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Usmle Step 2 > 100 surgical vignettes - surgical recall > Flashcards

100 surgical vignettes - surgical recall Flashcards

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USMLE® Step 1 flashcards
1
Q

elderly female, SBO, and air in biliary tract

A

gallstone ileus

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2
Q

elderly female with pain down inner aspect of thigh

A

obturator hernia (Howship-Romberg sign)

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3
Q

abdominal pain, hypotension, and abdominal pulsatile mass

A

ruptured AAA

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4
Q

abdominal pain “ out of proportion’ to abdominal exam

A

mesenteric ischemia

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5
Q

arm pain and syncope with arm movement

A

subclavian steal syndrome

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6
Q

increasing creatinine on ACEi

A

Renal artery stenosis

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7
Q

child with MIDLINE neck mass

A

thyroglossal duct cyst

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8
Q

child with LATERAL neck mass

A

Branchial cleft cyst

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9
Q

crush injury and dark urine

A

myoglobinuria

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10
Q

emesis, chest pain radiating to back, and mediastinal air

A

Boerhaave’s

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11
Q

Lower GI bleed + technectium pertechnetate scan

A

Meckel’s diverticulum

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12
Q

Flushing, diarrhea, and right-sided heart failure

A

carcinoid

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13
Q

pneumaturia and LLQ pain

A

colovesical fistula

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14
Q

Desmoid tumor, osteoma, and colon cancer

A

Gardner’s syndrome

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15
Q

Epigastric pain radiating to back and flank ecchymosis

A

Hemorrhagic pancreatitis

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16
Q

pancreatitis and palpable epigastric mass

A

pancreatic pseudocyst

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17
Q

Liver abscess with “anchovy paste’

A

Amebic abscess

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18
Q

RUQ pain, travel, and exposure to sheep

A

Hydatid cyst

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19
Q

Caput medusae

A

portal HTN, cirrhosis

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20
Q

45yo F with RUQ pain for 12 hrs, fever and leukocytosis

A

acute cholecystitis

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21
Q

elderly male with large nontender palpable gallbladder

A

pancreatic cancer (Courvoisier’s sign)

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22
Q

Female taking birth control pills with liver mass

A

hepatic adenoma

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23
Q

liver tumor with “central scar”

A

focal nodular hyperplasia

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24
Q

pancreatic mass, gallstones, DM, diarrhea

A

somatostatinoma

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25
Q

RUQ bruit and CHF in young adult

A

liver hemangioma

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26
Q

excruciating pain with bowel movement

A

anal fissue

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27
Q

abdominal pain, diarrhea, and anal fistulae

A

Crohn’s disease

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28
Q

EKG with “peaked” T waves

A

Hyperkalemia

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29
Q

Buccal Mucosa with pigmentation

A

Peutz- Jeghers syndrome

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30
Q

LLQ pain, fever, and change in bowel habits

A

diverticulitis

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31
Q

elevated urine 5-HIAA

A

carcinoid

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32
Q

institutionalized, abdominal pain, vomiting, and distention, with proximal colonic dilation

A

sigmoid volvulus

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33
Q

Infant with projectile vomiting

A

pyloric stenosis

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34
Q

newborn with failure to pass meconium in first 24 hours

A

Hirschsprung’s disease

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35
Q

infant with bilious vomiting

A

malrotation

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36
Q

Newborn with abdominal defect and umbilical cord on sac

A

omphalocele

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37
Q

teenager with knee pain and ‘onion skinning’ on x-ray

A

Ewing’s sarcoma

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38
Q

pulmonary capillary wedge pressure <18, CXR with B/L pulmonary infiltrates and PaO2: FiO2 ratio <300

A

ARDS

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39
Q

Increased peak airway pressure, low urine output, and urinary bladder>25mmHg

A

abdominal compartment syndrome

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40
Q

Newborn with inability to “pass an NGT”

A

esophageal atresia

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41
Q

Traumatic blinding in one eye followed bby blindness in the contralateral eye 2 weeks later

A

Sympathetic ophthalmia

42
Q

miotic pupil, ptosis, and anhidrosis

A

Horner’s syndrome

43
Q

Traumatic head injury, conscious in ER followed by unconsciousness, tearing of middle meningeal artery/branches, does not cross suture lines

A

Epidural hematoma (lucid interval)

44
Q

“worst headache of my life”

A

subarachnoid hemorrhage

45
Q

head trauma, crescent like CT scan, tearing of bridging veins, crosses the suture lines

A

subdural hematoma

46
Q

hematuria, flank pain, and abdominal mass (palpable)

A

renal cell carcinoma

47
Q

60 yo white male with painless hematuria

A

bladder cancer

48
Q

RUQ pain, jaundice and fever

A

cholangitis

49
Q

epigastric pain radiating to back with N/V

A

pancreatitis

50
Q

“tearing” chest pain radiating to back

A

aortic dissection

51
Q

40 yo male with tachycardia/HTN and confusion on postoperative day #2

A

alcohol withdrawal

52
Q

pheochromocytomas, medullary thyroid cancer, Marfanoid body habitus, mucosal neuromas

A

MEN 2B

53
Q

psammoma bodies

A

papillary thyroid cancer, papillary serous sporadic cystadenocarcinoma of the ovary, mesothelioma, meningioma

54
Q

yellow sulfur granules, orofacial abscesses, abdominal abscess, possibly PID in women with IUD

A

Actinomyces

55
Q

Thyroid tumor with AMYLOID tissue

A

medullary thyroid cancer

56
Q

palpable neck tumor and hypercalcemia

A

parathyroid cancer

57
Q

HTN, diaphoresis (episodic) and palpitations

A

pheochromocytoma

58
Q

HTN, elevated liver enzymes, low-platelets, preeclampsia

A

HELLP syndrome

59
Q

jejunal ulcers

A

Zollinger-Ellison syndrome

60
Q

pituitary tumor, pancreatic tumor (gastrinoma), and parathyroid tumor

A

MEN-1

61
Q

necrotizing migratory erythema

A

Glucagonoma

62
Q

medullary thyroid cancer, pheochromocytoma and hyperparathyroidism

A

MEN-2A

63
Q

hypoklaemia refractory to IV potassium supplementation

A

Hypomagnesemia

64
Q

Necrotizing enterocolitis (NEC)

A

newborn with pneumatosis

65
Q

child with abdominal mass that CROSSES midline

A

Neuroblastoma

66
Q

Child <4 yo with abdominal tumor that does NOT cross midline

A

Wilm’s tumor

67
Q

“currant jelly” stools and abdominal colic

A

intussusception

68
Q

femur (long-bone) fracture, respiratory failure, petechiae, and mental status changes

A

fat embolism

69
Q

hearing loss, tinnitus, and vertigo

A

Meniere’s disease

70
Q

adolescent boy with nasal obstruction and recurrent epistaxis

A

juvenile nasopharyngeal angiofibroma

71
Q

child <5 yo sitting upright and drooling with “hot potato” voice, no HIB vax

A

epiglottitis

72
Q

angina, syncope, and CHF

A

aortic stenosis

73
Q

tobacco use, asbestos exposure, and pleuritic chest pain

A

mesothelioma

74
Q

supracondylar fracture and contracture of forearm flexors

A

Volkmann’s contracture

75
Q

tibia fracture, “pain out of proportion’, pain on passive foot movement, and palpable pulses

A

compartment syndrome

76
Q

25 yo male with liver mass with fibrous septae and no history of cirrhosis or hepatitis

A

fibrolamellar hepatocellular carcinoma

77
Q

EKG with flattening of T waves and U waves

A

hypokalemia

78
Q

Central pontine myelinolysis

A

too-rapid correction of hyponatremia

79
Q

polydipsia, polyuria, and constipation

A

Hypercalcemia

80
Q

Factor VIII deficiency

A

Hemophilia A

81
Q

Abdominal pain, fever, hypotension, HYPERkalemia, and HYPOnatremia

A

adrenal insufficiency (Addisonian crisis)

82
Q

massive urine output and HYPERnatremia

A

Diabetes insipidus

83
Q

increased urine osmolality, HYPOnatremia, and low serum osmolality

A

SIADH

84
Q

IV antibiotics, fever, diarrhea

A

C.diff pseudomembranous colitis

85
Q

bleeding gums and wound dehiscence

A

central line infection

86
Q

appendectomy followed by fever and abdominal pain on postoperative day #7

A

peritoneal abscess

87
Q

advancing crepitus, fever, and blood blisters

A

necrotizing fasciitis

88
Q

high Intraoperative fever

A

malignant hyperthermia

89
Q

confusion, ataxia, and ophthalmoplegia

A

Wernicke’s encephalopathy

90
Q

tracheal deviation, decreased breath sounds and hyperresonance

A

Tension pneumothorax

91
Q

Hypotension, decreased heart sounds, and JVD

A

pericardial tamponade

92
Q

Four ribs broken in two places and pulmonary contusion

A

flail chest

93
Q

Otorrhea (clear) and Battle’s sign

A

Basilar skull fracture

94
Q

Ulcer and decreased pain with food

A

Duodenal ulcer

95
Q

vomiting, retching, and epigastric pain

A

mallory-weiss tear

96
Q

Fever on post-operative day #1, with “bronze” weeping, tender wound

A

clostridial wound

97
Q

hematochezia and tenesmus

A

rectal cancer

98
Q

upper GI bleed, jaundice, and RUQ pain

A

hemobilia

99
Q

gallstones, epigastric pain radiating to back, and nausea

A

gallstone pancreatitis

100
Q

18 yo F with blood nipple discharge

A

ductal papilloma

101
Q

irritability, diaphoresis, weakness, tremulousness, and palpitations

A

Insulinoma

Usmle Step 2 (7 decks)

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