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STEP 2
Surgery UWORLD
| Question | Answer |
|---|---|
| What is the best diagnostic test for aortic dissection? | CT aortography |
| What are the clinical findings of Aortic dissection? | Abrupt-onset chest pain + mediastinal widening on CXR |
| What is a common complication of cardiac catheterization? | AV fistula formation |
| How is an AV fistula presented clinically? | Local pain and swell, and continuous bruit + palpable thrill over the fistula |
| Acute limb ischemia + viable limb + arterial pulses detected on doppler and no motor/sensory deficits. What is the NBSM? | CT angiography followed by urgent catheter-based or surgical revascularization. |
| What are movements that can ↑ ICP? | Bending over, bowel movements, Valsalva maneuver |
| How is CSF rhinorrhea presented? | Clear, unilateral rhinorrhea that ↑ at times of ↑↑ICP. |
| What is the MCC of CSF rhinorrhea? | Head trauma which can cause meningitis |
| Which skeletons are involved in acromegaly? | Axial and appendicular skeletons |
| What are some features of excessive GH? | Hyperplasia of articular chondrocytes and synovial hypertrophy, manifested by joint space widening |
| What are endocrine manifestation of excessive GH? | Galactorrhea, hypogonadism, DM, and hyperTG. |
| What hemangioblastomas are associated with vHL? | Retinal and cerebellar hemangioblastomas |
| Other than hemangioblastomas, what are other cancers associated with vHL syndrome? | Clear renal cell carcinoma, pancreatic neuroendocrine tumors, endolymphatic sac tumors of the middle ear, and PHEOCHROMOCYTOMAS. |
| What adrenal medulla carcinoma is associated with vHL syndrome? | Pheochromocytoma |
| What is a common complication of patient chronically treated with glucocorticoids? | Adrenal crisis |
| Management of Adrenal crisis | IV hydrocortisone or dexamethasone + aggressive hydration |
| Management of symptomatic simple breast cyst | Fine-needle aspiration |
| Management of breast cyst that is not fully resolved with fine-needle aspiration | Core-needle BX to evaluate for breast cancer |
| What is the cut-off length of diverticular abscess to in order to perform surgery? | 4 cm |
| What is the management of a diverticular abscess of >4cm? | Percutaneous drain under CT or u/s guidance |
| What is the most effective test/procedure for colorectal polyp evaluation? | Sigmoidoscopy |
| What is a surgical emergency compilation of C. difficile infection? | Toxic megacolon |
| When to suspect toxic megacolon in patient with C. difficile? | At moment diarrhea stops and the clinical symptoms worsen |
| Large defect hiatal hernias are seen with: | Herniate around the stomach and intraabdominal organs |
| What are the CXR findings of Para-esophageal hernia? | Retrocardiac air-fluid level within the thoracic cavity |
| What is the term for "effort rupture of the esophagus"? | Boerhaave syndrome |
| What is a complication of Boerhaave syndrome in terms of air leakage? | Full thickness perforation --> leakage of air --> pneumomediastinum |
| How is the air from Boerhaave syndrome physical examination described? | Suprasternal crepitus |
| How is esophageal rupture confirmed? | Esophagography or CT-scan using water-soluble contrast |
| What are the u/s findings of cholecystitis? | Gallbladder distension, pericholecystic fluid, and a thickened gallbladder wall |
| Management of symptomatic cholecystitis patients | Laparoscopic cholecystectomy within 72 hours |
| What is the most common complication in IBD patients, especially early-on disease progression? | Toxic megacolon |
| What is the management for IBD-induced Toxic Megacolon? | IV corticosteroids |
| What are the types of solid liver masses? | 1. Focal nodular hyperplasia 2. Hepatic adenoma 3. Regenerative nodules 4. Hepatocellular carcinoma 5. Liver metastasis |
| What are clues/associations for Focal Nodular hyperplasia? | 1. Anomalous arteries 2. Arterial flow and central scar on imaging |
| What are clues/associations for Hepatic adenoma? | - Women of long term OCPs - ± hemorrhage or malignant transformation |
| What sort of solid liver mass is seen in acute or chronic liver injury (cirrhosis)? | Regenerative nodules |
| What are clues/association for HCC? | 1. systemic Si/Sx 2. Chronic hepatitis or cirrhosis 3. ↑↑ α-fetoprotein |
| What is the most common liver mass? | Metastasis |
| Rectal prolapse clues: | 1. Red mass with concentric rings that occurs with Valsalva 2. Mucus discharge, abdominal pain and mass sensation |
| External hemorrhoid: | 1. Dusky/purple lump/polyp 2. ± itching and bleeding 3. Thrombosis: acute enlargement with pain |
| Internal hemorrhoid: | Intermittent itching, PAINLESS bleeding, leakage of stool Digital exam can detect them or anoscopy |
| Contraindication for anoscopy evaluation in internal hemorrhoids | Prolapsed polyp |
| How is a Perianal abscess presented? | Fluctuant mass/swelling with erythema, Fever, and gradual onset |
| What shape have the anogenital warts? | Pink/flesh-colored papules with cauliflower. |
| What is the MC type of anorectal cancer? | Squamous cell anorectal carcinoma |
Created by:
rakomi
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