Full Length Part 3

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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?

β-hCG Signup and view all the answers

When is β-hCG elevated in seminomas?

Never Signup and view all the answers

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

To optimize image brightness Signup and view all the answers

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

Radical parathyroidectomy 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?

Laparoscopic hernia repair 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?

Late-night salivary cortisol (2 measurements) Signup and view all the answers

Which type of ryanodine receptor is expressed in the myocardium?

Type 2 Signup and view all the answers

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

Quadruple bismuth therapy Signup and view all the answers

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

Duodenal stump leak Signup and view all the answers

What causes duodenal atresia?

Failure of recanalization of the proximal small bowel Signup and view all the answers

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

Duodenal atresia Signup and view all the answers

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

Severely dilated small bowel Signup and view all the answers

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

Control of acid secretion 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?

Refeeding syndrome Signup and view all the answers

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

VHL Signup and view all the answers

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

Type I hiatal hernia Signup and view all the answers

Which gene mutation is associated with retinoblastoma?

RB1 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?

Acquired cholesteatoma Signup and view all the answers

What is the best treatment for refeeding syndrome?

Correction of electrolytes and initiation of low rate feeding Signup and view all the answers

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

Supportive care for the symptoms and correction of electrolyte abnormalities Signup and view all the answers

Which gene mutation is associated with breast and ovarian cancer?

BRCA1 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?

Type I ASD Signup and view all the answers

What is the mechanism of action in refeeding syndrome?

Redistribution of phosphate intracellularly due to insulin surge with food administration Signup and view all the answers

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

Extended right hemicolectomy 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?

Ileocolic artery 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?

Extended left colectomy Signup and view all the answers

What is the definitive treatment for mediastinitis?

Debridement and coverage with pectoralis muscle flaps Signup and view all the answers

What are the risk factors for developing mediastinitis?

Use of bilateral internal mammary arteries Signup and view all the answers

What are the most common locations for an accessory spleen?

Splenocolic ligament, greater omentum, tail of pancreas, splenic pedicle, splenic hilum Signup and view all the answers

What is Pancoast syndrome associated with?

Horner syndrome and shoulder and arm pain Signup and view all the answers

What is the most common acute transfusion reaction?

Febrile non-hemolytic transfusion reaction Signup and view all the answers

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

Indomethacin Signup and view all the answers

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

Place a loose, draining seton to prevent recurrence of an abscess 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?

Fistulotomy Signup and view all the answers

Which medications have been shown to improve fistulizing Crohn disease?

Azathioprine and 6-mercaptopurine Signup and view all the answers

What is the antidote for acetaminophen toxicity?

N-acetylcysteine Signup and view all the answers

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

Age of patient, preoperative sepsis, perioperative AKI Signup and view all the answers

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

Octreotide Signup and view all the answers

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

Sugammadex 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?

Calcium Signup and view all the answers

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

Sodium thiosulfate Signup and view all the answers

In which patients is intracranial pressure monitoring indicated?

Glasgow Coma Scale scores less than or equal to 8 with an abnormal head CT scan Signup and view all the answers

Which agent antagonizes cardiac depression in beta-blocker toxicity?

Glucagon Signup and view all the answers

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

Manometry Signup and view all the answers

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

60-80 years of age Signup and view all the answers

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

Correction of coagulopathy if present and avoidance of over-transfusion Signup and view all the answers

What is the primary treatment for melanoma?

Surgical excision Signup and view all the answers

What is the most common type of thyroid cancer?

Papillary thyroid carcinoma Signup and view all the answers

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

AMPLE Signup and view all the answers

Which cells are considered obligate glucose users?

Neoplastic cells Signup and view all the answers

What is the primary fuel source for neoplastic cells?

Glutamine Signup and view all the answers

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

Obstruction of the lymphatic vessels at the base of the mesentery or the cisterna chyli Signup and view all the answers

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

Esophagectomy Signup and view all the answers

What is the most common cause of Wernicke encephalopathy?

Malnutrition Signup and view all the answers

What are the manifestations of thiamine deficiency?

Ataxia, nystagmus, or other oculomotor dysfunctions Signup and view all the answers