High Yield Surgery

Question 1

Guarding and rebound case what is the next best step management

Answer 1

Exploratory laparotomy

Question 2

Widened mediastinum

Answer 2

CT angiography

Question 3

Inability to abduct the arm
Injury site and nerves affected?

Answer 3

Injury site: Surgical neck of Humerus
Nerves: aaxilla4y Nerve + Posterior circumflex humerus artery

Question 4

Inability to extend the elbow
Injury site and the nerves affected?

Answer 4

Injury: midshaft of humerus
Nerves: Radial Nerve + deep brachual artery

Question 5

Motor and sensory damage of first three digits
Injury site and nerves affected?

Answer 5

Injury to the supracondylar fracture of humerus
Median nerve and brachial artery

Question 6

Weak grip and sensory damage of last 2 digits

Answer 6

Injury to the medial epicondylar fracture of humerus
ULNAR nerve

Question 7

RuQ pain after fatty meals and resolves within a few hours
Can have elective sholecystectomy

Answer 7

BILIARY colic

Question 8

Constant RUQ pain + fever + inflammation of gallbladder
Usually requires cholecystectomy within 72 hrs

Answer 8

ACUTE CALCULOUS CHOLECYSTITIS

Question 9

ICU patients + cholecystitits symptoms + no stones visualised
Tx: antibiotics + percutaneous cholecystectostomy (cholecystectomy later when stabilised)

Answer 9

Acalculous cholecystitits

Question 10

Cholecystitis symptoms + creates in RUQ + air fluid levels
Tx: cholecystectomy

Answer 10

Emphysematous cholecystitis

Question 11

Fever + jaundice + RUQ pain (chariots triad) .
Tx: antibiotics + ERCP drainage

Answer 11

Acute Cholangitis

Question 12

Claudication, pain while sleeping (rest pain hx of ACS
Tips of toes

Answer 12

Eripheral Artery Disease

Question 13

Hyperpigmentatjoj of ankles
History of chronic LE edema
Medial malleolus

Answer 13

Chronic Venous Insufficiency

Question 14

Painless ulcer usually at the sole of the 1st metatarsal

Answer 14

Diabetic foot ulcer

Question 15

Painful, palpable, cord like swelling of veins
Asso qith GI malignancy and Buerger Syndrome (thromboangitis obliterans

Answer 15

Superficial thrombophlebitis

Question 16

Flat, painful streaks usually extending proximal from skin infection (cellulite, erysipelas

Answer 16

Lymphangitis

Question 17

Ipsilateral paralysis and normal sensation and contralateral pain. Or temp loss
Half transection

Answer 17

Brown square syndrome

Question 18

Bilater sensory loss of upper extremities
Loc: central cord , elderly person with neck whiplash injury

Answer 18

Central Cord Syndrome

Question 19

Anterior 2/3 of cord
Burst vertebral fracture or surgical damage to aorta branches
Bilateral weakness + pain = temp loss, normal sensation spared

Answer 19

Anterior cord syndrome

Question 20

Recent chest trauma with paradoxic movement of chest with breathing

Answer 20

Flail chest

Question 21

Fall on outstretched hand with pain in anatomical snuffbox with normal xray

Answer 21

Scaphoid fracture

Question 22

Elderly patient with history of alcoholism with recent head trauma and altered mental status

Answer 22

Subdural haematoma

Question 23

High speed MBC + upper extremity hypertension + hoarse voice

Answer 23

Traumatic aortic rupture

Question 24

Blunt rauma + left sided chest pain + NG tube in the pulmonary cavity

Answer 24

Traumatic diaphragmatic hernia

Question 25

Paediatric patient with trauma 24 hrs ago with new onset epigastric pain and Vomiting

Answer 25

Duodenal hematoma

Question 26

Head trauma with brief LOc, now has headache and nausea and Vomiting

Answer 26

Epidural haematoma or rupture of the middle meningeal artery

Question 27

Patient with pancreatic surgery with new onset non-anion gap metabolic acidosis

Answer 27

Pancreatic fistula

Question 28

Child with extremity pain, fever, leukocytosis with periosteal elevation and osteopathic lesions on MRI

Answer 28

Osteomyelitis

Question 29

Full thickness extremity burn with pain on passive stretch and rapidly increased swelling

Answer 29

Compartment syndrome from eschatology formation or escharotomy

Question 30

Sudden onset respiratory distress after remov of central.line, hypoxaemia, obstructive shock but normal breath sounds

Answer 30

Venous air embolism.

Question 31

Tall, young patient who experiences sudden onset respiratory distress, jvd and hyperresonance on percussion

Answer 31

Rimary spontaneous pneumothorax

Question 32

Rebound, guarding with free air under the diaphragm on Xray

Answer 32

Erforated peptic ulcer

Question 33

Diffuse rash with a net like appearance

Answer 33

Acute mesenteric ischaemia + lived reticularis

Question 34

RUQ pain that radiates to the back

Answer 34

Acute pancreatitis