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Abdomen > Abdominal enlargement > Flashcards

Abdominal enlargement Flashcards

1
Q 
Which of the following factors is suspected to cause arteriolar vasodilation initiating ascites formation?
A. Aldosterone
B. Acetylcholine 
C. Nitric oxide
D. Renin
A

C

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2
Q 
A 66/M complained of abdominal enlargement secondary to ascites. Ascitic fluid analysis showed neutrophil count of 1050/mm3 and multiple isolates of both gram positive and gram negative organism. The appropriate treatment for this patient is:
A. Third generation cephalosporin alone
B. Exploratory laparotomy
C. Large volume paracentesis (LVP)
D. LVP with albumin infusion
A

B

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3
Q

A 43/M OFW with 20 year history of chronic hepatitis B infection complained of sudden abdominal enlargement, fever, and abdominal pain. Which of the following conditions should be considered in this cirrhotic patient?
A. Spontaneous bacterial peritonitis (SBP) and acute pancreatitis
B. Acute pancreatitis and biliary leak
C. Biliary leak and superimposed malignancy (hepatocellular carcinoma/HCC)
D. Superimposed malignancy (HCC) and SBP

A

D

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4
Q

A 54 year old alcoholic male with recent onset of grade 1 ascites will require
A. Spironolactone and furosemide
B. Dietary salt restriction to 2 g/day
C. Therapeutic paracentesis
D. Hospitalization with complete bed rest

A

B

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5
Q 
A 56/F with ascites underwent paracentesis with the following findings: total protein 5.4 g/dl, albumin 1.4 g/dl, serum albumin requested was 3.2 g/dL. Which of the following conditions is consistent with these findings?
A. Pancreatitis
B. Biliary leak
C. Tuberculous peritonitis
D. Congestive heart failure
A

D

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6
Q 
35/M with abdominal enlargement underwent x-ray of the abdomen which showed dilated small intestines and large intestines. He had hypoactive bowel sounds. The most likely cause of his distention is
A. Abdominal obstruction
B. Pancreatitis
C. Ileus
D. Portal hypertension
A

C

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7
Q

46/F consulted because of abdominal enlargement. She has no fever, abdominal pain. She had a history of cervical carcinoma 5 years ago. If she has malignant ascites which of the following treatments will be LEAST helpful?
A. Sodium restriction and diuretics
B. Diuretics and large volume paracentesis (LVP)
C. LVP and transcutaneous drainage catheter placement
D. Transcutaneous drainage catheter placement and sodium restriction

A

A

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8
Q

Refractory ascites can be defined as persistent ascites despite
A. LVP and maximal diuretic use
B. Maximal diuretic use and sodium restriction
C. Sodium restriction and water restriction
D. Water restriction and LVP

A

B

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9
Q

30/F who underwent explore-lap for pelvic abscess 3 months ago came back at the hospital because of generalized abdominal enlargement. PE revealed an abdomen with hyperactive bowel sounds, hypertympanic with no direct and rebound tenderness. Rectal examination revealed empty rectal vault. The most likely clinical impression is

A

C

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10
Q

30/F with persistent vomiting consulted because of progressive painless abdominal enlargement and full rectal vault. This finding will expectedly be seen in this case
A. Segmental intestinal dilation by plain radiography
B. Hypoactive bowel sounds
C. Temperature >39C
D. Severe abdominal tenderness

A

B

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11
Q

In strangulated intestinal obstruction, the immediate cause of localized abdominal tenderness is
A. Marked intraluminal pressure build-up
B. Diltation of proximal intestinal segment
C. Transmural extravasation of intestinal toxin into the peritoneal cavity
D. Intraluminal accumulation of succus entericus

A

C

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12
Q 
Conservative management for 48-72 hours in an adult patient with intestinal obstruction secondary to postoperative adhesion consists of
A. Nothing per orem
B. Nasogastric tube decompression
C. Correction of fluid and electrolytes
D. AOTA
A

D

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13
Q 
Conservative management for 48-72 hours in an adult patient with intestinal obstruction secondary to postoperative adhesion consists of
A. Nothing per orem
B. Nasogastric tube decompression
C. Correction of fluid and electrolytes
D. AOTA
A

D

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14
Q

Indication for laparotomy in a patient with intestinal obstruction due to postoperative adhesion
A. Failure of conservative management
B. Clinical evidence of complete obstruction
C. Clinical evidence of strangulated obstruction
D. AOTA

A

D

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15
Q

38/M who underwent explore lap for ruptured appendicitis 2 weeks ago came back at the hospital because of generalized abdominal enlargement. PE revealed an abdomen with hyperactive bowel sounds, hypertympanitic with mild to absent tenderness at the mid-abdomen. The most likely reason for these physical findings will be
A. Retroperitoneal abscess formation
B. Intraperitoneal abscess formation of transudative fluid
C. Multiple solid organ enlargement
D. Proximal intraluminal fluid accumulation due to distal obstruction

A

D

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16
Q 
Component/s of conservative management in an adult patient with intestinal obstruction secondary to postoperative adhesion consists of
A. Clear liquid diet
B. Nasogastric tube decompression
C. Deprivation of fluid and electrolytes
D. AOTA
A

B

17
Q

A 34/M cachectic with moderate ascites was suspected to have tuberculous ascites. He underwent diagnostic paracentesis. Which of the following ascitic fluid findings are consistent with ascitic fluid from a patient with tuberculosis?
A. Serum-ascites albumin gradient (SAAG) 1.1, total cell count of 1000/mm3, lymphocytes 150/mm3 and neutrophil 850/mm3
C. SAAG 1.1, total cell count of 500/mm3, lymphocytes 150/mm3 and neutrophil 350/mm3

A

A

18
Q 
Angela consulted you because of abdominal distention. Your PE was negative for shifting dullness. However, subsequent ultrasound showed ascites. This can be explained because ascites to be detected by PE must be at least (in ml or cc):
A. 500
B. 800
C. 1500 
D. 1800
A

C

19
Q 
Component/s of conservative management in an adult patient with intestinal obstruction secondary to postoperative adhesion consists of
A. Clear liquid diet
B. Nasogastric tube decompression
C. Deprivation of fluid and electrolytes
D. AOTA
A

B

20
Q 
The recommended surgical procedure for complete intestinal obstruction due to adhesion in the presence of a viable bowel with no perforation is
A. Resection and anastomosis
B. Adhesiolysis
C. Proximal ileostomy
D. Bypass procedure
A

B

21
Q 
Which of the following DOES NOT account for the majority (60%) of abdominal masses in children?
A. Enlarged liver
B. Enlarged spleen
C. Enlarged kidneys
D. Teratoma
A

D

22
Q

The following is more likely to require diagnostic investigation
A. 4 year old boy, thriving well, with a 3 month history of difficult passage of stools following episodes of passage of blood-streaked stools
B. 3 year old girl with weight-for-height z-score of zero with straining on defecation after his previous nanny was replaced by a new one
C. 2 month old baby breastfed boy with abdominal distention, vomiting, and irregular passage of stools
D. 1 month old breastfed baby girl with bowel movements every 7 days

A

C

23
Q 
The most common etiology of mechanical small bowel obstruction in a 20 year old male with no previous laparotomy is
A. Intussusception
B. Groin hernia
C. Volvulus
D. Peritoneal adhesion
A

B

24
Q 
The recommended surgical procedure for strangulated small intestinal obstruction due to postoperative adhesion with resulting non-viable segment of small bowel will be
A. Resection and anastomosis
B. Adhesiolysis
C. Proximal ileostomy
D. Bypass procedure
A

A

25
Q

Which one is not a clinical feature of a functional intestinal obstruction?
A. Segmental dilation by plain radiography
B. Hypoactive bowel sounds
C. Generalized abdominal enlargement
D. Moderate to severe abdominal tenderness

A

A

26
Q 
Which one is considered to be a cardinal symptom of intestinal obstruction?
A. Colicky abdominal pain
B. Diarrhea
C. Generalized abdominal enlargement
D. Fever
A

A

Abdomen (20 decks)

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