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Surgery final

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Kartei Details

Karten	30
Lernende	31
Sprache	English
Kategorie	Medizin
Stufe	Universität
Erstellt / Aktualisiert	15.01.2021 / 06.06.2022
Lizenzierung	Keine Angabe
Weblink	https://card2brain.ch/box/20210115_urology_21
Einbinden	<iframe src="https://card2brain.ch/box/20210115_urology_21/embed" width="780" height="150" scrolling="no" frameborder="0"></iframe>

Flip-Modus

A 35 years old patient has been admitted to the surgery department with the diagnosis of acute pancreatitis secondary to chronic alcohol abuse. The patient complains of vomiting and epigastric pain. Imaging tests have confirmed edematous type of pancreatitis and ruled out bile duct stones or pathological fluid collections in the area. The signs of cholangitis are absent, and CRP low. What is the recommended management?

2020/21

a) 24 hrs hospital observation and then discharge home

b) Conservative treatment until the symptoms and signs subside, and lab parameters get back to normal

c) Laparoscopic cholecystectomy

d) ERCP or MRCP

e) Emergency laparotomy and peritoneal drainage

A 40 years old patients came to the Emergency Department complaining of a colicky right hypochondrial pain, radiating to the right scapula. The pain started two days ago. The patient reports vomiting and fever up to 40 degrees Celsius. On physical exam the right hypochondrial area is tender to touch. Lab tests reveal bilirubin level 4.5 mg/dl. The symptoms and signs mentioned above are typical for:

2020/21

a) Tumor of the papilla of Vater

b) Acute cholecystitis

c) Perforation of the gastrointestinal tract

d) Cholangitis

e) Complicated peptic ulcer

We describe Leriche’s syndrome as concomitant arterial occlusion of:

2020/21

a) Both common arteries

b) Both renal arteries

c) Both mesenteric arteries (upper and lower)

d) End segment of the abdominal aorta or both common iliac arteries

e) Both femoral arteries

Early gastric cancer is:

2020/21

a) A malignant tumor of the stomach involving deeper than the submucosa, but not transgressing the outer surface of the stomach wall

b) A malignant tumor of the stomach without distant organ metastases

c) A malignant tumor of the stomach diagnosed in a patient younger than 50 years old

d) A malignant tumor of the stomach, T1-2 according to TNM

e) A malignant tumor if the stomach involving only the mucosa or mucosa and submucosa, but not infiltrating the muscular layer

Incidentaloma means:

2020/21

a) Pheochromocytoma of an adrenal gland

b) Addison’s disease

c) Pancreatic insuloma

d) A common type of thyroid carcinoma

e) A tumor of an adrenal gland found incidentally on imaging tests

Liver metastases are the most common in the malignancy of:

2020/21

a) Central nervous system

b) Thyroid gland

c) Large intestine

d) Ovary

e) Testicles

A 65 year old female patient has been admitted to the Emergency Department following an incident of syncope. On admission she confessed to general weakness, increased heart rate and worse tolerance of exercise, lasting several weeks. Her husband added she had been rather pale for a few days. The patient said that for several months she had no appetite and occasionally felt abdominal pain, mostly in the right lower quadrant. She negated seeing any signs of gastrointestinal bleeding. On physical exam the abdomen is soft, painless, with no peritoneal signs and no palpable masses. Per rectum: normal stool. In lab tests HGB 4,0 g/dl and iron deficiency. The patient was admitted to the Internal Department and after blood transfusion her condition improved. Does she need any further diagnostics?

2020/21

a) No, because anemia was caused by iron deficiency in diet; the patient should be discharged home with prescription for iron supplementation

b) Yes, first of all a colonoscopy is indicated, because the symptoms and signs may indicate a malignant tumor of the cecum

c) Yes, first of all a gynecology examination is necessary, because the right lower quadrant pain may suggest a ruptured ovarian cyst

d) Yes, further tests of iron metabolism are necessary

e) Yes, first of all a bone marrow biopsy should be taken, as this could be myelodysplastic syndrome

A 75 years old patient with a history of chronic atrial fibrillation complains of a sudden onset pain of the right lower limb. On physical exam, pallor and cooling of the right leg is found, along with an absent pulse over the right popliteal artery. The correct management is:

2020/21

a) Diagnosis of acute lower limb ischemia, IV infusion of unfractionated heparin, and emergency revascularization surgery

b) Suspected diagnosis of acute lower limb ischemia and angio-CT to confirm the diagnosis

c) These symptoms and signs are typical for severe chromic lower limb ischemia, and the patient should be directed to a specialized outpatient angiology clinic

d) Diagnosis of lower limb ischemia, attempt at conservative treatment with unfractionated heparin for 12 hrs, and if ineffective – revascularization surgery

e) Emergency amputation of the right lower limb