Abdomen 2 Flashcards
What is true about primary bacterial peritonitis?
. The treatment of primary peritonitis is targeted antibiotic therapy for 21 days.
b. The consideration of primary peritonitis warrants surgical exploration
c. the causative organisms are usually polymicrobial
d. d. All of the choices
A.
A 27-year-old G1 P0, female, presented herself to the ER because of abdominal pain, fever & chills. After taking a thorough history & performing a complete PE, you are convinced that you have a case of secondary peritonitis. You are highly considering a sexually-transmitted infection as the etiology of her clinical condition. A pelvic abscess was reported by a diagnostic procedure & collecting an intra- abdominal specimen for culture & sensitivity is planned. The most appropriate method will be by
A. Direct visualization, by colposcopy
b. Transabdominal CT- guided aspiration
c. Ultrasound-guided, transvaginal aspiration
d. Direct visualization, by
culdocentesis
A.
. A 10-year-old male child was brought by his mother to the ER because of abdominal pain & vomiting. After taking a thorough history & performing a complete PE, you are convinced that you have a case of primary peritonitis. The most appropriate management approach in this case will be observation, hydration & antibiotics. The latter will be _____- based
AAminoglycoside bNitroimidazole
c. Fluoroquinolone
d. Cephalosporin
D. Cephalosporin
A 50 year old female diagnosed with incisional hernia was advised laparoscopic repair. She wants to know the most likely complication of the procedure. Which of the following would be your answer?
A. Increased risk for bowel injury
b. Increase days of hospital stay
c. Increased risk for wound infection
d. Increased recurrence rate
A. Increased risk for INJURY
The laparoscopic treatment of small bowel obstruction appears to be effective and leads to a shorter hospital stay in a highly selected group of patients. The following are the indications for laparoscopic treatment of intestinal obstruction , except
a. Proximal obstruction
b. Partial obstruction
c. No exception
d. Mild abdominal distention
allowing adequate
visualization
e. Anticipated single-band
obstruction
C. No exception
A 10-year-old male child was brought by his mother to the ER because of abdominal pain & vomiting. After taking a thorough history & performing a complete PE, you are convinced that you have a case of primary peritonitis. The evidence that could be LEAST associated with primary peritonitis would be
a. History of cough & colds
b. Post-circumcision edema of the foreskin (not sure)
c. Concurrent knee swelling, pain & warmth
d. History of on & off facial swelling
B. Post circumcision edema of the foreskin
A 27-year-old G1 P0, female, presented herself to the ER because of abdominal pain, fever & chills. After taking a thorough history & performing a complete PE, you are convinced that you have a case of secondary peritonitis. You are highly considering a sexually- transmitted infection as the etiology of her clinical condition. A pelvic abscess was reported by a diagnostic procedure . Source control may be achieved by all, EXCEPT
. Intravenous & oral antibiotics drainage of the abscess
b. Intravenous & oral antibiotics drainage of the abscess & total abdominal hysterectomy
c. Intravenous & oral antibiotics
d. Intravenous & oral antibiotics drainage of the abscess & salpingo- oophorectomy
D.
A 50 year old female was diagnosed with ventral incisional hernia . She wanted to know what technique should have been done by her previous surgeon to prevent this complication. What would be your answer?
a. Both
B. Closure of midline incisions with small
fascial stitches of five to 5
mm width
c. Neither
d. closure of midline incisions with small fascial stitches of five to 5-8 mm length
A. Both 5 and 5-8 mm
A policeman who sustained an abdominal wound in a covert operation underwent laparotomy and repair of a 2 point perforation in the colon. What is true about the management of the midline incision site of this patient
a. The surgeon should put a drain before closure of the incision site.
b. The surgeon should pack the skin and subcutaneous layers and allow it to heal by secondary intention
c. The surgeon should close the incision site primarily to avoid SSI.
d. The surgeon should wash the wound with povidone iodine solution
e. The surgeon should irrigate the wound copiously with antibiotic solution before closure
C. CLOSE
A patient presents with retroperitoneal abscess. Which of the following is a possible source of the abscess?
a. Neither
b. Appendicitis c. Diverticulitis d. Both
D both
A 10-year-old male child was brought by his mother to the ER because of abdominal pain & vomiting. After taking a thorough history & performing a complete PE, you are convinced that you have a case of primary peritonitis. Initial abdominal films of this patient showed dilated bowel loops consistent with ileus. If another radiologic procedure will be done, it should be
a. An abdominal CT-scan
b. A whole abdominal ultrasound
c. A serial abdominal plain film every 8 hours
d. An abdominal MRI
a. An abdominal CT-scan
A patient with intestinal obstruction had a CT scan of the whole abdomen. Which CT scan findings will indicate the presence of strangulated obstruction?
a. Presence of colic gas
the
b. Dilated intestinal bowel loops
c. Presence of ascites
d. Presence of portal vein
gas
e. Presence of air fluid
levels
Presence of portal vein gas
A 34 year old female post party for 3 months came to you for a bulge in the midline above the umbilicus. Which of the following is true of her condition ?
a. This is due to an abnormal separation of rectus muscles.
b. Both
c. Neither
d. This is due to the laxity at the linea alba.
Both
Which of the following is considered an intraluminal cause of intestinal obstruction ?
a. Intussusception
b. Malrotation
c. Carcinomatosis
d. Gallstone
e. Intestinal Tuberculosis
D. Gallstone
In patients with Chrons or other inflammatory bowel disease, what is the pathophysiologic mechanism of intestinal obstruction?
a. Acute bowel inflammation
b. Bowel edema
c. All of the answers are
correct
d. Bowel strictures
e. None of the answers is correct
ALL