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Surgery > wrong > Flashcards

wrong Flashcards

1
Q

tredelenburg sign is weakness of which muscles? innervated by which nerve?

A

gluteus muscles, innervated by superior gluteal nerve

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2
Q

falling on outstretched arms causes supracondylar fracture of the humerus, cx?

A

median nerve and brachial artery damage

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3
Q

intermittent bloody d/c from one nipple, no masses. Postmenopausal women. Ddx?

A

Intraductal papilloma

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4
Q

In hemodynamically unstable pts with abd trauma, start fluid resuscitation, and do US. If US shows peritoneal blood, and pt is still unstable, next step?

A

urgent laparotomy

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5
Q

stress (hairline) fx of metatarsal. Tx?

A

rest and analgesics b/c they heal on their own, no cast needed.

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6
Q

Pt recently underwent thoracic aortic aneurysm surgery, then suddenly developed b/l flaccid paralysis and loss of pain and temp. Vibration and proprioception preserved. Ddx?

A

Anterior spinal cord syndrome (also related to burst fracture of vertebrae)

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7
Q

Tachypnea, tachycardia, hypotension, distended neck veins, tracheal deviation. Ddx?

A

Tension pneumothorax

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8
Q

Pt with blunt chest trauma, with jugular venous distension, hypotension and tachycardia despite fluid resuscitation. Chest x-ray shows normal cardiac silhouette and no tension pneumothorax. Ddx?

A

Acute cardiac tamponade

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9
Q

Critically ill pt who on imaging shows thickening of gall bladder walls and pericholecystic fluid. No gallstones. Ddx? Tx?

A

acalculous cholecystitis

antibiotics and percutaneous cholecystostomy followed by cholecystectomy

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10
Q

oliguria, azotemia and BUN/creatinine >20:1 is what?

A

acute prerenal failure from hypovolemia

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11
Q

syringomyelia loses which sensation?

A

pain and temp in b/l UE

light touch, vibration, proprioception (dorsal column) preserved

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12
Q

Male in MVA, x-ray shows patchy irregular alveolar infiltrate on right side. Ddx?

A

pulmonary contusion

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13
Q

premie with pallor, cyanosis, hypotension, seizures, focal neurologic signs, bulging fontanel, apnea and bradycardia. US shows hemorrhage in germinal matrix. Ddx?

A

IVH

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14
Q

4yo immigrant boy with nasal d/c for 10 days, has follicular conjunctivitus and neovascularization over cornea. Ddx?

A

Chlamydia trachomatis

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15
Q

Babies with gastroschisis are at increased risk of neural tube defects. True or false?

A

False, omphalocele is closely related to neural tube defects.

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16
Q

Pt with postgastrectomy, experiences diaphoresis, postprandial abdominal cramps, lightheadedness, weakness. Ddx? Tx?

A

Dumping syndrome

dietary modification

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17
Q

nasopharyngeal cancer is closely assoc with what?

A

EBV infection

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18
Q

Elderly patient with hyperextension, cervical spondylosis, upper extremity weakness with loss of pain and temp sensation. Ddx?

A

Central cord syndrome

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19
Q

Breast abnormalities always need imaging, biopsy/aspiration is after that. Best modality for below 30 and above 30?

A

below 30: ultrasound

above 30: mammography and ultrasound

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20
Q

epidural hematoma shape?

A

biconvex collection

21
Q

subdural hematoma shape?

A

crescenteric

22
Q

severe left abdominal pain radiating to the groin, vomiting, cannot lie still. Ddx? Best diagnostic test?

A

ureterolithiasis

ultrasound or noncontrast spiral CT

23
Q

After MVA, thoracic chest wall is moving inward with inspiration and outward with expiration. multiple rib fx. PEEP makes chest movement normal again. Ddx?

A

Flail chest

24
Q

abdominal pain after MVA with vertebral fx and retroperiotoneal hemorrhage. Nausea, distended abdomen, absent bowel sounds, x-ray shows dilated small and large bowel. Ddx?

A

Paralytic ileus (also occurs after abdominal surgery)

25
Q

35 yo female with nipple retraction, mammogram shows coarse calcifications. Core biopsy shows foamy macrophages and fat globules. Ddx? Best next step?

A

Fat necrosis (benign)

no tx, self limited

26
Q

Best first step of management in urethral injury

A

Retrograde urethrogram

27
Q

Unhealing wounds can develop into what cancer?

A

SCC

28
Q

Constant and gnawing pain that is worse at night, anorexia with weight loss, jaundice. Migratory thrombophlebitis. Current smoker. Ddx?

A

Pancreatic cancer

29
Q

When is immediate laparotomy required?

A

When pt is unstable hemodynamically and there is proof of bleeding.

30
Q

Bilateral hip thigh and butt claudication, impotence and symmetric atrophy of b/l LE. Ddx?

A

Aortoiliac occulsion

31
Q

Pt w recent AAA repair presents with abdominal pain, bloody diarrhea, fever, leukocytosis. Ddx?

A

Bowel ischemia and infarction

32
Q

Worsening substernal chest pain radiating to the back, left chest pain after endoscopy. Chronic alcoholism. X-ray shows pleural effusion/pneumothorax that was not there before. Ddx?

A

Esophageal rupture

33
Q

Blunt abdominal trauma, epigastric pain. Intial CT is normal, but patient returns with fevers, chills, poor appetite and deep abdominal pain. Ddx?

A

Pancreatic laceration

34
Q

penile fracture best next step?

A

retrograde urethrogram with surgical exploration

35
Q

Fever, dysphagia, drooling, firm mass and crepitus in submandibular space. Ddx? Source of infx?

A

Ludwig’s angina (infx of submandibular and sublingual glands).

Teeth

36
Q

postprandial pain, early satiety, nonbilious vomiting, weight loss, recent acid ingestion. Abdominal succulent splash. Ddx?

A

Pyloric stricture

37
Q

wrist drop is caused by which nerve damage?

A

Radial nerve

38
Q

Tx of hydrocele?

A

Nothing, spontaneous by 12 months

39
Q

Reversal of warfarin?

A

fresh frozen plasma

40
Q

In prosthetic joints, which organisms cause early onset infection and which cause late onset infx?

A

early: staph aureus, pseudomonas
late: Staph epidermis

41
Q

When do you need tetanus IVIG?

A

Dirty severe wound with no previous vaccination

42
Q

ulcers that occur on high pressure points such as sole of foot just under first metatarsal bone is due to what?

A

peripheral neuropathy due to diabetes

43
Q

which drug contributes to postoperative ileus?

A

morphine

44
Q

Most common cause of lower GI bleeding in elderly?

A

diverticulosis

45
Q

Patients with fat malabsorption, such as Crohn’s disease, have tendency to develop nephrolithiasis. What kind of stones form?

A

oxalate stones

46
Q

what does the psoas sign suggest?

A

abscess near the psoas muscle, behind the appendix

47
Q

Blunt trauma. Persistent pneumothorax despite chest tube placement, pneumomediastinum and subcutaneous emphysema. Ddx?

A

tracheobronchial rupture

48
Q

After cardiac catheterization, pt develops hypotension, ipsilateral flank/back pain. Ddx?

A

retroperitoneal hematoma

Surgery (2 decks)

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