58 Questions
What is the rationale for positioning the patient as far away from the radiation source as possible during an angiogram?
To minimize the patient's exposure to radiation
Which procedure is preferred for recurrent or pervasive pilonidal disease?
Cleft lift procedure
Why is creating off-midline incisions for pilonidal cysts considered beneficial?
It decreases the risk of recurrence
Which serum tumor marker is elevated in the majority of nonseminomatous germ cell tumors?
β-hCG
When is β-hCG elevated in seminomas?
Never
Why should the image intensifier be positioned as close to the patient as possible during an angiogram?
To optimize image brightness
Which procedure involves en bloc resection of the parathyroid gland and ipsilateral thyroid lobe?
Radical parathyroidectomy
What is the best initial surgical management for a rare type of hernia that is present inferior to the inguinal ligament?
Laparoscopic hernia repair
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)
Which type of ryanodine receptor is expressed in the myocardium?
Type 2
What is the treatment for Helicobacter pylori if a penicillin allergy is present?
Quadruple bismuth therapy
What is the most feared complication after total or partial gastrectomy, especially with Billroth II reconstruction?
Duodenal stump leak
What causes duodenal atresia?
Failure of recanalization of the proximal small bowel
"The finding of a 'double-bubble' sign on abdominal radiography is usually pathognomonic for" which condition?
Duodenal atresia
Which of the following factors should prompt consideration of conversion to an open approach during laparoscopic intervention?
Severely dilated small bowel
What is the most effective initial treatment for patients with type I hiatal hernias who are asymptomatic?
Control of acid secretion
What condition is characterized by a deficiency in phosphate and worsened by insulin surge with the administration of food/nutrition?
Refeeding syndrome
What gene mutation is associated with Von Hippel-Lindau syndrome?
VHL
What type of hiatal hernia presents with dysphagia, early satiety, and postprandial pain?
Type I hiatal hernia
Which gene mutation is associated with retinoblastoma?
RB1
What type of cholesteatoma arises from either retraction pockets within the tympanic membrane or secondarily from a tympanic membrane perforation?
Acquired cholesteatoma
What is the best treatment for refeeding syndrome?
Correction of electrolytes and initiation of low rate feeding
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
Which gene mutation is associated with breast and ovarian cancer?
BRCA1
What type of atrial septal defect causes a left-to-right shunt with potential development of congestive heart failure?
Type I ASD
What is the mechanism of action in refeeding syndrome?
Redistribution of phosphate intracellularly due to insulin surge with food administration
What is the most appropriate surgical resection for a tumor in the proximal transverse colon?
Extended right hemicolectomy
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
Which treatment involves division of both branches of the middle colic artery and the origin of the inferior mesenteric artery?
Extended left colectomy
What is the definitive treatment for mediastinitis?
Debridement and coverage with pectoralis muscle flaps
What are the risk factors for developing mediastinitis?
Use of bilateral internal mammary arteries
What are the most common locations for an accessory spleen?
Splenocolic ligament, greater omentum, tail of pancreas, splenic pedicle, splenic hilum
What is Pancoast syndrome associated with?
Horner syndrome and shoulder and arm pain
What is the most common acute transfusion reaction?
Febrile non-hemolytic transfusion reaction
What is the drug of choice for closure of persistent ductus arteriosus?
Indomethacin
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
What should be avoided in all but the most simple and superficial fistulas in patients with no evidence of proctitis?
Fistulotomy
Which medications have been shown to improve fistulizing Crohn disease?
Azathioprine and 6-mercaptopurine
What is the antidote for acetaminophen toxicity?
N-acetylcysteine
Which factors may lead to increased 30-day mortality following emergency laparotomy?
Age of patient, preoperative sepsis, perioperative AKI
What is the preferred agent for managing esophageal variceal bleeding in the United States?
Octreotide
What is the reversal agent for the neuromuscular blockers rocuronium and vecuronium?
Sugammadex
What can cause a clinically significant decrease in oral fluoroquinolone bioavailability and an overall increase in fluoroquinolone-resistant bacteria?
Calcium
What is used as an antidote for sodium nitroprusside toxicity and cyanide toxicity?
Sodium thiosulfate
In which patients is intracranial pressure monitoring indicated?
Glasgow Coma Scale scores less than or equal to 8 with an abnormal head CT scan
Which agent antagonizes cardiac depression in beta-blocker toxicity?
Glucagon
What imaging is used to rule out motility disorders such as diffuse esophageal spasm or esophageal web/strictures?
Manometry
What is the most common age range for pancreatic cancer cases?
60-80 years of age
What is the initial management focus for patients with esophageal variceal bleeding?
Correction of coagulopathy if present and avoidance of over-transfusion
What is the primary treatment for melanoma?
Surgical excision
What is the most common type of thyroid cancer?
Papillary thyroid carcinoma
What is the mnemonic recommended by ATLS for the history component in the secondary survey?
AMPLE
Which cells are considered obligate glucose users?
Neoplastic cells
What is the primary fuel source for neoplastic cells?
Glutamine
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
What is the recommended treatment for non-disseminated cancer or long stricture associated with esophageal perforation?
Esophagectomy
What is the most common cause of Wernicke encephalopathy?
Malnutrition
What are the manifestations of thiamine deficiency?
Ataxia, nystagmus, or other oculomotor dysfunctions
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