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ABSITE TRULEARN 2019 > TRUELEARN 26 DEC 2018 > Flashcards

TRUELEARN 26 DEC 2018 Flashcards

1
Q

what do urine studies show with contrast induced nephropathy?

A
  • granular brown casts

- mild proteinuria (< 300 mg/day)

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2
Q

in contrast induced nephropathy is there oliguria or normal UOP?

A

normal

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3
Q

what is the FeNa with contrast induced nephropathy?

A

< 1%

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4
Q

what is the adjuvant regimen for stage III colon cancers?

A

FOLFOX

  • 5-FU
  • leucovorin
  • oxaliplatin
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5
Q

what is the histology seen in liver transplant rejection?

A
  • mixed portal cellular infiltrate
  • bile duct epithelial injury
  • endothelitis of central vein
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6
Q

what is the target for most cases of liver transplant rejection?

A

biliary system

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7
Q

what is the treatment for MILD liver rejection?

A
  • increase immunosuppressant levels
  • pulse dose corticosteroids

if unsuccessful, administration of antilymphocyte preparation is next step

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8
Q

what is the only known effective systemic medical therapy for patients with HCC? what is the MOA?

A
  • sorafenib
  • multikinase inhibitor with activity against VEGF receptor II, c-kit receptor, PDGF, and kinases in the b-Raf/Ras/MAPKK pathway
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9
Q

what is the most important determinant of overall survival in patients with pancreatic adenocarcinoma?

A

tumor stage

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10
Q

what is the primary determinant of pleural fluid turnover?

A

parietal pleura

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11
Q

what is the active clotting inhibitor of normal plasma?

A

plasmin

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12
Q

how are choledochal cysts confirmed?

A
  • ultrasound

- 99 mTc-IDA imaging study

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13
Q
  • virilization
  • low aldosterone
  • excess adrenal androgens
A

21-hydroxylase deficiency

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14
Q
  • ambiguous genitalia

- hypertension

A

11 B-hydroxylase deficiency

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15
Q

what colorectal anastomosis has the highest leak rate? the lowest?

A
  • highest: coloanal (10-20%)

- lowest: ileocolic (1-3%)

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16
Q

what are the defects in tetralogy of fallot?

A
  • pulmonary stenosis
  • VSD
  • overriding aorta with deviation of origin to right side
  • concentric RVH
17
Q

what is the cardiac auscultation abnormality in tetralogy of fallot?

A

crescendo-decrescendo with harsh systolic ejection quality (due to RV outflow obstruction)

18
Q

what are the boundaries of level I and II nodes in the breast?

A
  • anterior: clavipectoral fascia
  • posterior: subscapularis
  • superior: axillary vein
  • medial: pectoralis
  • lateral: latissimus
19
Q

what is the cause of hyperacute graft rejection?

A

lymphocytotoxic crossmatch for IgG antibodies against class I MHC receptors, activating the complement cascade (preformed antibodies toward either the HLA or ABO antigens of the donor)

20
Q

how is hyperacute graft rejection avoided?

A

conduct final lymphocytotoxic cross match to detect IgG antibodies against class I MHC receptors in the recipient

21
Q

in rectosigmoid surgery what are the areas in which a ureter injury can be encountered?

A
  • ligation of IMA
  • near cul de sac where ureter crosses under vas at sacral promontory
  • during division of lateral pedicles of rectum
  • during reperitonealization when ureter may be included in ligatures
22
Q

where is mesh placed in a rives-stoppa-wantz repair?

A

anterior to posterior sheath in the retrorectus position (sublay)

23
Q
  • what are the types of choledochal cysts (and associated treatments)?
A
  • type I: dilation in extrahepatic and/or intrahepatic bile ducts (RYGB)
  • type II: isolated diverticulum protruding from the CBD (simple resection)
  • type III: intraduodenal or intrapancreatic dilations of the distal CBD (sphincterotomy vs cyst marsupialization via ERCP vs transduodenal marsupialization)
  • type IV: dilation in extrahepatic and/or intrahepatic bile ducts (RYGB)
24
Q

how is the GDA controlled via suture when achieving hemostasis of a recurrent bleeding gastric ulcer?

A

superiorly and inferiorly followed by ligation of the medial transverse pancreatic branches with a U stitch

25
Q

silver nitrate leads to what electrolyte abnormality?

A

hyponatremia via extravasation

26
Q

what is the side effect of mafenide acetate?

A

metabolic acidosis via inhibition of carbonic anhydrase

27
Q

what tumor marker is used to monitor for recurrent granulosa cell tumors?

A

inhibin

28
Q

elevated AFP with an ovarian neoplasm is suggestive of what type of tumor?

A

endodermal sinus tumor

29
Q

biliary dyskinesia has what type of HIDA results?

A

EF < 35% at 20 minutes

30
Q

what is the most feared complication of a billroth II procedure?

A

duodenal stump leak

31
Q

what are the primary lymphoid organs?

A
  • liver
  • bone
  • thymus

can generate lymphocytes from immature cells

32
Q

what is the T staging for melanomas?

A
  • T1: 1 mm or less
  • T2: 1-2 mm
  • T3: 2-4 mm
  • T4: 4+ mm
  • a: no ulceration
  • b: ulceration
33
Q

when should SLNB be offered to patients with melanoma?

A

stage Ib and above

34
Q

what type of hernia repair is most appropriate for a patient with a strangulated femoral hernia requiring bowel resection and primary anastomosis?

A

mcvay (closes the femoral canal defect without incorporating mesh)

ABSITE TRULEARN 2019 (12 decks)

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