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1st Sem > Surgery > Flashcards

Surgery Flashcards

1
Q

A surgeon needs to access the pancreas for a surgery. Which incision would likely be used?
a. Pfannenstiel Incision
b. Mini Laparotomy Incision
c. Chevron Incision
d. McBurney’s Incision

A

c. Chevron Incision

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2
Q

The appropriate treatment of Meckel’s Diverticulum with narrow base is:
a. Observation
b. Resection and primary repair
c. Lateral component separation
d. Wedge resection

A

d. Wedge resection

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3
Q

A 50-year-old man who underwent total abdominal colectomy for familial adenomatous polyposis (FAP) 5 years ago presents with a gradually expanding painless 4 cm mass of the anterior abdominal wall. A core needle biopsy reveals a desmoid tumor with no sign of malignancy. On CT scan, the mass is noted to be resectable. What do you think will the senior surgical resident do?
a. End-to-end anastomosis
b. Doxorubicin, dacarbazine, or carboplatin
c. Tamoxifen and Sulindac
d. Radiotherapy

A

c. Tamoxifen and Sulindac

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4
Q

A patient presents to you with a newly recognized protrusion through the deep inguinal ring that is entering the right inguinal canal and extending into the right scrotum. The protrusion is lateral to the inferior epigastric blood vessels. Which of the following is the correct diagnosis?
a. Indirect inguinal hernia, right; Nyhus Type IVB; EHS PLx
b. Indirect inguinal hernia, right; Nyhus Type IIIB, EHS PLx
c. Direct inguinal hernia, right; Nyhus Type IVB, EHS PLx
d. Direct inguinal hernia, right; Nyhus Type IIIB, EHS PLx

A

b. Indirect inguinal hernia, right; Nyhus Type IIIB, EHS PLx

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5
Q

What structures make up the conjoint tendon?
a. Rectus abdominis and transversus abdominis
b. External oblique and internal oblique
c. Internal oblique and transversus abdominis
d. Rectus abdominis and internal oblique

A

c. Internal oblique and transversus abdominis

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6
Q

Which of the following statements about omental infarction are true?
a. Patients usually present with fever and lassitude.
b. Most cases are diagnosed on imaging studies.
c. Most cases do not require surgery.
d. Surgical resection is indicated in all cases.

A

b. Most cases are diagnosed on imaging studies.

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7
Q

75M consults at the out-patient department due to intermittent abdominal pain and constipation. On physical examination you noted a mass lesion that is mobile only from the patient’s right to left or left to right. CT scan was requested revealing a unilocular lesion without solid component on imaging. Which of the following is the cause of this condition?
a. Inflammatory and fibrotic process involving the intestinal mesentery due to increased tissue density within the mesentery.
b. Degeneration of mesenteric lymphatics or congenital peritoneal inclusions
c. Fibrous neoplasm originating from the musculoaponeurotic structures
d. Abnormal separation of rectus muscles and a laxity at the linea alba
e. Persistence of urachal remnants

A

b. Degeneration of mesenteric lymphatics or congenital peritoneal inclusions

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8
Q

Which of the following is true regarding abdominal incisions and the prevention of incisional hernias?
A. A 3:1 suture: wound length is the current recommended closure length.
B. There is no difference in hernia occurrence between a running closure and an interrupted closure.
C. A slowly absorbable monofilament suture is preferred in the closure of the fascia in a running fashion.
D. Prophylactic use of mesh after open aortic aneurysm surgery is not efficacious.
E. A 1-cm bite between each stitch is the recommended distance during abdominal closure.

A

C. A slowly absorbable monofilament suture is preferred in the closure of the fascia in a running fashion.

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9
Q

Which of the following is true regarding a rectus sheath hematoma?
A. If located above the umbilicus, it is more likely to resemble an acute intra-abdominal process.
B. If located below the umbilicus, it is more likely to cause severe bleeding.
C. The majority are associated with a history of trauma. Not sure SAME
D. Operative drainage is the treatment of choice in most cases.
E. Angiographic embolization is not useful.

A

B. If located below the umbilicus, it is more likely to cause severe bleeding.

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10
Q

The portion of the peritoneum surrounding the abdominal organs is known as which one of the following?
A. Mesentery
B. Omentum
C. Parietal peritoneum
D. Retroperitoneum
E. Visceral peritoneum

A

E. Visceral peritoneum

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11
Q

A patient presents to your ER with a penetrating injury in the 6-pack region above the arcuate line. Which of the following shows the order or layers the knife would have traversed?
A. Skin, Camper’s Fascia, Scarpa’s Fascia, Rectus Sheath, Rectus Abdominis, Rectus Sheath, Extraperitoneal Fascia, Peritoneum
B. Skin, Scarpa’s Fascia, Camper’s Fascia, Rectus Sheath, Rectus Abdominis, Rectus Sheath, Extraperitoneal Fascia, Peritoneum
C. Skin, Camper’s Fascia, Rectus Sheath, Rectus Abdominis, Scarpa’s Fascia, Extraperitoneal Fascia, Peritoneum
D. Skin, Camper’s Fascia, Scarpa’s Fascia, Rectus Sheath, Rectus Abdominis, Peritoneum, Extraperitoneal Fascia

A

D. Skin, Camper’s Fascia, Scarpa’s Fascia, Rectus Sheath, Rectus Abdominis, Peritoneum, Extraperitoneal Fascia

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12
Q

Laparoscopic repair of incisional hernias is associated with which of the following?
A. Reduced hospital cost
B. Reduced recurrence rate
C. Reduced wound infection rate
D. Reduced seroma formation

A

C. Reduced wound infection rate

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13
Q

Which of the following is not a content of the inguinal canal in males?
a. Spermatic Cord
b. Inferior epigastric artery
c. Genital branch of the genitofemoral nerve and vessels
d. Ilioinguial nerve

A

b. Inferior epigastric artery

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14
Q

Failure of the vitelline duct to regress leads to which of the following?
a. Colonic diverticulum
b. Vitelline duct fistula
c. Umbilical cord hernia
d. Omphalomesenteric duct cyst

A

b. Vitelline duct fistula

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15
Q

A patient presents to you with a protrusion in hesselbach’s triangle. You suspect that the patient has a direct inguinal hernia. Which of the following is not a boundary of hesselbach’s triangle?
a. Inferior epigastric blood vessels
b. Inguinal ligament
c. Rectus abdominis
d. Linea alba

A

d. Linea alba

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16
Q

A patient arrives at your clinic with a protruding mass from his superficial inguinal ring. He is diagnosed with an indirect inguinal hernia. The surgeon plans to do a tissue repair. The following are anterior approach to inguinal hernia except:
a. Bassini repair
b. mcVay repair
c. TAPP repair
d. Shouldice repair

A

c. TAPP repair

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17
Q

Which of the following types of hernias account for 75% of all abdominal hernias?
a. Femoral
b. Incisional
c. Inguinal
d. Femoral

A

c. Inguinal

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18
Q

Which of the following types of hernias cannot be reduced?
a. Incarcerated
b. Incisional
c. Inguinal
d. femoral

A

a. Incarcerated

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19
Q

Which of the following types of abdominal hernias is most likely to occur through defects in the transversus abdominal muscle?
a. Epigastric
b. Incisional
c. Spigelian
d. Umbilical

A

c. Spigelian

20
Q

When presented with a patient with an omphalocele or gastroschisis, how will you deal with the protruded intraabdominal contents?

A

Ans: Ideal use of silo bags is presented but due to limited resources, gauze wet with saline solution is used on the abdominal contents and eventually wrapped with cling wrap to attain the goal of primary closure.

21
Q

What is the procedure of choice for doing a biopsy of a CENTRALLY located lung lesion?

A

PNEUMONECTOMY

22
Q

What is the recommended margin (in cm) in doing a wide excision of a malignant chest wall mass?

A

4 cm

23
Q

What is the first step in the management of massive hemoptysis?

A

CONTROL AIRWAY

24
Q

What type of thoracotomy approach is recommended in patients requiring emergent surgery such as penetrating chest trauma?

A

ANTEROLATERAL THORACOTOMY

25
Q

List two (2) advanced airway procedures that may cause tracheal stenosis or strictures if not properly managed (2 pts): (separate the two answers with the word ‘’and’’)

A

TRACHEOTOMY and ENDOTRACHEAL INTUBATION

26
Q

What does VATS stand for?

A

VIDEO ASSISTED THORACOSCOPIC SURGERY

27
Q

List two (2) important differences between VATS which are decreased complications, pain and hospital stay (2 pts): (separate the two answers with the word ‘’and’’)

A

SMALLER INCISONS
MINIMAL TRAUMA

28
Q

What is the procedure performed to urgently drain a pleural effusion which can be done at bedside under local anesthesia without leaving an indwelling tube (1 pt)?

A

THORACENTESIS

29
Q

What is the advantage of using an organic or tissue valve in valve replacement surgery?

A

NO USE OF ANTICOAGULANTS
LESS RISK OF ANTICOAGULANT COMPLICATIONS

30
Q

What procedure is performed to immediately drain the pericardial cavity in cardiac tamponade?

A

PERICARDIOCENTESIS

31
Q

What is the most commonly used ARTERIAL graft in CABG?

A

INTERNAL MAMMARY or INTERNAL THORACIC ARTERY

32
Q

What is the open heart surgery performed for atrial fibrillation?

A

COX MAZE PROCEDURE

33
Q

What does CABG stand for?

A

CORONARY ARTERY BYPASS GRAFTING

34
Q

What does CPB stand for?

A

CARDIO-PULMONARY BYPASS

35
Q

Through which vein is the permanent pacemaker wire passed?

A

SUBCLAVIAN VEIN

36
Q

What is the definitive or ‘’gold standard’’ treatment for end stage heart disease or heart failure?

A

HEART TRANSPLANT or HEART TRANSPLANTATION

37
Q

What is the standard incisions/approach in conventional (open) cardiac surgery?

A

MEDIAN STERNOTOMY or STERNOTOMY

38
Q

What is the most common primary cardiac tumor?

A

MYXOMA

39
Q

What does ABI stand for?

A

ANKLE TO BRACHIAL INDEX

40
Q

What surgical procedure is done to revascularize the occluded lower extremity arteries in adult limb ischemia?

A

EMBOLECTOMY

41
Q

Give two (2) indications to consider surgical intervention in critical limb ischemia (2 pts): (separate the two answers with the word ‘’and’’)

A

PAIN AT REST OR LIMITING LIFESTYLE
TISSUE LOSS OR GANGRENE

42
Q

What does EVAR stand for?

A

ENDOVASCULAR ABDOMINAL AORTIC ANEURSYM REPAIR

43
Q

What open surgical procedure is considered in chronic venous insufficiency (CVI) with saphenofemoral vein junction and superficial venous reflux?

A

VEIN LIGATION AND STRIPPING

44
Q

Which type of aortic dissection requires emergent intervention?

A

STANDFORD TYPE A

45
Q

What non-invasive imaging modality is requested to confirm the diagnosis of an aortic aneurysm?

A

MRI/CT SCAN ANGIOGRAPHY

46
Q

What is considered the MAINSTAY in the comprehensive management of CVI?

A

COMPRESSION THERAPY

47
Q

Elective repair of an infrarenal abdominal aortic aneurysm is recommended once the aortic diameter is ___cm?

A

5 CM

1st Sem (6 decks)

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