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Step 2 > Surgery > Flashcards

Surgery Flashcards

1
Q

Prostatic Valve Dysfunction Diagnosis

A

Echo

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2
Q

Adolescent boy
Proximal Femur pain worse at night, relieved with NSAIDs, unrelated to activity
Small, round lucency (Xray)

A

Osteoid Osteoma

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3
Q

Breast pain
Cyclic, bilateral diffuse
mass
Next Step

A

Imaging

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4
Q

Breast pain
cyclic, bilateral, diffuse
No mass

A

observe

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5
Q

Breast pain
noncyclic, unilateral focal
no mass
Abnormal imaging

A

biopsy

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6
Q

Breast pain
noncyclic, unilateral focal
no mass
normal imaging

A

Observe

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7
Q

Breast pain
noncyclic, unilateral focal
mass

A

biopsy, referral to breast surgeon

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8
Q

Prior esophageal/gastric resection or reconstruction, Nissen fundoplication
Abdominal pain, diarrhea, nausea, hypotension, tachy, dizziness, AMS
15-30 minutes after meals

A

Dumping syndrome

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9
Q

Dumping Syndrome management

A

clinical diagnosis

small, frequent meals, replace simple sugars with complex carbs, high fiber and protein rick foods

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10
Q

Manage ureteral stone <10mm

A

Hydration
pain control
alpha blockers
strain urine

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11
Q

Diagnosis of postop urinary retention

A

Portable bladder ultrasound

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12
Q

Thunderclap headache, visual field defects, ophthalmoplegia

A

pituitary apoplexy

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13
Q

Within minutes to 24 hours of transfusion

fever, chills, hypotension, hemoglobinura, flank pain

A

Acute hemolytic transfusion Reaction

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14
Q

Lab findings of Acute hemolytic transfusion reaction

A

postive Coombs test

Hemolysis

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15
Q

Complications of Acute hemolytic transfusion reaction

A

acute renal failure

DIC

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16
Q

Diagnosis of open angle glaucoma

A

Tonometry

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17
Q

Diagnosis of Zenker’s Diverticulum

A

contrast esophagography

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18
Q

Hypotension, shock

nausea, vomiting, ab pain, fever, general weakness

A

Adrenal crisis

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19
Q

Treatment of adrenal crisis

A

hydrocortisone

Dexamethasone

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20
Q

Prolonged clamping of infrarenal aorta and iliac arteries complications

A

Metabolic acidosis via lactic acidosis
Increased bicarbonate reabsorption and increased H+ excretion, increased urinary Cl- excretion, increased excretion of ammonium

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21
Q

Trauma in one eye, then blurry vision in opposite eye. Path…

A

Sympathetic ophthalmia

T cell sensitization of self antigens

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22
Q

Brown Recluse Spider

A

eschar/ necrosis

clean wound and apply ice, supportive management

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23
Q

acute pericarditis ECG findings and diagnosis

A

diffuse ST segment elevations and PR segment depression

D(x): echo

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24
Q

Abrupt onset dyspnea, low grade fever, diffuse crackles/wheezes, infiltrate in dependent portion of lung

A 
Chemical pneumonitis (from gastric acid)
supportive care
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25
Q

Young patient with one sided headaches

Nausea and vomiting

A

Ruptured arteriovenous malformation

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26
Q

Anesthesia, succinylcholine or excessive heat
Rigidity
tachy
Hypercarbia resistant to increased minute ventilation
Rhabdo
Hyperkalemia
Hyperthermia

A

Malignant Hyperthermia

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27
Q

Treatment for perforated bowel

A

Surgical exploration

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28
Q

Medial knee pain and focal tenderness

A

pes anserinus syndrome

Manage with quadricep strengthening exercise

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29
Q

Hemodynamically stable patient with free fluid on FAST..next?

A

CT ab and pelvis

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30
Q

Hemodynamically unstable with free fluid on FAST

A

Laparotomy

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31
Q

Where is pelvic blood loss hidden?

A

retroperitoneum

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32
Q

Postop weakened dorsiflexion and diminished pinpoint sensation of big toe

A

common fibular N injury

Reassurance and physical therapy

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33
Q

High protein Ascites

A

CHF, constrictive pericarditis, peritoneal carcinomatosis, TB, Budd Chiari, fungal

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34
Q

Low Protein Ascited

A

Cirrhosis, nephrotic syndrome

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35
Q

Treatment for radiculopathy

A

NSAIDs and avoidance of provocative maneuvers

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36
Q

Infections in solid organ transplants

A

Nosocomial infections

CMV, PCP, Aspergillus

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37
Q

Local anesthetic complication

A

perioral numbness, metallic taste, tinnitus –> generalized tonic clonic seizures.

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38
Q

LUQ pain, left pleuritic chest pain and left pleural effusion

A 
Splenic abscess 
( via infective endocarditis- staph, strep, salmonella)
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39
Q

Unilateral frontal, parietal or temporal lobe lesion

NO PUPILARY INVOLVEMENT

A

Subfalcine herniation

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40
Q

elderly FOOSH

A

Colles Fracture

First step of management is closed reduction of fracture

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41
Q

head trauma or acceleration/deceleration

GCS <8, impaired more than imaging MRI finidings

A

Diffuse Axonal Injury

Punctate hemorrhages in white matter, blurring of gray-white matter junction

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42
Q

Slipped capital femoral epiphysis X ray findings

A

posteriorly displaced femoral head

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43
Q

Fever, focal/severe back pain, neuro findings

A

Spinal epidural abscess

Diagnosis with MRI of spine with contrast

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44
Q

Treatment for spinal epidural abscess

A

antibiotics (vanco + ceftriaxone)

urgent aspiration/ surgical decompression

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45
Q

Bowel problem that is associated with erythema nodosum

A

Inflammatory bowel disease

Crohns > UC

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46
Q

lytic lesion at epiphysis of distal femur

Soap bubble appearance on X ray

A

Giant cell tumor

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47
Q

Night driving difficulty and halos around bright lights

no pain

A

cataracts

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48
Q

Spinal abscess diagnosis

A

MRI with contrast

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49
Q

jaw pain and swelling exacerbated by eating

A

recurrent sialadenitis via sialolithiasis

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50
Q

ab pain and tenderness, hematochezia, diarrhea, lactic acidosis

A

colonic ischemia

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51
Q

Diagnosis of colonic ischemia

A

CT: colonic wall thickening fat stranding
Endoscopy: edematous and friable mucosa

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52
Q

Colonic Ischemia treatment

A

IVF and bowel rest
Abx with enteric coverage
colonic resection if necrosed

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53
Q

Patient >40

painless hematuria, hydronephrosis and voiding symptoms

A

bladder cancer

Do cystoscopy

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54
Q

Profuse watery diarrhea, liver inflammation and maculopapular rash after hematopoietic stem cell transplant

A

Acute graft vs host disease

D(x) with biopsy

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55
Q

snake bite treatment

A

limb immobilization and wound management
coag studies
antivenom
observe 12-24 hr

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56
Q

Most common pulmonary postop complication

A

Atelectasis (impaired cough and shallow breathing)

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57
Q

Diagnose Pulmonary embolism

A

CTA

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58
Q

ab/flank pain that radiates to groin or hip, ab pain with hip extension

A

Psoas abscess

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59
Q

Diagnose psoas abscess

A

CT scan of abdomen and pelvis

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60
Q

back pain, cachexia, high alkaline phosphatase and multiple osteoblastic/osteolytic vertebral lesion,
High AFP

A

hepatocellular carcinoma or testicular cancer

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61
Q

Treat priapism

A

aspirate blood fro the corpora cavernosa

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62
Q

Causes of priapism

A

cocaine, alcohol, testosterone, sickle cell disease, trazadone

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63
Q

blood products given in hemorrhagic shock

A

4 units FFP and 4 units platelets

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64
Q

Pleural effusions that can be managed with observation

A

small-moderate and not enlarging
early onset (1-2 days)
not associated with respiratory symptoms

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65
Q

Management of tender, purple bulge below the dentate line

A

external hemorrhoid

excision

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66
Q

Chronic back pain, intermittent bilateral heel pain, impaired spinal mobility and limited chest wall expansion

A

Ankylosing spondylitis

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67
Q

Heart complication of ankylosing spondylitis

A

chronic aortic regurgitation

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68
Q

Nausea vomiting
No flatus
Abdominal distension
Decreased or absent bowel sounds

A

Ileus

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69
Q

Management of ileus

A

antiemetics, bowel rest, serial examinations

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70
Q

What decreases risk of infection in burn patients

A

Early wound excision and grafting

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71
Q

chest/back pain or epigastric pain, crepitus, Hamman sign, pleural effusion
widened mediastinum on CT

A

Esophageal perforation

D(x): Esophagography with water soluble contrast

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72
Q

Treatment for UC

A

5-ASA agents (mesalamine, sulfasalazine)

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73
Q

How to prevent perioperative complications in patient with obstructive hypertrophic cardiomyopathy

A

ensure adequate IV hydration

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74
Q 
Acute Infective Endocarditis 
Preload
Afterload
Contractile function
EF
Forward stroke volume
A 
Mitral regurgitation
Preload: HIGH
Afterload: low
Contractile function: no change
EF: HIGH
Forward stroke volume: low
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75
Q

Management of sigmoid volvulus

A

Endoscopic detorsion (flex sig) and elective colectomy

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76
Q

Young male with weak/spraying stream, incomplete emptying

A

Urethral stricture
Dx postvoid residual
Manage: dilation/ urethroplasty

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77
Q

flexed hip, adducted, internal rotation

A

posterior hip dislocation

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78
Q

Treat hip dislocation

A

reduction within 6 hours of injury
if no fracture: closed reduction
if fracture: open reduction
if limp ischemia: CTA

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79
Q

Reason for transfusion reaction within an hour

A

ABO compatibility

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80
Q

Abx for osteomyelitis in sickle cell patients

A

clindamycine and ceftriaxone

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81
Q

Abx for osteomyelitis in healthy children

A

clindamycin/vancomycin

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82
Q

Diagnostic test to identify cause of priapism in patient with hepatosplenomegaly

A

CBC

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83
Q

Male breast mass management

A

Mammography

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84
Q

Hemorrhagic shock- continuing normal saline fluid can cause what complication

A

Increased risk for coagulopathy

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85
Q

Boys insidious hip pain, limp, restricted hip abduction, internal rotation, positive trendelenburg
Normal X ray

A

legg Calve Perthes

Avascular necrosis of femur

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86
Q

complications of nearsightedness

A

retinal detachment and macular degeneration

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87
Q

widened mediastinum prior falling from height

A

thoracic aortic injury

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88
Q

What type of hernia is more likely to be incarcerated

A

femoral hernia

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89
Q

History of alcohol and recent pancreatitis. Now progressive ab distension, nausea and vomiting.
CT round, well circumscribed, encapsulated fluid collection

A

Pancreatic pseudocyst

T(x): endoscopic drainage procedure

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90
Q

Exudative effusion

A

pleural/serum protein >.5
Pleural/serum LDH > .6
Pleaural LDH > 2/3 upper limit of normal for serum LDH

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91
Q

postop unilateral back pain, nausea and vomiting

A

hydronephrosis

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92
Q

unilateral floaters and progressive vision loss.

A

candida endophthalmitis

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93
Q

new onset hypoxia by pulse ox due to anesthetic use

A

acquired methmoglobinemia

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94
Q

headache, nausea, vomiting, ipsilateral ataxia, dysarthria, vertigo, nystagmus

A

cerebellar hemorrhage

Manage: surgical decompression

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95
Q

management of hidradenitis suppurativa

A

prolonged antibiotic

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96
Q

contraindication in cardioembolic stroke

A

thombolytics

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97
Q

diagnosis of meniscal tear

A

MRI

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98
Q

next step in management of infected foot ulcer

A

osteomyelitis (bone biopsy)

99
Q

X ray: disruption of cortical contour, external rotation of distal fragment, shortening of neck, lucency or hazy sclerosis at fracture plane

A

femoral neck fracture

100
Q

progressive sensorineural hearing loss, episodic vertigo with nystagmus due to changes in pressure in the inner ear (Valsalva)

A

Perilymphatic fistulas

101
Q

Liver mass in women on long term OC, possible hemorrhage or malignant transformation

A

Hepatic adenoma

102
Q

Liver mass with acute or chronic liver injury

A

Regenerative nodules

103
Q

Most common place for colonic ischemia

A

splenic flexure

104
Q

Complication of rhinoplasty

whistling noise

A

nasal septal perforation

105
Q

Hematuria, flack/abdominal pain, elevated LDH/AKI

Enlarging kidney on imaging

A

Renal Vein thrombosis

106
Q

Differentiate between level 1 axillary LN and Level 2

A

Pectoralis minor

107
Q 
Thyroid storm 
SVR
Cardiac output:
venous-o2 content
pulm capillary wedge pressure
A

SVR: low
Cardiac output: high
venous O2 content: high
Pulm capillary wedge pressure: high

108
Q

young patients with no tobacco exposure and multiple sexual partners.
enlarged firm neck mass and ulcerated tonsillar lesion

A

head and neck squamous cell carcinoma via HPV

109
Q

First line treatment for high risk basal cell carcinoma

A

Mohs micrographic surgery

110
Q

recurrent epistaxis and nasal crusting

A

CPAP usage

111
Q

Brittle hair, skin depigmentation, neuro dysfunction, anemia, osteoporosis
What is deficient?

A

Copper deficiency

112
Q

Risk factors of Euthyroid sick syndrome

A

severe acute illness
ICU admission
High dose glucorticoid therapy

113
Q

Euthyroid thyroid labs

A

Low T3, normal TSH and T4

114
Q

Aortic dissection patient

Initial study of choice in hemodynamically stable patients with no evidence of renal dysfunction

A

CT angio

115
Q

0-6 hours post op fever reasons

A

tissue trauma
blood products
malignant hyperthermia
T(x) symptomatic

116
Q

Frostbite management

A
  1. rapid rewarming
  2. Analgesia and wound care
  3. Angiography/ technetium 99m scan
  4. thrombolysis in severe cases
117
Q

ear pain with normal ear exam

poor dentition

A

Referred otalgia via muscosal head and neck squamous cell carcinoma

118
Q

Secretory diarrhea, bloating, abdominal cramps, umremarkable serum & stool studies

A

bile acid diarrhea

119
Q

Treatment for bile acid diarrhea

A

choestyramine or colestipol

120
Q

Unilateral, pruritic breast rash with breast erythema and edema, axillary LAD

A

Inflammatory breast cancer

121
Q

Inflammatory breast cancer diagnosis

A

breast biopsy (core needle)

122
Q

Management of venous air embolism

A

Left lateral decubitus positioning

High flow/hyperbaric O2

123
Q

Throbbing headache and nausea
Unilateral pronator drift
CT: calcifies extra axial mass
MRI: Homogenous, dural based

A

meningioma

124
Q

Management of symptomatic meningioma

A

complete resection

125
Q

post gastric surgery, bloating, flatulence, chronic water diarrhea, low B12 high folate

A

SIBO

126
Q

Management for small bowel obstruction

A

nasogastric tube insertion and emergency laparotomy

127
Q

dorsal penile plaque and pain/ curvature with erection

A

Peyronie disease

128
Q

Weakness in upper and lower extremities, atrophy in hands with hyperreflexia in legs, electric shock pain with neck flexion

A

cervical spinal cord compression

129
Q

First line therapy for burn wound infection

A

Meropenem and vanco

130
Q

velcro inspiratory crackles

CT: lower lobe subpleural honeycombing and reticular markings greatest and periphery

A

idiopathic pulmonary fibrosis

Management: antifibrotic therapy (pirfenidone, nintedanib)

131
Q

Management of HIT

A

stop heparin and start direct thrombin inhibitor (argatroban) or fondaparinux

132
Q

First line therapy for IBD induced toxic megacolon

A

IV corticosteroids

133
Q

fall with object in mouth, gradual onset hemiplegia, aphasia, neck pain and thunderclap headache

A

Carotid artery dissection

134
Q

Management of acute limb ischemia

A

anticoagulation (heparin)

Thrombolysis/surgery

135
Q

Within first 3 months of transplant. Fever, malaise, LFT elevations
Histo: inflammatory infiltration

A

Acute cellular rejection

136
Q

Management of acute cellular rejection

A

high dose corticosteroids

137
Q

sudden onset severe unilateral ab pain right after strenuous activity
US: pelvic free fluid

A

ruptured ovarian cyst

138
Q

Recommendation for medically stable patients who recover fro acute pancreatitis

A

Cholecystectomy

139
Q

fracture of >3 adjacent ribs in >2 locations

isolated chest wall segment that moves paradoxically

A

flail chest

140
Q

High alk phos and bilirubin

multifocal strictures of intrahepatic and extrahepatic bile ducts

A

PSC

141
Q

CKD patient with femoral neck fracture what lab do you order?

A

parathyroid hormone level

142
Q

small puncture wound appears minor initially

septic arthritis

A

Clenched fist bite injury

143
Q

Management of clenched fist bite injury

A

urgent surgical irrigation and debridement

amp/sul or amp/clav

144
Q

Complications of varicocele

A

infertility and testicular atrophy

145
Q

Diagnosis of acute diverticulitis

A

CT abdomen

146
Q

risk factors of avascular necrosis

A 
femoral head fracture
glucocorticoids
excessive alcohol use
sickle cell
SLE
147
Q

shortened internally rotated leg, hip flexed and adducted, knee flexed
unable to dorsiflex or straighten leg

A

posterior hip dislocation

148
Q

liver abscess management

A

percutaneous aspiration

149
Q

HIGH fever, tachy, hypertension, CHF, arrhythmia, agitation, delirium, goiter
postop

A

thyroid storm

150
Q

Management of thyroid storm

A

B blockers
PTU
glucocorticoids

151
Q

surgical indication in infective endocarditis

A

acute heart failure
extension of infection
difficult to eradicate organisms
persistent bacteremia on abx, large vagetation/ persistent septic emboli

152
Q

shortened external rotation

A

femoral neck fracture

153
Q

Pain out of proportion to injury, pain incrases on passive stretch, rapidly increasing and tense swelling, paresthesia

A

compartment syndrome

154
Q

abx for acute bacterial prostatitis

A

Levofloxacin

155
Q

complication of prolactinoma

A

bone loss

156
Q

PAD diagnostic management

A

ABI

157
Q

High pressure injection injury management

A

fasciotomy and debridement in the operating room

158
Q

electrical injury complications

A

rhabdomyolysis

159
Q

hard mass in the olecranon

A

tophaceous gout

160
Q

indications for CT scan in orbital trauma

A 
severe eye pain
evidence of fracture
painful extraocular movements
decreased visual acuity
suspected intraocular foreign body
inadequate examination
161
Q

Diagnostic imaging of appendicitis

A

CT abdomen

162
Q

Treatment of spiral fracture of toddler

A

immobilization and pain control

163
Q

adolescent
proximal airway obstruction
recurrent pneumonia
hemptysis

A

bronchial carcinoid tumor

164
Q

Path of flail chest

A

impaired generation of negative inspiratory pressure

165
Q

imaging for intraabdominal organ injury

A

CT scan

166
Q

abdominal distention, failure to pass flatus, absent bowel sounds.
X ray dilated gas filled loops with no transition point

A

paralytic ileus

167
Q

unilateral, painless testicular mass
dull ache in lower abdomen
High AFP, BhCG, LDH

A

testicular cancer

168
Q

Diagnose testicular cancer

A

scrotal US
labs
Radical inguinal orchiectomy

169
Q

Colles Fracture Nerve compression

A

Median N

170
Q

Salter III Fracture complication

A

limb length discrepancy

171
Q

Parasite that causes SBO

A

ascaris lumbricoides

172
Q

jaundice, pruritis, acholic stools, dark urine, weight loss, RUQ pain
high direct bilirubin ALP and GGT
CEA, CA19 and AFP

A

cholangiocarcinoma

173
Q

Candida infection is lost likely from what?

A

Central venous catheters

174
Q

contact lens abrasion management

A

topical antibiotic

175
Q

gold standard for sphincter of oddi dysfunction

A

Sphincter of oddi manometry

176
Q

Treatment for Zenkers

A

cricopharyngeal myotomy

177
Q

post burn injury
hyperglycemia, increased body temp, increased muscle wasting
tachy and HTN

A

Hypermetabolic response to burn injury

178
Q

Treatment of Hypermetabolic response in burn injury

A

early burn exciion and grafting
B blocker
Insulin
Nutrition and steroid

179
Q

rapid progressive cellulitis of the submandibular and sublinguial spaces

A

Ludwig angina

180
Q

Indications of worse prognosis in acute pancreatitis

A

elevated BUN
SIRS criteria
third spacing of fluid

181
Q

Predictors of postop outcomes following lung resection

A

Preop FEV1 and DLCO

182
Q

post gastric bypass, fever, ab pain, tachy and tachypnea

A

anastomotic leak

D(x) oral contrast enhanced CT

183
Q

stabbed in chest, respiratory distress, unilateral absent breath sounds, hypotension and distended neck veins

A

tension pneumothorax

184
Q

TBI, episodic HTN, tachy, diaphoresis

A

paroxysmal sympathetic hyperactivity

185
Q

most common opportunistic infection after renal transplant

A

CMV

186
Q

Actively bleeding + DVT management

A

inferior vena cava filter

187
Q

Right sided varicocele management

A

US abdominal

188
Q

causes of sialadenosis

A

chronic alcohol use, bulimia, malnutrition

189
Q

Type of dressing for venous stasis ulcers developed to cellulitis

A

wet to dry dressing

190
Q

Cervical spine imaging necessary if

A

neuro deficit, spinal tenderness
AMS
intoxication
distracting injury

191
Q

pain with ejaculation, many UTI

A

chronic bacterial prostatitis

192
Q

valve issue that is most common cause of pregnancy related complications

A

mitral stenosis

193
Q

Rectal prolapse with debilitating symptoms management

A

surgery

194
Q

tumor that causes nasal congestion with epistaxis, headache, cranial nerve palsy, serous otitis media

A

nasopharyngeal carcinoma via EBV

195
Q

treatment of plantar fasciitis

A

activity modification
stretching exercises
heel pads/ orthotics

196
Q

blood thinner, acute ab pain, abdominal mass and anemia

A

rectus sheath hematoma

197
Q

management of initial bloody output >1500mL via chest tube

A

emergent thoracotomy

198
Q

Arterial embolism vs. arterial thrombosis

A

Arterial embolism= pain, pallor, paresthesia, pulseless, paralysis
arterial thrombosis= claudication

199
Q

Most concerning of parotid malignancy

A

presence of facial droop

200
Q

pelvic fracture + unstable patient

first step in management

A

pelvic binder

201
Q

local complication of cardiac catheterization

A

AV fistula (continuous bruit with palpable thrill)

202
Q

Organisms that cause deep infections following puncture wounds

A

staph aureus

pseudomonas

203
Q

<24 hours after blunt thoracic trauma
tachypnea, tachy, hypoxia
CT: patchy, alveolar infiltrate not restricted by anatomic borders

A

pulmonary contusion

204
Q

persistent hoarseness and fungating laryngeal mass

smoker

A

laryngeal SCC

205
Q

complication of succinylcholine

A

cardiac arrhythmia due to electrolyte derangement

206
Q

progressive hearing loss, paradoxical improvement in noisy environments
reddish hue behind TM

A

otosclerosis

207
Q

Treatment for c. diff

A

fidaxomicin or vanco

208
Q

complication of C. diff

A

toxic megacolon

209
Q

arm in extension and pronated

no swelling, deformity or focal tenderness

A

Nursemaid elbow

treat via hyperpronation or supination of forearm and flexion of elbow

210
Q

post surgery, traumatic injury
Abdominal distension, pain, obstipation, vomiting
Xray: colonic dilation, normal haustra, nondilated small bowel

A

Oglivie syndrome

211
Q

unilateral bloody nipple discharge with no breast mass or LAD

A

intraductal papilloma

212
Q

treatment of small pneumothorax

A

supplemental oxygen

213
Q

abdominal pain, RUQ mass, jaundice

cystic dilation

A

biliary cyst

treat with ERCP

214
Q

posterior knee an calf pain with tenderness and swelling of the calf resembing DVT
arc of ecchymosis distal to medial malleolus

A

ruptured popliteal cyst

215
Q

management of suppurative parotitis

A

US/CT
hydration and oral hygiene
abx
massage

216
Q

bilateral hip, thigh, and buttock claudication

absent/ diminished femoral pulses, impotence

A

leriche syndrome

217
Q

post op fever, leukocytosis, high LFTs and RUQ pain

A

acalculous cholecystitis

218
Q

nonhealing ulcer at the site of chronic burn scar

A

squamous cell carcinoma

219
Q

CT well defined cyst with eggshell calcification

dogs at home

A

hyadatid cyst

220
Q

alopecia, pustular skin rash, hypogonadism, impaired wound healing, impaired taste, immune dysfunction

A

zinc deficiency

221
Q

most common empyema organisms

A

strep pneumo, staph aureus

222
Q

diagnostic of laryngomalacia

A

laryngoscopy

223
Q

malignant pericardial effusion management

A

TTE

224
Q

weeks to months after amputation
focal tenderness, altered local sensation
decreased pain with anesthetic injection

A

post traumatic neuroma

225
Q

complication of cardiac surgery. mild chest pain or sensation of chest wall instability and clicking

A

sternal dehiscence

T(x) surgical emergency sternal fixation

226
Q

irregular exophytic growths in clusters on vocal cords

A

laryngeal papillomas

227
Q

sudden sharp pain while pivoting ankle.

Cannot move foot when calf is squeezed, cannot walk of tippy toes

A

Achilles tendon rupture

228
Q

neuroendocrine malignancy from parafollicular cells

A

medullary thyroid cancer

check calcitonin

229
Q

bilateral renal infarcts and several abdominal arteries with microaneurysms and distal abrupt cutoffs

A

polyarteritis nodosa

230
Q

Management of pheochromocytoma preop

A

alpha blockage prior to beta blockade

231
Q

thyroid tumor marker

A

thyroglobulin

232
Q

abdominal pain or nausea post cholecystectomy

dilated common bile duct

A

postcholecystectomy syndrome

ERCP

233
Q

staging evaluation for rectal adenocarcinoma

A

CEA, CT scan, colonoscopy

234
Q

Thyroid nodule evaluation

A
  1. TSH and thyroid US

2. radioactive scintigraphy

235
Q

posterior displacement of distal humerus

nerve and artery damage

A

median nerve

brachial artery

236
Q

artery injured in knee dislocation

A

popliteal artery

237
Q

anterior mediastinal mass high AFP and B hCG

A

mixed germ cell tumor

238
Q

liver mass with arterial flow and central scarring

A

focal nodular hyperplasia

239
Q

RUQ pain, jaundice, anemia and hyperbilirubinemia after liver biopsy, upper GI bleed

A

hemobilia

240
Q

quick twisting motion around flexed knee, severe pain, popping noise

A

patellar dislocation

241
Q

indurated, erythematous mass near anal orifice associated with severe constant anal pain and low grade fever

A

perianal abscess

occlusion of an anal crypt gland

242
Q

blunt abdominal trauma with billous emesis, gastric dilation and scant distal gas

A

duodenal hematoma

243
Q

reduce intracranial pressure

A

hypertonic saline

244
Q

post splenectomy abx if fever

A

amoxicillin- clav

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