Surgery p435-447

Question 1

common cause & site of stress fracture

Answer 1

• repetitive insults to the bone

* metatarsals

Question 2

common cause & site of compression fracture

Answer 2

• osteoporosis

* most common site is lumbar vertebra

Question 3

pathologic fracture

Answer 3

fracture that occurs by minimal trauma in a bone that has been weakened by an underlying diseasee

Question 4

what do we need to rule out in case of anterior shoulder dislocation

Answer 4

axillary nerve and artery injury

Question 5

type of shoulder dislocation seen as a result of seizure or electrical burn

Answer 5

posterior type

Question 6

clavicular fracture poses a risk of injury to which neuromuscular structures

Answer 6

subclavian artery and brachial plexus

Question 7

treatment for scaphoid fracture

Answer 7

thumb spica cast

Question 8

best imaging modality when suspecting scaphoid fracture

Answer 8

MRI

Question 9

trigger finger treatment

Answer 9

steroids,

surgery to cut the tendon sheath in cases that don’t respond to steroids

Question 10

*fracture of long bone,
*dyspnea, petechial rash, confusion
*CXR infiltrates
Diagnosis?

Answer 10

fat embolism

Question 11

treatment for fat embolism

Answer 11

*Oxygen < maintain PO2 over 95%>

Intubation and mechanical ventilation in severely hypoxic cases.

Question 12

shopping cart sign is positive in

Answer 12

spinal stenosis

treated with NSAIDS/surgery

Question 13

*h/o lifting heavy weights
*electric pain with dermatomal distribution
straight leg raise test positive

Answer 13

disc herniation

treated with NSAIDS/activity modification

Question 14

imaging modality of choice in disc herniation

Answer 14

MRI

Question 15

best next step when suspecting compartment syndrome

Answer 15

immediate fasciotomy

Question 16

ligaments affected in unhappy triad of knee injury

Answer 16

a) anterior cruciate ligament
b) medial collateral ligament
c) lateral or medial meniscus

Question 17

bruit and pulsatile abd mass. Diagnosis?

Answer 17

Abdominal aortic aneurysm

Question 18

sudden onset tearing chest pain radiating to the back,

Dx and test of choice

Answer 18

aortic dissection

• -> MR angiogram (stable patients), CT angiogram, TEE
• ->TEE is fastest and used if patient is unstable

Question 19

management of ascending aortic dissection

Answer 19

emergent surgery and bp control

Question 20

management of descending aortic dissection

Answer 20

medical therapy for bp control

Question 21

cause of postoperative fever day 1-2 and its prevention

Answer 21

atelectasis or postoperative pneumonia

—>can be prevented by incentive spirometry, vancomycin and tazobactum-piperacillin

Question 22

cause of postoperative fever day3-5

Answer 22

UTI

Question 23

causes of postoperative fever day 5-7,

prevention

Answer 23

DVT, thrombophlebitis

|&raquo_space;can be prevented by heparin for 5 days in addition to warfarin 3-6 months

Question 24

cause of postoperative fever day 7

Answer 24

wound infection

Question 25

postoperative fever day 8-15

Answer 25

drug fever or deep abscess

Question 26

imaging modality for pulmonary embolism

Answer 26

spiral CT

Question 27

next best step if patient has second pulmonary embolism while on coumadin

Answer 27

IVC filter via inguinal catheterization

Question 28

test of choice for pulmonary embolism in patients with known contrast allergy

Answer 28

V/Q scan

Question 29

Management guidelines for abdominal aortic aneurysm based on size

Answer 29

Management guidelines for abdominal aortic aneurysm based on size a)3-4 cm : USG every 2-3 years b)4-5.4 cm: USG or CT every 6-12 months C)>= 5.5 cm : surgical repair even if asymptomatic