Pre-Test (Cardiothoracic, PVD, Urology, Ortho)

Question 1

Most common test used for predictor of post-op pulmonary reserve

Answer 1

Post op FEV1 > 60%

Question 2

Lung cancer treated w/ only chemo and radiation

Answer 2

Small cell

Question 3

What is empyema

Answer 3

Accumulation of pus in the pleural cavity

>6 weeks duration suggests fibrin deposition and decortication is needed

Question 4

SVC syndrome almost always due to

Answer 4

Malignancy (usually bronchogenic carcinoma)

Question 5

Initial tx of lung abscess

Answer 5

Ab aimed at causative organism (will usually resolved without drainage)

Question 6

Indications for operation in descending aortic aneurysms

Answer 6

End organ failure, continuation of pain, rupture or signs of impending rupture

Question 7

Operation for diffuse esophageal spasm

Answer 7

Myotomy along the length of the manometric abnormality

Question 8

First diagnostic step after severe chemical ingestion

Answer 8

Esophagram w/ water soluble contrast to look for rupture

Question 9

First test in suspected Boerhaave

Answer 9

Contrast esophagram (Barium if suspected in chest, Gastrografin if suspected in abdomen)

Question 10

Management of chylothorax

Answer 10

Chest tube and low fat diet (repair basically impossible)

Question 11

When can CABG or PCI be used for MI

Answer 11

Two vessel dz or proximal LAD obstruction

Question 12

Initial tx for thoracic outlet syndrome

Answer 12

Exercise program to strengthen should grilled muscles and decrease shoulder droop

Question 13

Primary treatment of bronchial carcinoid

Answer 13

Resection (lobectomy or lesser resection as long as the tumor is gone)

Question 14

What is needed after barium swallow shows achlasia

Answer 14

Esophageal motility test since other disorders may mimic achlasia

Question 15

What CT disorder would you look for in a patient with AR pupil

Answer 15

Thoracic Aortic aneurysm

Question 16

Exophthalmos from tricuspid regurg by?

Answer 16

Produces markedly enlarged venous pressure

Question 17

First line drug in tx of neurogenic shock

Answer 17

Phenylephrine

Question 18

Drug ass w/ increase in urine output in hypotensive, septic patients

Answer 18

Norepi (acts on alpha and beta)

Question 19

If oliguric right after cardiac surgery, good test for reason

Answer 19

Pulm Art Cath –> Will determine volume status and cardiac status

Question 20

Best test to evaluate the colon for early ischemia

Answer 20

Sigmoidoscopy

Question 21

Lymphedema that manifests its self early in life but not at birth

Answer 21

Lypmhedema praecox

Question 22

Most common area of ischemia after AAA repair

Answer 22

Sigmoid

Question 23

Best management for atherosclerosis

Answer 23

Aspirin, Lipid Lowering drugs, Lifestyle (no smoking, exercise)

Question 24

Best predictive test for perioperative ischemic cardiac events in patients undergoing non-cardiac surg

Answer 24

Dihyridamole-thalium imagin to find reversible perfusion defects

Question 25

Best management for patients presenting with acute arterial insufficiency w/ neurologic compromise of LE

Answer 25

Immediate surgery (Embolectomy)

Question 26

Most common peripheral artery aneurysms

Answer 26

Popliteal (53% are bilateral)

Question 27

Best first test for suspected acute mesenteric ischemia

Answer 27

Mesenteric angiogram (will differentiate b/w embolic or non-occlusive due to low Cardiac index)

Question 28

What veins can’t be visualized by duplex US

Answer 28

Proximal veins (not accesible due to anatomic location)

Question 29

Old frail person w/ bilateral iliac artery occlusion surgery

Answer 29

Axillofemoral bypass graft

Question 30

Stones > what size need lithotripsy

Answer 30

1cm

Question 31

Medicine to try for pt’s w/ bilateral undescended testis

Answer 31

Chorionic gonadotropin –> if not help after one month need surgery before age 2

Question 32

Surgery to resolve testicular torsion

Answer 32

Orchiopexy –> fixes testicles in place

Question 33

Tx for RCC

Answer 33

Radical nephrectomy (may be cure even w/ enlarged nodes because those may be reactive)

Question 34

Absolute indication for surgery in pt’s w/ BPH

Answer 34

Recurrent UTIS, retention refractory to medical therapy, upper tract dilation, renal inuff 2/2 outflow obstruction, bladder stones

Question 35

First test for suspected rupture of urethra

Answer 35

Retrograde urethrogram

Question 36

Given massive amounts of muscle damage during open fractures, what are liberally performed

Answer 36

Fasciotomies

Question 37

Posterior boundary of shoulder joint? Laterally by?

Answer 37

Posterior by teres minor and infraspinatus

Lateral by deltoid

Question 38

Injury to the wrist at the radial nerve would cause

Answer 38

Mostly sensory abnormalities (more proximally would cause extensor abnormalities)

Question 39

When is external fixation used in ortho trauma

Answer 39

Most often in the setting of high engr. trauma with significant soft tissue and vascular injury, or in polytrauma as “damage control”

Question 40

What is osteitis fibrosa cystica

Answer 40

Ass w/ hyperparathyroidism –> inc bone turnover w/ elevated alk phos
brown or osteoclastic tumors and bone cysts may be present on long bones

Question 41

Bone tumor where pain is relieved by aspirin

Answer 41

Small lucency on X-ray surrounded by reactive sclerosis