EOR exam questions (Kaplan notes + others) Flashcards
1
Q
What electrolyte must you check preoperatively if a patient is on hemodyalsis?
A
K+
2
Q
What 2 lab test must all childbearing women have prior to surgery
A
Preganancy test and CBC
3
Q
If the patient is taking insulin should they take it on the day of surgery?
A
No, only half of daily dose and start on D5NS
4
Q
Charcot’s triad
A
Fever
Jaundice
RUQ abdominal pain
seen in cholangitis
5
Q
Where is turner’s sign seen?
A
On the side
6
Q
Where is Virchow’s node? Which cancer?
A
metastatic tumor to the left supraclavicular node
seen in gastric cancer
7
Q
What is Boerhavve’s syndrome?
A
esophageal perforation
8
Q
What is Budd-Chiari syndrome?
A
Thrombosis of the hepatic vein
9
Q
What is cushing’s syndrome
A
Excessive cortisol production
10
Q
What is Mirizzi’s syndrome
A
Extrinsic obstruction of the common hepatic duct from a gallstone in the gallbladder or cystic duct
11
Q
What is RED reaction syndrome
A
Rapid vancomycin infusion resulting in skin erythema
12
Q
What is refeedng syndrome and what do electrolytes look like?
A
HypoK, HypoMg, HypoPhos
all 3 down
13
Q
For non-cardiac pt for surgery the ejection fraction must be
A
> 35%
14
Q
Which metabolic risk is an absolute CI for surg?
A
Diabetic coma
15
Q
MI patients should not have surgery for how long after MI?
A
6 months
16
Q
MCC of fever 1-3 days post up is
A
PNA (wind)
order a CXR
17
Q
Incentive spirometry prevents what
A
Atelectasis
NOT PNA
18
Q
What do you order for CAUTI
A
1 = remove foley
then UA and culture
19
Q
How do you treat CAUTI?
A
Cipro
think cyprus
20
Q
MCC of fever on day five
A
DVT
21
Q
Which score do you use for DVT
A
Wells score
22
Q
When do you order an US for DVT?
A
Wells score of 3 or more
high risk
23
Q
MCC of day 7 fever
A
wound infection
24
Q
Post-op day 10 fever
A
deep wound infection/abscess
25
What should you order post op fever day 10 and treatment
CT abd/pelvis with abd surgery
## Footnote
I&D followed by IV Cipro + Metro
26
Malignant hyperthermia is
seen after 30-45 min of an anesthetic with temp over 104
27
MCC of post-op fever day 1
Atelectasis
## Footnote
1-3 days is PNA, so think of atelectasis progressing to PNA
28
All patients with dyspepsia should be tested for
H pylori
29
MCC of non-GI n/v
otitis media
30
What lvl of bilirubin will cause jaundice
> 3
## Footnote
bil is a 3 letter word
31
MCC of recurrent jaundice
Gilbert syndrome
## Footnote
Poor gil gets so many episodes of jaundice
32
Gilbert syndrome deals with which bilirubin
Unconjugated bilirubin
33
Painless jaundice with weight loss is likely
Pancreatic CA
## Footnote
get a CT of abd
34
MCC of upper GI bleed
PUD
35
Hx of cirrhosis and portal HTN
Esophageal varices
36
MCC of PUD
H Pylori
37
SE of pepto-bismol
Dark colored tongue and stools
38
Norovirus is MCC of what?
Gastroenteritis
39
MCC of diarrhea in children
Rotavirus
## Footnote
vaccinate
40
Which bug can cause diarrhea after fried rice
B cerus
41
MCC of traveler's diarrhea
E coli
42
s/s of e coli
watery diarrhea, cramps, vomiting
43
Med that is the MCC of C dif
Clinda
44
Campylobacter enteritis is contracted from what?
Poultry (turkey)
## Footnote
at the camp they eat a lot of turkey
45
Ecchymosis of the inguinal ligament
Fox sign
## Footnote
seen in pancreatitis
46
What extraintestinal manifestation is seen more commonly in Crohn's disease then UC?
Erythema nodosum
47
Multiple polyps, sebaceous cysts, benign soft tissue tumors, desmoid tumors
Gardner syndrome
48
RF for hepatic adenoma
Woman
Anabolic steroids
OCPs
49
RF for sigmoid volvulus
elderly
instituionalized
chronic constipation w/ laxative use
50
Is smoking protective for UC or crohn's?
UC
51
Arthritis of the 2nd and 3rd MCPs, hips, and knees.
Hemochromatosis
## Footnote
joint pain of the fingers is a red flag for this disease!
52
Describe specifically the pain associated with diverticulitis
| refered pain?
## Footnote
characteristic of pain?
Steady ache in the LLQ with referal to the back
53
What does a porcelain gallbladder increase your risk of?
gallbladder cancer
54
MCC of bacterial diarrhea in the US
campylobacter
| According to Kaplan
## Footnote
remember, associated with poultry (turkey)
on thanksgiving?
55
Common cause of painless colonic bleeding in the elderly
Arteriovenous malformation (AV malformation)
## Footnote
communication between an arteriole and venule in the cecum, resulting in a bleed
56
Palpable Blumer shelf, left supraclavicular node, and periumbilical mass are associated with _____.
Gastric cancer
57
MC type of kidney vs gallbladder stone
kidney = calcium oxalate
gallbladder = cholestrol
58
# *
t/f biliary colic is RUQ pain that comes and goes
FALSE
## Footnote
constant NOT intermittent (according to Kaplan, but Idk if this is true)
59
Your patient has pruritis, fatigue, and hypothyroidism. What serum lab value will likely be elevated and why?
| also has enlarged liver and xanthomas and high cholestrol
antimitochondrial antibodies
| associated with primary biliary cirrhosis and hashimoto thyroiditis
60
Your patient has peritonitis and is on CAPD, what is the first-line management of this
Rocephin + Vanc
## Footnote
wanna cover for Staph and Epidermidis
61
Your patient has s/s of biliary colic and US shows no stones. HIDA and IV cholecysokinin don't show contractability of the gallbladder. What is the likely diagnosis?
Biliary dyskinesia
## Footnote
decreased ejection fraction with cholecystokinin challenge
62
What test for H pylori is useful for showing exposure but NOT as a test for cure to demonstrate eradication of the organism?
Serology testing
63
What SINGLE antibiotic regimen can be used for acute diverticulitis?
Augmentin
64
What happens to PT time with long standing cirrhosis?
Prolongs
65
Chronic alcoholic with dementia, paralysis of lateral gaze, and difficulty walking is likely to have deficiency in what?
Thiamine
| B1
## Footnote
remember, 1 brain
66
Which ulcer type is more commonly associated with malginancy - duodenal or gastric?
Gastric
## Footnote
less common luckily
67
If you are exposed to some1 with Hep A, what should be done?
Get Hep A IG w/in 2 weeks of exposure
68
MC early sign of colorectal cancer
chang in bowel habits
69
carcinoid syndrome is associated with what neurotransmitter?
serotonin
70
What can be used to prevent travelers diarrhea? Treat it?
Pepto to prevent
Cipro to treat
71
You have a child with bloody diarrhea and greenish NG aspiration. Workup for anal pathology is unremarkable. What is the next step in management and why?
Radioactively labeled technetium scan, as this is a likley cause of bleed in this patient pop.
72
What often precipitates hepatic encephalopathy in the setting of liver failure?
GI bleeding
73
First manifestation of Hep A
Shedding of fecal HAV
| even b4 development of IgM anti-HAV
## Footnote
fecal-oral, remember?
74
What is a worrying complication of Acute Pancreatitis d/t circulating phospholipase?
ARDS
| because phospholipase can attack aveoli
## Footnote
adult respiratory distress syndrome
75
Treatment of Wilson disease
D-penicillamine
76
What is the pattern of crohn's disease?
Cobblestone, transmural
77
t/f diuretics can be used to prevent hepatic encephalopathy
false
78
What marker is positive in the setting of UC
P-ANCA
79
Patient with down syndrome, bilious vomitting, and gas-filled stomach with abscence of gas in distal bowel likely has
Duodenal atresia
## Footnote
this is the double bouble sign
80
Where is the pyloris?
## Footnote
helpful for knowing the pahotphys of pyloric stenosis
the lower part of the stomach that connects to the small intestine
| this is why there is projectile vomitting - it can get to the stomach
81
MC benign lesion of the breast in young women
fibroadenoma
82
are fibroadenomas tender?
No
83
First line management of acute lmb ischemia
revascularization
84
# 1.
Gold standard to determine if a peripheral lung lesion is malginant or infectious
Open lung biopsy
85
First line medication for disease flares of crohn's disease
prednisone
86
What are the BP findings of type A vs B acute aortic dissections
Type A = hypotension
Type B = hypertension
87
Initial management of Type B acute aortic dissection
BB
88
what lab value is elevated with carcinoid tumors?
5-hydroxyindoleacetic acid?
89
First-line treatment of perianal abscess
I&D
90
Apart from MONA, what is given prior to percutatenous coronary intervention?
Ticagrelor
91
Best way to establish dx of Zenker's
Barium swallow
92
MC benign cause of large bowel obstruction
volvulus
## Footnote
CRC is MCC overall, but is not benign
93
Treatment of AAA that is > 5.5 cm
endovascular stent-graft placement
94
you see an ulcer near the medial malleuolus - what should you think?
venous ulcer
## Footnote
treatment = compression therapy
95
first line treatment of PAD?
statin therapy
cilostazol (increases walking distance)
96
anti-coag treatment of DVT if there is active malignancy
Monotherapy with LMWH
97
What is ogilvie syndrome
Radiographic evidence and signs of LBO with no sign of mechanical obsctruction
98
Indications for dialysis
AEIOU
## Footnote
acidosis
elocrolytes: hyperK
ingestions
overload (volume)
uremia
99
what compartment pressure requires emergent fasciotomy?
30+
## Footnote
normal = 0-4
concerning = 15-20
hourly monitoring = 20-30
100
What meds are given for a pheo?
Alpha blockades
CCB
## Footnote
phenoxybenzamine = alpha blocker
101
when should you get a toe brachial index?
ABI > 1.4
## Footnote
indicates noncompressible arteries d/t vascular calcification
102
What is boerhaave syndrome?
Sponatenous perforation of the esophagus after increased intraesophageal pressure with negative intrathoracic pressure
## Footnote
most commonly effects the left posterolateral aspect of the distal intrathoracic esophagus
103
what is a HIDA scan aka?
Cholescintigraphy
## Footnote
Gs for acute cholecystitis
104
parkland formula for fluid correction
4 x bw in kg x % BSA = total mL given
## Footnote
1/2 given in first 8 hours
1/2 given in the last 16 hours
105
MC clinical presentation of primary hyperPTH
asymptomatic hyperCa caught on routine screening
106
T/f metformin can be taken the day of surgery
FALSE
## Footnote
stop a day b4 and mng with insulin as needed
107
T/f thyroid meds can be taken the day of surgery
True
108
T/f cardio meds can be taken the day of surgery
true
109
classic triad of renal cell carcinoma
flank pain
palpable abd mass
hematuria
110
first line management of post-op inability to void
in-and-out cath
111
first-line management of drug induced exanthem
topical triamcinolone and hydroxyzine
## Footnote
prednisone only if severe
112
MCC of hematochezia in an infant and other symmptoms of this
Intussception (ballooning)
## Footnote
crying and drawing up legs to the abd
113
treatment of intussception
pneumatic dilation
114
What is a RF of SCC that are not RF of adeno of esophagus?
Eth
115
What is a RF of adeno that are not RF of SCC of esophagus?
GERD
116
What arrises from the superior hemorrhoidal cushion?
Internal hemorrhoids
117
when is total parental nutrition indicated
If the gut is not functional
## Footnote
Use mouth in all patients if you can!
118
definitive treatment of chronic pancreatitis
Address underlying cause is the only treatment
119
a plt count < ____ is an indication for plt transfusion if undergoing surgery
50k
120
a plt count < ____ is an indication for plt transfusion if there is CNS or ocular bleeding
100k
121
a plt count < ____ is an indication for plt transfusion in NON-bleeding patients
10k
122
MC urologic CA
bladder CA
123
what specifically is seen on CT non-contrast for SHD
concave, cresent-shape **hypodensity**
124
when do you use autolytic vs sharp debridement for pressure ulcers?
Autolytic = stage 1-2
Debridement = 3 (with necrosis)+
125
MC stone of primary choledocholithiasis
brown/pigmented
126
Imaging of choice for hernia
CT w/ IV + oral contrast
127
When do you feel pain with duodenal ulcers?
2-5 hours after eating a meal
128
Biggest complication of ERCP
acute pancreatitis
129
where do you feel pain with hemolytic anemia?
back
130
what abx can lead to flares of G6PD?
Bactrim
## Footnote
Sulfonamides
131
what gene is affected with sickle cell anemia? Alpha or beta globulin?
Beta globulin
132
what breast disease goes away after menopause?
fibroadenomas
133
what breast disease is associated with nipple discharge prior to menstruation?
fibrocystic disease
## Footnote
seen prior to menopause
134
what is paget's disease aka
infiltrating ductal carcinoma
## Footnote
not to be confused with infiltrating intraductal or infiltrating lobular
135
Over this age, a colonoscopy screening is a grade C (instead of A)
75+
136
What are the two types of 2nd degree burn?
Superfiscial partial
Deep partial
137
What differs a deep partial from a superfiscial partial burn?
Deep partial = only pain with pressure, blisters are easily unroofed and are wet/waxy
138
deep punch out appearance is seen in
arterial ulcers of PAD
139
Thiamine deficiency in a chronic alcoholic can lead to
Wernicke syndrome
140
1st line and 2nd line option for stopping esophageal variceal heomrrhage
1st line = band ligation
2nd line = balloon tamponade (as long as within 24 hours)
141
t/f mucous is found in the stool for UC
true
142
outpatient management of diverticulitis
Tylenol and a liquid diet
143
What is Barrett esophagus at the cellular level?
columnar metaplasia of the squamous epithelium
144
What is propofol?
A sedative-hypnotic for sedation and anesthesia
145
MCC of bloody discharge from the nipple
Intraductal papilloma
146
Muscular hypertrophy leading to pain/swelling to the UE, and cyanosis of the fingers
UE DVT
147
indications for US/ Mammogram for breast pain
20-50
Women under 30 years of age should have an ultrasound of the breast completed. Women between the ages of 30 and 39 years old should have an ultrasound and a focused or bilateral mammogram. Women over 40 years of age should have both a bilateral mammogram and an ultrasound.
148
Pyloric stenosis US classic finding buzzword
Target sign of the RUQ
149
# ```
```
basal cell hyperplasia + increased type III collagen + dysphagia
esophageal stricture
150
MC type of thyroid cancer and RF
Papillary
| head/neck radiation exposure
151
What is medullary thyroid CA associated with?
MEN2
| BUZZ WORDS
## Footnote
pheochromocytoma + hyperPARAthyroid
152
best location for a vena cava filter for DVT
At the inflow of the renal veins
153
Orchiopexy procedure
surgical procedure that moves an undescended testicle into the scrotum. It's also sometimes used to treat testicular torsion.
154
which side of the colon is more likely to dvlp cancer?
left
155
t/f change of bowel habits is the MC finding of right-sided CRC
FALSE
## Footnote
melena is
156
MCC of childhood malginancy of the abd
Wilm's tumor
## Footnote
abd pain + palpable mass to the right of hte abd
157
Hamman sign
mediastinal crunching sound that correlates with diastole of the heart, indicating esophageal perforation.
158
most appropriate IV fluid for a preop patient who is NPO
LR
159
treatment of sigmoid volvulus
sigmoidoscopy for detorsion
160
where do you do Moh's surgery for BCC?
| what size if not in this area?
H zone
| also if > 2 cm
## Footnote
areas around the eyes, lateral cheeks, ears, nose, and mouth
161
surgeries with high cardiac risk
open chole
open ventral hernia repair
whipple procedure
162
McGinn-White sign
S1Q3T3 pattern on ECG associated with pulmonary embolism.
163
t/f umbilical hernias are MC in females
true
164
preferred initial intervention of SBO
NG decompression
## Footnote
then adhesion removal
165
What does hypothyroidism do to BP?
Diastolic HTN
166
when might you use TPA for a PE
if hemodynamically unstable
167
MCC of painless urinary bleed?
Bladder cancer
168
biggest RF for bladder CA
smoking
169
triad of mesenteric ischemia
abdominal pain, fever, and heme-positive stool. T
## Footnote
ypically, patients will have forceful evacuation of bloody stool.
170
RF of mesenteric ischemia
fluid resuscitation, thrombolytic therapy, fibrinolytic intervention, or surgical resection of necrotic bowel.
171
Common RF of anal fistulas
Crohn's disease
172
Color of hematochezia other than bright red
maroon
173
Go to imaging for aortic dissection stable
CTA
MRA
174
Go to imaging for aortic dissection unstable
TEE (preferred)
TTE
175
MCC of hematochezia in pt > 60
diverticulosis
176
what specific US is first line for cholylithiasis
transabdominal US
177
triad of cardiac tamponade is known as
Beck triad
178
Beck triad
hypotension
JVD
Muffled heart sounds
## Footnote
pericardiocentesis!!!
179
when is a biopsy urease test not the test of choice for PUD?
If the patient has active bleeding or recent PPI or antibiotic use, then the most appropriate study would be a stool antigen test or breath urease test.
## Footnote
Biopsy urease testing during endoscopy will yield falsely negative results when there is bleeding.
180
age of colonic volvulus
younger patients
181
what thyroid condition can find-needle aspiration NOT dx
Follicular CA
182
when do you do a FNA vs Radinucleotide thryoid scan after a 2 cm thyroid mass?
**TSH normal or elevated** = fine needle
**TSH subnormal** = Radinucleotide thryoid scan
183
shave biopsy of BCC
multifocal nests of basophilic staining cells with peripheral palisading nuclei
184
treatment of low vs high risk patient for acute cholangitis
low = MR
high = pip/taz
185
INITIAL intervention of cholystitis
IV fluids
186
TOC of aneurysmal SAH
Nimodipine
187
what condition is known for gastrinomas?
ZES
## Footnote
get a fasting gastin test!
188
Chagas disease often leads to this GI condition
achlasia
189
Treatment of necrotic arerial ulcer 2ndary to PAD
surgical debridement
190
Between this range, an US should be completed every 6 months for AAA
5-5.4 cm
191
how often should a 4.0 to 4.9 centimeter AAA be evaluated?
12 months
192
how often should a 3 to 3.9 centimeter AAA be evaluated?
3 years
193
what cancer is crohn's associated with?
adenocarcinoma
## Footnote
leading to SBO
194
what echo is first line for new murmur
transTHORACIC echo
NOT
transESOPHAGEAL echo
## Footnote
Transesophageal echocardiogram is recommended if transthoracic echocardiogram is insufficient. While its diagnostic accuracy is higher compared with transthoracic echocardiography, it requires sedation.
195
treatment for complicated diverticulitis with pericolonic abscess
## Footnote
in addition to bowel rest and IV antibiotics
percutaneous drainage
196
Type of surgery rec for appendicitis
laproscopic
197
What plexus are external hemmorids associated with
internal hemorrhoidal plexus
198
If you wanna get a CTA instead of a colonscopy, how often do you need to get it done for screening?
every 5 years
199
If you wanna get a Fecal immunochemical test and DNA methylation instead of a colonscopy, how often do you need to get it done for screening?
every 10 years
200
first thing to give to correct hyperK
Calcium gluconate or chloride to maintain the cardiac membrane
201
presentation of hepatic enchpalopathy
confusion
scleral icterus
bloody nose
liver tox
202
treatment of hepatic encephalopathy
lactulose + rifaximin
203
what cancer is Epstein-Barr virus associated with?
CML
204
Increased fibrin degradation products + schistocytes and decreased Plts
with AMS and bleeding
DIC
205
1st line prophylaxis of esophageal varices
BBs
206
Posterior cerebral artery infarct symptoms
homonymous hemianopia
memory deficits
Preservations
Visual defects
207
treatment of idiopathic intracranial HTN **without** HA
Acetazolamide
208
treatment of idiopathic intracranial HTN **with** HA
topiramate
209
does a cold nodule uptake iodine?
No
210
Preop plan to lower risk of complications of an ET tube in a pt with asthma
Administering an inhaled rapid-acting beta-agonist before surgery
211
Prevention of cholithiasis in patients with rapid weight loss
Ursodeoxycholic acid is a bile salt that is used to prevent gallstone formation in patients with rapid weight los
212
Presentation of chronic mesenteric ischemia
postprandial pain
fear of eating
weight loss
| get a CTA and can do surgery or angioplasty
213
what location is pilondidal disease?
Pilonidal disease is a chronic glandular inflammation due to blocked hair follicles that occurs along the superior and inferior gluteal cleft
214
what thickness of margins are concerning for gastric CA
**thickened**
215
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preferred location for long-term hemodialysis
**UE** AV fistula
216
what are crypt abscesses seen in?
UC
217
best way to dx strangulated groin hernia
clinically
218
protein measurement that best assesses short-term nutritional status
prealbumin
219
preferred method of breast biopsy
core-needle biopsy
220
first line treatment of esophageal spasm
start with CCB alone
221
when do you do a carotid endarterectomy
70-99% stenosis and symptomatic
222
Treatment of symptomatic carotid artery disease < 50% stenosis
ASA and clopidogrel
## Footnote
DAPT
223
what surgery do you use to remove an adrenocortical carcinoma?
complete surgical resection
224
worry of surgical correction of anal fissure
irreversible fecal incontinence
225
t/f the wound of a stage 1 ulcer extends into the skin
FALSE
it would be stage 2 then
226
