ABSITE 2024-2025 Exam Preparation, Exams of Nursing

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Minimum FEV1 for pneumonectomy? For lobectomy? For wedge resection? - Pneumonectomy: FEV1 > 2 L Lobectomy: FEV1 > 1.5L Wedge resection: FEV1 > 0.8L Anatomic borders of a superior lumbar hernia of Grynfeltt? - Latissimus dorsi, serratus posterior inferior, and posterior border of the internal oblique Anatomic borders of a inferior lumbar hernia of Petit? - Latissimus dorsi (posteriorly), iliac crest (inferiorly), posterior border of the external oblique (anteriorly) What are the diagnostic criteria for brain death? - 1) Normothermia for > 6 hours

2. No brainstem reflexes
3. Positive apnea test (PCO2 > 60 or >20mmHg above baseline after 10 minutes off ventilator)
4. No paralytics, sedatives, or acid-base/electroyte disturbances What is the gold standard imaging test for brain death? What is an alternative test? - Gold standard: 4-vessel angiography Backup test: radionucleotide scintigraphy

What is the preop medication before resecting an aldosteronoma? - Spironolactone Treatment for an acute provoked VTE with modifiable risk factors? - Anticoagulation for at least 3 months, modify risk factors Treatment for an acute provoked PVE without modifiable risk factors? - Indefinite anticoagulation Treatment for an unprovoked VTE? - Indefinite anticoagulation Branching fibrovascular core with epithelial + myoepithelial layers and cellular atypia = what is the diagnosis? - Intraductal papilloma What is the threshold for empiric gallbladder polyp resection? - 10mm Besides size > 10mm, what are the 7 indications for CCX for gallbladder polyps? - - increase >2mm on serial U/S

• Native American ethnicity

Treatment is emergent re-transplantation. What is the best test to differentiate between esophageal motility disorders? - Manometry Side effect of mafenide (sulfamylon)? - Metabolic acidosis (carbonic anhydrase inhibitor) Side effect of silver nitrate? - Methemoglobinemia, hyponatremia (think of the negative nitrate ion chelating positive ions) Silver sulfadiazine (silvadene) - Transient neutropenia Bacitracin side effect? - Nephrotoxicity What is the empiric dose of epinephrine for anaphylaxis - 0.3 mg Name 4 genes associated with Lynch syndrome (HNPCC) - MLH1, MSH2, MSH6, PMS

What are the two cancers associated with HNPCC/Lynch syndrome? - Colon and endometrial cancer When should patients with a Lynch syndrome diagnosis undergo colonoscopy screening? - At age 20-25, or 2-5 years before the earliest known case of cancer, whichever is earliest How often should Lynch syndrome patients get screening colonoscopies? - Every 1-2 years Colonoscopy screening age and interval, normal risk patient? - Age 45, every 10 years if normal, every 3-5 years if benign polyps are found Colonoscopy screening age, prior history of abdominal RT? - 5 years after RT completion or age 30, whichever comes last; colonoscopy every 3-5 years Colonoscopy screening age/interval, IBD patient? - 8 years after IBD diagnosis, every 1-3 years

3. Enterobacter (5-10%) Describe the 5 classifications of Mirizzi syndrome - Class I - external compression of CHD without fistula Class II - fistula involving <1/3 of the CHD circumference Class III - fistula involving 1/3-2/3 of the CHD Class IV - complete destruction of the CHD Class V - CHD obstruction + cholecystoenteric fistula What are absolute contraindications to laparoscopic CCX? - 1) Inability to tolerate pneumoperitoneum
4. Uncontrolled coagulopathy Endoscopic mucosal resection is limited to what stage esophageal cancers? What pathologic depth does this correspond to? - EMR is only for Tis (epithelium) and T1a (has not penetrated into the submucosa) Structural injury associated w/ posterior shoulder dislocation? - Axillary artery injury

Structural injury associated with anterior shoulder dislocation? - Axillary nerve injury What is the RQ for lipid metabolization? - 0. What are the six risk factors that make up the Revised Cardiac Risk Index? - - major surgery

• IDDM
• ischemic heart disease
• CHF
• Cr > 2.
• prior CVA Tumor marker for hepatoblastoma? - AFP Most common extracranial solid tumor in children? - Neuroblastoma Colonoscopy frequency if no polyps found? - 10 years

What are first line treatments for desmoid tumors - NSAIDs (sulindac), tamoxifen, TK inhibitors (sorafenib, sunitinib) What cell cycle do carboplatin/cisplatin affect? - None - they are not cell cycle- specific BIRADS 1 =? - Normal BIRADS 2 =? - Benign finding BiRADS 3 =? - Probably benign BIRADS 4 =? - Suspicious BIRADS 5 =? - Very suspicious BIRADS 6 =? - Biopsy-confirmed cancer Malignancy risk, BIRADS 3? - <2%

Malignancy risk, BIRADS 4a? - 2-10% Malignancy risk, BIRADS 4b? - 10-50% Malignancy risk, BIRADS 4c? - 50-95% Malignancy risk, BIRADS 5? - 95%+ What chemoprevention is indicated for atypical ductal hyperplasia? - Tamoxifen for 5 years What is a treatment option for patients with side effects to tamoxifen? - Low-dose tamoxifen NCCN guidelines for age to start mammography? - 40 RR of breast cancer with atypical ductal hyperplasia? - 3-5X What is the upgrade rate to DCIS from ADH? - 20%

Highest TNM staging for colon cancer to remain Stage I? - T2N Highest TNM staging for colon cancer to remain Stage II? - T4N Highest TNM staging for colon cancer to remain Stage III? - T4N Name the syndrome: breast cancer, (osteo)sarcoma, brain tumors, adrenocortical carcinoma, Wilms tumor, phyllodes, pancreatic cancer, leukemia, neuroblastoma - Li-Fraumeni (TP53) Mutation of Li-Fraumeni - TP Syndrome: pancreatic islet cell tumors, parathyroid hyperplasia, pituitary adenomas - MEN Mutation of MEN1 - MENIN Syndrome: medullary thyroid cancer, pheochromocytoma, parathyroid hyperplasia - MEN

Mutation of MEN2 - RET Neurofibromas, neurofibrosarcoma, AML, brain tumors - NF Atypical lobular hyperplasia = what increase in lifetime breast cancer risk? - 4X E-cadherin+ stain = what diagnosis - Atypical ductal hyperplasia Adjuvant treatment for triple-negative breast cancer following surgery? - Olaparib (PARP inhibitor) Next step after identifying LCIS on CNBx? - Surgical excision to rule out associated DCIS (10-20% risk) non-calcified oval mass with focal asymmetry = diagnosis and management? - pseudoangiomatous stromal hyperplasia (PASH); benign, only excise if symptomatic well-circumscribed solid mass with calcifications = diagnosis? - fibroadenoma

4. Manometry (rule out motility disorders) Where does Siewert Type II adenocarcinoma come from? - Gastric cardia First-line treatment and intervention for bleeding esophageal varices? Second- line? Third-line? - 1st line: airway protection, resuscitation/transfusion, antibiotics, octreotide or somatostatin; balloon tamponade if in extremis 2nd line: endoscopic ligation or sclerotherapy 3rd line: TIPS or surgery Surveillance frequency for Barrett's esophagus w/o dysplasia? - EGD every 3- years with 4-quadrant biopsy If insufficient biopsies for Barrett's, when should repeat EGD be done? - 1 year Barrett's biopsy indeterminate for dysplasia - when to repeat EGD? - In 2-6 months Barrett's biopsy = high-grade dysplasia, next steps?Wg - Biopsy at 1cm intervals, endoscopic RFA

Most accurate imaging for locoregional esophageal cancer staging? - Ultrasound What is the anatomic cutoff for definitive RT for esophageal SCC? - Within 5cm of the cricopharyngeus Where is a Zenker's diverticulum located? - Inferior to thyropharyngeus, above cricopharyngeus Barrett's biopsy = low-grade dysplasia, next steps? - EGD in 6 months +/- endoscopic eradication What is a sentinel event - Safety mishap that causes patient death, harm, or risk of harm Threshold for corticosteroid therapy in ITP? - <30,000 platelets When should warfarin be stopped before low-risk, outpatient surgery? - 5 days before, no bridging When should dabigatran be stopped before colonoscopy? - 48 hours