24-28 JUL 2022 (studied 11 DEC)

Question 1

when is a second chest tube indicated?

Answer 1

• trapped lung
• multiloculated empyema
• hemothorax

Question 2

pathophysiology of late dumping

Answer 2

• rapid gastric emptying
• rapid carbohydrate delivery and absorption in proximal intestine
• hyperglycemia
• large insulin response
• large compensatory / rebound hypoglycemia
• hypoglycemia activates adrenal gland
• adrenal gland release catecholamines
• catecholamines result in diaphoresis, tremulousness, lightheadedness, tachycardia, confusion

Question 3

hard signs of vascular injury

Answer 3

• absent distal pulses
• pulsatile / arterial bleed
• expanding hematoma
• ischemic limb

Question 4

risk of HCV infection after a needlestick

Answer 4

1.8%

Question 5

normal abdominal pressure is __-__ mm Hg, however obese patients may have abdominal pressures from __-__ mm Hg at baseline

Answer 5

• normal: 5-7 mm Hg
• obese: 9-15 mm Hg

Question 6

grades of abdominal hypertension and their management

Answer 6

• grade I: 12-15 mm Hg (medical)
• grade II: 16-20 mm Hg (medical)
• grade III: 21-25 mm Hg (laparotomy)
• grade IV: > 25 mm Hg (laparotomy)

Question 7

• septated hyphae with narrow branching angles

vs

• nonseptated hyphae with broad, branching angles

Answer 7

• septated: aspergillus
• nonseptated: mucor

Question 8

rectus sheath hematoma classification

Answer 8

• type I: small and confined within rectus; does NOT cross midline or dissect fascial planes
• type II: confined within rectus however can dissect along transversalis or cross midline
• type II below arcuate line, large, bleeds into prevsical space of retzius and/or hemoperitoneum

Question 9

a ____ titer is strongly correlated with hashimoto thyroiditis

Answer 9

TPOAb

Question 10

non operative treatment of solid organ injury in children - what period of rest that is recommended?

Answer 10

grade of injury + 2 weeks

Question 11

difference between a panreatic pseudocyst and pancreatic necrosis, radiographically

Answer 11

• pseudocyst: homogenous fluid density
• necrosis: heterogenous

Question 12

what is the preferred approach for an internal sphincterotomy?

Answer 12

lateral

Question 13

what is the best single place to stimulate with the nerve monitor to confirm a functional vocal cord at the end of surgery?

Answer 13

ipsilateral vagus nerve

Question 14

management of popliteal aneurysms

Answer 14

> 2.0 cm or significant mural thrombus:

• elective repair
• surgical bypass with vein
• endovascular repair but requires 2 cm landing zone proximally and distally

Question 15

what finding differentiates between cardiac tamponade and pneumothorax?

Answer 15

decreased breath sounds

Question 16

total parathyroidectomy with immediate autotransplantation or subtotal parathyroidectomy is performed in cases of:

Answer 16

parathyroid hyperplasia, including patients with primary, secondary, and tertiary hyperparathyroidism

Question 17

what is one key pathologic finding that distinguishes lobular carcinomas from ductal carcinomas?

Answer 17

lack of epithelial cadherin expression

Question 18

a ____ block delivers anesthetic locally to the distal tip of the finger and is an ideal block for procedures involving the nail

Answer 18

wing

Question 19

histology of primary hyperparathyroidism due to an adenoma

Answer 19

a focus of chief cells with a rim of compressed normal tissue

less frequently, oxyphil cell is the more predominant type

Question 20

a focus of chief cells with a rim of compressed normal tissue?

Answer 20

primary hyperparathyroidism due to an adenoma