aLAPAROSCOPIC SURGERY
1) Which are the 3
methods to confirm
intraperitoneal with
VERESS NEEDLE
TECHNIQUE?
2) Which are the
physiologic
consequences of
LAPAROSCOPIC
PNEUMOPERITONEUM?
1) Pressure < 8!!, Inject
saline without return,
positive hanging drop
test.
2) HYPOTENSION,
DECREASED CO, AND
INCREASED SVR
CANCER
1) How do you reduce the
malignancy spread in
laparoscopic approach?
ESOPHAGUS
1) Which is the extension
of the HELLER
MYOTOMY?
ROBOTIC SURGERY
1) Which is the benefit of
ARTICULATED ARMS?
1) DECREASE CO2
SPREAD, deflate with
trochars in place, use
a bag for specimen,
removal of all lesions
prior deflation
1) 6 CM FROM
ESOPHAGUS & 2-3
CM FROM
STOMACH!!!
1) INTRACORPOREAL
SUTURING (EG
PELVIS)!!!
ENDOCRINE SURGERY
THYROID
1) Which is the most
common damaged
nerve in
thyroidectomy?
2) Which artery is
sacrified?
3) To what is associated
a RIGHT
NONRECURRENT
LARYNGEAL NERVE?
4) To what is associated
a LEFT
NONRECURRENT
LARYNGEAL NERVE?
5)
1) EXTERNAL BRANCH
OF SUPERIOR
Laryngeal Nerve
2) Superior Thyroid
artery
3) ARTERIA LUSORIA OR
ABERRANR RIGHT
SUBCLAVIAN ARTERY
4) RIGHT-SIDE AORTIC
ARCH!!!
ADRENALS
PLASTIC SURGERY
ULCERS
BREAST
ANESTHESIA
PHARMACOLOGY
ANTICOAGULATION
1) Which is the vascular
most critical step
during
ADRENALECOTOMY?
1) DIVISION OF THE
ADRENAL VEINS (RIVC, L- LRENAL VEIN)
1) Which is the best
treatment for a
STAGE 3 decubitus
sacral ulcer?
2) Why not wound vac?
1) Which are the 2 main
risk factors for
complications in
TRAM flaps?
1) Large fasciocutaneous
V-TO-Y
ADVANCEMENT
2) Only for STAGE 1 and
2 ULCERS
1) OBESITY AND
SMOKING
1) Which are the main
characteristics of
SUCCYNILCHOLINE?
2)
1) What is the
PROTAMINE
SULFATE?
2) Which is the most
common SIDE EFFECT
of protamine?
3) For how long should
be held Clopidogrel
and LMWH before
procedure?
4) Which is the MOA of
CLOPIDOGREL?
5) How do you reverse
it?
6) Which drugs are
reversed with 4Factor prothrombin
complex
concentrate?
1) DEPOLARIZING, Rapid
acting & short duration,
FASCICULATIONS,
increases POTASSIUM,
tachycardia in children,
METABOLIZED BY
PSEUDOCHOLINESTERASE
1) ANTIDOTE FOR HEPARIN
OVERDOSE
2) HYPOTENSION
3) Clopidogrel 7 days,
LMWH 12 hours, heparin
4-6 hours
4) INHIBITS PLATELET AGG
(P2Y2r) IRREVERSIBLE!!!
5) REVERSE WITH PLT
TRANSFUSION
6) WARFARIN, APIXABAN
AND RIVAROXABAN
COLORECTAL
COLORECTAL CANCER
MICROBIOLOGY
1) Which is the best
MARKER for
colorectal CA
recurrence?
2) Which is the pattern
of TUMOR LYSIS
SYNDROME?
3) To which tumor is it
related TLS?
1) Which toxin of CDiff
causes intestinal
necrosis and
increased
permeability?
2)
1) CEA!!!
2) Hematuria, AKI,
HyperKalemia,
HyperPhosphatemia,
hypocalcemia,
LEUCOCYTOSIS after
chemo
3) NH LYMPHOMA (in
Chron + Aza)
1) TOXIN A
1) Which stage is
endometrial CA when
pelvic LNs are
involved?
2) Which is the
treatment of stage
3b?
1) STAGE 3B
2) RADIATION AND
CHEMOTHERAPY
3)
2)
GYN/OB
ENDOMETRIAL CANCER
VASCULAR SURGERY
UPPER EXTREMITY
1) What is effort
thrombosis, or PagetSchroetter syndrome?
2) Which is the
treatment?
3) Which
AAA
1) Which Is the 30-day
mortality rate for
ENDOVASCULAR and
OPEN REPAIR AAA?
1) Which is the most
common nerve
injured during
intervention of short
saphenous vein at the
level of the calf?
2) What does it
innervate?
LOWER EXTREMITY
GASTRO
HISTOLOGY
1) Which PUMP from the
PARIETAL CELL secretes
HYDROCHLORIC ACID?
1) Is an AxillarySubclavian vein
thrombosis due to
compression of the
subclavian vein by a
cervical rib or muscle.
2) Thrombolytic therapy
first, then balloon
angiography and at
last removal of the rib
to decompress.
1) 1.6% for endovascular
and 4.8% for open
one.
1) SURAL NERVE
2) Lateral and posterior
calf, ankle, foot
1) The H+/K+ ATPase PUMP!!!
ESOPHAGEAL
PERFORATION
GASTRINOMA
CHRONIC
PANCREATITIS
PANCREATIC
LACERATION
ACUTE
PANCREATITIS
WOUNDS
NUTRITION
1) Which study should be
done in an
hemodynamically stable
patient with HIGH
suspicion of
ESOPHAGEAL
PERFORATION?
2) What if no findings but
still HIGH suspicion?
1) Which are the main
characteristics of
GASTRINOMA?
1) In a patient with
CHRONIC PANCREATITIS
with ISOLATED GASTRIC
VARICES, what should
you suspect?
1) Which 2 criteria are used
to REMOVE pancreatic
drains?
1) Which are the main
FINDINGS in SEVERE
ACUTE PANCREATITIS?
2) Which are the 3
evidences of
RETROPERITONEAL
Hemorrhage in acute
pancreatitis?
1) Which are the
contaminated wound
categories and which is
the appropriate closure?
2) When is delayed closure
of the fascia needed?
3) Which is the treatment
for an EARLY FASCIAL
DEHISCENCE? (SALMONCOLORED FLUID)
1)
1) ESOPHAGOGRAPHY WITH
WATER SOLUBLA CONTRAST +
start abx
2) FLEXIBLE ESOPHAGOSCOPY
1) 80% SPONTANEOUS, 20% MEN1,
commonly found near
DUODENUM, MALE
preponderance.
1) SPLENIC VEIN THROMBOSIS
LEADING TO BLEEDING…
PERFORM SPLENECTOMY!!!
1) OUTPUT & AMYLASE LEVEL (IF 3
TIMES OVER SERUM AMYLASE,
THERE IS A FISTULA!!!)
1) Necrosis of at least 1/3 of
pancreas, HYPOTENSION <90,
RENAL FAILURE Cr >2.9, GI
BLEEDING, RESP FAILURE PaO2
<60, local complications as:
hemorrhage, abscess,
pseudocyst.
2) PERIUMBILICAL-CULLEN, FLANK
– GREY-TURNER, INGUINAL –
FOX
1) III and IV, contaminated and
dirty. Tx is closure of the fascia
but delayed primary closure of
the skin (due to contamination.
2) If damage control lap, acidosis or
hemodynamic instability.
3) URGENT WOUND EXPLORATION
IN OR!!!
1)
LIVER
BILLIARY
TRACT
1) Which is the treatment
for HEPATORENAL
SYNDROME?
2) Which patients should
receive always this
treatment?
1) Which are the 3 US
findings of A
CHOLECYSTITIS?
2) Which is the diameter of
CBM in obstruction?
3) Which is the ETIOLOGY
of ACALCULOUS
CHOLECYSTITIS?
4) What is the INITIAL TX
for BILE DUCT injuries of
<72 hrs?
5) What is the INITIAL TX
for BILE DUCT injuries of
>72 hrs?
6) Which treatment should
be given first in cases of
COMPLETE
TRANSECTION OR
OCCLUSION (E1,E2)?
7) Which are the
INDICATIONS for
TRANCYSTIC COMMON
BILE DUCT
EXPLORATION?
8) Which are the risks of
TRANSDUCTAL CBD
EXPLORATION?
9) Which is the next step in
tx if during a
cholecystectomy there is
an ABERRANT DUCT
FROM THE CYSTIC DUCT?
10) Which are the clinical
findings of SPHINCTER
OF ODDI DYSFUNCTION?
11) Which is the DX GOLD
STANDARD?
1) ALBUMIN + VASOCONSTRICTOR
(midrodine + ocreotide) (to
decrease vasodilation and
increase renal bloodflow)
2) Patients with SBP (ascites +
altered mental status)
1) PERICHOLECYSTIC FLUID, WALL
THICKNESS >4MM, STONE AT
THE NECK
2) > 7MM
3) BILE STASIS -> FAST
LITHOGENICITY, DISTENSION OF
WALL, ISCHEMIA OF WALL!!!
4) PRIMARY REPAIR OR
HEPATICOJEJUNOSTOMY
5) Drainage, sepsis control and
stabilize.
6) PERCUTANEOUS TRANSHEPATIC
CHOLANGIOGRAPHY and
PERCUTANEOUS TRANSHEPATIC
BILLIARY DRAIN PLACEMENT
7) SUSPECTED CBD STONE IN IOC
or PROVEN STONE when IOC is
not possible (allergy, pregnancy)
8) Bile leak, biliary stricture,
pancreatitis (only used when the
latter one fails).
9) INTRAOPERATIVE
CHOLANGIOGRAM (FROM THE
CYSTIC DUCT)!!!!
10) PERSISTENT RUQ ABD PAIN
YEARS AFTER
CHOLECYSTECTOMY!!!
11) MANOMETRY!!!
12) ERCP!!!
13) PRIMARY DUCT STONES OF
PIGMENTED CALCIUM
BILIRRUBINATE!!!!
14) SIMPLE LIGATION OF DUCT AND
PLACEMENT OF A DRAIN!!!
15) TUBE CHOLANGIOGRAM TO
EVALUATE BILIARY DUCTS
16) CHOLECYSTECTOMY IN 6-8
WEEKS!!!
12) Which is the tx for
POSTCHOLECYSTECTOMY
CHOLEDOCOLITHIASIS?
13) Which kind of stones
does it have?
14) Which is the tx of BILE
DUCT INJURY if <3mm in
diameter?
15) Which is the mx of
CHOLECYSTOSTOMY
TUBE in POOR SX
CANDIDATES?
16) Which is the mx of
CHOLECYSTOSTOMY
TUBE in GOOD SX
CANDIDATES?
17) Which is the composition
of PRIMARY COMMON
BILE DUCT STONES?
18) Which is the composition
of secondary bile duct
stones (gallbladder)
19) Which is the tx for
GALLBLADDER CANCER
TYPE 1B OR MORE?
20) And if Type 1A?
21) Which is the best INITIAL
STUDY for ACUTE
CHOLANGITIS or
CHOLELITHIASIS?
22) Which is the minimum
indicated liver remnant
after hepatectomy?
23) Which is the tx for
abscess of <3cm!!! after
a lap appy?
24) And if >3cm?
25) Which is the source of
BACTERIAL PERITONITIS
in a px with recent
BOWEL RESECTION +
CHRONIC STEROID USE?
17) CALCIUM BILLIRUBINATE AND
CHOLESTEROL!!! (brown
pigment stones-infext)
18) Cholesterol stones or calcium
billirubinate (black pigment from
hemolytic disorders)!!!
19) LIMITED HEPATIC RESECTION OF
SEGMENTS IVB AND B + PORTAL
LYMPHADENECTOMY WITH
COMMON BILE DUCT
RESECTION, AND ROUX-EN-Y
RECONSTRUCTION
20) Cholecystectomy alone is OK!
21) ABDOMINAL ULTRASOUND!!!
22) 20% if healthy, 30% if
dysfunction, 40% if cirrhosis
23) IV ANTIBIOTICS
24) PERCUTANEOUS DRAINAGE!!!
25) SECONDARY BACTERIAL
PERITONITIS by ANASTOMOTIC
LEAK!!!
26) FIBROSIS AND THICKENING OF
THE GALLBLADDER!!!
GERD
ERCP
ABDOMEN –
CANCER
26) Which are the US
findings of CHRONIC
CHOLECYSTITIS?
1) Which is the most
common complication of
CHRONIC GERD?
2) Which anatomic
structures and incised
when doing a NISSEN
FUNDUPLICATION?
3) How is the ENDOSCOPIC
SURVEILLANCE for
BARRET WITH LOWGRADE DYSPLASIA?
4) Which is the most
common complication of
HELLER MYOTOMY?
5) What do you do to avoid
it?
1) When is the patient
ROTATED TO PRONE
POSITION?
2) Which endoscope is used
that provides best view
of the AMPULLA OF
VATER?
3) Which is the position of
the AMPULLA OF VATER?
4) Which is the position of
the COMMON BILE DUCT
ORIFICE in the ampulla?
5) Which is the position of
the PANCREATIC DUCT in
the ampulla?
1) Which are the risks
factors of PERITONEAL
MESOTHELIOMA?
2) Which are its CLINICAL
FINDINGS?
3) Which is the tx?
4) Which is the tx for
GALLBLADDER CANCER if
> T1b (tumor invades
muscular layer or more)?
1) SHORTENING OF THE
ESOPHAGUS!!!
2) SHORT GASTRIC VESSELS!!!
(Tension free wrap, decreases
risk of dysphagia).
3) EVERY 6 MO FOR ONE YEAR,
THEN YEARLY!!!
4) REFLUX
5) PARTIAL FUNDUPLICATION!!!
1) When SCOPE IS IN PLACE IN THE
SECOND PORTION OF THE
DUODENUM.
2) A SIDE-VIEW ENDOSCOPE!! !
3) AT 12 OR 1 O’CLOCK
4) 11 O’CLOCK!!!
5) BETWEEN 1 TO 3 O’CLOCK!!!
1) ASBESTOS EXPOSURE +
SHIPYARD JOB
2) CARCINOMATOSIS SYNDROME:
DIFFUSE ABDOMINAL PAIN +
WEIGHT GAIN + INCREASED ABD
GIRTH
3) Cryored sx and hypertherminc
intraperitoneal chemo.
5) Which is the first step in
TX for a RUPTURED
APPENDICEAL
MUCINOUS
ADENOCARCINOMA?
6) Which is the second
step?
7) HYPERTHERMIC
INTRAPERITONEAL
CHEMOTHERAPY (HIPEC)
is only effective if?
8) Which is the appropriate
cancer surveillance in pxs
with PRIMARY
SCHLEROSING
CHOLANGIITIS?
9) Which is the most
common origin of
PSEUDOMYXOMA
PERITONEII?
10) Which is the first line
treatment of ovarian
pseudomyxoma
peritonei?
11) Which is the best initial
dx study for an
UNILATERAL TESTICULAR
MASS?
12) Which condition is
associated with
DESMOID TUMORS?
13) CYTOREDUCTIVE SX is
most effective in which
type of PERITONEAL
CARCINOMATOSIS?
14) Which are the most
common tumors in von
Hippel-Lindau
syndrome?
15) Which is the best TX for
hypoglycemic episodes
due to INSULINOMA?
16) Which tumor causes
CHOLELITHIASIS,
4) RE-RESECTION + HEPATIC
RESECTION OF 4 & 5B + PORTAL
LYMPHADENECTOMY
5) APPENDECTOMY + DX
LAPAROSCOPY
6) CRYORX SX: RIGHT
HEMICOLECTOMY, RIGHT
LOWER QD PERITONEAL RX,
OMENTECTOMY AND
HYPERTHERMIC CHEMO!!!
7) COMPLETE CRYOREDUCTION
(<2mm)
8) MRI/MR
CHOLANGIOPANCREATOGRAPHY
EVERY 6 MONTHS
(CHOLANGIOCARCINOMA),
ANNUAL RUQ US (GALLBLADDER
CARCINOMA), COLONOSCOPY
EVERY 1-2 YEARS, ANNUAL CA
19-9
9) APPENDIX
10) DEBULKING SX +
INTRAPERITONEAL
CHEMOTHERAPY
11) DUPPLEX US
12) FAMILIAL ADENOMATOUS
POLYPOSIS
13) If MALIGNANT PERITONEAL
MESOTHELIOMA!!!
14) CNS and retinal
HEMANGIOBLASTOMAS, RENAL
CELL CARCINOMA, and
PHEOCHROMOCYTOMAS!!!
15) HIGH-CARBOHYDRATE DIET!!!
16) SOMASTOSTINOMA
17) DIARRHEA, HYPOKALEMIA,
HYPOCHLORYDRIA
ANUS
APPENDIX
COLON
NEURO
TUMORS
STEATORRHEA, and
DIABETES?
17) What does VIPOMA
cuase?
1) Which structure is used
as a guidance when
separating the rectum to
the levator ani muscles
in a perineal resection?
2) When is sx indicated in
rectal cancer?
3) Sx for UPPER RECTUM
CANCER?
4) SX for MIDDLE AND
LOWER RECTUM?
5) CLOSE TO ANAL
SPHINCTERS SX?
6) Within 8cm from anal
verge and <3cm?
18)
1) Which is the common
age and CT sign of a
SIGMOID VOLVULUS?
2) Which is the tx for
UNSTABLE PERITONITIS
with SIGMOID
VOLVULUS?
1)
2)
3)
4)
5)
COCCYX
Only if STAGE 1
LEFT HEMICOLECTOMY
LOW ANTERIOR RESECTION
ABDOMINOPERINEAL
RESECTION.
6) TRANSANAL LOCAL EXCISION.
18)
1) 70yo, WHIRL SIGN!!!
2) SIGMOIDECTOMY!!!
1) Which Tumor can be
thoracic/cervical and
cause Horner’s
syndrome (ptosis,
myosis, anhidrosis)?
2) Which are the
characteristics of
EPENDYMOMA?
3) Which tumor can
cause SEIZURES,
SPASTIC WEAKNESS,
MOTOR/SENSORY
DEFICITS,
INCONTINENCE?
1) NEUROBLASTOMA
2) HEADACHE, visual
LOSS (PAPILLEDEMA),
VOMITING, +
BABINSKY
3) MENINGIOMA
RESPIRATORY
CANCER
BREAST
CANCER
ABSCESS
FAT NECROSIS
PEDIATRICS
BILLIARY
1) Which is the
incidence of
MESOTHELIOMA?
2) Which lesion gives
you TRIGLYCERIDES in
PLEURAL fluid?
3) How do you treat
LYMPHOMA-related
chylothorax?
4)
1) Which is the most
common gene
mutation implicated
in MALE BREAST
CANCER?
2) In which
chromosome is
BRCA2 found?
1) Which is the tx for
BREAST ABSCESS?
1) Which are the
mammographic
findings of FAT
NECROSIS
1) Which are the type 3
choledocal cysts?
2) Treatment?
3) Which are the type 4
and five?
4) Treatment?
1) 80% ASBESTOS
EXPOSURE, 20%
SPONTANEOUS!!!
2) CHYLOTHORAX
3) Conservative
measures: Drainage,
NPO, TPN, continue
chemotherapy
4)
5)
1) BRCA2
2) CHROMOSOME 13
1) US-GUIDED FINE
NEEDLE ASPIRATION +
ABX
1) SPICULATED MASS,
MICROCALCIFICATIONS,
ARCH DISTORTION +
ALWAYS HX OF
TRAUMA!!!
1) INTRAPANCREATIC or
INTRADUODENAL
dilations of CBD
2) ERCP and
MARSUPIALIZATION
3) Four: intra and
extrahepatic duct
dilations, five only
intrahepatic.
4) LIVER TRANSPLANT
TRAUMA
TRANSPLANT
LIVER
Complications
KIDNEY TRANSPLAN
HEMATOLOGY
COAGULATION DISORDERS
TRAUMA
1) Which is the
STANDAR DOSE of
CRYSTALLOIDS IN
PEDS?
2) Which is the dose of
BLOOD in peds?
3)
1) Which score is used
to assess severity of
liver transplantation?
2) Which are the FOUR
parameters included
in the MELD SCORE?
3) Which are the 4
ONCOLOGIC
CONDIITIONS that
can be cured with
LIVER
TRANSPLANTATION?
4) Which is the most
common cause of
cholangitis after a
liver transplant?
1) Which is the most
common cancer after
transplant?
1) Which is the first step
in management of
OLIGURIA after RT?
2) What should be done
if PRERENAL and
HYPERKALEMIA?
1) Which is the first-line
treatment for VWf
deficiency?
1) 20mL/kg TWICE
2) 10mL/kg!!!
3)
1) MELD SCORE (Model of
End-Stage Liver Diseas)
2) SODIUM, INR,
BILIRRUBIN, AND
CREATININE
3) HCC (<5CM or 3 <3CM),
PERIHILIAR
CHOLANGIOCARCINOMA
(<3CM AND AFTER
NEOAD CHEMO),
METASTATIC
COLORECTAL
CARCINOMA
4) ANASTOMOTIC BILLIARY
STRICTURE!!!
1) SKIN CANCER (SCC)
1) DOPPLER AND FLUSH
FOLEY OR BLADDER
SCAN
2) BOLUS OF LACTATED
RINGER (if normal K+ is
LR or NS).
1) Type 1 & 2
DESMOPRESSIN, Type
3 – FACTOR VIII/VWf
CONCENTRTE.
SPLENECTOMY
HERNIAS
1) Which splenic
ligament has the
splenic artery?
2) Which ligament has
the SHORT GASTRIC
ARTERIES?
1) Which is the tx for
CHRONIC
INGUINODYNIA after
inguinal hernia
repair?
2) Which is the best SX
APPROACH for LONG
STANDING
DIAPHRAGMATIC
HERNIAS?
3) Which is the best
surgical technique to
repair a
STRANGULATED
FEMORAL HERNIA?
4) Which structures
does MCVAY joins?
5) Which surgery
sutures the cojoint
with the inguinal
ligament?
6) Which are the
borders of the
inguinal canal?
7) Which vessels are
close and easy to
damage on its inferior
aspect (INGUINAL
LIGAMENT)?
8) Which surgery uses a
mesh to reconstruct
the inguinal floor?
9) Which are the
boundaries of the
FEMORAL CANAL?
1) The SPLENORENAL
LIGAMENT
2) GASTROSPLENIC
LIGAMENT
1) LOCAL ANESTHETIC
NERVE BLOCK. IF
FAILS: NEURECTOMY +
REMOVAL OF MESH!!!
2) THORACOABDOMINAL
APPROACH!!!
3) THE MCVAY or
COOPER’S REPAIR
(repairs the hernia
without using a mesh)
4) Sutures the cojoint
tendon with the
Cooper’s ligament!
5) The BASSINI REPAIR
(for direct and indirect
inguinal hernias)
6) Inferior: Inguinal
ligament/lacunar
ligament.
Posterior/floor:
Cojoint tendon (transv
and int oblique).
Anterior: Aponeurosis
of ext oblique.
Superior: ext oblique,
int oblique and
transversalis
aponeurosis.
7) EXTERNAL ILIAC
VEIN/ARTERY
8) LICHTENSTEIN
REPAIR!!!
9) Anterior: ILIOPUBIC
TRACT (or INGUINAL
LIGAMENT). Posterior:
Pectineus. Medially:
Lacunar ligament.
RECTUM
HEMORRHAGIC SHOCK
10) Which are the
boundaries of the
INDIRECT INGUINAL
HERNIA?
11) Which are the
boundaries of the
HASSELBACH
TRIANGLE (DIRECT
INGUINAL HERNIAS)?
12) Which mesh is used if
clean or cleancontaminated?
13) Mesh used for grossly
spilled contaminated?
14) Posterior boundary of
FEMORAL CANAL?
15) Which are the 3
nerves that should be
protected in a
LICHTENSTEIN
HERNIA REPAIR?
16) Which one travels
superiorly to the
spermatic cord?
17) Which is the primary
treatment for RECTUS
DIASTESIS?
18) If patient suffers from
poor abdominal wall
fx, and pulmonary
effects, what does the
procedure involves?
19) Which is the best
technique to repair
SUBESTOMAL
HERNIAS?
1) Which is the
management
treatment for
EXTRAPERITONEAL
RECTAL INJURIES?
1) In class III or IV (30>40% BLOOD LOSS),
Laterally: Femoral
vein
10) Anterior: Ext. Oblique
aponeurosis.
Posterior: Conjoint
tendon. Medially:
Lacunar ligament.
11) Inferior: Inguinal
ligament. Medially:
Rectus sheath.
Lateral: Inferior
epigastric artery
12) SYNTHETIC MESH
(decreased
recurrence, lo infex)
13) BIOLOGICAL MESH
14) PECTINEAL COOPER’S
LIGAMENT!!!
15) ILIOINGUINAL,
ILIOHYPOGASTRIC,
AND GENITAL
NERVES!!!
16) ILIOINGUINAL!!!
17) Exercise & weight loss
18) PLICATION OF THE
RECTUS!!!
19) SUGARBAKER MESH
TECHNIQUE (less
recurrence) (second
one is the KEYHOLE
technique).
1) FECAL DIVERSION
AND PRIMARY REPAIR
WITH LOOP
COLOSTOMYSIGMOID!!!!!!!!!
1) DIRECTLY BLOOD!!
MASSIVE
what should be
transfused?
ORTHO
UPPER EXTREMITY
CARDIOTHORACIC SURGERY
AORTIC DISSECTION
TRANSFUSION
PROTOCOL 1:1
1) Which nerve is
damaged in a
MIDSHAFT HUMERAL
FX?
2) When radial nerve is
damaged at the
midshaft, which is the
clinical finding?
1) RADIAL NERVE
2) WRIST DROP
(INABILITY TO EXTEND
THE WRIST)!!!
1) What should be done
after ECG with ST
elevation in the
setting of possible
AORTIC DISSECTION?
1) ANATOMIC CT
ANGIOGRAM!!!
MICELLANEOUS
1) Which is the FIRST BRANCH of the SUBCLAVIAN ARTERY?
- THE INTERNAL THORACIC ARTERY!!!
2) What does it supply?
- ANTERIOR CHEST WALL AND BREASTS!!! (Branches: thymus, mediastinum, sternum)
3) It bifurcates in the SIXTH INTERCOSTAL SPACE TO:
- MUSCULOPHRENIC AND SUPERIOR EPIGASTRIC ARTERIES!!!
4) Where is the ABSORPTION OF B12 AND BILE GIVEN?
- IN THE TERMINAL ILEUM!!!
5) What does DUODENUM ABSORB?
- ADEK (SECONDARY) + Ca + iron + phosphorus
6) And JEJUNUM?
- MAIN!!! ADEK & MINERALS!!!
7) Which is the most common intestinal part affected by CHRON?
- TERMINAL ILEUM!!!
8) Which ANTIHYPERTTENSIVES should be dc before sx?
- ACEI’S
VASCULAR
1) Which is the area of bowel distribution of the SMA?
2)
3)
4)
-
Proximal jejunum to distal TRANSVERSE colon
Which areas of the SMA are affected by an emboli?
ILEOCOLIC ARTERY -> MID JEJUNUM AND ASCENDING COLON!!!
Which is the tx for new-onset CLAUDICATION?
SMOKING CESSATION, STATIN, ASPIRIN
When is CILOSTAZOL CONTRAINDICATED?
HEART FAILURE!!!
HEMATOLOGY
1) Which is the most common associated infection in blood products?
- BACTERIAL INFECTION
PLASTIC SURGERY
1) Which are the 3 phases of SKIN GRAFT HEALING?
- IMBIBITION (1), INOSCULATION (2), AND REVASCULARIZATION!!!
GENERAL SURGERY
1) Which is the best tx for INTRAABDOMINAL infex px in penicillin allergic pxs?
- METRONIDAZOLE (OR CLINDA) & AMINOGLYCOSIDE
2) Which inguinal hernia is LATERAL to INFERIOR EPIGASTRIC ARTERY?
- INDIRECT ONE
3) Which is its cause?
- PATENT PROCESSUS VAGINALIS!!!
4) Which is the cause of DIRECT INGUINAL HERNIA?
- COJOINT TENDON WEAKNES!!
COLORECTAL SURGERY
1) Which is the best tx for CHRONIC ANAL FISTULAS (resistant to nonoperative tx)?
- LATERAL INTERNAL SPHINCTEROTOMY!!!
2) And if they have HYPOTONIC ANAL SPHINCTER (obstetric trauma or previous anal sx)?
- FISSURECTOMY WITH ANOCUTANEOUS ADVANCEMENT FLAP
TRAUMA
1) Which is the best tx for TRACHEAL INJURY?
- REPAIR WITH 1 LAYER OF ABSORBABLE SUTURE + BUTTRESS WITH STRAP MUSCLE!!
2) Which are the 6 MOTOR from GCS?
6: F COMMANDS, 5: LOCALIZES PAIN, 4: WITHDRAWS, 3: DECORTICATE, 2: DECEREBRATE, 1:
NONE
3) Which are the 5 VERBAL from GCS?
5: NORMAL CONVERSATION, 4: DISORIENTED, 3: NONCOHERENT, 2: GROANS/MOANS, 1:
NONE
4) Which are the 4 EYE from GCS?
4: SPONTANEOUS, 3: TO VOICE, 2: TO PAIN, 1: NONE
5) For how long should you give PPX ABX for a blunt/penetrating intraabdominal trauma?
-
12 TO 24 HOURS!!!
SICU
1) Which ELECTROLYTE DISTURBANCES ARE SEEN BY HYPOMAGNESEMIA by DIARRHEA?
- REFRACTORY HYPOKALEMIA AND HYPOCALCEMIA
2) From TEG, what does R mean and how you treat it?
- COAGULATION FACTORS (time to form a clot) -> TX FFP!!!
3) And K-time and alpha curve?
- CLOT FIXED STRENGHT, AND FIBRIN ACCUMULATION -> TX CRYOPRECIPITATE!!
4) And MAX AMPLITUD?
- PLATELETS AND DESMOPRESSIN
5) AND LYSIS AT 30 MINS?
- EXCESS OF FIBRINOLYSIS -> TX: TRANEXEMIC AC OR AMINOCAPROIC ACID!!!
BREAST
1) Which is the tx for PAGET ?
- RADICAL MASTECTOMY + SNL
ONCOLOGY
1) What should be done PRIOR to FORMAL ONCOLOGIC RESECTION OF PANCREATIC
CANCER?
- DIAGNOSTIC LAPAROSCOPY!
2) Which is the tx of LOW GRADE MALT LYMPHOMA BY HELICOBACTER PYLORI?
- ANTIBIOTICS: CLARYTHROMYCIN AND AMOXICILLIN
3) And for HIGH GRADE MALT LYMPHOMA?
- RADIATION AND CHEMOTHERAPY
MISC
1) Which is the mech of action of SILVER?
- RIBOSOMAL TOX, INTERCALATES IN DNA!!!, DISRUPTS BACT CELL MEMBRANE,
DENATURATION OF PROTEINS!!!
CARDIOTHORACIC
1) Which is the management of UNCOMPLICATED TYPE B AORTIC DISSECTION?
- IV B-BLOCKERS (ESMOLOL DRIP)
NEW
1)
2)
3)
Which are the 2 classic findings of PERITONITIS SECONDARY TO PERITONEAL DIALYSIS?
CLOUDY PERITONEAL DIALYSATE
ABD PAIN
SYSTEMIC SXS
How do you diagnose it?
PERITONEAL FLUID ANALYSIS!!!
Which is the tx for an abdominal RECTUS SHEATH HEMATOMA?
4)
5)
STABLE: CTA THEN ANGIOEMBOLIZATION
UNSTABLE: SX INTERVENTION
Which is the main characteristic of a PEDIATRIC MESENTERIC CYST?
FREE MOBILE AND PERPENDICULARLY TO THE ATTACHMENT OF THE MESENTERY
Which is the management if VENTRAL HERNIA if found when trying to put a pERITONEAL
DIALYSIS CATHETER?
- HERNIA REPAIR WITH EXTRAPERITONEAL PROSTHETIC MESH AND PLACEMENT OF PDC
6) Which is the tx for endometriosis found in laparoscopy?
LASER (THERMAL) ABRASION or EXCISION
7) Which is the tx for TYPE 3 ABDOMINAL RECTUS SHEATH HEMATOMAS (hematoma
between transversalis fascia and muscle in the peritoneum and in the prevesical
space)!!!?
- ANGIOEMBOLIZATION OF INGERIOR EPIGASTRIC ARTERY