GI

Question 1

Schatzki rings are almost always associated with what other upper gastrointestinal pathology?

Answer 1

hiatal hernia

Question 2

MC postop complication related to general anesthesia

Answer 2

N/V

Question 3

What 5 meds can be used to tx postop N/V from general anesthesia

Answer 3

transdermal scopolamine

dexamethasone

ondansetron

prochlorperazine

droperidol

Question 4

does SMOKING increase or decrease chances of postop N/V?

Answer 4

smoking= decreases chances

Question 5

serum marker for pancreatic cancer

Answer 5

CA 19-9

Question 6

what preop abx is given in acute appy w/o perforation/abscess

Answer 6

single dose of cefotetan 2 g intravenously

Question 7

describe the tremor seen in hyperthyroidism

Answer 7

high frequency, low amplitude tremor

present with action

Question 8

At what age should individuals with Lynch syndrome begin colorectal cancer screening via colonoscopy?

Answer 8

Q 1-2years beginning at age 20 to 25 years

or

2-5yrs prior to the earliest age of colorectal cancer diagnosis in the family

(whichever comes first)

Question 9

What dx test would be the initial biochemical test performed for a patient who is considered high risk for a pheochromocytoma (family history, familial tumor syndrome, history of previously resected pheochromocytoma, or presence of adrenal mass found incidentally).

Answer 9

Plasma fractionated metanephrines

Question 10

initial test for pt considered to be LOW risk for pheochromocytoma

Answer 10

24-hour urine fractionated metanephrines and catecholamines

Question 11

respiratory alkalosis results in what electrolyte disturbance?

Answer 11

alkalosis= HYPOkalemia

acidocis= HYPERkalemia

(Intracellular K is exchanged for H+)

Question 12

what pre-op study should be ordered for a COPD patient w/ increasing respiratory symptoms, decreasing exercise tolerance, or new lung auscultation findings on exam

Answer 12

CXR

(to rule out an active infection and heart failure)

Question 13

3 tumor markers seen in testicular cancer

Answer 13

AFP

HCG

LDH

Question 14

TIA tx?

Answer 14

• Symptomatic carotid stenosis of 70-99% + life expectancy >5yrs (perioperative M&M <6%)= ASA** + **carotid endarterectomy
  
  • If carotid lesion not suitable for surgical access, radiation induced stenosis or clinically significant coronary, pulmonary or other dz that increases risk of anesthesia/surgery–> Carotid artery stenting preferred
• Symptomatic carotid stenosis <50%–> antithrombotics

Question 15

TIA tx:

when is carotid stenting preferred over carotid endarterectomy?

Answer 15

• Symptomatic carotid stenosis of 70-99% + life expectancy >5yrs= ASA** + **carotid endarterectomy
  
  • If carotid lesion not suitable for surgical access, radiation induced stenosis or clinically significant coronary, pulmonary or other dz that increases risk of anesthesia/surgery–> Carotid artery stenting preferred

Question 16

Cardio functional status: what is poor, moderate and excellent?

Answer 16

• Poor functional capacity (<4 METS)= Self-care, the ability to complete activities of daily living (ADLs), vacuuming, walking 2 mph, and writing
• Mod functional capacity (4-10 METS)= The ability to walk up a flight of stairs, walk 4 mph, walking a golf course, doing yard work, and cycling
• Excellent functional capacity (>10 METS)= Jogging, playing singles tennis, swimming, and skiing

walking 2 flights of stairs or 4 blocks= good sign

Question 17

Risk factors for small bowel carcinoma

Answer 17

• Diet: salt-cured foods, refined sugar, red meat, smoked foods
• alcohol
• genetic: lynch, peutz-jeghers, familial adenomatous polyposis
• IBD (Chrons)

Question 18

MC location of small bowel carcinoma

Answer 18

ileum

Question 19

tx for melanoma that is <1mm thick? >1mm thick?

Answer 19

• < 1mm** thick= Wide excision w/ **1cm margins
• > 1mm** thick= wide excision w/ **2cm margins

Question 20

Indications for emergent craniotomy in pt with epidural hematoma

Answer 20

• hematoma volume > 30 cm3, regardless of Glasgow Coma Scale,
• acute epidural hematoma with a GCS score < 9 in the presence of anisocoria.
  *

Question 21

when can a pt with an epidural hematomy be treated medically

Answer 21

• Patients with stable and small epidural hematoma with mild symptoms who have :
  
  • epidural hematoma volume < 30 cm3
  • clot thickness < 15 mm on head CT
  • midline shift of < 5 mm
  • no coma (GCS score > 8)
  • no neurological deficits can be managed nonoperatively.

Question 22

1st line tx for outpatient pediatric pneumonia

Answer 22

Amoxicillin

Question 23

Which of the following medications helps prevent cerebral vasospasm in patients with spontaneous subarachnoid hemorrhage?

Answer 23

Oral Nimodipine

Question 24

what are classic imaging findings of MS

Answer 24

The classic brain noncontrast MRI findings:

multiple T2 hyperintensities found most commonly in the periventricular white matter, brainstem, cerebellum and spinal cord.

Question 25

What is Lofgren Syndrome?

Answer 25

Acute form of Sarcoidosis:

1. Hilar lymphadenopathy
2. Erythema nodosum
3. Polyarthralgia

Question 26

What is seen in CSF of patient with West Nile Encephalitis? What is an expected lab abnormality

Answer 26

elevated lymphocytes, glucose, protein

expected lab abnormality: lymphopenia