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Questions and Answers

What is the respiratory quotient (RQ) defined as?

  • Ratio between CO2 produced and O2 consumed (correct)
  • Ratio between glucose produced and ATP consumed
  • Ratio between lipids produced and protein consumed
  • Ratio between O2 produced and CO2 consumed

    • What does an RQ of 0.7 indicate?

  • Pure carbohydrate utilization
  • Pure fat utilization (correct)
  • Underfeeding/starvation
  • Mixed substrate utilization

    • When does an RQ of 1 or greater suggest that the principal nutrient being metabolized is carbohydrate?

  • Pure fat utilization
  • Underfeeding/starvation
  • Mixed substrate utilization
  • Pure carbohydrate utilization (correct)

    • What does an RQ of 0.8-0.9 indicate?

    <p>Mixed substrate utilization</p> Signup and view all the answers

    What feeding status does an RQ greater than 1.0 indicate?

    <p>Overfeeding</p> Signup and view all the answers

    What critical insight can the RQ provide about the feeding status of a patient?

    <p>Nutrient utilization</p> Signup and view all the answers

    Which of the following is the least invasive, definitive management option with favorable outcomes for a patient with a pancreatic pseudocyst?

    <p>Endoscopic cystogastrostomy</p> Signup and view all the answers

    What is the most likely cause of chronic anemia in the patient?

    <p>Colonic angiodysplasia</p> Signup and view all the answers

    What is the reason for not giving aromatase inhibitors in men?

    <p>Increased risk of intra-abdominal abscess formation</p> Signup and view all the answers

    What common symptom is associated with chromium deficiency?

    <p>Insulin intolerance (hyperglycemia)</p> Signup and view all the answers

    Which mineral deficiency leads to altered mental status and coma?

    <p>Molybdenum</p> Signup and view all the answers

    What is the possible explanation for the slightly higher risk of intra-abdominal abscess formation after laparoscopic appendectomy compared to open appendectomy?

    <p>Mechanical spread of intraperitoneal bacteria from insufflation or irrigation</p> Signup and view all the answers

    Which mineral deficiency is associated with poor wound healing?

    <p>Zinc</p> Signup and view all the answers

    What are the symptoms of deficiency associated with zinc?

    <p>Poor wound healing, night blindness, skin lesions</p> Signup and view all the answers

    What is the preferred surgical approach for appendectomy today?

    <p>Laparoscopic appendectomy due to favorable outcomes and shorter length of hospital stay.</p> Signup and view all the answers

    What is the management option for a patient with a colonic angiodysplasia presenting with chronic anemia?

    <p>Argon plasma coagulation ablation</p> Signup and view all the answers

    What is the standard treatment of choice for a simple low fistula and some mid-rectovaginal fistulas?

    <p>Beger procedure</p> Signup and view all the answers

    Which procedure involves resection of the pancreatic head, duodenum, and distal one-third of the stomach, and requires reconstruction with a gastrojejunostomy, pancreaticojejunostomy, and hepaticojejunostomy?

    <p>Whipple procedure</p> Signup and view all the answers

    What is the first-line treatment for idiopathic thrombocytopenic purpura (ITP)?

    <p>Corticosteroid therapy</p> Signup and view all the answers

    Which surgical approach is chosen for chronic pancreatitis with dilated duct without head involvement?

    <p>Puestow procedure</p> Signup and view all the answers

    What is the most appropriate anastomosis for patients with no evidence of distal ductal dilatation undergoing duodenum-preserving pancreatic head resection?

    <p>End-to-side pancreaticojejunostomy</p> Signup and view all the answers

    What is the diagnosis of exclusion characterized by isolated thrombocytopenia without an apparent cause?

    <p>Idiopathic thrombocytopenic purpura (ITP)</p> Signup and view all the answers

    Which procedure involves coring out the head of the pancreas with a longitudinal dissection of the pancreatic duct toward the tail, followed by a Roux-en-Y pancreaticojejunostomy?

    <p>Frey procedure</p> Signup and view all the answers

    Which type of repair has the lowest recurrence rates for inguinal or femoral hernias?

    <p>Mesh repair</p> Signup and view all the answers

    What is the last line of therapy for stress gastritis bleeding?

    <p>Total gastrectomy</p> Signup and view all the answers

    What is the primary treatment for patients with anal squamous cell carcinoma?

    <p>Chemoradiotherapy</p> Signup and view all the answers

    What is the most common site for well-differentiated neuroendocrine tumors (NETs) within the GI tract?

    <p>Rectum</p> Signup and view all the answers

    What is the most common presenting symptom of small bowel neuroendocrine tumors (NETs)?

    <p>Abdominal pain</p> Signup and view all the answers

    What is the main reason for performing Heineke-Mikulicz strictureplasty in patients with Crohn disease?

    <p>To avoid short gut syndrome</p> Signup and view all the answers

    What effect can excessive carbohydrate administration in total parenteral nutrition (TPN) have?

    <p>Failure to wean from ventilator</p> Signup and view all the answers

    What initiates acute appendicitis?

    <p>Luminal obstruction</p> Signup and view all the answers

    What is the unfortunate adverse effect of gastric reconstruction most commonly seen in patients who have undergone Billroth II gastrojejunostomy?

    <p>Bile reflux gastritis</p> Signup and view all the answers

    What type of neoplasms can be observed if they are less than 3 cm in size and lack any suspicious features in CT or MRI?

    <p>Branched duct-intraductal papillary mucinous neoplasms</p> Signup and view all the answers

    What is classified as a simple low rectovaginal fistula?

    <p>Fistula repairable perianally</p> Signup and view all the answers

    What output qualifies a fistula as a low output fistula?

    <p>&lt; 200 mL/day</p> Signup and view all the answers

    What is the 3-year event-free survival rate for hepatoblastomas in the Good Prognostic Stratum?

    <p>90%</p> Signup and view all the answers

    Which type of internal hemorrhoids prolapse through the anus but reduce spontaneously?

    <p>Grade 2</p> Signup and view all the answers

    Which topical antimicrobial agent is effective against methicillin-resistant Staphylococcus aureus and is contraindicated in renal toxicity at high doses/large areas?

    <p>Bacitracin</p> Signup and view all the answers

    When should orchiopexy ideally be performed to improve fertility and testicular growth?

    <p>Before 6 months of age</p> Signup and view all the answers

    Which protein is frequently used to assess the overall body iron stores due to its correlation with serum ferritin?

    <p>Ferritin</p> Signup and view all the answers

    What is the most common cause of injury to the duodenum during laparoscopic cholecystectomy?

    <p>Direct coupling</p> Signup and view all the answers

    What are the important symptoms of chronic venous disease due to great saphenous vein or small saphenous vein incompetence?

    <p>Lower extremity pain and swelling</p> Signup and view all the answers

    What repair technique involves suturing the conjoined tendon to the inguinal ligament from the pubic tubercle medially to the area of the internal ring laterally, without using mesh?

    <p>Bassini repair</p> Signup and view all the answers

    Which procedure is preferred for a recurrent inguinal hernia that was initially performed in an open fashion?

    <p>Laparoscopic approach</p> Signup and view all the answers

    Which topical antimicrobial agent is associated with skin discoloration and contraindicated near eyes, during pregnancy, breastfeeding, and in newborns under 2 months?

    <p>Silver sulfadiazine (Silvadene®)</p> Signup and view all the answers

    Which surgical repair method is primarily used when the use of mesh is contraindicated, for example, in a contaminated field due to perforated or ischemic bowel?

    <p>Open tissue repair method</p> Signup and view all the answers

    What type of varicose veins are important contributors to chronic venous disease?

    <p>Varicose veins of superficial veins</p> Signup and view all the answers

    Which factor is most likely to contribute to the development of Frey syndrome?

    <p>Parotidectomy</p> Signup and view all the answers

    What is the most common malignancy encountered in the post–solid organ transplant setting?

    <p>Nonmelanoma skin cancers</p> Signup and view all the answers

    What is the primary blood component associated with a 0.00028% incidence of HIV transmission in transfusion-transmitted infections in the United States?

    <p>Packed RBCs (pRBCs)</p> Signup and view all the answers

    What is the best method for diagnosing accessory spleens?

    <p>99m Technetium sulfur colloid scan</p> Signup and view all the answers

    Which symptom is characteristic of mild ischemic colitis?

    <p>Diarrhea without abdominal pain</p> Signup and view all the answers

    What is the most important indication for surgical resection of hepatic adenomas?

    <p>Size &gt; 5 cm</p> Signup and view all the answers

    What is the recommended first-generation cephalosporin for surgical prophylaxis?

    <p>Cefazolin</p> Signup and view all the answers

    Which agent is useful for the treatment of methemoglobinemia?

    <p>Methylene blue</p> Signup and view all the answers

    Which type of pancreatic tumor poses a risk of rupture and malignant transformation?

    <p>Hepatic adenoma</p> Signup and view all the answers

    What is the most common cause of full-thickness necrosis and perforation in ischemic colitis?

    <p>Large vessel occlusion</p> Signup and view all the answers

    Which antibiotic is generally given to prevent theoretical bacterial translocation in ischemic colitis?

    <p>Metronidazole</p> Signup and view all the answers

    Which is the most appropriate management for patients with no evidence of transmural ischemia or perforation in ischemic colitis?

    <p>Supportive treatment without antibiotics</p> Signup and view all the answers

    Which antibiotic is generally given to prevent theoretical bacterial translocation in ischemic colitis?

    <p>Metronidazole</p> Signup and view all the answers

    What is the most common cause of injury to the duodenum during laparoscopic cholecystectomy?

    <p>Excessive insufflation pressure</p> Signup and view all the answers

    What critical insight can the Respiratory Quotient (RQ) provide about the feeding status of a patient?

    <p>Carbohydrate utilization efficiency</p> Signup and view all the answers

    What are the important symptoms of chronic venous disease due to great saphenous vein or small saphenous vein incompetence?

    <p>Leg pain, swelling, and skin changes</p> Signup and view all the answers

    What feeding status does an RQ greater than 1.0 indicate?

    <p>Carbohydrate utilization</p> Signup and view all the answers

    Which agent is useful for the treatment of methemoglobinemia?

    <p>Methylene blue</p> Signup and view all the answers

    What is the reason for not giving aromatase inhibitors in men?

    <p>Lack of evidence for therapeutic benefit</p> Signup and view all the answers

    What is the most common type of malignancy encountered in the post–solid organ transplant setting?

    <p>Nonmelanoma skin cancers</p> Signup and view all the answers

    What type of varicose veins are important contributors to chronic venous disease?

    <p>Saphenous varicose veins</p> Signup and view all the answers

    What is the best method for diagnosing accessory spleens?

    <p>99m Technetium sulfur colloid scan</p> Signup and view all the answers

    Which mineral deficiency is associated with poor wound healing?

    <p>Zinc deficiency</p> Signup and view all the answers

    What common symptom is associated with chromium deficiency?

    <p>Skin discoloration</p> Signup and view all the answers

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