15 - 18 (1) SEP 2022 (studied 12 JAN 2023)

Question 1

the principles of fistula surgery include:

Answer 1

• unroofing the fistula
• eliminating the primary opening (infective source)
• establishing adequate drainage

Question 2

for patients with high transsphincteric fistulas, ________ is an appropriate sphincter-preserving procedure

Answer 2

ligation of the intersphincteric fistula tract (LIFT)

Question 3

bilateral ischiorectal abscesses (also known as “horseshoe” abscesses) most commonly arise from the _________ space

Answer 3

deep postanal

Question 4

the classic method for sepsis control of a “horseshoe” abscess involves:

Answer 4

• open posterior drainage of the deep postanal space through the anococcygeal ligament
• division of the internal sphincter muscle up to the involved anal duct
• open drainage of the bilateral ischiorectal fossae

Question 5

the most common complication after hemorrhoidectomy is:

Answer 5

urinary retention

Question 6

how can urinary retention be prevented as a complication from hemorrhoidectomy?

Answer 6

• fluid restriction intraop
• anterior perineum is not injected with excessive local anesthetic

Question 7

sacral nerve stimulation for incontinence stimulates what nerve root?

Answer 7

S3

Question 8

the most common location for a typical anal fissure is the:

Answer 8

posterior midline

Question 9

the ________________ artery supplies both superior and inferior parathyroids

Answer 9

inferior thyroid

Question 10

in a large series of 762 retrieval procedures, the most important variable related to requiring advanced techniques for IVC filter removal was a dwell time of __ months or longer

Answer 10

7

Question 11

how to calculate an ABI

Answer 11

dividing the systolic blood pressure (SBP) in the injured extremity by the greatest brachial SBP of the upper extremities, regardless of laterality

Question 12

ABIs less than ___ in the setting of trauma require further workup with formal or CT angiography, whereas ABIs greater than that can generally be safely observed

Answer 12

0.9

Question 13

___________ is a defect with exposed bowel to the right of the umbilicus

Answer 13

gastroschisis

Question 14

what step differentiates a two-incision orchiopexy from a fowler-stephens?

Answer 14

division of the testicular vessels in fowler stephens

Question 15

creation of a dartos pouch is part of what type of orchiopexy procedure?

Answer 15

inguinal

Question 16

according to the neuraxial guidelines for anticoagulation of the American Society of Regional Anesthesia and Pain Medicine (ASRA), __ hours must pass from the time an epidural catheter can be removed before anticoagulation can be restarted

Answer 16

6 hours

Question 17

the most common reason for long-term failure of a prosthetic AV access is:

Answer 17

intimal hyperplasia at the distal anastomosis

Question 18

a __% level of carboxyhemoglobin produces confusion

Answer 18

20%

Question 19

a __% carboxyhemoglobin level is normal for nonsmokers and a __% carboxyhemoglobin level is normal for smokers

Answer 19

• nonsmokers: 5%
• smokers: 10%

Question 20

at a __% carboxyhemoglobin level, brain death occurs, and patients are not responsive

Answer 20

60%