Gastroenterology MOC Sample Questions

The correct answer is A. Partial nephrectomy

Explanation: Partial nephrectomy is a moderately invasive procedure performed by a surgeon under general anesthesia. It involves the resection of a portion of the kidney, typically leaving the adjacent adrenal tissue intact. Possible complications include bleeding, infection, and renal infarction if the renal vasculature is interrupted. Indications include a solitary, localized renal mass such as a renal cell carcinoma, patients with the need for nephrectomy but with only one functioning kidney, and patients with bilateral renal cell carcinoma.

Radical nephrectomy is an invasive procedure performed by a surgeon under general anesthesia. It involves the resection of the entire kidney and typically the adjacent adrenal tissue as well. Possible complications include bleeding, infection, and possibly endocrine issues due to the removal of the adrenal gland. Indications include a large renal mass, a solitary renal mass position in the center of the kidney, and invasion of a renal mass into the adjacent adrenal gland.

Coronary angioplasty is a minimally invasive procedure performed by an interventional cardiology under moderate sedation. The patient’s arterial system is entered via the groin, and a catheter is threaded cranially and into the coronary arteries, after which the affected artery is re-expanded with a balloon. Possible complications include infection, groin site hematoma, and cardiac arrhythmia.

Cystectomy is a relatively invasive surgical operation performed by a urologist under general anesthesia. It involves the resection of the urinary bladder, and often utilizes a segment of the small bowel to act as the urinary reserve. Possible complication include post-operative urinary leak, infection, and hematuria. Indications include locally advanced bladder cancers, transitional cell cancers with associated pelvic lymph node metastases, and any bladder cancer that involves the muscular layers of the bladder.

Septal myotomy is an invasive surgical procedure performed by cardiac surgeons under general anesthesia. The operation involves the surgical resection of portions of the interventricular septum which can block the flow of blood from the left ventricle into the thoracic aorta. Complications can include cardiac perforation and sepsis. Indications include patients with severe hypertrophic cardiomyopathy, certain congenital cardiac defects, and idiopathic left ventricular outflow obstruction.