Random Ass Qs (Surg)

Question 1

Baby is diagnosed with pyloric stenosis. What happens next?

Answer 1

Fluid resuscitation and correcting metabolic derangements

Question 2

Can newborn pyloric stenosis progress to complete obstruction?

Answer 2

Yes

Question 3

What should any baby with bilious emesis immediately be evaluated for?

Answer 3

Malrotation with volvulus

By upper GI contrast study

Question 4

When is sentinel lymph node bx CI in breast cx?

Answer 4

• palpable axillary nodes
• multicentric disease
• hx of reaction to blue dye

Question 5

Patient develops neck swelling and dyspnea after thyroid surgery. What’s the immediate next step?

Answer 5

Reopen wound to check for hematoma

Question 6

What type of thyroid cancer is associated with amyloid on biopsy?

Answer 6

Medullary

Question 7

What is the treatment for medullary thyroid cancer?

Answer 7

Total thyroidectomy with modified radical neck dissection if palpable lymph node

**very aggressive cancer

Question 8

What are the effects of inflating the abdomen with CO2 for laparoscopic surgery?

Answer 8

• hypercarbic
• acidotic
• decreased venous return
• increased afterload
• distended peritoneum
• elevated diaphragm

Question 9

In what position will patients with septic arthritis of the hip present?

Answer 9

Hip flexed and externally rotated

Question 10

Describe the scoring for GCS

Answer 10

Eye: Spontaneous 4, Speech 3, Pain 2, None 1

Motor: Obeys 6, Localizes 5, Withdraws 4, Flexion 3, Extension 2, Flaccid 1

Verbal: Oriented 5, Confused 4, Words 3, Sounds 2, None 1

Question 11

What are symptoms of zinc deficiency?

Answer 11

Diarrhea, AMS, alopecia, dermatitis

Question 12

Where would the aorta most likely be damaged in a deceleration injury?

Answer 12

Just distal to left subclavian artery

**aorta is fixed here and susceptible to shear forces

Question 13

Where is the most common location of a gastrinoma?

Answer 13

Pancreas

Question 14

Esophageal manometry demonstrates absence of peristaltic waves and non relaxing LES…….dx?

Answer 14

Achalasia

Question 15

Esophageal manometry demonstrates presence of peristaltic waves but non relaxing LES…..dx?

Answer 15

Pseudo-achalasia (tumor or iatrogenic)

Question 16

Precordial crackles heard on auscultation correlating with heart sounds + mediastinal emphysema ….. dx?

Answer 16

Esophageal perforation

Question 17

What is the most common cause of anorectal fistula and abscess?

Answer 17

Infection of the anal glands

Question 18

What is the most common need for surgery in Crohn’s disease?

Answer 18

Recurrent bowel obstruction

Question 19

Ulcerative colitis vs Crohn’s disease : which has higher increased risk of colon cancer?

Answer 19

Ulcerative colitis (10-20%)

Question 20

At the start of a hemicectomy for colon cancer a large mass in the liver is confirmed to be a met. What now?

Answer 20

Continue with hemicolectomy and do met evaluation after

Question 21

How does a Halsted radical mastectomy differ from a modified radical mastectomy?

Answer 21

Modified preserves pectoralis major

Question 22

During colonoscopy a bx finds a polyp to be a villous adenoma with atypia but it cannot be removed through the colonoscope. What now?

Answer 22

Hemicolectomy due to malignant potential

Question 23

Duodenal vs Gastric ulcer:

Which has a higher incidence of association with malignant process?

Answer 23

Gastric

Question 24

Where is the most common site of emboli event in acute mesenteric ischemia?

Answer 24

SMA

Question 25

What typically causes the symptoms of TIA?

Answer 25

Embolic event

Question 26

Describe the blood supply to the stomach and where those arteries branch

Answer 26

• right gastric (hepatic)
• left gastric (celiac trunk)
• right gastroepiploic (gastroduodenal)
• left gastroepiploic (splenic)
• short gastrics (splenic)

Question 27

In what type of carcinoid tumor might you see carcinoid syndrome?

Answer 27

• massive hepatic met

- tumors that bypass hepatic filter (ie retroperitoneal)

Question 28

What is the most common normal intestinal flora that bowel surgery exposes to the wound?

Answer 28

Bacteroides

Question 29

Where is the bleeding in subdural hemorrhage?

Answer 29

Bridging veins

Question 30

Where is the bleeding in epidural hematoma?

Answer 30

Middle meninges artery

Question 31

What anesthetic should be avoided in burn/crush injury patients? Why?

Answer 31

• succinylcholine

- adds to hyperkalemia leading to cardiac arrest

Question 32

What is the most common site of extra-adrenal pheochromocytoma?

Answer 32

Paraaortic area (along embryonic path of gland)

Question 33

Core breast biopsy demonstrates atypical ducal hyperplasia. What is the next step in treatment?

Answer 33

Excisional biopsy to establish diagnosis

Question 34

Is zenker diverticulum a true diverticulum?

Answer 34

No, it only involves mucosa and submucosa

Question 35

When should an elective cholecystectomy be performed for incidentally found gallstones?

Answer 35

• Stone >2.5cm
• children
• sickle cell
• calcifications in gall bladder wall

Question 36

Gall bladder removed for stones is found to have cancer invasive into submucosa, what now?

Answer 36

Observation and follow up

Question 37

What is hungry bone syndrome?

Answer 37

Hypocalcemia following surgical correction of hyperparathyroidism