ABSITE COMPLETE EXAMINATION TEST
QUESTIONS WITH VERIFIED SOLUTIONS
●● MCCOD in Blunt Trauma
Answer: Brain Injury
●● EGD Findings a/w increase ulcer re-bleeding (3)
Answer: 1. Active Bleeding / Oozing
2. Visible Vessel
3. Adherent Clot
●● DDx Inguinal Ulcer/Lesion (3)
Answer: 1. Hidratenitis: affects apocrine (axilla/inguinal) glands,
represents chronic infection of gland
2. Granuloma Inguinale: only inguinal, think 3rd world
3. Lymphogranulosum Venerum: inguinal, think STI
●● Glomus Tumor
- Define
- Presentation Triad
,- Two Key Signs
- Treatment
Answer: - Define: sub-ungal AV fistula
- Presentation Triad: pain, cold insensitivity, tenderness on palpation
- Two Key Signs
1. Love's = point tenderness
2. Hildreth's = relief with insufflation
- Treatment: surgery
●● Inguinal Hernia
- Recurrence with/without mesh
- Risk of incarceration each year
Answer: - Recurrence with/without mesh = 5 vs. 20%
- Risk of incarceration each year = 0.18%/year
●● Procidentia
- Etiology (2)
- Recognizing full vs. mucosal prolapse
- Definitive Test
,- 3 Treatments + Description
Answer: - Etiology (2)
1. Pudendal nerve injury
2. Laxity of anal sphincter
- Recognizing full vs. mucosal prolapse
1. Full = circular folds
2. Mucosal = linear folds
- Definitive Test = defecating proctogram
- 3 Treatments + Description
1. Transanal Excision = Altemier (incision 2cm above dentate line to
open peritoneum, then tack peritoneum at level to puborectalis)
2. Delorme (ideal of older patients): Mucosal excision + muscular
plication
3. LAR with Sigmoid Pexy
●● Biliary Dyskinesia
- When to suspect?
- Describe method
, - Treatment
Answer: - When to suspect?
Signs/symptoms of biliary colic with negative USG, CT, ERCP
- Describe method
Gallbladder gets filled with Tc99, infuse CCK. If EF <35% at 20min =
diagnosis
- Treatment = lap chole
●● Injecting dye before WLE melanoma/breast:
- When to inject?
- Where to inject (layer of skin)?
- Why not inject after WLE?
Answer: - When to inject? hours before procedure
- Where to inject (layer of skin)? dermis, where lymphatics are
- Why not inject after WLE? b/c WLE disrupts the lymphatic pathways
●● Post-Hemorrhoidectomy Bleeding Etiologies/Mgmt
- Early (<24hrs)
- Late (>POD5)
Answer: - Early (<24hrs): likely to be surgical error, needs evaluation
QUESTIONS WITH VERIFIED SOLUTIONS
●● MCCOD in Blunt Trauma
Answer: Brain Injury
●● EGD Findings a/w increase ulcer re-bleeding (3)
Answer: 1. Active Bleeding / Oozing
2. Visible Vessel
3. Adherent Clot
●● DDx Inguinal Ulcer/Lesion (3)
Answer: 1. Hidratenitis: affects apocrine (axilla/inguinal) glands,
represents chronic infection of gland
2. Granuloma Inguinale: only inguinal, think 3rd world
3. Lymphogranulosum Venerum: inguinal, think STI
●● Glomus Tumor
- Define
- Presentation Triad
,- Two Key Signs
- Treatment
Answer: - Define: sub-ungal AV fistula
- Presentation Triad: pain, cold insensitivity, tenderness on palpation
- Two Key Signs
1. Love's = point tenderness
2. Hildreth's = relief with insufflation
- Treatment: surgery
●● Inguinal Hernia
- Recurrence with/without mesh
- Risk of incarceration each year
Answer: - Recurrence with/without mesh = 5 vs. 20%
- Risk of incarceration each year = 0.18%/year
●● Procidentia
- Etiology (2)
- Recognizing full vs. mucosal prolapse
- Definitive Test
,- 3 Treatments + Description
Answer: - Etiology (2)
1. Pudendal nerve injury
2. Laxity of anal sphincter
- Recognizing full vs. mucosal prolapse
1. Full = circular folds
2. Mucosal = linear folds
- Definitive Test = defecating proctogram
- 3 Treatments + Description
1. Transanal Excision = Altemier (incision 2cm above dentate line to
open peritoneum, then tack peritoneum at level to puborectalis)
2. Delorme (ideal of older patients): Mucosal excision + muscular
plication
3. LAR with Sigmoid Pexy
●● Biliary Dyskinesia
- When to suspect?
- Describe method
, - Treatment
Answer: - When to suspect?
Signs/symptoms of biliary colic with negative USG, CT, ERCP
- Describe method
Gallbladder gets filled with Tc99, infuse CCK. If EF <35% at 20min =
diagnosis
- Treatment = lap chole
●● Injecting dye before WLE melanoma/breast:
- When to inject?
- Where to inject (layer of skin)?
- Why not inject after WLE?
Answer: - When to inject? hours before procedure
- Where to inject (layer of skin)? dermis, where lymphatics are
- Why not inject after WLE? b/c WLE disrupts the lymphatic pathways
●● Post-Hemorrhoidectomy Bleeding Etiologies/Mgmt
- Early (<24hrs)
- Late (>POD5)
Answer: - Early (<24hrs): likely to be surgical error, needs evaluation
