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Hi-Yield for PLE > Anatomy-Surgery BLITZ > Flashcards

Anatomy-Surgery BLITZ Flashcards

1
Q

Blood supply of scalp?

A

Branches of ECA

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2
Q

Scalping occurs at what layer?

A

Loose areolar tissue

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3
Q

Dnagerous area of the scalp

A

Loose areolar tissue

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4
Q

Largest and most constant passes through the mastoid to the lateral sinus

A

Emissary vessels

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5
Q

Emissary vessels are also known as

A

Cerebral veins and bridging veins

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6
Q

Classification of subdural hematoma

A

Acute (up to 48 hours) blood and clot - hyperdense
Subacute (2-14days) clotted blood and fluid - hypodense
Chronic (>14 days) liquifies hematoma - hypodense

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7
Q

Group of disorders that result from the abnormal obliteration if premature fusion of the cranial suture

A

Craniosynosthosis

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8
Q

Complication of forceps delivery

A

Facial nerve injury

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9
Q

Structure in the head that is not present at birth and develops during the first 2 years of life

A

MasTWOid process

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10
Q

Cranial fossa weakest

A

Middle cranial fossa

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11
Q

Thinnest part of the lateral wall of the skull

A

Pterion

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12
Q

Artery affect if there’s fracture of the pterion

A

Anterior branch of the middle meningeal artery

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13
Q

Hematoma that manifests LUCID INTERVAL

A

Epidural hematoma

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14
Q

Basilar skull fracture affects what part of the cranium?

A

Petrous portion of temporal bone

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15
Q

Part of the cranial floor that separates the middle and posterior cranial fossa

A

Petrous portion of temooral bone

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16
Q

What nerve is affected if there is damage in the petrous portion of temporal bone?

A

CNVIII

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17
Q

Ecchymosis of the mastoid process

A

Battle’s sign

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18
Q

Hemotympanum, battle’s sign and raccoob eyes are signs seen in what cranial fracture?

A

Basilar skull fracture

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19
Q

What cranial nerves are seen in the cavernous sinus?

A

CN III, IV and VI

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20
Q

Mildest form of head injury that results to rotational acceleration of the head in the absence of significant injury

A

Concussion

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21
Q

Most common site of hypertensive bleed

A

Putamen

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22
Q

Arteries involved in hypertensive bleed

A

Lenticulostriate arteries

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23
Q

Most common cause of SAH

A

Traumatic

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24
Q

Most common cause of spontaneous SAH

A

Ruptured Aneurysm

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25
Q

ADPKD is associated with aneurysm. T/F

A

T

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26
Q

Buttresses of the face

A

Nasomaxillary, alveolar, zygomaticofrontal and maxillary, superior and inferior orbital, pterygomaxillary

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27
Q

Vertical buttress comprises of

A

Zygomaticofrontal maxillary (lateral)
Nasomaxillary (medial)
Pterygomaxillary (posterior)

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28
Q

Horizontal buttress comprises of

A

Supraorbital bar
Inferior orbital rim/orbital floor
Alveolus

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29
Q

Type of facial fracture according to location that involves the frontal bone, frontal sinus and supraorbital ridge

A

Upper third of the face

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30
Q

Type of facial fracture according to location that affects the nasal bone, orbital bones, naso-orbito-ethmoidal complex, zygoma, maxilla and alveolar process

A

Middle third of the face

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31
Q

Type of facial fracture that involves the alveolar process and mandible

A

Lower third of face

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32
Q

An opacification in the upper maxillary sinus, which represents periorbital fat and possibly an entrapped EOM in the maxillary sinus

A

Tear drop sinus

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33
Q

Most common fractures of the facial bone in descending order

A

Nasal
Zygomatic
Mandible

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34
Q

Artery contained in the cavernous sinus

A

ICA

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35
Q

Trecher Collins Syndrome is also known as

A

Mandibulofacial dysostosis

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36
Q

_____week of embryogenesis that cleft lip and palate develop

A

8th

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37
Q

His (classic theory)

Cleft lip and palate

A

Failure of fusion theory

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38
Q

Stark

Cleft lip and palate

A

Mesodermal penetration theory

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39
Q

Incomplete clefts affect only a portion of the lip and contain a bridge of tissue connectinf the central and lateral lip elements referred to as

A

Simonart’s band

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40
Q

Disorder of unknown etiology, beginning in childhood or adolescence, in which hemifacial atrophy of the skin, subcutaneous fat, muscle, bone and cartilage

A

Romberg’s progressive hemifacial atrophy also known as Parry-Romberg syndrome

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41
Q

Complete closure of lip and palate can be seen when?

A

After 12th week

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42
Q

Mkst common cleft palate that has a trid deformities of bifid uvula, diastasis of velum (thin membrane) and palpable posterior notch

A

Submucous cleft palate

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43
Q

Cheiloplasty (primary cleft lip repair) rule of 10’a

A

At least 10 weeks age
10 lbs
Hgb 10g/dL

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44
Q

Palatoplasty
Timing of operation:
Controversial:

A

Timing of operation: before 1 y/o

Controversial: early closure, improved speech, midface retrusion

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45
Q

1st step in the NB tx with a complex cleft lip and palate

A

Nasoalveolar molding, prosthesis in infancy, followed by stages repair

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46
Q

2-3 cm above the clavicle anteriorbto C6 transverse process, most superficial passage of brachial plexus

A

Erb’s point

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47
Q

Ill-fitted crutches affects what nerve?

A

Radial nerve

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48
Q

Muscles innervated by Radial Nerve

A 
Abductor pollicis longus
Brachioradialis
Anconeus
Triceps
Extensors
Supinator
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49
Q

Mishaft humeral fracture and nerve in spiral groove, wristdrop

A

Radial nerve (C5-T1)

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50
Q

Saturday night palsy and honeymooner’s palsy

A

Radial nerve damage

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51
Q

Tennis elbow

A

Lateral epicondylitis

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52
Q

Golfer’s elbow

A

Medial epicondyliis

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53
Q

Nursemaid’s elbow aka as pulled elbow

A

Annular ligament displacement
Radial head subluxation
Indicative of child abuse

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54
Q

Fractures of the forearm

A

Colle’s
Smith
Galeazzi
Monteggia

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55
Q

Fracture of the distal end of the radius with the distal fragment displaced dorsally
Posterior dislocation
Dinner fork deformity

A

Colle’s fracture

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56
Q

Fracture of the distal end of the radius with the distal fragment displaced volarly
Anteriorly displaced
Reverse colle’s

A

Smith’s fracture

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57
Q

Fracture of the proximal end of the radius with dislocation of radio-ulnar joint

A

Galeazzi’s fractre

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58
Q

Fracture of the shaft of ulna with anterior dislocation of the radial head and rupture of annular ligament

A

Monteggia’s fracture

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59
Q

GRIMUS

A

Galleazzi - radial fracture, inferior dislocation

Monteggia - ulnar fracture, superior dislocation

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60
Q

Weakest part of the clavicle

A

Junction of its middle and lateral thirds

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61
Q

Treatment of clavicular fracture

A

Figure of 8 splint

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62
Q

Classic history of clavicular fracture

A

Fall on the shoulder or outstretched hand

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63
Q

Direction of clavicular fracture

A

Distal fragment goes downward, medial and forward by pectoralis major
Medial end pulled upward by SCM

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64
Q

Artery that divides the clavicle

A

Subclavian artery

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65
Q

Scapular fractures

A

Result of severe trauma
Run-over accident victims, VA
Require little treatment

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66
Q

Delayed ossification of midline structures, particularly membranous bone
Partly missing/absent clavicle

A

Cleidocranial dysostosis

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67
Q

Muscle that divides the subclavian artery into three part

A

Scalenus anterior

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68
Q

3 parts of the subclavian artery divided by scalenus anterior

A
  1. First part: vertebral artery, thyrocervical trunk and internal thoracic
  2. Second part
  3. Third part
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69
Q

Axillary artery is the continuation of what artery?

A

Subclavian artery

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70
Q

Axillary artery

A

Begins at lateral border of the first rib until lower border of teres major (brachial artery)
Related to the cords of the brachial plexus
Enclosed with them in the axillary sheath

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71
Q

Muscle that divides the axillary artery into 3 parts

A

Pectorialis minor

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72
Q

3 parts of the axillary artery

Screw The Lawyer Save A Patient

A

1st part: supreme or highest thoracic artery
2nd part: thoracocacromial, lateral thoracic
3rd part: subscapular, anterior and posterior humeral circumflex artery

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73
Q

Small branches of the axillary artery

A

Brachial
Radial/ulnar
Palmar arch

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74
Q

Course of brachial artery

A

Begins at lower border of teres major (from axillary artery)
Descends through anterior compartment of arm on brachialis muscle
Enters cubit fossa
Ends at level of neck of radius divides into radial and ulnar artery

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75
Q

Boundaries of radial pulse

A

Laterally: tendon of brachioradialis
Medially: tendon of FCR

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76
Q

Radial artery is ________than ulnar artery

A

Smaller

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77
Q

Course of ulnar artery

A

Descend through the anterior compartment
Enters palm in front of flexor retinaculum with the ulnar nerve
Ends by forming superficial palmar arch gives rise to superficial palmar branch of radial artery

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78
Q

Palmar arches

A

Radial artery -> deep palmar arch

Ulnar artery -> superficial palmar arch

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79
Q

Allen test

A

Should return in 7 seconds
Prior to radial artery cannulation
Prior to heart bypass surgery

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80
Q

Most mobile yet unstable joint

A

Shoulder joint

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81
Q

Rotator cuff muscles

A 
SITS muscle
- supraspinatus (superior)
- infraspinatus (posterior)
- teres minor (posterior)
- subscapularis (anterior)
Supports the humeral head to the glenoid fossa
Inferiorly: no support
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82
Q

Boundaries of quadrangular space

A

Superior: subscapularis
Lateral: humerus
Inferior: teres major
Medial: triceps (long head)

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83
Q

Contents of quadrangular spaces

A

Axillary nerve

Posterior humeral circumflex

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84
Q

Volkmann’s ischemic contracture

A

Occurs in supracondylar fracture
Permanent flexion contracture of the hand and wrist (clawlike deformity)
Compressed brachial artery

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85
Q

Most common carpal bone fracture

A

Scaphoid

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86
Q

Most common dislocated carpal bone

A

Lunate

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87
Q

Artery injured in scaphoid fracture

A

Radial artery

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88
Q

Nerve injured in hamate fracture

A

Ulnar nerve

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89
Q

Froment sign is a test of what nerve?

A

Ulnar nerve

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90
Q

Artery traverses the anatomic snuffbox

A

Radial artery

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91
Q

2nd most commonly fractured carpal bone

A

Lunate fracture

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92
Q

Nerve compressed in lunate fracture

A

Median nerve

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93
Q

Boundaries of anatomic snuffbox

A

EPoL
APoL
EPB

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94
Q

Floor of the anatomic snuffbox

A

Scaphoid bone

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95
Q

No man’s land

A

Flexor tendon injuries at zone 2 have poor prognosis

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96
Q

Osteoarthritis
Heberden nodes
Bouchard nodes

A

Heberden nodes: distal

Bouchard nodes: proximal

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97
Q

Injury to the extensor digitorum tendon

A

Mallet finger

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98
Q

Contracture of palmar aponeurosis seen in Uremia

A

Dupuytren contracture

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99
Q

Action of the lumbricals

A

Flex MCP and extend IP

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100
Q

Contents of the middle mediastinum

A 
Heart
Roots of great vessels
Primary bronchi
Phrenic nerve
Arch of azygous
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101
Q

Contents of the posterior mediastinum

A 
Thoracic aorta
Esophagus
Azygos and hemiazygos vein
Vagus nerve
Thoracic duct
Sympathetic trunk
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102
Q

Immediate management of tension pneumothorax

A

Needle thoracostomy (2nd ICS)

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103
Q

Definitive management of tension pneumothorax

A

CTT (4th or 5th ICS AAL)

- may be done at a lower ICS but not lower than 5th rib on either side (dome of diaphragm)

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104
Q

Sternal space of Burns

A

It is where the deep infection in the neck and esophageal perforation affects the mediastinum causing mediadtinitis

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105
Q

Mediastinoscopy (procedure) used to obtain samples of tracheobronchial lymph nodes through thensubsternal space

A

Chamberlain procedure

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106
Q

Apical lung tumor that causes Horner syndrome

A

Pancoast tumor or superior sulcus tumor

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107
Q

Right brachiocephalic + left brachiocephalic =

A

SVC

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108
Q

Structure formed behind the lower border of the 1st costal cartilage

A

SVC

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109
Q

SA node location

A

Sulcus terminalis

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110
Q

Pemberton sign is seen at what disease entity?

A

SVC syndrome

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111
Q

Sign used to denote flushing of head when hands are raised

A

Pemberton sign

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112
Q

Branches of the arch of the aorta

A

Brachiocephalic trunk
Left common carotid
Left subclavian

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113
Q

2 branches of the pulmonary trunk

A

Right and left pulmonary artery

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114
Q

Most sensitive CXR finding suggesting tear of the aorta

A

Widened mediastinum

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115
Q

Best screening test for aortic tear

A

Dynamic spiral CT

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116
Q

Definitive test for aortic tear

A

Aortography

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117
Q

Aortic tear or disruption is caused by

A

Deceleration injury

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118
Q

Location of injury in aortic tear

A

Distal to subclavian artery at level of ligamentum arteriosum

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119
Q

CXR finding of aortic tear

A

Widened mediastinum
Pleural capping
1st and 2nd rib fracture
Loss of aortic knob

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120
Q

Atypical rib that is the broadest, shortest, most sharply curved, groove for subclavian artery

A

Rib 1

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121
Q

Site of intercostal nerve block

A

Lower border of the robins

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122
Q

Site of needle thoracentesis

A

2nd or 3rd ICS MCL, upper border of rib

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123
Q

Weakest part of the rib where most fractures occur

A

Anterior to the angle usually rib 5-10

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124
Q

Paradoxical chest movement caused by Two separates fractures in >3 contiguous ribs ( junction and angle)

A

Flail chest

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125
Q

Major cause of respiratory compromise

A

Pulmonary contusion

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126
Q

Cervical prominence

A

C7

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127
Q

Causes of thoracic outlet syndrome

A

Cervical rib, physical injuries and muscle enlargement

128
Q

Thoracic outlet syndrome causes compression of the NV bundle namely

A

Subclavian vessels and brachial plexus

129
Q

Lining epithelium of esophagus

A

Stratified squamous

130
Q

Muscle of the upper 1/3 of the esophagus

A

Striated muscle

131
Q

Muscle of the lower 1/3 of the esophagus

A

Smooth muscle

132
Q

Level of esophagus

A

C6 to cardiac

133
Q

Length of esophagus

134
Q

Constriction of esophagus

A

Cervical constriction
Bronchoaortic constriction
Diaphragmatic constriction

135
Q

Blood supply
Cervical esophagus
Thoracic esophagus
Abdominal esophagus

A

Cervical esophagus: inferior thyroid artery
Thoracic esophagus: bronchial arteries and aorta
Abdominal esophagus: left gastric artery and inferior phrenic artery

136
Q

Triad of achalasia

A

Hypertensive LES
Aperistalsis of esophageal body
Failure of LES to relax

137
Q

Surgical treatment for achalasia

A

Heller’s myotomy with or without Partial fundoplication

138
Q

Gold standard in diagnosis of GERD

A

24 hour pH monitoring

139
Q

Most effective surgical treatment for GERD

A

Nissen fundoplication

140
Q

Hallmark of intestinal metaplasia

A

Presence of jntestinal goblet cells

141
Q

Most common location of esophageal adenocarcinoma

A

Middle 3rd

142
Q

Linear laceration of esophagus which is common in alcoholics with history of forceful retching or vomiting

A

Mallory weiss tear

143
Q

Most common location of Mallory weiss tear

144
Q

Thin submucosal ring in the lower esophagus presenting with dysphagia

A

Schatzki’s ring

145
Q

Plummer Vinson is characterized as

A

Esophageal webs
Atrophic glossitis
IDA

146
Q

CA predisposed by Plummer Vinson syndrome

A

Squamous cell CA

147
Q

Spontaneous pressure rupture of esophagus

A

Boerhaave’s syndrome

148
Q

Location of Boerhaave’s syndrome

A

Left pleural cavity or just above the GEJ

149
Q

Most common benign tumor of the esophagus and stomach

150
Q

Most common presenting symptom of esophageal CA

A

Dysphagia (60% of esophageal lumen is infiltrated)

151
Q

Ivor-Lewis procedure

A

Trans-thoracic esophagectomy

Wider lymphadenopathy

152
Q

Orringer’s procedure

A

Trans-hiatal procedure
Avoids thoracotomy
Less morbidity

153
Q

Most common site of Zenker’s diverticulum

A

Killian’s triangle

154
Q

Most common site of esophageal perforation

A

Killian’s triangle

155
Q

Weaknspit between inferior constrictor and cricopharyngeus muscles

A

Killian’s triangle

156
Q

Most common type of esophageal diverticula

A

Pharyngoesophageal (Zenker’s diverticula) thru Killian’s triangle usually left

157
Q

Contents of the inguinal canal

A

Ilioinguinal nerve
Spermatic cord (male)
Round ligament of uterus (female)

158
Q

Structure that guides the descent of testis

A

Gubernaculum

159
Q

Caused by poor gubernacular fixation leading to torsion of testes

A

Bell clapper deformity

160
Q

Other name of inguinal, lacunar ligament and Cooper’s ligament?

A

Poupart’s, Gimbernat and Pectineal Ligament

161
Q

Conjoint tendon (Cinta) aka Falc Inguinalis are formed by what 2 structures?

A
  1. Transverse Abdominis

2. Internal oblique

162
Q

Boundaries of Hesselbach triangle

A

Medially, rectus abdominis
Inferiorly, inguinal ligament
Laterally, inferior epistric vessel

163
Q

Contents of spermatic cord

A

Vas deferens, testicular artery and vein pampiniform plexus), genital branch of genitofemoral nerv
Cremaster artery, artery of the vas

164
Q

Triangle of Doom affected vessels

A

Iliac vessels, genital brach of genitofemoral nerve, ductus deferens

165
Q

Triangle of pain boundaries

A

Inferolateral border: iliopubic tract
Superomedial border: gonadal vessels
Lateral border: reflected peritoneum

166
Q

Triangle of pain affected vessels

A

Iliopubic tract
Lateral and anterior femoral cutaneous nerve
Iliac vessels

167
Q

Circle of death or corona mortis affected vessels

A

Aberant artery
Obturator artery
Internal iliac artery

168
Q

Femoral triangle

From lateral to medial

A

NAVEL

Nerve, artery, vein, empty, lymphatics

169
Q

Boundaries of femoral triangle

A

Superiorly: inguinal ligament
Laterally: sartorius muscle
Medially: adductor longus muscle

170
Q

Floor of femoral triangle

A

Iliopsoas, pectineus, adductor longus

171
Q

Hernia that is most common in both gender described as the neck of the hernia is LATERAL to the inferior epigastric vessels

A

Inguinal hernia

172
Q

Hernia that is MEDIAL to the inferior epigastric vessels

A

Direct hernia

173
Q

Superior lumbar triangle is what type of hernia?

A

Grynfeltt’s hernia

174
Q

Inferior lumbar triangle is what type of hernia

A

Petit’s hernia

175
Q

Hernia repair consisting of tightening an enlarged deep ring only (simple ring closure)
Hernioplasty of choice for women with IIH

176
Q

Hernial repair involving TO, TA, TF approximated to iliopubic tract and the shelving edge of inguinal ligament with interrupted sutures
Non anatomic
May cause tension, hence recurrence

177
Q

Same aponeurotic layers in Bassini are approximated by precise layered imbrication with continuous suture
Non-anatomic
May cause tension, hence recurrence of hernia

178
Q 
Hernia repair that is
Longer duration
More extensive dissection
More pain
More suturing
More dissection
A

Shouldice repair

179
Q

Hernia repair wherein the transverse aponeurotic arch is sutured to Cooper’s ligament medially and to the femoral sheath laterally
Anatomic basis: a strong posterior inguinal wall is the best protection againstnangroin hernia in an adult

A

McVay-Lotheissen

180
Q

Hernia repair that bridges the decect without tension along with tissue through the internstices of a prosthetic marerial (MESH) to reinfore the repair
Mesh is sutured circumferentially to IO, rectus sheath and shelving edge of inguinal ligament

A

Lichtenstein

181
Q

The line of Cantle represents location of what hepatic vein?

A

Middle hepatic vein

182
Q

Functional segments of the lover
1
2-4
5-8

A

1 caudate lobe
2-4 left hemiliver
5-8 right hemiliver

183
Q

Divides the liver anatomically

A

Falciform ligament

184
Q

Postero-inferior surface of the piver, in between the quadrate and caudate lobe
Within the hepatoduodenal ligament

A

Porta hepatis/hilum of liver

185
Q

Boundaries of porta hepatis

A

Anteriomedial: heptic artery
Antero-lateral: CBD
Posterior: portal vein

186
Q

Maneuver used to clamp the prota hepatis

A

Pringle’s maneuver

187
Q

Union of SMV and splenic vein

A

Portal vein

188
Q

Vein that drains venous blood from lower 3rd of esophagus doen to half of anal canal
Opens into porta hepatis and divides into left and right branches

A

Portal vein

189
Q

Major blood supply of the liver comes from the portal vein (____%) then the hepatic artery (______%)

A

portal vein (70%) then the hepatic artery (30%)

190
Q

Esophageal varices comes from what vessels?

A

Distal 3rd, esophageal branches of left gastric vein (portal)

191
Q

Hemorrhoids come from what vessel?

A

Superior rectal vein (portal)

192
Q

Caput medusae comes from what vessels?

A

Paraumbilical vein (superficial veins of anterior abdominal wall)

193
Q

Next Surgical management for recurrent esophageal varices despite medical management and esophageal sclerotherapy

A

TIPS for Child’s B and C

Surgical shunt for Child’s A

194
Q

Shunt that has the least incidence of hepatic encephalopahty

A

Distal splenorenal shunt (Waren shunt)

195
Q

Bilirubin is detectable at what level?

A

> 2.5 mg/dL

196
Q

During liver biopsy, the needle is inserted into what ICS?

A

Right 10th ICS MAL in full expiration

197
Q

Congestive hepatopathy characterized by obstruction to hepatic venous outflow

A

Budd-Chiari Syndrome

198
Q

Definitive study for Budd-Chiari Syndrome

A

Heptic venography

199
Q

Pyogenic abscess, as caused by E.coli in 2/3, affects what lobe in the liver?

A

Right lobe

200
Q

Organism involved in hepatic abscess more common in the 3rd world countries and has a characteristic finding of anchovy paste (necrotic central portion containing reddish brown pus-like material)

201
Q

Most common form of liver abscess worldwide

A

Amebic abscess

202
Q

Commonly affects the antero-inferior or postero-inferior portions of the right lobe characterized by dull RUQ pain or abdominal distention, allergic or anaphylactic reaction with cyst rupture

A

Hydatid disease

203
Q

Water-lily sign?

A

Hydatid disease

204
Q

Most common primary hepatic tumor in children

A

Hepatoblastoma

205
Q

Most common benign hepatic tumor

A

Hemangioma

206
Q

Most common metastatic site of colon CA

207
Q

Most common primary liver malignancy

208
Q

Triad of hemobilia (or Quincke’s)

A

RUQ pain, UGIB and jaundice

209
Q

Part of the pancreas that has projection to left behind SMA

A

Uncinate process

210
Q

Most common and clinically significant congenital anomaly of the pancreas
Functional obstruction of duct of Santorini

A

Pancreas divisum

211
Q

2nd part of the duodenum surrounded by a rim of pancreatic tissue

A

Annular pancreas

212
Q

Treatment of annular pancreas

A

Duodenoduodenostomy

213
Q

Signs of hemorrhagic pancreatitis

A 
Grey Turner sign
Cullen sign (blood dissects up to the falciform ligament and create periumbilical ecchymosis)
214
Q

Acute pancreatitis radiologic finding

A

Calcification, lesser sac fas, blurred psoas, COLON CUT-OFF SIGN, reverse or inverted 3 sign

215
Q

Pancreatic head mass radiologic finding?

A

Double duct sign

216
Q

Chronic pancreatitis radiologic finding?

A

Chain of lakes

217
Q

Most common cause of chronic pancreatitis?

A

Alcohol consumption and abuse

218
Q

Most common primary malignancy of the pancreas

A

Ductal adenocarcinoma

219
Q

Most common site of pancreatic CA

A

Pancreatic head

220
Q

Most frequent altered oncogene in pancreatic CA

A

Kras (also colon CA)

221
Q

The current diagnostic and staging test of choice for pancreatic CA?

A

Spiral CT with contrast

222
Q

Etiology for the severe pain experienced by patients with pancreatic CA

A

Invasion of retroperitoneal nerve

223
Q

Drug used for palliative treatment of advanced pancreatic CA

A

Gemcitabine

224
Q

Tumor linked with whipple’s triad

A

Insulinoma

225
Q

Syndrome of watery diarrhea, hypokalemia and achlorhydia?

A

WDHA syndrome/ VIPoma/ Verner-Morrison syndrome

226
Q

Pancreatic disease in the presence of migratory erythema

A

Glucagonoma

227
Q

Characteristics of glucagonoma

A

Serum glucagon >500pg/mL
Usually at body and tail
Metastatic at time of diagnosis
Debulking at treatment

228
Q

Blood supply of lesser curvature

A

Right and left gastric

229
Q

Blood supply of greater curvature

A

Right and left gastroepiploic

230
Q

Blood supply of fundus of the stomach

A

Short gastric (from splenic artery)

231
Q

Most abundant of gastric cell

A

Chief cell

232
Q

Gastric cell responsible for carcinoid tumor

A

Enterochromaffin like cell

233
Q

Main innervation of the stomach

A

Left and right vagal trunk

234
Q

Location of left vagal trunk

A

Anterior surface, gives hepatic branch and nerve of Latarjet

235
Q

Location of right vagal trunk

A

Posterior surface, gives rise to celiac branch, gives rise to criminal nerve of Grassi

236
Q

Nerve often missed during vagotomy and is then responsible for recurrence of PUD

A

Criminal nerve of Grassi

237
Q

Posterior nerve of the lesser curvature is a branch of the posterior vagal trunk which supplies the pylorus

A

Nerve of Latarjet

238
Q

Removal of Nerve of Latarjet will predispose the patient to what gastric condition

A

Dumping syndrome

239
Q

Nerve of Latarjet was left intact in what procedure

A

Highly selective vagotomy

240
Q

Other name of the nerve of Latarjet

A

Crow’s foot

241
Q

Ulcer treatment associated with the least recurrence and highest mortality

A

Antrectomy + bilateral truncal vagotomy

242
Q

Hormones that will induce gastric acid secretion

A

Ach, Histamine, Gastrin

243
Q

Hormone that will inhibit acid secretion

A

Somatostatin

244
Q

Most potent physiologic stimulus for pepsinogen release

245
Q

Most potent inhibitor of gastrin release

A

Luminal acid

246
Q

Most common type of gastric ulcer

A

Antral lesser curvature

247
Q

Define type II gastric ulcer

A

Type 1 plus duodenal ulcer

248
Q

Define type III gastric ulcer

A

Pre-pyloric ulcer

249
Q

Define type IV gastric ulcer

A

High in the lesser curvature

250
Q

Type of gastric associated with NSAID use

251
Q

Length of duodenum

252
Q

Most common site of duodenal ulcer

A

1st part of the duodenum

253
Q

Artery that lies directly behind the first portion of the duodenum

A

Gastroduodenal artery

254
Q

Horizontal folds of mucuous membrane, around orifice of ileum

A

Ileocecal valve

255
Q

Hormone controls the ileocecal sphincter

256
Q

Sphincter that controls flow of contents from ileum into colon

A

Ileocecal sphincter

257
Q

Most common surgical disorder of the small interstines

A

Mechanical small bowl obstruction (75% adhesions)

258
Q

Hernia in a meckel’s diverticulum

A

Littre’s hernia

259
Q

Most common cause of mesenteric ischemia

A

Arterial embolus

260
Q

Arterial embolus, causing Mesenteric Ischemia, is usually found in ____% with cardiac disease, from left atrial thrombi, lodges to SMA distal to middle colic

261
Q

Complication of mesenteric ischemia

A

Full-thickness infarction within 6 hours

262
Q

Classic history of mesenteric ischemia

A

Physical examination finding is not compatible

263
Q

Most common site of bowel ischemia

A

Griffith’s point (watershed area of SMA and IMA)

264
Q

Artery that forms an umportant anastomosis beween SMA and IMA, and forms a continuous arterial circle or arcade along the inner border of the colon

A

Marginal artery of Drummond

265
Q

Another anastomosis present kn the colonic mesentery that connecta the proximal middle colic artery with the left colic artery

A

Arc of Riolan

266
Q

Blood vessel that is compressed in Nutcracker syndrome

A

Renal vein

267
Q

Most common site of aneurysm

A

Infrarenal

268
Q

Most common risk factor

A

Atherosclerosis

269
Q

Weight of prostate gland

270
Q

Medication that relaxes the prostate and provide larger urethral opening

271
Q

Medication that shrinks the prostate

A

Finasteride

272
Q

Prostate adenocarcinoma is often asymptomatic and ____% nodule on DRE

273
Q

Most common grading system of prostate CA

A

Gleason system

274
Q

Calcium stones that is associated with distal RTA

A

Calcium phosphate stone

-described as balck, grey or white small smooth or spiky, dense

275
Q

Renal stone that is caused by repeated UTI with urease producing bacteria

A

Struvite stone or Magnesium Aluminum Phosphate

276
Q

Level of PSA that is considered micrometastatic

277
Q

Most common solid renal tumor

A

Renal cell tumor

278
Q

Classic triad of renal cell CA (10-15%)

A

Flank pain, hematuria and palpable mass

279
Q

Most common solid renal tumor of childhood

A

Wilms tumor

280
Q

What fascia is included in radical !nephrectomy?

A

Gerota’s fascia

281
Q

Bladder CA is highly associated with what risk factor?

A

Smoking (2-naphthylamine 4-aminobiphenyl)

282
Q

Most common urothelial carcinoma subtype in developing countries and caused by schistosoma haematobium

A

Squamous cell carcinoma

283
Q

Most common complication of thyroglossal duct cyst

284
Q

Surgical procedure for thyroglossal duct cyst

A

Sistrunk operation

285
Q

Most common branchial cleft anomaly gound in te opening between middle and lower third of SCM

A

2nd branchial cleft anomaly

286
Q

Surgical procedure for branchial cleft anomaly

A

“Stepladder” incision to remove entire tract

287
Q

Most common site of cystic hygroma

288
Q

Lymphatic malformation as a result of a maldeveloped localized lymphatic network, which fails to connect or drain into the venous system (lymphangioma)

A

Cystic hygroma

289
Q

Treatment of choice for cystic hygroma

A

Surgical excision

290
Q

Sclerosing agent for cystic hygroma

A

OK-432 (or Picibanil) or bleomycin

291
Q

Bleomycin is notorious for causing what complication?

A

Pulmonary fibrosis

292
Q

Congenital Diaphragmatic Hernia

a. Bochdalek’e hernia
b. Morgagni’s hernia

A

a. Bochdalek’e hernia: posterilateral

b. Morgagni’s hernia: anterior

293
Q

UGIS finding in pyloric stenosis

A

String sign orbdouble railroad sign

294
Q

Surgical management of pyloric stenosis

A

Fredet-Ramstedt pyloromyotomy

295
Q

Location of 85% cases of duodenal atresia

A

Ampulla of vater

296
Q

Meconium ileus is associated with what condition?

A

Cystic fibrosis (>95%)

297
Q

Soap bubble seen in meconium ileus is known as what sign?

A

Neuhaser’s sign (meconium mixes with air and appeara like ground glass)

298
Q

Most common GI emergency in neonatal period

A

Necrotizing enterocolitis

299
Q

Single most important risk factor for the development of NEC

A

Prematurity

300
Q

Pneumatosis intestinalis is seen in what condition?

301
Q

Surgical indication of NEC

A

Pneumatosis or free abdominal air

302
Q

Most common ectopic tissue fron Meckel’s diverticulum

A

Gastric mucosa (85%)

303
Q

Complications of Meckel’s Diverticulum

A

Hemorrhage (50%)
Obstruction (25%)
Inflammation (20%)

304
Q

Most common cause of colon obstruction

A

Hirschprung’s disease

305
Q

Diagnosis of a pediatric patient with failure of passage of meconium in 24 hours

A

Hirschprung’s disease

306
Q

Mutation of what gene is Hirschprung’s disease associated with?

A

Ret protooncogene

307
Q

Most common presentation of Hirschprung’s disease

A

Constipation, abdominal distention and failure to thrive

308
Q

Definitive surgical management of Hirschprung’s disease

A

Pull-through

309
Q

Diagnostic of Hirschprung’s disease

A

Barium enema: transition zone

Deep rectal or suction biopsy

310
Q

2 types of imperforate anus

A

High type: rectum ends above levator muscle, usually had fistula into membranous urethra in M or vagina in F
Low type: rectum descends into levator muscle, fistula in perineum found in median raphe of scrotum in M or at posterior fourchette in F

311
Q

Surgical management for imperforate anus

A

High: colostomy (newborn) and pull-through procedure at 2 months
Low: anoplasty

312
Q

Pentalogy of Cantrell

A 
D COPS
Diaphragmatic defect
Cardiac abnormality
Omphalocele
Pericardium malformation
Sternal cleft
313
Q

Defect of the abdominal wall; extruded viscera not covered by sac, defect lateral to umbilicus (R>L)

A

Gastrochisis

314
Q

Uncommon anomaly in gastrochisis comprising of 10-15% of cases

A

Intestinal atresia

315
Q

Swenson, Duhamel and Soave are procedure of what congenital gastrointestinal tract?

A

Hirschprung’s disease

Hi-Yield for PLE (6 decks)

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