13 JUL 2022 (studied 21 NOV)

Question 1

what is the surveillance for recurrence of adrenocortical carcinoma?

Answer 1

• CT or MRI C/A/P q3 months x2 years
• then q4-6 months x 5 years

if high risk for local recurrence (R1 resection - positive margins, vascular / capsular invasion, intraoperative spillage, high grade):

• adjuvant cytotoxic chemo, EBRT, EBRT + mitotane

Question 2

what indicates a succesful excision of a parathryoid gland intraoperatively?

Answer 2

50% decrease in PTH level

Question 3

when are 3.5 or 4 gland excisions indicated for parathyroid surgery?

Answer 3

parathyroid hyperplasia only

Question 4

how should injuries involving less than 50% of the bowel circumference be repaired?

Answer 4

one or two layers

Question 5

attempts to close wounds that have counts higher than 105/g of tissue will fail ___%-___% of the time,

Answer 5

75-100%

Question 6

cesarean section should only be considered in patients who have reached _____ weeks gestation

Answer 6

23-24 weeks

Question 7

perimortem cesarean section should be performed within __ minutes of maternal cardiac arrest

Answer 7

4

Question 8

all patients with incidentally found gallbladder cancers of stage T1b and above that are resectable require re-resection of segment(s) _________ of the liver and ___________________

Answer 8

• IVb and V
• regional lymphadenectomy

Question 9

in functional gall bladder disease, cholecystectomy is curative / will improve symptoms in ___% of patients

Answer 9

75%

Question 10

in the setting of a germline mutation in MMR proteins (Lynch syndrome), a sebaceous carcinoma would be a manifestation of what other syndrome?

Answer 10

Muir Torre syndrome

Question 11

in the setting of a germline mutation in MMR proteins (Lynch syndrome), what finding would be indicative of Muir Torre syndrome?

Answer 11

sebaceous carcinoma

Question 12

patients with clinically positive lymph nodes are recommended to undergo ______________

Answer 12

axillary nodal dissection

Question 13

what type of study?

cases are selected on the basis of disease presence, not on the basis of exposure

Answer 13

case control

Question 14

case control studies are subject to what type of errors / biases?

Answer 14

• confounding factors
• recall bias

Question 15

recurrent intussusception occurs in what % of patients and within what timeframe?

Answer 15

• 10%
• minutes to months (most commonly 48h)

Question 16

initial treatment for uncomplicated extraperitoneal bladder injury?

Answer 16

urethral catheter drainage for decompression

Question 17

3 main components of inhalational injury?

Answer 17

1. direct thermal
2. products of combustion
3. CO toxicity

Question 18

the blood supply to the extrahepatic bile duct runs along the duct at what positions?

Answer 18

the 3-o’clock and 9-o’clock positions

Question 19

dissection of the common bile duct should be performed only on the ________ portion of the duct to avoid devascularization

Answer 19

anterior

Question 20

the bile cholesterol saturation index is a numerical value derived from the relative concentrations of ________, ________, and _________. A value of greater than ___ represents supersaturation with cholesterol

Answer 20

• cholesterol, lecithin, and bile salts
• > 1.0