Where are ilioinguinal nerve blocks performed? Correct Answer: Where the nerve pierces the
transversus abdominus 2cm medial to the ASIS
,Tx for malignant hyperthermia Correct Answer: Dantrolene
Ideal placement of ET tube Correct Answer: 2cm above carina
How does WHO classification categorize colorectal tumors? Correct Answer: Epithelial
Non-epithelial
Polyps
Secondary
Biggest RF's for Ogilvies syndrome Correct Answer: #1 metabolic imbalances
#2 trauma
According to TrueLearn, MCC of anastomotic leak in colorectal surgery Correct Answer: Staple line
failure
Ideal ostomy location Correct Answer: Through the summit of an infra-umbilical fan fold and through
the rectus muscle
Colonoscopic findings in UC Correct Answer: Distorted vasculature
Continuous lesions
Pseudopolyps
Crypt Abscesses
Superficial fissures
Blood supply remaining after extended right hemicolectomy Correct Answer: Marginal Artery
Ligaments taken down during L hemicolectomy Correct Answer: Splenocolic
Renocolic
Gastrocolic
Pacreaticolic
Which extra-intestinal manifestations of Crohns improve with successful treatment? Correct Answer:
Erythema nodosum
Apthous ulcers
Peripheral arthritis
Pre-op workup for new colon CA Correct Answer: CT chest/abd/pelvis
Basic labs
CEA
Colonoscopy
Local recurrence after pelvic exenteration for rectal CA (removing rectum, bladder, prostate)? Correct
Answer: 5%
Medical management of colonic pseudo-obstruction after fixing metabolic disturbances? Correct
Answer: Neostigmine - acetylcholinesterase inhibitor
10 synchronous colonic polyps in 19year old Correct Answer: Mut Y Homolog Associated Polyposis -
autosomal recessive
, Rome III criteria Correct Answer: For diagnosing irritable bowel syndrome:
Recurrent abdominal pain three days per month for three months associated with...
Improvement on defecation
Change in stool frequency
Change in stool appearance
Which two landmarks indicate adequate mobilization of R colon during R hemicolectomy Correct
Answer: Duodenum and IVC
Medications for treatment of functional (slow transit) constipation Correct Answer: Lubiprostone
(calcium channel activator)
Linaclotide (guanyl cyclase receptor activator)
Both are still in trial
Colectomy has variable outcomes
Nodular lymphoid hyperplasia found on colonoscopy, next step? Correct Answer: Test for HIV and
other immunodeficiencies
Management of soft colonic lipomas during colonscopy ("probe sinks into center") Correct Answer:
Leave them be
Big differences between cecal and sigmoid volvulus? Correct Answer: Cecal shows early vascular
compromise and almost always requires surgery rather than colonoscopic reduction
Most common GI location for melanoma to metastasize Correct Answer: Small bowel
In general, the role of radiation in colon cancer is... Correct Answer: Only palliative
(but used in neoadjuvent for rectal CA)
General Steps of APR: Correct Answer: Abdominal Dissection: mobilize descending, sigmoid, colon
Pelvic Dissection: anus, sphincters and ischial rectal dissected to levators
Then connect the dots by using sharp scissors to cut levators using coccyx as a guide to avoid
neurovascular structures
Management of metastatic prostate CA to colon Correct Answer: External beam radiation and
hormonal therapy
Treatment of mets is always dependent on primary
Concern for Ogilvies syndrome on exam and KUB, next step? Correct Answer: CT to rule out
mechanical obstruction, then medical management eg neostigmine
Management of ureteral injury in abdominal surgery Correct Answer: <7days → re-explore and
primarily repair
>7day → perc nephrostomy or stents until you can re-enter abdomen
Graded A
Management of knee dislocation from a vascular perspective Correct Answer: Fizer says all patient
should get CTA
TrueLearn says if normal ABI, can observe 12-24hrs
Pathophysiology of infra-inguinal pseudoaneurysms after LE bypass surgery Correct Answer: Usually
due to progressive degeneration of recipient artery but must rule out graft infection as cause (culture
the excised graft)
MCC of upper vs lower extremity amputations Correct Answer: Upper: trauma
Lower: PVD
As anesthesiology, management of sudden increase in end tidal Correct Answer: Sign of atelectasis
and hypoventilation, increase TV or RR
**First step: make sure circuit isn't disconnected**
How should ICD/PPM's be managed before surgery? Correct Answer: ICD turned off
PPM in demand mode at a fixed rate
Inheritance pattern of malignant hyperthermia Correct Answer: AD
What should insulin dependent patient's do the AM of surgery? Correct Answer: Take 1/2 dose of
short acting insulin
Do not take daily dose of long acting insulin
Most common anesthesia complication leading to unplanned admission? Correct Answer: Nausea
and vomiting (PONV)
Anesthesia agent that can cause seizures Correct Answer: Meperidine
Anesthesia agent that can cause methemoglobinemia Correct Answer: Any local anesthesia
(lidocaine, cetacaine), especially when injected during endoscopic procedures
When is EKG indicated as part of regular pre-op workup? Correct Answer: Hx CAD or arrhythmia
NOT just based on age
Biggest RF for cardiac complications after any surgery Correct Answer: CHF
Feared complication of ileoinguinal nerve block Correct Answer: Femoral nerve palsy (usually
because too much local is injected)
Where are ilioinguinal nerve blocks performed? Correct Answer: Where the nerve pierces the
transversus abdominus 2cm medial to the ASIS
,Tx for malignant hyperthermia Correct Answer: Dantrolene
Ideal placement of ET tube Correct Answer: 2cm above carina
How does WHO classification categorize colorectal tumors? Correct Answer: Epithelial
Non-epithelial
Polyps
Secondary
Biggest RF's for Ogilvies syndrome Correct Answer: #1 metabolic imbalances
#2 trauma
According to TrueLearn, MCC of anastomotic leak in colorectal surgery Correct Answer: Staple line
failure
Ideal ostomy location Correct Answer: Through the summit of an infra-umbilical fan fold and through
the rectus muscle
Colonoscopic findings in UC Correct Answer: Distorted vasculature
Continuous lesions
Pseudopolyps
Crypt Abscesses
Superficial fissures
Blood supply remaining after extended right hemicolectomy Correct Answer: Marginal Artery
Ligaments taken down during L hemicolectomy Correct Answer: Splenocolic
Renocolic
Gastrocolic
Pacreaticolic
Which extra-intestinal manifestations of Crohns improve with successful treatment? Correct Answer:
Erythema nodosum
Apthous ulcers
Peripheral arthritis
Pre-op workup for new colon CA Correct Answer: CT chest/abd/pelvis
Basic labs
CEA
Colonoscopy
Local recurrence after pelvic exenteration for rectal CA (removing rectum, bladder, prostate)? Correct
Answer: 5%
Medical management of colonic pseudo-obstruction after fixing metabolic disturbances? Correct
Answer: Neostigmine - acetylcholinesterase inhibitor
10 synchronous colonic polyps in 19year old Correct Answer: Mut Y Homolog Associated Polyposis -
autosomal recessive
, Rome III criteria Correct Answer: For diagnosing irritable bowel syndrome:
Recurrent abdominal pain three days per month for three months associated with...
Improvement on defecation
Change in stool frequency
Change in stool appearance
Which two landmarks indicate adequate mobilization of R colon during R hemicolectomy Correct
Answer: Duodenum and IVC
Medications for treatment of functional (slow transit) constipation Correct Answer: Lubiprostone
(calcium channel activator)
Linaclotide (guanyl cyclase receptor activator)
Both are still in trial
Colectomy has variable outcomes
Nodular lymphoid hyperplasia found on colonoscopy, next step? Correct Answer: Test for HIV and
other immunodeficiencies
Management of soft colonic lipomas during colonscopy ("probe sinks into center") Correct Answer:
Leave them be
Big differences between cecal and sigmoid volvulus? Correct Answer: Cecal shows early vascular
compromise and almost always requires surgery rather than colonoscopic reduction
Most common GI location for melanoma to metastasize Correct Answer: Small bowel
In general, the role of radiation in colon cancer is... Correct Answer: Only palliative
(but used in neoadjuvent for rectal CA)
General Steps of APR: Correct Answer: Abdominal Dissection: mobilize descending, sigmoid, colon
Pelvic Dissection: anus, sphincters and ischial rectal dissected to levators
Then connect the dots by using sharp scissors to cut levators using coccyx as a guide to avoid
neurovascular structures
Management of metastatic prostate CA to colon Correct Answer: External beam radiation and
hormonal therapy
Treatment of mets is always dependent on primary
Concern for Ogilvies syndrome on exam and KUB, next step? Correct Answer: CT to rule out
mechanical obstruction, then medical management eg neostigmine
Management of ureteral injury in abdominal surgery Correct Answer: <7days → re-explore and
primarily repair
>7day → perc nephrostomy or stents until you can re-enter abdomen
