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Surgery EOR > EOR exam questions (Kaplan notes + others) > Flashcards

EOR exam questions (Kaplan notes + others) Flashcards

1
Q

What electrolyte must you check preoperatively if a patient is on hemodyalsis?

A

K+

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2
Q

What 2 lab test must all childbearing women have prior to surgery

A

Preganancy test and CBC

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3
Q

If the patient is taking insulin should they take it on the day of surgery?

A

No, only half of daily dose and start on D5NS

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4
Q

Charcot’s triad

A

Fever
Jaundice
RUQ abdominal pain

seen in cholangitis

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5
Q

Where is turner’s sign seen?

A

On the side

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6
Q

Where is Virchow’s node? Which cancer?

A

metastatic tumor to the left supraclavicular node

seen in gastric cancer

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7
Q

What is Boerhavve’s syndrome?

A

esophageal perforation

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8
Q

What is Budd-Chiari syndrome?

A

Thrombosis of the hepatic vein

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9
Q

What is cushing’s syndrome

A

Excessive cortisol production

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10
Q

What is Mirizzi’s syndrome

A

Extrinsic obstruction of the common hepatic duct from a gallstone in the gallbladder or cystic duct

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11
Q

What is RED reaction syndrome

A

Rapid vancomycin infusion resulting in skin erythema

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12
Q

What is refeedng syndrome and what do electrolytes look like?

A

HypoK, HypoMg, HypoPhos

all 3 down

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13
Q

For non-cardiac pt for surgery the ejection fraction must be

A

> 35%

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14
Q

Which metabolic risk is an absolute CI for surg?

A

Diabetic coma

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15
Q

MI patients should not have surgery for how long after MI?

A

6 months

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16
Q

MCC of fever 1-3 days post up is

A

PNA (wind)

order a CXR

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17
Q

Incentive spirometry prevents what

A

Atelectasis

NOT PNA

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18
Q

What do you order for CAUTI

A

1 = remove foley

then UA and culture

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19
Q

How do you treat CAUTI?

A

Cipro

think cyprus

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20
Q

MCC of fever on day five

A

DVT

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21
Q

Which score do you use for DVT

A

Wells score

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22
Q

When do you order an US for DVT?

A

Wells score of 3 or more

high risk

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23
Q

MCC of day 7 fever

A

wound infection

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24
Q

Post-op day 10 fever

A

deep wound infection/abscess

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25
Q

What should you order post op fever day 10 and treatment

A

CT abd/pelvis with abd surgery

I&D followed by IV Cipro + Metro

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26
Q

Malignant hyperthermia is

A

seen after 30-45 min of an anesthetic with temp over 104

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27
Q

MCC of post-op fever day 1

A

Atelectasis

1-3 days is PNA, so think of atelectasis progressing to PNA

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28
Q

All patients with dyspepsia should be tested for

A

H pylori

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29
Q

MCC of non-GI n/v

A

otitis media

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30
Q

What lvl of bilirubin will cause jaundice

A

> 3

bil is a 3 letter word

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31
Q

MCC of recurrent jaundice

A

Gilbert syndrome

Poor gil gets so many episodes of jaundice

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32
Q

Gilbert syndrome deals with which bilirubin

A

Unconjugated bilirubin

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33
Q

Painless jaundice with weight loss is likely

A

Pancreatic CA

get a CT of abd

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34
Q

MCC of upper GI bleed

A

PUD

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35
Q

Hx of cirrhosis and portal HTN

A

Esophageal varices

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36
Q

MCC of PUD

A

H Pylori

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37
Q

SE of pepto-bismol

A

Dark colored tongue and stools

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38
Q

Norovirus is MCC of what?

A

Gastroenteritis

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39
Q

MCC of diarrhea in children

A

Rotavirus

vaccinate

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40
Q

Which bug can cause diarrhea after fried rice

A

B cerus

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41
Q

MCC of traveler’s diarrhea

A

E coli

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42
Q

s/s of e coli

A

watery diarrhea, cramps, vomiting

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43
Q

Med that is the MCC of C dif

A

Clinda

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44
Q

Campylobacter enteritis is contracted from what?

A

Poultry (turkey)

at the camp they eat a lot of turkey

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45
Q

Ecchymosis of the inguinal ligament

A

Fox sign

seen in pancreatitis

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46
Q

What extraintestinal manifestation is seen more commonly in Crohn’s disease then UC?

A

Erythema nodosum

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47
Q

Multiple polyps, sebaceous cysts, benign soft tissue tumors, desmoid tumors

A

Gardner syndrome

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48
Q

RF for hepatic adenoma

A

Woman
Anabolic steroids
OCPs

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49
Q

RF for sigmoid volvulus

A

elderly
instituionalized
chronic constipation w/ laxative use

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50
Q

Is smoking protective for UC or crohn’s?

A

UC

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51
Q

Arthritis of the 2nd and 3rd MCPs, hips, and knees.

A

Hemochromatosis

joint pain of the fingers is a red flag for this disease!

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52
Q

Describe specifically the pain associated with diverticulitis

refered pain?

characteristic of pain?

A

Steady ache in the LLQ with referal to the back

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53
Q

What does a porcelain gallbladder increase your risk of?

A

gallbladder cancer

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54
Q

MCC of bacterial diarrhea in the US

A

campylobacter

According to Kaplan

remember, associated with poultry (turkey)
on thanksgiving?

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55
Q

Common cause of painless colonic bleeding in the elderly

A

Arteriovenous malformation (AV malformation)

communication between an arteriole and venule in the cecum, resulting in a bleed

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56
Q

Palpable Blumer shelf, left supraclavicular node, and periumbilical mass are associated with _____.

A

Gastric cancer

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57
Q

MC type of kidney vs gallbladder stone

A

kidney = calcium oxalate
gallbladder = cholestrol

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58
Q

*

t/f biliary colic is RUQ pain that comes and goes

A

FALSE

constant NOT intermittent (according to Kaplan, but Idk if this is true)

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59
Q

Your patient has pruritis, fatigue, and hypothyroidism. What serum lab value will likely be elevated and why?

also has enlarged liver and xanthomas and high cholestrol

A

antimitochondrial antibodies

associated with primary biliary cirrhosis and hashimoto thyroiditis

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60
Q

Your patient has peritonitis and is on CAPD, what is the first-line management of this

A

Rocephin + Vanc

wanna cover for Staph and Epidermidis

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61
Q

Your patient has s/s of biliary colic and US shows no stones. HIDA and IV cholecysokinin don’t show contractability of the gallbladder. What is the likely diagnosis?

A

Biliary dyskinesia

decreased ejection fraction with cholecystokinin challenge

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62
Q

What test for H pylori is useful for showing exposure but NOT as a test for cure to demonstrate eradication of the organism?

A

Serology testing

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63
Q

What SINGLE antibiotic regimen can be used for acute diverticulitis?

A

Augmentin

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64
Q

What happens to PT time with long standing cirrhosis?

A

Prolongs

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65
Q

Chronic alcoholic with dementia, paralysis of lateral gaze, and difficulty walking is likely to have deficiency in what?

A

Thiamine

B1

remember, 1 brain

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66
Q

Which ulcer type is more commonly associated with malginancy - duodenal or gastric?

A

Gastric

less common luckily

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67
Q

If you are exposed to some1 with Hep A, what should be done?

A

Get Hep A IG w/in 2 weeks of exposure

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68
Q

MC early sign of colorectal cancer

A

chang in bowel habits

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69
Q

carcinoid syndrome is associated with what neurotransmitter?

A

serotonin

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70
Q

What can be used to prevent travelers diarrhea? Treat it?

A

Pepto to prevent
Cipro to treat

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71
Q

You have a child with bloody diarrhea and greenish NG aspiration. Workup for anal pathology is unremarkable. What is the next step in management and why?

A

Radioactively labeled technetium scan, as this is a likley cause of bleed in this patient pop.

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72
Q

What often precipitates hepatic encephalopathy in the setting of liver failure?

A

GI bleeding

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73
Q

First manifestation of Hep A

A

Shedding of fecal HAV

even b4 development of IgM anti-HAV

fecal-oral, remember?

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74
Q

What is a worrying complication of Acute Pancreatitis d/t circulating phospholipase?

A

ARDS

because phospholipase can attack aveoli

adult respiratory distress syndrome

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75
Q

Treatment of Wilson disease

A

D-penicillamine

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76
Q

What is the pattern of crohn’s disease?

A

Cobblestone, transmural

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77
Q

t/f diuretics can be used to prevent hepatic encephalopathy

A

false

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78
Q

What marker is positive in the setting of UC

A

P-ANCA

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79
Q

Patient with down syndrome, bilious vomitting, and gas-filled stomach with abscence of gas in distal bowel likely has

A

Duodenal atresia

this is the double bouble sign

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80
Q

Where is the pyloris?

helpful for knowing the pahotphys of pyloric stenosis

A

the lower part of the stomach that connects to the small intestine

this is why there is projectile vomitting - it can get to the stomach

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81
Q

MC benign lesion of the breast in young women

A

fibroadenoma

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82
Q

are fibroadenomas tender?

A

No

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83
Q

First line management of acute lmb ischemia

A

revascularization

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84
Q

1.

Gold standard to determine if a peripheral lung lesion is malginant or infectious

A

Open lung biopsy

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85
Q

First line medication for disease flares of crohn’s disease

A

prednisone

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86
Q

What are the BP findings of type A vs B acute aortic dissections

A

Type A = hypotension
Type B = hypertension

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87
Q

Initial management of Type B acute aortic dissection

A

BB

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88
Q

what lab value is elevated with carcinoid tumors?

A

5-hydroxyindoleacetic acid?

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89
Q

First-line treatment of perianal abscess

A

I&D

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90
Q

Apart from MONA, what is given prior to percutatenous coronary intervention?

A

Ticagrelor

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91
Q

Best way to establish dx of Zenker’s

A

Barium swallow

92
Q

MC benign cause of large bowel obstruction

A

volvulus

CRC is MCC overall, but is not benign

93
Q

Treatment of AAA that is > 5.5 cm

A

endovascular stent-graft placement

94
Q

you see an ulcer near the medial malleuolus - what should you think?

A

venous ulcer

treatment = compression therapy

95
Q

first line treatment of PAD?

A

statin therapy
cilostazol (increases walking distance)

96
Q

anti-coag treatment of DVT if there is active malignancy

A

Monotherapy with LMWH

97
Q

What is ogilvie syndrome

A

Radiographic evidence and signs of LBO with no sign of mechanical obsctruction

98
Q

Indications for dialysis

A

AEIOU

acidosis
elocrolytes: hyperK
ingestions
overload (volume)
uremia

99
Q

what compartment pressure requires emergent fasciotomy?

A

30+

normal = 0-4
concerning = 15-20
hourly monitoring = 20-30

100
Q

What meds are given for a pheo?

A

Alpha blockades
CCB

phenoxybenzamine = alpha blocker

101
Q

when should you get a toe brachial index?

A

ABI > 1.4

indicates noncompressible arteries d/t vascular calcification

102
Q

What is boerhaave syndrome?

A

Sponatenous perforation of the esophagus after increased intraesophageal pressure with negative intrathoracic pressure

most commonly effects the left posterolateral aspect of the distal intrathoracic esophagus

103
Q

what is a HIDA scan aka?

A

Cholescintigraphy

Gs for acute cholecystitis

104
Q

parkland formula for fluid correction

A

4 x bw in kg x % BSA = total mL given

1/2 given in first 8 hours
1/2 given in the last 16 hours

105
Q

MC clinical presentation of primary hyperPTH

A

asymptomatic hyperCa caught on routine screening

106
Q

T/f metformin can be taken the day of surgery

A

FALSE

stop a day b4 and mng with insulin as needed

107
Q

T/f thyroid meds can be taken the day of surgery

A

True

108
Q

T/f cardio meds can be taken the day of surgery

A

true

109
Q

classic triad of renal cell carcinoma

A

flank pain
palpable abd mass
hematuria

110
Q

first line management of post-op inability to void

A

in-and-out cath

111
Q

first-line management of drug induced exanthem

A

topical triamcinolone and hydroxyzine

prednisone only if severe

112
Q

MCC of hematochezia in an infant and other symmptoms of this

A

Intussception (ballooning)

crying and drawing up legs to the abd

113
Q

treatment of intussception

A

pneumatic dilation

114
Q

What is a RF of SCC that are not RF of adeno of esophagus?

A

Eth

115
Q

What is a RF of adeno that are not RF of SCC of esophagus?

A

GERD

116
Q

What arrises from the superior hemorrhoidal cushion?

A

Internal hemorrhoids

117
Q

when is total parental nutrition indicated

A

If the gut is not functional

Use mouth in all patients if you can!

118
Q

definitive treatment of chronic pancreatitis

A

Address underlying cause is the only treatment

119
Q

a plt count < ____ is an indication for plt transfusion if undergoing surgery

A

50k

120
Q

a plt count < ____ is an indication for plt transfusion if there is CNS or ocular bleeding

A

100k

121
Q

a plt count < ____ is an indication for plt transfusion in NON-bleeding patients

A

10k

122
Q

MC urologic CA

A

bladder CA

123
Q

what specifically is seen on CT non-contrast for SHD

A

concave, cresent-shape hypodensity

124
Q

when do you use autolytic vs sharp debridement for pressure ulcers?

A

Autolytic = stage 1-2
Debridement = 3 (with necrosis)+

125
Q

MC stone of primary choledocholithiasis

A

brown/pigmented

126
Q

Imaging of choice for hernia

A

CT w/ IV + oral contrast

127
Q

When do you feel pain with duodenal ulcers?

A

2-5 hours after eating a meal

128
Q

Biggest complication of ERCP

A

acute pancreatitis

129
Q

where do you feel pain with hemolytic anemia?

A

back

130
Q

what abx can lead to flares of G6PD?

A

Bactrim

Sulfonamides

131
Q

what gene is affected with sickle cell anemia? Alpha or beta globulin?

A

Beta globulin

132
Q

what breast disease goes away after menopause?

A

fibroadenomas

133
Q

what breast disease is associated with nipple discharge prior to menstruation?

A

fibrocystic disease

seen prior to menopause

134
Q

what is paget’s disease aka

A

infiltrating ductal carcinoma

not to be confused with infiltrating intraductal or infiltrating lobular

135
Q

Over this age, a colonoscopy screening is a grade C (instead of A)

A

75+

136
Q

What are the two types of 2nd degree burn?

A

Superfiscial partial
Deep partial

137
Q

What differs a deep partial from a superfiscial partial burn?

A

Deep partial = only pain with pressure, blisters are easily unroofed and are wet/waxy

138
Q

deep punch out appearance is seen in

A

arterial ulcers of PAD

139
Q

Thiamine deficiency in a chronic alcoholic can lead to

A

Wernicke syndrome

140
Q

1st line and 2nd line option for stopping esophageal variceal heomrrhage

A

1st line = band ligation
2nd line = balloon tamponade (as long as within 24 hours)

141
Q

t/f mucous is found in the stool for UC

A

true

142
Q

outpatient management of diverticulitis

A

Tylenol and a liquid diet

143
Q

What is Barrett esophagus at the cellular level?

A

columnar metaplasia of the squamous epithelium

144
Q

What is propofol?

A

A sedative-hypnotic for sedation and anesthesia

145
Q

MCC of bloody discharge from the nipple

A

Intraductal papilloma

146
Q

Muscular hypertrophy leading to pain/swelling to the UE, and cyanosis of the fingers

A

UE DVT

147
Q

indications for US/ Mammogram for breast pain
20-50

A

Women under 30 years of age should have an ultrasound of the breast completed. Women between the ages of 30 and 39 years old should have an ultrasound and a focused or bilateral mammogram. Women over 40 years of age should have both a bilateral mammogram and an ultrasound.

148
Q

Pyloric stenosis US classic finding buzzword

A

Target sign of the RUQ

149
Q

```

~~~

basal cell hyperplasia + increased type III collagen + dysphagia

A

esophageal stricture

150
Q

MC type of thyroid cancer and RF

A

Papillary

head/neck radiation exposure

151
Q

What is medullary thyroid CA associated with?

A

MEN2

BUZZ WORDS

pheochromocytoma + hyperPARAthyroid

152
Q

best location for a vena cava filter for DVT

A

At the inflow of the renal veins

153
Q

Orchiopexy procedure

A

surgical procedure that moves an undescended testicle into the scrotum. It’s also sometimes used to treat testicular torsion.

154
Q

which side of the colon is more likely to dvlp cancer?

A

left

155
Q

t/f change of bowel habits is the MC finding of right-sided CRC

A

FALSE

melena is

156
Q

MCC of childhood malginancy of the abd

A

Wilm’s tumor

abd pain + palpable mass to the right of hte abd

157
Q

Hamman sign

A

mediastinal crunching sound that correlates with diastole of the heart, indicating esophageal perforation.

158
Q

most appropriate IV fluid for a preop patient who is NPO

A

LR

159
Q

treatment of sigmoid volvulus

A

sigmoidoscopy for detorsion

160
Q

where do you do Moh’s surgery for BCC?

what size if not in this area?

A

H zone

also if > 2 cm

areas around the eyes, lateral cheeks, ears, nose, and mouth

161
Q

surgeries with high cardiac risk

A

open chole
open ventral hernia repair
whipple procedure

162
Q

McGinn-White sign

A

S1Q3T3 pattern on ECG associated with pulmonary embolism.

163
Q

t/f umbilical hernias are MC in females

A

true

164
Q

preferred initial intervention of SBO

A

NG decompression

then adhesion removal

165
Q

What does hypothyroidism do to BP?

A

Diastolic HTN

166
Q

when might you use TPA for a PE

A

if hemodynamically unstable

167
Q

MCC of painless urinary bleed?

A

Bladder cancer

168
Q

biggest RF for bladder CA

A

smoking

169
Q

triad of mesenteric ischemia

A

abdominal pain, fever, and heme-positive stool. T

ypically, patients will have forceful evacuation of bloody stool.

170
Q

RF of mesenteric ischemia

A

fluid resuscitation, thrombolytic therapy, fibrinolytic intervention, or surgical resection of necrotic bowel.

171
Q

Common RF of anal fistulas

A

Crohn’s disease

172
Q

Color of hematochezia other than bright red

A

maroon

173
Q

Go to imaging for aortic dissection stable

A

CTA
MRA

174
Q

Go to imaging for aortic dissection unstable

A

TEE (preferred)
TTE

175
Q

MCC of hematochezia in pt > 60

A

diverticulosis

176
Q

what specific US is first line for cholylithiasis

A

transabdominal US

177
Q

triad of cardiac tamponade is known as

A

Beck triad

178
Q

Beck triad

A

hypotension
JVD
Muffled heart sounds

pericardiocentesis!!!

179
Q

when is a biopsy urease test not the test of choice for PUD?

A

If the patient has active bleeding or recent PPI or antibiotic use, then the most appropriate study would be a stool antigen test or breath urease test.

Biopsy urease testing during endoscopy will yield falsely negative results when there is bleeding.

180
Q

age of colonic volvulus

A

younger patients

181
Q

what thyroid condition can find-needle aspiration NOT dx

A

Follicular CA

182
Q

when do you do a FNA vs Radinucleotide thryoid scan after a 2 cm thyroid mass?

A

TSH normal or elevated = fine needle
TSH subnormal = Radinucleotide thryoid scan

183
Q

shave biopsy of BCC

A

multifocal nests of basophilic staining cells with peripheral palisading nuclei

184
Q

treatment of low vs high risk patient for acute cholangitis

A

low = MR
high = pip/taz

185
Q

INITIAL intervention of cholystitis

A

IV fluids

186
Q

TOC of aneurysmal SAH

A

Nimodipine

187
Q

what condition is known for gastrinomas?

A

ZES

get a fasting gastin test!

188
Q

Chagas disease often leads to this GI condition

A

achlasia

189
Q

Treatment of necrotic arerial ulcer 2ndary to PAD

A

surgical debridement

190
Q

Between this range, an US should be completed every 6 months for AAA

A

5-5.4 cm

191
Q

how often should a 4.0 to 4.9 centimeter AAA be evaluated?

A

12 months

192
Q

how often should a 3 to 3.9 centimeter AAA be evaluated?

A

3 years

193
Q

what cancer is crohn’s associated with?

A

adenocarcinoma

leading to SBO

194
Q

what echo is first line for new murmur

A

transTHORACIC echo
NOT
transESOPHAGEAL echo

Transesophageal echocardiogram is recommended if transthoracic echocardiogram is insufficient. While its diagnostic accuracy is higher compared with transthoracic echocardiography, it requires sedation.

195
Q

treatment for complicated diverticulitis with pericolonic abscess

in addition to bowel rest and IV antibiotics

A

percutaneous drainage

196
Q

Type of surgery rec for appendicitis

A

laproscopic

197
Q

What plexus are external hemmorids associated with

A

internal hemorrhoidal plexus

198
Q

If you wanna get a CTA instead of a colonscopy, how often do you need to get it done for screening?

A

every 5 years

199
Q

If you wanna get a Fecal immunochemical test and DNA methylation instead of a colonscopy, how often do you need to get it done for screening?

A

every 10 years

200
Q

first thing to give to correct hyperK

A

Calcium gluconate or chloride to maintain the cardiac membrane

201
Q

presentation of hepatic enchpalopathy

A

confusion
scleral icterus
bloody nose
liver tox

202
Q

treatment of hepatic encephalopathy

A

lactulose + rifaximin

203
Q

what cancer is Epstein-Barr virus associated with?

A

CML

204
Q

Increased fibrin degradation products + schistocytes and decreased Plts
with AMS and bleeding

A

DIC

205
Q

1st line prophylaxis of esophageal varices

A

BBs

206
Q

Posterior cerebral artery infarct symptoms

A

homonymous hemianopia
memory deficits
Preservations
Visual defects

207
Q

treatment of idiopathic intracranial HTN without HA

A

Acetazolamide

208
Q

treatment of idiopathic intracranial HTN with HA

A

topiramate

209
Q

does a cold nodule uptake iodine?

A

No

210
Q

Preop plan to lower risk of complications of an ET tube in a pt with asthma

A

Administering an inhaled rapid-acting beta-agonist before surgery

211
Q

Prevention of cholithiasis in patients with rapid weight loss

A

Ursodeoxycholic acid is a bile salt that is used to prevent gallstone formation in patients with rapid weight los

212
Q

Presentation of chronic mesenteric ischemia

A

postprandial pain
fear of eating
weight loss

get a CTA and can do surgery or angioplasty

213
Q

what location is pilondidal disease?

A

Pilonidal disease is a chronic glandular inflammation due to blocked hair follicles that occurs along the superior and inferior gluteal cleft

214
Q

what thickness of margins are concerning for gastric CA

A

thickened

215
Q

preferred location for long-term hemodialysis

A

UE AV fistula

216
Q

what are crypt abscesses seen in?

A

UC

217
Q

best way to dx strangulated groin hernia

A

clinically

218
Q

protein measurement that best assesses short-term nutritional status

A

prealbumin

219
Q

preferred method of breast biopsy

A

core-needle biopsy

220
Q

first line treatment of esophageal spasm

A

start with CCB alone

221
Q

when do you do a carotid endarterectomy

A

70-99% stenosis and symptomatic

222
Q

Treatment of symptomatic carotid artery disease < 50% stenosis

A

ASA and clopidogrel

DAPT

223
Q

what surgery do you use to remove an adrenocortical carcinoma?

A

complete surgical resection

224
Q

worry of surgical correction of anal fissure

A

irreversible fecal incontinence

225
Q

t/f the wound of a stage 1 ulcer extends into the skin

A

FALSE

it would be stage 2 then

226
Q
A

Surgery EOR (17 decks)

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