Full Length Practice 1

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In dyssynergic defecation type II, which of the following is true?

The subject can generate an adequate propulsive force but there is either absent relaxation or inadequate relaxation of the anal sphincter

The subject is unable to generate an adequate propulsive force together with an absent or inadequate relaxation of the anal sphincter

The subject can generate an adequate propulsive force with a paradoxical anal contraction (correct)

The subject is unable to generate an adequate propulsive force with a paradoxical increase in anal sphincter pressure

Which abnormal pattern of defecation is characterized by the subject being able to generate an adequate propulsive force along with a paradoxical increase in anal sphincter pressure?

Type II dyssynergia

Type III dyssynergia

Type IV dyssynergia

Type I dyssynergia (correct)

What does the ABCD rule refer to in the context of skin cancers?

Asymmetry, blister irregularity, color variation, diameter more than 6 mm

Asymmetry, basement membrane irregularity, color variance, diameter more than 6 mm

Asymmetry, border irregularity, color variegation, diameter more than 6 mm (correct)

Asymmetry, base irregularity, color variation, diameter more than 6 mm

What is the most common malignancy following transplantation from prolonged immunosuppression?

Squamous cell or basal cell skin cancer Signup and view all the answers

What percentage of recipients with white skin color ultimately develop skin lesions following transplantation?

Around 50% Signup and view all the answers

In a normal pattern of defecation, what happens to the anal sphincter when the subject generates a good pushing force?

The anal sphincter relaxes Signup and view all the answers

What is the appropriate treatment for amebic liver abscess due to Entamoeba histolytica?

Metronidazole alone Signup and view all the answers

What is the gold standard for the diagnosis of bladder rupture?

CT cystography Signup and view all the answers

How are small (< 2 cm) primary ventral hernias typically repaired?

Sutures with or without mesh reinforcement Signup and view all the answers

What is the recommended treatment regimen for Clostridioides difficile colitis?

PO fidaxomicin 200 mg 2 times a day for 10 days Signup and view all the answers

What is the treatment of choice for schistosomiasis?

Praziquantel Signup and view all the answers

What is the ideal repair for a ventral hernia between 2 and 10 cm in size?

Open retrorectus (sublay) repair with mesh Signup and view all the answers

What is the recommended treatment for severe Clostridioides difficile colitis?

Per rectum vancomycin 500 mg every 6 hours as a retention enema Signup and view all the answers

What is the first step when a bladder injury is identified?

Determine the location of the injury Signup and view all the answers

What type of injury requires operative management according to the text?

Intraperitoneal rupture Signup and view all the answers

What are GISTs?

Malignant non-epithelial tumors of the GI tract that arise from smooth muscle cells and stain positive for c-kit and CD34. Signup and view all the answers

What should be used to repair extraperitoneal bladder injuries requiring repair?

A Pfannenstiel incision. Signup and view all the answers

What is the appropriate treatment for persistent cases of amebic liver abscess?

Aspiration. Signup and view all the answers

In patients with familial adenomatous polyposis (FAP), what is the approximate risk of developing duodenal cancer?

4.5% Signup and view all the answers

What is the preferred approach for repair of incomplete transection of the proximal left anterior descending artery (LAD) in most patients?

Permanent, interrupted 6-0 or 7-0 sutures Signup and view all the answers

What is the recommended frequency of surveillance for patients with Spigelman Stage IV duodenal adenomas?

Every 3–6 months Signup and view all the answers

Which chemotherapeutic agent carries a risk of cardiotoxicity and requires evaluation of baseline cardiac function before administration?

Trastuzumab Signup and view all the answers

What is the primary intention in wound healing?

Approximation of skin edges with sutures or staples Signup and view all the answers

What is the main purpose of vacuum-assisted closure (negative-pressure wound therapy)?

Reducing edema surrounding the wound Signup and view all the answers

When is tertiary intention (delayed primary closure) used in wound management?

When the skin is left open, treated with negative-pressure wound therapy, then approximated with sutures or staples Signup and view all the answers

What is recommended for wound management in cases of damage control laparotomy?

"Loosely" approximating incision and placing packing in between loosely approximated skin edges Signup and view all the answers

"Dynamic (elastic) abdominal closure" is primarily used for managing what type of condition?

"Open abdomen" Signup and view all the answers

"Hormonal therapy, e.g., tamoxifen, anastrozole," is recommended for which type of breast cancer tumors?

"ER/PR+" Signup and view all the answers

"Adjuvant chemotherapy" is recommended for patients with breast cancer showing evidence of which characteristic?

"Nodal disease" Signup and view all the answers

What is the most common coronary artery injury among cardiothoracic injured patients?

Left anterior descending artery (LAD) Signup and view all the answers

Which classification system is used for categorizing acute limb ischemia?

Rutherford Classification System Signup and view all the answers

What is the specific diagnostic feature seen on CT in cases of autoimmune pancreatitis?

Diffusely enlarged pancreas with minimal peripancreatic fat stranding Signup and view all the answers

Injury to which nerve can affect voice pitch without affecting the airway?

External branch of the superior laryngeal nerve Signup and view all the answers

Which organ is most commonly affected by autoimmune pancreatitis in addition to the pancreas?

Bile ducts Signup and view all the answers

What is the first step in managing hyperkalemia?

Obtaining an ECG Signup and view all the answers

Which patient presentation is most common in autoimmune pancreatitis?

Jaundice Signup and view all the answers

In which traumatic scenario does neurogenic shock typically occur?

Spinal cord injury above the level of the 6th thoracic vertebra Signup and view all the answers

Which fluid resuscitation formula is recommended for patients with burns covering more than 15% of their total body surface area (TBSA)?

$4 mL x TBSA x weight (in kg)$ Signup and view all the answers

What is the main symptom associated with ovarian melanoma spreading via intra-peritoneal seeding?

Ascites Signup and view all the answers

What should be administered if ECG changes such as peaked T waves are present in a patient with hyperkalemia?

Calcium gluconate Signup and view all the answers

Which type of surgical wound has a risk of surgical site infection ranging from 3-11%?

Clean-contaminated (Type II) Signup and view all the answers

What might be seen on CT in cases of autoimmune pancreatitis focally involving the head of the pancreas?

Appearance as a mass on CT Signup and view all the answers

Which of the following is a marker for increased breast cancer susceptibility and does not require complete excision?

Lobular carcinoma in situ (LCIS) Signup and view all the answers

What is the preferred treatment for anal squamous cell carcinoma in the case of local recurrences after treatment with radiation therapy and chemotherapy?

Salvage abdominoperineal resection (APR) Signup and view all the answers

Which nerve is responsible for abducting the small finger?

Ulnar nerve Signup and view all the answers

What type of drugs are classified based on their effect at the motor end plates?

Neuromuscular-blocking drugs Signup and view all the answers

Which organ's metastases are much more common in the small bowel than primary neoplasms?

Kidneys Signup and view all the answers

What is the treatment for cutaneous melanoma involving the small intestine?

Palliative resection Signup and view all the answers

Which of the following findings classifies a patient as high-risk for bleeding based on endoscopic findings using the Forrest classification model?

Active bleeding and a visible vessel Signup and view all the answers

What is the preferred treatment for a simple fistula involving less than 30–40% of the sphincter complex?

Fistulotomy Signup and view all the answers

What are the characteristics of lesions without active bleeding according to the Forrest classification model?

Clean base ulcer Signup and view all the answers

What is used to facilitate drainage and promote fibrosis in complex fistulas?

Draining seton Signup and view all the answers

Which common malignancy has the highest risk among all solid organ transplant recipients?

Lung cancer Signup and view all the answers

What is the specific common malignancy associated with the pancreatic allograft?

Pancreatic adenocarcinoma Signup and view all the answers

Which solid organ transplant recipient has the second-highest risk of developing lung carcinoma?

Heart Signup and view all the answers

What is the most common anaerobic isolate in perforated appendicitis?

Bacteroides fragilis Signup and view all the answers

What is the calculated cerebral perfusion pressure (CPP) using the given equation: CPP = mean arterial pressure (MAP) – intracranial pressure (ICP)?

$MAP - ICP$ Signup and view all the answers

What is the recommended management for approximately 80-90% of patients with a lung abscess?

Antibiotic therapy only Signup and view all the answers

Which is the first of the deep inguinal lymph nodes to receive drainage and is often viewed as the gateway to the deep inguinal lymphadenectomy?

Cloquet's node Signup and view all the answers

What is generally performed if Cloquet's node is positive for metastatic disease or if there is evidence of deep inguinal lymph node involvement on PET/CT?

Deep inguinal lymphadenectomy Signup and view all the answers