questions 2025-2026 most recent version
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90% of bile is reabsorbed daily. Through which circulation and what means? -
CORRECT ANSWER: Enterohepatic circulation
Active resorption: of conjugated bile in terminal ileum (45%)
Passive resorption of non-conjugated bile in SB (40%)/colon (5%)
Abnormal fallopian tube at appendectomy - what do? - CORRECT ANSWER:
appendectomy, leave tube alone
acid-base disturbance seen in treatment with sulfamylon (mafenide sodium) -
CORRECT ANSWER: hyperchloremic metabolic acidosis due to carbonic anhdrase
inhibition, leads to decreased renal conversion of bicarb to water and Co2, ultimately
leading to alkalinization of urine
Action of prostacyclin A2 - CORRECT ANSWER: inhibitor of platelet aggregation
adverse post op effect of colchicine - CORRECT ANSWER: inhibits wound contraction
adverse reaction seen in treatment of burns with silvadene - CORRECT ANSWER:
neutropenia and thrombocytopenia
anatomy of the foramen of winslow - CORRECT ANSWER: portal triad anterior (portal
vein posterior, CBD lateral, hepatic artery medial), IVC posterior, duodenum inferior,
liver superior
,Avoid cervical sympathectomy in pts with? - CORRECT ANSWER: scleroderma
Best way to Dx SB injury in awake trauma pt - CORRECT ANSWER: serial exams
Best way to predict risk of bleeding - CORRECT ANSWER: H&P
Biliary: lap chole injury to CBD - what characterizes minor injury and what is treatment?
- CORRECT ANSWER: recognized intra-op, repair primarily +/- stent
Biliary: what is needed normally for major CBD injury, and what is not needed? -
CORRECT ANSWER: need RNY hepaticojejunostomy, not hepatico or
choledochoduodenostomy (never feasible)
Biliary: what is treatment for gallbladder CA based on presentation (2 major options)? -
CORRECT ANSWER: If T1a (confined only to lamina propria) cholecystecotmy;
anything else, then skeletonize area, plus wedge segment 4/5 liver and regional nodes,
consider CBD if cystic duct involved
Biliary: what is treatment for types of choledochal cyst (1-5)? - CORRECT ANSWER: all
need resection with CCY / CBD removal, RNY hepaticojejunostomy, 4+5 need
hepatectomy vs. transplant if diffuse
Boundaries of femoral hernias - CORRECT ANSWER: cooper's ligament, inguinal
ligament, femoral vein. hernia passes under inguinal ligament, bulge in anteromedial
thigh, reduce through inguinal ligament division, repair with McVay or Bassini repair.
Breast: for atypical ductal hyperplasia; atypical lobular hyperplasia; LCIS, how are these
characterized and what treatment should be considered? - CORRECT ANSWER:
benign proliferative dz. Incr risk of CA.
Need to resect - don't need (-) margins
,Can give hormone therapy
- pre-meno: tamoxifen
- post-meno: raloxifene
Bilateral total mastectomy (no ALND)
Breast: LCIS -- what % have synchronous cancer? - CORRECT ANSWER: 5%
Breast: LCIS -- what is treatment (4 possibility, 2 things not needed ever)? - CORRECT
ANSWER: 1) Need to resect the lesion but do not need neg margins
2) nothing and careful F/U
3) Hormonal therapy
-(pre-meno: tamoxifen; Post-meno: raloxifene)
4) bilateral subcutaneous mastectomy (no ALND)
Breast: LCIS -- who primarily gets this, what is most important characteristic, what %
get cancer, where, and what type? - CORRECT ANSWER: - pre-menopausal
- NOT premalignant itself
- 30% lifetime risk
70% ductal CA
Breast: what are 3 chemo agents used for breast CA typically? - CORRECT ANSWER:
1) adriamycin; 2) cyclophosphamide; 3) taxol
Breast: What are contraindications to BCT (lumpectomy) in stage I breast cancer (and
what specifically is not)? - CORRECT ANSWER: 1) prior irradiation;
2) pos margins;
3) inflammatory;
4) pregnancy (unless 3rd trimester)
, Breast: what are the axillary node levels (1-3, and one more category)? - CORRECT
ANSWER: 1 - lateral to pec minor;
2 - beneath pec minor;
3 - medial to pec minor;
Rotter's Nodes - between pec major and pec minor
Breast: What are the benign proliferative breast lesions that have increased risk of CA?
(3)
Tx? - CORRECT ANSWER: - LCIS
- Atypical ductal hyperplasia
- atypical lobular hyperplasia
Tx: resect the lesion w/ (-) margins
Breast: what do you do if you can't find radiotracer dye in SNLB? - CORRECT
ANSWER: have to do formal ALND
Breast: what is main SE of adriamycin (doxorubacin)? - CORRECT ANSWER:
cardiomyopathy
Breast: what is main SE of taxol? - CORRECT ANSWER: taxol - neuropathy
Breast: what is not needed for patient with negative SLNB? - CORRECT ANSWER:
ALND -- just do BCT or mastectomy depending on tumor is fine
Breast: What is presentation, treatment, prognosis for intraductal papilloma? -
CORRECT ANSWER: presents with bleeding/bloody nipple discharge (most common
cause), usually benign, biopsy/resect via major duct excision