PAEA GENERAL SURGERY QUESTIONS
|GUARANTEED ACCURATE ANSWERS
Earliest sign of lower extremity acute arterial insufficiency. -
ACCURATE ANSWERS✔✔ Hyperthesias along distribution of
peroneal nerve. No great toe dorsiflexion. Foot drop.
MC site of embolism in acute arterial insufficiency? - ACCURATE
ANSWERS✔✔ Femoral Artery
Aortoiliac occlusion, impotence, butt claudication, absent/decreased
femoral pulses. Can be secondary to either athero or takayasu -
ACCURATE ANSWERS✔✔ Leriche Syndrome
- most commonly at SFA at adductor canal
- nonoperative management: Cilostazol
- operative management: fem pop bypass which uses the saphenous vein
reversed OR endarterectomy which is limited to short lesions of the SFA
at the adductor canal or origin of profunda. - ACCURATE
ANSWERS✔✔ Infrainguinal Disease
The management of primary acute arterial occlusion - ACCURATE
ANSWERS✔✔ depends upon distinguishing between embolism and
thrombosis.
,- Emboli are sudden in onset, have a demonstrable source and lodge
most frequently at the common femoral bifurcation. Embolectomy is the
treatment of choice.
- Acute thrombosis is usually preceded by prolonged, progressive,
ischemia, is less abrupt in onset and occurs most commonly in the
superficial femoral artery. The initial treatment is anticoagulation with
heparin, followed by artery repair if indicated. One of the goals of
treatment for Acute Limb Ischemia is to prevent thrombus propagation;
therefore, expedient anticoagulation with heparin is indicated as soon as
the diagnosis is suspected.
What is the recommended imaging modality in the assessment of acute
arterial embolism that is not immediately limb-threatening, according to
the American College of Radiology. - ACCURATE ANSWERS✔✔ CTA
of the pelvis with runoff
Gold standard test for carotid artery stenosis? - ACCURATE
ANSWERS✔✔ carotid angiogram
When do you use carotid endarterectomy in carotid artery stenosis? -
ACCURATE ANSWERS✔✔ - ipsilateral neurological symptoms with
carotid artery stenosis as seen on angiogram
- asymptomatic with >70% carotid stenosis
- give CCB after to prevent vasospasm
,complications:
- vagus nerve injury from clamping of common carotid
- hoarseness from RLN injury
- horner syndrome d/t injury to sympathetic plexus
What test do you use to assess AAA in acute phase? - ACCURATE
ANSWERS✔✔ CT
What test do you use to assess AAA for screening/ to follow aneurysm
already known? - ACCURATE ANSWERS✔✔ U/S
MC peripheral aneurysm? - ACCURATE ANSWERS✔✔ popliteal
A compartment pressure of _____________ is an indication for
fasiotomy? - ACCURATE ANSWERS✔✔ 30mmHg
normal pressure = 0-8mmHg
Thyroglossal duct cysts elevates with - ACCURATE ANSWERS✔✔
swallowing and tongue protrusion
centrally located, full thickness abdominal wall defect leading to
exposed bowel - ACCURATE ANSWERS✔✔ gastroschisis
, herniation of abdominal contents into the base of the umbilical cord with
protective membrane present. - ACCURATE ANSWERS✔✔
Omphalocele
narrowing of the pyloric canal due to hypertrophy of the musculature -
ACCURATE ANSWERS✔✔ pyloric stenosis
usually evident between 2 weeks- 2 months old
- *nonbilious, projectile vomiting*
- hungry after vomiting
- *midepigastric mass "olive"*
- hypochloremic metabolic alkalosis with paradoxic aciduria
- first born male - ACCURATE ANSWERS✔✔ pyloric stenosis
- get an U/S
What test do you run for pyloric stenosis? - ACCURATE
ANSWERS✔✔ U/S
- reveals elongated pyloric channel and thickened pyloric wall
Radiographic contrst series of pyloric stenosis reveal - ACCURATE
ANSWERS✔✔ -- string sign - from elongated pyloric channel
-- shoulder sign - bulge of pyloric muscle into the antrum
|GUARANTEED ACCURATE ANSWERS
Earliest sign of lower extremity acute arterial insufficiency. -
ACCURATE ANSWERS✔✔ Hyperthesias along distribution of
peroneal nerve. No great toe dorsiflexion. Foot drop.
MC site of embolism in acute arterial insufficiency? - ACCURATE
ANSWERS✔✔ Femoral Artery
Aortoiliac occlusion, impotence, butt claudication, absent/decreased
femoral pulses. Can be secondary to either athero or takayasu -
ACCURATE ANSWERS✔✔ Leriche Syndrome
- most commonly at SFA at adductor canal
- nonoperative management: Cilostazol
- operative management: fem pop bypass which uses the saphenous vein
reversed OR endarterectomy which is limited to short lesions of the SFA
at the adductor canal or origin of profunda. - ACCURATE
ANSWERS✔✔ Infrainguinal Disease
The management of primary acute arterial occlusion - ACCURATE
ANSWERS✔✔ depends upon distinguishing between embolism and
thrombosis.
,- Emboli are sudden in onset, have a demonstrable source and lodge
most frequently at the common femoral bifurcation. Embolectomy is the
treatment of choice.
- Acute thrombosis is usually preceded by prolonged, progressive,
ischemia, is less abrupt in onset and occurs most commonly in the
superficial femoral artery. The initial treatment is anticoagulation with
heparin, followed by artery repair if indicated. One of the goals of
treatment for Acute Limb Ischemia is to prevent thrombus propagation;
therefore, expedient anticoagulation with heparin is indicated as soon as
the diagnosis is suspected.
What is the recommended imaging modality in the assessment of acute
arterial embolism that is not immediately limb-threatening, according to
the American College of Radiology. - ACCURATE ANSWERS✔✔ CTA
of the pelvis with runoff
Gold standard test for carotid artery stenosis? - ACCURATE
ANSWERS✔✔ carotid angiogram
When do you use carotid endarterectomy in carotid artery stenosis? -
ACCURATE ANSWERS✔✔ - ipsilateral neurological symptoms with
carotid artery stenosis as seen on angiogram
- asymptomatic with >70% carotid stenosis
- give CCB after to prevent vasospasm
,complications:
- vagus nerve injury from clamping of common carotid
- hoarseness from RLN injury
- horner syndrome d/t injury to sympathetic plexus
What test do you use to assess AAA in acute phase? - ACCURATE
ANSWERS✔✔ CT
What test do you use to assess AAA for screening/ to follow aneurysm
already known? - ACCURATE ANSWERS✔✔ U/S
MC peripheral aneurysm? - ACCURATE ANSWERS✔✔ popliteal
A compartment pressure of _____________ is an indication for
fasiotomy? - ACCURATE ANSWERS✔✔ 30mmHg
normal pressure = 0-8mmHg
Thyroglossal duct cysts elevates with - ACCURATE ANSWERS✔✔
swallowing and tongue protrusion
centrally located, full thickness abdominal wall defect leading to
exposed bowel - ACCURATE ANSWERS✔✔ gastroschisis
, herniation of abdominal contents into the base of the umbilical cord with
protective membrane present. - ACCURATE ANSWERS✔✔
Omphalocele
narrowing of the pyloric canal due to hypertrophy of the musculature -
ACCURATE ANSWERS✔✔ pyloric stenosis
usually evident between 2 weeks- 2 months old
- *nonbilious, projectile vomiting*
- hungry after vomiting
- *midepigastric mass "olive"*
- hypochloremic metabolic alkalosis with paradoxic aciduria
- first born male - ACCURATE ANSWERS✔✔ pyloric stenosis
- get an U/S
What test do you run for pyloric stenosis? - ACCURATE
ANSWERS✔✔ U/S
- reveals elongated pyloric channel and thickened pyloric wall
Radiographic contrst series of pyloric stenosis reveal - ACCURATE
ANSWERS✔✔ -- string sign - from elongated pyloric channel
-- shoulder sign - bulge of pyloric muscle into the antrum
