Rapid Fire Power Review P767-774 Flashcards

1
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
1. Elderly woman, SBO,
and air in biliary tract
P767

A

Gallstone ileus

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2
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
2. Elderly woman with
pain down inner aspect
of thigh
P767
A

Obturator hernia (Howship-Romberg sign)

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3
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
3. Abdominal pain,
hypotension, and
abdominal pulsatile
mass
P767
A

Ruptured abdominal aortic aneurysm

AAA

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4
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
4. Abdominal pain “out
of proportion” to
abdominal exam
P767
A

Mesenteric ischemia

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5
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
5. Arm pain and syncope
with arm movement
P767

A

Subclavian steal syndrome

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6
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
6. Increasing creatinine
on ACE inhibitor
P767

A

Renal artery stenosis

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7
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
7. Child with MIDLINE
neck mass
P767

A

Thyroglossal duct cyst

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8
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
8. Child with LATERAL
neck mass
P767

A

Branchial cleft cyst

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9
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
9. Crush injury and dark
urine
P767

A

Myoglobinuria

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10
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
10. Emesis, chest pain
radiating to back, and
mediastinal air
P767
A

Boerhaave’s

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11
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
11. Lower GI bleed
\+ technetium
pertechnetate scan
P767
A

Meckel’s diverticulum

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12
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
12. Flushing, diarrhea,
and right-sided heart
failure
P768
A

Carcinoid

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13
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
13. Pneumaturia and LLQ
pain
P768

A

Colovesicular fistula

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14
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
14. Desmoid tumor, osteoma,
and colon cancer
P768

A

Gardner’s syndrome

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15
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
15. Epigastric pain
radiating to back and
flank ecchymosis
P768
A

Hemorrhagic pancreatitis

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16
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
16. Pancreatitis and
palpable epigastric mass
P768

A

Pancreatic pseudocyst

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17
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
17. Liver abscess with
“anchovy paste”
P768

A

Amebic abscess

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18
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
18. RUQ pain, travel, and
exposure to sheep
P768

A

Hydatid cyst

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19
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
19. Caput medusa
P768

A

Portal hypertension

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20
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
20. 45-year-old woman with
RUQ pain for 12 hours,
fever, and leukocytosis
P768
A

Acute cholecystitis

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21
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
21. Elderly man with large
nontender palpable
gallbladder
P768
A

Pancreatic cancer (Courvoisier’s sign)

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22
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
22. Female taking birth control
pills with liver mass
P768

A

Hepatic adenoma

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23
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
23. Liver tumor with
“central scar”
P768

A

Focal nodular hyperplasia

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24
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
24. Pancreatic mass,
gallstones, diabetes,
and diarrhea
P768
A

Somatostatinoma

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25
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
25. RUQ bruit and CHF in
young adult
P768

A

Liver hemangioma

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26
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
26. Excruciating pain with
bowel movement
P769

A

Anal fissure

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27
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
27. Abdominal pain, diarrhea,
and anal fistulae
P769

A

Crohn’s disease

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28
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
28. EKG with “peaked”
T waves
P769

A

Hyperkalemia

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29
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
29. Buccal mucosa with
pigmentation
P769

A

Peutz-Jeghers syndrome

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30
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
30. LLQ pain, fever, and
change in bowel habits
P769

A

Diverticulitis

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31
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
31. Elevated urine 5-HIAA
P769

A

Carcinoid

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32
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
32. Institutionalized, abdominal
pain, vomiting,
and distention, with
proximal colonic dilation
P769
A

Sigmoid volvulus

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33
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
33. Infant with projectile
vomiting
P769

A

Pyloric stenosis

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34
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
34. Newborn with failure
to pass meconium in
first 24 hours
P769
A

Hirschsprung’s

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35
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
35. Infant with bilious
vomiting
P769

A

Malrotation

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36
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
36. Newborn with
abdominal defect and
umbilical cord on sac
P769
A

Omphalocele

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37
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
37. Teenager with knee
pain and “onion
skinning” on x-ray
P769
A

Ewing’s sarcoma

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38
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
38. Pulmonary capillary
wedge pressure 18,
CXR with bilateral pulmonary
infiltrates, and
PaO2:FiO2 ratio <200
P769
A

Acute respiratory distress syndrome

ARDS

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39
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
39. Increased peak airway
pressure, low urine
output, and urinary
bladder >25 mmHg
P770
A

Abdominal compartment syndrome

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40
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
40. Newborn with inability
to “pass an NGT”
P770

A

Esophageal atresia

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41
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
41. Traumatic blinding
in one eye followed
by blindness in the
contralateral eye
2 weeks later
P770
A

Sympathetic ophthalmia

42
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
42. Mitotic pupil, ptosis,
and anhydrosis
P770

A

Horner’s syndrome

43
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
43. Traumatic head
injury, conscious
in ER followed by
unconsciousness
P770
A

Epidural hematoma (“lucid interval”)

44
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
44. “Worst headache of my
life”
P770

A

Subarachnoid hemorrhage

45
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
45. Hematuria, flank pain,
and abdominal mass
(palpable)
P770
A

Renal cell carcinoma

46
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
46. 60-year-old white
man with painless
hematuria
P770
A

Bladder cancer

47
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
47. RUQ pain, jaundice,
and fever
P770

A

Cholangitis

48
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
48. Epigastric pain
radiating to back, with
nausea and vomiting
P770
A

Pancreatitis

49
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
49. Chest pain radiating to
back and described as
a “tearing” pain
P770
A

Aortic dissection

50
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
50. 40-year-old man
with tachycardia/
hypertension
and confusion on
postoperative day #2
P771
A

Alcohol withdrawal

51
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
51. Marfanoid body habitus
and mucosal neuromas
P771

A

MEN II-b

52
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
52. Psammoma bodies
P771

A

Papillary thyroid cancer

53
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
53. Sulphur granules
P771

A

Actinomyces infection

54
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
54. Thyroid tumor with
AMYLOID tissue
P771

A

Thyroid medullary cancer

55
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
55. PALPABLE neck tumor
and hypercalcemia
P771

A

Parathyroid cancer

56
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
56. Hypertension,
diaphoresis (episodic),
and palpitations
P771
A

Pheochromocytoma

57
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
57. Jejunal ulcers
P771

A

Zollinger-Ellison syndrome

58
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
58. Pituitary tumor,
pancreatic tumor, and
parathyroid tumor
P771
A

MEN- I

59
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
59. Necrotizing migratory
erythema
P771

A

Glucagonoma

60
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
60. Medullary thyroid
    cancer, pheochromocytoma,
   and hyperparathyroidism
P771
A

MEN-IIa

61
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
61. Hypokalemia refractory
to IV potassium
supplementation
P771
A

Hypomagnesemia

62
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
62. Newborn with
pneumatosis
P771

A

Necrotizing enterocolitis (NEC)

63
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
63. Child with abdominal
mass that crosses midline
P771

A

Neuroblastoma

64
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
64. Child 4 years of age
with abdominal tumor
that does NOT cross
midline
P772
A

Wilms’ tumor

65
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
65. “Currant jelly” stools
and abdominal colic
P772

A

Intussusception

66
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
66. Femur fracture,
respiratory failure,
petechiae, and mental
status changes
P772
A

Fat embolism

67
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
67. Hearing loss, tinnitus,
and vertigo
P772

A

Ménière’s disease

68
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
68. Adolescent boy with
nasal obstruction and
recurrent epistaxis
P772
A

Juvenile nasopharyngeal angiofibroma

69
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
69. Child <5 years of age sitting upright and drooling, with
“hot potato” voice
P772

A

Epiglottitis

70
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
70. Angina, syncope, and
CHF
P772

A

Aortic stenosis

71
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
71. Tobacco use, asbestos
exposure, and pleuritic
chest pain
P772
A

Mesothelioma

72
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
72. Supracondylar fracture
and contracture of
forearm flexors
P772
A

Volkmann’s contracture

73
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
73. Tibia fracture, “pain out
of proportion,” pain on
passive foot movement,
and palpable pulses
P772
A

Compartment syndrome

74
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
74. 25-year-old man with
liver mass with fibrous
septae and NO history
of cirrhosis or hepatitis
P772
A

Fibrolamellar hepatocellular carcinoma

75
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
75. EKG with flattening of
T waves and U waves
P773

A

Hypokalemia

76
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
76. Central pontine
myelinosis
P773

A

Too-rapid correction of hyponatremia

77
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
77. Polydipsia, polyuria,
and constipation
P773

A

Hypercalcemia

78
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
78. Factor VIII deficiency
P773

A

Hemophilia A

79
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
79. Abdominal pain,
fever, hypotension,
HYPERkalemia, and
HYPOnatremia
P773
A

Adrenal insufficiency (Addisonian crisis)

80
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
80. Massive urine output
and HYPERnatremia
P773

A

Diabetes insipidus

81
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
81. Increased urine
osmolality,
HYPOnatremia, and
low serum osmolality
P773
A

SIADH

82
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
82. IV antibiotics, fever,
diarrhea
P773

A

Clostridium difficile pseudomembranous

colitis

83
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
83. Bleeding gums and
wound dehiscence
P773

A

Vitamin C deficiency

84
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
84. Fever, central line, and
HYPERglycemia
P773

A

Central line infection

85
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
85. Appendectomy
followed by fever and
abdominal pain on postoperative
day #7
P773
A

Peritoneal abscess

86
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
86. Advancing crepitus,
fever, and blood blisters
P773

A

Necrotizing fasciitis

87
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
87. High INTRAoperative
fever
P773

A

Malignant hyperthermia

88
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
88. Confusion, ataxia, and
ophthalmoplegia
P773

A

Wernicke’s encephalopathy

89
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
89. Tracheal deviation,
decreased breath
sounds, and
hyperresonance
P774
A

Tension pneumothorax

90
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
90. Hypotension, decreased
heart sounds, and JVD
P774

A

Pericardial tamponade

91
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
91. Four ribs broken in
two places and
pulmonary contusion
P774
A

Flail chest

92
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
92. Otorrhea (clear) and
Battle’s sign
P774

A

Basilar skull fracture

93
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
93. Ulcer and decreased
pain with food
P774

A

Duodenal ulcer

94
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
94. Vomiting, retching, and
epigastric pain
P774

A

Mallory-Weiss tear

95
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
95. Fever on postoperative
day #1, with “bronze”
weeping, tender wound
P774
A

Clostridial wound infection

96
Q

TOP 100 CLINICAL SURGICAL MICROVIGNETTES
96. Hematochezia and
tenesmus
P774

A

Rectal cancer

97
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
97. Upper GI bleed,
jaundice, and RUQ
pain
P774
A

Hemobilia

98
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
98. Gallstones, epigastric
pain radiating to back,
and nausea
P774
A

Gallstone pancreatitis

99
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
99. 18-year-old woman
with bloody nipple
discharge
P774
A

Ductal papilloma

100
Q
TOP 100 CLINICAL SURGICAL MICROVIGNETTES
100. Irritability, diaphoresis,
weakness, tremulousness,
and palpitations
P774
A

Insulinoma