GenSurgQuestions

Question 1

AAA is atleasts what measurement

Answer 1

> 3cm

Question 2

Most AAA are in what location

Answer 2

infrarenal

Question 3

What is used to dx AAA and what is used to characterize and measure

Answer 3

US for dx, then CT

Question 4

Who gets screenings for AAA

Answer 4

men 65-75 hx smoking

Question 5

When is surgical repair indicated for AAA

Answer 5

5cm or larger

Question 6

Ascending thoracic AA usually dt

Answer 6

elastin degradation

Question 7

Descending thoracic AA usually dt

Answer 7

atherosclerosis

Question 8

Arch aneurysm seen in

Answer 8

trauma or deceleration injuries

Question 9

What is the TOC to characterize thoracic AA

Answer 9

MRI or CT, often discovered on CXR

Question 10

Surgical repair indicated for thoracic AA that are

Answer 10

6cm, rapid expansion, of symptomatic

Question 11

AAA or thoracic AA- which is more likely to sponatenous rupture?

Answer 11

AAA

Question 12

Varicose veins usually occur where

Answer 12

in the saphenous vein

Question 13

Aortic dissection usually occurs

Answer 13

in ascending aorta

Question 14

Typical pt for aortic dissection

Answer 14

men 60-70, HTN or connective tissue disorders

Question 15

Majority aortic dissections are what type

Answer 15

Proximal (Stnadord A), DeBakey I

Question 16

ripping retrosternal back pain, pulse discrepancies, HTN w/o

Answer 16

CXR, CT or TEE

Question 17

What kinds of aortic dissections must receive surgcal repair?

Answer 17

Stanford type A/Proximal

Question 18

DVT management

Answer 18

Anticoag with heparin, LMWH, or fondaparinux
some cases lytics or thrombectomy
3m anticoagulation, consider IVC filter if not a good candidate

Question 19

What lung cancer is NOT associated with smoking

Answer 19

Adenocarcinoma

Question 20

MC type of thyroid CA

Answer 20

papillary adenocarcinoma

Question 21

Bariatric sx limited to pts with BMI

Answer 21

> 40 or >35 if complications are present

Question 22

opacification of the eye lens is called

Answer 22

cataract

Question 23

gallstone that has traveled to the common bile duct

Answer 23

cholecocholithiasis

Question 24

fever, RUQ pain, jaundice

Answer 24

Charcot’s triad- ascending cholangitis

Question 25

fever, RUQ pain, jaundice, confusion, HoTN

Answer 25

Reynold's pentad- ascending cholangitis

Question 26

Tx for ascending cholangitis

Answer 26

Zosyn or Cef + Flagyl | biliar drainage via ERCP

Question 27

Toxic megacolon is a dilation of greater than

Answer 27

6cm

Question 28

MC hernia is

Answer 28

indirect inguinal

Question 29

what esophageal neoplasm is associated with Barrett's esophagus

Answer 29

Adenocarcinoma

Question 30

What esophageal neoplasm is associated with alcohol and tobacco use

Answer 30

Squamous cell carcinoma

Question 31

Benign tumors of the esophagus include

Answer 31

Leiomyoma Adenoma Esophageal papilloma (can transform to SCC)

Question 32

small bowel neoplasms usally located in

Answer 32

the ileum

Question 33

MC primary colorectal CA

Answer 33

Adenocarcinoma

Question 34

MC benign liver tumor

Answer 34

hemangioma

Question 35

what benign liver tumor is associated with long term estrogen use

Answer 35

Hepatic adenoma

Question 36

hepatocellular carcinoma usually occurs with

Answer 36

chornic liver diseas or cirrhosis

Question 37

Who/how gets screened for liver CA

Answer 37

High risk pts (chronic liver dis, cirrhosis) screened q6m via US

Question 38

What lab value rises in malignant hepatocellualr carcinoma

Answer 38

AFP

Question 39

extraintestinal manifestations of inflammatory bowel disease

Answer 39

Uveitis, erythema nodosum, pyoderma, liver, joints

Question 40

Who should get screenings for Barrett's esophagus

Answer 40

EGD for aduts 50 with 5-10 yr hx GERD, and EGD q3y for pts with known Barret

Question 41

MC breast CA

Answer 41

Invasive ductal carcinoma

Question 42

MC skin CA

Answer 42

Basal Cell Carcinoma

Question 43

MC renal CA

Answer 43

renal cell carcinoma

Question 44

Courvoisier's Sign

Answer 44

palpable gallbladder due to compression of bile duct | dt tumors of biliary tree or pancreatic head tumors

Question 45

BMI to dx obesity

Answer 45

>30 kg/m2

Question 46

BMI to dx morbid obesity

Answer 46

>40 kg/m2

Question 47

BMI to dx overwt

Answer 47

25.0-29.9

Question 48

Normal BMI

Answer 48

18.5-24.9

Question 49

What type of closure is best for pilondial cysts

Answer 49

delayed closure has lower likelihood of recurrence

Question 50

work up for post menopausal bleeding

Answer 50

To r/o endometrial neoplasm transvag US assess endometrial stripe, >5mm warrants bx Bx

Question 51

Colorectal Sx recommended abx

Answer 51

cefoxitin | preop neomycin + erythromycin

Question 52

Cardiac sx recommended abx

Answer 52

Cefazolin

Question 53

GU sx recommended abx

Answer 53

Cefazolin

Question 54

Non perforated appendectomy recommended abx

Answer 54

cefoxitin + metronidazole

Question 55

Things that keep fistulas open

Answer 55

``` Fb Radiation Inflamm (Chrons)/ Infec Epithelization Neoplasm Distal obstruction Sepsis ```

Question 56

What are the indications for dialysis?

Answer 56

(AEIOU) | Acidosis, electrolytes, ingestions, overload, uremia

Question 57

Causes of AG metabolic acidosis

Answer 57

``` Methanol Uremia DKA, AKA, SKA Paraldehyde INH Lactic acidosis Ethanol Salicylates ```

Question 58

MCC SBO in virgin belly

Answer 58

indirect inguinal hernia

Question 59

Tx of hyperkalemia

Answer 59

``` CBIGK- die calcium gluconate bicarb insulin and glucose kayexalate ``` dialysis

Question 60

ACUTE tx of AMS

Answer 60

``` DONT dextrose oxygen naloxone thiamine ```

Question 61

rule of 10s for pheochromocytoma

Answer 61

10% bilat 10% malignant 10% extra-adrenal

Question 62

Fever on POD 2 consider

Answer 62

atelectasis, pna

Question 63

peripheral smear showing microangiopathy hemolytic anemia

Answer 63

DIC

Question 64

Abx for breast abscess

Answer 64

dicloxacillin, cephalexin, or clindamycin

Question 65

Solid rubbery round movable breast mass

Answer 65

Likely fibroadenoma US to determine if solid -needle bx/monitor and regular exms increased risk breast CA

Question 66

phyllodes tumor tx

Answer 66

Require excision | if malignant wider margins/mastectomy

Question 67

Where do phyllodes tumors mets to?

Answer 67

Lungs NOT LN

Question 68

tx mastitis in breast feeding mother

Answer 68

Augmentin or cephalexin, dicloxacillin MRSA- clindamycin or cipro

Question 69

2 MCC nipple discharge | w/o

Answer 69

intraductal papilloma mammary duct ectasia w/o- diagnostic mammogram is first step

Question 70

mammography screenings MUST start at what age

Answer 70

50 q1yr till 65 | then q2yr till 75

Question 71

What does a BIRADS score of 0 mean?

Answer 71

insufficient exam, may need repeat or additional views

Question 72

What does a BIRADS score of 3 mean?

Answer 72

most likely nl-2% chance CA

Question 73

What does a BIRADS score of 6 mean?

Answer 73

known CA, already confirmed by pathologist

Question 74

ER+ therapies include

Answer 74

a SERM- Tamoxifen | an aromatase inhibitor- not in premenopausal