Surgery COMAT Complete Practice Questions & Verified Answers
What is the size guideline for Spontaneous pneumothorax:
treatment of a spontaneous <2 cm observe
pneumothorax? >2 cm large and stable = needle aspiration or chest
tube
5 W's of Post-op surgery? 5 W's
• Wind
○ Pneumonia, PE, Aspiration
• Wound
○ Surgical site infections
• Water
○ Urinary tract infections
§ Increased risk due to indwelling catheters
§ Associated with enteric organisms ie. E. coli,
Klebsiella, Proteus mirabillis
• Walk
○ Deep vein thrombosis
• Wonder Drugs
○ Drug fever, blood products, IV lines
○ Drug fever: diagnosis of exclusion
§ Usually associated with anticonvulsants, antibiotics
(beta-lactams, sulfonamides) and allopurinol
§ Occurs within 1-2 weeks of drug initiation
Modified Radial Mastectomy vs. MRM includes:
Simple mastectomy? • Includes axillary dissection
• Level I and Level II axillary dissection being the
standard procedure
altnernate name for hidradenitis acnes inversa
suppurative
What is hidradenitis suppurativa? hronic skin inflammatory condition that is associated
with:
• Induration
• Abscess
• Sinus tracts
It is similar in character and location as many other
conditions but can be differentiated by careful history
and identifying presence of hyperkeratosis induced
follicular occlusion (family history and reccurrence)
, Surgery COMAT Complete Practice Questions & Verified Answers
What is Paraphimosis? Paraphimosis is considered a urological emergency
and occurs when the retracted foreskin develops a
fixed constriction proximal to the glans
Treatment of parphimosis? The glans is first compressed for several minutes to
decrease edema
Followed by application of ice and attempting to push
the prepuce distally while the glans is pushed
proximally
Balanoposthitis is an inflammation secondary to an infection of the
glans penis and the surrounding foreskin
The majority of cases are due to poor hygiene or
external irritation with subsequent colonization by a
fungus
Treatment of Balanoposthitis? Cleaning the region with soap and water, adequate
hygiene, avoiding moist environment and application
of antifungal creams such as nystatin or clotrimazole
Peyronie's disease Peyronie's disease is a rare condition also known as
chronic inflammation of the tunica albuginea
Associated with abnormal growth of the fibrous
plaques and scar formation in the sheath of tissue
surrounding the corpora cavernosa (tunica albuginea)
of the penis
, Surgery COMAT Complete Practice Questions & Verified Answers
Phimosis Phimosis is the inability to retract the foreskin
proximally to the glans penis
• Can be a result of normal development or may be
due to infection or poor hygiene
Priapism? Priapism is another urological emergency but is not
involved with foreskin constriction or retraction
difficulties
• Priapism is a urological emergency and is defined
as painful, involntary and persistent erection in which
both corpora cavernosa are engorged with stagnant
blood
• Impotence can result with sustained erection, thus
urgent action is imperative when faced with this
condition
Treatment of priapism? adequate analgesia, hydration, stopping the
offending agent, administration of terbutaline (beta2-
mimetic), application of ice packs and corporal
aspiration of blood
A-fib complication and acute The patient in the vignette has A-fib as seen in the
abdomen? exhibit and is reportedly non-compliant with medical
therapy predisposing him to atrial clot formatiom
which can subsequently embolize and cause
ischemic colitis. These patients present with:
• Acute abdominal pain
• Bloody diarrhea
• Vomiting
• Abdominal tenderness
Other causes of ischemic colitis • Embolus
• Hypoperfusion from any cause
• Bowel obstruction
, Surgery COMAT Complete Practice Questions & Verified Answers
Clinical findings of ischemic colitis? • Labs show characteristically elevated WBC count
and elevated lactic acid level because of ischemia
• Imaging techniques:
○ CT scan can show bowel wall thickening
○ Barium enema may show a "thumb printing"
○ Sigmoidoscopy can reveal bloody and edematous
tissue
Treatment of ischemic colitis? • Aimed at the cause, in this case embolization is a
possibility
• If treatment is delayed the bowel necroses then
surgical resection is indicated
• Patients should get IV fluids, bowel rest, and ab to
cover for normal gastrointestinal bacteria
• The left side of the colon is invlved most of the time
in ischemic colitis
what part of the colon is most • The left colon is most commonly involved in
commonly involved in ischemic colitis? ischemic colitis
• This portion of the colon is supplied by the IMA
• The IMA supplies the descending colon, the sigmoid
colon, and the upper rectum
ileocolic artery Arises from the end of the SMA and supplies the
cecum, appendix, and terminal ileum
Marginal artery (artery of Drummond) Marginal artery (artery of Drummond)
Is the connection between the SMA and the IMA
found at the splenic flexure
It is considered a watershed area and an area often
involved in ischemic colitis
Middle colic artery Branch of the SMA that supplies the transverse colon
It anastamoses with the L. colic artery of the IMA to
form the marginal artery
SMA Arises from the anterior portion of the abdominal
aorta just inferior to the celiac artery
It supplies a portion of the duodenum, the small
bowel, the right colon, and 2/3 of the transverse colon
What is the size guideline for Spontaneous pneumothorax:
treatment of a spontaneous <2 cm observe
pneumothorax? >2 cm large and stable = needle aspiration or chest
tube
5 W's of Post-op surgery? 5 W's
• Wind
○ Pneumonia, PE, Aspiration
• Wound
○ Surgical site infections
• Water
○ Urinary tract infections
§ Increased risk due to indwelling catheters
§ Associated with enteric organisms ie. E. coli,
Klebsiella, Proteus mirabillis
• Walk
○ Deep vein thrombosis
• Wonder Drugs
○ Drug fever, blood products, IV lines
○ Drug fever: diagnosis of exclusion
§ Usually associated with anticonvulsants, antibiotics
(beta-lactams, sulfonamides) and allopurinol
§ Occurs within 1-2 weeks of drug initiation
Modified Radial Mastectomy vs. MRM includes:
Simple mastectomy? • Includes axillary dissection
• Level I and Level II axillary dissection being the
standard procedure
altnernate name for hidradenitis acnes inversa
suppurative
What is hidradenitis suppurativa? hronic skin inflammatory condition that is associated
with:
• Induration
• Abscess
• Sinus tracts
It is similar in character and location as many other
conditions but can be differentiated by careful history
and identifying presence of hyperkeratosis induced
follicular occlusion (family history and reccurrence)
, Surgery COMAT Complete Practice Questions & Verified Answers
What is Paraphimosis? Paraphimosis is considered a urological emergency
and occurs when the retracted foreskin develops a
fixed constriction proximal to the glans
Treatment of parphimosis? The glans is first compressed for several minutes to
decrease edema
Followed by application of ice and attempting to push
the prepuce distally while the glans is pushed
proximally
Balanoposthitis is an inflammation secondary to an infection of the
glans penis and the surrounding foreskin
The majority of cases are due to poor hygiene or
external irritation with subsequent colonization by a
fungus
Treatment of Balanoposthitis? Cleaning the region with soap and water, adequate
hygiene, avoiding moist environment and application
of antifungal creams such as nystatin or clotrimazole
Peyronie's disease Peyronie's disease is a rare condition also known as
chronic inflammation of the tunica albuginea
Associated with abnormal growth of the fibrous
plaques and scar formation in the sheath of tissue
surrounding the corpora cavernosa (tunica albuginea)
of the penis
, Surgery COMAT Complete Practice Questions & Verified Answers
Phimosis Phimosis is the inability to retract the foreskin
proximally to the glans penis
• Can be a result of normal development or may be
due to infection or poor hygiene
Priapism? Priapism is another urological emergency but is not
involved with foreskin constriction or retraction
difficulties
• Priapism is a urological emergency and is defined
as painful, involntary and persistent erection in which
both corpora cavernosa are engorged with stagnant
blood
• Impotence can result with sustained erection, thus
urgent action is imperative when faced with this
condition
Treatment of priapism? adequate analgesia, hydration, stopping the
offending agent, administration of terbutaline (beta2-
mimetic), application of ice packs and corporal
aspiration of blood
A-fib complication and acute The patient in the vignette has A-fib as seen in the
abdomen? exhibit and is reportedly non-compliant with medical
therapy predisposing him to atrial clot formatiom
which can subsequently embolize and cause
ischemic colitis. These patients present with:
• Acute abdominal pain
• Bloody diarrhea
• Vomiting
• Abdominal tenderness
Other causes of ischemic colitis • Embolus
• Hypoperfusion from any cause
• Bowel obstruction
, Surgery COMAT Complete Practice Questions & Verified Answers
Clinical findings of ischemic colitis? • Labs show characteristically elevated WBC count
and elevated lactic acid level because of ischemia
• Imaging techniques:
○ CT scan can show bowel wall thickening
○ Barium enema may show a "thumb printing"
○ Sigmoidoscopy can reveal bloody and edematous
tissue
Treatment of ischemic colitis? • Aimed at the cause, in this case embolization is a
possibility
• If treatment is delayed the bowel necroses then
surgical resection is indicated
• Patients should get IV fluids, bowel rest, and ab to
cover for normal gastrointestinal bacteria
• The left side of the colon is invlved most of the time
in ischemic colitis
what part of the colon is most • The left colon is most commonly involved in
commonly involved in ischemic colitis? ischemic colitis
• This portion of the colon is supplied by the IMA
• The IMA supplies the descending colon, the sigmoid
colon, and the upper rectum
ileocolic artery Arises from the end of the SMA and supplies the
cecum, appendix, and terminal ileum
Marginal artery (artery of Drummond) Marginal artery (artery of Drummond)
Is the connection between the SMA and the IMA
found at the splenic flexure
It is considered a watershed area and an area often
involved in ischemic colitis
Middle colic artery Branch of the SMA that supplies the transverse colon
It anastamoses with the L. colic artery of the IMA to
form the marginal artery
SMA Arises from the anterior portion of the abdominal
aorta just inferior to the celiac artery
It supplies a portion of the duodenum, the small
bowel, the right colon, and 2/3 of the transverse colon
