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Boards Study - everything > general surgery > Flashcards

general surgery Flashcards

1
Q

what comprises the border of hesselbach’s triangle (hernia)?

A

inguinal ligament
inferior epigastric vessels
border of rectus femoris muscles

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2
Q

what is a richter hernia?

A

only partial circumference of bowel is incarcerated or strangulated; the gangrenous piece may spontaneously reduce and perforate inside of the abdomen

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3
Q

what is the most common cause of small bowel obstruction?

A

post-operative adhesions

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4
Q

What is the most common cause of large bowel obstruction?

A

tumor (cancer)

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5
Q

patient has a large bowel obstruction that requires surgical correction. You need to start them on empiric antibiotics. Which do you choose?

A

Tazobactam/piperacillin (Zosyn)

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6
Q

You see an abdominal XRAY showing multiple air-fluid levels and a “coiled spring” sign. What is the dx

A

small bowel obstruction

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7
Q

what is charcot’s triad?

A

cholangitis:

fever, jaundice, biliary colic

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8
Q

an appendix with a diameter > ___ mm is indicative of appendicitis?

A

> 6 mm

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9
Q

you are working up a patient for biliary colic; US is not able to visualize sludge. What do you order next?

A

HIDA scan

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10
Q

What are the 2 types of esophageal cancer and where are they located

A

Squamous - proximal 2/3 esophagus

Adenocarcinoma - distal 1/3 (barrets)

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11
Q

First line therapy for GERD

A

Lifestyle modifications

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12
Q

How do you diagnose ZES?

A

Secretin test >200 pg/mL

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13
Q

Which 2 lymph nodes may be indicative of gastric adenocarcinoma that has spread?

A

Supraclavicar (virchow node)

Umbilical (sister Mary Joseph node)

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14
Q

pancreatic beta cells secrete ______

A

insulin

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15
Q

what are the 3 digestive enzymes secreted by the pancreatic acinar cells?

A

Lipase - digests fats
Amylase: digests starch
Protease - digests proteins

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16
Q

what enzyme causes the gallbladder to relax?

A

glucagon

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17
Q

you perform US for suspected gallstones. Common bile duct diameter measures 6 mm. Is this considered dilated and concern for stone?

A

YES - anything >5 mm is indicative of obstruction.

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18
Q

what enzyme causes the gallbladder to contract?

A

cholecystokinin

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19
Q

what enzyme causes the gallbladder to relax?

A

glucagon

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20
Q

what labs will be markedly elevated in cholelithiasis?

A

AST
ALT
Total Bilirubin

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21
Q

what medication can you apply topically to the anus in a patient with anal fissure?

A

Topical Nifedipine

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22
Q

the liver actually has a dual blood supply that feeds it. What are the 2 vessels?

A 
Hepatic Artery (20%)
Portal Vein (80%)
23
Q

what labs will be markedly elevated in cholelithiasis?

A

AST
ALT
Total Bilirubin

24
Q

what medication can you apply topically to the anus in a patient with anal fissure?

A

Topical Nifedipine

25
Q

what antibiotic do you use to empirically treat bowel obstruction on admission?

A

piperacillin/tazobactam (Zosyn)

26
Q

what is Paget carcinoma

A

itchy dermatitis of the nipple with overlying ulceration, often associated with underlying ductal carcinoma

27
Q

what is the antibiotic regimen for diverticulitis?

A

metronidazole (Flagyl) + Fluoroquinolone (Cipro)

28
Q

at what levels of bilirubin do you start to see jaundice?

A

> 2

29
Q

this type of breast cancer is often confused with mastitis

A

inflammatory (entire breast is red, swollen) - the most malignant form

30
Q

what is the antibiotic regimen for diverticulitis?

A

metronidazole (Flagyl) + Fluoroquinolone (Cipro)

31
Q

at what levels of bilirubin do you start to see jaundice?

A

> 2

32
Q

this type of breast cancer is often confused with mastitis

A

inflammatory (entire breast is red, swollen) - the most malignant form

33
Q

what is the most common, least aggressive form of thyroid cancer?

A

papillary

34
Q

what is the most concerning and fastest growing thyroid cancer?

A

medullary

35
Q

what is the thickness needed on US for diagnosing pyloric stenosis?

A

> 4 mm

36
Q

what is the age range for pyloric stenosis?

A

2-6 weeks

37
Q

what is the antibiotic that most commonly causes CDIFF

A

CLINDAMYCIN
penicillins
cephalosporins

38
Q

can pregnant people have warfarin?

A

no - contraindicated

39
Q

what are the W’s of post-operative fever?

A 
Wind - atelectasis
water - uti
wound - infection
walking - DVT
wonder drug - drug induced fever
40
Q

in what type of cancer will you likely see sister mary node and virchows node?

A

gastric cancer

41
Q

most common cause of polycythemia (increased RBC?)

A

hypoxia

secondary to pulmonary disease (COPD)

42
Q

what is administered for quickest response in a person with hyperkalemia that is having peaked T waves?

A

Calcium gluconate (30 min onset)

43
Q

which antibiotics cover MRSA?

A

clindamycin
Bactrim
tetracyclines

44
Q

what is the management for ascending aortic dissection?

A

emergent open heart surgery

45
Q

what is the management of descending aortic dissection

A

BP control and monitoring

46
Q

patient with longstanding smoking history presents with painless jaundice, epigastric pain, and unintentional weight loss. What are you worried about?

A

Pancreatic cancer

47
Q

patient with resistant HTN is found to have an adrenal mass (primary adrenal insufficiency). Prior to adrenalectomy, which medications should be administered in preparation?

A

phenoxybenzamine (alpha blocker) for 10 days
propranolol (beta blocker) for 3 days

THEN surgery!

48
Q

what is indicative of a right-sided sausage shaped mass?

A

intussusception

49
Q

why do you not perform colonoscopy during acute diverticulitis?

A

risk of perforation is high! Get a CT w/ contrast

50
Q

which medication should be started prior to endarterectomy in a patient with carotid stenosis?

A

aspirin. Continue for 3 months following surgery

51
Q

what is the most common type of breast cancer?

A

ductal carcinoma

52
Q

what is the triad of pheochromocytoma?

A

headache
diaphoresis
tachycardia/HTN

53
Q

what is nitroprusside (Nitropress) used for?

A

acutely lowering symptomatic hypertensive crisis

Boards Study - everything (5 decks)

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