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Worksheetsgeneral surgery part exam 2022-2
Total questions: 30
Worksheet time: 58mins
Which of the following statements about primary sclerosis cholangitis is correct?
Is frequently associated with high fever and chills
Course is usually rapidly progressive to liver failure
Can usually be managed successfully by anti-inflammatories and corticosteroids
Is commonly associated with inflammatory bowel disease
Which of the following regarding splenic trauma is true?
Most children with blunt splenic trauma require splenectomy
Patients may return to full-contact activity in 3 weeks
Active blushes and pseudoaneuryms are usually managed non-surgically
Splenic salvage is associated with increased transfusion.
Which of the following proto-oncogenes is associated with a G protein defect?
Myc
Ras
Src
Erb B
Which of the following antibodies is the most abundant in the body?
IgM
IgG
IgA
IgD
Regarding microsomal drug metabolism, which of the following is true?
Phase II reactions describe demethylation, oxidation, reduction, and hyrolysis reactions
Cimetidine is a P-450 inducer
Warfarin is a P-450 inhibitor
The P-450 system transforms aromatic hydrocarbons into carcinogens
A schistosomiasis abscess is best treated by:
Percutaneous drainage and antibiotics
Flagyl
Levofloxacin
Praziquantel
An amoebic abscess is best treated by:
Percutaneous drainage and antibiotics
Flagyl
Levofloxacin
Praziquantel
A pyogenic abscess is best treated by:
Percutaneous drainage and antibiotics
Flagyl
Levofloxacin
Praziquantel
All of the following are true about bladder cancer except;
The most common type is transitional cell carcinoma
Schistosomiasis infection is a/w squamous cell cancer of the bladder
Transitional cell cancer limited to the submucosa can be treated with intra-vesicle BCG or trans-urethral resection
Transitional cell cancer with muscle invasion (T2) can be treated with wedge resection
The most common type of ovarian tumor is:
Epithelial
Germ cell
Sex-cord
Lymphoma
The following structures are found in the anterior compartment of the leg:
Posterior tibial artery, peroneal artery, tibial nerve
Anterior tibial artery and superficial peroneal nerve
Sural nerve, gastrocnemius, soleus, and plantaris muscles
Anterior tibial artery, deep peroneal nerve
You are asked to see a 1-day old infant with Down’s syndrome due to feeding intolerance. In addition to the diagnosis of Down’s the records indicate that polyhydramnois was noted during the pregnancy. The mother describes the baby’s emesis as green. Which of the following condition does this child most likely have?
Tracheoesophageal fistula
Intussesception
Duodenal atresia
Pyloric stenosis
A mother brings her 1-month old to you because of a sudden onset of bilious emesis. You examine the patient then order an upper GI which reveals that the duodenum does not cross the midline. Given the most likely diagnosis, what will ultimately be required to correct this problem?
Pyloromyotomy
Air-contrast enema
Duodenojejunostomy
Resect Ladd’s band, counterclockwise rotation of bowel, place cecum in LLQ (cecopexy), and perform an appendectomy
A 48 yo male that drinks a case of beer daily had nausea and vomiting at home about 5 hours before he presents to the ER due to chest pain. Vitals- BP 100/50, HR 110; you subsequently bolus crystalloid. A chest xray shows a left effusion and pneumothorax. What is the most sensitive test to diagnose this pt’s condition?
Abdominal CT
Chest CT
Angiogram
Gastrograffin swallow followed by thin barium swallow
The most common location for Boerhaave’s to occur is:
The left posterior lower esophagus
The left posterior middle esophagus
The upper stomach
The left posterior upper esophagus
أجمل وحده مين ؟
^_^
وحدة
^_^
^_^
You open the pt and find gastric contents coming out through a hole in his esophagus. You wash it out and then FIRST:
Place a chest tube and close
Perform a myotomy
Full thickness bites where you see fluid coming out
Esophagectomy
All of the following are true about nitrous oxide (NO) except:
Increases cAMP
Precursor is arginine
Released primarily from vascular endothelium
Receptor is guanyl cyclase
All of the following are true of the hepatic acute phase response except:
IL-6 is the most potent stimulus
Albumin is decreased
C-reactive protein is increased
Transferrin in increased
Which correctly describes the zones of the retroperitoneum?
Zone 1 includes the pelvis and is associated with pelvic fractures
Zone 2 includes the central retroperitoneum
If you find a hematoma in zone 2 when exploring the patient for blunt trauma, you do not have to explore it if it remains stable throughout the operation
Zone 3 injuries, whether they are blunt or penetrating, always need to be explored
Which of the following is true regarding the efficacy of prophylactic antibiotics following a GSW through the colon?
Giving a single dose of abx 2 hrs preoperatively increases SSI in these patients
Infection rates are significantly lower when antibiotics are given for a complete 5 day course
There is no statistical difference when antibiotics are given within 2 hours of initial skin incision and when given within the first 3 hours when the skin incision is made
There is no evidence supporting continuing abx beyond 24 hours even when the bowel is perforated
Which of the following is the most important prognostic factor in patients with malignant melanoma?
Surface size
Tumor grade
Depth
SLN biopsy status
Which of the following is NOT a component of informed consent?
Disclosure
Comprehension
Competency
Voluntariness
Description of basic procedural standards of care
Which of the following is true about the secretory diarrhea seen in gastrinoma patients?
It partially is due to enterocyte damage from the excessive acid
It can be improved by NG suctioning
It may be the only complaint in around 20% of patients presenting with gastrinoma
A and C only
All of the above are true
Which of the following forms does fat take to enter the lymphatic system and eventually reach the liver?
Free fatty acids
Chylomicrons
Triglycerides
Monoglycerides
A 63 yo female with a longstanding history of Type 2 diabetes and noncompliance with medication presents with some bony deformity of her right foot and a clean ~4 cm plantar ulcer. The pulses are good and there is no evidence of cellulitis. Which of the following is the most appropriate initial treatment for this patient?
Ulcer debridement and skin graftingBony reconstruction and ulcer debridement
Bony reconstruction and ulcer debridement
Modified fitted boots
Below knee amputation with early prosthetic fitting
A 38 yo female underwent a laparoscopic Nissen fundoplication and hiatal hernia repair 2 days ago that was technically difficult. She now is mildly tachycardic and complains of shortness of breath. Chest x-ray shows an effusion on the left and a small amount of free air under the diaphragm. Her SBP is 140/90 mmHg and UOP is good. Which study is best to determine the site of leak?
MRI of chest and abdomen
Water-soluble contrast study
EGD
EUS
Which of the following patients with an AAA should be offered elective repair?
A 45 yo male with a 4 cm aneurysm that was 3.8 cm 6 months ago
A 59 yo female with a 5.1 cm asymptomatic aneurysm
A 61 yo male with a 4.8 cm aneurysm that was 4.0 cm 6 months ago
All of the above should be offered elective repair
Of the following, which is the most critical component of neovascularization in tumor metastases?
HER receptor
VEGF receptor
Neu receptor
FGF receptor
Which of the following lab values is most consisted with primary hyperparathyroidism?
Cl 105, phos, 3, elevated renal cAMP
Cl 105, phos 4, elevated renal cAMP
Cl 107, phos 3, and decreased renal cAMP
Cl 106, phos 4, decreased renal cAMP
