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ABSITE Qs > More ABSITE Questions > Flashcards

More ABSITE Questions Flashcards

1
Q

Cameron’s Lesions

A

Chronic blood loss as a result of mechanically induced linear erosion at the level of diaphragm within the hiatal hernia

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2
Q

Where can GI hyperplastic polyps be found?

A

anywhere in the GI tract; they have low GI malignant potential

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3
Q

What is considered an abnormal Gastric emptying study?

A

When > 60% of contents at 2 hours, or >10% at 4 hours

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4
Q

What do you do in a Bilroth 2 patient with gastroparesis

A

Total gastrectomy!

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5
Q

What do you do for a type 2 and 3 gastric ulcer

A

Antrectomy and vagotomy

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6
Q

Do you get reflux in B2 patients?

A

Yes, d/t defective pyloric channel, leading to itnestinalization of the gastric mucosa. No ulcers

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7
Q

What vessel do you need to preserve in a subtotal gastrectomy?

A

LEFT gastroepioploic (right gets saved in a esophagectomy)

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8
Q

What is early dumping syndrome d/t?

A

Osmotic load (late is d/t carbs rushing into the duodenum, causing a surge of insulin causing overcompensate causing hypoglycemia

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9
Q

What is the most predictive index for GIST tumors?

A

mitotic index

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10
Q

How do GIST tumors spread

A

Hematogenous

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11
Q

Is PET good for gastric cancer?

A

No. 50% PET avid

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12
Q

What are the risk factors for stress gastritis?

A

Coagulation, prolonged ventilation

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13
Q

What are the 3 types of gastric carcinoids?

A
  1. Type 1- chronic gastritis and pernicious anemia
  2. MEN1 and ZES, small
  3. Large, aggressive
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14
Q

What are the stages of GIST?

A

Stage 1A- < 5cm;
Stage 2 <5cm with high mitotic rate or > 10cm
Stage 3A- 5-10cm with high rate
Stage 3B- 10cm with high mitotic

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15
Q

What type of surgery for BCC?

A

Mohs

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16
Q

What margins for melanoma

A

0.5mm in face

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17
Q

What rx do you give for metastatic melanoma?

A

Dacarbazine

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18
Q

When do you do incisional vs excisional bx for sarcoma?

A

4cm

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19
Q

How do you treat malignant sarcoma?

A

Doxorubicin

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20
Q

How do you treat keloids?

A

Lidocaine/triamcinolone injection into the scars

Topical anti-inflammatory with silicon sheet

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21
Q

What is the standard scalp reconstruction?

A

Lat dorsi flap

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22
Q

What is the most common melanoma?

A

Superficial spreading

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23
Q

What is the most aggressive melanoma?

A

Nodular

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24
Q

Which melanoma is the least malignant?

A

Lentigo maligna

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25
Q

Features of dermatofibroma sarcmoa

A 
Lateral tentacles
CD34
Low grade
High risk of recurrence
2cm block excision
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26
Q

What are the Hurley stages for Hiradenitis suppurativa

A
  1. Abscess
  2. Recurrent abscess, sinus tract and scarring
  3. Diffuse
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27
Q

What is the modified Brook formula for fluid resuscitation?

A

TBSA x weight (kg) x 2

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28
Q

How do you treat esophageal leiomyoma?

A

NO BX! scarring
Resect it. It is benign
Endoscopic repair is <5cm, otherwise VATS

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29
Q

How much esophagus do you want in the abdomen?

A

2-3 cm, otherwise need a Collis

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30
Q

What type of incision do you make for a mid esophageal perforation?

A

Right POSTEROLATERAL

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31
Q

What does esophagus dimpling indicate on imaging

A

Hiatal hernia

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32
Q

Is there help with mesh for hiatal hernia?

A

Short term outcomes show improvement, but no long term improvement

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33
Q

What do you save for a Ivor Lewis?

A

RIGHT GEA

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34
Q

What cancer treatment do you use for esophageal?

A

Cisplatin and 5FU

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35
Q

How do you repair Zenker in a patient with cervical stenosis?

A

Open repair (less than 2cm diverticulectomy. If larger, remove sac with myotomy)

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36
Q

How much should you dilate the esophagus during dilations to avoid perf

A

No more than 2mm per session

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37
Q

What is Borchardts triad

A

Severe epigastric pain, inability to vomit, can’t pass a NG

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38
Q

For a hiatal hernia and dysmotility what type of repair do you do?

A

Dor

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39
Q

Where is esophageal perf occur?

A

Cricopharyngeus,

Instrumental also at distal esophagus

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40
Q

For prior gastric surgery but have reflux and need surgery, what type of surgery?

A

Hill esophagogastropexy

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41
Q

How much time must pass frmo time of catheter removal before rivaroxaban can be restarted?

A

6 hours (otherwise 3 days if pain control)

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42
Q

What is the risk of an anterior scalene nerve block? What sx do you see

A

Phrenic nerve (travels over the surface of the anterior scalene)

SOB d/t hemidiaphragm

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43
Q

Why does total spinal anesthsia occur?

A

Result of excessive cephalic spread of local anesthetic

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44
Q

What is the early sign of local toxicity of anesthetic?

A

Neuro sx- ringing in ear, pica, confusion

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45
Q

What does a severe drop in CO2 during OR mean?

A

Extubation, disconnection, or cessation of CO like d/t CO2 embolism

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46
Q

How do you traet a CO2 embolus?

A

Stop insufflation, position to push CO2 to prevent right ventricle, ventilate

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47
Q

What anesthetic spray can cause methemoglobinemia?

A

Benzocaine
“chocolate brown” arterial blood.
Pulse ox is not reliable

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48
Q

When wuld you not use NO?

A

closed spaces, like SBO or PTX

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49
Q

What is ASA Class 2?

A

Mild systemic disease- controlled HTN or D, smoking

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50
Q

What is ASA Class 4?

A

Severe constant threat to life

51
Q

What is the pathology of mucinous cystic neoplasm?

A

Ovarian type stroma

52
Q

What is a consequence of short gut syndrome with NEC?

A

Dependence of TPN, leading to cholestatic hepatic dysfunction

53
Q

What do you do about incidental intusseption?

A

Nothing to do

54
Q

What is associated with an absent vas deferens?

A

Cystic fibrosis

55
Q

How do you treat H type TE fistula?

A

Right cervicotomy

56
Q

How do you treat jejunal atresia?

A

Differently. Preserve bowel length and avoid short gut

57
Q

What is associated with complex gastroschisis?

A

Stenosis, intestinal atresia, perforation, volvulus

58
Q

DO you operate on a ped appy overnight?

A

No, wait and resuscitate until the morning. Better outcomes and lower risk of abscess formation

59
Q

Repair a hernia when?

A

> 24 hours later because of the associated swelling and risk of missing a direct hernia

60
Q

How do you treat a patent omphalomesenteric duct?

A

Elective resection

61
Q

What medical imaging do you use for a HDS malro kid?

A

Upper GI series with contrast

62
Q

What is PTLD

A

post transplant lymphoproliferative disorder.

over expression of EBV, development of lymphomas in transplant patient.

  1. Reduce immunosuppressive regimen
  2. nd line rituximab and or CHOP

No surgery

63
Q

Treatment of Zenker’s

A

Diverticulectomy <2cm
ectomy and myotomy for good surgical patients.
Pexy and myotomy for moderate size.
<2 pexy or myotomy alone

64
Q

What is teh most common location for ectopicsuperior parathyroid?

A

TE groove

65
Q

Ectopc inferior parathyoid?

A

thyrothymus

66
Q

Missed adenoma of parathyroid?

A

TE groove

67
Q

Missed parathyroid?

A

Normal anatomy

68
Q

When would you do an emergent thoracotomy time wise?

A

< 10 minutes prearrival

69
Q

How long of CPR before pronounce?

A

20 minutes

70
Q

What is type 1 hepatorenal syndrome

A

Acute, doubling of Cr in < 2 weeks, has a precipitating event, no history of diuretic resistant ascited, 10% survive without traetment

71
Q

IABP

A

intra aortic balloon pump, placed when a reduced EF. It reduces preload nad afterload, improving myocardial perfusion, thereby improving cardiac output

72
Q

What volume do you use for ARDSnet/ prevention

A

6mL/kg during ventilaton

73
Q

What heart rhythms require defibrillation

A

V fib and V tach

74
Q

What type of cancer in undescended testicles?

A

Seminoma

75
Q

What is the gold standard for imaging choledochal cyst

A

MRCP

76
Q

What are worrisome features for pancreatic ca?

A

Jaundice, enhancing solid component and MD > 1cm

77
Q

For male breast cancer, when do men get chemo?

A

if cancer > 5mm

78
Q

Radial scars architecture

A

Fibroelastic core that pulls and distorts ducts and lobules

79
Q

Find linear pleomorphic microcalcifications

A

DCIS

80
Q

What other cancer is BRCA1 associated with

A

high occurrence of medullary cancer

81
Q

What LN levels for ANLD?

A

Zone 1 and 2

82
Q

What will Phyllodes stain as

A

Vimentin and actin because of fibrous and stromal componenets

83
Q

Children 20-40
D/t bacterial, parasite, fungi; MCC Staph/Strep pyo
Fluctuant mass, with normal TFTs
Do FNA and cx and if abscess/pyriform sinus fistula present, surgical drainage may be indicated

A

Acute suppurative

84
Q

What is loss of opposed phase chemical shift in MRI for adrenal

A

Cortical adenoma (d/t intracellular lipid). Carcinoma does not lose signal

85
Q

When do you convert from lap to open adrenalectomy

A

> 6-8cm

86
Q

What age groups are at risk for thyroid cancer

A

Young and old

87
Q

What does lithium do to parathyroid

A

4 gland parathyroid hyperplasia

88
Q

What differentiates T1 vs T2 adrenal cancer?

A

5cm

89
Q

How does myxedema coma present

A

hypothyroid, hypocortisol, hypoventilation, hypothermia, hypoglycemia, infection

90
Q

How does secretin stimulation test work

A

Causes an icnrease in gastrin levels > 120 pg/mL over basal levels

91
Q

When to give mitotane

A

R1 resection, invasion into vascular or capsule, intraoperative tumor spillage

92
Q

MCC cancer in transplant

A

Squamous

93
Q

How doyou determine urine Cr?

A

MAG-3 or urine creatinine

94
Q

S/e of mycophenolate

A

GI, GIB, pancytopenia

95
Q

nivolumab

A

PD-1

96
Q

caspofungin mech

A

D-glucan, used for g glabrata

97
Q

CAH patients watch out for what?

A

testes nodules, adrenal tissue

98
Q

What is renal lac grades

A

Grade 2- parenchyma, Grade 3- medulla, Grade 4- collecting duct

99
Q

What do you watch out for resecting the kidney/adrenal

A

tail of panc

100
Q

How do you repair ureter injuries b/w the UPJ and pelvic braim

A

Ureteroureterostomy

101
Q

When dont ing data is sufficientyou need liver bx

A

Lab and imag

102
Q

R/f for HCC

A

A1AT deficiency, excessive androgen use, HFE, vinyl chloride, aflatoxin

103
Q

MCC of Budd Chiari

A

myeloproliferative d/o

104
Q

How do you treate hytadid cyst

A

Albendzaole

105
Q

What are the borders of the foramen of winslow

A

duodenum inferior, liver superior, IVF posterior, and portal triad anterior

106
Q

Petit triangle

A

EO, lat, iliac rest

107
Q

BNSIM obturator hernia

A

Operate. 50% are SBO.

108
Q

Rec for deep cuff placement of PD catheter

A

Placement of the deep cuff in the muscle allows for tissue ingrowth and strong fixation of the catheter

109
Q

HIPEC drugs

A

Cisplatin, doxorubicin, mitomycin C

110
Q

What prevents radiation injury to the bowel

A

Amifostin

111
Q

What is blind loop

A

Loops of intestine bypassed by enteroenteric fistulas, may stagnate and proligerate backteria leading to malabsorption symtpoms of B12 and steatorrhea

112
Q

What does radiation enteritis look like

A

Pale, friable mucosa with telangietcasis

113
Q

Where do ureters get damaged

A

at level of uterine artery

114
Q

What do you need for previable fetus

A

just pre and post op fetal heart tracings

115
Q

tx for cervical cancer

A

TAH; add cisplatin/paclitzel if greater than IIb

116
Q

Sx of essential fatty acid deficiency

A

dermatitis, alopecia, patchy red areas of skin, brittle nails, bruising, delayed wound healing

117
Q

what does resp quotient > 1 mean

A

excessive feeding, more CO2 prodction, likely hard to get off vent

118
Q

Intragastric feeding- what group NOT to give

A

head trauma. gastroparesis results

119
Q

What is caloric requirement for burn patients

A

25 kcal/kg/day + (30 x % burn)

120
Q

Calculate nitrogen balance

A

protien/6.24 - (UUN + 4)

121
Q

Grades of HTN

A

Grade 1- 12-15mmHg, Grade 2 16-20mmHg, nonsurgical management.
NPO, gut ecompression wiht NG, limit NG

Grade 3 and 4 above 20mmHg require laparotomy decompression

122
Q

Ti NE tumors

A

Right hemicolectomy

123
Q

large bowel stricture management

A

RESECTION!

risk of malignancy

ABSITE Qs (2 decks)

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