Endoscopy
Most common site of perforation during a colonoscopy
Rectosigmoid colon
Branches off the aortic arch
Brachiocephalic Trunk (R common carotid, R subclavian)
Left common carotid
Left subclavian
At what age do you repair an asymptomatic umbilical hernia in a toddler?
5 years
Which hormone is the most sensitive indicator of thyroid disease?
TSH
Definition of high output ileostomy
>1.5L/day
When doing a colonoscopy, what is the minimum recommended time of scope withdrawal?
6 minutes
What is the name of the disease that causes hip/buttock claudication, erectile dysfunction, and absent femoral pulses?
Leriche Syndrome
What is the size cut-off for mesh repair of a ventral hernia vs primary repair?
2 cm
Describe TIRADS 3
Mildly suspicious (FNA >2.5 cm, follow ig 1.5-2.5 cm)
Most common cancer to metastasize to small bowel
Melanoma
If a sigmoid polyp was removed in one single piece and pathology returns with adenocarcinoma, does the patient require partial colectomy?
No, observation is an option.
Describe May-Thurner Syndrome
Left iliac vein compression by right iliac artery causign pain, swelling, DVT
Borders of the ingiunal canal
Anterior: external oblique aponeurosis
Posteriorly: transversalis fascia
Superiorly: internal oblique and transversus abdominis muscles
Inferiorly: Inguinal Ligament
The course that the right recurrent laryngeal nerve runs (different from left)
loops around the subclavian artery
Left - loops around aorta
Meckel's diverticulum rules of 2s (3/5)
2% of the population
2 inches long
2 feet of IC valve
Often presents before age 2
2 types of ectopic tissue
What is a technique used to remove a large sessile polyp?
submucosal injection
Which nerve crosses distal to the carotid bifurcation?
Hypoglossal nerve CN XII
What is the most common clinical presentation of an obturator hernia?
Obstruction (>80%)
Howship-Romberg sign (pain down the medial thigh with abduction, extension, or internal rotation of the knee) present in <50% of cases.
Most common nerve injured during thyroidectomy
Superior laryngeal
Surgical options for rectal prolapse
Altmeier (perineal rectosigmoidectomy)
Delorme
Rectopexy (often with resection)
Is EMR the recommended resection technique for an esophageal adenocarcinoma that invades the muscularis propria?
No (T2)
AV Fistula Rule of 6s
>600 ml/min flow
Vein diameter >6 mm
Vein depth <6mm
Where does an inferior lumbar hernia (Petit hernia) occur?
iliac crest (base), latissimus dorsi (medial), external oblique (lateral)
Indications for a total thyroidectomy if FNA is papillary carcinoma. (need 3)
- Known distant mets
- Extrathryoidal extension
- Lateral cervical LN mets or gross central neck LN mets
- Poorly differentiated and differentiated high grade
- Prior radiation exposure
- Bilateral nodularity
- >4 cm
60 year old female on chemotherapy ovarian cancer presenting with RLQ pain and CT imaging showing notable inflammation and a small amount of pneumatosis in the ileum and cecum. Clinically stable without any signs of obstruction.
Most likely diagnosis and management?
Typhlitis. Antibiotics, bowel rest, and serial exams.