Surgery

Question 1

1st line therapy for HCM?

Answer 1

Beta Blockers

Question 2

Abdominal pain, copious vomiting, distended abdomen with voluntary guarding. Hgb decreased from 13.5 to 7.8 in 24hrs with no fecal occult blood and normal sinus rhythm… dx?

Answer 2

Intramural hematoma of the small bowel

Question 3

Incidental solitary solid pulmonary nodule is 3.5 mm in size and has a low risk for malignancy (no risk factors) .. next best step?

Answer 3

no further evaluation is indicated.

Question 4

nontender cystic midline swelling that moves upwards on protrusion of the tongue dx and nxt best step

Answer 4

thyroglossal duct cyst. Patient should undergo ultrasonography to confirm the diagnosis of a thyroglossal duct cyst

Question 5

first-time Bartholin gland abscess treatment

Answer 5

Incision and drainage followed by irrigation and packing

Question 6

advanced non-seminoma with metastases to the liver and increased tumor markers what is the next best step

Answer 6

1. Radical inguinal orchiectomy
2. Adjuvant chemotherapy with cisplatin, etoposide, and bleomycin (BEP regimen) is the standard of care for treating non-seminomas in all stages

Question 7

Patient presents with severe abdominal pain, nausea, vomiting, leukocytosis, and signs of sepsis, with hx of abx treatment for pseudomembrane colitis.. dx?

Answer 7

Toxic megacolon

Question 8

What will an Abdominla x-ray show in a patient with toxic megacolon

Answer 8

Dilation of the colon with loss of haustration

Question 9

What are the clinical manifestations of a retropharyngyeal abscess

Answer 9

Neck pain
Odynophagyia
fEVER 
nuchal rigidity 
Bulging of pharyngeal wall

Question 10

Complication of a retropharyngeal abscess

Answer 10

Acute necrotising mediastinitus (drainage into danger space)

Question 11

Which diseases increase the risk of atraumatic splenic rupture

Answer 11

CLL (and the lymphomas and leukemias)
EBV
SLE

Question 12

Confirmation diagnosis of a fibroadenoma

Answer 12

Breast mass biopsy

Question 13

Associate injuries with lower rib fracture (9-12) and mode of diagnosis

Answer 13

Lungs, liver (right), spleen (left) and kidney (posterior ribs 11-12)
DX: CT scan with IV contrast

Question 14

After initial stabilisation burn patients who require aggressive fluid resuscitation should require what immediate best next step

Answer 14

Urethral catheterization

Question 15

An imperforate atrioventricular septum in the right sideof the heart .. diagnosis and other findings

Answer 15

Tricuspid atresia 9blood unable to go from RA to RV)

Also see tall P waves and small r waves in right pericordial lead (V1, V2)

Question 16

Treatment of choice in a patient with a hemothorax

Answer 16

Inserting a chest tube in the fifth intercostal space at the mid-axillary line

Question 17

What is Leriche syndrome and its a marker for what

Answer 17

Combination of claudication in the buttocks, buttock atrophy and impotence.
Patients require aortoilliac bypass graft

Question 18

What will a patient with superficial thrombophlebitis present with and the treatment

Answer 18

Hx of varicose veins with localized leg pain, superficial cordlike induration, reddish discolouration an dmild fever.

Question 19

What is the modality of treatment for renal cell cancer with distant metastasis

Answer 19

Immunotherapy (interlukin-2)

Question 20

The 4 hallmark warning signs of urethral injury

Answer 20

1. boggy, movable prostate on exam
2. blood at the urethral meatus
3. severe pelvic fracture
4. scrotal/perineal ecchymosis

Question 21

Where is the new transplant kidney placed in a recpient

Answer 21

Iliac fossa or pelvis (for easy bx access)