What anatomical structure delimits the junction between the head and the pancreatic isthmus?
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The hooked process.
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What anatomical structure delimits the junction between the head and the pancreatic isthmus?
The hooked process.
What is a false statement regarding primary varicose veins?
They do not cause edema.
What are the inferior pancreaticoduodenal arteries branches of?
Gastroduodenal arteries.
What is a false statement about the ankle-brachial index (ABI)?
ABI > 0.9 is abnormal.
Which pancreatic enzyme is secreted in its active form?
Amylase.
Which of the following is a malignant pancreatic tumor?
a) Mucinous Cystadenocarcinoma, e) Adenocarcinoma.
What is a false statement regarding surgical treatment in peripheral arterial disease?
Aortobifemoral bypass does not require prosthetic grafting.
Which factor is NOT associated with the etiopathogenesis of acute pancreatitis?
Lupus erythematosus.
What percentage of pancreatic cancers are adenocarcinomas?
Over 90%.
What is a false statement about infrainguinal occlusive disease?
Anastomosis on the distal popliteal artery is done only with a synthetic graft.
What investigation is useful for uncertain diagnosis of acute pancreatitis?
Abdominal computed tomography with contrast substance.
What is a false statement regarding venous anatomy?
The peripheral venous system includes the inferior vena cava.
What is the most common mutation involved in pancreatic cancer?
K-ras oncogenes.
What are some etiological factors that can cause acute pancreatitis?
Gallstones, Alcohol, Hypercalcemia, Hyperuricemia.
What does the Courvoisier sign in pancreatic cancer consist of?
b) Palpable painless gall bladder.
What biological change is suggestive of obstructive jaundice?
a) Increased direct bilirubin, c) Increased alkaline phosphatase.
Which statement is true about computed tomography in pancreatic cancer?
a) Computed tomography is the best method of exploring the pancreas.
What are common clinical symptoms of peripheral arterial disease?
Resting pain, gangrene, muscle pain triggered by physical exertion, skin ulcers.
What defines the resectability of a pancreatic tumor?
b) Absence of remote dissemination, c) Absence of SMV, PV, vena cava invasion.
What is one of the most common conditions in adults?
Venous disease.
What is a characteristic of ischemic ulcers?
They have a pale or necrotic base and are intensely painful for diabetics.
What is the Cullen sign associated with?
Acute pancreatitis.
What are two representations of venous disease?
Varicose veins and post-thrombotic syndrome.
What imaging technique does not require a puncture for angioaccess in the femoral artery?
AngioCT.
What are common signs found during clinical examination in acute pancreatitis?
Pain in the upper abdominal floor with muscular defense, the wooden abdomen, fecal vomiting, and ileus adinamic.
What is the length of the esophageal sphincter in healthy individuals?
More than 2 cm.
How does the incidence of venous disease change with age?
It decreases with age.
What is a key component of medical treatment for peripheral arterial disease?
Smoking cessation, control of hypertension, antiplatelet administration, control of dyslipidemia.
What criteria determine the severity of acute pancreatitis?
Balthazar score grade D/E, occurrence of SIRS, outbreaks of pancreatic necrosis, acute peripancreatic fluid collections, and amylasemia over 3 times the normal values.
What type of bacteria is H. pylori?
Microaerophilic bacteria.
What is the acute form of venous disease?
Venous thrombosis.
What does endovascular treatment of peripheral arterial disease consist of?
Percutaneous transluminal angioplasty and allows subintimal recanalization.
Is preoperative drainage of the biliary system indicated for resectable pancreatic tumors?
No, it is not indicated.
What is a necessary medical treatment for acute pancreatitis?
Hydroelectrolytic balancing to maintain adequate tissue perfusion.
What is a key component of the medical treatment for gastric ulcers?
Discontinuation of potentially ulcerogenic agents.
What may venous disease develop into?
Ulcers.
Is curative intervention indicated in all cases of pancreatic cancer?
No, it is not indicated in all cases.
What is a requirement for endovascular treatment in peripheral arterial disease?
Administration of Clopidogrel and aspirin for at least 6 months.
What surgical interventions can be performed in acute pancreatitis?
Early cholecystectomy, ERCP with sphincterotomy, early interventions for pancreatic necrosis, external drainage of a communicating pseudocyst, and internal drainage of a mature pseudocyst.
What occurs in Mallory-Weiss syndrome?
Upper gastrointestinal bleeding through a linear rupture of the mucosa at the gastroesophageal junction.
What is the direction of blood flow in the venous system?
Unidirectional.
Is endovascular treatment indicated for asymptomatic patients?
Yes, it is also practiced in asymptomatic patients.
What must be corrected before any major intervention in pancreatic cancer treatment?
Coagulopathies.
How is infected pancreatic necrosis evidenced?
By CT examination.
Which infection is an important risk factor for gastric adenocarcinoma?
H. pylori infection.
What type of valves are found in the venous system?
Tricuspid valves.
What classification system is used to indicate endovascular treatment?
The TASC classification system.
What is the best surgical approach for cephalic tumors?
Cephalic duodenopancreatectomy.
What is the main etiological factor for chronic pancreatitis in women?
Gallstones.
What are the two distinct histological types of gastric adenocarcinoma?
Intestinal and diffuse.
What do perforating veins do?
Direct blood from the deep system to the superficial system.
What is a contraindication for endovascular treatment in peripheral arterial disease?
It is not performed in patients with severe claudication.
When is total pancreatectomy indicated?
In pancreatic tail tumors.
What does CT show in chronic pancreatitis?
Atrophy, inflammation, tumor masses, fluid collections or pseudocysts, dilation of pancreatic ducts, or calcifications.
Which type of gastric adenocarcinoma is associated with H. pylori infection?
Only the intestinal type.
What causes varicose veins over time?
Venous reflux.
What does cephalic duodenopancreatectomy involve resecting?
The distal portion of the common bile duct, duodenum, and pancreas.
What is a characteristic of diffuse type gastric adenocarcinoma?
It spreads hematogenously.
What is the main treatment for patients with chronic pancreatitis?
Surgery (drainage or resection procedures).
What is the prognosis of the intestinal type of gastric adenocarcinoma?
It is well differentiated and has a better prognosis.
What causes reflux in the venous system?
Incompetence of the valves.
What is the mortality rate of cephalic duodenopancreatectomy?
Over 5%.
How does diffuse type gastric adenocarcinoma disseminate?
By lymphatic invasion and local extension.
What is a perforated ulcer classified as?
A surgical emergency.
In which type of gastric adenocarcinoma do older patients typically present?
Diffuse type.
What are some causes of venous thrombosis?
Sepsis, pregnancy, malnutrition, oral contraceptives, and endothelial injury.
Can cephalic duodenopancreatectomy be performed laparoscopically?
Yes, it can be performed by laparoscopic or robotic approach.
What type of cells are found in diffuse type gastric adenocarcinoma?
Poorly differentiated cells in the ring with seals.
What must be done immediately when a perforated ulcer is diagnosed?
Surgery must be performed before any other medical treatment.
What does endarterectomy excise?
The endothelium with the stenotic plate and a portion of the middle.
Which anastomosis is most frequently affected by fistula after cephalic duodenopancreatectomy?
The pancreaticojejunal anastomosis.
Which blood group is associated with diffuse type gastric adenocarcinoma?
Blood group B.
What is searched during surgical exploration of a perforated ulcer?
The place of perforation.
Are postoperative complications common after cephalic duodenopancreatectomy?
No, they are rare.
In which age group does diffuse type gastric adenocarcinoma commonly occur?
Younger patients.
What does surgical treatment of a perforated ulcer often involve?
Performing a definitive operation to reduce gastric acidity.
In which artery is endarterectomy particularly useful?
The carotid artery.
What is true about plastic linitis?
Diffuse infiltrates the entire stomach.
What surgical technique is more common for treating perforated ulcers?
Ulcer suturing with omentoplasty.
Is endarterectomy commonly used in peripheral arterial disease (PAD) in the lower limbs?
Yes.
What is true about Type I gastric ulcers?
Type I gastric ulcers are the most rare lesions in frequency.
In rare cases, who may be treated non-surgically for perforated ulcers?
Young patients with a recent onset of symptoms.
What appearance may the stomach have in plastic linitis?
It may look like a rigid tube.
Can endarterectomy be part of hybrid procedures?
Yes.
Where do Type I gastric ulcers typically appear?
On the lesser curvature of the stomach.
What characterizes elderly patients who may be treated non-surgically for perforated ulcers?
They are clinically stable with multiple medical conditions and present relatively late.
What is the prognosis for patients with plastic linitis?
Patients have a poor prognosis.
Is endarterectomy widely used for aortoiliac disease?
Yes.
Which type of gastric ulcers are associated with duodenal ulcers?
Type II gastric ulcers.
What is included in the non-surgical treatment for perforated ulcers?
Installation of a nasogastric tube and volume resuscitation.
What does radical surgical resection for gastric adenocarcinoma involve?
Radical subtotal gastrectomy for distal lesions.
What is an indication for extraanatomical bypass?
Hostile abdomen.
Where do Type III gastric ulcers develop?
In the subcardial region.
What must be interrupted in non-surgical treatment of perforated ulcers?
Oral feeding.
What is required for proximal tumors during radical surgical resection?
Total gastrectomy.
What types of bypass are represented in extraanatomical bypass?
Axillofemoral or femurofemoral bypass.
What is associated with Type IV gastric ulcers?
Acid hypersecretion.
What often requires surgery in the case of non-surgical treatment for perforated ulcers?
Clinical improvement.
What is a common site for metastasis in gastrointestinal stromal tumors?
The liver.
What type of graft is used in extraanatomical bypass?
Venous graft.
What is the most frequent type of gastric carcinoma?
Ulcerated gastric carcinomas.
What endoscopic sign indicates an increased risk of relapse bleeding in complicated ulcers?
Active hemorrhage at the time of endoscopy.
What is a recommended treatment for uncomplicated duodenal ulcer?
Eradication of H. pylori infection.
Can extraanatomical bypass be performed in critically ill patients?
No, it cannot be performed.
What is the most frequent operation for Type IV gastric ulcers?
Extensive antrum excision (hemigastrectomy).
What is a concerning endoscopic finding in the ulcer crater?
A visible vessel.
What are the main manifestations of complicated peptic ulcer disease?
Perforation, hemorrhage, and gastric stenosis.
Does extraanatomical bypass have better patentability than aortofemoral bypass?
Yes.
Is vagotomy associated with antral excision contraindicated for Type II and III gastric ulcers?
Yes, it is contraindicated.
What location of the ulcer is associated with increased risk of relapse bleeding?
Antral location.
What is a cause of bypass occlusion?
Anastomotic neointimal hyperplasia.
Is complete total excision of the ulcer ever an option?
No, it is never an option.
What does fresh clot on the surface of the ulcer indicate?
Increased risk of relapse bleeding.
What can cause graft occlusion related to its placement?
Compressed graft in the tunnel.
What might Type I, II, and III gastric ulcers require?
Total or subtotal gastrectomy.
What does old clot on the surface of the ulcer indicate?
Increased risk of relapse bleeding.
What is an important aspect of postoperative follow-up in peripheral arterial disease?
Doppler ultrasound examination of the anastomosis.
What must be done with every resected specimen of gastric ulcer?
It must be sent for histopathological examination.
What is a possible intervention for stenosis after surgery?
Balloon angioplasty of stenoses.
In which patients does the Cushing ulcer appear?
In patients with severe burns, lesions of the central nervous system, critically ill patients, severe trauma, and multiple organ insufficiency syndrome.
What are immediate local complications in arterial bypass?
Graft infection.
What is true about hyperplastic polyps?
Hyperplastic polyps have a lower risk of malignant transformation.
When is amputation indicated in peripheral arterial disease?
In patients with gangrene without the possibility of revascularization.
Do adenomatous polyps suffer malignant transformation?
Yes, they can suffer malignant transformation.
What is important regarding the level of amputation?
It is set as the lowest but to ensure the healing of the abutment.
Are gastric polyps associated with poliposic syndromes?
No, they are not associated with poliposic syndromes.
What is a benefit of proximal amputation?
Better rehabilitation potential.
Why is maintaining the knee joint important in amputation?
It allows for moving with minimal energy consumption after prosthesis.
