PAEA General Surgery EOR questions with
answers 2024
what hare hthe h2 hconditions hunder hthe hinflammatory hbowel hdisease humbrella? h- hANS-
1. hulcerative hcolitis
2. hcrohn's hdz
in hcomparing hulcerative hcolitis hand hcrohn's hdz, hwhich his:
-limited hto hthe hcolon hw/ hrectum halways hinvolved h*VS* hmouth hto hanus
-transmural h*VS* hmucosa/submucosa hinvolved
-LLQ h*VS* hRLQ hpain
-bloody hdiarrhea h*VS* hnon
-complications hof hperianal hdz, hstrictures, hfistulas h& hgranulomas h*VS* hcolon hcancer h&
htoxic hmegacolon
-colonoscopy hshowing h"skip hlesions" h& hcobblestoning h*VS* hulceration h&
hpseudopolyps
-barium hstudies hshowing h"stovepipe hsign" h(loss hof hhaustral hmarkings) h*VS* h"string
hsign" hnarrowing hthrough hscarred hareas
-(+)P-ANCA h*VS* h(+)ASCA h(anti hsaccharomyces hcerevisiae hAb)
-curative h*VS* hnoncurative h- hANS-1. h*ulcerative hcolitis*- hcolon/rectum,
hmucosa/submucosa, hLLQ hpain, hbloody hdiarrhea, hcomps hof hcolon hcancer h& htoxic
,hmegacolon, hcolonoscopy hw/ hulcerations h& hpseudopolyps, h"stovepipe hsign" h(loss hof
hhaustral hmarkings), h(+)P-ANCA, hcurative
2. h*crohn's hdz*- hmouth hto hanus, htransmural, hRLQ hpain, hnonbloody hdiarrhea, hcomps
hof hperianal hdz, hstrictures, hfistulas, hgranulomas, h"skip hlesions" h& h"cobblestoning",
h"string hsign", h(+)ASCA, hnoncurative
what hare hthe hbest hstudies hof hchoice hfor hulcerative hcolitis hvs hcrohn's hdz hin hacute hdz?
h- hANS--UC: h*flex hsigmoidoscopy* hin hacute hdz h(colonoscopy hand hbarium henema
hCONTRAINDICATED hin hacute hdz hbc hcan hcause hperf hor htoxic hmegacolon)
-crohn's hdz: h*upper hGI hseries* h(barium hswallow) hin hacute hdz
what hmedications hare hused hto htreat hulcerative hcolitis hand hcrohn's hdz? h- hANS-1. h5-
aminosalicylic hacids h(anti-inflammatory) h*oral hmesalamine* hbest hfor hmaintenance,
htopical hmesalamine h(rectal hsuppositories h& henemas), h*sulfasalzine* h(give hw/ hfolic
hacid); h*all hof hthese hwork hbest hin hthe hcolon- hso hare hbetter hfor htx'ing hUC*
2. h*corticosteroids* hin h*acute hflares* honly
3. himmune hmodifying hagents: h6-mercaptopurine, hazathioprine hand hMTX
4. hanti-TNF hagents- hadalimumab, hinfliximab hcertolizumab
barrett's hesophagus h(from hprolonged/untreated hGERD) hinvolves htransition hof h_________
hcells hto h_________ hcells h(nml hto hprecancerous); hwhat hkind hof hcancer hcan hGERD h=>
hbarrett's hturn hinto? h- hANS--*squamous* hepithelium hto hmetaplastic h*columnar*
-esophageal h*adenocarcinoma*
,tx hfor hintermittent/mild hvs hmod/severe hGERD h- hANS-besides hlifestyle hchanges
h(food/drink havoidance, havoiding hrecumbency, hwt hloss, hsmoking hcessation
-int/mild: hOTC hantacids h(tums, hMOM, hmaalox, hmylanta) h& hH2 hreceptor
hantagonists/blockers h(ranitidine, hcimetidine, hfamotidine)
-mod/severe: hH2RAs, hPPIs h(omeprazole, hesomeprazole, hpantoprazole), h& hprokinetic
hagents h(cisapride), hnissen hfundoplication hif hrefractory
DDx hfor hhematemesis h- hANS-MC his h*PUD* h(gastric h> hduodenal), hvarices,
hangiodysplasia, hmasses h(adenocarcinoma, hpolyps), h& hmallory-weiss htears
dx/tx? hvomiting hblood hafter ha hnight hof hheavy hdrinking hor hin ha hbulimic hpt; hwhat his
hseen hon hEGD? h- hANS--dx: hmallory-weiss hsyndrome/tears h(d/t hsudden hrise hin
hintragastric hpressure)
-tx: hsupportive hunless hsevere hbleeding hmay hneed hepi hinj, hband hligation hor hballoon
htamponade
-EGD: hsuperficial hlongitudinal hmucosal herosions/lacerations
dx? hdysphagia, hesophageal hwebs, hIDA, hglossitis, hangular hcheilitis, hkoilonychias h- hANS-
plummer-vinson hsyndrome
test hof hchoice his hbarium hswallow
tx: hdilation
, dx? hlower hesophageal hwebs/constrictions hat hsquamocolumnar hjunctions hMC
hassociated hw/ hsliding hhiatal hhernias hbut halso hcan hbe hs/p hcorrosive hinjury h- hANS-
schatzki hring
test hof hchoice his hbarium hsallow
tx: hdilation
esophageal hvarices hare hMC hd/t? htx hto hprevent hrebleeds? h- hANS--cirrhosis has ha
hcomplication hof hportal hvenous hHTN h
-long hterm htx: h
1. hnonselective hBB: h*propranolol, hnadolol* h1st hline h(reduces hportal hpressure) hbut hnot
hused hin hacute hbleeds hbc hpt hmay halready hbe hhypovolemic
2. h*isosorbide*: hlong hacting hnitrate h(vasodilator)
tx hof han hacute hesophageal hvarices hbleed? hthese hhave ha h30-50% hmortality hrate hw/
h1st hbleed hand h70% hrecurrence hrate hw/i h1st hyr! h- hANS-1. h2 hlarge hbore hIV hlines,
hIVF, h+/- hblood htransfusion
2. h*endoscopic hligation* his htx hof hchoice
3. hpharmacologic hvasoconstrictors- h*octreotide* h1st hline h(somatostatin hanalog),
hvasopressin
4. hballoon htamponade
