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ZSurgery Clerkship > Clinical Microvignettes > Flashcards

Clinical Microvignettes Flashcards

1
Q

60 year old woman with long term estrogen replacement therapy with new onset of vaginal bleeding

A

Endometrial carcinoma

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2
Q

8 year old boy with acute scrotal pain; a small “blue dot” is seen through the scrotal skin

A

Testicular torsion

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3
Q

22 year old woman with acute onset of lower abdominal pain, hypotension, tachycardia, adnexal mass, and free fluid on vaginal US

A

Ectopic pregnancy rupture

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4
Q

70 year old male retired leather worker, cigarette smoker; presents with painless gross hematuria

A

Bladder transitional cell carcinoma

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5
Q

22 year old male who develops a right scrotal hydrocele with elevated serum B-HCG

A

Testicular cancer

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6
Q

28 year old woman involved in a high-speed, side-impact MVC; stable vital signs; CXR reveals widened mediastinum

A

Thoracic aortic injury

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7
Q

55 year old woman with diabetes, recurrent pyelonephritis, increased BUN, IVP reveals radiolucent defects in the kidney collecting system

A

Papillary necrosis

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8
Q

31 year old man with right flank pain radiating into scrotum, gross hematuria, right sided hydronephrosis and normal abdominal x-ray

A

Uric acid kidney stone

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9
Q

18 year old woman with fever; costovertebral tenderness; flank mass, and WBCs, RBCs and gram negative rods in the urine

A

Renal abscess

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10
Q

65 year old man with groin pain who goes into septic shock after a rectal prostatic exam

A

Bacterial prostatitis

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11
Q

19 year old man s/p spinal anesthetic for a groin hernia repair returns to clinic with back pain, fever, and decreased LLE sensation and movement

A

Epidural abscess

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12
Q

30 year old woman with thoracic back pain, destruction of thoracic vertebral bodies on x-ray, +PPD

A

Pott’s disease (TB of spine)

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13
Q

22 year old man s/p MVC with transection of right optic nerve; progresses to blindness in the contralateral left eye 3 weeks later

A

Sympathetic ophthalmia

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14
Q

29 year old diabetic with chronic bacterial sinusitis, new onset seizures, fever, and R weakness

A

Brain abscess

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15
Q

29 year old man with intermittent vertigo, intermittent hearing loss, tinnitus, and a subjective feeling of having ear swelling

A

Meniere’s disease

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16
Q

16 year old girl with severe sore throat, lateral uvula displacement, bulging tonsillar pillar, + strep pyogenes

A

Quinsy’s abscess (peritonsillar abscess)

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17
Q

60 year old woman with a thyroid mass, + follicular cells on biopsy, + capsular invasion, + vascular invasion

A

Thyroid follicular carcinoma

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18
Q

42 year old woman with thyroid mass, + amyloid on histology, hypercalcemia

A

Medillary thyroid carcinoma

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19
Q

25 year old man with thyroid mass, + psammoma bodies

A

Papillary thyroid carcinoma

20
Q

Hypothyroidism, “woody” hard thyroid, tracheal compression

A

Riedel’s thyroiditis

21
Q

17 year old woman with URI followed by fever, neck pain, dysphagia, tender thyroid gland, + strep cultures

A

Acute suppurative thyroiditis

22
Q

28 year old woman with tender thyroid, hypothyroidism, elevated antimicrosomal antibodies, increased antithyroglobulin antibodies

A

Hashimoto’s thyroiditis

23
Q

45 year old woman with itching of the right nipple for 6 mo and a right breast mass

A

Paget’s disease (infiltrating ductal carcinoma with spread to the nipple)

24
Q

60 year old man with nipple discharge

A

Male breast cancer

25
Q

36 year old woman with right breast mass after hitting her right breast on the door handle

A

Fat necrosis

26
Q

39 year old woman with bilateral milky breast discharge, decreased lateral vision fields, and pituitary mass

A

Prolactinoma

27
Q

28 year old woman with unilateral green-brown nipple discharge increasing immediately before menses

A

Fibrocystic disease

28
Q

What is the GCS for an 18 year old woman s/p MVC in a “coma”

A

8

29
Q

What is the GCS for a 40 year old man brought in dead after an MVC by the rescue paramedics?

A

3 (eyes=1, motor=1, verbal=1)

30
Q

What is the GCS for 20 year old woman s/p motorcycle collision with open eyes, grunting only, and withdrawals to pain?

A

10 (eyes 4, motor 4, verbal 2)

31
Q

What is the GCS for a 29 year old woman s/p skiing accident into a tree who is intubated; eyes closed even to pain, decorticate posturing only?

A

5T (eyes 1, intubated=IT, motor=3)

32
Q

28 year old man involved in high-speed MVC with lower back spine fracture, bladder/bowel incontinence, decreased lower extremity sensation, and decreased LE strength

A

Cauda equina syndrome

33
Q

24 year old woman with spine fracture; paraplegia but with touch and proprioception intact

A

Anterior spinal cord syndrome

34
Q

29 year old man s/p 45 ft fall with L loss of pain and temp sensation; R paresis and loss of proprioception

A

Brown-Sequard syndrome

35
Q

18 year old woman with a cervical spinal fracture after diving into a shallow pool; intact perianal sensation and decreased lower extremity sensation and movement

A

Central cord syndrome

36
Q

50 year old woman with painless proptosis and a brain tumor stuck to the dura

A

Meningioma

37
Q

24 year old heavy cigarette smoker with initial onset of foot pain followed by digit necrosis

A

Buerger’s disease

38
Q

55 year old woman with calf claudication, “hourglass’ stenosis on angiogram of popliteal artery, and cyst on US of posterior knee

A

Cystic degeneration of the popliteal artery

39
Q

65 year old woman started on Coumadin alone for A-fib develops acute DVT

A

Coumadin-induced hypercoagulable state due to decreased protein C&S

40
Q

56 year old woman with hemorrhoids that prolapse with defecation but then retract by themselves

A

2nd degree internal hemorrhoids

41
Q

67 year old male smoker on coumadin for chronic DVT notices LLQ pain after strenuous coughing spell; LLQ mass detected on physical exam

A

Rectus sheath hematoma

42
Q

34 year old woman with hemorrhoids that prolapse after defecation and that she has to “push back in”

A

3rd degree internal hemorrhoids

43
Q

56 year old woman with hemorrhoids that are “stuck out” after a bowel movement

A

4th degree internal hemmorrhoid

44
Q

61 year old man develops acute onset of pain and “blurry” vision in the right eye; sees “rings” around lights; states that he feels a little nauseated

A

Open-angle glaucoma

45
Q

23 year old woman while playing basketball gets hit in the left eye; has “blurry” vision in that eye; sees flashing lights and then sees things “floating” across

A

Detached retina

ZSurgery Clerkship (1 decks)

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