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Questions and Answers

What is the rationale for positioning the patient as far away from the radiation source as possible during an angiogram?

  • To reduce the risk of infection
  • To minimize the patient's exposure to radiation (correct)
  • To improve the manipulation of catheters and wires
  • To optimize the image brightness

Which procedure is preferred for recurrent or pervasive pilonidal disease?

  • Karydakis procedure
  • Midline incision procedure
  • Cleft lift procedure (correct)
  • Lateral incision procedure

Why is creating off-midline incisions for pilonidal cysts considered beneficial?

  • It decreases the risk of recurrence (correct)
  • It optimizes the manipulation of catheters and wires
  • It improves image brightness
  • It minimizes the patient's exposure to radiation

Which serum tumor marker is elevated in the majority of nonseminomatous germ cell tumors?

<p>β-hCG (D)</p> Signup and view all the answers

When is β-hCG elevated in seminomas?

<p>Never (C)</p> Signup and view all the answers

Why should the image intensifier be positioned as close to the patient as possible during an angiogram?

<p>To optimize image brightness (C)</p> Signup and view all the answers

Which procedure involves en bloc resection of the parathyroid gland and ipsilateral thyroid lobe?

<p>Radical parathyroidectomy (A)</p> Signup and view all the answers

What is the best initial surgical management for a rare type of hernia that is present inferior to the inguinal ligament?

<p>Laparoscopic hernia repair (B)</p> Signup and view all the answers

Which testing should be recommended as a first-line test in patients with suspected Cushing syndrome, according to The Endocrine Society's clinical guidelines?

<p>Late-night salivary cortisol (2 measurements) (C)</p> Signup and view all the answers

Which type of ryanodine receptor is expressed in the myocardium?

<p>Type 2 (C)</p> Signup and view all the answers

What is the treatment for Helicobacter pylori if a penicillin allergy is present?

<p>Quadruple bismuth therapy (C)</p> Signup and view all the answers

What is the most feared complication after total or partial gastrectomy, especially with Billroth II reconstruction?

<p>Duodenal stump leak (D)</p> Signup and view all the answers

What causes duodenal atresia?

<p>Failure of recanalization of the proximal small bowel (D)</p> Signup and view all the answers

"The finding of a 'double-bubble' sign on abdominal radiography is usually pathognomonic for" which condition?

<p>Duodenal atresia (D)</p> Signup and view all the answers

Which of the following factors should prompt consideration of conversion to an open approach during laparoscopic intervention?

<p>Severely dilated small bowel (B)</p> Signup and view all the answers

What is the most effective initial treatment for patients with type I hiatal hernias who are asymptomatic?

<p>Control of acid secretion (C)</p> Signup and view all the answers

What condition is characterized by a deficiency in phosphate and worsened by insulin surge with the administration of food/nutrition?

<p>Refeeding syndrome (A)</p> Signup and view all the answers

What gene mutation is associated with Von Hippel-Lindau syndrome?

<p>VHL (B)</p> Signup and view all the answers

What type of hiatal hernia presents with dysphagia, early satiety, and postprandial pain?

<p>Type I hiatal hernia (C)</p> Signup and view all the answers

Which gene mutation is associated with retinoblastoma?

<p>RB1 (B)</p> Signup and view all the answers

What type of cholesteatoma arises from either retraction pockets within the tympanic membrane or secondarily from a tympanic membrane perforation?

<p>Acquired cholesteatoma (B)</p> Signup and view all the answers

What is the best treatment for refeeding syndrome?

<p>Correction of electrolytes and initiation of low rate feeding (D)</p> Signup and view all the answers

What is the main treatment modality for signs of refeeding syndrome when nutritional support is started?

<p>Supportive care for the symptoms and correction of electrolyte abnormalities (D)</p> Signup and view all the answers

Which gene mutation is associated with breast and ovarian cancer?

<p>BRCA1 (C)</p> Signup and view all the answers

What type of atrial septal defect causes a left-to-right shunt with potential development of congestive heart failure?

<p>Type I ASD (C)</p> Signup and view all the answers

What is the mechanism of action in refeeding syndrome?

<p>Redistribution of phosphate intracellularly due to insulin surge with food administration (B)</p> Signup and view all the answers

What is the most appropriate surgical resection for a tumor in the proximal transverse colon?

<p>Extended right hemicolectomy (B)</p> Signup and view all the answers

What is the terminal branch of the superior mesenteric artery that supplies blood flow to the terminal ileum and the proximal ascending colon?

<p>Ileocolic artery (D)</p> Signup and view all the answers

Which treatment involves division of both branches of the middle colic artery and the origin of the inferior mesenteric artery?

<p>Extended left colectomy (C)</p> Signup and view all the answers

What is the definitive treatment for mediastinitis?

<p>Debridement and coverage with pectoralis muscle flaps (A)</p> Signup and view all the answers

What are the risk factors for developing mediastinitis?

<p>Use of bilateral internal mammary arteries (B)</p> Signup and view all the answers

What are the most common locations for an accessory spleen?

<p>Splenocolic ligament, greater omentum, tail of pancreas, splenic pedicle, splenic hilum (A)</p> Signup and view all the answers

What is Pancoast syndrome associated with?

<p>Horner syndrome and shoulder and arm pain (A)</p> Signup and view all the answers

What is the most common acute transfusion reaction?

<p>Febrile non-hemolytic transfusion reaction (D)</p> Signup and view all the answers

What is the drug of choice for closure of persistent ductus arteriosus?

<p>Indomethacin (A)</p> Signup and view all the answers

What should be done to obtain infectious source control in anorectal Crohn abscess/fistula?

<p>Place a loose, draining seton to prevent recurrence of an abscess (D)</p> Signup and view all the answers

What should be avoided in all but the most simple and superficial fistulas in patients with no evidence of proctitis?

<p>Fistulotomy (A)</p> Signup and view all the answers

Which medications have been shown to improve fistulizing Crohn disease?

<p>Azathioprine and 6-mercaptopurine (C)</p> Signup and view all the answers

What is the antidote for acetaminophen toxicity?

<p>N-acetylcysteine (D)</p> Signup and view all the answers

Which factors may lead to increased 30-day mortality following emergency laparotomy?

<p>Age of patient, preoperative sepsis, perioperative AKI (A)</p> Signup and view all the answers

What is the preferred agent for managing esophageal variceal bleeding in the United States?

<p>Octreotide (D)</p> Signup and view all the answers

What is the reversal agent for the neuromuscular blockers rocuronium and vecuronium?

<p>Sugammadex (C)</p> Signup and view all the answers

What can cause a clinically significant decrease in oral fluoroquinolone bioavailability and an overall increase in fluoroquinolone-resistant bacteria?

<p>Calcium (A)</p> Signup and view all the answers

What is used as an antidote for sodium nitroprusside toxicity and cyanide toxicity?

<p>Sodium thiosulfate (B)</p> Signup and view all the answers

In which patients is intracranial pressure monitoring indicated?

<p>Glasgow Coma Scale scores less than or equal to 8 with an abnormal head CT scan (C)</p> Signup and view all the answers

Which agent antagonizes cardiac depression in beta-blocker toxicity?

<p>Glucagon (A)</p> Signup and view all the answers

What imaging is used to rule out motility disorders such as diffuse esophageal spasm or esophageal web/strictures?

<p>Manometry (B)</p> Signup and view all the answers

What is the most common age range for pancreatic cancer cases?

<p>60-80 years of age (B)</p> Signup and view all the answers

What is the initial management focus for patients with esophageal variceal bleeding?

<p>Correction of coagulopathy if present and avoidance of over-transfusion (C)</p> Signup and view all the answers

What is the primary treatment for melanoma?

<p>Surgical excision (A)</p> Signup and view all the answers

What is the most common type of thyroid cancer?

<p>Papillary thyroid carcinoma (B)</p> Signup and view all the answers

What is the mnemonic recommended by ATLS for the history component in the secondary survey?

<p>AMPLE (A)</p> Signup and view all the answers

Which cells are considered obligate glucose users?

<p>Neoplastic cells (D)</p> Signup and view all the answers

What is the primary fuel source for neoplastic cells?

<p>Glutamine (D)</p> Signup and view all the answers

What is the etiology of chylous ascites in a patient with end-stage pancreatic cancer?

<p>Obstruction of the lymphatic vessels at the base of the mesentery or the cisterna chyli (D)</p> Signup and view all the answers

What is the recommended treatment for non-disseminated cancer or long stricture associated with esophageal perforation?

<p>Esophagectomy (D)</p> Signup and view all the answers

What is the most common cause of Wernicke encephalopathy?

<p>Malnutrition (A)</p> Signup and view all the answers

What are the manifestations of thiamine deficiency?

<p>Ataxia, nystagmus, or other oculomotor dysfunctions (B)</p> Signup and view all the answers

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