USMLEasy 7

Question 0

MoA of PCL injury?

Answer 0

Direct force to knee

Question 1

Signs of an ACL tear?

Difference in collateral ligament tear?

In meniscal injury?

Answer 1

#twisting injury with a popping feeling
#Immediate effusion
#Still able to bear weight

Collateral ligament tear would have more instability

More catching, locking, or giving way

Question 2

Patient develops malignant hyperthermia – management?

Answer 2

#Hyperventilation with 100% oxygen
#IV dantrolene
#alkalinize urine (to protect the kidneys from myoglobin precipitation)

Question 3

Recommendations concerning immunization pregnancy:

1. Influenza
2. Typhoid
3. Hepatitis
4. Cholera
5. TDaP
6. Polio
7. Smallpox
8. yellow fever
9. MMR
10. Rabies

Answer 3

1. Serious underlying disease
2. Traveling to endemic area
3. After exposure or before travel
4. For travel
5. If no primary series or 10 years without booster
6. During epidemic
7. Unnecessary
8. Before travel time.
   9 Contraindicated
9. Same as nonpregnant patients

Question 4

Patient wants repeat C-section with simultaneous tubal ligation – recommendation?

Answer 4

VBAC followed by postpartum tubal ligation at later date

Question 5

Most common form of anesthesia for vaginal delivery?

Why not use paracervical block?

Complication of low spinal anesthesia (saddle block)?

Answer 5

Pudendal block

Implicated in fetal death

Hypotension and decrease in uteroplacental perfusion

Question 6

Anesthesia that will increase labor and delivery time?

Answer 6

Epidural

Question 7

Conjunctivitis 6-12 hours after birth? Consequence of?

2 to 5 days after birth? If untreated?

5 to 14 days after birth? If untreated?

Answer 7

Chemical conjunctivitis; ocular silver nitrate or erythromycin prophylaxis

Gonococcal conjunctivitis (corneal ulceration, perforation, blindness)

Chlamydial conjunctivitis (pneumonia)

Question 8

Conversion disorder vs somatization?

Answer 8

Single symptom with sudden onset in response to severe stress

Versus

Many complaints with no organic cause

Question 9

When is surgery indicated after eye trauma?

Answer 9

#Enopthalmos most greater than 2 mm
#diplopia on primary/inferior gaze
#entrapment of ocular muscles
 #fracture of over 50% of orbital floor

Question 10

Why low transverse cesarean versus classic section?

Answer 10

Classic C-section associated with greater blood loss and higher incidence of rupture

Question 11

Most Significant issue to consider when using nitrates for stable angina?

Answer 11

Development of tolerance

Question 12

Fetus is found to have single umbilical artery – Indicates? Management?

Answer 12

Increased incidence of congenital anomalies

Offer amniocentesis, cordocentesis, or chorionic villus sampling to study fetal chromosomes

Question 13

Schizoid personality disorder versus schizophrenia versus schizoaffective disorder

Answer 13

No psychotic symptoms

versus

schizophrenia (delusions, hallucinations, negative symptoms for at least six months)

versus

schizophrenia + major depressive or manic episode

Question 14

Frank versus complete beach?

Answer 14

Lower extremities flexed at the hips and extended knees (Feet close to head)

Versus

One or both knees flexed

Question 15

Patient presents with rash, fever, and mouth sores. Multiple vesiculobulbous lesions on conjunctiva and mouth. Normal visual acuity. Target lesions on the palms and soles – diagnosis? Management?

Answer 15

Erythema multiforme

Admit, normal saline IV, oral prednisone, analgesics antihistamines, mouth rinses

Question 16

Confrontation?

Interpretation?

Clarification?

Answer 16

pointing out something patient is trying to avoid

Explanatory statement that links behavior or feeling to it’s unconscious meaning

Putting together information and reflecting back to patient in more organized form

Question 17

Acute fatty liver during pregnancy – management?

Answer 17

Immediate delivery

Question 18

Normal Intraocular pressure?

Answer 18

10-21 mm Hg

Question 19

Mechanism of acute angle closure glaucoma?

Answer 19

Aqueous humor production in posterior chamber is unable to drain through anterior chamber

Question 20

Signs of increased intraocular pressure?

Answer 20

#Mid-dilated and Nonreactive pupils
#Corneal clouding
#Decreased vision

Question 21

Symptoms of hyperventilation?

Answer 21

#Anxiety
#Perioral tingling
#Carpopedal spasm
#Derealization feelings

Rebreathe into paper bag to reverse hypocapnia (normalizing cerebral blood flow and ionized calcium)

Question 22

Hydrocele in infant – management?

Answer 22

Will usually resolve spontaneously in first year of life