21 - 25 AUG 2022 (studied 05 JAN)

Question 1

what is the first sign that heralds the development of compartment syndrome in the lower extremity in a neurologically intact individual?

Answer 1

pain

Question 2

cameron ulcers are caused by:

Answer 2

repetitive movement of the gastroesophageal junction through the hiatus

Question 3

wound classifications and % of infection risk

Answer 3

• Clean: 1% to 3%
• Clean-contaminated: 2% to 8%
• Contaminated: 6% to 15%
• Dirty: 7% to 40%

Question 4

the major side effect of trastuzumab therapy is:

Answer 4

cardiomyopathy

Question 5

ureter repair for lower third injury?

Answer 5

reimplantation into bladder

Question 6

ureter repair options for middle third injury?

Answer 6

• nephrostomy tube
• transureteroureterostomy

Question 7

in sepsis, initial fluid resuscitation begins with __ mL/kg of crystalloid within the first __ hours

Answer 7

• 30 ml/kg
• 3 hours

Question 8

what is the Ravitch procedure

Answer 8

for pectus carinitum, open procedure with removal of the affected costal cartilages and a sternal osteotomy with sternal reconstruction

Question 9

type I choledochal cyst is a risk factor for:

Answer 9

cholangiocarcinoma

Question 10

• oxycodone has an oral morphine equivalent (OME) conversion factor of ___
• hydrocodone has an OME conversion factor of ___

Answer 10

• 1.5
• 1.0

Question 11

in rectal cancer the goal is to obtain ___ mm negative margins around the tumor if possible

Answer 11

10 mm

Question 12

patients with a VIP-producing NET will have what type of acid base disorder?

Answer 12

metabolic acidosis

Question 13

in incidentally found renal cancer during abdominal surgery, less than what percentage of relative function would favor nephrectomy rather than preservation of the kidney, assuming no adjuvant nephrotoxic chemotherapy is planned?

Answer 13

15-20%

Question 14

AAST grading system for renal injuries

Answer 14

Grade I: contusions with an intact renal capsule.

Grade II: minor lacerations to the renal parenchyma extending to the superficial renal cortex, but does not involve the medulla or collecting system.

Grade III: major parenchymal lacerations that involve the renal cortex and medulla, but does not involve the collecting system.

Grade IV: major parenchymal laceration extending through the cortex and medulla as well as the collecting system, and involves the renal vasculature with locally contained hemorrhage.

Grade V: shattered kidney, where multiple deep parenchymal lacerations involve the cortex, medulla and collecting system, and involves the renal vasculature with extensive hemorrhage or thrombosis

Question 15

bilateral prophylactic mastectomy has been shown to reduce the risk of breast cancer in high-risk patients by up to __%

Answer 15

90%

Question 16

what is the miami criterion?

Answer 16

• in parathyroid surgery, a more than 50% drop in PTH level at 10 minutes following excision of the suspected abnormal gland compared to the highest (preincision or preexcision) PTH level is predictive of surgical cure
• if this criterion is not met at 10 minutes postgland excision, then the surgeon should repeat the PTH level at 20 minutes
• if the PTH level has still not decreased by more than 50% after this additional measurement, then the remaining parathyroid glands should be explored

Question 17

todani classification of choledochal cysts

Answer 17

• type I: fusiform dilation of the common bile duct without intrahepatic involvement
• type II: diverticulum off of the common bile duct
• type III: isolated true diverticulum protruding from wall of CBD
• type IVa: a single fusiform dilation of the extrahepatic bile ducts as well as dilation of intrahepatic bile ducts
• type IVb: multiple extrahepatic bile duct dilations
• type V: (Caroli disease) consists of an intrahepatic bile duct cyst only

Question 18

which types of choledochal cysts have the highest chance of malignancy?

Answer 18

I and IV

Question 19

serous pancreatic cysts are composed of what type of cells?

Answer 19

uniform cuboidal glycogen-rich cells

Question 20

how do you differentiate between primary hyperparathyroidism and familial hypocalciuric hypercalcemia?

Answer 20

24 hour urinary creatinine excretion