NAME

Question types


Start with


Question limit

of 77 available terms

Advertisement Upgrade to remove ads
Print test

5 Written questions

5 Matching questions

  1. 76yM alcoholic with hematemesis. MNGT
  2. 21yM in MVA has laceration to aorta. Most common location?
  3. 21yF with breast lump. Core bx dx is LCIS. MNGT
  4. 45yM smoker often experiences pain at night while lying in bed, and the pain improves with positioning of the affected extremity. Ddx? MNGT?
  5. 65yM s/p gastrectomy presents with abdominal pain, N/V, palpitations. MNGT
  1. a small, low carb, cholestyramine, no ppi, (
    These symptoms can be managed by
    *eating small, low carbohydrate meals throughout the day.
    •Postvagotomy diarrhea is related to the
    *rapid transit of unconjugated bile salts and is effectively
    *treated with cholestyramine.
    * [NOT] Proton pump inhibitors are not a useful therapy for alkaline reflux.)
  2. b peripheral arterial occlusive disease, arterial duplex of leg, aorta vs iliac, then angiogram, (
    The symptoms described by the patient are classic for rest pain.
    •Initial evaluation of this patient should be an
    ***arterial duplex study of the vessels of the affected leg. This
    noninvasive test can provide great detail on the extent of the disease
    and the location of hemodynamically significant obstruction.
    Furthermore, it will help determine if inflow obstruction is present
    in the aorta or iliac vessels.
    It is crucial in these patients to determine if the
    •arterial obstruction involves the aortoiliac vessels or is
    •confined to the lower extremity vasculature.

    After determining the location of the atherosclerotic lesion, you can
    •proceed with a traditional angiogram,
    ***CT angiogram, or even an
    ***MRI/MRA to evaluate the vessels in order to plan your intervention.)
  3. c fluid, coags, blood, (
    The initial
    •management should include
    * fluid resuscitation and
    *replacement of blood and clotting factors as needed.)
  4. d decel, distal to left subclavian at lig art, (
    •In deceleration injuries, laceration involving the aorta most
    frequently occurs just
    *distal to the left subclavian artery at the
    *level of the ligamentum arteriosum.
    This is where the aorta is fixed and thus more susceptible to shear
    forces. The tear may be complete or partial.)
  5. e b9, risk to b/l breasts, tamoxifen, (
    •LCIS is a benign diagnosis and alone does not have a risk of
    progression to an invasive cancer.
    •However, a diagnosis of LCIS does increase the risk for development
    of future breast cancer at a rate of about 1% per year. It is
    important to remember that the
    *risk is increased for both breasts. It has been shown that
    *chemo-prevention with tamoxifen can decrease the incidence of breast
    cancer by 49%.
    It is also sufficient to follow this population closely with
    *annual mammograms and
    *semiannual clinical examinations.
    *Prophylactic bilateral mastectomies are an option and result in a 90% decrease in the risk of subsequent breast cancer.
    Since a diagnosis of LCIS increases the risk of cancer in both breasts, a mastectomy of the affected side is insufficient treatment.)

5 Multiple choice questions

  1. mammograms, tamoxifen, bl mastectomy, (Once
    this diagnosis has been confirmed,
    ***management decisions can be made including
    1. close observation with frequent screening mammograms,
    2. chemoprevention with tamoxifen, or
    3. prophylactic bilateral mastectomy.

    A unilateral mastectomy is not an option as a diagnosis of
    •atypical ductal hyperplasia increases the risk of breast cancer in
    both breasts.)
  2. carcinoma (20% incidence of gallbladder carcinoma. Signs and symptoms of carcinoma of the gallbladder are generally indistinguishable from those associated with cholecystitis and
    cholelithiasis. They include abdominal discomfort, right upper
    quadrant pain, nausea, and vomiting. )
  3. technetium pertechnetate, (
    • diagnosed using
    ***nuclear medicine scans technetium pertechnetate
  4. compression, ORIF, embolize, no exlap, (
    The x-ray described demonstrates an
    •open book pelvic fracture. This type of injury can often be
    associated with
    *significant hemorrhage.
    It is most commonly seen in frontal impacts involving anterior-
    posterior compression. The majority of the bleeding occurs from the
    tearing of pelvic veins in the posterior of the pelvis.

    •The initial treatment for open book pelvic fractures is to
    *reduce the pelvic volume to decrease the amount of hemorrhage. In
    the trauma bay, this can easily be accomplished by
    *wrapping a sheet around the superior iliac crests and twisting the
    sheet tight using a dowel or by
    *applying the pneumatic compression garment.
    These are useful techniques in the short term, but definitive
    treatment will be necessary. This involves
    *formal repair of the pelvis with external fixation or open reduction
    and internal fixation.
    •If hemorrhage persists despite reduction of the pelvic fracture,
    *pelvic angiography would be the next step in the treatment algorithm
    to attempt to identify the source of the hemorrhage and
    *embolize the vessel.
    Given the difficulty of identifying a bleeding vessel in an
    expanding pelvic hematoma,
    *exploratory laparotomy is NOT recommended.
    *Finally, an unstable patient should never be transported for imaging
    studies.)
  5. hypoglycemia, coag, elev ammonia, acidosis, hyperk, oliguria, (
    Signs of liver dysfunction include
    ***hypoglycemia as the liver is unable to perform gluconeogenesis,
    ***coagulopathy with elevated prothrombin times,
    ***elevated ammonia levels,
    ***acid-base changes unable to clear lactate via the Cori cycle,
    ***hyperkalemia, and
    ***oliguria.)

5 True/False questions

  1. Colon Cancer stagingthrough int inguinal ring, in spermatic cord, (
    A direct hernia comes through the medial inguinal canal floor and is
    found behind the spermatic cord. An indirect hernia passes though the
    internal inguinal ring, and thus can be found within the spermatic
    cord. The spermatic cord also contains the vas deferens, the
    testicular artery, lymphatics, and nerve fibers.)

          

  2. Risk factors for dehiscencethrough int inguinal ring, in spermatic cord, (
    A direct hernia comes through the medial inguinal canal floor and is
    found behind the spermatic cord. An indirect hernia passes though the
    internal inguinal ring, and thus can be found within the spermatic
    cord. The spermatic cord also contains the vas deferens, the
    testicular artery, lymphatics, and nerve fibers.)

          

  3. 76yM alcoholic with hematemesis. Undergoes portal shunt. What types used for stable patient for recurrent episodes?mesocaval, splenorenal, (
    *TIPS have increased in popularity as a method for portal
    decompression. This can be performed in the acute setting. Surgical
    shunts are also an option, but are primarily reserved for stable
    patients with recurrent bleeding episodes and
    * not performed in an acutely unstable patient.
    *Mesocaval shunts connect the SMV to the IVC in a variety of manners.
    *Splenorenal shunts are actually the most common type of shunt.
    *Nonselective shunts that completely divert portal blood flow from
    the liver can actually INCREASE hepatic encephalopathy. Most surgeons
    prefer selective shunts, which preserve a component of hepatic blood
    flow and thus function. Synthetic graft material can be safely used to
    create the shunts. Postoperative mortality is directly related to the
    patient's preprocedure medical condition and degree of hepatic
    failure i.e., Child class.)

          

  4. MCC location of Meckel's diverticulum?Asx, GI bleed, (
    •Meckel's diverticuli are usually found incidentally, although they
    can present with
    ***painless lower GI bleeding or
    ***inflammation
    ***confused with acute appendicitis. They are usually found within)

          

  5. 18yM with thin habitus, presents with spontaneous pneumothorax. MNGTsmall, low carb, cholestyramine, no ppi, (
    These symptoms can be managed by
    *eating small, low carbohydrate meals throughout the day.
    •Postvagotomy diarrhea is related to the
    *rapid transit of unconjugated bile salts and is effectively
    *treated with cholestyramine.
    * [NOT] Proton pump inhibitors are not a useful therapy for alkaline reflux.)