PAEA General Surgery EOR questions with answers 2024.

PAEA General Surgery EOR questions with
answers 2024


what hare hthe h2 hconditions hunder hthe hinflammatory hbowel hdisease humbrella? h- hANS-

1. hulcerative hcolitis

2. hcrohn's hdz



in hcomparing hulcerative hcolitis hand hcrohn's hdz, hwhich his:

-limited hto hthe hcolon hw/ hrectum halways hinvolved h*VS* hmouth hto hanus

-transmural h*VS* hmucosa/submucosa hinvolved

-LLQ h*VS* hRLQ hpain

-bloody hdiarrhea h*VS* hnon

-complications hof hperianal hdz, hstrictures, hfistulas h& hgranulomas h*VS* hcolon hcancer h&

htoxic hmegacolon


-colonoscopy hshowing h"skip hlesions" h& hcobblestoning h*VS* hulceration h&

hpseudopolyps


-barium hstudies hshowing h"stovepipe hsign" h(loss hof hhaustral hmarkings) h*VS* h"string

hsign" hnarrowing hthrough hscarred hareas


-(+)P-ANCA h*VS* h(+)ASCA h(anti hsaccharomyces hcerevisiae hAb)

-curative h*VS* hnoncurative h- hANS-1. h*ulcerative hcolitis*- hcolon/rectum,

hmucosa/submucosa, hLLQ hpain, hbloody hdiarrhea, hcomps hof hcolon hcancer h& htoxic

,hmegacolon, hcolonoscopy hw/ hulcerations h& hpseudopolyps, h"stovepipe hsign" h(loss hof


hhaustral hmarkings), h(+)P-ANCA, hcurative


2. h*crohn's hdz*- hmouth hto hanus, htransmural, hRLQ hpain, hnonbloody hdiarrhea, hcomps

hof hperianal hdz, hstrictures, hfistulas, hgranulomas, h"skip hlesions" h& h"cobblestoning",


h"string hsign", h(+)ASCA, hnoncurative




what hare hthe hbest hstudies hof hchoice hfor hulcerative hcolitis hvs hcrohn's hdz hin hacute hdz?

h- hANS--UC: h*flex hsigmoidoscopy* hin hacute hdz h(colonoscopy hand hbarium henema


hCONTRAINDICATED hin hacute hdz hbc hcan hcause hperf hor htoxic hmegacolon)


-crohn's hdz: h*upper hGI hseries* h(barium hswallow) hin hacute hdz



what hmedications hare hused hto htreat hulcerative hcolitis hand hcrohn's hdz? h- hANS-1. h5-

aminosalicylic hacids h(anti-inflammatory) h*oral hmesalamine* hbest hfor hmaintenance,

htopical hmesalamine h(rectal hsuppositories h& henemas), h*sulfasalzine* h(give hw/ hfolic


hacid); h*all hof hthese hwork hbest hin hthe hcolon- hso hare hbetter hfor htx'ing hUC*


2. h*corticosteroids* hin h*acute hflares* honly

3. himmune hmodifying hagents: h6-mercaptopurine, hazathioprine hand hMTX

4. hanti-TNF hagents- hadalimumab, hinfliximab hcertolizumab



barrett's hesophagus h(from hprolonged/untreated hGERD) hinvolves htransition hof h_________

hcells hto h_________ hcells h(nml hto hprecancerous); hwhat hkind hof hcancer hcan hGERD h=>


hbarrett's hturn hinto? h- hANS--*squamous* hepithelium hto hmetaplastic h*columnar*


-esophageal h*adenocarcinoma*

,tx hfor hintermittent/mild hvs hmod/severe hGERD h- hANS-besides hlifestyle hchanges

h(food/drink havoidance, havoiding hrecumbency, hwt hloss, hsmoking hcessation


-int/mild: hOTC hantacids h(tums, hMOM, hmaalox, hmylanta) h& hH2 hreceptor

hantagonists/blockers h(ranitidine, hcimetidine, hfamotidine)


-mod/severe: hH2RAs, hPPIs h(omeprazole, hesomeprazole, hpantoprazole), h& hprokinetic

hagents h(cisapride), hnissen hfundoplication hif hrefractory




DDx hfor hhematemesis h- hANS-MC his h*PUD* h(gastric h> hduodenal), hvarices,

hangiodysplasia, hmasses h(adenocarcinoma, hpolyps), h& hmallory-weiss htears




dx/tx? hvomiting hblood hafter ha hnight hof hheavy hdrinking hor hin ha hbulimic hpt; hwhat his

hseen hon hEGD? h- hANS--dx: hmallory-weiss hsyndrome/tears h(d/t hsudden hrise hin


hintragastric hpressure)


-tx: hsupportive hunless hsevere hbleeding hmay hneed hepi hinj, hband hligation hor hballoon

htamponade


-EGD: hsuperficial hlongitudinal hmucosal herosions/lacerations



dx? hdysphagia, hesophageal hwebs, hIDA, hglossitis, hangular hcheilitis, hkoilonychias h- hANS-

plummer-vinson hsyndrome



test hof hchoice his hbarium hswallow

tx: hdilation

, dx? hlower hesophageal hwebs/constrictions hat hsquamocolumnar hjunctions hMC

hassociated hw/ hsliding hhiatal hhernias hbut halso hcan hbe hs/p hcorrosive hinjury h- hANS-


schatzki hring



test hof hchoice his hbarium hsallow

tx: hdilation



esophageal hvarices hare hMC hd/t? htx hto hprevent hrebleeds? h- hANS--cirrhosis has ha

hcomplication hof hportal hvenous hHTN h


-long hterm htx: h

1. hnonselective hBB: h*propranolol, hnadolol* h1st hline h(reduces hportal hpressure) hbut hnot

hused hin hacute hbleeds hbc hpt hmay halready hbe hhypovolemic


2. h*isosorbide*: hlong hacting hnitrate h(vasodilator)



tx hof han hacute hesophageal hvarices hbleed? hthese hhave ha h30-50% hmortality hrate hw/

h1st hbleed hand h70% hrecurrence hrate hw/i h1st hyr! h- hANS-1. h2 hlarge hbore hIV hlines,


hIVF, h+/- hblood htransfusion


2. h*endoscopic hligation* his htx hof hchoice

3. hpharmacologic hvasoconstrictors- h*octreotide* h1st hline h(somatostatin hanalog),

hvasopressin


4. hballoon htamponade