TrueLearn Flashcards

1
Q

Explain the maneuver:
Mattox
Cattell Brasch

A

Mattox: left medial-visceral rotation

Cattell Brasch: right colon mobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Amino acid associated with T cell stimulation

A

Arginine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Radiotracer or methylene blue for SLNB in pregnancy

A

Radiotracer (meth blue is teratogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Dysplastic changes of basal layer of skin, parakeratosis, dermal solar elastosis

A

Actinic keratosis (pre-SCC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dx of biliary dyskinesia on CCK HIDA

A

EF <35% at 20 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Central line type associated with lowest DVT and line infection

A

Subclavian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Intestinal hamartoma
Hyperpigmented oral lesions
Breast, cervical, thyroid, lung ca

A

Peutz Jeghers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Associated tumor marker:

  • Embryonal cell ca, ovarian chorioca, mixed germ cell
  • Yolk sac, embryonal cell, immature teratoma
  • Dysgerminoma
  • Granulosa cell
A
  • Embryonal cell ca, ovarian chorioca, mixed germ cell: HCG
  • Yolk sac, embryonal cell, immature teratoma: AFP
  • Dysgerminoma: LDH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Gastrinoma: M or F predominant?

A

Male 2:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Contraindication to nitrous oxide

A

SBO (air filled cavities)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acid-base dx after pancreas txp

A

Met acidosis from HCO3 losses in pancreatic secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When in gestation does alveolar phase of development begin

A

7 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Phyllodes margin and recurrence rate

A

1-2 cm margins

20% recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

First step in massive hemoptysis

A

Rigid bronch and packing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ID the liver lesion:

  • Homogenous enhancement of hypodense lesion with central scar
  • Heterogenous mass with arterial phase enhancement
  • Low density and peripheral nodular enhancement
A
  • Homogenous enhancement of hypodense lesion with central scar: FNH
  • Heterogenous mass with arterial phase enhancement: adenoma
  • Low density and peripheral nodular enhancement: hemangioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Child’s scores and corresponding surgery mortality

A

A: 5-6 points -> 10% mortality
B: 7-9 -> 30%
C: 10-15 -> 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Preop medical tx of adrenal aldo-secreting tumor

A

Spironolactone/eplerenone and K+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tx of Frey Syndrome

A

Antiperspirant application to affected skin

If refractory -> tympanic neurectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Best route for esophageal substitution

A

Posterior mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Reason for urinary retention acutely post-hemorrhoidectomy

A

Pelvic floor muscle spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mechanism by which hypomagnesemia results in hypocalcemia (2)

A
  • Impaired PTH release

- Impaired PTH receptor sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Immediate tx for ABO incompatible blood transfusion

A

Stop transfusion

Large volume fluid resusc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Two genes associated with HNPCC

A

MSH2, MLH1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Workup of bile reflux gastritis after Billroth

A

EGD and [bile] in gastric secretions OR HIDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Minimum roux limb length in ReY gastrojejunostomy to avoid bile reflux

A

45 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Types A and B aneurysm size criteria for repair

A

Type A: >=5.5 cm

Type B: >=6.5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Most common source of zone III trauma bleeding

A

Sacral venous plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Indications for radical neck dissection for parotid tumours

A

High grade malignant tumours (mucoepidermoid, squamous cell), even if clinically N0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Antidote for ethylene glycol poisoning

A

Fomepizole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How to manage clinically positive nodes in melanoma

A

FNA -> equivocal -> excisional bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Criteria for surgery for intussusception

A

Necrotic bowel, 2+ recurrences, incomplete reduction

Squeeze mass distal to proximal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q
Secretin stimulation study:
Total volume
Enzyme level
HCO3
- ZES, malnutrition, chronic pancreatitis, cancer, end-stage pancreatitis
A

ZES: High volume; normal enzyme, HCO3
Malnutrition: Decreased enzyme; normal volume, HCO3
Chronic panc: Low HCO3; normal enzyme, volume
Cancer: Low volume; normal enzyme, HCO3
End stage pancreatitis: Low volume, enzyme, HCO3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Most common site of traction esophageal diverticuli

A

Mid esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How to do a Puestow

A

Open duct anteriorly, extend medially to level of GDA, and laterally past all strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tx of LCIS

A

Excisional bx -> close observation, tamoxifen, or prophylactic bilat mastectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Most common presentation for lap band erosion

A

port site infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

RFs for gastric polyps (2)

A

Atrophic gastritis and H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

TIPS one-year shunt re-stenosis rate

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Most common cause of dysphagia immediately s/p Nissen

A

Edema; should resolve in 6-8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Three stages of skin graft survival in recipient site

A

Imbibition -> inosculation -> angiogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Best patency after angioplasty (artery)

A

iliac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Indication for liver txp for hilar cholangioca

A

N0 and M0 unresectable dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Rule of 6s for AVFs

A

blood flow >600 mL/min
diameter >0.6 cm
depth 0.6 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Aberrant anatomy to consider when dividing gastrohepatic ligament in Nissen

A

Replaced left hepatic coming from L gastric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Most common site of SB lymphoma

A

Ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Splenic laceration grading (AAST)

A

1: subcapsular hematoma <10% of surface area
parenchymal laceration <1 cm depth
2: subcapsular hematoma 10-50% of surface area
intraparenchymal hematoma <5 cm
parenchymal laceration 1-3 cm in depth
3: subcapsular hematoma >50% of surface area
ruptured subcapsular or intraparenchymal hematoma ≥5 cm
parenchymal laceration >3 cm in depth
4: any injury in the presence of a splenic vascular injury* or active bleeding confined within splenic capsule
parenchymal laceration involving segmental or hilar vessels producing >25% devascularisation
5: shattered spleen
any injury in the presence of splenic vascular injury* with active bleeding extending beyond the spleen into the peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

When to resume physical activity after splenic trauma?

A

Grade + 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Most common cause of AVF thrombosis

A

Intimal hyperplasia of venous anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which component of GCS is most sensitive to neurotrauma

A

Motor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Type of salivary gland tumor with propensity to metastasize along nerves

A

Adenoid cystic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Agents that increase or decrease LES tone

A

Increase LES: gastrin, motilin

Decrease: secretin, CCK, estrogen, progesterone, somatostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Most prevalent organism in non-aneurysmal aortic infection

A

Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Early vs. interval appy

A
Early:
Early return to work
Increased complications (SBO, reoperation, wound infection)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Tx of solitary rectal ulcer syndrome

A

Conservative: high fiber, biofeedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Mechanism of diverticular bleed

A

Rupture of vasa recta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Most devastating cause of PONV following sleeve gastrectomy

A

Portomesenteric venous thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Longest phase of the cell cycle

A

G1 (11 h)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Pharmacokinetics vs. pharmacodynamics

A

PK: What happens to a drug in the body
PD: What the drug does to the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Orlistat

A

Anti-obesity agent that inhibits GI lipases and decreases fat absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Cancer associated with vinyl chloride

A

Hepatic angiosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

When to do classic Whipple (+antrectomy) vs. pylorus-preserving Whipple

A

Classic when D1 involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q
Common burn meds ADR:
AgNO3
Ag sulfadiazene
Mafenide acetate
Neomycin/baci/polymyxin B
A

AgNO3: hyponatremia
Ag sulfadiazene: neutropenia
Mafenide acetate: met acidosis
Neomycin/baci/polymyxin B: nephrotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Zn deficiency signs (3)

A

Impaired wound healing
FTT
Rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Selenium deficiency signs (3)

A

Cardiomyopathy
Hypothyroidism
Neuro changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Initial step in improving hypotension in pregnant trauma

A

Roll to the left (uterus rolls off the IVC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What group of cells stimulates fibroblasts in wound healing

A

Macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q
% weight loss after 
Lap band
Sleeve
Bypass
Switch
A

Lap band 40-55%
Sleeve 54-70%
Bypass 60%
Switch 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

First line tx of stage 4 RCC

A

Sunitinib, panzopanib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Tx for parotid tumours if

  • Benign (warthin, pleomorphic)
  • Malignant (mucoepidermoid, adenoid cystic)
A
  • Benign (warthin, pleomorphic): WLE

- Malignant (mucoepidermoid, adenoid cystic): total parotidectomy, MRND, XRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Melanoma subtypes with worst and best prognosis

A

Worst: nodular
Best: lentigo maligna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Cationic trypsinogen gene mutation

A

Hereditary pancreatitis (PRSS1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

High risk features of BCC/SCC warranting Mohs

A
Poorly differentiated
Face, genitalia, hands/feet
>=6mm
Depth >=4 mm
PN invasion
Immunosuppression
Marjolin ulcer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

First step if gastric conduit does not reach esophagus

A

Kocher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Signs of contrast nephropathy

A
Normal UOP
SCr >25% elevated
Muddy brown casts
FeNa <1
Mild proteinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Most common gene mutation in pancreatic cancer

A

K-ras

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Most common complication of I and D

A

bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Diagnosis of melanoma (what kind of bx)

A

Must be full thickness bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Margins for melanoma WLE

A

is: 0.5-1 cm
<1 mm: 1 cm
1-2 mm: 1-2 cm
>2 mm: >=2 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Where should you not place tacks in IHR

A

Inferior to iliopubic tract and lateral to epigastrics (neurovascular injury)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Best tx for low grade gastric MALT

A

Abx for hP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Tx for gastric band slippage

A

Concern for ischemia so immediately remove saline from band and go to OR for band removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Only effective chemo for HCC

A

Sorafenib (VEGF inhibitor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Milan criteria for resectable HCC (3)

A

<5 cm lesion
<=3 lesions each smaller than 3 cm
No extrahepatic dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Tx of asymptomatic histoplasmosis

A

Nothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Bx margin for suspected melanoma

A

Full thickness bx with 1-2 mm margins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Goal lactate in resuscitation of trauma

A

<2.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Which organism that causes PID is most associated with infertility

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Size at which adrenal masses should be resected

A

> 6 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Tx for supracondylar humerus fx

A

Closed reduction with pin fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Most common organism in lymphangitis

A

Group A strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

For ITP splenectomy, when is plt transfusion given

A

Right after splenic artery ligation

92
Q

% ICA stenosis at which to perform CEA

A

Sx: >50%
Asx: >60%

93
Q

Calcitonin effect on PO4

A

Promotes PO4 excretion

94
Q

HCG criterion for MTX for ectopic pregnancy

A

HCG <=5000

95
Q

Hepatoblastoma associated with which familial syndromes

A
Beckwith-Wiedmann
Hemihypertrophy
Li Fraumeni
FAP 
T18
96
Q

% of total daily calories to be given as N2 in patients with malnutrition needing TPN

A

15%

97
Q

Most anterior and posterior structures in porta hepatis

A

Anterior: artery
Posterior: portal vein

98
Q
Tx for choledochal cysts type:
1
2
3
4
A

1/4: hepaticojej

2: Cyst excision, primary closure of CBD
3: ERCP marsupialization or transduodenal excision

99
Q

Type of mesh to use in splenorrhaphy for trauma

A

Absorbable

100
Q

Tx for recurrent anal canal SCC

A

APR

101
Q

Respiratory quotient

A

CO2 produced/O2 consumed

102
Q

Best operation for Crohn duodenal strictures causing obstructive sx

A

Gastrojejunostomy

103
Q

Manometry findings for scleroderma esophageal dysmotility (amplitude, type of contractions, LES pressure)

A

Low amplitude
Simultaneous contractions
Normal/low LES pressure

104
Q

Anterior to posterior thoracic outlet: scalene, axillary nerve, axillary vein, brachial plexus

A

Vein
Muscle
Artery
Nerve

105
Q

Tx of radial scar (breast)

A

Excisional bx

106
Q

PE finding for obturator hernia

A

Medial thigh pain elicited by internal rotation and extension of thigh (Howship-Romberg sign)

107
Q

What is the organ with the highest K secretion?

A

Colon

108
Q

Dermatofibrosarcoma protuberans

  • Signs
  • Path
  • Tx
A

Firm, red plaques that resemble keloids
Path: finger-like projection of spindle cells
Tx: WLE w/ 2 cm margins or Mohs; adjuvant XRT if >5 cm

109
Q

First step in evaluating bloody diarrhea s/p AAA repair

A

Sigmoidoscopy

110
Q

Latent error

A

System defect that is insidious until a mistake is made

111
Q

Tx of nitroprusside toxicity

A

Amyl nitrite

112
Q

Criteria for transanal resection of rectal cancer:

  • Size
  • Location (cm from verge)
  • T grade
  • High risk features
  • % circumference involved
A
  • Size < 3cm
  • Location (cm from verge) <8 cm
  • T1
  • High risk features: no mucin, no LV involvement
  • % circumference involved: <30%
113
Q

CN XI

  • Where does it exit
  • Which nerve roots
  • Muscles supplied
A
  • Exits in jugular foramen
  • C1-5
  • SCM, trapezius
114
Q

Cell origin of GIST

A

Interstitial cells of Cajal

115
Q

McVay repair

A

Approximate transversus abdominus to Cooper’s ligament with relaxing incision on anterior rectus
Good for emergent femoral hernia repair

116
Q

Between which two abdominal muscle layers is mesh placed in Rives-Stoppa VHR

A

Between rectus muscle and posterior rectus sheath

117
Q

Tx of unresectable hepatoblastoma

A

Neoadjuvant cisplatin -> try to make it resectable

118
Q

Tx of multiloculated splenic abscess

A

Splenectomy

119
Q

4 types of cholangiocarcinoma

A

1: common hepatic duct only
2: hepatic bifurcation
3: secondary hepatic ducts on one side
4: secondary hepatic ducts on both sides

120
Q

Size of Zenker above which diverticulectomy is added to myotomy

A

> 2 cm

121
Q

Goal UOP in electrical burns

A

2 ml/kg/hr

122
Q

Signs of cholestasis/bile leak after liver txp associated with what vascular condition?

A

Hepatic artery thrombus

123
Q

Most common presenting symptom for pseudomyxoma peritonei

A

Widening abdominal girth

124
Q

Tx for CIN 1 vs. CIN2-3

A

CIN1: Observation

CIN2-3: LEEP

125
Q

Tx for simple intersphincteric fistula

What if sphincter involved?

A

Intersphincteric: fistulotomy

If significant sphincter involvement: seton

126
Q

EKG findings in PE

A

S1Q3T3

Anterior leads T wave inversion

127
Q

What does NOT improve after colectomy for UC (2)

A

PSC

Ankylosing spondylitis

128
Q

Initial workup of suspected gastroparesis

A

EGD -> gastric emptying study

129
Q

Most common postop complication after kidney txp

A

PGD

130
Q

Safest laparoscopic access in redo abdomen

A

Hasson

131
Q

Hypothermia: Temp, sx?

  • Mild
  • Mod
  • Severe
A

Mild: 32-34 C; shivering, AMS, tachycardia
Mod: 29-32 C; agitation, spasticity, afib, hypotension
Severe: 21-29 C; prolonged QRS, osborn waves, flaccid, coma, vfib, death
Profound: <21C; death

132
Q
Energy in kcal/g for TPN
Lipid
Protein
Oral carbs
Dextrose
A

Lipid 9
Protein 4
Oral carbs 4
Dextrose 3.4

133
Q

Risk factors for small bowel adenocarcinoma (4)

A

Crohns
FAP
HNPCC
Celiac

134
Q

Tx for gastric cardia >T2N0 cancer

Number of nodes?

A

Neoadjuvant chemo
TOTAL gastrectomy (to get 5 cm margins)
15 nodes at least

135
Q

Parastomal hernia

  • Best repair
  • What if other stoma-related problems?
A
  • Lap repair w/ bio mesh

- If other problems, can just resite stoma and reinforce with bio mesh

136
Q

Best test to assess for colovesical fistula

A

CT (air in bladder)

137
Q

Criteria for neoadjuvant chemo for bladder cancer (2)

A

T3 or higher (extends into fat)

N+

138
Q

Tx for positive SLNB in melanoma

A

Can do completion LNB OR observe (U/S q3-12 mos x 2-3 years)

139
Q

Tx of F XI deficiency

A

FFP, NOT purified factor (thrombogenic)

140
Q

Safest inhalation anesthetic for low EF

A

Nitrous oxide

141
Q

Most common organism in early vs. late vascular graft infections

A

early: s. aureus
late: s. epidermidis

142
Q

Most potent stimulator of pancreatic enzymes vs. fluid/HCO3

A

Enzymes: cck

Fluid/HCO3: secretin

143
Q

Most common malignant peds lung tumors

A

Pleuropulmonary blastoma #1

Carcinoid

144
Q

Time interval for operating on thrombosed hemorrhoids

A

Within 4 days of sx

145
Q

Minimum diameter of vessel to use bipolar cautery

A

> =7mm

146
Q

Tx for retrorectal masses

A

Always excise

147
Q

Tx of echinococcus splenic cysts

A

Sterilize -> splenectomy

148
Q

Size and chronicity criteria for conservative management of pancreatic pseudocysts

A

<6 cm and <6 weeks should be conservative management

Enlarging cysts and sx -> cystgastrostomy

149
Q

Most common malignant tumor of appendix

A

Adenoca (carcinoids not always malignant…)

150
Q

Two most common organisms in pyogenic liver abscess

A

Klebsiella, e. coli

151
Q

Pancreatic cancer that is associated with ovarian stroma

A

Mucinous cystic

152
Q

Where in posterior pituitary is ADH released

A

Supraoptic and paraventricular nuclei

153
Q

Four RFs for gb cancer

A

Cholelithiasis
Choledochal cysts
Porcelain
Polyps

154
Q

Management algorithm for suspected perineal Paget

A

First CT abdomen and colonoscopy (50% occult cancer)

Then WLE w/ perianal bx

155
Q

Most important predictor of survival for pancreatic cancer

A

T stage (also N stage)

156
Q

Liver mass w/ central scar but normal AFP and high neurotensin

A

Fibrolamellar HCC

157
Q

Most common and most favourable cholangioca type

A

Most common: Nodular

Most favourable: Papillary

158
Q

CAH (21 hydroxylase def)

  • Na, K
  • Which steroid is high
A
  • Low Na, high K

- 17 hydroxyprogesterone high

159
Q

Most radiosensitive tumour

A

Seminoma

160
Q

Tx for Merkel cell carcinoma

A

WLE, SLNB, adjuvant XRT

161
Q

Type of EGD (rigid or flexible) for foreign body in esophagus

A

Flexible is good enough these days (need anesthesia for rigid)

162
Q

Four poor prognostic factors for neuroblastoma

A

Age >1
High NSE (neuron specific enolase)
High LDH
N-myc amplification

163
Q

Minimum artery and vein diameter for AVF creation

A

Artery > 2mm

Vein > 3mm

164
Q

Succinylcholine

  • How is it eliminated
  • Three contraindications to use
A
  • Pseudocholinesterase elimination

- Contraindications: Large burns, spinal cord injuries, renal failure

165
Q

Which nondepolarizing muscle blocker is safe for anesthesia in renal and hepatic failure

A

Cistracurium (Hoffman degradation)

166
Q

Dose of long and short acting insulin the day of surgery

A

Half of long acting and no short acting

167
Q

Tx of superficial vs deep septic thrombophlebitis

A

Superficial: abx, vein excision
Deep: abx, heparin

168
Q

Tx for ruptured umbilical hernia associated with ascites

A

Urgent surgery

169
Q

21 vs. 11 hydroxylase deficiency:
Mineralocorticoid level
K
Na

A

In 11 hydroxylase def, MC level HIGH, K LOW, Na HIGH

In 21, MC level LOW, K HIGH, Na LOW

170
Q
Sx of
Anterior cord
Central cord
Posterior cord
Brown Sequard
Cauda equina
A

Anterior cord: no motor/pain/temp below level of injury; preserved proprioception, fine touch
Central cord: upper extremity weakness > lower; sacral sensory sparing
Posterior cord: loss of proprioception and vibration only
Brown Sequard: ipsilateral loss of motor, contralateral loss of pain/temp
Cauda equina: areflexive bowel/bladder

171
Q

Most common site of minor salivary gland tumors

A

Palate

172
Q

Bilateral parotid masses associated with smoking

A

Warthin tumors

173
Q

Three strongest predictors of operative mortality after CABG

A

Redo CABG
Prior heart surgery
Low EF

174
Q

Most common cancer of upper vs. lower lip

A

Upper: basal cell
Lower: scc

175
Q

Richter hernia

A

Contains antimesenteric side of bowel (high strangulation risk)

176
Q

Most potent stimulator of bile secretion

A

Secretin

177
Q

Algorithm of axillary adenocarcinoma with no known primary

A

Mammo/MRI -> whole body PET -> axillary dissection, chemo/endocrine, whole breast XRT

178
Q

Depth criterion for SLNB in melanoma

A

> =0.75 mm (stage IB)

179
Q

Estimate free H2O deficit

A

Weight x 0.6 x (Na-140/140)

180
Q

Steroid of choice in acute adrenal insufficiency

A

IV dexamethasone

181
Q

Margins for low risk basal cell carcinoma

A

0.3-0.5 cm

182
Q

Most common cause of death in lung txp <1 year and >1 year

A

<1 year: infection

>1 year: chronic rejection

183
Q

Most common cause of rectovaginal fistula

A

Obstetric trauma

184
Q

Immunosuppressive med and ADRs:

  • Tacrolimus
  • Sirolimus
  • Thymoglobulin
  • Mycophenolate
  • Cyclosporine
A
  • Tacrolimus: HTN
  • Sirolimus: poor wound healing
  • Thymoglobulin: fever, hypotension
  • Mycophenolate: diarrhea
  • Cyclosporine: gingival hyperplasia, hirsutism
185
Q

Lipoprotein with highest concentration of cholesterol

A

LDL

186
Q

Tx of bone spindle cell tumor (malignant fibrous histiocytoma)

A

Neoadj chemo -> WLE

187
Q

MCC of portal venous thrombus in kids

A

Umbilical vein infection

188
Q

F/U for nonfunctioning small adrenal masses

A

Imaging at 6, 12, 24 months

Annual hormone testing for four years

189
Q

Management of indeterminate pathology after FNA of thyroid nodule

A

Repeat FNA

190
Q

Most commonly injured nerve in lap IHR

A

Genitofemoral

191
Q

Nodular lymphoid hyperplasia in SB and colon associated with what kind of diseases?

A

Immunosuppression

192
Q

What is the function of protein C?

A

It deactivates fVa and fVIIIa by proteolysis

193
Q

Tx for type II choledochal cyst

A

Cystectomy and primary CBD closure

194
Q

Tx for trauma medial or lateral to the lateral canthus of the eye

A

Medial: can observe
Lateral: must operate

195
Q

FMD of the carotid

Imaging finding? Tx?

A

Imaging: beaded stenoses of carotid
Tx: PTCA

196
Q

INR vs. PTT: which represents extrinsic vs. intrinsic pathway?

A

INR: extrinsic
PTT: intrinsic (does NOT measure F VII)

197
Q

Max volume of air that can be expired after max inhalation

A

Vital capacity

198
Q

In trauma laparotomy, order in which to pack: inframesocolic, supramesocolic, lesser sac, retroperitoneum

A

Inframesocolic -> supramesocolic -> RP -> lesser sac

199
Q

Highest sensitivity initial test for pheo

A

Plasma free metanephrines

200
Q

Decreased total exocrine secretion volume in pancreas

A

Pancreatic cancer

201
Q

Decreased HCO3 secretion in pancreas

A

Chronic pancreatitis

202
Q

Decreased pancreatic enzyme secretion

A

Malnutrition

203
Q

Decreased volume, enzyme, and HCO3 from pancreas

A

End stage pancreatitis ‘burnout’

204
Q

Tx for cT1 vs. cT2 bladder cancer

A

T1: TURB + HCG

T2 (muscle invasive)+: Cystectomy, ileal conduit

205
Q

Worrisome vs. high risk features for IPMN

A

Worrisome (EUS at least):
Main duct 5-9 mm, change in duct caliber, adenopathy, pancreatitis, BD IPMN > 3 cm, mural nodules, thickened, enhancing wall
High risk (resect):
Main duct >1cm, enhancing solid component within cyst, jaundice

206
Q

What cancer is CDH1 mutation associated with

A

Diffuse signet ring cell gastric cancer

207
Q

Seven variables in Gail’s model

A

Age
Age at menarche
Age at first child
Family history of breast cancer (first degree)
No. of past breast bx
No. of past breast bx showing atypical hyperplasia
Race/ethnicity

208
Q

Which enzyme is cleared fastest in pancreatitis?

A

Amylase

209
Q

Which pancreatic enzyme is secreted into the duct in its active form?

A

Lipase

210
Q

Tx for low rectovaginal fistula

A

Endorectal advancement flap

211
Q

Most common location for small bowel lymphoma

A

Ileum

212
Q

Electrolyte abnormality associated with Sheehan syndrome

A

Hyponatremia

213
Q

Teduglutide

A

GLP-2 agonist used in short bowel syndrome

214
Q

Does right or left vagus become posterior? Which gives rise to hepatic branch? Grassi?

A

Right is posterior. Right: Grassi. Left: Hepatic

215
Q

In Heller length of myotomy on esophagus and stomach

A

5-6 cm on esophagus; 2 cm on stomach

216
Q

Two electrolyte imbalances associated with amphotericin B

A

Hypokalemia

Hypomagnesemia

217
Q

Hypertriglyceridemia + hypercholesterolemia are a toxicity of this immunosuppressive medication

A

Sirolimus

218
Q

How to calculate expected weight loss after bari surgery

A

(Current weight - ideal weight)*percent weight loss expected

219
Q

Most common ectopic location of superior vs. inferior parathyroid gland

A

Superior: TE groove
Inferior: thyrothymic ligament

220
Q
  1. First major steps in liver resection

2. From anterior to posterior, structures in porta hepatis

A
  1. Division of ligaments -> chole

2. artery, portal vein, hepatic vein

221
Q

Type of liver cells present in FNH

A

Kupffer cells

222
Q

Signs of essential FA deficiency

A

Scaly rash
Poor healing
Sparse hair growth

223
Q

Minimum liver remnant after resection (%)

A

20%

224
Q

Most common cause of splenic injury during laparoscopy

A

Forceful retraction of omentum

225
Q

Most common and favorable morphology of cholangio

A

Common: sclerosing
Favorable: papillary

226
Q

Initial and hourly chest tube output warranting thoracotomy following trauma

A

> 1.5 L upfront

>200-300 mL/hr