SURGERY COMAT LATEST
EXAM
WHich narcotic has a lower risk of causing constipation? - ANSWERS-
Fentanyl
Causes of perirectal abscesses? - ANSWERS-obstruction and
subsequent infection of the anal glands
clinical presentation of perirectal abscess? - ANSWERS-perirectal pain,
swelling, and possibly discharge of blood, pus, and mucous (most
patients deny fever)
Treatment of anal fissure? - ANSWERS-stool softeners or topical
nitroglycerin
if the fissures are refractory to the treatment or recur then a partial
sphincterotomy can be considered
Proctitis? - ANSWERS-inflammation of the rectum, patients present
with rectal fullness, anal or rectal pain, diarrhea, and possible bleeding
Split thickness skin grafts (STSG) vs. Full thickness skin grafts (FTSG)
- ANSWERS-STSG are more versatile than full thickness skin grafts,
END OF
PAGE
1
, SURGERY COMAT LATEST
EXAM
and are used to reconstruct large burn wound areas and close donor flap
sites
What should be ensured prior to skin graft? - ANSWERS-the burn area
should be debrided and must be free of hematoma, exudate, or infection
What is the most commonly used wound dressing for fresh burn
wounds? - ANSWERS-Silver sulfadiazine
Gastroparesis - ANSWERS-One of the most common causes of
gastroparesis is diabetic autonomic neuropathy (leading to delayed
gastric emptying)
symptoms of gastroparesis? - ANSWERS-N/V, abdominal pain,
bloating, and anorexia or early satiety
diagnosis of gastroparesis? - ANSWERS-gastric emptying study
Treatment of gastroparesis? - ANSWERS-diet modifications, prokinetic
agents such as metoclopramide and erythromycin and antiemetics
END OF
PAGE
2
, SURGERY COMAT LATEST
EXAM
Chapman point for stomach peristalsis? - ANSWERS-6th intercostal
space on the left about one inch lateral to the sternoclavicular joint
corresponding posterior point is just lateral to the spinous process of the
6th vertebral body on the left
Adrenal chapman point? - ANSWERS-Anterior: 2-2.5 inches superior
and one inch lateral to the umbilicus
Posterior: located bt the spinous and transverse processes of T11-T12
Esophagus chapman points? - ANSWERS-Anterior: ICS bt ribs 2 and 3
close to the sternum
Posteriorly: middle of the transverse processes of T2
Liver chapman points? - ANSWERS-anterior: 5th and 6th ICS on the
mid-clavicular line on the right
END OF
PAGE
3
, SURGERY COMAT LATEST
EXAM
posterior: between the transverse and spinous processes or T5-7 on the
right
Small bowel chapman points? - ANSWERS-Anterior: 8th-10th ICS
close to the cartilage
Posterior: between transverse and spinout proceses T8-T11
Indications for surgical repair of splenic artery aneurysms? -
ANSWERS-symptomatic aneurysms (pain), occurrence during the child
bearing years, aneurysms >2cm in size
indications for AAA surgical repair? - ANSWERS->5.5cm in size, rapid
enlargement (>0.5 cm/6mo, or >1cm/1year)
diagnosis of hypersplenia post splenectomy? - ANSWERS-visualization
or Identified with Tecnectium-99 (tagged RBC) scan
Direct hernia etiology? - ANSWERS-Weakness in the conjoint tendon
which forms the posterior wall of the inguinal canal can lead to a direct
hernia
END OF
PAGE
4
EXAM
WHich narcotic has a lower risk of causing constipation? - ANSWERS-
Fentanyl
Causes of perirectal abscesses? - ANSWERS-obstruction and
subsequent infection of the anal glands
clinical presentation of perirectal abscess? - ANSWERS-perirectal pain,
swelling, and possibly discharge of blood, pus, and mucous (most
patients deny fever)
Treatment of anal fissure? - ANSWERS-stool softeners or topical
nitroglycerin
if the fissures are refractory to the treatment or recur then a partial
sphincterotomy can be considered
Proctitis? - ANSWERS-inflammation of the rectum, patients present
with rectal fullness, anal or rectal pain, diarrhea, and possible bleeding
Split thickness skin grafts (STSG) vs. Full thickness skin grafts (FTSG)
- ANSWERS-STSG are more versatile than full thickness skin grafts,
END OF
PAGE
1
, SURGERY COMAT LATEST
EXAM
and are used to reconstruct large burn wound areas and close donor flap
sites
What should be ensured prior to skin graft? - ANSWERS-the burn area
should be debrided and must be free of hematoma, exudate, or infection
What is the most commonly used wound dressing for fresh burn
wounds? - ANSWERS-Silver sulfadiazine
Gastroparesis - ANSWERS-One of the most common causes of
gastroparesis is diabetic autonomic neuropathy (leading to delayed
gastric emptying)
symptoms of gastroparesis? - ANSWERS-N/V, abdominal pain,
bloating, and anorexia or early satiety
diagnosis of gastroparesis? - ANSWERS-gastric emptying study
Treatment of gastroparesis? - ANSWERS-diet modifications, prokinetic
agents such as metoclopramide and erythromycin and antiemetics
END OF
PAGE
2
, SURGERY COMAT LATEST
EXAM
Chapman point for stomach peristalsis? - ANSWERS-6th intercostal
space on the left about one inch lateral to the sternoclavicular joint
corresponding posterior point is just lateral to the spinous process of the
6th vertebral body on the left
Adrenal chapman point? - ANSWERS-Anterior: 2-2.5 inches superior
and one inch lateral to the umbilicus
Posterior: located bt the spinous and transverse processes of T11-T12
Esophagus chapman points? - ANSWERS-Anterior: ICS bt ribs 2 and 3
close to the sternum
Posteriorly: middle of the transverse processes of T2
Liver chapman points? - ANSWERS-anterior: 5th and 6th ICS on the
mid-clavicular line on the right
END OF
PAGE
3
, SURGERY COMAT LATEST
EXAM
posterior: between the transverse and spinous processes or T5-7 on the
right
Small bowel chapman points? - ANSWERS-Anterior: 8th-10th ICS
close to the cartilage
Posterior: between transverse and spinout proceses T8-T11
Indications for surgical repair of splenic artery aneurysms? -
ANSWERS-symptomatic aneurysms (pain), occurrence during the child
bearing years, aneurysms >2cm in size
indications for AAA surgical repair? - ANSWERS->5.5cm in size, rapid
enlargement (>0.5 cm/6mo, or >1cm/1year)
diagnosis of hypersplenia post splenectomy? - ANSWERS-visualization
or Identified with Tecnectium-99 (tagged RBC) scan
Direct hernia etiology? - ANSWERS-Weakness in the conjoint tendon
which forms the posterior wall of the inguinal canal can lead to a direct
hernia
END OF
PAGE
4
