Dr. Pestana's

Question 1

Treatment for mitral valve stenosis

Answer 1

surgical commissure ostomy or balloon valvuloplasty

Question 2

Unilateral hearing loss in adults

Answer 2

Acoustic neuroma

Question 3

Test for cushing’s

Answer 3

Dexamethasone suppression test

high dose–»suppression–> pituitary
High dose–> No suppression–> adrenal adenoma

Question 4

treatment for testicular cancer

Answer 4

platinum based chemo

Question 5

Bullet in upper zone of neck

Answer 5

arteriographic diagnosis

Question 6

Testicle in kid that is undefended but can be pulled down

Answer 6

hyperactive cremasteric muscle

Question 7

Treatment for gun wound to abdomen

Answer 7

Ex lap

Question 8

next steps for palpable breast mass

Answer 8

biopsy to rule out cancer

Question 9

most common bone tumors

Answer 9

Mets
Female–Breast–>lytic
Males–Prostate–> Blastic

Question 10

Childs class C

Answer 10

Uncontrolled ascites and encephalopathy

Bili >4, INR 2x nl, Alb

Question 11

Signs of left colon cancer

Answer 11

frank blood in stools, narrow caliber stool

Question 12

Right colon cancer signs

Answer 12

anemia

Question 13

HIV +, fun gating mass in anus with enlarged lymph nodes

Answer 13

squamous cell carcinoma

Question 14

treatment of liver abscess after acute ascending choliangitis

Answer 14

Pyogenic liver abscess

Drainage

Question 15

Treatment of breast mass near nipple that is large

Answer 15

mastectomy + sentinel nodes if not palpable

Question 16

Causes of double bubble sign

Answer 16

Duodenal atresia (no normal gas past double bubble)
annular pancreas
malrotation (some normal gas pattern)

Question 17

Prostate cancer diagnosis

Answer 17

transrectal needle biopsy

Question 18

how to treat 7mm kidney stones

Answer 18

extracorporeal shock wave lithotripsy

Question 19

Route of fluid resuscitation in kids

Answer 19

if not IV then interosseous cannulation of proximal tibia

Question 20

Abdominal compartment syndrome closure

Answer 20

temporally cover with absorbable mesh

Question 21

How to see if rabies in animal bite

Answer 21

kill animal and look at brain.

Question 22

Femoral shaft fracture risks

Answer 22

blood loss

fat embolism

Question 23

treatment of ankle fractures

Answer 23

open reduction and internal fixation

Question 24

additional testing for closed head injuries

Answer 24

look at CT of neck for C spine injury

Question 25

Post op day 7 SOB, chest pain, hypoxemia. diagnosis? treatment?

Answer 25

PE
spiral CT
Heparinization

Question 26

Fluids for hypernatremia

Answer 26

D5 1/2 NS

Question 27

Treatment for femoral neck fracture

Answer 27

replace head

Question 28

treatment for intertrochanteric fracture

Answer 28

open reduction and internal fixation

Question 29

Treatment for post op fistulas

Answer 29

fluids, nutritional support, protection of abd wall