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2018 Flashcards

1
Q

Pt with RUQ pain N/V, fever, WBC leukocytosis, LFTs normal, Bilirubin N
1. 4 findings on ultrasound?
2. What is the management?
3. What are the complications of the surgery?
4. Maybe they asked about DDx (not sure)

A

?

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2
Q

There was a question on negative trauma of a female. … idk if thectshowed a pancreas or what it was exactly

A

-

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3
Q
  1. Mention 2 causes
  2. One Xray finding pre-operative?
A
  1. -
  2. Air under diaphragm
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4
Q

CXR (tension pneumo?)
1. What is the diagnosis?
2. What is the treatment?

A

?

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5
Q
  1. What is this?
  2. Mention four complications.
A
  1. Ileostomy
  2. Infection
    Stenosis
    Parastomal herniation
    Skin irritation
    Necrosis
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6
Q
  1. What is the name of the study shown?
  2. Name 2 abnormalities seen.
  3. Give 2 differential diagnosis.
  4. Mention 2 other studies to do.
A
  1. Barium swallow test
  2. Narrowing of gastroesophageal junction
    Dilated esophageal lumen
    Bird beak appearance
  3. Achalasia
    Oesophageal cancer
  4. Upper GI endoscopy
    Esophageal manometry
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7
Q

A 63-year-old woman with a 3-week history of a breast mass that is not responding to antibiotics.
1. List two abnormal findings.
2. List two investigations that you would order to help establish the diagnosis.
3. What is the most likely diagnosis?

A
  1. Ulceration and necrosis/destruction of the nipple-areola complex
    Skin erythema and dimpling (Peau d’orange)
  2. Mammography
    Skin punch biopsy
  3. Inflammatory breast carcinoma
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8
Q
  1. What is the operation shown in the figure?
  2. Mention 4 specific complications to this operation.
A
  1. Lichtenstein open (tension-free) mesh hernia repair
  2. -
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9
Q
  1. Name 4 radiological finding? Name what’s pointed at by the arrows?
  2. Diagnosis?
  3. What is the definitive treatment?
A
  1. Sunburst appearance / Codman’s triangle
  2. Osteosarcoma
  3. -
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10
Q

Name the labeled structures and their clinical signs or tests

A
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11
Q
  1. What’s the name of the device shown in the picture?
  2. Give 4 indications to use it?
A
  1. External skeletal fixator
  2. Severely contaminated fracture
    Pelvic fractures
    Infected fractures
    Initial management in polytrauma patient
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12
Q
  1. What is the fracture?
  2. What is the treatment that is used?
A
  1. Intertrochanteric fracture
  2. ORIF and Gamma nail
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13
Q

Name 4 findings.

Steps of emergency management in ER

Would this affect the survival of the patient? Or survival of femur head? Or both?

A

?

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14
Q

Pelvic inlet view DDH, hx of funny gait since childhood with B/L groin and hip pain
Q1: what the cause?
Q2: mention xray findings
Q3: Tx

A
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15
Q

CT mass in RT kidney, complains of painless hematuria
1. Describe the CT findings.
2. Mention 2 hereditary conditions.
3. Treatment if disease is localized
4. List 4 differential diagnosis:

A
  1. -
  2. -
  3. -
  4. RCC / PKD / Stones / Bladder Ca
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16
Q

It was an issue near bladder (black area)
- Name the modality?
- Describe what you see?
- Give 2 differentials ?

(Im not sure 100% but this is what I remember)

A

?

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17
Q

What is each device called?

A
  • Inflatable penile implant
  • Malleable penile implant
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18
Q

Man married for 15 years and started experiencing erectile dysfunction 6 months ago.
1. What’s the class of this drug? What’s the mechanism of action?
2. Mention 5 causes of erectile dysfunction?
3. What will you ask the patient during history to differentiate between psychological or organic erectile dysfunction?

A
  1. -
  2. -
  3. Onset (psychogenic is sudden but organic is gradual), Frequency (psychogenic is sporadic but organic is in all circumstances), age (psychogenic is in younger and organic in older), organic risk factors (HTN, DM, dyslipidemia), nocturnal/morning erection (present in psychogenic not in organic)
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19
Q

57-year-old male presented withdiffuse abdominal pain, constipation and wight loss
Q1: Name the study shown in the image
Q2: From the image, what is the diagnosis
Q3: List 2 investigations to confirmt h e diagnosis
Q4: What is thebest next step for treatment

A
  1. Barium enema
  2. Colon cancer of the proximal transverse colon
  3. 1-Colonoscopy with biopsy
    -2 Metastatic workup: abdominal CT, chest X-ray, bone scan
  4. Stabilize the patient with VI fluids, analgesia.Administer antibiotics, and shift urgently to surgery (extended right hemicolectomy)
20
Q

Old lady with a breast mass
1. What is the investigation?
2. What other investigation you’ll do?
3. 5 DDx?
4. Treatment?

A
  1. Mammogram
  2. -
  3. -
  4. -
21
Q
  1. Identify the test:
  2. Mention 2 findings:
  3. One confirmatory test?
  4. Complications?
A
  1. ERCP
  2. filling defect + dilated CBD
  3. -
  4. -
22
Q

60 y/o male with a mass for 20 years *
1. Most likely diagnosis?
2. Indications for surgery
3. mention specific complications to this surgery
4. if the patient came after surgery with reduced voice range, which nerve is affected?

23
Q
  1. Imaging modality?
  2. Findings?
  3. Causes?
  4. Initial management?
  5. Treatment?
24
Q

Q1: what is the n a m eof the test shown?
Q2: describe the image.
Q3: what is the diagnosis?
Q4: how can you confirm the diagnosis?
Q5: mention two treatment options for this condition

A
  1. Barium swallow test
  2. Narrowing at gastroesophageal junction
    Bird beak appearance
    Dilated esophageal lumen ( megaesophagus )
  3. Achalasia
  4. Esophageal Manometry
  5. Medical: calcium channel blockers
    Endoscopic :dilation of LES using pneumatic ballon injection of botulinum toxin
    Surgical- Division of the muscle at lower end of esophagus
25
Q

43-year-old male presented withthisfinding, he has no relevant medicalor surgical history
Q1: What is thediagnosis
Q2: What is treatment
Q3: What will happen fi left untreated, list 2.

A
  1. Spigelian hernia (the picture is very close to what we got in the exam, not sure of the answer)
  2. Hernioplasty, tension free mesh repair
  3. -1Incarceration and bowel obstruction
    2- Strangulation and mesenteric ischemia
26
Q

A Patient presented with severe abdominal pain and obstipation.
Q1: what is the diagnosis?
Q2: what is your initial step in managing this patient?
Q3: name two options for treating this patient.

A
  1. Sigmoid volvulus
  2. Decompression by flexible sigmoidoscopy
  3. We’re not sure of the answer as The picture wasn’t clear, but fi it showed an enterovesical Fistula then the
    treatment is resection of the affected Intestinal segment
27
Q

Identify the injuries and give treatments. (we don’t remember the exact picturesL)
1. Open book fracture
2. Monteggia fracture
3. Galeazzi fracture

28
Q

A picture of patellar fracture.
(we don’t remember the exact picture)
1. Movement affected?
2. Tendon affected?
3. Treatment?

29
Q

There was a Q about the long steps of fracture management including ATLS

30
Q

Xray of posterior Hip dislocation
(we don’t remember the picture or the questions)

31
Q

CT urography of Renal cancer.
(we don’t remember the exact pictures)
* Questions
1. Give 2 familial causes?
2. What are the findings?
3. What is the definitive treatment?

32
Q

20 y/o complaining of primary infertility for 3 years (Table with sperm analysis was shown)
* Questions:
1. List the abnormal findings (normal levels were given)
* U/S doppler of the testis of the same patient was shown (they gave the description which included dilatation of the paminiform plexus due to patent venous valves)
1. What is the diagnosis?
2. What is the treatment?
3. List 5 contents of the spermatic cord

A
  1. oligospermia- asthenispermia-teratospermia
  2. varicocele
  3. -
  4. -
33
Q

A Patient presented with severe abdominal pain and obstipation.
1. what is the diagnosis?
2. What is your initial step in managing this patient?
3. Mention two surgical treatment for this complication?

A
  1. Sigmoid volvulus
  2. Decompression by flexible sigmoidoscopy
  3. Fistulectomy
    * Seton placement
    * (not sure if it was fistula)
34
Q
  1. What do you see
  2. What is your diagnosis?
  3. Mention Two causes that can lead to this?
  4. Mention Two managements for this patient?
A
    • Multiple air- fluid levels
      * Distention of the small bowel with prominent plicae circulares
  2. Small bowel obstruction
  3. Adhesions
    * Hernia
  4. NPO
    * Iv fluid and electrolytes correction
    * NG tube and foly cath placment
    * If the area is ischemec; resection
    * Surgery to treat the cause ( lysis of adhesion, hernia repair)
35
Q

A Patient came complaining of right upper quadrant pain after ingestion Of fatty meals.
1. Describe the finding.
2. List four possible complications.
3. What is the definitive management?

A
  1. Gallbladder stone with posterior acoustic shadow
    • Acute cholecystitis
      * Choledocholithiasis
      * Biliary pancreatitis
      * Gallstone ileus
      * Ascending cholangitis
  3. Laparoscopic cholecystectomy
36
Q
  1. What is shown in the top picture
  2. mention an indication of it?
  3. What is shown in the bottom picture
  4. mention an indication of it?
A
  1. Sengstaken blackemore tube
  2. Upper GI bleeding intervention after failure of medical / endoscopic therapy
  3. Percutaneous endoscopic gastrostomy
  4. Gastric feeding in the case of proximal GI pathology
37
Q
  1. What is the diagnosis? *
  2. Give two possible sequelae if it was left untreated.
  3. A 16 year old female presented with this mass that moves with tongue protrusion
  4. What is the diagnosis?
  5. What is the treatment?
A
  1. Appendicitis
  2. Rupture and peritonitis
    * appendicular mass
    * appendicular abscess
  3. -
  4. Thyroglossal duct cyst
  5. Surgical removal (Not sure)
38
Q
  1. This patient presents with lower back pain but no bowel/urinary symptoms.
  2. Which level is affected?
  3. What symptoms might the patient have other than pain?
  4. What is your initial management?
  5. If the patient presented with urinary and fecal incontinence, how would you manage?
A
  1. -
  2. L4-L5
  3. Bilateral lower limb weakness
    * Numbness and paresthesia
  4. Lifestyle modifications: Weight reduction, Smoking cessation
    * Physiotherapy * NSAIDs
  5. Emergent Laminotomy and Discectomy (Cauda Equina Syndrome)
39
Q
  1. What’s the direction of force that caused the injury?
  2. Name the abnormalities in the X-ray?
  3. What is a major complication of this injury?
  4. What structures are at risk?
  5. What is the treatment modality used for this patient?
A
  1. Anterioposterior
  2. Pubic Diastasis
    * SI joint Disruption
  3. Massive Bleeding
  4. Urogenital organs
  5. External Fixator
40
Q
  1. What complication might the patient develop after the fracture?
  2. After the surgery, would you let the patient fully bear weight?
  3. What is inserted in the picture below?
A
  1. Fat embolism * Hemorrhage
  2. Yes (not sure; but according to Dr. Ali Jaragh, whats the purpose of surgery if you wouldn’t let the patient walk after?)
  3. IM nail
41
Q
  1. What treatment modality is used for this patient?
  2. What is the rationale of using such
    modality?
A
    • Skeletal Traction
  2. Maintaining bone alignment * Decrease muscle spasms
42
Q
  1. What is the diagnosis?
  2. What is the presentation of the limb affected?
  3. Mention 2 complications
  4. Which nerve is affected?
A
  1. Posterior Hip Dislocation
  2. Hip Flexed, Adducted, and internally rotated
  3. Hemorrhage
    * Osteoarthritis (late)
  4. Sciatic
43
Q
  1. A patient presented with painless hematuria. The urologist did him a cystoscopy which revealed the shown abnormality.
  2. What is the diagnosis?
  3. What are 4 risk factors for this condition
  4. What 4 things would you do next?
A
  1. -
  2. Bladder carcinoma
    • Smoking
      * Aniline dyes (working in rubber and dye industries)
      * Cyclophosphamide
      * Schistosomiasis
      * Aromatic amines
      * Chronic bladder irritation
      4- * Resect and stage by TURBT
      * Urine cytology
      * Metastatic work up
      * CT urogram
      * Kidney ultrasound for hydronephrosis
44
Q
  • There was a video showing urethral
  • stricture.
    1. What is the diagnosis?
    2. What are the causes?
A
  1. Urethral stricture
    • Recurrent infections.
      * Recurrent/prolonged instrumentations. (foley’s catheter).
45
Q

A young man presented with a hard scrotal mass. He underwent Orchidectomy.
1. Name two anatomical structures in the picture.
2. Where should the surgeon make the incision for this Procedure?
3. What investigations will you order to confirm the diagnosis?
4. tumor markers:

A
    • testis
      * spermatic cord
  2. Inguinal ligament
  3. ultrasound of testis
    * CT scan –
  4. AFP, HCG, LDH
46
Q

In the exam we had a video, attached picture shows the exact steps of The video.
1. What is the diagnosis
2. What is the name of the procedure?

A
    • Ureteral stone
  2. Ureteroscopy with laser lithotripsy

Surgery ELOOPs (9 decks)

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