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AMC MCQ > Surgery > Flashcards

Surgery Flashcards

1
Q

Most common type of esophageal cancer?

A

Squamous cell CA

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2
Q

MEN Syndrome

A

MEN 1….PPP
MEN 2A..MPP (med, ca, Pheo,Parathyroid)
MEN 2B..MMP *med. CA, Mucosal nueroma, Pheo)

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3
Q

what is the screening in place for prostate cancer?

A

ALL men >50….voluntary yearly PSA

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4
Q

Pt with family history of prostate cancer, when to start screening if concerned?

A

40 years

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5
Q

Steroid regiment for steroid dependent individual going for surgery

A

100mg IV preop….
100mg IV intra op
100mg iv upto 24 hrs post op
then oral steroids when tolerated

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6
Q

hard throid nodule with elevated TSH, think?

A

Hashimotos thyroiditis

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7
Q

5 tests for the knee

A
  1. ACL ==Lachman test
  2. PCL==posterior draw test and posterior sag
  3. Meniscus injury ==Mcmurray test
  4. Collateral ligament== Varus and valgus test
  5. Patellar disloc==patellar apprehension test
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8
Q

Best ABX to cover abdominal surgery prophylactic?

A

Metronidazole +

Gent or cephazolin

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9
Q

Which Hernia is unlikely to strangulate?

A

Direct Hernias

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10
Q

MCC of acute limb ischemia?

A

Thrombosis

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11
Q

Tension pneumothorax, where to place needle and tube?

A

Needle = 2 intercoastal space mid clavicular

Tube = 5 th ICS mid Axillary

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12
Q

Pt with abdominal trauma, hemodynamically unstable, what to do?

A

FAST

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13
Q

Fracture of mid shaft of humerus, what nerve is affected?

A

Radial Nerve

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14
Q

Suspected urethral injury, what to do?

A

Retrograde Urethrogram

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15
Q

Common Peroneal nerve damage sign?

A

foot drop….inability to dorsiflex

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16
Q

Any male or post menopausal female with iron deficiency, what to do?

A

Refer for colonoscopy

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17
Q

Unknown hx of tetanus vaccination, what to do?

A

give both IVIG and toxoid

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18
Q

Unilateral neck mass with no symptom, most likely diagnosis

A

Multinodular goiter

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19
Q

Bilateral neck mass with no symptom, most likely diagnosis

A

Adenocarcinoma or carcinoma

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20
Q

Tx of choice for Pleomorphic Adenomas?

A

Superficial paroidectomy

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21
Q

Most common cardiac tumor?

A

Myxoma

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22
Q

MC complication of TURP?

A

UTI

Followed by bleeding

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23
Q

1st investigation in suspected esophageal malignancy?

A

Barium swallow

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24
Q

MC cause of bone tumor in pelvis of young adult?

A

Metastatic tumor

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25
Q

Tx of calcified gall bladder (porcelain)

A

Prophylactic cholecystectomy

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26
Q

Pt present to ER after blunt force trauma, FAST or CT?

A 
Stable = CT
Unstable = FAST
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27
Q

Which drug gives rebound htn when stopped suddenly?

A

clonidine (an alpha blocker)

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28
Q

Migratory superficial thrombophlebitis and DVT, suspect?

A

Pancreatic cancer

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29
Q

MC cause of large bowel obstruction in Australia?

A

Colon Cancer

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30
Q

Most useful inv. for detecting gallstones?

A

US

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31
Q

Melanoma and clear margins for excision

A

depth of 1mm —1cm clear margin required
2 - 4 mm —-1-2cm margin required
4mm —2cm margin required

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32
Q

when do you do prophylactic cholecystectomy?

A

gallstone >3cm or porcelin gallbladder

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33
Q

Pt after trauma presents to ER after lucid interval, suspect?

A

Epidural hematoma

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34
Q

investigation of choice in recurrent kidney stones?

A

US + X Ray

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35
Q

How to monitor secondary spread in seminoma?

A

LDH Lactate dehydrogenase

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36
Q

First line investigation for chronic pancreatitis? (2)

A

CT, if unavailble use US

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37
Q

Tx of Duputrens contracture?

A

Open fasciectomy

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38
Q

Liver and Pancreas
Amebic Liver Abscess
Causative organism……

A

Entameba Histolytica
Usually singe and located at upper lobe
Anchovy paste fluid

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39
Q

Abdominal pain, dysentery and bloody diarrhea
RUQ pain
Fever and chills
with travel History to endemic area vvvvvv imp

common presentation

A

Entameba Histolytica

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40
Q

Wbcs in Entameba Histolytica

A

increased

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41
Q

Stool analysis in Entameba Histolytica

A

trophozoites

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42
Q

CT Entameba Histolytica

A

cystic lesions

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43
Q

TTT Entameba Histolytica

A

ORAL METRONIDAZOLES

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44
Q

HYDATIC CYST
Causative organism
Initial Inv?
Best Inv?

A

Echinococcus granulosus

US

CT

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45
Q

Definitive host for HYDATIC CYST

A

dog
Many cases are asymptomatic
Abd pain, fever, and may be jaundice

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46
Q

CT presentation of HYDATIC CYST

A

Egg shell calcification of hepatic cyst

one big cyst with multiple daughter cysts

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47
Q

Risk for HYDATIC CYST if rutured

A

anaphylaxis if ruptured

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48
Q

if CT does not reveal it (HYDATIC CYST) do?

A

Serology

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49
Q

TTT of HYDATIC CYST

A

SURGERY under cover of albendazole

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50
Q

Liver malignancy

Primary shows?

A

Increased alpha fetoprotein

Less common than metastasis

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51
Q

CT in primary Liver malignancy

A

SOLITARY LESION

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52
Q

TTT of primary Liver malignancy

A

SURGERY, CHEMOTHERAPY, AND

INTRAHEPATIC EMBOLIZATION

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53
Q

Secondary Liver malignancy is from?

A

the colon

Much more common than primary

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54
Q

CT in Secondary Liver malignancy shows?

A

MULTIPLE SPOTS

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55
Q

HEPATIC ADENOMA is related to

A

OCP use

Benign rare tumour

Normal liver function test and alpha feto protein

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56
Q

Acute pancreatitis

Causes

A

Gall stones…Alcohol

Others…….trauma, infection, increase lipids TIL

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57
Q

Acute pancreatitis

Complications:

A

1 - Pseudocyst…..most common complications
Timing …………..within weeks,
Cp…………………..epigastric MASS,
Fate………………..usually resolve spontaneously
HAPPy PAD

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58
Q

When to drain Pseudo cyst??:

A

If persists more than 6 wks , size more than 6 cm, or if infected

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59
Q

How to drain Pseudo cyst?.

A

Endoscopic internal drainage to stomach

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60
Q

Most common early complication of Acute Pancreatitis

A

2 - ARF…………

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61
Q

Most common cause of acute pancreatitis

A

stones

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62
Q

Most common complication overall of acute pancreatitis?

A

pseudocyst

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63
Q

TTT of acute pancreatitis?

A

conservative

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64
Q

PANCREATIC CANCER Presentation

A 
Sex……….usually male
Age………old
Most cancer causes death within 5 years
Risk factors……SMOKING, DM, ALCOHOL
Dull abdominal pain radiating to back
Weight loss
If at head…………deep jaundice
Recurrent thrombophlebitis
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65
Q

Investigations of PANCREATIC CANCER:

Serum bilirubin

A

increased(direct)

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66
Q

DILATATION OF GALL BLADDER

what inv to do?

A

US…

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67
Q

MASS AT HEAD OF PANCREAS

BEST ( inv of choice) for Pancreatic cancer?

A

CT

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68
Q

TTT of Pancreatic cancer

A

Surgery…whipple’s operation

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69
Q

Symptomatic ttt of pancreatic cancer

A

stent

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70
Q

Causes of CHRONIC PANCRATITIS (2)

A

alcoholism…..cystic fibosis…

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71
Q

Levels of Amylase and lipase in chronic pancreatitis?

A

normal

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72
Q

CT of CHRONIC PANCRATITIS shows?

A

THE BEST …..calcification

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73
Q

TTT of CHRONIC PANCRATITIS

A

PANCREATIC ENZYMES REPLACEMENT

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74
Q

Nephrolithiasis Presentation

A

Sudden onset flank pain
Colicky pain referred to the scrotum
Nausea and vomiting
Hematuria

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75
Q

Imaging Investigation of Nephrolithiasis:
Best:
In pregnancy
Before surgery what imaging?

Tx?

A

Best………… (non contrast) CT
Pregnant with renal stones………ultrasound

…….X-Ray

Best analgesic outside the hospital………NSAIDS

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76
Q

Most kidney stones are visible

A

majority are radiopaque

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77
Q

MOST COMMON renal stones?

A

Ca oxalate

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78
Q

Uric acid are what kind of stones?

A

radiolucent

Struvite stone……….alkaline urine………proteus

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79
Q

Treatment of kidney stones

A

Excess rehydration and thiazide with all cases

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80
Q

ureteric stones :

First line of ttt

A

Ureteroscopic laser lithotripsy for stones at any level

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81
Q

Kidney stones

If less than 2 cm

A

ESWL

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82
Q

Kidney stones More than 2 cm

A

Percutaneous nephrolithotripsy

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83
Q

Staghorn stone

A

Open nephro- or pyelo-Lithotomy

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84
Q

Young pt complains of flank pain asking for strong analgesic first step

A

drug screen by urine analysis ……take sample in front of you

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85
Q

Kidney stones Recurrence rate

A

50% within 5 years

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86
Q

Definitive treatment of:
ureteric stones :
First line of ttt

A

Ureteroscopic laser lithotripsy for stones at any level

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87
Q

Kidney stones tx

A

<0.5 conservative
If less than0.5 - 2 cm………ESWL
More than 2 cm……… Percutaneous nephrolithotripsy
Staghorn stone………………….. Open nephro- or pyelo-lithotomy

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88
Q

Indications of surgery with renal stones:

A

1 - obstruction and infection ….. Most absolute indication…vvvvvvvvvvvvvvvv imp
2 - too large to pass
3 - pain cannot be controlled

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89
Q

Inv that should be done before going to surgery on renal stones

A

X-Ray….vvvvvv imp

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90
Q

Most common cause of fever after urology procedure…

ttt

A

bacteremia Urosepsis

Empirical antibiotics……….amoxycillin and gentamycin

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91
Q

Renal cell carcinoma presentation

INV

TTT

A

Triad of;
Flank pain
Hematuria
Renal mass

CT
Biopsy……..(better to be avoided)

………..surgery ( Total Nephrectomy)…vvv imp

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92
Q

Incidental discovery of renal mass:
IF OLD AGE:
First step

Imaging of choice for surveillence

TTT of choice

A

……….active surveillance
………CT
………Total nephrectomy

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93
Q

When laparoscopic partial nephrectomy can be done??????

A

1-small tumour in one kidney (less than 4cm)
2- Cancer in both kidneys
3-only one working kidney.

94
Q

What if metastasis of renal mass???

A

Total nephrectomy followed by immunotherapy

95
Q

Young pt with renal mass , what to do?

A

Partial Nephrectomy

Active surveillance is NOT generally recommended for young patients

96
Q

Causes of Kidney injury

A

blunt trauma in the abdomen

97
Q

Presentation of Kidney Injury:

Inv…

TTT

A

Hematuria
Flank pain

……CT with contrast

……..most cases heal conservatively….imp
If unstable……….laparotomy

98
Q

Rupture of urethra
HISTORY OF TRAUMA

Investigation……

A

Blood at urethral meatus……key word
Never ever insert a catheter

……retrogradeurothrography

99
Q

Polycystic kidney disease

Two types:

A

Infantile………..AR………early mortality

Adult……..AD

100
Q

Clinical picture of PKD

Strong association

Investigation…
First………

Best

TTT:

A

Age………usually above 50
PAINLESS HEMATURIA
Hypertension
Bilateral flank mass

Intracranial berry aneurysm……SAH

..US
…CT

TTT of hypertension

101
Q

Most common cause of death in PKD

A

renal failure

102
Q

Inv of choice In PKD

A

CT

103
Q

Acute prostatitis presentation

Best inv…

TTT……

A 
Fever, chills, ++WBC
Urinary urgency and dysuria
Tender prostate
………..mid stream urine collection
……ANTIBIOTICS
104
Q

BPH Presentation

Investigation……

TTT….

A 
Male usually above 50 ys
Frequency
Nocturia…….first symptom
Hesitancy
Weak stream
Hypertrophy usually start at central zone
PR…………smooth and firm enlargement

…….US………to detect hydronephrosis

Alpha blocker eg: prazocin
TURP
Surgery

105
Q

Complications of TURP:

A

UTI
Bleeding (2nd common)…….important.]
Clot retention and clot colic

106
Q

TURP Syndrome:

A

Hyponatremia and water intoxication (TO AVOID THIS ….limit length of the procedure is limited to less than one hour,.[6]
Bladder neck stenosis
Urinary incontinence
Retrograde ejaculation

107
Q

PRASTATIC CANCER presentation

RISK factor

A

Most common malignancy in men
Age …….usually above 70

…..FH, increased fat in diet
SAME PICTURE AS BPH

108
Q

Type of PROSTATIC CANCER

A

adenocarcinoma

109
Q

PR of PROSTATIC CANCER

A

hard and asymmetry

110
Q

Complications of PROSTATIC CANCER

A

spread to vertebrae…….osteoblastic lesions…..back pain

111
Q

Sequence of investigations for PRASTATIC CANCER???

A

1st step………PSA

2nd step…….transrectal US

112
Q

TTT for Prastatic Cancer :

A

Very old patient and not fit for surgery……….WATCHFUL WAITING
Guidelines of prostate cancer ttt

113
Q

Treatment of choice if of Prostate Cancer if:

FOCAL
LOCALLY ADVANCED
METASTATIC
RECURRENT

A

Focal ……………..radical prostatectomy
Locally advanced……radiation
Metastatic………androgen ablation
Recurrent………..hormonal therapy

114
Q

According to Gleason score:

Less than/equal to 6 …
Less than/equal to 7…
Less than/equal 8-10…

A

Less than or equal to 6…………active surveillance or radical prostatectomy
7 ……………radical prostatectomy or Radation
8-10………..androgen ablation

115
Q

According to PSA:

If less than 10

A

If less than 10 ……….active surveillance

116
Q

Screening for Prostatic cancer

A

Not recommended

Done by PR and PSA

117
Q

What if the patient asked for prostate screening???

A

First step……..Counseling

Second step………Do it

118
Q

DD multiple myeloma VS prostatic cancer??

both of them

A

old age male with back pain

119
Q

Multiple myeloma will display

A

hypercalcemia……vvv imp

120
Q

Prostate cancer will display

A

normal or high calcium

So…..if old male with back pain and normal calcium NEVER CHOSE MM

121
Q

VARICOLCELE

primary. ..
secondary. ..

A

Primary……….usually at left side

Secondary……….due to malignancy

122
Q

Clinical picture of VARICOLCELE

Age...
Type of Pain...
Examination...
Complication...
Investigation 
TX
A

Age………..young
Asymptomatic or dragging pain
EXAMINATION……….bag of worm sensation
Complication……..hypofertility , and thrombosis
Investigation………semen analysis and doppler
TTT…………CONSERVATIVE
SURGERY WITH SEMEN ABNORMALITY

123
Q

1ry Varicecole

Young/Old Patient?
Gradual/Sudden onset
Empty/Full Scrotum?
Inv?

A

1ry……..young patient
gradual onset
empty on elevation of scrotum
inv………US

124
Q

2ry Varicecole

Young/Old Patient?
Gradual/Sudden onset
Empty/Full Scrotum?
Inv?

A

2ry……..old patient
sudden onset
does not empty
inv………CT

125
Q 
Hydrocele
What is it?
Complication?
CP?
Investigation?
TX?
A 
Collection of serous fluid in procesus vaginalis
Primary or secondary
CP……..PAINLESS scrotal swelling
Complication……..infection, hge, 
Investigation………….transillumination 
                                      US
TTT ASPIRATION OR SURGERY
126
Q

HYDROCELE IN PEDIATRICS

TEST
TTT

A

TEST………TRANSILLUMINATION (POSITIVE)
US
NEVER TO TTT ANY INFANT BEFORE FIRST YEAR ………………REASSURE THE MOTHER
ADULTS;
Usually secondary
TTT…….ASPIRATION PLICATION OF TUNICA ALBUGINEA

127
Q

Acute epididymo - orchitis

Age...?
Most Common Causative Organism?
Sexually Active young less than 35 =?
Investigation?
Treatment?
A

Age …………middle age
Most common Causative organism……E-COLI
Sexually active young less than 35………chlamydia
Fever, pain, swelling, redness
Elevation of testis does decrease pain
Investigation………..urine analysis and culture
TREATMENT ……………….antibiotics eg; cefotriaxone

128
Q

Epididymal cyst and spermatocele

Cp:

A

Painless small scrotal swelling

129
Q

Epididymal cyst and spermatocele Exam:

A

Purely scrotal swelling…… you can get above it

130
Q

Epididymal cyst and spermatocele Site

A

above and behind the testis

Cystic and translucent

131
Q

Epididymal cyst and spermatocele TTT:

A

Small….. no ttt…………review after 3-6 months

Large,,,,surgery……transscrotal

132
Q

Additional notes:* Delete?*****

A

Translucent lesions in the scrotum……hydrocele and epididymal cyst
Spermatocele……radio opaque

133
Q

How to deal with epididymal cyst in sequence???

First step

A

First step………examination

134
Q

Second step of dealing with an epididymal cyst

A

Second step………US

135
Q

Third step of dealing with an epididymal cyst

A

Third step…………tumour markers

136
Q

Fourth step of dealing with an epididymal cyst

A

Fourth step………review after 3-6 months

137
Q

If u decide to ttt an epdidymal cyst

A

transscrotal approach

138
Q

Torsion of testis
Age?
Predisposing Factor?

A

Age……………5-15

Predisposing factor………….transverse lying

139
Q

Clinical picture of torsion of testis

Complication..?

A 
History of trauma
Sudden severe pain at the testis
Swelling, pain and redness
Nausea and vomiting and may be shock
Elevation of the testis doesnot relieve the pain
Complication…………..gangrene
140
Q

TTT… of torsion of testis

A

URGENT SURGERY……..LESS THAN 6 HOURS

141
Q

Undescended testis

CLINICAL PICTURE

A

Empty scrotum

142
Q

Complications of Undescended testis

A

Sterility
Trauma
Torsion
Malignancy

143
Q

Association of undescended testis

A

.indirect inguinal hernia

144
Q

TTT

A

SURGERY IS A MUST BEFORE FIRST YEAR

145
Q

TESTICULAR CANCER
Age ?
Symptoms?

A

Young male 20-30 years
Painless enlargement of testis
Loss of testicular sensation
Spread……….lung and paraaortic LN

146
Q

TYPES of Testicular Cancer

A

SEMINOMA………GOOD PROGNOSIS

Non seminoma……bad prognosis

147
Q

Tumor Markers

AFP

A

Increase with non seminoma

always normal with seminoma

148
Q

Tumor Markers

B-HCG

A

Choriocarcinoma 100%

SEMINOMA 10%

149
Q

Investigation for testicular Cancer
What to use for metastasis
Can you do a needle Biopsy

A

US……BEST
CT chest………for metastasis
NEVER to do needle biopsy…….spread of cancer

150
Q

TTT of SEMINOMA…

A

.RADIOSENSITIVE

SURGERY

151
Q

TTT of NON SEMINOMA

A

CHEMO AND SURGERY

152
Q

If metastasis TTT

A

chemo and surgery

153
Q

Any young male with painless enlargement of testes is _____________ until proven otherwise

A

Any young male with painless enlargement of testes is CANCER TESTIS until proven otherwise

154
Q

Hematuria
Types:
Macroscopic:
Common sources

A

Bladder Cancer (painless)
urethra
Kidney(Polycystic Kidney)
Prostate
Painful Hematuria………… stones , infection or Kidney Infarction

155
Q

Investigations (hematuria)

A

IV Urography

156
Q

Pseudo Hematuria

A

Foods, Drugs , Porphyrins, Free Hemoglobin. Myoglobin

157
Q

Most common cause of painless hematuria

A

bladder cancer

158
Q

Best inv for the bladder

A

cystoscopy and biopsy

159
Q

Second most common cause of painless hematuria

A

cancer kidney

160
Q

Best inv for the kidney

A

CT

161
Q

Most common cause of painful hematuria

A

stones

162
Q

Inv of choice for the stone

A

CT without contrast

163
Q

If immigrant + painful hematuria

A

shistosomiasis

164
Q

If immigrant + painless hematuria

A

cancer bladder

165
Q

1st inv in hematuria

A

urine culture and sensitivity

166
Q

If normal(1st inv of hematuria)

A

.US

167
Q

Inv of choice for painless hematuria

A

cystoscopy

168
Q

Inv of choice for cancer kidney

A

CT

169
Q

Inv of choice for renal stones

A

CT KUB

170
Q

Inv of choice for renal stones in PKD

A

US KUB

171
Q

Carcinoid syndrome

products:

A

Vasoactive substance (serotonin, histamine)

172
Q

C/P of carcinoid syndrome

A

Flushing , diarrhea , wheezes
Serotonin induce fibrosis for tricuspid , pulmonary
Abdominal Pain

173
Q

Carcinoid tumor

Sites :

A

1-Appendix……………most common site

2-terminal ileum

174
Q

Carcinoid tumor

Investigation:

A

24 hour urine 5-HIAA

175
Q

Carcinoid tumor

Treatment :

A

1- octreotide

2- < 2cm Reassure > 2cm hemicolectomy + 5FU(chemotherapy

176
Q

Inflammatory Bowl Disease

C/P:

A

Fever , Diarrhea , WT , Abdominal pain , Bleeding

177
Q

ulcerative colitis Lead to Colon Cancer after _ - __ years

A

ulcerative colitis Lead to Colon Cancer after 8-10 years

178
Q

Ulcerative Colitis
Treatment :

Outpatient?
Admission?

A

Outpatient mild Attack

Admission severe Attack

179
Q

Medical treatment for Ulcerative Colitis

A

Sulfasalazine main stay TTT

Corticosteroid

180
Q

Immunosuppressive Drugs : (ulterative colitis)

A

Azathioprine
-Cyclosporin
Surgery if fail medical TTT

181
Q

Crohn’s

Most common cause of perianal fistula

A

abscess

182
Q

Most common cause of multiple or recurrent anal fistulae

A

crohn’s

183
Q

Cause of low lying fistula

A

Crohn’s

184
Q

TTT of anal fissure with Crohn’s

A

infliximab

185
Q

Coeliac Disease ( Gluten Sensitive Enteropathy ) most common age

A

Any age ( children 9-18 months)

186
Q

Causes of Coeliac Disease

A

genetic

187
Q

C/P of Coeliac Disease:

A

Previously healthy infant
FTT ( wasting buttocks ) + fatigue
-Malabsorption Steatorrhea + abdominal distension
- Iron and Folate Deficiency Anemia

188
Q

Investigations of Coeliac Disease :

Golden Standerd?

A

Duodenal Biopsy golden standard…..atrophic villi
IG Antiendomysial AB
IGA Transglutamines
IGA Antigliadin for screening

189
Q

Complications of Coeliac Disease :
Most feared?
Skin?

A

-Intestinal Lymphoma…….MOST FEARED COMPLICATION

Skin………..dermatitis herpetiformis

190
Q

association (coeliac disease)

A

Type 1 DM , IGA deficiency , Autoimmune Thyroiditis , Dermatitis herpitiformis,Osteoporosis

191
Q

Management of Coeliac Disease :

A

Gluten free diet
vitamin replacement , Pneumococcal Vaccine
Dapsone ……..for dermatitis herpetiformis

192
Q

Acute gastric dilatation

CAUSES:

A

Post operative
Fractures
Septicemia,

193
Q

Acute gastric dilatation cp:

A

Hiccough, vomiting and upper abd. Pain

194
Q

Acute gastric dilatation TTT:

A

MAINLY naso gastric suction

no surgery

195
Q

Lung Abscess

Causes:

A

Aspiration due to Alcoholism or intubation

196
Q

Lung Abscess C/O:

A

Anaerobic Bacteria

Aerobic Bacteria eg. Klebsiella in alcoholism

197
Q

Lung Abscess C/P:

A

Purulent cough + Hemoptysis

198
Q

Lung Abscess Investigations:

A

X-ray……..air fluid level

199
Q

Lung Abscess Treatment :
Antibiotic?
If not improved?

A

Physiotherapy
Antibiotic,,,,,,,,main TTT……….. clindamycin
If not improved……..transpleural drainage….vvvvimp

200
Q

Empyema

Cause…

A

Lung infections…..most common cause

201
Q

Empyema Symptoms :

A

Fever, cough, shortness of breath, and pleurisy.

202
Q

Empyema Inv:

A

X-ray

203
Q

Empyema Treatment : (2 )

A

1- Intravenous antibiotics…….. cephalosporins ,metronidazole and penicillins
Clindamycin for patients who are allergic to penicillin.
2-chest tube
If complex empyema………chest tube is a must…vvvvvvimp

204
Q 
Epidermoid cyst (sebaceous cyst )
C/P:
A

Firm to soft regular lump

Found in hairy skin central punctum

205
Q

Complication of epidermoid cyst

A

Inflammation

206
Q

Management fo epidermoid cyst

Before puberty?
Small?
Trouble/Infected?

A

Before puberty —– Polyposis coli
Small —— Leave it
Troubling or infected ——- Surgery (under local anesthesia)

207
Q

.commonest for acute pancreatitis

.

A

Gall stones…

208
Q

commonest for chronic pancreatitis

A

Alcoholism…

209
Q

Clinical presentation of acute pancreatitis

A

SEVERE EPIGASTRIC ABDOMINAL PAIN RADIATING TO THE BACK
Nausea, vomiting, and tenderness
CULLEN SIGN……..bluish discoloration around umbilicus
GREY TURNER SIGN……bluish discoloration at flanks

210
Q

In colon surgery, where do you want INR?

A

,<1.5

211
Q

MC cancer post transplant?

A

Squamous cell

212
Q

Aside from immobilization after surgery, what is the other risk factor for VTE?

A

Cardiac failure

213
Q

2 situations where tetanus toxoid should be considered

A
  1. unknown vacination hx

2. less than 3 doses

214
Q

When to give tetanus IVIG?

A

when wound is dirty

215
Q

Most important sign of orbital fracture?

A

Diplopia

216
Q

MC presentating symptom of ampullary carcinoma?

A

Obstructive jaundice

217
Q

Pt develops acute limb ischemia and required a procedure, what to do for life?

A

warfarin for life

218
Q

Presentation of chronic Pancreatitis?

A

Chronic epigastric abd pain
Malabsorption……….diarrhea and steatorrhea
Weight loss and DM

219
Q

A pop and immediate swelling of knee, think?

A

ACL

220
Q

You can get above a painless scrotal mass, suspect?

A

Testicular tumor

221
Q

What to do when u suspect testicular tumor?

A

Color doppler

222
Q

Organism responsible for cholecystitis?

A

ecoli

223
Q

Tx of house maids knee (prepartella bursitis)

A

Steroid injection in prepatella bursa

224
Q

Mortality rate of ruptured AAA?

A

80%

225
Q

What to do when you suspect esophageal cancer? (3)

A
  1. barium swallow
  2. scope and biopsy
  3. CT chest and abdomen
226
Q

Pt can not lift hand above head,,,,,this is called?

A

Impingement syndrome (rotator cuff injury)

227
Q

fluid replacement in burns?

A

4 X numbers given…eh 4 x Weight X burn area

4 x 80kg x 15

228
Q

MC fracture to eye

A

Orbital floor fracture

229
Q

Head injury with Lucid interval, Think?

A

Epidural. Luci on top!

230
Q

Pt with paradoxical breathing, how to avoid impending doom?

A

Intubate and ventilate

231
Q

Pt with vascular claudication, when do you refer?

A

Rest Pain

232
Q

Old male with back pain and normal/high calcium never chose…

A

Multiple Myeloma

AMC MCQ (14 decks)

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