pestena 3

Question 1

___________ should be suspected when sudden death occurs in a chest trauma patient who is intubated and on a respirator

Answer 1

Air embolism

Question 2

Penetrating urologic injuries rx

Answer 2

are as a rule surgically explored and repaired

Question 3

Genu valgus (knock-knee) is normal between ages _________. No treatment is needed.

Answer 3

4 and 8

Question 4

____________ is the most common primary malignant bone tumor.

Answer 4

Osteogenic sarcoma: It is seen in ages 10 to 25, usually around the knee

Question 5

Hip- extremity shortened, adducted, and internally rotated.

Answer 5

posterior dislocation

Question 6

Fungating mass grows out of the anus, metastatic inguinal nodes are often felt.

Answer 6

Squamous cell carcinoma of the anus is more common in HIV+

Nigro chemoradiation protocol, followed by surgery if there is residual tumor ( surgery rarely is required)

Question 7

Modified vs Radical mastectomy

Answer 7

modified: whole breast out, pecs stay

full radical: breast and muscle out

Question 8

Double bubble sign may be?

Answer 8

duodenal atresia, annular pancreas, or malrotation

Question 9

Malrotation is diagnosed with

Answer 9

• contrast enema (safe, but not always diagnostic)

* upper GI study (more reliable, but more risky).

Question 10

___________ are the most common reason for a newborn boy not to urinate during the first day of life

Answer 10

Posterior urethral valves

meatal stenosis should also be looked for

Question 11

Posterior urethral valves test and rx

Answer 11

Voiding cystourethrogram= diagnostic test

endoscopic fulguration or resection will get rid of them.

Question 12

tool for getting rid of big kidney stones

Answer 12

The most common tool used is extracorporeal
shock-wave lithotripsy (ESWL).

Other options include basket extraction, sonic probes, laser beams, and open surgery

Question 13

retrograde cystogram x-ray must include __________ view, that might be obscured by the bladder full of dye.

Answer 13

post void films, to see extraperitoneal leaks at the base of the bladder

extraperitoneal: foley rx

For intraperitoneal leaks, surgical repair is done and protected with a suprapubic cystostomy

Question 14

AP, lateral, and mortise x-rays show displaced fractures of both malleoli. rx?

Answer 14

Open reduction and internal fixation is needed if the fragments are displaced.

Question 15

Anal fissure rx

Answer 15

stool softeners, topical nitroglycerin, local injection of botulinum toxin, forceful dilatation, or lateral internal sphincterotomy.

ccbs such as diltiazem ointment x 6 weeks have 80–90% success rate

Question 16

Pancreatic cancers that have produced obstructive jaundice are often big enough to do ________ next

Answer 16

CT scan–> Percutaneous biopsy would then follow

Question 17

A common final pathway for death in hemorrhagic pancreatitis is the development of _________

Answer 17

multiple pancreatic abscesses, and to anticipate

them and drain them, if at all possible, daily CT scans are recommended.

Question 18

persistent fever and leukocytosis develop about 10 days after the onset of pancreatitis.

Answer 18

Pancreatic abscess

Pancreatic pseudocyst is usually about 5 weeks after

Question 19

Cystosarcoma phyllodes

Answer 19

• very large, replacing and distorting the entire breast: yet not invading or becoming fixed.
• late 20s, grow over many years
• Most are benign, but potential to –> malignant sarcomas.
• Core or incisional biopsy is needed (FNA is not sufficient), and removal is mandatory.

Question 20

Mammary dysplasia work up

Answer 20

Mammary dysplasia = fibrocystic disease, cystic mastitis ( 30-40 yo, gone by menopause)

if no“dominant” or persistent mass–> mammogram only

persistent mass –> Aspiration is done (not FNA, but aspiration w/ bigger needle and syringe).

If the mass persists or recurs after aspiration, formal biopsy is required.

Question 21

Thyroid nodules test

Answer 21

FNA

Question 22

Cystosarcoma phyllodes biopsy

Answer 22

FNA is not sufficient

Core or incisional biopsy is needed and removal is mandatory.

Question 23

Most hyperthyroid patients are treated with ________ , but those with a “hot adenoma” have the
option of surgical excision of the affected lobe

Answer 23

radioactive iodine

Question 24

dexamethasone suppression test results

Answer 24

• Suppression at low dosage= no disease
• Suppression at a higher dose= pituitary microadenoma.
• No suppression at either dosage identifies adrenal adenoma (or paraneoplastic syndrome).

Question 25

Most hyperthyroid patients are treated with radioactive iodine, but those with a “hot adenoma” have the option of ____________

Answer 25

surgical excision of the affected lobe

Question 26

pheochromocytoma pre op meds

Answer 26

Surgery requires careful pharmacologic preparation

with alpha-blockers.

Question 27

extracorporeal membrane oxygenation (ECMO) is, and is helpful for?

Answer 27

ECMO (Extracorporeal Membrane Oxygenation) is a procedure that uses a machine to take over the work of the lungs and sometimes the heart.

Congenital diaphragmatic hernia with hypoplastic lung