SURGERY COMAT QUESTIONS ACTUAL EXAM WITH DETAILED
ANSWERS
Question 1.
What is the size guideline for treatment of a taneous pneumothorax?
Correct Answer: Spontaneous pneumothorax: spon- <2 cm observe >2 cm large
and stable = needle aspiration or chest tube
Question 2.
5 W's of Post-op surgery?
Correct Answer: 5 W's • Wind Ë Pneumonia, PE, Aspiration • Wound Ë Surgical
site infections • Water Ë Urinary tract infections § Increased risk due to
indwelling catheters § Associated with enteric organisms ie. E. coli, Klebsiella,
Proteus mirabillis • Walk Ë Deep vein thrombosis • Wonder Drugs Ë Drug fever,
blood products, IV lines Ë Drug fever: diagnosis of exclusion § Usually associated
with anticonvulsants, antibiotics (beta-lactams, sulfonamides) and allopurinol §
Occurs within 1-2 weeks of drug initiation
Question 3.
Modified Radial Mastectomy vs. Simple mastectomy?
Correct Answer: MRM includes: • Includes axillary dissection • Level I and Level
II axillary dissection being the standard procedure
Question 4.
altnernate name for hidradenitis suppurative
Correct Answer: acnes inversa
Question 5.
What is hidradenitis purativa?
Correct Answer: sup- 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)
Question 6.
What is Paraphimosis?
Correct Answer: Paraphimosis is considered a urological emergency and occurs
when the retracted foreskin develops a fixed constriction proximal to the glans
,Question 7.
Treatment of parphimosis?
Correct Answer: 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
Question 8.
Balanoposthitis
Correct Answer: 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
Question 9.
Treatment of Balanoposthitis?
Correct Answer: Cleaning the region with soap and water, adequate hygiene,
avoid-ing moist environment and application of antifungal creams such as
nystatin or clotrimazole
,Question 10.
Peyronie's disease
Correct Answer: 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
Question 11.
Phimosis
Correct Answer: 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
Question 12.
Priapism?
Correct Answer: 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
, Question 13.
Treatment of priapism?
Correct Answer: adequate analgesia, hydration, stopping the offending agent,
administration of terbutaline (beta2-mimetic), application of ice packs and
corporal aspiration of blood
Question 14.
A-fib complication and acute abdomen?
Correct Answer: The patient in the vignette has A-fib as seen in the 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
Question 15.
Other causes of ischemic colitis
Correct Answer: • Embolus • Hypoperfusion from any cause • Bowel obstruction
Question 16.
Clinical findings of ischemic colitis?
Correct Answer: • Labs show characteristically elevated WBC count and elevated
lactic acid level because of ischemia • Imaging techniques: Ë CT scan can show
bowel wall thickening Ë Barium enema may show a "thumb printing" Ë
Sigmoidoscopy can reveal bloody and edematous tissue
Question 17.
Treatment of ischemic colitis?
Correct Answer: • 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
ANSWERS
Question 1.
What is the size guideline for treatment of a taneous pneumothorax?
Correct Answer: Spontaneous pneumothorax: spon- <2 cm observe >2 cm large
and stable = needle aspiration or chest tube
Question 2.
5 W's of Post-op surgery?
Correct Answer: 5 W's • Wind Ë Pneumonia, PE, Aspiration • Wound Ë Surgical
site infections • Water Ë Urinary tract infections § Increased risk due to
indwelling catheters § Associated with enteric organisms ie. E. coli, Klebsiella,
Proteus mirabillis • Walk Ë Deep vein thrombosis • Wonder Drugs Ë Drug fever,
blood products, IV lines Ë Drug fever: diagnosis of exclusion § Usually associated
with anticonvulsants, antibiotics (beta-lactams, sulfonamides) and allopurinol §
Occurs within 1-2 weeks of drug initiation
Question 3.
Modified Radial Mastectomy vs. Simple mastectomy?
Correct Answer: MRM includes: • Includes axillary dissection • Level I and Level
II axillary dissection being the standard procedure
Question 4.
altnernate name for hidradenitis suppurative
Correct Answer: acnes inversa
Question 5.
What is hidradenitis purativa?
Correct Answer: sup- 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)
Question 6.
What is Paraphimosis?
Correct Answer: Paraphimosis is considered a urological emergency and occurs
when the retracted foreskin develops a fixed constriction proximal to the glans
,Question 7.
Treatment of parphimosis?
Correct Answer: 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
Question 8.
Balanoposthitis
Correct Answer: 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
Question 9.
Treatment of Balanoposthitis?
Correct Answer: Cleaning the region with soap and water, adequate hygiene,
avoid-ing moist environment and application of antifungal creams such as
nystatin or clotrimazole
,Question 10.
Peyronie's disease
Correct Answer: 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
Question 11.
Phimosis
Correct Answer: 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
Question 12.
Priapism?
Correct Answer: 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
, Question 13.
Treatment of priapism?
Correct Answer: adequate analgesia, hydration, stopping the offending agent,
administration of terbutaline (beta2-mimetic), application of ice packs and
corporal aspiration of blood
Question 14.
A-fib complication and acute abdomen?
Correct Answer: The patient in the vignette has A-fib as seen in the 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
Question 15.
Other causes of ischemic colitis
Correct Answer: • Embolus • Hypoperfusion from any cause • Bowel obstruction
Question 16.
Clinical findings of ischemic colitis?
Correct Answer: • Labs show characteristically elevated WBC count and elevated
lactic acid level because of ischemia • Imaging techniques: Ë CT scan can show
bowel wall thickening Ë Barium enema may show a "thumb printing" Ë
Sigmoidoscopy can reveal bloody and edematous tissue
Question 17.
Treatment of ischemic colitis?
Correct Answer: • 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
