"Oncologic Resection" Definition for CRC (Margins + Nodes) - CORRECT ANSWERS-
Negative margins at 2-5 cm
12 Negative Nodes
(T/F) All femoral hernias require correction. - CORRECT ANSWERS-True
(T/F) All inguinal and umbilical hernias in kids should be fixed stat. - CORRECT
ANSWERS-False for two reasons:
- Umbos only >2 years old
- Inguinal after 24-48 hours of observation after reduction b/c edema needs to go down
(T/F) All patients with fibrocystic change suspected should undergo mammogram. -
CORRECT ANSWERS-TRUE
(T/F) Bronchial arteries originate from the thoracic aorta; there are two on the right and
one on the left. - CORRECT ANSWERS-False, backwards
(T/F) Carcinoid syndrome is most associated with a tumor in the small bowel, though
MC location for carcinoid tumors (without the syndrome) is the appendix. - CORRECT
ANSWERS-TRUE
(T/F) Lap appy shows normal appendix, but ileitis involving cecum. Proceed to take out
appendix. - CORRECT ANSWERS-FALSE, proceed ONLY if there is NO cecal
involvement. Isolated ileitis you can take out appendix therefore if it recurs you won't be
confused by possible appendicitis.
(T/F) PDAC is a complication of chronic pancreatitis. - CORRECT ANSWERS-FALSE
(T/F) PET scans have fale positive rate of 40% - CORRECT ANSWERS-False, 10-20%
(T/F) Post-angioplasty patency is better the more distal you go. - CORRECT
ANSWERS-FALSE, it is better for the more proximal vessels because there is higher
flow and because these vessels are often SHORT SEGMENTED (think common iliac
vs. popliteal)
,(T/F) Rarely is vertebral artery stenosis intervened upon. - CORRECT ANSWERS-True,
only if person has posterior circulation stroke symptoms, which again is VERY rare b/c
contralateral side and CoW are typically patent
(T/F) Woman >40 comes in with palpable breast mass. Next step is fine needle
aspiration. - CORRECT ANSWERS-FALSE, because:
- First step is DIAGNOSTIC (don't get tricked and pick screening mamo) imaging
- next step is CORE needle, not fine needle (unless cyst)
(T/F): DM is MCC gastroparesis.
(T/F): Gastroparesis increases risk for gastric cancer. - CORRECT ANSWERS-False,
idiopathic is MCC
False, no increased risk
***(T/F) Skeletal muscle contributes to glucose stores in starvation via mobilizing
glycogen. - CORRECT ANSWERS-FALSE, does not have glucose-6-phosphatase so
cannot mobilize glucose. However, it does participate in Cori Cycle (Lactate -->
PYRUVATE)
3 Absolute CI to Gallbladder - CORRECT ANSWERS-1. Gallbladder cancer (NOT
including Porcelain GB)
2. Inability to tolerate insufflation
3. Frozen abdomen
3 Adjuvant Therapy for Melanoma and when to use each - CORRECT ANSWERS-1.
IFN alpha 2b: thick >4.0 mm melanoma
2. IL-2: +met disease
3. Radiation: +nodes
3 Criteria for Transanal Excision (WLE for Adeno for instance) - CORRECT ANSWERS-
1. <4cm in size
2. <40% of circumference
3. Within 8 cm of anal verge
4 Indications for PPX CCY - CORRECT ANSWERS-1. Bariatric Surgery
2. Liver Transplant
3. Hematologic Disease
4. Porcelain GB
5 year survival after liver transplant for HCC?
Stipulation? - CORRECT ANSWERS-50%, stipulation is that these are in well-selected
pts with one lesion <5 cm, multiple <3 cm and no vascular invasion/met disease
AAA
- Become threat when > _____
,- 30 day mortality after EVAR vs. Open - CORRECT ANSWERS->5.5 cm
EVAR = 1.5%
Open = 5%
Abdominal Wall Defects
1. Four Types
2. Treatment of Umbilical vs. Inguinal Hernia in Kids
3. Differentiate Direct vs. Indirect (old vs. young) - CORRECT ANSWERS-1. Four
Types
- Umbilical Hernia: failure of umbilical ring (umbilical vein in round ligament, uraches,
umbilical arteries and transversalis fascia)
- Inguinal hernia: persistent processus vaginalis
- Omphalocele: failure of anterior abdominal wall to close
- Gastroschisis: defect from weakness in R umb vein/failure of umbilical coelum to
develop
2. Treatment of Umbilical vs. Inguinal Hernia in Kids
- Umbilical: delay until 2-4 y/o b/c self-limited
- Inguinal: treat within 72 hours of diagnosis (NO MESH)
3. Differentiate Direct vs. Indirect (old vs. young)
- Direct: old b/c age weaknes transversalis fascia
- Indirect: MC in newborns
ABO transfusion incompatibility presentation - CORRECT ANSWERS-Pain at IV site,
chest pain --> hypotension/DIC
ABx with best pancreatitic penetration? - CORRECT ANSWERS-Imipenem
Accessory Spleen MC Location - CORRECT ANSWERS-Splenic hilum; occurs
anywhere along migration of sleen during embryogenesis (so basically think along
splenic vessels or pancreas)
Achalasia Treatment
- Steps (3)
- All followed by _____ - CORRECT ANSWERS-Lap Heller Myotomty
1. Longitudinal myotomty 5cm proximally and 3 cm distally
2. Dissect down to submucosa
3. Pull muscles at least 50% circumferentially to not allow reapproximation
All should be followed by partial fundoplication (Toupet, Dor) vs. full (nissen) to prevent
dysphagia; this component reapproximates the Angle of his
Afferent Loop Syndrome
- What surgical patients get this?
, - Pathophysiology - CORRECT ANSWERS-- What surgical patients get this?
B2 patients, afferent limb = PB limb
- Pathophysiology
B/c afferent limb is under hormone control (PB limb), increase secretions but decrease
flow = stasis + bacterial proliferation = obstruction
All patients post-diverticular abscess management require _____ after ___ weeks to
evaluate ______ - CORRECT ANSWERS-Colonoscopy after 3 weeks to determine
extent of disease and make sure a perf'd mass didn't cause the abscess
All patients with Paget's disease of anus should have _____. - CORRECT ANSWERS-
Colonoscopy, 50% have synchronous visceral malignancy
Alveoli
1. Development starts at _____ and continues until ____.
2. Three Types of Pneumocytes - CORRECT ANSWERS-7 months, 10 years
Pneumocytes
1. Type 1 = squamous cells providing structures
2. Type 2 = surfacant
3. Type 3 = alveolar macrophages
Aminoglycoside
- MoA
- Bacteriocidal vs. static
- Resistance - CORRECT ANSWERS-- MoA: 30S inhibitor
- Bacteriocidal vs. static: CIDAL
- Resistance: decrease in active transport
Aortic Injury
- MC Location in Blunt Trauma
- MC Location in Penetrating Trauma
- Which is worse? - CORRECT ANSWERS-- MC Location in Blunt Trauma = Isthmus
- MC Location in Penetrating Trauma = Infra-renal aorta (+IVC)
- Which is worse?: suprarenal injuries, so generally blunt
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