07 (3) - 11 AUG 2022 (studied 29 DEC)

Question 1

what type of pancreatic neoplasm?

low fluid amylase and low CEA, and they are glycogen rich

Answer 1

serous cystic neoplasms

Question 2

low fluid amylase, low CEA, and necrotic cells

Answer 2

solid pseudopapillary tumors

Question 3

high fluid amylase, moderate CEA, and mucin-producing columnar epithelium

Answer 3

intraductal papillary mucinous neoplasms

Question 4

components of the MELD score

Answer 4

• Cr
• bilirubin
• INR
• sodium

Question 5

what is the most common gene mutation associated with autosomal dominant hereditary pancreatitis?

Answer 5

PRSS1 9protease serine 1 gene)

Question 6

what is the cephalad limit of the dissection in an ilioinguinal lymphadenectomy? what is the caudal limit?

Answer 6

• cephalad: bifurcation of the common iliac artery to the internal and external iliac arteries
• caudal: inguinal canal

Question 7

• medial wall of femoral sheath?
• posterior wall of the femoral canal?
• anterior superior margin of the femoral triangle?
• the ___________ muscle lies laterally and posterior at the origin of the femoral canal

Answer 7

• lacunar ligament
• pectineus muscle fascia
• inguinal ligament
• iliopsoas

Question 8

where should a laparoscopic ultrasound probe be placed to assess the celiac lymph node basin?

Answer 8

on the left lobe of the liver or directly on the hepatoduodenal ligament

Question 9

the intercostobrachial nerve arises from the ____________ nerve root

Answer 9

second thoracic (T2 and occasionally T1)

Question 10

a high output fistula is over ____ cc/day

Answer 10

> 500 cc / day

Question 11

what is Oncotype DX testing?

Answer 11

multigene assay used in early-stage ER-positive tumors to help guide treatment and determine the need for adjuvant chemotherapy

Question 12

based on the Brisbane nomenclature, a left trisectionectomy (extended left hepatectomy) involves what liver segments?

Answer 12

II, III, IV, I, and VIII

Question 13

what provocative maneuvers can be done to identify underlying popliteal arterial entrapment during physiologic or angiographic testing?

Answer 13

active ankle plantar flexion and passive ankle dorsiflexion

Question 14

what is the use of pamidronate?

Answer 14

calcium binder, slows calcium release from bones (nitrogen-containing bisphosphonate)

Question 15

what is the standard of care for an unruptured ectopic pregnancy in a stable patient?

Answer 15

laparoscopic salpingostomy

Question 16

what is the first sign in local anesthetic systemic toxicity?

Answer 16

neuro - tinnitus and perioral numbness > headache > seizures

Question 17

what are the gastric lymph node classifications?

Answer 17

D1 - Perigastric nodes along the lesser and greater curvature

D2 - D1 + nodes along the left gastric artery, common hepatic artery, celiac trunk, splenic hilum, splenic artery

D3 - D2 + nodes along the common hepatic artery, celiac trunk, splenic hilum, splenic artery, along the hepatoduodenal ligament, retropancreatic space, along the root of the superior mesenteric vein and artery

D4 - D3 + the periaortic lymph nodes

Question 18

the use of NSAIDs like indomethacin after 32 weeks should be avoided because they may cause:

Answer 18

premature closure of the fetal ductus arteriosus

Question 19

best test to determine cause of OROPHARYNGEAL dysfunction?

Answer 19

modified barium swallow

Question 20

what are the two types of delirium?

Answer 20

• hyperactive / agitated
• hypoactive