Surgical Pathognomonic vignettes

Question 1

What is the correct diagnosis? Elderly woman with small bowel obstruction and air in the biliary tract

Answer 1

Gallstone ileus

Question 2

Postmenopausal woman with new onset of vaginal bleeding

Answer 2

Endometrial carcinoma

Question 3

Abdominal pain “out of proportion to exam”

Answer 3

Mesenteric ischemia

Question 4

“Hot potato” voice

Answer 4

Epiglottitis or peritonsillar abscess

Question 5

Chest pain “tearing” to the back

Answer 5

Aortic dissection

Question 6

Chest pain described as “an elephant sitting on my chest”

Answer 6

Myocardial infarction

Question 7

Newborn with bilious vomiting

Answer 7

Malrotation

Question 8

Nonbilious vomiting in an infant , 2 months old

Answer 8

Pyloric stenosis

Question 9

“Currant jelly” stool in young child

Answer 9

Intussusception

Question 10

Failure to pass meconium within first 24 hours of life

Answer 10

Hirschsprung’s disease

Question 11

Syncope with the use of the le arm

Answer 11

Subclavian steal syndrome

Question 12

Coiled NGT in the left pleural cavitya after blunt trauma

Answer 12

Diaphragm rupture

Question 13

Inability to pass an NGT in a newborn

Answer 13

Esophageal atresia

Question 14

A “gasless” abdomen in a newborn

Answer 14

Esophageal atresia

Question 15

Intraperitoneal free air on abdominal x-ray and abdominal pain

Answer 15

Perforated viscus

Question 16

Blunt trauma patient with GCS , 8 and otorrhea

Answer 16

Basilar fracture

Question 17

Abdominal pain, flank mass, hematuria

Answer 17

Renal cell carcinoma

Question 18

Acute varicocele and hematuria

Answer 18

Left renal tumor

Question 19

Bone tumor with “onion skinning” histology

Answer 19

Ewing’s sarcoma

Question 20

Necrotizing migratory erythema

Answer 20

Glucagonoma

Question 21

Newborn with pneumatosis intestinalis

Answer 21

NEC (necrotizing enterocolitis)

Question 22

Jejunal ulcers

Answer 22

Zollinger-Ellison syndrome

Question 23

Thyroid mass and psammoma bodies on histology

Answer 23

Papillary thyroid carcinoma

Question 24

Neck abscess with sulfur granules

Answer 24

Actinomyces infection

Question 25

Palpable parathyroid gland and hypercalcemia

Answer 25

Parathyroid carcinoma

Question 26

Tender pulsatile abdominal mass

Answer 26

Abdominal aortic aneurysm

Question 27

Trauma patient with increasing JVD with inspiration

Answer 27

Cardiac tamponade (Kussmaul’s sign)

Question 28

Trauma patient with hypertension and bradycardia

Answer 28

Cushing’s response to increased ICP

Question 29

Trauma patient with hypotension and bradycardia

Answer 29

Spinal cord injury