08 (3) SEP - 15 SEP 2022 (studied 12 JAN 2023)

Question 1

a ____________________ is the best incision to use to gain access to the carina and proximal left mainstem bronchus

Answer 1

right posterolateral thoracotomy

Question 2

most common incision for open repair of a left congenital diaphragmatic hernia?

Answer 2

left subcostal

Question 3

consensus guidelines suggest a safe FLR% of __-__% for patients with normal liver parenchyma, __-__% for those who have steatosis or have received chemotherapy, and more than ___% for those who have underlying cirrhosis

Answer 3

• 20-30%
• 30-40%
• 40+%

Question 4

ideal length of a J pouch?

Answer 4

15-20 cm

Question 5

most of the colonic absorption of fluids and electrolytes occurs in the:

Answer 5

ascending colon

Question 6

most patients with pouchitis respond to treatment with:

Answer 6

flagyl

Question 7

recently updated guidelines also suggest PO _________ as an alternative to PO vancomycin for c. diff colitis

Answer 7

fidaxomicin

Question 8

routine monitoring of serum ___________ levels should be performed in all patients who undergo a hemithyroidectomy

Answer 8

thyrotropin (TSH)

Question 9

in determining the cause of steatorrhea, <__g of fecal fat is consistent with an intestinal etiology, whereas >__g of fecal fat is consistent with pancreatic insufficiency

Answer 9

• 20 g
• 20 g

Question 10

treatment for all stages of anal squamous cell cancer is:

Answer 10

chemoradiation

Question 11

the modified Nigro regimen that is currently used consists of:

Answer 11

5-fluorouracil, mitomycin C, and pelvic radiation therapy with 50 Gy to the primary carcinoma and 35 to 45 Gy to the pelvic inguinal lymph nodes

Question 12

calculation of functional liver remnant (FLR):

Answer 12

FLR% = FLR ÷ (total liver volume – tumor volume)

Question 13

Pembrolizumab is a monoclonal antibody against ____ and has significantly increased long-term survival, up to 40% or more, for patients with metastatic melanoma

Answer 13

PD-1

Question 14

_________________ is a monoclonal antibody against PD-1 and has significantly increased long-term survival, up to 40% or more, for patients with metastatic melanoma

Answer 14

Pembrolizumab

Question 15

Pembrolizumab is a monoclonal antibody against PD-1 and has significantly increased long-term survival, up to 40% or more, for patients with ________________

Answer 15

metastatic melanoma

Question 15

treatment for greater saphenous vein thrombosis in order to prevent DVT?

Answer 15

fondaparinux 2.5 mg

Question 16

where should you make an incision in the perianal skin for a simple perianal abscess?

Answer 16

as close to anal verge as possible (to minimize any potential future fistula tract length)

Question 17

treatment of a thrombosed external hemorrhoid - before and after 72h

Answer 17

• before: excision
• after: non-op - sitz baths and pain control

Question 18

hemorrhoid grading

Answer 18

Grade I: prominent hemorrhoidal vessels without prolapse

Grade II: prolapse with straining; spontaneous reduction

Grade III: prolapse with straining; manual reduction required

Grade IV: chronic prolapse; manual reduction not possible

Question 19

a keyhole deformity (from an inappropriate posterior sphincterotomy) leads to fecal incontinence in what % of patients?

Answer 19

30-40%