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Question 1

timing of problems after MI

Answer 1

• acute = RV failure
• 3-5 days = papillary muscle rupture or interventricular septum rupture (LAD)
• 5-14 days = free wall rupture
• several months = LV aneurysm

Question 2

dishwater drainage

Answer 2

indicative of necrotizing surgical site infection

Question 3

secondary spontaneous penumothorax

Answer 3

presents in the setting of known lung disease, acute onset SOB, hypoxia and unilateral decreased breath sounds

Question 4

best test for acute pancreatitis

Answer 4

RUQ ultrasound

Question 5

HIDA vs ERCP

Answer 5

HIDA = for acute cholecystitis
ERCP = for obstruction in CBD

Question 6

penile fracture is a tear in….

Answer 6

tunica albuginea (envelopes corpus cavernosum)

Question 7

test after fracture penis

Answer 7

retrograde urethrogram if there is evidence of urethral injury

Question 8

indications of retrograde urethrogram

Answer 8

• blood at meatus
• hematuria
• dysuria
• urinary retention

Question 9

most common cause of extraperotineal bladder rupture

Answer 9

pelvic fracture (sits anterior to bladder)

Question 10

most common epithelial thyroid malignancy

Answer 10

papillary, followed by follicular

Question 11

characteristics of follicular thyroid cancer

Answer 11

like benign adenomas, but with invasion into capsule, can metastasize via blood

Question 12

features of papillary thyroid cancer

Answer 12

• slow spread
• large cells with ground glass, pale nuclei with inclusion bodies
• psammoma bodies
• lymph node involvement

Question 13

Hurthle cells

Answer 13

seen in follicular thyroid cancer, benign adenomas and hashimoto’s thyroiditis

Question 14

soap bubble tumor

Answer 14

giant cell tumor of bone

Question 15

feature of giant cell tumors

Answer 15

• lytic bone soap bubble lesion in epiphysis of long bones
• benign but locally destructive
• young adults or Paget disease
• progressive local pain
• RANKL is overexpressed, can use denosumab

Question 16

type A and B aortic aneurysms

Answer 16

A = ascending B = descending

Question 17

initial test for ruptured AAA

Answer 17

CT angio - patient must be stable

Question 18

epidermal inclusion cyst

Answer 18

• dome shaped, firm, mobile nodule with central punctum
• epidermis lodged in dermis from trauma or comedones or de novo
• produces keratin

Question 19

dermatofibroma

Answer 19

• benign fibroblast proliferation, firm, hyperpigmented nodule
• center dimpling

Question 20

most common complications of cardiac cath

Answer 20

bleeding, hematoma, dissection, thrombosis, pseudoaneurysm, or AV fistula

Question 21

fluid for burns

Answer 21

LR - correct acidosis and maintains normal blood pH

Question 22

things damaged in uncal herniation

Answer 22

• oculomotor nerve

- ipsalateral hemiparesis (crus cerebri compression)

Question 23

indication for congenital umbilical hernias

Answer 23

larger than 1.5 cm or older than 5

Question 24

symptoms of delirium tremens

Answer 24

confusion, agitation, fever, tachycardia, hypertension, diaphoresis, hallucinations

Question 25

firm solitary neck lymph nodes in smoker

Answer 25

likely metastatic squamous cell carcinoma

Question 26

treatment of acute prostatitis

Answer 26

fluoroquinolone or bactrim

Question 27

GI bleeding following AAA repair

Answer 27

bowel ischemia, due to lack of collateral blood supply