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NBME-Step 2(BA) > Surgery Form 1-4 > Flashcards

Surgery Form 1-4 Flashcards

1
Q

alcoholism, diarrhea, generalized weakness, enlarged liver, disuse tenderness, shifting dullness, Calcium 6 & normal amylase. Cause of hypocalcemia?

A

Hypomagnesemia

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2
Q

Why does low magnesiums causes low calcium?

A

PTH cannot be released

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3
Q

Hx of heartburn, cxray air-fluid level posterior to the cardiac silhouette. Barium swallow stomach herniating through the esophageal hiatus. Dx? NSIM?

A
  • hiatal hernia

- EGD (esophagogastroduodenoscopy)

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4
Q

Small painless sore with defined edges and a flat base containing purulent debris in ulcerative colitis

A

Pyoderma gangrenosum

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5
Q

Pyoderma gangrenous, abd pain and nausea

A

Crohn’s disease

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6
Q

Pyoderma gangrenous, mouth ulcer, genital ulcer

A

Behcet’s disease (silk road disease), rare blood vessel inflammation throughout the body

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7
Q

Pyoderma gangrenosum, bloody in stool and anemia

A

Ulcerative colitis

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8
Q

NSIM for possible popliteal aneurysm?

A

Arteriography with runoff

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9
Q

After arteriography procedure using right groin, pt noted with palpable thrill and a continuous machinery murmur at the site. Dx? Predictive info for hearth failure?

A
  • AV fistula

- Size of the abnormalities (cause of increased venous return, high CO, heart failure)

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10
Q

Very high ALP (Alkaline phosphatase) & narrow bile ducts on ERCP. Dx? predisposing factor?

A
  • Primary sclerosis cholangitis

- Ulcerative colitis

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11
Q

Bright red blood per rectum, ulcer in the posterior midlines of the anal canal, edematous skin tag at the anal verge. Dx? Tx?

A
  • Anal fissure

- Sitz bath

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12
Q

Hx HTN, DM, cholesterol embolus in a retinal artery. Cause?

A

Carotid plaque (Hollenhorst plaque)

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13
Q

Dysphagia and chest pian, GERD, inability to swallow solid food

A
  • Stricture of the distal esophagus
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14
Q

Inability to swallow both liquid and solid

A

Achalasia

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15
Q

Uncircumcised older man, multiple partners, painless ulcer on the penile glans that is growing

A

Penile cancer (multiple partner indicates possible HPV)

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16
Q

37F with liver mass that has central scar. Dx? NSIM?

A
  • Focal nodular hyperplasia (Benign)

- No further workup needed

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17
Q

37F, neck swelling, no weight changes or temp intolerance, Normal TSH, T4 & T3. Positive Thyroid peroxidase and thyroglobulin antibodies. Dx?

A

Early Hashimoto disease (before TSH, T3,T4 changes)- chronic lymphocytic thyroiditis

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18
Q

14YO boy, obese with hip and knee pain

A

Slipped capital femoral epiphysis (SCFE)

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19
Q

Child after URI with hip pain, high WBC

A

Viral arthritis (Toxic synovitis)

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20
Q

Pt on mechanical ventilation, ARDS, washing out numerous organisms on abx, Cavitation lesion on right upper lobe of the lung. Dx?

A

Lung abscess

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21
Q

deep stupor, high BP, left hemiparesis and early decerebrate posturing, NO trauma. Dx?

A

Ruptured intracerebral aneurysm

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22
Q

a sudden severe headache, with NO focal neuro deficits

A

SAH , possible from AVM, berry aneurysm

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23
Q

82 post cholecystectomy two days ago, got pneumonia, cause

A

impaired cough mechanism

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24
Q

PE confirmed with no hypotension. Tx?

A

Heparin

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25
Q

PE confirmed with hypotension. Tx?

A

Pulmonary embolectomy

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26
Q

Coffe bean in abd xray. Dx? NSIM?

A
  • Sigmoid volvulus

- Sigmoidoscopy-guded placement of a rectal tube

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27
Q

Elderly with high calcium and bone resorption. Dx? what other lab?

A

Hyperparathyroidism and low phosphorus

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28
Q

HIV male pt with cauliflower-like mass on perineum. Dx? NSIM?

A
  • SSC

- Biopsy of the mass

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29
Q

MVA, femur fracture operation done, PRRC given, Jaundice after 9 days, elevated indirect bilirubin. Cause?

A

Overproduction of bilirubin

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30
Q

5 days Post pancreticoduodenectomy surgery after trauma. What is the best nutrition delivery method?

A

Enteral tube feedings

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31
Q

Pt with CKD who got AV fistula 24hr ago has SOB, tachpenic, , JVD, S3 is

A

High-output CHF, due to AV fistula having more fluid overload

32
Q

rust-colored breast discharge in 42 yo woman.

A 
Intraductal papilloma (usually in premenopausal women) 
or papillary carcinoma
33
Q

Pt with CV risk for surgery and can’t tolerate stress test do

A

pharmacologic stress test (Dipyridamole-thallium scanning) Radionuclide scan

34
Q

Pallor optic disc, macular edema, thin arterioles, and sausage-like narrowing of the retinal veins. Dx?

A

Central retinal artery occlusion

35
Q

Whipple triad is

A
  • hypoglycemia symptoms brought on by fasting
  • BS < 50 during symptomatic attack
  • Glucose administration brings relief of symptoms
36
Q

Laparoscopy vs laparatomy

A

-Laparotomy is open like celiotomy, where as laparoscopy is not

37
Q

Infections in axilla and groin area on 30YO, purulent drainage from small sinus opening along the indurated skin of the axilla. Infection involves

A

Apocrine glands - Hydradenitis

38
Q

Steps to how to treat esophageal varies

A
  • 2 large IV catheters
  • IVF
  • Octeriotide
  • Abx
  • Once pt is stable Upper GI endoscopy
39
Q

Cornual pregnancy is

A

considered ectopic pregnancy that can rupture

40
Q

Borborgymi sounds heard in upper abd indicates

A

early SBO with hyperactive and loud gurgling sound. Late SOB becomes hypoactive bowel

41
Q

Succussion splash heard on abd indicates

A

gastric outlet obstruction

42
Q

Pt with hearing loss and ringing on r ear, unsteadying on gait. Weber test localized to the L ear, Ring test air conduction is greater than bone conduction bilaterally. Sensation to temperature is decreased over the R side of face, and decreased movement of the face on R side. MRI will show

A

Acoustic neuroma (vestibular shwannoma)

43
Q

persistent air leak after chest tube placement for pneumothorax is

A

-tracheobronchial injury

44
Q

Giant cell vasculitis tx

A

-Immediate prednisone therapy and temporal artery biosy

45
Q

Rupture of the descending thoracic aorta b/p is ______ vs ascending _______

A

hypertensive vs hypotensive in ascending

46
Q

Roby mass in the hemiscrotum

A

Varicocele, also called “Bag of worms”

47
Q

The purpose of Indomethacin in PDA is

A

cyclo-oxygenase inhibition with increased NE releases

- it is inhibitor of prostaglandin E2

48
Q

19 year old female with server abd pain. U/S abd with cystic mass increasing in size and leucocytosis. Dx? NSIM?

A
  • Ovarian torsion

- Exploratory operation (if only cyst watch on contraceptive)

49
Q

19 YO with RLQ pain after sexual activities

A

Rupture of ovarian cyst

50
Q

“Hot nodules” on thyroid scan are

A

Toxic thyroid adenoma

51
Q

Cachectic is caused by what factor?

A

Tumor necrosis factor (TNF)

52
Q

Knee pain from sitting to standing position & tenderness to palpation along the medial joint line with effusion

A

Torn meniscus (Meniscus tear)

53
Q

8yo with eye sensation, treating with erythema or the conjunctiva, photophobia and small vesicles with an erythematous base on the eyelid

A

Herpes simplex conjunctivitis

54
Q

Diagnostic for carpal tunnel

A

Nerve conduction studies (it is not EMG)

55
Q

multiple dilated loop of small bowel suggests

A

obstruction

56
Q

gas in small bowel and liver suggests

A

communication between enteric and biliary tract (possible due to stones)
-Cholecystoduodenal fistula

57
Q

What is the best indicator for adequate fluid resuscitation

A

Urine output 30-40ml/hr

58
Q

Pearly surfaced lesion on upper lip

A

Basal cell carcinoma

59
Q

Keratin surface lesion on the lower lip

A

Squamous cell carcinoma

60
Q

treatment for biliary atresia

A

liver transplantation

61
Q

which shock has high PCWP?

A

Cardiogenic

62
Q

Treatment for intermittent leg claudication or PDA

A

stope smoking
walking program
aspirin with clopidogrel
Cilostazol

63
Q

Best screening test for Cervical trauma

A

X-ray

64
Q

82YO man with L groin pain, N/V, febrile, 90/60, 110, leukocytosis. Dx?

A

Strangulated inguinal hernia

65
Q

In traumatic injures, in what order do you fix the order of injury to structural damage

A
  1. Bone
  2. Vascular
  3. Nerve
66
Q

What are the two paraneoplastic syndrome that secret PRHrp?

A
  • Squamous cell carcinoma or lung

- Renal cell carcinoma

67
Q

Low pitched, rumbling diastolic murmur heard at the apex, that disappears when pt lies on the R side

A

Atrial myxoma

68
Q

Venous Duplex US with occlusion of left iliac veins, what should be given prior to perineal resection for rectal cancer

A

Low-dose heparin prophylaxis

69
Q

Renal stenosis on R kidney which kidney will produce more renin or is it both?

A

Only the affected kidney

70
Q

52 with R foot swelling, Hx of DM, x-ray R ankle osteopenia and disruption of disorganization of the joints

A

Charcot joint (Neuropathic arthropathy)

71
Q

A hernia medial to the femoral vein

A

A femoral hernia

72
Q

EGD shows stricture of the GJ junction and barrett’s esophagus

A

Sliding hiatal hernia (associated with GERD)

73
Q

symptomatic nephrolithiasis will have __ in urinalysis?

A

RBC segmented (gross or microscopic hematuria)

74
Q

Nulligravid women with ascites

A

Ovarian tumor- Meigs syndrome

75
Q

Failure to suppress class II antigen recognition in the host, what kind of transplant rejection is it?

A

acute

NBME-Step 2(BA) (2 decks)

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