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2024 > Board Study > Flashcards

Board Study Flashcards

1
Q

McVay (Cooper’s) Repair

A

Transversus Abdominis Aponeurosis to Cooper’s LIgament
-At medial edge sutures placed through transverses abdominis, Cooper’s Ligament and iliopubic tract
-Relaxing incision made in anterior rectus sheath

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2
Q

First line treatment of ITP

A

High dose corticosteroids
IVIG (2nd because it takes 3-5 days)
Rituximab as maintenance
Splenectomy if failure of medical management

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3
Q

Management of blunt trauma lower extremity with asymmetry in pulses or ABI <0.9

A

angiogram

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4
Q

Management of blunt trauma lower extremity with absent pulse or hard sign of vascular injury

A

OR

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5
Q

Refractory peptic ulcer disease, diarrhea, ulcers in absence of H. pylori

A

Zollinger-Ellison syndrome (gastrin >1000)

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6
Q

Confirmatory test for ZES

A

Secretin Stimulation Test
+ test is increase in gastrin >200

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7
Q

Vitamin Deficiency that causes skin rashes/hair loss

A

zinc

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8
Q

Vitamin deficiency that causes poor glycemic control

A

chromium

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9
Q

Vitamin deficiency that causes pancytopenia

A

copper

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10
Q

Vitamin deficiency that causes sideroblastic anemia and peripheral neuropathy

A

B6/pyridoxine

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11
Q

Vitamin deficiency that causes cardiomyopathy

A

selenium

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12
Q

Surgical resection of colon cancer principles (R0)

A

2-5cm margin
12 lymph nodes
Right sided: ligation of ileocolic/right colonic
Transverese: proximal to right branch of middle colic
Left sided: high ligation of IMA

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13
Q

Phyllodes Pathology

A

Fibrosacrcomatous Elements

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13
Q

Nigro Protocol

A

for Anal SCC
Radiation, 5-FU, Mitomycin C

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14
Q

Side effects of amiodarone

A

Pulmonary fibrosis
Thyroid dysfunction (high iodine content) –> treat with steroids

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15
Q

Anatomic landmarks of subclavian vein

A

Deltopectoral Groove
Sternal Notch
Medial Third of the Clavicle

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16
Q

Malignant Hyperthermia gene

A

RYR1 ryanodine receptor gene (AD)

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17
Q

Findings of Uncal Herniation

A

Blown pupil (IL CN III palsy)
CL Hemiplegia/posturing

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18
Q

Spread of follicular carcinoma (thyroid)

A

Local extension and hematogenous dissemination

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19
Q

Blood vessels injured during clamshell

A

LIMA/RIMA off internal thoracic (branch of subclavian)

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20
Q

Central lucency w/ surrounding architectural distortion on mammogram

A

Radial Scar
Often appear as speculated masses

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21
Q

Pathology of radial scars

A

Fibroelastic core w/ entrapped ducts and lobules, surrounding adenosine

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22
Q

Breast pathology: lobular lesion w/ increased fibrous tissue and glandular cells

A

sclerosis adenosine

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23
Q

Tamoxifen mechanism of action

A

competitive estrogen antagonist in breast, partial agonist in non-breast tissues

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24
Q

Primary bile acids

A

Chenodeoxycholic acid
Cholic acid

(decreased in patients with acute on chronic liver failure, decreased fat soluble vitamin absorption –> vitamin K deficiency)

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25
Q

Primary stimulus for fibroblasts in wound healing

A

macrophages

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26
Q

Most common complication leading to chronic lung allograft failure

A

bronchiolitis obliteranes

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27
Q

Liver mass, well circumscribed, early enhancement on arterial phase, no uptake on sulfur colloid

A

adenoma

associated with OCPs

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28
Q

Liver mass with peripheral to central enhancement

A

hemangioma

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29
Q

Liver mass w/ central stellate scar, containing Kupffer cells (uptake on Sulfur colloid scan)

A

Focal Nodular Hyperplasia

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30
Q

Smear findings of patient w/ sideroblastic anemia

A

Pappenheimer bodies (iron containing dark blue granules)

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31
Q

Smear finding of patients w/ G6PD, thalassemias, s/p splenectomy etc

A

Heinz bodies (denatured hemoglobin)

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32
Q

Smear findings of patients s/p splenectomy

A

Howell-Jolly bodies (nuclear remnants)

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33
Q

Early onset graft infections

A

staph aureus or gram negative

Would see systemic symptoms due to higher virulence

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34
Q

Late onset graft infections

A

staph epidermis

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35
Q

Risk of upstaging ADH on excisional biopsy

A

15-30%

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36
Q

Predictive preoperative FEV1 in patients for lobectomy

A

> 0.8L
if <0.8 –> V-Q scan

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37
Q

Which IPMN should be resected

A

Main Duct
Branch Duct w/ high risk stigmata (obstructive jaundice, enhancing nodule >5mm, main duct >10mm)

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38
Q

CEA/Amylase/Mucin in IPMN

A

High/High/High

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39
Q

CEA/Amylase/Mucin in Serous Cystic Neoplasm

A

Low/Low/Low

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40
Q

CEA/Amylase/Mucin in Mucinous Cystic Neoplasm

A

High/Low/High

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41
Q

Side effect associated w/ vincristine

A

Peripheral Neuropathy

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42
Q

Side effects associated w/ carboplatin and vinblastine

A

myelosuppression

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43
Q

Side effects associated w/ cisplatin

A

ototoxicity

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44
Q

Side effects associated w/ doxorubicin

A

cardiomyopathy

45
Q

ABI indicating critical limb ischemia

A

<0.5

46
Q

Course of the IMV

A

Starts as superior rectal vein, becomes IMV coursing posterior to body of pancreas draining into splenic vein which merges w/ SMV to form portal vein

47
Q

Most common hepatic artery variant that may be seen during cholecystectomy

A

Replaced right hepatic artery from SMA (will course through medial aspect of Calot’s Triangle)

48
Q

Management of Barrett’s w/o dysplasia

A

-start PPI
-EGD q3-5y
-Anti-reflux surgery

49
Q

Management of Barrett’s w/ low grade dysplasia

A

-Endoscopic eradication
-EGD q6-12m

50
Q

Management of Barrett’s w/ high grade dysplasia

A

-Endoscopic eradication
-EGD q3m

51
Q

Frey Syndrome

A

Aberrant Regrowth of parasympathetic nerve fibers associated with the auriculotemporal nerve into the sweat glands of the skin overlying the parotid gland

provides sensation to upper earlobe

52
Q

numbness after parotid surgery caused by damage to which nerve

A

the great auricular nerve (sensation to lower earlobe)

53
Q

Management of pediatric hydrocele

A

Observe until age 2 unless symptomatic or skin compromise occurs

54
Q

GI tract secretions per day

A

9L total
PO intake - 2L
Saliva - 1.5L
Stomach 1-2L
Bile 0.5L
Pancreatic 1.5L
Small Bowel 1.5L

55
Q

Muddy brown casts on UA

A

Acute tubular necrosis

56
Q

Most common site of metastases for malignant phyllodes

A

Lung

57
Q

Whipple Triad and diagnosis of Insulinoma

A

Neuroglycopenic symptoms, resolution w/ IV glucose, serum glucose <50

Dx: serum glucose < 50

58
Q

Lab value to diagnose somatostatinoma

A

Fasting somatostatin >100

59
Q

Secretin stimulation test

A

Baseline gastrin drawn, patient given 0.4ug/kg of secretin, gastrin measured at 2,5,10 min

Patient w/ gastronome will have increase in gastric >120

60
Q

Lab value suggestive of gastrinoma

A

gastrin >200

61
Q

Symptoms of glucagonoma

A

Dermatitis (necrolytic migratory erythema)
mild diabetes
stomatitis
anemia
weight loss

62
Q

Lab value suggestive of glucagonoma

A

Glucagon >1000

63
Q

Most common cause of chronic mediastinitis

A

Histoplasma capsulatum

Can result in SVC syndrome

64
Q

First line treatment for C. diff

A

PO findaxomicin 200mg BID x 10 days
Alternative PO vancomycin 125mg QID

65
Q

Fulminant C.diff treatment

A

PO vancomycin 500mg QID
PR vancomycin 500mg QID
IV flagyl q8h

66
Q

Recurrent C. diff treatment

A

1st recurrence fidaxomicin 200mg

67
Q

Most common cause of acute liver failure in US vs World

A

US: acetaminophen
World: viral

68
Q

Caroli Disease

A

Type V cysts
Intrahepatic component only

69
Q

Ideal CVP during liver transection

A

<5mmHg to decrease blood loss
Normal CVP is 8-12

70
Q

Main blood supply to the transverse colona after extended right hemicolectomy

A

marginal artery of Drummond

71
Q

Fetal Blood Flow

A

Oxygenated blood from placenta into single umbilical vein prior to draining into IVC

72
Q

WAGR syndrome

A

Deletion of short arm of chromosome 11
Wilms Tumor
Aniridia
GU anomalies
Mental Retardation

73
Q

Electrolyte abnormalities with pyloric stenosis

A

hypo kalemic
hypochloremic
metabolic alkalosis (elevated bicarb)

Paradoxical acuduria (increased urine K, decrease urine Na)

74
Q

Approach for TEF repair

A

Most repaired through right thoracotomy or thoracoscopic approach, H type repaired via cervical approach

75
Q

Components of FOLFOX

A

Oxaliplatin
Leucovorin
Fluorouracil

76
Q

Nutrient depleted quickly in bariatric patients w/ nausea/vomiting

A

Thiamine (deficiency causes ataxia, nystagmus, oculomotor dysfunction)

77
Q

Most commonly used chemotherapy during HIPEC

A

Mitomycin

78
Q

Treatment of Stewart-Treve Syndrome

A

lymphangiosarcoma –> WLE or amputation

79
Q

Hormone associated w/ granulosa cell tumors of the ovary

A

inhibit

80
Q

antidote for benzodiazepine overdose

A

Flumazenil 0.2mg

81
Q

Li Fraumeni Syndrome

A

Tp53 mutation
Autosomal dominant
Breast cancer, rhabdomyosarcoma, Wilms, adrenocortical, leukemia

82
Q

Cowden Syndrome

A

PTEN
Breast, endometrium, thyroid

83
Q

Most common site of a leak after RNYGB

A

Gastrojejunostomy

84
Q

What anatomic variant would cause retro aortic bleeding with infrarenal clamping

A

retro aortic left renal artery

85
Q

Most common cause of Cushing syndrome

A

Cushing disease (pituitary) - corticotropin secretion

86
Q

Wound infection rates for clean wound

A

1-2%

87
Q

Wound infection rates for clean contaminated

A

5-10%

88
Q

Wound infection rates for contaminated wound

A

15-30%

89
Q

Wound infection rates for dirty wound

A

30%

90
Q

How does enterococcus develop gentamicin resistance

A

Development of specific enzymes

91
Q

Antidote for nitroprusside or cyanide toxicity

A

sodium thiosulfate

92
Q

Antidote for rocuronium/vecuronium toxicity

A

sugammadex

93
Q

Antidote for benzodiazepine toxicity

A

flumazenil

94
Q

Antidote for acetaminophen toxicity

A

N-acetylcysteine

95
Q

Petersen space

A

Defect between the mesentery of the Roux limb and transverse mesocolon during RNYGB

96
Q

Most common bacteria associated w/ VAP

A

Pseudomonas or MRSA

97
Q

Most common bacteria associated w/ CAP

A

s. pneumoniae

98
Q

Pentad of thrombotic thrombocytopenia purpura

A

thrombocytopenia purpura
neurologic manifestatins
kidney injury or hematuria
hemolytic anemia
fever

99
Q

Felty Syndrome

A

Rheumatoid Arthritis
Neutropenia
Splenomegaly

100
Q

Most potent stimulator of pancreatic enzyme secretion

A

CCK

101
Q

Most potent stimulator of pancreatic bicarb secretion

A

Secretin

102
Q

Primary vs secondary hypothermia

A

Primary: prolonged enivronmental exposures

Secondary: metabolic responses impaired by illness or substance

103
Q

When to excise radial scar found on mammography

A

if >6mm in diameter

104
Q

Paget disease of nipple pathology

A

large cells w/ pale cytoplasm and prominent nucleoli in the epidermis

105
Q

Boundaries of axilla

A

Superior: axillary vein
Medial: serrates anterior
Inferior: tail of breast
Lateral: latissimus dorsi

106
Q

Where is long thoracic nerve found in axillary dissection

A

adherent to chest wall along medial border

107
Q

Gastric NET management

A

<2cm –> endoscopic resection
>2cm –> antrectomy/resection

108
Q

Where do short gastric arteries arise from

A

left gastroepiploic and splenic

109
Q

Midshaft humerus fx associated w/ what injury

A

Radial Nerve injury (wrist drop)

110
Q
A

2024 (3 decks)

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