USMLEasy2

Question 0

Focal nodular hyperplasia of the liver – when surgery?

Answer 0

Only if symptomatic

Question 1

When to do a 4 compartment fasciotomy?

Answer 1

Acute arterial occlusion without collateral flow AND rapid reperfusion of ischemic muscle

Question 2

Operative management:

1. UC
2. Toxic Megacolon
3. Squamous cell carcinoma
4. Current/persistent squamous cell carcinoma
5. Proximal or mid-rectal cancers

Answer 2

1. Total proctocolectomy with an ileostomy or cheap pouch
2. Subtotal colectomy with and ileostomy
3. Chemoradiation with Niekro protocol
4. Abdominal-peroneal resection of the anus/rectum with permanent end colostomy
5. Lower anterior resection

Question 3

Newborn with cleft lip/palate – when to repair?

Answer 3

Prepare lip at three months

Repair palate at 12-18 months

Question 4

Common complications of paraesophageal hernia?

Answer 4

Microcytic anemia, gastritis, ulceration

Question 5

Quincke pulse? Associated with?

Answer 5

Alternate flushing and paling of skin under nailbeds

Aortic regurgitation

Question 6

Charcot triad? For?

Answer 6

Fever, jaundice, right upper quadrant pain

Cholangitis

Question 7

Routine postoperative immunosuppression for a renal transplant includes?

Answer 7

#Cyclosporine (nephrotoxic, so wait until creatinine returns to normal), 
#azathioprine (Bone marrow toxicity)
#steroids

Question 8

Signs of acute versus chronic increases in ICP?

Answer 8

Cushing’s Triad versus papilledema

Question 9

Choledochal cyst – preferred management?

Answer 9

Surgery

Question 10

Side effect of these anesthesia drugs:

1. Morphine
2. Pancuronium
3. Succinylcholine

Answer 10

1. Hypotension
2. Tachycardia
3. Hyperkalemia

Question 11

Sign that warrant reconstructive arterial surgery?

Answer 11

Rest pain or gangrene

Question 12

Patient with chylothorax – management?

Answer 12

Tube thoracostomy and low fat diet (repair impractical because of friability thoracic duct)

Question 13

Posttransplant lymphoproliferative disorder associated with what Virus?

Answer 13

EBV

Question 14

MELD score based on?

Answer 14

Total bilirubin, INR, creatinine

Question 15

Management for epidermoid carcinoma of the anus?

Answer 15

Chemotherapy (Nibroc protocol) with surgery with treatment failure

Question 16

Radical orchiectomy – when is lymph node dissection indicated?

Answer 16

Embroynal carcinoma or teratoma if no supradiaphragmatic spread

Question 17

Most common location of non-Hodgkin’s lymphoma of the G.I. tract? Management?

Answer 17

Stomach

#If not invading beyond submucosa, surgical resection
#Chemoradiation

Question 18

Treatment for pyoderma gangrenosum?

Answer 18

Systemic steroids and immunosuppressants

Question 19

Treatment for neurogenic shock?

Answer 19

IV fluid bolus followed by vasoconstrictors (dopamine/phenylephrine)