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| [299157] 主题： General Surgery出科英文考题精选！ |
| 作者： parapara (值班医生) | ||
| 标题： General Surgery出科英文考题精选！ | ||
| 来自： 192.168.*.* | ||
| 发贴时间： 2004年10月30日 21:03:54 | ||
| 长度： 2981字 | ||
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这些题在研究生入学考试和中期考核中也经常会碰到，故和大家一起分享！
Questions How do you treat DCIS ? How do you treat an incidentally-found ovarian/adnexal mass ? How do you treat a tubo-ovarian abscess ? How does IABP (intra-aortic balloon pump) improve hemodynamics ? When is IABP contraindicated ? What syndrome includes a necrloytic migratory erythema? How do you confirm the diagnosis of carcinoid syndrome? What criteria meet "critical" aortic stenosis ? What criteria meet "critical" mitral stenosis ? What is the most common cause of a solid renal mass in an adult ? How do you treat an intra-caval renal cell cancer ? How do you treat a testicular mass ? What are the serum markers in testicular cancer ? What is the BIRADS Classification ? What is the first test for a palpable breast mass ? What is the most effective treatment for an aspiration episode ? How do you treat clear, serous discharge from a single duct in the female breast ? What is the most common palpable breast mass in a pregnant female ? What is the operative approach to a thoracic duct leak? What causes most bloody nipple discharge ? What chromosome is responsible for Gardner's syndrome? What are the "Amsterdam Criteria" ? When do you see a bird's beak esophagus ? What is the most common cause of lower GI bleeding ? What is the most common cause of Massive lower GI bleeding ? What is the most common cause of Massive lower GI bleeding in patients > age 70 ? How do you treat an infected urachal cyst ? What level differentiates colon cancer from rectal cancer? How do you approach a BIRADS 0 classification ? What is a Stage III colon cancer ? When do you administer preoperative neoadjuvant therapy for esophageal cancer ? Where is iron absorbed ? What is the most common cause of Portal HTN in the United States ? What is the Budd-Chiari Syndrome ? What is the best way to prevent a first bleed in a portal HTN patient ? What is the preferred treatment of Ascites ? What is the preferred treatment for Grave's Disease ? How do you treat a 3 cm. Appendiceal Carcinoid ? What are the two main risk factors for Papillary Thyroid CA? How does follicular thyroid cancer spread ? What do C-cells produce ? What is the origin of the Superior Thyroid Artery ? How do you treat a duodenal diverticulum ? What is the most common manifestation of the Carcinoid Syndrome ? What are 3 extra-colonic manifestations associated with Ulcerative Colitis ? What is the half-life of Parathyroid Hormone ? What is the best diagnostic screen for a "lost parathyroid" ? What is the most common cause of a "cushing's picture"? What is the most common cause of primary hyperparathyroidism ? How do you treat a 100 % occlusion of the internal carotid artery ? -- ※作者已于 2004-10-30 22:44:32 修改本文※ |
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| 作者： parapara (值班医生) | ||
| 标题： Re: General Surgery出科英文考题精选！ | ||
| 来自： 192.168.*.* | ||
| 发贴时间： 2004年10月30日 21:21:04 | ||
| 长度： 4291字 | ||
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标准答案：
1. DCIS: wide local excision to negative margins, followed by XRT to the ipsilateral breas t 2. The "Incidental Ovarian Mass" First, always perform the operation that you went there to perform Remember, you can always come back Then, describe fully what you see i.e. peritoneal studding, omental caking... never do a wedge biopsy of the mass or ovary never do a TAH-BSO, at the time of initial discovery Antibiotics, antibiotics, antibiotics.... 3. When you find a tubo-ovarian abscess, you are likely exploring for suspected appendici tis; perform the appendectomy and describe the relevant findings. Unless the ovary is nec rotic or gangrenous, do not proceed with resection (especially in the pre-menopausal fem ale). If the abscess progresses or begins to lead to septic complications, you can always g o back and resect. 4. 2 effects of IABP: a. Increases coronary blood flow b. decreases afterload 5. IABP is contraindicated in: a. Aortic regurgitation b. Lower limb ischemia 6. Glucagonoma 7. Carcinoid Diagnosis: Check Urinary 5-HIAA level** 8. Critical aortic stenosis: Area < 1 cm² P > 50 mmHg 9. Critical mitral stenosis: Area < 1.5 cm² P > 15 mmHg 10. Renal Cell CA 11. Resection; intracaval spread does not preclude a full and complete resection, i.e. a r adical nephrectomy without previous biosy. 12. A testicular mass is cancer till proven otherwise and should be treated with an inguina l orchiectomy. Do not violate the median raphe or perform a scrotal biopsy. 13. Serum markers in testicular cancer: AFP B-HCG LDH 14. BIRADS Classification: "0" - inadequate mammogram "I" - normal mammogram "II" - radiographic abnormality present, likely benign "III" - undetermined lesion, low suspicion for carcinoma "IV" - suspicious lesion present "V" - malignancy strongly suspected (i.e. a solid mass with calcifications) 15. FNA 16. Aggressive suctioning ― consider endotracheal intubation and formal bronchoscopy 17. Ductogram followed by complete ductal excision 18. Lactating adenoma 19. Right Thoracoctomy ― with ligation of the duct just above the diaphragm (VATS if avail able) 20. Papilloma 21. Chromosome 5q 22. Amsterdam Criteria: the Lynch Syndromes, 3 relatives, in 2 or more generations, where at least 1 is a first-degree relative 23. Achalasia 24. Colonic neoplasia 25. Diverticulosis 26. A-V Malformations 27. Antibiotics, followed by complete excision (including the associated cuff of bladde r) 28. 12 cm. from the dentate line ― above is condidered "colon" & below is "rectum" 29. You must repeat the mammogram, and may require cone-views 30. Duke's Colon Ca: A - Limited to the Bowel Wall B - Extension through the Bowel Wall with Negative Nodes C - Regional Node Metastasis Duke's Modification: C1 - Regional Node Metastasis C2 - Node Involvement at the Point of Vessel Ligation 31. Stage II or Stage III Esophageal CA 32. Duodenum 33. Alcoholic cirrhosis 34. Budd-Chiari Syndrome: hepatic vein thrombosis leading to post-sinusoidal portal hy pertension 35. Beta-blockade is the only proven method to prevent a FIRST bleed 36. Medical management: fluid & salt restriction spironolactone surgery carries a minimal role in the direct treatment of ascites 37. I Ablation, followed by supplemental replacement 38. Right hemicolectomy with ileocolic anastamosis, and remember to take the regional no des. 39. Risk Factors ― Papillary CA: Childhood exposure to Radiation Positive family history 40. Follicular cancer does not spread through the lymphatics; it spreads hematogenously to bone and lung 41. Calcitonin 42. The external carotid artery 43. Resect the diverticulum 44. Diarrhea 45. Erythema nodosum, erythema multiforme, & pyoderma gangrensum (just to name a few ) 46. 8 minutes, this is why on-table PTH levels are helpful in parathyroid surgery 47. Sestamibi scan 48. Exogenous steroid use 49. A single adenoma 50. Observation ― you do not treat a 100 % occlusion. Place on ASA qd and follow the contrala teral carotid with surveillance duplex sreening -- ※作者已于 2004-10-30 22:45:20 修改本文※ |
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| 作者： parapara (值班医生) | ||
| 标题： Re: General Surgery出科英文考题精选！ | ||
| 来自： 192.168.*.* | ||
| 发贴时间： 2004年10月30日 22:43:55 | ||
| 长度： 2746字 | ||
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既然有人顶，那就继续：
Question: Which one carries a better prognosis, EDH or SDH ? When do you elevate table fractures of the skull ? (and why ?) What is the significance to 'sulfur granules'? What is the most common skin manifestation in HIV patients ? You're a surgeon ... name 2 spirochetes ? Which space-occupying lesion is the most common in HIV ? Does endoscopic banding work for gastric varices ? What is Grave's Disease ? How do you treat duodenal atresia ? How do you diagnose and treat malrotation ? When would you want to keep a PDA open ? What do you administer to close a PDA ? Will Positive Pressure Ventilation, by itself, increase or decrease CVP ? Where do you place a Greenfield filter for lower extremity DVT ? What level corresponds radiographically to the renal veins ? What are Ranson's Criteria at 48 hours ? What chromosome is responsible for MEN-II ? What is the primary effect of heparin ? What is the clinical significance of a negative D-dimer ? What is the normal SvO2 ? (and what PO2 does it correspond to ?) What are the three reasons for a marginal ulcer ? What is the most objective measure of a true compartment syndrome ? What are the three zones of the neck ? What is the maximal height you should raise the barium column when trying to reduce an intus sception ? What are the Class I antigens ? (and what cells are they found on ?) What is Milroy's Disease ? What does OKT3 target ? What is the usual maximal-preservation time in UW solution for the following organs: Kidn eys ?Pancreas ?Liver ?Heart / Lungs / Small Bowel? How do you repair ureteral transection ? How do you treat CMV ? What causes "dimpling" of the skin in breast cancer ? What is the breast bud ? How do you treat a Phylloides Tumor ? What is Cushing's Syndrome ? What is Paget's Disease of the breast ? What defines Stage I breast cancer ? What drug can be administered in an attempt to relieve a colonic pseudo-obstruction ? How do you treat a Type IV Gastric Ulcer ? Which form of Barret's esophagitis has malignant potential ? How do you treat a Stage II breast cancer ? How do you diagnose and treat inflammatory breast cancer? What causes early-dumping ? (how do you treat it ?) What causes late-dumping ? (how do you treat it ?) What is the Nigro Protocol ? How do you treat an anal melanoma ? How do you treat a chronic anal fissure ? How do you calculate the RQ ? When do you proceed with a lymph node dissection, in melanoma ? How do you treat a melanoma on the anterior face ? How do you treat a melanoma on the scalp or ear ? |
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| 作者： parapara (值班医生) | ||
| 标题： Re: General Surgery出科英文考题精选！ | ||
| 来自： 192.168.*.* | ||
| 发贴时间： 2004年10月30日 22:50:54 | ||
| 长度： 6018字 | ||
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标准答案：
1 EDH ― there is less underlying parenchymal injury than seen in SDH 2 When the depression is greater than 5 mm (some say 1 cm, or more than one full-thickness wid th) ― this decreases the risk of seizures 3 Actinomycosis ― remember, this is a bacterial infection (treat with high-dose PCN) 4 Molluscum contagiosum 5 2 spirochetes: Borrelia (Lyme disease, relapsing fever) ― Tx with ceftriaxoneTreponema (Syphilis) ― Tx with PCN 6 Toxoplasmosis 7 No, banding only works for esophageal varices. With gastric varices, and true portal hyp ertension, you will likely require TIPS 8 Hyperthyroidism due to the formation of an autoimmune antibody directed against the TSH receptor; treatment of choice is radioactive ablation (I 131) 9 Duodenal atresia: side-to-side duodenoduodenostomy with a decompressive g-tube 10 Lower GI ― look for the cecum in the LUQ 11 Coarctation of the aorta; you keep the PDA open by administering prostaglandin 12 Indomethacin 13 Positive pressure increases CVP 14 Below the renal veins (if there is thrombosis of the filter, you do no want to occlude the r enals) 15 L2 16 Ranson's Criteria of severity: 17 Chromosome # 10 18 Stimulates Anti-thrombin III 19 A negative d-dimer effectively rules-out a pulmonary embolus 20 75 (40) 21 Incomplete vagotomy, incomplete antrectomy, Z-E Syndrome 22 Intracompartmental pressures > 30 mmHg (indication for urgent fasciotomy) 23 Zone I: from the clavicles to cricoidZone II: from cricoid to the mandibular angleZone I II: from the mandibular angle to the base of the skull 24 3 feet 25 A, B ― found on all nucleated cells 26 Milroy's: a chronic hereditary lymphedema with onset at or near birth (in a few patients it does not develop until after the age of 35, i.e. 'lymphedema tarda'). It is caused by a de velopmental abnormality of the lymphatics 27 The CD3 receptor 28 kidneys ― 48 hrs; pancreas ― 24 hrs; liver ― 12 hrs; heart, lung, small bowel ― 8 hrs 29 There are several ways to repair an accidental transection; the one I prefer is an interr upted, primary repair using 5-0 dacron sutures over a 6fr. Double-J silastic stent. The st ent is removed via cytsocopy 6 weeks after the repair. I always leave a drain behind (but som e do not). 30 Gancyclovir 31 Involvement of Cooper's Ligaments (not lymphatic invasion or "skin edema") 32 The breast bud is a normal, developmental structure seen at the onset of puberty. It shou ld never be biopsied ! 33 A Phyllodes tumor is an uncommon stromal lesion consisting of both epithelial and mesen chymal cells. The far majority (> 90 %) are completely benign and related to fibroadeno ma. Treatment is via wide local excision to negative margins and there is no role for axilla ry dissection or adjuvant therapy. 34 Cushing's Syndrome is the state of hypercortisolism. Unfortunately, the term has been used carelessly in the past which has led to confusion regarding the underlying disease p rocess. Primary Hypercortisolism (the real, "Cushing's syndrome", i.e. related to a pri mary disease within the adrenal gland), is seen with an adrenal tumor. Cushing's Disease is due to a central process (usually a pituitary tumor) which release an excess of ACTH and thus produces a Secondary Hypercortisolism.*** 35 Paget's disease of the breast is Invasive Ductal Carcinoma involving the nipple-areol a complex; a palpable mass may or may not be present. It is treated by Modified Radical Maste ctomy. 36 Stage I Breast Cancer: T1, No, Mo (a T1 lesion is less than 2 cm in total diameter). Treat wi th Breast-conserving therapy ! 37 Neostigmine 2 mg IV over 5 minutes with EKG monitoring pt must not have peritoneal signs o r a true volvulusover 90 % effective dose may be repeated in 3 hrs. if necessarymay cause sym ptomatic bradycardia in 20 % of pts. (treated with Atropine) 38 Treatment of a Type IV Gastric Ulcer: Excision. (maintaining the GE Junction is preferr ed if anatomically possible) 39 Intestinal Metaplasia 40 Treatment of a Stage II Breast CA: Breast-conserving therapy (i.e. lumpectomy, XRT, &a mp; sentinel-node biopsy). At present, little role of MRM. 41 Treatment of Inflammatory Breast CA: Biopsy the lesion. Rule out metastases with mammo graphy, bone scans and a CT scan of the chest, abdomen, brain (and axilla ?). Begin neoadjuv ant therapy with FAC/CAFV/CMF. After an initial course (4 ― 6 weeks), complete the mastec tomy and axillary dissection followed by radiation therapy and adjuvant chemotherapy. I f no response is obtained with chemotherapy initially, then proceed with radiation thera py. Proceed with mastectomy if possible after radiation therapy and follow with adjuvant chemotherapy. Overall prognosis is poor with a median survival of 31 months 42 Early dumping: Hyperosmolar Load 43 Late dumping: Inappropriate Insulin Response 44 The Nigro Protocol ― given for all biopsy-proven anal carcinoma (except melanoma) 5-FU, 1000 mg IV qd for the first 3 days of therapy200 rads external beam radiation, each day M ― F for 5 weeksLast 3 days of treatment, 5-FU, 1000 mg IV qdRe-examine the pt in 2 weeksIf n o visible tumor remaining, do a biopsy of the areaIf biopsy is negative, treatment is finis hed and pt undergoes close follow-upIf biopsy is positive, Give 1000 Rads of radiation for a total of 6,000 then re-biopsyIf gross tumor remains after the 5000 Rads, then APRIf ther e is clinically-positive nodes, then perform a superficial groin dissection (you should never irradiate a groin) 45 Wide local excision 46 Botox injection 47 RQ = CO2 Produced / O2 Consumed 48 When the melanoma is "Intermediate Thickness", 1 ― 4 mm 49 Anterior face Melanoma: Wide local excision with Superficial Parotidectomy and Modif ied Radical Neck Dissection 50 Wide Local Excision (may require plastic reconstruction after excision) -- ※作者已于 2004-10-30 23:05:12 修改本文※ |
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| 作者： parapara (值班医生) | ||
| 标题： Re: General Surgery出科英文考题精选！ | ||
| 来自： 192.168.*.* | ||
| 发贴时间： 2004年10月30日 22:57:31 | ||
| 长度： 2855字 | ||
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呵呵！再来！
Question: What is the most common primary liver tumor? How do you calculate: MAP?CO?SVR? How do you treat a GSW to the rectum? Where does the aorta perforate in a "jumper" that hits 'feet-first'? Why would a young, healthy woman present to the ED with sudden-onset hypotension? What will improve the appetite in HIV patients or in chronic-cancer patients? How do you treat an elevated bleeding time? How do you treat Mobitz-type II? How do you treat peaked T waves? What three things do you need to have 'ARDS'? What is the first clinical sign of hypermagnesemia? What is the most common cause of hypoxemia in a surgical patient? How do you manage "follicular hyperplasic" on a thyroid FNA? What can a posterior dislocation of the clavicle cause? (how do you treat it?) What level is the tracheal bifurcation at? What is the pulmonary ligament? Which intercostal space is the widest? In cancer, when do you see an "onion-skin appearance"? In cancer, when do you see a "sunbusrt-appearance"? How do you calculate an Anion Gap? What causes a normal-AG acidosis? What is the best operation to perform for secondary hyperparathyroidism? What is phlegmasia alba dolens? What is the clinical half-life: Albumin? Transferrin? Prealbumin? Retinol Binding Prot ein? What is Mondor's Disease? What is the meaning of an RQ of 0.7? How do you treat "Gallbladder Ca" found by the pathologist following a lap chole? What is the significance of UUN? What is the mortality rate of an aspiration episode? What is the most common nosocomial infection? What are the Vitamin K-dependent factors? Why does "purified-Factor VIII" not work for Von Willebrand's disease? How do you treat a low-grade MALT? What is a Zenker's Diverticulum? How do you treat a sigmoid volvulus? When do you see "Reed-Sternberg Cells"? Which anal cancers are related to human papilloma virus? How do you diagnose a pheochromocytoma? How do you treat an acute, severe bleeding episode in a patient with known ITP? What is the most common location for an accessory spleen? What other conditions should you consider in a patient with SBO? How do you treat a cystadenocarcinoma of the appendix? What valvular disease do you see in patients with the carcinoid syndrome? What is a Monteggia fracture? What is Phlegmasia alba dolens? How do you treat a 4 cm villous adenoma of the descending colon? What is the treatment for a benign-appearing gastric ulcer along the lesser curve? How do you treat a subclavian vein thrombosis secondary to central line placement? What are the two classic signs of arterial insuffiency? What is the most commonly-seen anatomy in popliteal artery syndrome? |
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| 作者： parapara (值班医生) | ||
| 标题： Re: General Surgery出科英文考题精选！ | ||
| 来自： 192.168.*.* | ||
| 发贴时间： 2004年10月30日 23:04:41 | ||
| 长度： 4133字 | ||
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标准答案：
1 Hemangioma 2 MAP = + DBP CO = HR x SV SVR = (MAP ― CVP / CO) x 80 dynes-cm ―5 3 Presacral drainage ("u"-incision), with a diverting colostomy 4 It tears at the aortic root, not at the ligamentum arteriosum ** also "common" in jumpers i s renal artery avulsion 5 EctopicBleeding hepatomaRuptured splenic artery aneurysm 6 Megace 7 DDAVP, 0.3 units/kg ― can be given twice in succession 8 Pacemaker 9 Peaked T waves = Hypercalcemia First, protect the myocardium: CalciumSecond, Third, Fo urth ― must decrease the total body calcium 10 ARDS ― 3 criteria: PaO2 / FiO2 < 200 Bilateral infiltrates on CXRNo evidence of CHF (P w < 18) 11 Loss of Deep Tendon Reflexes 12 V-Q Mismatch 13 Thyroid Lobectomy with Isthmusectomy; if frozen section or permanent histology revea ls true follicular carcinoma proceed with total thyroidectomy 14 Tracheal Compression with airway compromise; treated by surgical reduction 15 T4 16 The pulmonary ligament is a reflection of the visceral pleura 17 The 3rd intercostals space 18 "Onion-skin" = Ewing's Sarcoma 19 "Sunburst Appearance" = Osteogenic Sarcoma 20 AG = (Na+ + K+) ― (Cl- + HCO3-) 21 Normal AG Acidosis DiarrheaFistulasRenal Tubular Acidosis 22 Kidney Transplant 23 Phelgmasia alba dolens: a variant of ileofemoral thrombosis characterized by arteria l spasm and a pale, cool leg with diminished pulses (treated via heparinization) 24 Half-Life: Albumin ― 18 days Transferrin ― 8 days Prealbumin ― 3 daysRetinol Binding Protein 12 hrs 25 Mondor's Disease: a localized thrombophlebitis of the anterolateral chest wall 26 RQ = 0.7; this means that fats are being utilized as the primary fuel source 27 Gallbladder Ca on the path report: reoperation for wedge resection of the liver bed plus regional lymhadenectomy 28 UUN ― urine urea nitrogen, a guide to nitrogen balanceUUN = N2 Intake ― N2 Ouput UUN = (G p rotein / 6.25) ― (UUN + 4) 29 Mortality approaches 50% 30 UTI 31 II, VII, IX, and X 32 "Purified Factor VIII" does not contain VonWillebrand's Factor ― which is the defienc y in Von Willebrand's disease 33 Treat the associated H. pylori ! 34 Zenker's Diverticulum: a paryngoesophageal pulsion diverticulum that arises in the p osterior midline of the neck ― just above the cricopharyngeus muscle and below the inferi or constrictor (surgical therapy is the treatment of choice ― excision with myotomy of th e cricopharyngeal muscle) 35 Sigmoid Volvulus: colonoscopic decompression** 36 Reed-Sternberg Cells = "owl-eye cells" = Hodgkin's lymphoma 37 All anal cancers are associated with Human Papilloma Virus 38 Pheo = Urinary Metanephrines 39 Gamma-globulin 40 Splenic hilum 41 Small Bowel Obstruction: (after adhesions from previous surgery) Hernias Crohn's dis ease Carcinoid 42 Right hemicolectomy, and consider taking out both ovaries (especially in a post-menop ausal female; they are more likely to develop ovarian cancer) 43 Tricuspid Insuffiency 44 The "night-stick fracture": a common story is that of a burglar being hit by a police nigh t-stick; the burglar brings his arm up to protect his face and sustains an ulnar fracture ― commonly associated with a dislocated radial head. Must get a lateral elbow film to rule- this out 45 Phlegmasia alba dolens: 46 Segmental colectomy with primary reanastamosis* 47 Treatment of a gastric ulcer: all gastric ulcers should get brushings & biopsied • Medical Management: Anti-secretory Agent (Proton Pump Inhibitor) Antibio tics against H. pylori D/C all Nsaid's & Cox II inhibitors • Indications for Surgery: Biopsy positive or suspicious for malignancyLarg e ulcer (especially if it is located along the greater curve) Failure to heal with medical m anagement after 3 months 48 Remove the central line and heparinize the pt. 49 Elevation pallor & Dependent rubor 50 The most commonly seen abnormality leading to popliteal entrapment is a artery that run s medial to the medial head of the gastrocnemius** |
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