OME

Question 1

DDx for postop fever

Answer 1

Anytime: wonder drugs (malignant hyper, sepsis)
Day 1-2: wind (atelectasis, PNA)
Day 3: water (UTI)
Day 5: walking (DVT, PE)
Day 7, 10-14: wound (cellulitis, abscess)

Question 2

Migratory thrombophlebitis

Answer 2

Pancreatic cancer
(endoscopic u/s with bx)
Whipple

Question 3

Beads on string on MRCP

Answer 3

PSC (cancer = choleangiocarcinoma)
ERCP with bx
Resect

Question 4

Ampulla of vater cancer?

Answer 4

+FOBT, -colonoscopy
Normal CT scan
ERCP with bx
Resect

Question 5

Longstanding GERD with metaplasia treatment

Answer 5

Metaplasia: high dose PPI
Dysplasia: Ablation
Adenocarcinoma: resect
+/- Nissen

Question 6

Achalasia workup/treatment

Answer 6

Barium swallow: bird beak sign
Manometery: best test
EGD with bx (rule out pseudo aka cancer)
Tx: botox q6, dilation (perf, need repeat), myotomy (best(

Question 7

Pediatric patient

Asymmetric light reflex and lateral movement of one eye with the other covered

Answer 7

Strabismus

Tx: Patch or blur (cyclopentolate drops) good eye so weak eye needs to work

Question 8

Young female

Painless loss of vision, APD, normal posterior eye exam

Answer 8

Optic neuritis

Question 9

Painless loss of vision, APD, retinal pallor, cherry red spot in fovea

Answer 9

Retinal artery occulsion

Question 10

Treatment of cavernous sinus thrombosis

Answer 10

Vanco (covers MRSA)

Enoxaparin

Question 11

Signs of basilar skull fracture

Answer 11

Battle’s sign (petrous fracture)
Raccoon’s eyes (anterior)
CSF rhinorrhea (anterior)

Question 12

Stroke symptoms that resolve within 1 hour without intervention?

Answer 12

TIA

Question 13

Indications for surgical evacuation of chronic subdural hematoma

Answer 13

> 10mm
5mm shift
Moderate to severe cognitive impairment