Surgical Instruments
Anatomy
Post Operative Complications
Medications
Miscellaneous
100
Name this instrument
What is senn retractor
100
This is the first branching vessel off of the external carotid artery
BONUS: (50 pts) The vessel runs with this nerve.
What is the superior thyroid artery?
BONUS: What is the external branch of the superior laryngeal nerve?
100
Low grade fever within 48 hours of surgery is most commonly due to this mechanism.
What is inflammatory cytokine release or atelectasis?
100
Empiric antimicrobial therapy for suspected necrotizing soft tissue infection must include these three components.
What is vancomycin plus Zosyn (or Carbapenem) plus clindamycin?
Broad gram-positive coverage, broad gram-negative/anaerobic coverage, and additional agent to inhibit toxin production
100
This phenomenon occurs when increased intra-abdominal pressure leads to decreased venous return, reduced renal perfusion, elevated airway pressures, and ultimately multi-organ dysfunction if untreated.
What is abdominal compartment syndrome?
200
Name this instrument
What is a curved mayo
200
The inferior thyroid vein drains into this vessel.
What is the innominate vein?
200
A chronically malnourished patient initially recovers after laparotomy but develops respiratory failure and arrythmias after nutrition is restarted.
Bonus: (100 pts) This is the underlying pathophysiology responsible for the electrolyte abnormalities.
What is refeeding syndrome?
Bonus: What is an insulin surge causing intracellular shift of phosphate, potassium, and magnesium during anabolic restart?
200
This medication is used in high-output enterocutaneous fistulas because it reduces this physiologic process.
What is octreotide decreasing gastrointestinal secretions (splanchnic flow)?
200
In severe acute pancreatitis, autodigestion is driven by premature intracellular activation of this enzyme, which then triggers a cascade activating other digestive zymogens.
What is trypsin?
300
Name this instrument
What is Lahey
300
The superior laryngeal nerve supplies this muscle.
Bonus: (100 pts) Injury to this nerve during surgery causes this.
What is the cricothyroid muscle?
Bonus: What is loss of projection and easy voice fatigability?
300
A patient on this chronic medication undergoing emergent laparotomy requires perioperative adjustment of this medication to avoid refractory hypotension.
What is corticosteroids?
300
This common colorectal cancer agent is notorious for causing cold-induced neuropathy.
Bonus: (100 pts) This is the mechanism of action.
What is oxaliplatin?
Bonus: What is platinum-induced DNA crosslinking causing inhibition of DNA replication?
300
Following massive small bowel resection, patients initally develop high-volume diarrhea and electrolyte wasting. This occurs not only from reduced absorptive surface area, but from the loss of this specific negative feedback hormone produced in the terminal ileum. It normally suppresses gastric acid hypersecretion.
Bonus: (100 pts) This is the initial management of this syndrome.
What is peptide YY?
Bonus: What is PPIs and H2 blockers in addition to fluid and nutritional support?
400
Name this instrument
What is a Finochietto retractor
400
These two vessels meet to form the portal vein.
What is the SMV and the splenic vein?
400
A patient on POD#2 after low anterior resection develops tachycardia, oliguria, and mild respiratory alkalosis but has a benign abdominal exam and normal CT scan.
What is evolving early anastomotic leak?
400
This monoclonal antibody must be held preoperatively because it dramatically increases the risk of anastomotic leak and wound dehiscence.
Bonus: (200 pts) This is the mechanism of action.
What is bevacizumab?
Bonus: What is inhibition of vascular endothelial growth factor (VEGF), preventing angiogenesis?
400
The underlying mechanism involves paradoxical thrombosis due to depletion of this natural anticoagulant.
What is acquired Protein C deficiency?
500
Name this instrument
What is a Balfour
500
This is the #1 hepatic artery variant.
Bonus: (200 pts) This is the vessel it branches off of and it runs like this in relation to the CBD.
What is the replaced right hepatic artery?
Bonus: What is the SMA? What is it courses behind the pancreas, posterolateral to the CBD?
500
Following major abdominal surgery, a sudden increase in serosanguinous drain output with a falling hemoglobin on POD#6 should prompt concern for this complication?
Bonus: (200 pts) What is the most appropriate initial diagnostic test in a hemodynamically stable patient?
What is delayed postoperative hemorrhage from intra-abdominal sepsis or pseudoaneurysm formation?
Bonus: What is CT angiography?
500
A patient with type 2 diabetes undergoes an uncomplicated colorectal resection. On POD#2 they develop tachypnea, mild anion-gap metabolic acidosis, normal lactate and only modest hyperglycemia (~160 mg/dL).
Bonus: (300pts) This is the class of the medication that should have been held preoperatively.
What is euglycemic diabetic ketoacidosis?
Bonus: What are SGLT2 inhibitors?
500
A patient with colorectal liver metastases treated with modern systemic therapy develops a bluish, congested liver with increased bleeding risk during resection due to this chemotherapy-associated liver injury pattern.
Bonus: (200 pts) This is the pathophysiology.
What is sinusoidal obstruction syndrome from oxaliplatin-based chemotherapy?
Bonus: What is endothelial injury to hepatic sinusoids leading to congestion and portal hypertension physiology?