Docsity
Docsity

Prepare for your exams
Prepare for your exams

Study with the several resources on Docsity


Earn points to download
Earn points to download

Earn points by helping other students or get them with a premium plan


Guidelines and tips
Guidelines and tips

ABSITE 2024/2025 Questions and Answers (Actual Exam), Exams of Nursing

ABSITE 2024/2025 Questions and Answers (Actual Exam)

Typology: Exams

2024/2025

Available from 01/16/2025

may-blessed
may-blessed 🇺🇸

5

(1)

1.5K documents

Partial preview of the text

Download ABSITE 2024/2025 Questions and Answers (Actual Exam) and more Exams Nursing in PDF only on Docsity!

ABSITE 2024/2025 Questions and Answers (Actual

Exam)

MC model for the dissemination and implementation of evidence-based best practices Right Ans - RE-AIM Adjustment for trough being too high Right Ans - DECREASE frequency of administered antibiotic (increase time between dosing) Immunohistochemical stain that differentiates Epithelioid hemangioendothelioma from other nonvascular tumors? Right Ans - Factor VII Best predictor of long-term success in patients with TBI Right Ans - Post- resuscitation GCS (not initial) Cardiac allograft rejection Right Ans - Usually asymptomatic, steroid treatment in first 3 months of rejection T-cell mediated Pathophysiology behind refeeding syndrome Right Ans - Sudden influx of phosphate into cells triggered by the resumption of adenosine triphosphate production, which results in hypophosphatemia. Pneumobilia vs. portal venous gas Right Ans - Pneumobilia: Central Portal venous gas: Peripheral Immunosuppressive agent with the highest rate of post-transplant new onset diabetes Right Ans - Tacrolimus MC organism in SBP Right Ans - E.coli (usually monomicrobial) If polymicrobial, concern for perforated viscus MCC of benign biliary stricture Right Ans - Previous cholecystectomy

Primary lymphoid organs Right Ans - "The Best Lymphoid" Thymus, Bone, Liver Treatment for SCC of proximal esophagus Right Ans - Definitive chemoradiation Adrenal-lytic used for recurrent, residual, or metastatic disease Right Ans - Mitotane Hypomagnesemia can led to which electrolyte deficiencies Right Ans - Hypokalemia and hypocalcemia Treatment of ventral hernia in dialysis patients about to get PD catheter placed Right Ans - Repair hernia with extraperitoneal mesh and place PD catheter at same time MC malignant tumor of the small bowel Right Ans - Mets from another primary (MELANOMA) MC primary malignant tumor of the small bowel Right Ans - Adenocarcinoma (rare) Medical management for patients with desmoid tumors with high risk or have high morbidity if managed surgically, such as those involving the mesentery, major vessels, or other critical structures Right Ans - NSAIDs and Tamoxifen Initiating event in the formation of ascites Right Ans - Sinusoidal portal hypertension Antibiotic re-dosing for colon procedures Right Ans - Re-dose if > 2 hours or if significant blood loss Surgical management of duodenal tumors less than 1 cm in diameter Right Ans - Endoscopic polypectomy VTE prophylaxis in patients undergoing major abdominal/pelvic operations for cancer Right Ans - Subcutaneous LMWH for 28 days

Work-up for children with cervical lymphadenopathy Right Ans - < 2cm: 2 week follow up if non-tender, mobile

/= 2cm: CBC, ESR, CRP, CXR

  • If concerning features -> biopsy
  • If not, 10-14 days abx with follow up Primary cancer most likely to mets to the adrenal glands Right Ans - Lung Reversal of Clopidogrel Right Ans - Transfused pooled platelets, Desmopressin Which immunotherapy agent targets PD-L1 and what caner is it used for? Right Ans - Pembrolizumab, NSCLC Which immunotherapy agent targets RET and what caner is it used for? Right Ans - Selpercatinib, medullary thyroid cancer in MEN 2A/2B Which immunotherapy agent targets CTLA-4 and what caner is it used for? Right Ans - Ipilimumab, Melanoma Symptoms of gastrogastric fistula after RYGB Right Ans - Recurrent reflux and weight gain Diagnose with UGIS or CT w/ PO contrast What is Howship-Romberg sign, and what does it indicate? Right Ans - Pain with extension, adduction and internal rotation on leg, indicates obturator hernia Patient-applied treatments for perianal condyloma acuminata Right Ans - Imiquimod, podophyllotoxin (but not podophyllin resin, which is second line), and sinecatechins Indications of deep inguinal lymph node dissection Right Ans - 1) More than four lymph nodes positive on superficial dissection
  1. Positive cloquet node
  2. Enlarged ileo-obturator lymph nodes on CT scan
  3. Clinically palpable or extracapsular invasion of femoral lymph nodes.

MC location of origin of pseudomyxoma peritonei Right Ans - Appendix (mucin-secreting cells) In what patient population would you not use NO as an induction agent Right Ans - SBO, PTX NO diffuses into air-filled spaces Reversal agent for Rocuronium and vecuronium Right Ans - Sugammadex Highest risk factors for cardiovascular events after procedure Right Ans - #1: Decompensated HF #2: Recent MI Operative treatment for patients with inflammatory breast cancer Right Ans - Total mastectomy (MRM) with axillary lymph node dissection NASCET Trial Right Ans - 70-99% ICA stenosis: 2-year risk of ipsilateral stroke 26% with medical management, 9% with CEA 50-69% ICA stenosis: 2-year risk of ipsilateral stroke 22.2% with medical management, 15.7% with CEA Repair of complete diaphragmatic avulsion Right Ans - Reattach in a primary fashion using permanent sutures placed circumferentially around the ribs Imaging for parathyroid reoperations Right Ans - Selective venous sampling, MRI, PET scan Cephalad and caudal limits of deep ilioinguinal lymphadenopathy Right Ans - Cephalad: bifurcation of the CIA Caudal: Inguinal ligament Best regional block for AVF creation Right Ans - Supraclavicular block (all trunks and divisions of brachial plexus can be anesthetized)

Types of jejunal atresia Right Ans - Type I: intact bowel wall and mesentery with a mucosal atresia. Type II: Blind ends separated by a fibrous cord, but intact mesentery. Type IIIa: V-shaped mesenteric gap. Type IIIb: Larger mesenteric defect with an apple-peel deformity. Type IV: Multiple atresias. First-line therapy for metastatic colon cancer Right Ans - Bevacizumab, 5- FU, Oxaliplatin "FOB" Relative contraindications to laparoscopic transcystic common bile duct exploration Right Ans - Gallstones in the common hepatic duct above the junction of the cystic and common bile ducts, a small (< 3 mm) or friable cystic duct, gallstones greater than 6 to 8 mm, more than eight stones in the common bile duct What percentage of patients have anatomic variations in biliary anatomy? Right Ans - 30-40% Heart rate change after insufflation Right Ans - Bradycardia 2/2 increased pneumoperitoneum causing stretch of vasovagal receptors Malignant potential of gastric fundic polyps Right Ans - None First test for pehochromocytomas Right Ans - Plasm free metanephrines (Sensitivity 99%) Rate control medication of choice in patients with COPD/bronchospasm Right Ans - CCB not beta blockers Example of an anti-angiogenic factor that is induced by hypoxia Right Ans - Interferons

Late development of dysphagia after anti-reflux surgery suggests what? Right Ans - Esophageal obstruction and anatomic failure- MC is hiatal hernia recurrence or slipped wrap Which phase of the cell cycle is most variable in length of time? Right Ans - G Types of odontoid fractures Right Ans - Type I: obliquely oriented and occur through the upper portion of the dens. Type II: extend into the base of the dens. These fractures are unstable and are also associated with a relatively high rate of nonunion, especially in those over age 50. Type III: extend into the C2 vertebral body. Overall, these tend to have a better healing rate than Type II and rarely need surgical intervention MOA of streptokinase and urokinase Right Ans - Streptokinase: binds to plasminogen and exposes an active site on the streptokinase molecule that converts plasminogen into plasmin. Urokinase: is a serine protease that directly converts plasminogen into plasmin. Prophylactic antibiotics for colon surgeries Right Ans - Cefoxitin, cefotetan, or cefazolin plus metronidazole Need aerobic and anaerobic coverage Which local anesthetic type has increased risk of allergic reactions? Right Ans - Esters due to PABA analogue Components of cryoprecipitate Right Ans - -Factor VIII -Fibrinogen -Factor XIII -Fibronectin -Von-Willebrand Factor -80 uL of Factor VII/unit

150 mg/dL fibrinogen

When are beta lactam antibiotics most effective? Right Ans - When drug levels exceed the minimum inhibitory concentration (MIC) greater than 50% of the time between doses After surgical debulking and before initiation of intraperitoneal chemotherapy, the surgeon should determine that there are no tumor deposits larger than what size? Right Ans - > 2mm (chemotherapy may not be able to penetrate) Less than what percentage of relative function would favor nephrectomy rather than preservation of the right kidney? Right Ans - Less than 15-20% Most effective tool for rewarming of patients with severe hypothermia Right Ans - Extracorporeal membrane oxygenation (ECMO) Which condition is associated with bilateral absence of the vas deferens? Right Ans - Cystic fibrosis Definitive surgical treatment in patients with persistent enterocutaneous fistula Right Ans - Single stage procedure- Excision of the fistula tract and segmental bowel resection with reanastomosis What level of infrainguinal arterial occlusive disease is someone most at risk for developing based on this history of smoking or DM/renal failure Right Ans - Smoking: SFA disease DM/Renal failure: Infrapopliteal disease Compartments of the thigh, and which compartment rarely develops compartment syndrome? Right Ans - Anterior, posterior, medial Medial compartment rarely develops compartment syndrome MC pathologic lead point in children with ileocolic intussusception Right Ans - Inverted Meckel's diverticulum (followed by intestinal polyps and lymphoma) Nelson syndrome Right Ans - Pituitary enlargement from chronic CRH stimulation of pituitary adenoma that compresses optic nerve

Aldosterone to renin ratio a/w Conn syndrome Right Ans - > 20 Carney Complex Right Ans - PR-KAR tumor suppressor gene Myxomas of heart & skin Skin hyperpigmentation (lentiginosis) Cushing's syndrome Type of Billroth II that has increased risk of blind loop syndrome Right Ans

  • Antecolic loop Felon vs. paronychia and treatments Right Ans - -Paronychia: Infection around the paronychia fold proximal to nail bed. -Treatment: Incision and drainage of a paronychia requires lifting up the nail bed to evacuate the purulence. Felon: Infection of the fingertip pulp. -Treatment: Incision and drainage of the fingertip pulp. MCC of soiling after a pull-through procedure for Hirschsprung's disease Right Ans - Chronic constipation with overflow of stool What is a jersey finger? Tx? Right Ans - Unable to flex distal interphalangeal (DIP) joint Tendon rupture, needs repair What type of medications causes and increase hepatic metabolism of thyroid hormone? Right Ans - Antiepileptics, including phenobarbital, carbamazepine, and phenytoin What causes inhalation injuries? Right Ans - Inhaled toxins (heat is dissipated in the upper airways) Operative treatment of a ureteral injury in an unstable patient Right Ans - Ligation of ureter, nephrostomy tube placement, and delayed reconstruction in 3 months SSI rates Right Ans - Clean wounds: 1-5% Clean-contaminated wounds: 3-11%

Contaminated wounds: 10-17% Dirty wounds: >27% MCC of postoperative parotiditis Right Ans - Staph aureus Where do pancreatic ductal adenocarcinomas infiltrate Right Ans - Vascular, lymphatic, and perineural spaces What does Mycophenolate mofetil inhibit Right Ans - Purine synthesis Treatment for bronchial carcinoid Right Ans - Resection and mediastinal LN sampling MCC of end-stage renal disease leading to renal transplant Right Ans - Diabetes mellitus Steps to perform subxiphoid approach of establishing a pericardial window Right Ans - - A vertical incision of about 5-8 cm is made over the xiphoid toward the abdomen, and the linea alba is incised, exposing the xiphoid

  • Xiphoid is completely removed, then the retrosternal space is entered using finger dissection
  • With upward retraction, the diaphragmatic aspect of the pericardium is visualized, which is grasped with an Allis clamp and sharply incised
  • The fluid is aspirated, then a drainage tube is inserted through a separate stab incision, and the surgical incision is closed in layers Side effect of Bacitracin Right Ans - Nephrotoxicity MC risk factor of post-op a fibb Right Ans - Fluid overload MC location of ewing sarcoma Right Ans - PELVIS, then femur Treated like most unresectable sarcomas: bony implants are irradiated. MC pulmonary fungal invasive infection of immunocompromised patients. Right Ans - Invasive aspergillosis- Tx = Voriconazole

In patients presenting with thyroid cancer and hoarseness or dyspnea, what is the best next step? Right Ans - Indirect laryngoscopy to evaluate for vocal cord paralysis Impediments to spontaneous closure of fistulas Right Ans - FRIEND mnemonic (foreign body, radiation, inflammation/infection, epithelialization, neoplasia, distal obstruction). In addition, fistulas that are high-output (> 500 mL/day), short (< 2 cm), or multiple in number are less likely to close spontaneously MCC of antibiotic resistance Right Ans - Transfer of plasmids What early-morning random cortisol level indicates impaired HPA axis Right Ans - < 5mcg/dL Which induction agent should not be used in a patient with HPA axis suprression Right Ans - Etomidate -> can further suppress adrenal function Anticoagulation duration in patients with a DVT Right Ans - Inciting stimulus: 12 weeks No inciting stimulus: 6 months Removal of epidural catheter in patients on chemical PPX Right Ans - Removed 4 hours before and more than 12 hours after last dose of chemical VTE PPX with LMWH Presentation with neuroblastoma called MS (previously called 4S) Right Ans - Subcutaneous metastases, positive bone marrow, and massive hepatomegaly due to hepatic metastasis Treatment for fulminant c. dif and an ileus Right Ans - IV Flagyl, PO Vanc, rectal vanc enemas Operative approach for H-type TEF Right Ans - Right cervicotomy -> located at the thoracic inlet Which U/S growth pattern is concerning for cancer in thyroid U/S Right Ans - TALLER than wide

What is a concern with decreased urine output after a hysterectomy? Right Ans - Bilateral ureteral obstruction from injury during procedure MC site of mets from phyllodes tumor, what is the treatment Right Ans - Lung, rare hematogenous mets NO SLNB or ALND Tx= WLE with 1cm margins Inflammatory breast cancer punch biopsy results Right Ans - Dermal lymphatic invasion Stewart-Treves Syndrome Right Ans - Lymphangiosarcoma after lymphedema from ALND Dark purple lesion on arm Tx: sarcoma work-up & resection Best treatment for slow transit constipation Right Ans - Total abdominal colectomy with ileorectal anastomosis Where do you find ulcerations with a Meckel's diverticulum Right Ans - MESENTERIC border, antimesenteric border is where the Meckel's is located MC location of duodenal diverticulum and operative treatment Right Ans - 2nd portion of the duodenum (62%), and most are located near the ampulla (88%). The most common procedure performed for uncomplicated duodenal diverticula is an open diverticulectomy by performing a wide Kocher maneuver and then closing the duodenal defect primarily. Half-life of albumin, prealbumin, and transferrin Right Ans - Albumin: 20 days Prealbumin: 2-3 days (use as marker in acute setting) Transferrin: 8-10 days Why do we use hypotonic saline in children under 2 years old? Right Ans - Decreased ability to concentrate urine

Appropriate placement of tracheostomy Right Ans - Between second and third tracheal ring Kasabach-Merritt Syndrome Right Ans - Hepatic hemangioma, consumptive coagulopathy, congestive heart failure Most significant factors influencing the oxygen content of blood Right Ans - Hgb What are common mnl Right Ans - Ulceration, telangiectasias, fistulas Solitary rectal ulcer syndrome pathology findings Right Ans - Fibromuscular obliteration of the lamina propria Indications for XRT after mastectomy Right Ans - > 4 nodes Skin or chest wall involvement Positive margins Tumor > 5 cm (T3) Extracapsular nodal invasion Inflammatory CA Fixed axillary nodes (N2) or internal mammary nodes (N3) In breast cancer patient with positive nodes, who gets adjuvant chemo? Right Ans - Everyone EXCEPT postmenopausal women with positive estrogen receptors → they can get hormonal therapy only with aromatase inhibitor (anastrozole Pathologic finding of lobular breast cancer Right Ans - Lack of e-cadherin Ki-67 in breast cancer Right Ans - < 10% = good

25% = bad Presentation of SMA aneurysm rupture Right Ans - Presentation can be acute or chronic with mesenteric ischemic symptoms and eventually with aneurysmal rupture. Causes: Bacteremia, IVDU, infective endocaditis

MC type of dysrhythmia on an initial ECG in a patient with blunt cardiac injury Right Ans - PVCs Early intragastric feeding in burn patients vs. in patients with severe head injury/torso trauma Right Ans - Burn patients: Decreases gastroparesis Head injury/torso trauma: Increase gastroparesis Pathology reports for various parathyroid lesions Right Ans - Parathyroid adenoma: A single focus of chief cells, surrounded by a compressed rim of normal tissue Parathyroid hyperplasia: A diffuse proliferation of clear cells with little remaining normal tissue Parathyroid malignancy: Marked mitotic activity, dense fibrous stroma, and evidence of local invasion into the capsule or surrounding vessels Strongest risk factor for AIN Right Ans - HPV MC primary malignant peritoneal neoplasm Right Ans - Mesothelioma Corrected Calcium Right Ans - 0.8 (4-pts albumin) + pts Ca Corrected Na Right Ans - Na + 0.16 (glucose-100) Serum Osmolality Right Ans - 2 × [Na] + BUN/2.8 + glucose/ Most common benign neoplasm of the spleen Right Ans - Hemangioma Most common locations for an accessory spleen Right Ans - Splenic hilum, the tail of pancreas, greater omentum, along the splenic artery, gastrosplenic ligament, splenocolic ligament, the retroperitoneal, greater curve of the stomach, gastrocolic ligament, and mesentery of mid small bowel The most common location for undescended testes Right Ans - At the superficial inguinal ring Most common type of sarcoma in the GI tract Right Ans - Gastrointestinal Stromal Tumor

Stomach #1 followed by small bowel The primary treatment for uncomplicated lung abscesses < 4 cm Right Ans

  • IV ABX and pulmonary toilet Administration of what is associated with higher rates of primary fascial closure? Right Ans - Hypertonic saline Mos common anomaly associated with gastroschisis Right Ans - Intestinal atresia Treatment for isolated local disease after Nigro protocol for anal squamous cell cancer Right Ans - Salvage abdominoperineal resection Colon cancer with signet-ring components. What is the most likely molecular marker associated with this tumor? Right Ans - Microsatellite instability seen in patients with sporadic colon cancer Combined or staged approach for combined rectal and uterine prolapse Right Ans - Combined sacrocolpopexy with rectopexy The lowest recurrence and complication rates for pelvic organ prolapse are achieved with a combined, rather than staged, approach Bile gastritis pathology Right Ans - Foveolar hyperplasia, glandular cystic degeneration, and edema of lamina propria without evidence of inflammatory cell infiltration MC with Billroth II Which monopolar mode is the safest for use in this patient with an implanted cardiac electronic device? Right Ans - Cut mode is the lowest voltage monopolar mode. Thus, it transfers the least amount of energy to a nearby cardiac device. Coagulation mode is the highest voltage mode and transfers the greatest amount of energy to a nearby cardiac device.

Surgical treatment for NEC Right Ans - Resection of necrotic bowel and ostomy creation Treatment for pancreatic divisum Right Ans - ERCP with sphincterotomy Risk factors for cholangiocarcinoma Right Ans - Primary sclerosing cholangitis, choledochal cysts, ulcerative colitis, and biliary tract infection. Dermatofibrosarcoma pathology and staining Right Ans - Spindle-like and CD-34 immunhistochemical stain-positive What reduces the risk of short bowel syndrome during small bowel resection Right Ans - Competent ICV Which hormone is inhibited by acidification of the duodenum? Right Ans - Gastrin Classes of hypothermia, by temperature Right Ans - mild hypothermia: 34- 36C moderate hypothermia: 32-34C, arrhythmias, hypotension severe hypothermia: < 32C (mortality > 50%) Initial treatment of choice for gastric outlet obstruction Right Ans - EGD with pyloric dilation, H. pylori testing and eradication What additional treatment can be added to portal vein embolization to prevent tumor growth before hepatectomy? Right Ans - Transarterial chemoembolization (TACE) Patients who undergo mastectomy and are considered high risk for post- mastectomy radiotherapy best breast reconstructive therapy Right Ans - Delayed autologous tissue reconstruction MC genotype for HCV Right Ans - Genotype 1 Most likely long-term complication of esophageal atresia repair Right Ans - Dysphagia Diagnosis of toxic megacolon Right Ans - Colonic dilation > 6 cm

Signs of systemic toxicity: Fever, tachycardia, leukocytosis, anemia, and end- organ failure. Absolute contraindications to radioactive iodine Right Ans - Breastfeeding and any trimester pregnancy Abnormal gastric emptying study results for gastroparesis Right Ans - > 60% tracer remains at 2 hours

10% remains at 4 hours Propofol infusion syndrome Right Ans - Hyper metabolic syndrome 2/ impaired mitochondrial/fatty acid metabolism --> metabolic acidosis rhabdomyolysis, CHF, bradycardia lactic acidosis, hyperkalemia, renal failure Usually, in children with high doses given Sump syndrome Right Ans - Side-to-side choledochoduodenostomy can result in recurrent episodes of cholangitis as a result of the accumulation of stones, sludge, and debris in the distal common bile duct. This results in biliary stasis and obstruction, which puts the man at increased risk for cholangitis. First-line antihypertensive intraoperatively for pheochromocytoma Right Ans - Nitroprusside Hidradenitis suppurativa stages and treatments Right Ans - Hurley stage 1: This stage involves a localized abscess that may be described as a painful lump or inflammatory nodule. This stage is not characterized by any sinus tracts or scarring -> Topical Clinda gel Hurley stage 2: This stage involves recurrent abscesses. It also includes sinus tracts and scarring. However, there should be separation of areas by skin that appear healthy/normal -> Oral Doxy

Hurley stage 3: This stage involves diffuse disease. It includes multiple interconnected sinus tracts. Abscesses that involve an entire area with scarring should be present. Purulent drainage may also occur -> Adalimumab (TNF-a inhibitor) What change from the basal fasting gastrin level is indicative of a gastrinoma after secretin stim test? Right Ans - More than 120 pg/mL over basal fasting levels in 10 minutes is positive. Serum gastrin levels usually peak by 10 minutes. Grades of intraabdominal hypertension Right Ans - Grade I: IAP 12 to 15 Grade II: IAP 16 to 20 Grade III: IAP 21 to 25 Grade IV: IAP greater than 25 In an open AAA repair, before releasing your distal clamps pressure should be held over the common femoral artery to flush any potential emboli down which artery? Right Ans - Internal iliac to prevent limb ischemia Pelvis has a robust collateral flow Margins for cutaneous squamous cell carcinoma of high-risk regions (larger than 2 cm, invasive to fat, or in high-risk locations (i.e., central face, ears, scalp, genitalia, hands, feet) Right Ans - 6mm minimum (6-10mm) Pancreatic biopsy pathology for autoimmune pancreatitis Right Ans - Lymphoplasmacytic sclerosing pancreatitis or > 10 IgG4-positive cells with at least 2 of the following: periductal lymphoplasmacytic infiltrate, obliterative phlebitis, and acinar fibrosis. Screening recommendations in a patient with ≥ 1 first-degree relative with CRC at any age Right Ans - Colonoscopy 10 years prior to relative age of diagnosis or age 40, repeat every 5 years if normal What are you concerned for in a patient with a "herald bleed" 6 days status post a video-assisted retroperitoneal debridement (VARD) for pancreatic necrosis Right Ans - A pseudoaneurysm of a peripancreatic vessel, such as the splenic, gastroduodenal, or pancreaticoduodenal artery

For which type of Crohn's is Infliximab useful for? Right Ans - Fistulizing Crohn's High output stoma Right Ans - > 2L/24h Which immunosuppressant can form gallstones Right Ans - Cyclosporine (calcineurin inhibitor) MSLT-2 Trial Right Ans - Patients with a low burden of disease (percent nodal involvement, small metastatic focus, and number of positive nodes) in their sentinel lymph nodes -> Observation with ultrasounds of the right groin nodal basin every 4 months and referral to medical oncology for discussion of adjuvant systemic therapy MC location of Lymphoma in small bowel Right Ans - ILeum Reactive leukocytosis and thrombocytosis after splenectomy limits Right Ans - Leukocytosis in the 12 to 18 x 10^3/mL Thrombocytosis up to 1,000 x 10^3/mL Muir-Torre syndrome Right Ans - An autosomal dominant syndrome (MMR) related to HNPCC which presents with visceral and skin cancers (tumors of the sebaceous glands or keratoacanthoma). INCREASED risk of pancreatic cancer Breast implant-associated anaplastic large cell lymphoma Right Ans - Rare complication of implant-based reconstruction It usually presents years after implant placement and may be linked to textured implants. Workup for suspected BIA-ALCL should include needle aspiration of the peri- implant seroma, with fluid cytologic and pathologic evaluation. What is the central enzyme in apoptosis Right Ans - Caspase

Which benzodiazepine undergoes only glucuronide conjugation? Right Ans

  • Lorazepam What should be the length of an ileal J pouch? Right Ans - 15-20cm Where do you inject local for a perianal nerve block? Right Ans - Ischioanal fossa All blood products carry a risk of viral hepatitis except? Right Ans - Albumin (heat-treated) Vinyl Chloride (PVC) and arsenic exposure increases risk of what cancer? Right Ans - Hepatic angiosarcoma Chylous ascites fluid analysis Right Ans - HIGH triglycerides, leukocytosis with lymphocytic predominance, LOW cholesterol, negative cultures What is Schatski's ring associated with and what does the patient have a decreased risk of Right Ans - Hiatal hernia Decreased risk of Barrett's MCC of acquired aortic valve stenosis in the US Right Ans - Senile calcification What cells do carcinoid tumors arise from Right Ans - Enterochromaffin- like cells (aka Kulchitsky cells) Initial management of post-op chyle leak Right Ans - Medium chain fatty acids and low fat diet Treatment of annular pancreas with obstruction Right Ans - Surgical bypass (i.e., duodenoduodenostomy, gastrojejunostomy, or duodenojejunostomy) What is the primary substrate (or precursor) for hepatic gluconeogensis? Right Ans - Alanine

Primary pancreatic lymphoma lab abnormalities Right Ans - Elevated lactate dehydrogenase (and beta-2 microglobulin), and a normal serum CA 19- Two biggest risk factors for developing stress ulcers Right Ans - Prolonged ventilation > 48 hours and coagulopathy What is a central tenet of care for a neonatal congenital diaphragmatic hernia ventilation-wise? Right Ans - Pressure-limited, goal-directed ventilation allowing hypercapnia What is the advantage of a transperitoneal approach over the retroperitoneal approach for aortic surgery? Right Ans - Better access to the right renal and iliac arteries Daily fluid passing through GI tract Right Ans - Exogenous PO intake is about 2000 ml Saliva 1500 ml Stomach 1000-2000 ml Biliary 500 ml Pancreatic 500-1500 ml Small bowel 1500 ml Most of those 9 liters are absorbed in the small and large bowels as the following: Small bowel 8500 ml Large bowel 400 ml Net loss of fluid with stool is about 100-200 ml/day The presence of any of the following risk factors have a negative effect on survival in patients with hepatic metastases from colorectal cancer Right Ans - 1) Node-positive primary tumor

  1. Disease-free interval less than 12 months
  2. Multiple liver metastases
  3. Largest hepatic metastasis greater than 5 cm
  4. Serum CEA level greater than 200 ng/mL

Which amino acids can only be used for ketogenesis (not gluconeogenesis) Right Ans - Leucine and Lysine Which syndrome is the only disorder that has been shown to have a clear association between gynecomastia and breast cancer? Right Ans - Klinefelter's Among patients with a history of mastectomy and irradiation who do not want to pursue any procedure on the contralateral breast, what is the best flap option for symmetry? Right Ans - DIEP (deep inferior epigastric perforator) flap MCC of death in patients after heart transplant Right Ans - Chronic allograft vasculopathy What is ITP caused by? Right Ans - IgG is commonly directed against the fibrinogen receptor (glycoprotein IIb/IIIa and IR/IX) Hydatid cyst classifications Right Ans - Stage CE1 (unilocular unechoic cystic lesion with double line sign) and CE3a (detached membranes (water- lily sign)) cysts less than 5 cm typically have a single compartment and may be treated with albendazole alone. Stage CE2 (multiseptated, "rosette-like" "honeycomb" cyst) and CE3b (daughter cysts in solid matrix) cysts have many compartments and requires either modified catheterization technique (eg, non-PAIR percutaneous therapy) or surgery (with adjunctive drug therapy). Stages CE4 (heterogenous hypoechoic/hyperechoic contents; no daughter cysts) CE5 (solid plus calcified wall) are inactive cysts that may be managed with observation Which organism is responsible for late prosthetic graft infections (those occurring > 4 months postoperatively) Right Ans - Staph epidermidis (biofilm)

What tumor marker is used to monitor this patient for evidence of recurrent disease of granulosa cell tumors? Right Ans - Inhibin Which finding on paracentesis is most sensitive for SBP Right Ans - Absolute neutrophil count > 250 Meperidine (Demerol) toxicity Right Ans - Renal impairment increases the risk of meperidine toxicity, as its metabolites are cleared by the kidneys. Normeperidine can accumulate to toxic levels, leading to life-threatening seizures and CNS irritability. VISAGE Score Right Ans - age < 40 years, visual pursuit, swallowing, and Glasgow Coma Score > 10 The most validated criteria to predict weaning in neurosurgical patients The transection plane at the neck of the pancreas is created by developing a tunnel anterior to which structure Right Ans - Superior mesenteric vein Which vessel provides collateral flow between the SMA to the hepatic and celiac arteries? Right Ans - Inferior pancreaticoduodenal artery via the GDA Treatment for PTLD Right Ans - Initial: Reduction in immunosuppression Persistent disease: R-CHOP What is Bouveret syndrome? Right Ans - Gastric outlet obstruction caused by impaction of a migrated gallstone through a choledochoenteric fistula into the pylorus of proximal duodenum Mutation a/w metastatic pheochromocytoma Right Ans - SDHB (succinate dehydrogenase subunit B) Syndrome a/w a single rectal ulcer with a gray-white base, rectal bleeding, copious mucus discharge? Right Ans - Solitary Rectal Ulcer Syndrome (SRUS)

What side effect can Benzocaine cause Right Ans - Benzocaine-induced methemoglobinemia (look for cyanosis and low pulse ox) -> give methylene blue MCC of small bowel hemorrhage Right Ans - Angiodysplasia (MC location = ileum) Most potent stimulator of bile secretion Right Ans - Secretin MCC of outflow failure during peritoneal dialysis Right Ans - Constipation Most important prognostic factor for GIST Right Ans - Mitoses per hpf MRSA produces an altered penicillin-binding protein encoded by which gene? Right Ans - mecA What antigens are detected in invasive aspergillosis? Right Ans - Galactomannan Immunohistochemistry stains for melanoma Right Ans - HMB-45, Melan-A, S-100, MITF, SOX-10 MCC of hepatorenal syndrome Right Ans - Spontaneous bacterial peritonitis Pathognomonic sign on imaging for duodenal villous adenoma Right Ans - "Soap bubble" or "paintbrush" sign Incision to gain access to innominate artery Right Ans - Median sternotomy What patient factors cause a decreased MAC values and decreased anesthetic requirement? Right Ans - Older age, metabolic acidosis (compensated) and hypothermia Post-pneumonectomy syndrome Right Ans - Dynamic compression of the airway. Higher incidence after right pneumonectomy.

Symptoms: dyspnea, stridor, recurrent pneumonia Treatment: Saline-filled tissue expander into post-pneumonectomy site What is the LADD procedure Right Ans - Laparoscopic appendectomy and duodenocolic dissociation. Used for malrotation. Antibiotic choice for pouchitis Right Ans - Oral ciprofloxacin Best imaging modality to evaluate for a bladder rupture Right Ans - CT cystogram (fill bladder with contrast, clamp, then take images before filling, after filling, and after drainage) ASIA scale Right Ans - American Spinal Injury Association scale Grade A: Complete spinal cord injury with no motor and sensory function below injury level Grade B: Sacral sensation, no sensation below injury Grade C: Some motor function, LESS THAN 3/5 in more than 50% key muscles Grade D; Some motor function, AT LEAST 3/5 in 50% or more key muscle Treatment for microscopic colitis Right Ans - Steroids (Budesonide) Gambee suture Right Ans - Interrupted single layer suture that causes inversion of mucosa during small bowel anastomosis (improves healing by aligning the layers) The MCC of small bowel hemorrhage Right Ans - Angiodysplasia Daily fluid passing through the GI tract breakdown Right Ans - Exogenous PO intake is about 2000 ml Saliva 1500 ml Stomach 1000-2000 ml Biliary 500 ml

Pancreatic 500-1500 ml Small bowel 1500 ml MC location of ewing sarcoma Right Ans - Pelvis, followed by femure