2024 General Surgery EOR Exam New Latest Test Bank with All Questions from Actual Past Exam and 100% Correct Answers
A ______is head trauma results in blood below the arachnoid membrane and above the pia. Most often supratentorial (contains the cerebrum). ------------ Correct Answer ------- Subarachnoid hemorrhage
What electrolyte abnormality is associated with pancreatitis? ---------- Correct Answer --- -------- hypocalcemia
How does a duodenal ulcer differ than a peptic ulcer? ---------- Correct Answer ----------- Pain is better after eating, then returned 3-4 hours after eating.
What are three important questions to ask a patient with a hernia needing surgery? ------ ------ Correct Answer ------- history of BPH, constipation, or COPD/coughing --- all these things can interfere with healing post-op because of straining
A _____hernia is midline along the linea alba. ------------ Correct Answer ------- ventral
A _____hernia is at or below the junction between the vertical semilunar line and lateral to the rectus abdominus muscle. ------------ Correct Answer ------- spigelian
What are the three most common causes of subarachnoid hemorrhage? ------------ Correct Answer ------- 1 - trauma
- - ruptured berry aneurysms
- - AVM - arteriovenous malformations
A ______is a secular outpouching of vessels in the circle of willis, usually at bifurcations). ------------ Correct Answer ------- berry aneurysm
A _____is a congenital abnormality of the vasculature with connections between arterial and venous circulations without interposed capillary network. ------------ Correct Answer - ------ AVM - arteriovenous malformations
How does a patient with a SAH present? ------------ Correct Answer ------- "worst headache of my life" -- positive Kernig and Brudzinski sign
What is the difference between nuchal rigidity, Kernig's, and Brudzinski's signs? ---------- -- Correct Answer ------- nuchal rigidity - neck stiffness when bending neck forward Kernig's - inability to straighten the leg when the hip is flexed at a 90 degree angle Brudzinski's - when the examiner flexes the patient's neck, knees, and hips at the same time
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What is part of the work-up of SAH? ------------ Correct Answer ------- CT scan and arteriogram (to look for aneurysms or AVMs)
The most common cause of morbidity and mortality with a SAH is _____. ------------ Correct Answer ------- vasospasm -- other complications are brain edema (increased ICP) and rebleeding
What is the treatment for SAH? ------------ Correct Answer ------- --Nimodipine CCB for vasospasm --surgical metal clipping for aneurysm (alternative is balloon occlusion or coil embolization)
--AVM: pre op embolization -- for surgically inaccessible lesions, radiosurgery
A ______is bleeding into the brain parenchyma. Prognosis poor. Dx w CT. ------------ Correct Answer ------- intracerebral hemorrhage
These are _____indications for intracerebral hemorrhage are CNIII palsy (oculomotor nerve) and progressive alteration of consciousness. 2/3 present with coma, lateral gaze preference, aphasia, homonymous hemianopsia. ------------ Correct Answer ------- surgical
______is blood collection under the dura. Caused by tearing of "bridging" veins that pass through the space between. The cortical surface and the dural venous sinuses or injury to the brain surface with resultant bleeding from cortical vessels. ------------ Correct Answer ------- Subdural hemorrhage
What are the CT finding of a subdural hemorrhage? Treatment? ------------ Correct Answer ------- CT findings = curved, crescent shaped hematoma (sUbdural = cUrved) Treatment = reduce mass effect usually by craniotomy with clot evacuation
A ________is a collection of blood between the skull and dura. Usually in association with skull fracture as bone fragments lacerate meningeal arteries. What artery is most commonly affected? ------------ Correct Answer ------- epidural hematoma; middle meningeal artery
What are the CT findings with epidural hematoma? ------------ Correct Answer ------- lenticular or LENS shaped hematoma (Epidural = lEnticular)
What are the s/s of basilar skull fracture? ------------ Correct Answer ------- raccoon eyes and battle's sign, hemotypanum, CSF rhinorrhea/otorrhea
What are the surgical indications for brain tumors? ------------ Correct Answer ------- establishing a tissue diagnosis, relief of increased ICP, relief of neurologic dysfunction caused by tissue compression, attempt to cure in the setting of localized tumor
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What is the #1 and #2 most common intracranial tumor in adults? ------------ Correct Answer ------- #1 - glioblastoma ("Greatest Brain Tumor Malignancy") #2 - meningiomas
Some risk factors of _______are radiation exposure, neurofibromatosis 2, and female sex. ------------ Correct Answer ------- meningiomas
What are the most common brain tumors in children? ------------ Correct Answer ------- medulloblastomas, astrocytomas, ependymonomas
Cerebellar astrocytomas - peak age between 5 & 9 years old. In 75% of cases, they are completely _____. ------------ Correct Answer ------- resectable
Medulloblastoma - peak age 3-7 yo. ------------ Correct Answer ------- Most common location is cerebellar vermis in children
With pituitary tumors, the most common is a ____. The most common presentation is bitemporal hemianopsia (lateral visual fields blind). Medical tx = bromocriptine. Surgical tx = transsphenoidal resection. ------------ Correct Answer ------- prolactinoma
Explain the Glasgow Coma Score. ------------ Correct Answer ------- *Eyes* 4 - opens spontaneously 3 - opens to voice 2 - opens to pain 1 - none
*Verbal* 5 - normal conversation 4 - disoriented conversation 3 - words, incoherent 2 - incomprehensible sounds 1 - none
*Motor *6 - normal 5 - localizes to pain 4 - withdraws from pain 3 - decorticate posturing
- - decerebrate posturing 1 - none
Most edema (causes - CHF, meds, pregnancy, cirrhosis, kidney dz, lymphatic deficiency, lower extremity vein injury or weakness) is treatment with _____. Home remedies are elevation, movement, massage etc. ------------ Correct Answer ------- diuretics
Causes of orthostatic hypotension ------------ Correct Answer ------- dehydration, heart conditions, endocrine (addisons disease, hypoglycemia, DM), nervous system disorders (Parkinsons, multiple system atrophy, Lewy body dementia, pure autonomic failure, amyloidosis), meds (diuretics, alpha blockers, beta blockers, CCB, ACE inhibitors, nitrates)
What is the treatment for urinary retention? ------------ Correct Answer ------- foley catheter
Dysuria: Pain starting at the start of urination may indicate ____pathology, whereas pain occurring at the end of micturition is usually of _____origin. ------------ Correct Answer --- ---- urethral; bladder origin 3 / 4
_______is more than 2x/night of voiding. ------------ Correct Answer ------- Nocturia
Urinary frequency during the day wo nocturia is usually related to _______. Nocturia without frequency may occur in ____ patient in whom intravascular volume and urine output increase when supine. Also, renal concentrating ability decreases with age; therefore urine production in the geriatric patient ________. ------------ Correct Answer -- ----- anxiety; CHF; increases at night
GU pain is usually associated with either ____or____. ------------ Correct Answer ------- urinary tract obstruction or inflammation
The source of GU pain: inflammation is most severe when it involves the _____of a GU organ. Do tumors in the GU tract cause pain? ------------ Correct Answer ------- parenchyma (inflammation of hollow organs produces discomfort); usually not painful unless they produce obstruction -- also a late manifestation
_____pain is caused by acute distention of the capsule and located on the back and can radiate across the flank anteriorly. Pain is steady. Obstruction fluctuates in intensity.------------ Correct Answer ------- Renal
______pain is acute and secondary to obstruction. Can be located around McBurney's point or lower vesicle irritability including frequency, urgency, and suprapubic discomfort. ------------ Correct Answer ------- Ureteral
______pain is produced either by overdistention of the bladder as a result of acute urinary retention or by inflammation. Inflammatory conditions usually produce intermittent pain. ------------ Correct Answer ------- Vesicle
_______pain is usually secondary to inflammation with secondary edema and distention of the prostatic capsule. Pain is poorly localized -- frequency associated with irritative sx such as frequency, dysuria, and in prostatic edema ------------ Correct Answer ------- Prostatic
______pain primarily arises from w/in the scrotum and is usually secondary to acute epididymitis, torsion, or testicular appendices. ------------ Correct Answer ------- Testicular
________is usually related to noninflammatory conditions such as a hydrocele, varicocele, and pain is characterized as dull, heavy sensation in testes that does not radiate. ------------ Correct Answer ------- Chronic scrotal pain
____pain is acute, scrotum is red and warm to touch. Relief with elevation of the testis of the appropriate side. ------------ Correct Answer ------- Epididymal
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