Surgery GI

Question 1

Best way to assess nutrition through enteral feeds

Answer 1

Albumin

Question 2

Tissue in meckels

Answer 2

Remnant of ophalomesenteric duct

Question 3

Omphalocele covered by

Answer 3

Peritoneum

Question 4

Umbilical Hernia covered by

Answer 4

Skin

Question 5

Gastroschisis covered by

Answer 5

Nothing

Question 6

Beckwith wiedeman

Answer 6

Macroglossia
Macrosomia
Omphalocele
Ear creases
Hypoglycemia

Question 7

What size umbilical hernia will spontaneously close

Question 8

When is surgery recommended for persistent hernias

Answer 8

Age 5

Question 9

What side of umbilicus does gastroschisis herniate

Answer 9

Right side

Question 10

Gastroschisis tx

Answer 10

Surgical emergency

Question 11

Umbilical granuloma

Answer 11

Soft moist pink pedunculated friable lesion after umbilical cord separation

Question 12

Umbilical granuloma tx

Answer 12

Silver nitrate

Question 13

How to assess deep abdominal spaces

Answer 13

Psoas sign

Question 14

Appendicitis time of rupture

Answer 14

after 5 days

Question 15

appendiceal abcess tx

Answer 15

stable = Abx, drain, rest, appendectomy after 6 weeks
unstable = urgent appendectomy

Question 16

appendiceal adenocarcinoma tx

Answer 16

R. Hemicolectomy

Question 17

tongue cancer what nodes

Answer 17

submandibular or cervical

Question 18

tongue cancer what nerves

Answer 18

hypoglossal nerve/ 
lingual nerve(mandibular branch of trigeminal)

Question 19

Gallstone ileus

Answer 19

is caused by erosion of a stone from the gallbladder into the GI tract (most commonly the duodenum)

Question 20

Gallstone Ileus tx

Answer 20

ileotomy for stone extraction followed by an interval cholecystectomy is often a safer alternative. Interval means do it later.

Question 21

succussion splash

Answer 21

retained gastric material >3 hours after a meal indicates pyloric stricture.

Done by rocking pt. back and forth

Question 22

tender swelling and tingling

Answer 22

think compartment syndrome

Question 23

MCC SBO

Answer 23

adhesion

Question 24

MCC colon obstruction

Answer 24

cancer

Question 25

melena

Answer 25

bleeding above ligament of treitz

Question 26

SMA syndrome

Answer 26

compression of duodenum by AA

Question 27

radiation proctitis

Answer 27

diarrhea, rectal bleeding, tenesmus (feeling of pooping), incontinence

Question 28

massively dilated colon without small bowel obstruction

Answer 28

colonic pseudoobstruction

Question 29

how do you know there is perforation of the bowel

Answer 29

free air under diaphragm

Question 30

how to dx acute appendicitis

Answer 30

clinical diagnosis

Question 31

appediceal abcess for >5 days

Answer 31

has likely walled off as a phlegmon... conservative tx and appendectomy weeks later

Question 32

Pancreatic injury dx

Answer 32

Serial CTs because a pancreatic abcess may take a while to form

Question 33

pancreatic abcess tx

Answer 33

percutaneous drain, culture, and debreidment

Question 34

anatomic location of duodenum

Answer 34

retroperitoneal

Question 35

positive FAST... what next?

Answer 35

``` stable = CT unstable = ex lap ```

Question 36

what will relax the sphincter of Oddi

Answer 36

anticholinergics

Question 37

pericholecystic fluid

Answer 37

may indicated acalculus cholecystitis

Question 38

tx for acalculus cholecystitis

Answer 38

Abx + percutaneous cholecystotomy via radiologic guidance

Question 39

periumbilical abdominal pain out of proportion to exam

Answer 39

mesenteric ischemia

Question 40

fat malabsorption like in Crohns causes what to be absorbed

Answer 40

hyperoxaluria

Question 41

CRAP

Answer 41

Colon then Rectum then Anus then Poop

Question 42

Acute Cholecystitis

Answer 42

RUQ fever leukocytosis

Question 43

treatment if stones cause ductal dilation

Answer 43

ERCP

Question 44

Duodenal Hematoma blood collects where?

Answer 44

between mucosa and submucosa following trauma epigastric pain and vomiting resolves in 2 weeks so use nasogastric suction