Combank 1

Question 1

What is the treatment of choice for adenocarcinoma in the antrum of the stomach and then in the fundus/body of stomach with no metastasis?

Answer 1

Subtotal gastrectomy

Total gastrectomy

Question 2

What is paraphimosis?

What is phimosis?

Answer 2

When the foreskin is retracted and gets stuck proximal to the glans causing a stricture.

Inability to retract the foreskin

Question 3

What syndrome can develop after circumferential full thickness burns?

Answer 3

Compartment syndrome

Question 4

What do we lose in anterior cord syndrome?
What do we lose in posterior cord syndrome?
What do we lose in central cord lesion and where do we most commonly see it?
What surgery do we commonly see anterior cord syndrome?

Answer 4

Motor, pain and temp
Proprioception and touch
Motor in upper extremities, cervical lesions
Thoracic abdominal aneurysm repair

Question 5

What do we lose in brown sequard?

Answer 5

Ipsilateral proprioception, motor and contralateral pain and temp

Question 6

When presented with an excoriated nipple and an underlying breast mass, the most likely diagnosis is what?

Answer 6

Paget’s disease

Question 7

What is the recommendation for removal or large polyps in the colon when performing colonoscopy?

Answer 7

Electrocautery snare

Question 8

What is the most common cause of bloody nipple discharge?

Answer 8

Intraductal papilloma

Question 9

What is a richter hernia?

Answer 9

Anti mesenteric wall of a hollow abdominal organ becomes incarnated in an inguinal hernia

Question 10

What is an Amyand hernia?

Answer 10

Appendix herniates through inguinal hernia

Question 11

What is a sliding hernia?
What is a littre hernia?
What is a pantaloon hernia?

Answer 11

Hollow retroperitoneal organ, bladder or colon, through the hernia

Contains meckels diverticulum

Inguinal that has elements of direct and indirect hernia

Question 12

What should we be thinking with pelvic fractures?
Two clinical signs of it?
Best next step in management?

Answer 12

Urethral injuries
Blood in meatus or high riding prostate
Retrograde urethrogram

Question 13

What type of breast cancer are we thinking when there is dimpling of the skin?

Answer 13

Inflammatory

Question 14

Atypical ductal hyperplasia of the breast requires what for management?

Answer 14

Excisional biopsy

Question 15

How do you treat zinkers diverticulum?

Answer 15

Cricopharyngeal myotomy

Question 16

Best test for esophageal motility?

Answer 16

Manometry

Question 17

What test is used to diagnose ruptured spleen?

What vaccines to give when someone has their spleen out or its ruptured?

Answer 17

CT
Against pneumonia, meningococcal and Hib
PCV, MCV4 and HIB

Question 18

What procedure treats an intestinal malrotation?

Answer 18

Ladd procedure

Question 19

What procedure treats refractory GERD or hiatal hernia?

Answer 19

Nissen fundoplicaiton

Question 20

What is the procedure called that treats pyloric stenosis?

Answer 20

Ramstedt pyloromyotomy

Question 21

What is howship Romberg sign and what does it tell us?

Answer 21

Medial thigh pain when IR and extension of hip.

Obturator hernia because the motion causes the sac to compress the obturator nerve

Question 22

What is an effective treatment option for acute cholecystitis in patients who are poor surgical candidates?

Answer 22

Cholecystostomy tube

Question 23

What layer of the intestinal wall is most important in maintaining tensile strength when constructing anastomoses and why?

Answer 23

Submucosal

Tons of collagen

Question 24

What happens in the billroth 2 procedure?
What happens in the billroth 1 procedure?
What is a feared complication in the billroth 2 procedure?

Answer 24

Connect stomach to jejunum
Connect stomach to duodenum
Duodenal stump leak

Question 25

What is the fluid of choice for resuscitation in a trauma patient and why?

Answer 25

Lactated ringers because it is isotonic and the lactate is converted to bicarb to buffer any acidosis

Question 26

What is the typical protocol for a hypotensive trauma patient?

Answer 26

2-3 liters of fluid and then blood or colloid

Question 27

4 things ischemic colitis presents with?

Answer 27

Ab pain, N, V and bloody diarrhea

Question 28

What part of the colon and artery is most commonly involved in ischemic colitis? What does the superior mesenteric artery supply? Inferior? Middle colic? Marginal? Ileocolic?

Answer 28

Left colon, inferior Duodenum, small bowel, right colon, 2/3 transverse Left colon, sigmoid, upper rectum Transverse Splenic flexure connection of superior and inferior mesenteric Terminal ileum, cecum, and appendix

Question 29

What is recommended medical treatment for peptic ulcers?

Answer 29

PPIs and stop NSAIDS

Question 30

2 clinical findings of meniscal tear for knee?

Answer 30

Joint line tenderness and clicking/popping sounds with passive flexion and extension of knee

Question 31

Blind loop syndrome can lead to what deficiency?

Answer 31

B12

Question 32

In a patient with multi centric breast cancer, what is the appropriate treatment?

Answer 32

Mastectomy with sentinel lymph node

Question 33

What is the procedure to treat perforated peptic ulcer?

Answer 33

Omental patch repair

Question 34

Zinc deficiency can cause what two things?

Answer 34

Skin rash and hair loss

Question 35

How do you treat appendiceal carcinoid tumors greater than 1.5 cm? Less than 1.5 cm?

Answer 35

Right hemicolectomy | Just take out appendix

Question 36

If i see orange skin color and bleeding what am I thinking?

Answer 36

Hemochromatosis, liver cirrhosis, esophageal varices

Question 37

If i see firm, fixed, palpable, non tender breast mass, what am I thinking?

Answer 37

Breast cancer

Question 38

What GI problem to know associated with Peutz Jeghers syndrome?

Answer 38

Intussusception

Question 39

What is grade 1-4 internal hemorrhoids? Treat each one?

Answer 39

1: no prolapse, high fiber 2. Prolapse but reduce automatically, rubber band 3. Prolapse but need to be manually reduced, surgery 4. Prolapse and cant be reduced, surgery