U World Questions

Question 1

Clinical Features of an epidural hematoma

Answer 1

Brief LOC w/ lucid interval;
Hematoma expansion leads to lowered consciousness, increasing ICP –> HA w/ nausea and vomiting;
failure to treat –> uncal herniation

Question 2

Shape of epidural hematoma

Answer 2

biconvex (lens-shaped)

Question 3

Trauma to sphenoid bone with tearing of middle meningeal artery causes

Answer 3

epidural hematoma - blood in the potential space between the cranium and the dura mater

Question 4

How is coma diagnosed?

Answer 4

Pupillary reaction, corneal reflexes, extraocular reflexes (not GCS)

Question 5

Use Valgus stress test to test for

Answer 5

MCL injury
Stabilize lateral thigh with one hand. Place the other along medial leg and apply outward pressure. Laxity indicates MCL injury

Question 6

Use Lachman test to test for

Answer 6

ACL injury
Place knee at 30 degrees, stabilize distal femur with 1 hand and pull proximal tibia anteriorly with the other. Laxity of tibia indicates ACL injury

Question 7

What is the Thessaly test used for?

Answer 7

Meniscal tear - Patient stands on 1 leg with knee flexed 20 degreed. Patient then internally and externally rotates on flexed knee

Question 8

What is the McMurray test used for?

Answer 8

Meniscal tear - Passive knee flexion and extension while holding the knee in internal or external rotation. Pain, clicking, or catching indicates meniscal tear

Question 9

Meniscal tears are confirmed through

Answer 9

MRI or arthroscopy

Question 10

Squamous cell carcinoma arising within a burn wound is called a

Answer 10

Marjolin ulcer

Question 11

What are the causes of acute adrenal insufficiency aka Adrenal crisis?

Answer 11

Adrenal hemorrhage or infarction;

Acute illness/injury/surgery in patients with chronic adrenal insufficiency or long-term glucocorticoid use

Question 12

What are the symptoms of an adrenal crisis?

Answer 12

Hypotension
Nausea/vomiting, abdominal pain
Weakness
Fever

Question 13

What is the treatment for adrenal crisis?

Answer 13

Hydrocortisone or dexamethasone;

High flow IV fluids

Question 14

The rotator cuff is formed by:

Answer 14

the tendons of the supraspinatus, infraspinatus, teres minor and subscapularis muscles.
The supraspinatus is the most commonly injured (FOOSH injury)

Question 15

The drop test is used for

Answer 15

Rotatr cuff injury - patient cannot lower arm slowly past 90 degrees

Question 16

Common findings suggestive of aortic injury include:

Answer 16

Hypotension
Widened mediastinum
Large left-sided hemothorax
Deviation of mediastinum to the right 
Disruption of the normal aortic contour
Confirm dx w/ CT

Question 17

Signs of myocardial contusion

Answer 17

Tachycardia
New bundle branch blocks
Arrythmia
Sternal fracture is also seen

Question 18

What are the symptoms of Dumping Syndrome?

Answer 18

Abdominal pain, diarrhea, nausea;
Hypotension/tachycardia
Dizziness/confusion, fatigue, diaphoresis

Question 19

What is the cause of dumping syndrome?

Answer 19

Common postgastrectomy complication - up to 50% of patients (ie ulcer repair);
Loss of normal action of pyloric sphincter due to injury or surgical bypass –> rapid emptying of hypertonic gastric contents into the duodenum –> fluid shifts from the intravascular space to the lumen –> hypotension, stimulation of autonomic reflexes, release of vasoactive peptides

Question 20

What are some common causes of primary hypoparathyroidism?

Answer 20

1. Post-surgical (most common)
2. Autoimmune
3. Congenital absence or maldevelopment of the parathyroid glands ie DiGeorge syndrome
4. Defective calcium-sensing receptor on the parathyroid glands
5. Non-autoimmune destruction of the parathyroid gland due to infiltrative diseases such as hemochromatosis, Wilson disease, neck irradiation

Question 21

Hypoparathyroidism is characterized by:

Answer 21

Hypocalcemia and hyperphosphatemia in the presence of normal renal function