ABSITE Final Indispensable Study Assessment Guide Exam Questions with all Questions Accurately Answered Updated 2024/2025
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ABSITE
ABSITE Final Indispensable Study Assessment Guide Exam Questions with all Questions Accurately Answered Updated 2024/2025
How much weight loss following gastric sleeve? - correct answer 5-year weight loss is approximately 60% of excess body weight
Steps for gastric sleeve - correct answer
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ABSITE Final Indispensable Study
Assessment Guide Exam Questions with all
Questions Accurately Answered Updated
2024/2025
How much weight loss following gastric sleeve? - correct
answer 5-year weight loss is approximately 60% of excess body
weight
Steps for gastric sleeve - correct answer
The essential steps for completion of sleeve gastrectomy include:
1. Devascularization of the greater curve of the stomach
2. Insertion of a bougie (34 French - 40 French) or endoscope to
size the gastric sleeve
3. Transection of the stomach starting at a location 2 cm to 6 cm
proximal to the pylorus
4. Specimen extraction.
Sleeve gastrectomy - correct answer During the operation for
sleeve gastrectomy, the greater curvature of the stomach is
completely devascularized prior to being resected.
Answer C: Blood supply to the gastric sleeve is received from the
left and right gastric arteries as well as branches from the right
gastroepiploic.
Answer D: The posterior stomach does not require extensive
dissection to mobilize in a patient who has not previously
,undergone a gastric procedure or had inflammation within the
are of the lesser sac.
Answer E: Larger staples (3.5mm) are needed to divide the
stomach due to its thickness. The antrum is typically the thickest
portion of the stomach so care must be taken when dividing this
area. Smaller staple heights may strangulate the closure and
increase risk for a leak.
Ureteral injuries - correct answer Injuries to the ureter can
be approached by dividing the ureter into thirds. Lower ureter
injuries are commonly managed with reimplantation of the
proximal ureter into the bladder. If the ureter has been ligated
without transection, repair can be attempted with primary
ureteroureterostomy over a stent.
Answer A: Foley catheter placement and observation is not
indicated due to morbidity from urinoma development.
Answer B: Proximal ureteral injuries are typically managed with
primary ureteroureterostomy. If there is significant ureteral loss,
a segment of ileum may be used for ureteral replacement.
Answer D: Autotransplantation is rarely performed for ureteral
injury and is not advisable in trauma situations secondary to
increased operative times.
,Answer E: Injuries to the midureter can be managed by primary
ureteroureterostomy or transureteroureterostomy. Distal
mobilization of the ureter provides additional length but it is
important to avoid devascularizing the ureter.
Bottom Line: Traumatic distal ureteral transaction is best
managed with reimplantation of the proximal ureter into the
bladder.
CBD stone - correct answer Glucagon causes sphincter of
Oddi relaxation and allows CBD stones to be flushed more easily.
Intravenous glucagon administration is the next step in stone
removal when flushing alone fails
CBD exploration - correct answer There are multiple different
extraction methods to allow for laparoscopic clearance of
common bile duct (CBD) stones which include basket extraction
using fluoroscopy, choledochoscopic basket extraction, and
laparoscopic choledochochotomy with balloon sweep extraction.
Laparoscopic choledochotomy is considered an advanced
laparoscopic technique and should only be attempted if one is
familiar with this technique. After this is completed, a T-tube
should be left in place in a similar manner to an open procedure.
Choledochoscopy is limited by the necessity for the cystic duct to
be dilated up to 8 mm. Basket extraction using fluoroscopy is a
skill that many surgeons are quite comfortable with given its
similarities to angiography. However, if a surgeon is not familiar
with these techniques and there are no other options available
(either surgically or radiographically) to extract the stone, then
converting to an open CBD exploration should be performed.
, Transcystic choledochotomy and stone retrieval usually entails
making a transverse incision about halfway of the diameter of
the cystic duct and inserting an endoscope to explore. In a pinch,
a ureteroscope can be used if a choledochoscope is unavailable.
Stone extraction - correct answer Transoral endoscopic
retrograde cholangiography (ERCP) is not recommended since
the patient's gastric pouch is a considerable distance from the
patient's duodenum due to her Roux-en-Y bypass. However, it is
possible to laparoscopically assist a successful ERCP by bringing
the remnant stomach to the abdominal wall and allowing access
by creating a gastrostomy. Percutaneous transhepatic
cholangiography (PTC) with stone extraction is possible. Stone
extraction through a previously placed T-tube remains the best
and easiest option in this patient. If all else fails, an open
common duct exploration is always a valid option.
Pancreatic enzymes - correct answer Some of the pancreatic
digestive enzymes are synthesized and secreted in their active
forms without the need for an activation step (e.g., amylase,
lipase, ribonuclease). Lipase does require colipase to function
properly.
Answers B & C & D: The endopeptidases, which include trypsin,
chymotrypsin, and elastase act on peptide bonds at the interior
of the protein molecule, producing peptides that are substrates
for the exopeptidases (carboxypeptidases), which serially remove
a single amino acid from the carboxyl end of the peptide.
Answer E: Most of the digestive enzymes are synthesized and
secreted by acinar cells as inactive proenzymes or zymogens
that, in health, are activated only after they reach the duodenum
where enterokinase activates trypsinogen and the trypsin
catalyses the activation of the other zymogens.
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