uworld: surgery

Question 1

marjolin ulcer has what type of cancer arising from a wound?

Answer 1

squamous cell carcinoma

Question 2

cutaneous t cell lymphoma appears how?

Answer 2

scaly pruritic patches or plaques

Question 3

penetrating injuries always need what type of intervention

Answer 3

exploratory surgery

Question 4

hard signs of vascular injury (indicating ex lap)

Answer 4

pulsatile bleeding

bruit/thrill over injury

expanding hematoma

distal ischemia signs

Question 5

BUN: Cr >20 indicates

Answer 5

prerenal acute kidney injury (hypovolemic)

Question 6

initial step to manage prerenal AKI

Answer 6

bolus of isotonic saline

Question 7

prepatellar bursitis presentation

Answer 7

anterior knee pain, tenderness, erythema, swelling

common in jobs of repetitive kneeling

Question 8

prepatellar bursitis caused by which bacteria?

Answer 8

staph aureus

Question 9

patellar tendinitis presentation

Answer 9

episodic pain
tenderness at inferior patella and patellar tendon

athletes- forceful knee extension

Question 10

all patients with blunt abdominal trauma, even without specific intraabdominal injury should undergo

Answer 10

FAST exam to assess intraperitoneal hemorrhage

Question 11

what imaging to do if FAST exam is positive vs negative

Answer 11

Positive: abdominal CT

negative: abdominal series

Question 12

what is this: impaired wound healing, ginigivits, arthralgia, weakness, eccymosis, petechiae, etc.

Answer 12

scurvy

Question 13

whats fastest way to reverse warfarin if you want to emergently do surgery on someone who is on warfarin?

Answer 13

fresh frozen plasma

Question 14

what is one of the most common pulmonary post-op complications on day 2-3 after abdominal surgery? and how

Answer 14

atelectasis

pain, changes in compliance–> impaired cough, shallow breathing –> mucus plugging –> low O2

Question 15

ways to decrease atelectasis incidence

Answer 15

pain meds
deep breathing, spirometry
directed coughing
moving

Question 16

ventilator associated pneumonia happens after how long of being on the ventilator?

Answer 16

48 hours

Question 17

diaphragm rupture after traumatic accident present how on CXR and what should be done after?

Answer 17

bowel loops in left lung (herniation)
elevated hemidiaphragm
mediastinal deviation

Do a CT to confirm

Question 18

indications for urethrogram

Answer 18

blood at meatus
hematuria
dysuria
urinary retention

Question 19

succinylcholine side effect

Answer 19

arrhythmias from hyperkalemia

Question 20

what does PE look like on CXR?

Answer 20

normal

Question 21

nasopharyngeal carcinoma associated with what?

Answer 21

EBV virus

China

Question 22

presentation of nasopharyngeal carcinoma

Answer 22

nasal congestion
nose bleed
HA
CN palsies
otitis media

Question 23

umbilical hernias present with what risk factors

Answer 23

african american
premature
Ehrlers - Danlos 
Backwidth-weidemann
hypothyroidism

Question 24

surgery for umbilical hernias indicated when?

Answer 24

persist beyond age 5
complicated
over 1.5 cm in diameter

Question 25

transtentorial herniation would cause:

Answer 25

ipsilateral hemiparesis
ipsilateral mydriasis and strabismus
contralateral hemianopsia
altered mental status

Question 26

where would injury be to affect CN XI?

Answer 26

medulla- occlusion of PICA

anterolateral neck

Question 27

where would injury be to affect CN IX?

Answer 27

jugular foramen syndrome