Truelearn

Question 1

criteria for transanal excision for anal cancer

Answer 1

T1 
<3cm
<30% circum
<8cm from anal verge
no lymphovascular invasion, no mucin

Question 2

MC abberant left and right hepatic arteries

Answer 2

left- from LGA (in hepatogastric ligament)

right- from SMA (will be posterior to cystic duct)

Question 3

radioactive iodine treatment indications in thyroidectomy

Answer 3

tumor 2-4cm
vascular invasion
anti TG antibodies
TG <5

Question 4

AV fistula preferences

Answer 4

1 auto radiocephalic (forearm)
2 auto brachiocephalic
3 auto brachiobasilic
4 brachiocephalic prosthetic

Question 5

Rule of 6 for fistulas

Answer 5

1 blood flow >600cc/min
2 diameter >0.6cm (for easy cannulation)
3 depth ~0.6cm from skin

Question 6

benign and malignant parotid tumors

Answer 6

benign - pleomorphic adenomas and warthin

malignant- mucoepidermoid or adenoid cystic carcinomas

Question 7

fistula in ano management

Answer 7

intersphincteric- fistulotomy

transphincteric- seton

Question 8

gastric adenocarcinoma management

Answer 8

5cm margins always
total gastrectomy for proximal tumors (in order to get margins)
chemo for T2 and above

Question 9

Number of lymph nodes in gastric node dissection

Answer 9

15lymph nodes

Question 10

thoracic outlet: anterior to posterior

Answer 10

subclavian v
phrenic n
ant scalene
subclavian a
brachial plexus

Question 11

liver lesion imaging

Answer 11

heterogeneous enhancing - adenoma
peripheral cetripetal enhancement- hemangioma
stellate scar- FNH

Question 12

pseudocyst management

Answer 12

conservative if <6wks, <6cm

Question 13

Milan criteria for liver transplantation

Answer 13

1 lesion <5cm
up to 3 lesions, each <3 cm
no extrahepatic dz

Question 14

signs of air embolus and management

Answer 14

drop in ET CO2

place Tberg, left lateral decub

Question 15

early vs late dumping syndrome

Answer 15

early (within 30 min) - hyperosmotic load

late (2-3 hrs) - hypoglycemia

Question 16

succinylcholine- characteristics, side effects, contraindications

Answer 16

fast on/off
pseudocholinesterase elimination
hyperkalemia, malignant hyperthermia
contraindicated in SCI, burns, renal failure, immobility

Question 17

isolated gastric varices

Answer 17

think splenic vein thrombosis

Question 18

cordlike breast mass

Answer 18

mondors (superficial thrombophlebitis)

NSAIDs

Question 19

melanoma margins

Answer 19

in situ - 0.5 -1cm
<1mm - 1cm
1-2mm - 1-2cm
>2mm - 2cm

Question 20

bismuth corlette classification of cholangiocarcinoma

Answer 20

I- common hepatic
II- bifurcation
III- unilateral 2ndary hepatic ducts
IV- bilateral 2ndary hepatic ducts

Question 21

types of melanoma and characteristics

Answer 21

acral lentiginous- AA
nodular- worst prognosis
superficial spreading- most common
lentigo maligna- old sun exposed, best prognosis

Question 22

anal adenomcarcinoma management

Answer 22

transanal excision if <3cm or <40% circumference, limited to submucosa
otherwise, APR

Question 23

nerve injury in thyroidectomy

Answer 23

superior laryngeal nerve- (cricothyroid) loss of projection and fatigability
recurrent laryngeal nerve- (all other laryngeal mm)- hoarsenss, bilateral –> airway obstruction

Question 24

incidental adrenal mass

Answer 24

observation if benign characteristics
<4cm
nonfunctioning
<10 HF units
rapid washout >50%

Question 25

anal fissure usual location

Answer 25

usu posterior midline

if lateral, consider workup for etiology (crohns sti hidraadenitis)

Question 26

gastrinoma dx

Answer 26

gastrin >1000
basal acid >15
secretin stim test >200 increase in gastrin (not necessary to dx)

Question 27

management thrombosed hemorrhoids

Answer 27

<4 days- excise

>4days conservative

Question 28

predictors of successful antireflux surgery

Answer 28

1 typical symptoms
2 abnormal 24hr pH monitoring
3 improvement w PPI

Question 29

Term ileum resection complications

Answer 29

B12 megaloastic anemia
Gallstones
Steatorrhea from bile acid loss
Oxalate kidney stones
Fat vit malabsorb

Question 30

Innervation epiglottis and larynx

Answer 30

Epiglottis- cn 9 (gag) and sup laryngeal
Above vocal cord - sup laryngeal (cough)
Below - RLN

Question 31

Innervation epiglottis and larynx

Answer 31

Epiglottis- cn 9 (gag) and sup laryngeal
Above vocal cord - sup laryngeal (cough)
Below - RLN

Question 32

Fibrolamellar HCC

Answer 32

Well circumscribed, central scar

Elevated neurotensin

Question 33

Fibrolamellar HCC

Answer 33

Well circumscribed, central scar

Elevated neurotensin