PAEA General Surgery EOR Exam With Best Solutions

PAEA General Surgery EOR Exam With Best Solutions

Ranson Criteria for assessing the severity of acute pancreatitis. GA LAW - glucose >
200mg/dl
Age > 55
Lactate Dehydrogenase > 350u/L
Aspartate Aminotransferase > 250u/L
WBC>16,000
With the Ranson Criteria, what criteria means a worsening prognosis in the 1st 48 hours of
pancreatitis? CHOBBS - Hematocrite drop >10%
BUN rise >5mg/L
PO2<60mmHg
Ca<8mg/dL
Base Deficit>4meq/L
Estimated fluid sequestration>6L
Kidney stones: _______(like in cystic fibrosis) causes ingested fat to bind Ca allowing free
oxalate to be absorbed....thus causing hyperoxalurea. - Steatorrhea
What are the medical treatments (conservative) that can be used to help anal fissure pain? -
CCB, nitroglycerine -- they try to relax interal and external sphincter muscle
What type of hernia is most common in African Americans? - umbilical
What are three important questions to ask a patient with a hernia needing surgery? - history
of BPH, constipation, or COPD/coughing --- all these things can interfere with healing postop because of straining
A _____hernia is midline along the linea alba. - ventral
A _____hernia is at or below the junction between the vertical semilunar line and lateral to
the rectus abdominus muscle. - spigelian
A ___is a combination of a direct and indirect hernia that straddles the inferior epigastric
vessels. - Pantaloon
A sliding hernia contains ____organs. - intra-abdominal
An ___hernia is common in thin, elderly women, SBO from herniation into the obturator
canal. - obturator
A _____hernia contains a Meckel's diverticulum. - Littre
A Richter hernia is when a portion of bowel protrudes, the lumen is patent, what is the
result? - usually gangrenous necrosis
what are the 2 conditions under the inflammatory bowel disease umbrella? - 1. ulcerative
colitis
2. crohn's dz
in comparing ulcerative colitis and crohn's dz, which is:
-limited to the colon w/ rectum always involved *VS* mouth to anus
-transmural *VS* mucosa/submucosa involved
-LLQ *VS* RLQ pain
-bloody diarrhea *VS* non
-complications of perianal dz, strictures, fistulas & granulomas *VS* colon cancer & toxic
megacolon
-colonoscopy showing "skip lesions" & cobblestoning *VS* ulceration & pseudopolyps
-barium studies showing "stovepipe sign" (loss of haustral markings) *VS* "string sign"
narrowing through scarred areas
-(+)P-ANCA *VS* (+)ASCA (anti saccharomyces cerevisiae Ab)
-curative *VS* noncurative - 1. *ulcerative colitis*- colon/rectum, mucosa/submucosa, LLQ
pain, bloody diarrhea, comps of colon cancer & toxic megacolon, colonoscopy w/ ulcerations
& pseudopolyps, "stovepipe sign" (loss of haustral markings), (+)P-ANCA, curative
2. *crohn's dz*- mouth to anus, transmural, RLQ pain, nonbloody diarrhea, comps of perianal
dz, strictures, fistulas, granulomas, "skip lesions" & "cobblestoning", "string sign", (+)ASCA,
noncurative
what are the best studies of choice for ulcerative colitis vs crohn's dz in acute dz? - -UC:
*flex sigmoidoscopy* in acute dz (colonoscopy and barium enema CONTRAINDICATED in
acute dz bc can cause perf or toxic megacolon)
-crohn's dz: *upper GI series* (barium swallow) in acute dz