SURGERY UWORLD ROUND
Comprehensive Questions with
Verified Answers Graded A+
patient with fever, jaundice, RUQ pain are concering for acute cholangitis --> life threatening
infection
common bile duct cyst --> underlying etiology is a congenital biliary cyst
what is the best next step in management? - Answer: urgent biliary drainage (Endoscopic
sphincterotomy) with ERCP
perform later the complete surgical excision of the cyst to reduce the risk of
cholangiocarcinoma
chronic constipation with a low fiber and high fat diet are risk factors for which disease?
present with abdominal pain ( LLQ), fever, nausea, vomiting, and leukocytosis
which test should be done to diagnose the ddx? - Answer: Acute diverticulitis
Abdominal CT with contrast
,patient with weight loss , epigastric fullness, and abdominal pain (epigastric pain that worsens
with eating) relieved with antacids raises suspicion for what disease?
how do we diagnose it? - Answer: Gastric cancer
Esophagogastroduodenoscopy (EGD) to visualize the stomach and obtain biopsy samples if
suspicious lesions
blunt abdominal trauma in the RUQ at the 8th and 9th ribs with hypotension that is refractory
to rapid infusion and hypovolemic shock should raise suspicion for what injury? - Answer: Liver
laceration
Blunt adbominal trauma assessment tree - Answer:
what is the most commonly affected organ from metastatic colon adenocarcinoma?
what should be done as the curative method when metastatic colon ca is confined to the liver
(regardless of stage this is recommended in patients with obstruction or threatened obstruction
of the colonic lumen)? - Answer: Liver
Surgical resection
early satiety, intractable nausea and vomiting and weight loss
abdominal tenderness
abdominal distension
succussion splash
hypochloremic metabolic alkalosis and hypokalemia
,unexplained hyperglycemia in malnorished and elderly patient is highly suggestive of which
ddx? - Answer: Pancreatic adenocarcinoma with gastric or duodenal invasion
segmental transmural inflammation of medium sized arteries which leads to luminal narrowing,
thrombosis, and organ ischemia
kidney and gi tract are affected
mesenteric angiography typically revreals multiple arteries with microaneurysms, irrgeular
luminal narrowing, and distal occlusions - Answer: Poly arteritis nodosa
what is the most major risk factor of pancreatic cancer ? - Answer: Cigarette smoking
what do we use to assess esophageal perforation? - Answer: Esophagography with water
soluble contrast
Preparation for batiatric surgery - Answer:
Atraumatic splenic rupture - Answer:
which hernias are more common in elderly women and are more likely than inguinal hernias ?
small bowel obstruction can occur and typically presents with progressive abdominal pain,
nausea/vomiting, high-pitched bowel sounds on examination, distended loops of bowel with air
fluid levels on x-ray - Answer: Femoral hernia
presents in patients who travel to endemic regions
often asymptomatic but may cause pulmonary or intestintal manifestiations
, complications include obstruction of the small bowel or hepatobiliary tree ( cholangitis,
pancreatitis)
ddx?
treatment? - Answer: Ascariasis
treat with albendazole or mebendazole
history of tobacco use with weight loss, fatigue, anorexia, and painless jaundice with dilation of
the common bile duct on ultrasound
ddx?
scan for staging and preoperative planning? - Answer: Pancreatic cancer
Abdominal CT scan
patient underwent laparoscopic appendectomy 10 days ago and now has RUQ pain, fever,
leukocytosis and pulmonary manifestations (SOB, hiccups, and right sided effusion) --> ddx?
diagnosis requires which scan?
treated with what? - Answer: subphrenic abscess
CT scan of abdomen
treated with drainage and intravenous antibiotics
Comprehensive Questions with
Verified Answers Graded A+
patient with fever, jaundice, RUQ pain are concering for acute cholangitis --> life threatening
infection
common bile duct cyst --> underlying etiology is a congenital biliary cyst
what is the best next step in management? - Answer: urgent biliary drainage (Endoscopic
sphincterotomy) with ERCP
perform later the complete surgical excision of the cyst to reduce the risk of
cholangiocarcinoma
chronic constipation with a low fiber and high fat diet are risk factors for which disease?
present with abdominal pain ( LLQ), fever, nausea, vomiting, and leukocytosis
which test should be done to diagnose the ddx? - Answer: Acute diverticulitis
Abdominal CT with contrast
,patient with weight loss , epigastric fullness, and abdominal pain (epigastric pain that worsens
with eating) relieved with antacids raises suspicion for what disease?
how do we diagnose it? - Answer: Gastric cancer
Esophagogastroduodenoscopy (EGD) to visualize the stomach and obtain biopsy samples if
suspicious lesions
blunt abdominal trauma in the RUQ at the 8th and 9th ribs with hypotension that is refractory
to rapid infusion and hypovolemic shock should raise suspicion for what injury? - Answer: Liver
laceration
Blunt adbominal trauma assessment tree - Answer:
what is the most commonly affected organ from metastatic colon adenocarcinoma?
what should be done as the curative method when metastatic colon ca is confined to the liver
(regardless of stage this is recommended in patients with obstruction or threatened obstruction
of the colonic lumen)? - Answer: Liver
Surgical resection
early satiety, intractable nausea and vomiting and weight loss
abdominal tenderness
abdominal distension
succussion splash
hypochloremic metabolic alkalosis and hypokalemia
,unexplained hyperglycemia in malnorished and elderly patient is highly suggestive of which
ddx? - Answer: Pancreatic adenocarcinoma with gastric or duodenal invasion
segmental transmural inflammation of medium sized arteries which leads to luminal narrowing,
thrombosis, and organ ischemia
kidney and gi tract are affected
mesenteric angiography typically revreals multiple arteries with microaneurysms, irrgeular
luminal narrowing, and distal occlusions - Answer: Poly arteritis nodosa
what is the most major risk factor of pancreatic cancer ? - Answer: Cigarette smoking
what do we use to assess esophageal perforation? - Answer: Esophagography with water
soluble contrast
Preparation for batiatric surgery - Answer:
Atraumatic splenic rupture - Answer:
which hernias are more common in elderly women and are more likely than inguinal hernias ?
small bowel obstruction can occur and typically presents with progressive abdominal pain,
nausea/vomiting, high-pitched bowel sounds on examination, distended loops of bowel with air
fluid levels on x-ray - Answer: Femoral hernia
presents in patients who travel to endemic regions
often asymptomatic but may cause pulmonary or intestintal manifestiations
, complications include obstruction of the small bowel or hepatobiliary tree ( cholangitis,
pancreatitis)
ddx?
treatment? - Answer: Ascariasis
treat with albendazole or mebendazole
history of tobacco use with weight loss, fatigue, anorexia, and painless jaundice with dilation of
the common bile duct on ultrasound
ddx?
scan for staging and preoperative planning? - Answer: Pancreatic cancer
Abdominal CT scan
patient underwent laparoscopic appendectomy 10 days ago and now has RUQ pain, fever,
leukocytosis and pulmonary manifestations (SOB, hiccups, and right sided effusion) --> ddx?
diagnosis requires which scan?
treated with what? - Answer: subphrenic abscess
CT scan of abdomen
treated with drainage and intravenous antibiotics
