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Absite killer Exam With Complete Solutions 100% Correct
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Absite killer Exam With Complete Solutions100% Correct
What is the treatment for a meconium ileus? - ANSWER Gastrograffin enema -
diagnostic and therapeutic
What is the presentation of necrotizing enterocolitis in a newborn? - ANSWER After
initiating feeds in a neonate (premie) in the 2nd or 3rd week of life with blood in the stool
OR free air/peritonitis/acidosis Classic triad: abd dist, bloody stools, pneumatosis
What is the treatment for imperforate anus? - ANSWER If low - anoplasty If
high-meconium in urine, fistula to bladder, vagina or urethra-need colostomy
What are the characteristics of gastroschisis? - ANSWER Congenital abd wall defect,
intrauterine rupture of umbilical cord, no associated defects, lateral-right-defect, no sac
What are the characteristics of omphalocele? -ANSWER midline defect, may contain
liver or other non-bowel contents, frequent anomalies, has peritoneal sac.
What is responsible for converting norepinephrine into epinephrine? -ANSWER PNMT
-Phenylethanolamine N-methyltransferase
What is common to a pheochromocytoma? -ANSWER 10% are: malignant, bilateral, in
children, part of MEN, extra-adrenal
At what site can the most common extra-adrenal pheochromocytoma be found?
-ANSWER Organ of Zuckerkandl at aortic bifurcation
What is the preoperative management for a pheochromocytoma? -ANSWER
,alpha-blockers first, then beta-blockers if tachycardic
How is the diagnosis of pheochromocytoma made? -ANSWER screen with urine
metanephrines, VMA; MIBG can localize
What is Nelson's syndrome? -ANSWER rapid enlargement of a pituitary adenoma that
occurs after bilateral adrenalectomy (10%) -incr ACTH, muscle weakness, pigmentation,
vision changes
What is Waterhouse Friderichsen syndrome? -ANSWER adrenal hemorrhage a/w
meningococcal sepsis
Conn's syndrome is? - ANSWER hyperaldosteronism = 80% adenoma, 20% bilateral
hyperplasia - HTN, low K, high Na
Addison's disease is? - ANSWER low aldosterone and glucocorticoids = low Na, high K,
hypoglycemia. Crisis presents similar to sepsis w/hypoTN, fever; steroids are diagnostic
and therapeutic
Most common cause of congenital adrenal hyperplasia? - ANSWER 21-hydroxylase
deficiency
What is Cushing's disease? - ANSWER Excessive secretion of ACTH from the anterior
pituitary, usually from a pituitary adenoma. Causes 70% of non-iatrogenic Cushing's
syndrome.
What is the most common cause of Cushing syndrome? - ANSWER iatrogenic
What is Cushing's syndrome? - ANSWER hormone disorder with high levels of cortisol -
symptoms include characteristic weight gain (truncal obesity, moon face, buffalo
hump), purple striae, hirsutism, polyuria, htn, insulin intolerance
,Which of the following is a way you determine what kind of Cushing syndrome you have?
-ANSWER Dexamethasone suppresion test: Pituitary - high ACTH, cortisol suppressed
with steroids Adrenal - low ACTH, not suppressed Ectopic - high ACTH, not suppressed
Which hormones does the anterior pituitary secrete? -ANSWER GH, ACTH, TSH, LH,
FSH, Prolactin
Which hormones does the posterior pituitary secrete? -ANSWER ADH, Oxytocin
What is the classic vision change with pituitary mass effect? - ANSWER Bitemporal
hemianopsia - vision missing in outer half of both right and left visual fields
What is the #1 pituitary adenoma? What are the symptoms? - ANSWER Prolactinoma -
galactorrhea, irregular menses
What is Sheehan syndrome? - ANSWER postpartum lack of lactation and persistent
amenorrhea caused by necrosis of pituitary from blood loss during/after childbirth
What is the treatment for a prolactinoma? - ANWER Bromocriptine or transphenoidal
resection
What is the pathophysiology of hidradenitis? - ANSWER involves apocrine glands, thus
seen after puberty
What are the three steps to the healing of a skin graft? - ANSWER Imbibition,
inosculation, revascularization
What is the most common cause of flap necrosis? - ANSWER venous thrombosis
What is the malignancy that characteristically demonstrates "peripheral palisading" of
nuclei and "retraction artifact" - ANSWER Basal cell carcinoma
, Where are the classic locations for melanoma? - ANSWER Skin > eyes > rectum #1 skin
site for men = back, women = legs Worse prognosis on "BANS" - back arms, neck, scalp
What kind of scar extends beyond borders: keloid or hypertrophic? - ANSWER keloid
In what way does keloid scar occur? -ANSWER failure of breakdown of collagen and
increased production of collagen
Name four major types of melanoma. -ANSWER superficial spreading, most common,
nodular, lentigo maligna, acral lentiginous
What is Breslow classification of melanoma? -ANSWER <0.75 mm, 90% cure,
0.75-1.5mm, 1.5-4mm, >4mm, 80% distant mets
What type of melanoma has the best prognosis? the worst? - ANSWER best = lentigo
maligna; worst = nodular
What are the suggested surgical margins for resection of a melanoma? - ANSWER in situ
= 0.5-1 cm margin <1mm depth = 1 cm margin 1-2mm depth = 1-2 cm margin (w/ SNL)
>2mm depth = 2 cm margin
What is MALT a precursor to? - ANS gastric lymphoma - regresses with H. pylori
treatment
What are the types of gastric ulcers? - ANS Type I - lesser curve/body Type II - 2 ulcers
(lesser curve and duodenum) Type III - prepyloric (w/i 3 cm) Type IV - high lesser
curve/proximal Type V - anywhere a/w NSAIDS
What is the correlation between blood type and gastric ulcers? - ANSWER Type I = blood
type A; Others = type O
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