12 FEB 2017 1708 SURG

Question 1

what is the management of a spontaneous pneumothorax?

Answer 1

• small (under 2cm): observation and oxygen
• large and stable: needle aspiration or chest tube
• unstable: chest tube

Question 2

what is the cause of acalculous cholecystitis? what is the typical patient?

Answer 2

• cholestatis and gallbladder ischemia leading to secondary infection by enteric organisms and resultant edema and necrosis of the gallbladder
• seen in severely ill patients usually in the ICU with multiorgan failure

Question 3

what are the radiographic signs of acalculous cholecystitis?

Answer 3

• gallbladder wall thickening and distension

- pericholecystic fluid

Question 4

meningiomas arise from what cell type?

Answer 4

meningothelial cells

Question 5

what is the most common diagnosis in a patient with traumatic abdominal injury and an abdominal XR revealing gas filled loops of both small and large intestine?

Answer 5

paralytic ileus

Question 6

a succussion splash is heard in what condition?

Answer 6

gastric outlet obstruction

Question 7

if hemorrhage / hematoma formation is to occur following cardiac catheterization, by what timepoint will it occur?

Answer 7

within 12 hours

Question 8

what is the treatment for retroperitoneal hematomas (eg from cardiac catheterization complications)?

Answer 8

supportive - intensive monitoring, bed rest, IVF, transfusions

*surgical repair is rarely indicated

Question 9

platelet counts greater than ____________ provide adequate hemostasis for most invasive procedures

Answer 9

50,000 / mm3

Question 10

what is ludwig angina?

Answer 10

rapidly progressive bilateral cellulitis of the submandibular and sublingual spaces, most often resulting from an infected mandibular molar

Question 11

what are the early and late physical manifestations of stasis dermatitis?

Answer 11

• early: xerosis

- late: lipodermatosclerosis, ulceration

Question 12

diastolic collapse due to elevated right ventricular filling pressure is characteristic of what heart condition?

Answer 12

tamponade

Question 13

a dilated left ventricle with apical hypokinesis and engorgement of the IVC is characteristic of ___________ shock

Answer 13

cardiogenic shock

Question 14

how are shin splints differentiated from a tibial stress fracture based on pain presentation?

Answer 14

• shin splints: regional pain

- tibial stress fracture: focal tenderness