Medical Diagnostics and Treatment Criteria

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Questions and Answers

Which of the following are diagnostic criteria for Acute pancreatitis? (Select all that apply)

Kidney failure (correct)
Rebound tenderness (correct)
Clinical signs: abdominal pain, vomiting (correct)
Computed tomography signs of acute pancreatitis (correct)
3-fold elevation of lipase (from upper normal limit) (correct)

Which of the following is NOT a diagnostic criteria for chronic autoimmune pancreatitis?

Microbiological culture (correct)
Histological findings
Other organ involvement
Positive effect from corticosteroid therapy
Serology

Which of the following diagnostic criteria methods could be used for a hemodynamically unstable polytrauma patient with suspected bleeding? (Select all that apply)

Diagnostic peritoneal lavage (correct)
MRI angiography (correct)
Contrast enhanced computed tomography (correct)
FAST ultrasonography (correct)

Which of the following are indications for interventional or surgical treatment in case of acute pancreatitis? (Select all that apply)

Gastric outlet obstruction (A), Severe pain syndrome (B), Infected walled-off necrosis (C) Signup and view all the answers

Which of the following is included in Charcot's Triad?

Vomiting (B), Jaundice (C), Fever (D) Signup and view all the answers

Which of the following is the most sensitive imaging tool for detection of stones in the common bile duct?

MRCP (A) Signup and view all the answers

Which of the following tumor markers is specific for pancreas adenocarcinoma?

CA19-9 (A) Signup and view all the answers

Which of the following are indications for surgical treatment of patients with chronic pancreatitis? (Select all that apply)

Unresolved pseudocyst (size 9 cm) (A), Ductal hypertension with pain syndrome (B), Exocrine insufficiency (C), Infected pseudocyst (size 4.5 cm) (D) Signup and view all the answers

Which of the following is the gold standard treatment for Acute Cholecystitis?

Laparoscopic cholecystectomy (B) Signup and view all the answers

Zollinger-Ellison syndrome is most commonly caused by which of the following?

Gastrinoma (C) Signup and view all the answers

Which of the following is NOT a characteristic finding in mild acute pancreatitis?

Acute necrotic collection (confirmed by computed tomography) (B) Signup and view all the answers

Which of the following are signs of mechanical jaundice? (Select all that apply)

Increased bilirubin levels (B), Increased liver enzymes (C), Dilatation of the common bile duct (D), Intrahepatic cholestasis (E) Signup and view all the answers

Which of the following are interventional or surgical treatment methods for acute necrotizing pancreatitis? (Select all that apply)

Retroperitoneal drainage/necrosectomy (A), Percutaneous US-guided drainage of fluid collection (B), Distal pancreatectomy (C), Pancreatoduodenectomy (D), Endoscopic transgastric drainage of fluid collection (E) Signup and view all the answers

Which of the following surgical procedures is considered a radical surgery in the management of pancreatic head ductal adenocarcinoma?

Pancreatoduodenectomy (Whipple procedure) (B) Signup and view all the answers

Which of the following is the most informative or first-choice imaging method for Acute cholecystitis?

CT with I/V contrast (D) Signup and view all the answers

Which of the following is NOT included in the lethal trauma triad?

Hyperthermia (B) Signup and view all the answers

Which of the following is most commonly associated with bile duct injuries?

Bile duct anatomy misinterpretation (B), Lack of surgeon experience (C) Signup and view all the answers

What is the normal size of the gallbladder wall?

0.3 - 0.5 cm (A) Signup and view all the answers

Which of the following is the most accurate imaging tool to define the diagnosis of pancreas head cancer?

CT with I/V contrast (A) Signup and view all the answers

Which of the following are diagnostic criteria for Acute Cholecystitis according to the Tokyo Guidelines 2018? (Select all that apply)

Fever (A), Vomiting (B), Increased CRP (C), Right upper abdominal pain (D), Dilated gallbladder (E), Thickened gallbladder wall (F) Signup and view all the answers

After endoscopic hemostasis for a patient with a bleeding ulcer, how long should a continuous infusion of a proton pump inhibitor (PPI) be given?

72 hours (C) Signup and view all the answers

Which signs are considered certain signs of shock?

Tachycardia (A), Warm extremities (D), Good pulse volume (E) Signup and view all the answers

Which of the following statements about lymph is true?

Lymph is the product of interstitial fluid, originating from ultrafiltration of plasma in the cisterna chyli. (D) Signup and view all the answers

Which of the following is a radical operation for a liver flexure adenocarcinoma?

Hemicolectomy (D) Signup and view all the answers

Which of the following are indications for surgery in chronic pancreatitis? (Select all that apply)

Endocrine insufficiency (A), Mechanical jaundice (B), Ductal hypertension (C), Exocrine insufficiency (D) Signup and view all the answers

Which of the following is a palliative care option in patients with distal gastric cancer and gastric outlet obstruction? (Select all that apply)

Endoscopic stenting (A), Percutaneous endoscopic gastrostomy (B), Gastrojejunal anastomosis (C) Signup and view all the answers

Upper gastrointestinal bleeding refers to bleeding that originates in which of the following locations?

Proximal to the ligament of Treitz (D) Signup and view all the answers

Which of the following are congenital abnormalities or anatomic variants of the pancreas that can most likely lead to the development of one of the following conditions? (Choose one)

Chronic pancreatitis (A) Signup and view all the answers

Infusion of erythromycin before endoscopy in certain cases significantly improves endoscopic visualization, reduces the need for a second-look endoscopy.

True (A) Signup and view all the answers

Which of the following is NOT a general strategy for the reduction of adhesions?

Minimization of operating time (D) Signup and view all the answers

What is the leading symptom of distal gastric cancer localization?

Difficulty swallowing food (C) Signup and view all the answers

Which of the following is NOT an indication for surgery in the case of upper gastrointestinal bleeding?

Endoscopic finding - Forrest 1B (C) Signup and view all the answers

Which of the following are recommended surgical approaches in the management of obstructing sigmoid colon cancer? (Select all that apply)

Sigmoid resection with primary anastomosis and preventive ileostomy (A), Sigmoid resection with primary anastomosis (B), Hartmann's procedure (C) Signup and view all the answers

Which of the following are considered neuroendocrine tumors of the pancreas? (Select all that apply)

Vipoma (A), Gastrinoma (C), Insulinoma (D) Signup and view all the answers

Which of the following is NOT included in a CT scan for polytrauma?

Head/facial bones (A) Signup and view all the answers

Which diagnostic method is most suitable for the detection of gastric cancer in the peritoneum?

Laparoscopy (A) Signup and view all the answers

In the case of early gastric cancer, where is the invasion verified?

In the mucosa (C) Signup and view all the answers

It is possible for lymphedema to occur from bacterial infections that originate from the skin flora.

False (B) Signup and view all the answers

Which of the following is the most common cause of upper gastrointestinal tract bleeding?

Peptic ulcer disease (C) Signup and view all the answers

Which of the following are two correct statements about the lymphatic drainage system?

<ol start="3"> <li>The right lymphatic drains into the bloodstream at the junction of the right internal jugular and the right subclavian vein. 4. The thoracic duct drains into the bloodstream at the junction of the left internal jugular vein and the left subclavian vein. (B)</li> </ol> Signup and view all the answers

Which of the following are clinical signs of gastric cancer in the admitted patient?

Weight loss (A), Weakness (B), Nausea (C), Fixed tumor in epigastric region (D) Signup and view all the answers

Which of the following are management options for a patient with a mucinous cystadenoma? (Select all that apply)

Resection of lesion (A), Dynamic surveillance (repeated imaging) (B), Total pancreatectomy (C) Signup and view all the answers

Which of the following is NOT a pathohistological form of gastric cancer?

Basal cell carcinoma (C) Signup and view all the answers

Which of the following are indications for invasive treatment of patients with chronic pancreatitis? (Select all that apply)

Unresolved pseudocyst (size 9 cm) (A), Exocrine insufficiency (B), Infected pseudocyst (size 4.5 cm) (C), Jaundice (D), Unresolved pseudocyst (size 4 cm) (E), Splenic artery pseudoaneurysm (F) Signup and view all the answers

Which of the following are confirmed findings in individuals with primary hypothyroidism?

Low free T4 and high TSH (A) Signup and view all the answers

Prolapse of an internal hemorrhoid node with spontaneous reposition corresponds to which degree of hemorrhoid?

1st degree (E) Signup and view all the answers

Which of the following are treatment options for a patient with a stomach ulcer perforation? (Select all that apply)

Laparoscopic suturation of the perforated ulcer (A), Antibacterial treatment in the postoperative period (C), Surgery - suturation of the perforated ulcer (D) Signup and view all the answers

Which of the following is considered a richer type of incarceration?

Incarceration of stomach in diaphragmatic hernia (E) Signup and view all the answers

What is the most common complication associated with gastric and duodenal ulcers?

Bleeding (A) Signup and view all the answers

Why is a marking clip placed into the breast tumor prior to neoadjuvant chemotherapy (NAC)?

For the surgeon to visualize the tumor zone in case of complete clinical remission. (B), The clip helps to precisely localize the area that needs radiation. (C) Signup and view all the answers

Flashcards

Acute Pancreatitis Diagnostic Criteria

Criteria for diagnosing acute pancreatitis include a 3-fold elevation of lipase from the upper normal limit, computed tomography signs of acute pancreatitis, abdominal pain, and vomiting.

Chronic Autoimmune Pancreatitis Diagnostic Criteria

Chronic autoimmune pancreatitis is diagnosed by the presence of histological findings, other organ involvement, and a positive response to corticosteroid therapy. Microbiological culture and serology are not diagnostic criteria.

Hemodynamically Unstable Polytrauma Patient - Imaging

For a hemodynamically unstable polytrauma patient with suspected bleeding, diagnostic tools include FAST ultrasonography, diagnostic peritoneal lavage, and contrast enhanced computed tomography. MRI angiography is not suitable in this scenario.

Indications for Intervention in Acute Pancreatitis

Interventional or surgical treatment is indicated in acute pancreatitis cases with gastric outlet obstruction, severe pain syndrome, and infected walled-off necrosis. Asymptomatic acute peripancreatic fluid collection does not typically require intervention.