High-Yield and Frequently Missed ABSITE
questions
90% of bile is reabsorbed daily. Through which circulation and what means? -
ANS-Enterohepatic circulation
Active resorption: of conjugated bile in terminal ileum (45%)
Passive resorption of non-conjugated bile in SB (40%)/colon (5%)
Abnormal fallopian tube at appendectomy - what do? - ANS-appendectomy, leave tube alone
acid-base disturbance seen in treatment with sulfamylon (mafenide sodium) -
ANS-hyperchloremic metabolic acidosis due to carbonic anhdrase inhibition, leads to decreased
renal conversion of bicarb to water and Co2, ultimately leading to alkalinization of urine
Action of prostacyclin A2 - ANS-inhibitor of platelet aggregation
adverse post op effect of colchicine - ANS-inhibits wound contraction
adverse reaction seen in treatment of burns with silvadene - ANS-neutropenia and
thrombocytopenia
anatomy of the foramen of winslow - ANS-portal triad anterior (portal vein posterior, CBD lateral,
hepatic artery medial), IVC posterior, duodenum inferior, liver superior
Avoid cervical sympathectomy in pts with? - ANS-scleroderma
Best way to Dx SB injury in awake trauma pt - ANS-serial exams
Best way to predict risk of bleeding - ANS-H&P
Biliary: lap chole injury to CBD - what characterizes minor injury and what is treatment? -
ANS-recognized intra-op, repair primarily +/- stent
Biliary: what is needed normally for major CBD injury, and what is not needed? - ANS-need
RNY hepaticojejunostomy, not hepatico or choledochoduodenostomy (never feasible)
Biliary: what is treatment for gallbladder CA based on presentation (2 major options)? - ANS-If
T1a (confined only to lamina propria) cholecystecotmy; anything else, then skeletonize area,
plus wedge segment 4/5 liver and regional nodes, consider CBD if cystic duct involved
Biliary: what is treatment for types of choledochal cyst (1-5)? - ANS-all need resection with CCY
/ CBD removal, RNY hepaticojejunostomy, 4+5 need hepatectomy vs. transplant if diffuse
Boundaries of femoral hernias - ANS-cooper's ligament, inguinal ligament, femoral vein. hernia
passes under inguinal ligament, bulge in anteromedial thigh, reduce through inguinal ligament
division, repair with McVay or Bassini repair.
Breast: for atypical ductal hyperplasia; atypical lobular hyperplasia; LCIS, how are these
characterized and what treatment should be considered? - ANS-benign proliferative dz. Incr risk
of CA.
Need to resect - don't need (-) margins
Can give hormone therapy
- pre-meno: tamoxifen
- post-meno: raloxifene
, Bilateral total mastectomy (no ALND)
Breast: LCIS -- what % have synchronous cancer? - ANS-5%
Breast: LCIS -- what is treatment (4 possibility, 2 things not needed ever)? - ANS-1) Need to
resect the lesion but do not need neg margins
2) nothing and careful F/U
3) Hormonal therapy
-(pre-meno: tamoxifen; Post-meno: raloxifene)
4) bilateral subcutaneous mastectomy (no ALND)
Breast: LCIS -- who primarily gets this, what is most important characteristic, what % get cancer,
where, and what type? - ANS-- pre-menopausal
- NOT premalignant itself
- 30% lifetime risk
70% ductal CA
Breast: what are 3 chemo agents used for breast CA typically? - ANS-1) adriamycin; 2)
cyclophosphamide; 3) taxol
Breast: What are contraindications to BCT (lumpectomy) in stage I breast cancer (and what
specifically is not)? - ANS-1) prior irradiation;
2) pos margins;
3) inflammatory;
4) pregnancy (unless 3rd trimester)
Breast: what are the axillary node levels (1-3, and one more category)? - ANS-1 - lateral to pec
minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter's Nodes - between pec major and pec minor
Breast: What are the benign proliferative breast lesions that have increased risk of CA? (3)
Tx? - ANS-- LCIS
- Atypical ductal hyperplasia
- atypical lobular hyperplasia
Tx: resect the lesion w/ (-) margins
Breast: what do you do if you can't find radiotracer dye in SNLB? - ANS-have to do formal ALND
Breast: what is main SE of adriamycin (doxorubacin)? - ANS-cardiomyopathy
Breast: what is main SE of taxol? - ANS-taxol - neuropathy
Breast: what is not needed for patient with negative SLNB? - ANS-ALND -- just do BCT or
mastectomy depending on tumor is fine
Breast: What is presentation, treatment, prognosis for intraductal papilloma? - ANS-presents
with bleeding/bloody nipple discharge (most common cause), usually benign, biopsy/resect via
major duct excision
Breast: what is treatment for DCIS in male/female? - ANS-female -- BCT + xrt OR mastectomy;
male -- mastectomy
Breast: what is treatment for inflammatory breast cancer (in order)? - ANS-neoadjuvant chemo,
then mastectomy (mod radical), then XRT
questions
90% of bile is reabsorbed daily. Through which circulation and what means? -
ANS-Enterohepatic circulation
Active resorption: of conjugated bile in terminal ileum (45%)
Passive resorption of non-conjugated bile in SB (40%)/colon (5%)
Abnormal fallopian tube at appendectomy - what do? - ANS-appendectomy, leave tube alone
acid-base disturbance seen in treatment with sulfamylon (mafenide sodium) -
ANS-hyperchloremic metabolic acidosis due to carbonic anhdrase inhibition, leads to decreased
renal conversion of bicarb to water and Co2, ultimately leading to alkalinization of urine
Action of prostacyclin A2 - ANS-inhibitor of platelet aggregation
adverse post op effect of colchicine - ANS-inhibits wound contraction
adverse reaction seen in treatment of burns with silvadene - ANS-neutropenia and
thrombocytopenia
anatomy of the foramen of winslow - ANS-portal triad anterior (portal vein posterior, CBD lateral,
hepatic artery medial), IVC posterior, duodenum inferior, liver superior
Avoid cervical sympathectomy in pts with? - ANS-scleroderma
Best way to Dx SB injury in awake trauma pt - ANS-serial exams
Best way to predict risk of bleeding - ANS-H&P
Biliary: lap chole injury to CBD - what characterizes minor injury and what is treatment? -
ANS-recognized intra-op, repair primarily +/- stent
Biliary: what is needed normally for major CBD injury, and what is not needed? - ANS-need
RNY hepaticojejunostomy, not hepatico or choledochoduodenostomy (never feasible)
Biliary: what is treatment for gallbladder CA based on presentation (2 major options)? - ANS-If
T1a (confined only to lamina propria) cholecystecotmy; anything else, then skeletonize area,
plus wedge segment 4/5 liver and regional nodes, consider CBD if cystic duct involved
Biliary: what is treatment for types of choledochal cyst (1-5)? - ANS-all need resection with CCY
/ CBD removal, RNY hepaticojejunostomy, 4+5 need hepatectomy vs. transplant if diffuse
Boundaries of femoral hernias - ANS-cooper's ligament, inguinal ligament, femoral vein. hernia
passes under inguinal ligament, bulge in anteromedial thigh, reduce through inguinal ligament
division, repair with McVay or Bassini repair.
Breast: for atypical ductal hyperplasia; atypical lobular hyperplasia; LCIS, how are these
characterized and what treatment should be considered? - ANS-benign proliferative dz. Incr risk
of CA.
Need to resect - don't need (-) margins
Can give hormone therapy
- pre-meno: tamoxifen
- post-meno: raloxifene
, Bilateral total mastectomy (no ALND)
Breast: LCIS -- what % have synchronous cancer? - ANS-5%
Breast: LCIS -- what is treatment (4 possibility, 2 things not needed ever)? - ANS-1) Need to
resect the lesion but do not need neg margins
2) nothing and careful F/U
3) Hormonal therapy
-(pre-meno: tamoxifen; Post-meno: raloxifene)
4) bilateral subcutaneous mastectomy (no ALND)
Breast: LCIS -- who primarily gets this, what is most important characteristic, what % get cancer,
where, and what type? - ANS-- pre-menopausal
- NOT premalignant itself
- 30% lifetime risk
70% ductal CA
Breast: what are 3 chemo agents used for breast CA typically? - ANS-1) adriamycin; 2)
cyclophosphamide; 3) taxol
Breast: What are contraindications to BCT (lumpectomy) in stage I breast cancer (and what
specifically is not)? - ANS-1) prior irradiation;
2) pos margins;
3) inflammatory;
4) pregnancy (unless 3rd trimester)
Breast: what are the axillary node levels (1-3, and one more category)? - ANS-1 - lateral to pec
minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter's Nodes - between pec major and pec minor
Breast: What are the benign proliferative breast lesions that have increased risk of CA? (3)
Tx? - ANS-- LCIS
- Atypical ductal hyperplasia
- atypical lobular hyperplasia
Tx: resect the lesion w/ (-) margins
Breast: what do you do if you can't find radiotracer dye in SNLB? - ANS-have to do formal ALND
Breast: what is main SE of adriamycin (doxorubacin)? - ANS-cardiomyopathy
Breast: what is main SE of taxol? - ANS-taxol - neuropathy
Breast: what is not needed for patient with negative SLNB? - ANS-ALND -- just do BCT or
mastectomy depending on tumor is fine
Breast: What is presentation, treatment, prognosis for intraductal papilloma? - ANS-presents
with bleeding/bloody nipple discharge (most common cause), usually benign, biopsy/resect via
major duct excision
Breast: what is treatment for DCIS in male/female? - ANS-female -- BCT + xrt OR mastectomy;
male -- mastectomy
Breast: what is treatment for inflammatory breast cancer (in order)? - ANS-neoadjuvant chemo,
then mastectomy (mod radical), then XRT
