Upper Abdomen

Question 1

55y M sternal pain following egd, wbc 18K, left lung diminished, tachy, hypotn
Starting work up and orders
additional history questions

Answer 1

IVF, BS abx including fungal, EKG, chest xr

PUD, gerd, smoking, alcohol, reason for EGD, card hx, cancer

Question 2

55y M sternal pain following egd, wbc 18K, left lung diminished, tachy, hypotn

Imaging???

Answer 2

CXR
Esophagram w/ WS conrast

then barium if still worried

Question 3

4 steps for mid esophageal perf repair

Answer 3

1)thoracotomy
2)Harves intercostal
3) Debride and repair in 2 layers
4) leave drain, ngt and chest tube

Question 4

when to feed esophageal repair

Answer 4

day 5 if esophagram negative

Question 5

Types of choledochal cysts and treatment

Answer 5

HJ
cystectomy
Endo
Hapatic rescetion
Liver transplant

Question 6

Risk of cancer with choledocal cyst

Answer 6

10-20%

Question 7

Main cause of choledochal cyst

Answer 7

PAcreatico biliary anomolous path

Question 8

Imaging for choledochal cyst

Answer 8

U/s MRCP ERCP

Question 9

why resect choledochal cyst

Surveillanc

Answer 9

s/s relief and dec ca risk

CMPs and imaging yearly

Question 10

Treatment for sigmoid volvulus without peritonitis

Answer 10

flex sig and rectal tube, delayed surgery

Question 10

Abdominal distension, start with what imaging

Answer 10

xr

Question 11

What T stage is the threshold for operation for gallbladder cancer

Answer 11

T1b -muscle

Question 12

3 assessments for bariatric surgery

Answer 12

1. Mental health
2. Nutrition
   3 Health(Cards, OSA)

Question 13

Indications for bariatric surgery

Answer 13

> 35
30-35 with comorbidities

Question 14

4 possible nutritiona deficiencs with roux

Answer 14

iron
thiamine
ca
b12

Question 15

complications of roux

Answer 15

internal hernia
marginal ulcer
gg fistula
leak

Question 16

generally with leaks in general when can you place drain

Answer 16

focal tenderness/contained/ not sick

Question 17

splenectomy vax sched

Answer 17

haem
mening, q 5y
pneumo 13 , q 5y

Question 18

Imaging workup for panc adeno

labs?

Answer 18

CTCAP
MRCP
EUS
ERCP

CA 19 9
KRAS testing

Question 19

What needs to be further evaluated when duodenal atresia is present

Answer 19

Get echo

Question 20

What do you need to ask about if concerned for panc endocrine mass

Answer 20

Familial involvement

Question 21

labs for panc endo dg

Answer 21

Question 22

malign potential for each endo panc

Answer 22