28-31(3) JUL 2022 (studied 26 DEC)

Question 1

histology of multigland parathyroid hyperplasia

Answer 1

diffuse proliferation of clear cells in multiple glands

Question 2

rectoperineal fistula in a neonate is appropriately addressed with a:

Answer 2

posterior sagittal anorectoplasty (PSARP)

Question 3

patients who are able to achieve more than ___ METs worth of activity without symptoms have a minimal risk of cardiac events

Answer 3

4

Question 4

______________ is the most common acute and late vascular complication and has been reported in 10% to 70% of patients undergoing venoarterial extracorporeal membrane oxygenation

Answer 4

limb ischemia

Question 5

complications from TPN

Answer 5

• metabolic bone disease
• parenteral nutrition–associated liver disease
• cholelithiasis
• nephrolithiasis (hyperoxaluria)
• catheter-related bloodstream infections

Question 6

the infrarenal inferior vena cava is best accessed via what maneuver?

Answer 6

right medial viscerl rotation

Question 7

supramesocolic aortic injury can be accessed using what maneuver?

Answer 7

left medialvisceral rotation

Question 8

inframesocolic aortic injury can be identified by what maneuver?

Answer 8

elevating the transverse mesocolon and moving small bowel to the left allowing access to the midline retroperitoneum

Question 9

the first-line treatment of blind loop syndrome is:

Answer 9

• broad-spectrum antibiotics (rifaximin, tetracycline, augmentin)
• parenteral replacement of vitamin B12

Question 10

in the upper extremity, the _______ artery often serves as the dominant vessel that perfuses the hand

Answer 10

ulnar

Question 11

types of endoleak

Answer 11

Type I: failure to achieve satisfactory seal at proximal zone (type Ia) or distal zone (type Ib).

Type II (most common): retrograde filling of the aneurysm sac by lumbar branches or by the inferior mesenteric artery

Type III: failure of an individual component or of seal between components of graft system, preventing exclusion of the aneurysm sac

Type IV endoleak: leakage through porous materials of the graft

Type V endoleak: persistent growth of the aneurysm sac without detectable leak (endotension)

Question 12

treatment of serious local anesthetic systemic toxicity (LAST):

Answer 12

• early administration of 20% lipid emulsion 1.5 mL/kg given over 2-3 minutes
• benzos if seizing
• ABCs / ACLS
• call for help

Question 13

what is the most common initial sign of local anesthetic systemic toxicity?

Answer 13

seizures

Question 14

• flow velocity RATIO between the renal artery and aorta of more than ___ is considered abnormal and indicative of renal artery stenosis
• if measured by systolic velocity?

Answer 14

• 3.5x
• > 180 cm/s

Question 15

luminal narrowing of about ___% is necessary to produce symptoms of renal artery stenosis

Answer 15

50%

Question 16

recurrence rates in children for laparoscopic vs open inguinal hernia repair:

Answer 16

similar

Question 17

therapy for thyroid B cell lymphoma

Answer 17

CHOP (cytoxan, hydroxy dooxorubicin, oncovin, prednisone) + radiation

Question 18

CDC revaccination recommendations for post-splenectomy patients

Answer 18

booster dose of the 23-valent pneumococcal vaccine 4 to 6 years after the initial dose

Question 19

in patients with normal splenic function, approximately ___% of transfused platelets are sequestered in the spleen

Answer 19

40%

Question 20

SVR and CI in septic shock

Answer 20

• SVR decreased
• CI increased