PAEAGeneralSurgeryexamwith
correctanswers
Earliestsignoflowerextremityacutearterialinsufficiency.-correct answer✔✔Hyperthesias along
distributionofperonealnerve.Nogreattoedorsiflexion.Footdrop.
MCsiteofembolisminacutearterial insufficiency?-correct answer✔✔Femoral Artery
Aortoiliacocclusion, impotence,buttclaudication,absent/decreased femoralpulses.Canbe
secondarytoeitheratheroortakayasu-correct answer✔✔LericheSyndrome
-mostcommonlyatSFAatadductorcanal
-nonoperativemanagement:Cilostazol
-operativemanagement:fempopbypasswhichusesthesaphenousveinreversedORendarterectomy
whichislimitedtoshortlesionsoftheSFAattheadductorcanalororiginofprofunda.-correct
answer✔✔Infrainguinal Disease
Themanagementofprimaryacutearterialocclusion-correct answer✔✔dependsupon
distinguishingbetweenembolismandthrombosis.
-Emboliaresuddeninonset,haveademonstrablesourceandlodgemostfrequentlyatthecommon
femoral bifurcation.Embolectomyisthetreatmentofchoice.
-Acutethrombosisisusuallyprecededbyprolonged,progressive, ischemia,islessabruptinonsetand
occursmostcommonlyinthesuperficial femoralartery.Theinitialtreatmentisanticoagulationwith
heparin,followedbyarteryrepairifindicated.OneofthegoalsoftreatmentforAcuteLimbIschemiais
topreventthrombuspropagation;therefore,expedientanticoagulationwithheparinisindicatedas
soonasthediagnosisissuspected.
,Whatistherecommendedimagingmodalityintheassessmentofacutearterialembolismthatisnot
immediatelylimb-threatening,accordingtotheAmericanCollegeofRadiology.-correct
answer✔✔CTAofthepelviswithrunoff
Goldstandardtestforcarotidarterystenosis?-correct answer✔✔carotidangiogram
Whendoyouusecarotidendarterectomyincarotidarterystenosis?-correct answer✔✔-ipsilateral
neurologicalsymptomswithcarotidarterystenosisasseenonangiogram
-asymptomaticwith>70%carotidstenosis
-giveCCBaftertopreventvasospasm
complications:
-vagusnerveinjuryfromclampingofcommoncarotid
-hoarsenessfromRLNinjury
-hornersyndromed/tinjurytosympatheticplexus
WhattestdoyouusetoassessAAAinacutephase? -correct answer✔✔CT
WhattestdoyouusetoassessAAAforscreening/tofollowaneurysmalreadyknown?-correct
answer✔✔U/S
MCperipheralaneurysm?-correct answer✔✔popliteal
Acompartmentpressureof_____________isanindicationforfasiotomy? -correct
answer✔✔30mmHg
normal pressure=0-8mmHg
,Thyroglossal ductcystselevateswith-correct answer✔✔swallowingandtongueprotrusion
centrallylocated,fullthicknessabdominal walldefectleadingtoexposedbowel-correct
answer✔✔gastroschisis
herniationofabdominal contentsintothebaseoftheumbilical cordwithprotectivemembrane
present.-correct answer✔✔Omphalocele
narrowingofthepyloric canalduetohypertrophyofthemusculature-correct answer✔✔pyloric
stenosis
usuallyevidentbetween2weeks-2monthsold
-*nonbilious,projectilevomiting*
-hungryaftervomiting
-*midepigastricmass"olive"*
-hypochloremicmetabolicalkalosiswithparadoxicaciduria
-firstbornmale-correct answer✔✔pyloric stenosis
-getanU/S
Whattestdoyourunforpyloricstenosis?-correct answer✔✔U/S
-revealselongatedpyloric channel andthickenedpyloric wall
Radiographiccontrstseriesofpyloric stenosisreveal -correct answer✔✔--stringsign-fromelongated
pyloricchannel
--shouldersign-bulgeofpyloricmuscle intotheantrum
--doubletracksign-parallelstreaksofbariumintothenarrowchannel
, obliterationoftheentireextrahepaticbiliarytreeatorabovetheportahepatis-correct
answer✔✔biliaryatresia
-neonataljaundicebeyondfirstweek
-hyperbilirubinemia
-highGGTlevel
-signsofportalhypertension
-accountsfor90%ofextrahepaticobstructioninneonates-correct answer✔✔biliaryatresia
acuteonsetofbiliousvomitinginaninfantis__________________________ untilprovenotherwise-
correct answer✔✔malrotationandvolvulus
invagination ofoneportionofthebowelintoitself-correct answer✔✔intussusception
MCsiteforintussusception-correct answer✔✔ileocolic
-intermittentcolickyabdominalpain
-biliousvomiting
-currantjellystool
triadfor_____________ -correct answer✔✔intussusception
-thistriadisonlypresentin20%ofcases
-absenceofcurrantjellystooldoesNOTexcludethediagnosis
absence ofbowelin*rightlowerquadrant*withadiffuse*sausage shapedRUQmass*-correct
answer✔✔intussusception;Dance'ssign
susseption- saussage
correctanswers
Earliestsignoflowerextremityacutearterialinsufficiency.-correct answer✔✔Hyperthesias along
distributionofperonealnerve.Nogreattoedorsiflexion.Footdrop.
MCsiteofembolisminacutearterial insufficiency?-correct answer✔✔Femoral Artery
Aortoiliacocclusion, impotence,buttclaudication,absent/decreased femoralpulses.Canbe
secondarytoeitheratheroortakayasu-correct answer✔✔LericheSyndrome
-mostcommonlyatSFAatadductorcanal
-nonoperativemanagement:Cilostazol
-operativemanagement:fempopbypasswhichusesthesaphenousveinreversedORendarterectomy
whichislimitedtoshortlesionsoftheSFAattheadductorcanalororiginofprofunda.-correct
answer✔✔Infrainguinal Disease
Themanagementofprimaryacutearterialocclusion-correct answer✔✔dependsupon
distinguishingbetweenembolismandthrombosis.
-Emboliaresuddeninonset,haveademonstrablesourceandlodgemostfrequentlyatthecommon
femoral bifurcation.Embolectomyisthetreatmentofchoice.
-Acutethrombosisisusuallyprecededbyprolonged,progressive, ischemia,islessabruptinonsetand
occursmostcommonlyinthesuperficial femoralartery.Theinitialtreatmentisanticoagulationwith
heparin,followedbyarteryrepairifindicated.OneofthegoalsoftreatmentforAcuteLimbIschemiais
topreventthrombuspropagation;therefore,expedientanticoagulationwithheparinisindicatedas
soonasthediagnosisissuspected.
,Whatistherecommendedimagingmodalityintheassessmentofacutearterialembolismthatisnot
immediatelylimb-threatening,accordingtotheAmericanCollegeofRadiology.-correct
answer✔✔CTAofthepelviswithrunoff
Goldstandardtestforcarotidarterystenosis?-correct answer✔✔carotidangiogram
Whendoyouusecarotidendarterectomyincarotidarterystenosis?-correct answer✔✔-ipsilateral
neurologicalsymptomswithcarotidarterystenosisasseenonangiogram
-asymptomaticwith>70%carotidstenosis
-giveCCBaftertopreventvasospasm
complications:
-vagusnerveinjuryfromclampingofcommoncarotid
-hoarsenessfromRLNinjury
-hornersyndromed/tinjurytosympatheticplexus
WhattestdoyouusetoassessAAAinacutephase? -correct answer✔✔CT
WhattestdoyouusetoassessAAAforscreening/tofollowaneurysmalreadyknown?-correct
answer✔✔U/S
MCperipheralaneurysm?-correct answer✔✔popliteal
Acompartmentpressureof_____________isanindicationforfasiotomy? -correct
answer✔✔30mmHg
normal pressure=0-8mmHg
,Thyroglossal ductcystselevateswith-correct answer✔✔swallowingandtongueprotrusion
centrallylocated,fullthicknessabdominal walldefectleadingtoexposedbowel-correct
answer✔✔gastroschisis
herniationofabdominal contentsintothebaseoftheumbilical cordwithprotectivemembrane
present.-correct answer✔✔Omphalocele
narrowingofthepyloric canalduetohypertrophyofthemusculature-correct answer✔✔pyloric
stenosis
usuallyevidentbetween2weeks-2monthsold
-*nonbilious,projectilevomiting*
-hungryaftervomiting
-*midepigastricmass"olive"*
-hypochloremicmetabolicalkalosiswithparadoxicaciduria
-firstbornmale-correct answer✔✔pyloric stenosis
-getanU/S
Whattestdoyourunforpyloricstenosis?-correct answer✔✔U/S
-revealselongatedpyloric channel andthickenedpyloric wall
Radiographiccontrstseriesofpyloric stenosisreveal -correct answer✔✔--stringsign-fromelongated
pyloricchannel
--shouldersign-bulgeofpyloricmuscle intotheantrum
--doubletracksign-parallelstreaksofbariumintothenarrowchannel
, obliterationoftheentireextrahepaticbiliarytreeatorabovetheportahepatis-correct
answer✔✔biliaryatresia
-neonataljaundicebeyondfirstweek
-hyperbilirubinemia
-highGGTlevel
-signsofportalhypertension
-accountsfor90%ofextrahepaticobstructioninneonates-correct answer✔✔biliaryatresia
acuteonsetofbiliousvomitinginaninfantis__________________________ untilprovenotherwise-
correct answer✔✔malrotationandvolvulus
invagination ofoneportionofthebowelintoitself-correct answer✔✔intussusception
MCsiteforintussusception-correct answer✔✔ileocolic
-intermittentcolickyabdominalpain
-biliousvomiting
-currantjellystool
triadfor_____________ -correct answer✔✔intussusception
-thistriadisonlypresentin20%ofcases
-absenceofcurrantjellystooldoesNOTexcludethediagnosis
absence ofbowelin*rightlowerquadrant*withadiffuse*sausage shapedRUQmass*-correct
answer✔✔intussusception;Dance'ssign
susseption- saussage
