ABSITE prep for intern year questions and answers with solutions 2025

ABSITE prep for intern year questions and answers
with solutions 2025
Heller myotomy -O O



ANSWER a surgical procedure in which the muscles of the cardia (lower esophageal sphincter or
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LES) are cut, allowing food and liquids to pass to the stomach; treats achalasia
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Killian triangle -
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OANSWER Area of potential weakness situated behind the esophagus at the level of the cricopha
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ryngeus muscle O




which vagus is anterior vs posterior? - ANSWER LARP
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left anterior, right posterior
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what does the right vagus become? -
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ANSWER posterior vagal trunk, celiac plexus, criminal nerve of Grassi
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what does the left vagus become? - ANSWER anterior vagal trunk, gastric plexus, liver branches
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criminal nerve of Grassi -
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OANSWER from right vagus, causes persistently high acid levels post op if left after vagotomy, sup
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plies the posterior fundus
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types of hiatal hernia - ANSWER type 1: sliding hiatal hernia (~95%).
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type 2: paraesophageal hiatal hernia with the gastro-esophageal junction in a normal position.
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type 3: mixed or compound type, paraesophageal hiatal hernia with displaced gastro-
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esophageal junction. O




type 4: mixed or compound type hiatal hernia with additional herniation of viscera (most comm
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only colon).
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, phi angle - O O



OANSWER A normal phi angle is ranging between 4 and 58 degrees. The phi angle is a useful mea
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sure in assessing of gastric lap band position. This patient is need to revise the position of the sli
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pped band. O




treatment for slipped gastric band - ANSWER plain x-
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ray (measure phi angle) or swallow study, deflate the band
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ddx: tachycardic, fever, abdominal pain after gastric bypass -
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OANSWER leak until proven otherwise (other complications = bleed, PE); if there is any suspicion
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of leak, go straight to the OR because swallow studies miss 30% of leaks and CT misses 20% leak
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s (imaging not reliable enough)
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where does a gastric sleeve usually leak? -
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ANSWER at the angle of His or GE junction since those areas are the least vascularized
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when do gastric bypasses leak, if they are going to? - ANSWER usually post op day 3
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when do gastric bypasses get internal hernias, if they are going to? -
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ANSWER months to years after the surgery, once the patient has lost weight and the mesenteric
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closures have loosened up
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Peterson defect - O O



ANSWER internal hernia in the mesentery of the roux limb when it is made antecolic
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swirl sign - O O



OANSWER dilated bowl indicating an internal hernia, usually on the left side after gastric bypass
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splenic ligaments and their contents - ANSWER splenorenal - splenic vessels, pancreatic tail
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gastrosplenic - short gastrics, left gastroepiploic O O O O O