100 clinical surgical vignettes Flashcards
(100 cards)
1
Q
Elderly woman, SBO, and air in biliary tree
A
gallstone ileus
2
Q
elderly woman w/ pain down inner aspect of thigh
A
Obturator hernia
Howship-Romberg sign
3
Q
- Abdominal pain
- Hypotension
- Pulsating abdominal mass
A
AAA rupture
4
Q
Abdominal pain “out of proportion” to abdominal exam
A
Mesenteric ischemia
5
Q
arm pain and syncope with arm movement
A
subclavian steal syndrome
6
Q
increasing creatinine while on ACEI
A
Renal artery Stenosis
7
Q
child with midline neck mass
A
thyroglossal duct cyst
8
Q
child with lateral neck mass
A
branchial cleft cyst
9
Q
crush injury and dark urine
A
myoglobinuria
10
Q
- Vomiting
- Chest Pain radiating to back
- Mediastinal air
A
Boerhaave’s
11
Q
Lower GIB + technetium pertechnetate scan
A
meckels diverticulum
12
Q
- Flushing
- Diarrhea
- Right sided HF
A
Carcinoid
13
Q
Pneumaturia and LLQ pain
A
colovesicular fistula
14
Q
- Desmoid tumor
- Osteoma
- Colon cancer
A
Gardner’s syndrome
15
Q
Epigastric pain radiating to back and flank ecchymosis
A
Hemorrhagic pancreatitis
16
Q
pancreatitis and palpable epigastric mass
A
pancreatic pseudocyst
17
Q
- RUQ pain
- Travel
- Exposure to sheep
A
Hydatid cyst
18
Q
Caput medusa
A
portal HTN
19
Q
45 year old woman with RUQ pain for 12 hours, fever, and leukocytosis
A
Acute cholecystitis
20
Q
Elderly man with large contender palpable gallbladder
A
Pancreatic cancer (Courvoisier’s sign)
21
Q
Female taking birth control. pills with liver mass
A
Hepatic adenoma
22
Q
liver tumor with “central scar”
A
focal nodular hyperplasia
23
Q
- Pancreatic mass
- Gallstones
- Diabetes
- Diarrhea
A
Somatostatinoma
24
Q
RUQ bruit and CHF in young adult
A
liver hemangioma
25
excruciating pain with bowel movement
anal fissure
26
Liver abscess with "anchovy paste"
amebic abscess
27
- Abdominal pain
- Diarrhea
- Anal fistulae
Crohn's disease
28
EKG with Peaked T waves
Hyperkalemia
29
Buccal mucosa with pigmentation
Peutz-Jeghers syndrome
30
- LLQ pain
- Fever
- Change in bowel habits
Diverticulitis
31
Elevated urine 5-HIAA
carcinoid
32
- Institutionalized
- Abdominal pain
- Vomiting
- Distention
- Proximal colonic dilation
Sigmoid volvulus
33
Newborn with failure to pass meconium in first 24 hours
Hirschsprung's
34
infant with bilious vomiting
malrotation
35
infant with projectile vomiting
pyloric stenosis
36
newborn with abdominal defect and umbilical cord on sac
omphalocele
37
teenager with knee pain and "onion skinning" on X-ray
Ewing's sarcoma
38
PCWP <16, CXR with bilateral pulmonary infiltrates, PaO2:FiO2 ratio < 300
ARDS
39
- Increased peak airway pressure
- Low UOP
- Urinary bladder >25 mmHg
Abdominal Compartment syndrome
40
Newborn with inability to "pass an NGT"
Esophageal atresia
41
traumatic blinding in one eye followed by blindness in the contralateral eye 2 weeks later
sympathetic ophthalmia
42
- Miotic pupil
- Ptosis
- Anhydrosis
Horner's syndrome
43
- Traumatic head injury
| - Conscious in ER followed by unconsciousness
```
Epidural hematoma
(lucid interval)
```
44
"Worst headache of my life"
subarachnoid hemorrhage
45
- Hematuria
- Flank pain
- Abdominal mass (palpable)
Renal cell carcinoma
46
60 year old White Man with Painless Hematuria
bladder cancer
47
- RUQ pain
- Jaundice
- Fever
Cholangitis
48
- Epigastric pain radiating to back
| - N/V
Pancreatitis
49
Chest pain radiating to back and described as a "tearing" pain
Aortic dissection
50
40 year old Man with Tachycardia/HTN and confusion on POD#2
Alcohol withdrawal
51
Marfanoid body habitus and mucosal neuromas
MEN 2B
52
Psammoma bodies
papillary thyroid cancer
53
sulfur granules
Actinomyces infection
54
Thyroid tumor with AMYLOID tissue
Thyroid medullary cancer
55
PALPABLE neck tumor and hypercalcemia
Parathyroid cancer
56
- HTN
- Sweating
- Palpitations
Pheochromocytoma
57
Jejunal ulcers
Zollinger-Ellison syndrome
58
- Pituitary tumor
- Pancreatic tumor
- Parathyroid tumor
MEN 1
59
Necrotizing migratory erythema
Glucagonoma
60
- Medullary thyroid cancer
- Pheochromocytoma
- Hyperparathyroidism
Men 2A
61
Hypokalemia refractory to IV potassium supplementation
Hypomagnesemia
62
Newborn with pneumatosis
Necrotizing enterocolitis (NEC)
63
child with abdominal mass that crosses midline
Neuroblastoma
64
child <4 years old with abdominal tumor that does NOT cross midline
Wilms' Tumor
65
"Currant jelly" stools and abdominal colic
Intussusception
66
- Femur fracture
- Respiratory failure
- Petechiae
- AMS
Fat embolism
67
Hearing loss + Tinnitus + Vertigo
Meniere's disease
68
Adolescent boy with nasal obstruction and recurrent epistaxis
Juvenile nasopharyngeal angiofibroma
69
Child <5 yr old sitting upright and drooling, with "Hot-potato" voice
Epiglottitis
70
- Angina
- Syncope
- CHF
Aortic stenosis
71
- Tobacco use
- Asbestos exposure
- Pleuritic chest pain
Mesothelioma
72
Supracondylar fracture and contracture of forearm flexors
Volkmann's contracture
73
- Tibia fracture*
- "Pain out of proportion"
- Pain on PASSIVE foot movement
- Palpable pulses
Compartment syndrome
74
25 yr old man with liver mass with fibrous septa and NO history of cirrhosis or hepatitis
Fibrolamellar hepatocellular carcinoma
75
EKG:
- Flattening of T waves
- U waves
Hypokalemia
76
Central pontine myelinolysis
Too rapid correction of hyponatremia
77
- Polydipsia
- Polyuria
- Constipation
Hypercalcemia
78
Factor VIII deficiency
Hemophilia A
79
- Abdominal pain
- Fever
- Hypotension
- HYPERkalemia
- HYPOnatremia
Adrenal insufficiency (Addisonian crisis)
80
Massive UOP and HYPERnatremia
Diabetes insipidus
81
- Increased urine osmolality
- HYPOnatremia
- Low Serum osmolality
SIADH
82
IV ABX, fever, diarrhea
C. diff colitis
83
Bleeding gums and wound dehiscence
Vitamin C deficiency
84
- Fever
- Central line
- HYPERglycemia
central line infection
85
Appendectomy followed by fever and abdominal pain on POD#7
Peritoneal abscess
86
- Advancing crepitus
- Fever
- Blood blisters
Necrotizing fasciitis
87
high INTRAoperative fever
malignant hyperthermia
88
- Confusion
- Ataxia
- Ophthalmoplegia
Wernicke's encephalopathy
89
- Tracheal deviation
- Decreased Breath sounds
- Hyperresonance
Tension PTX
90
- Hypotension
- Decreased heart sounds
- JVD
Pericardial Tamponade
91
Four ribs broken in two places and pulmonary contusion
flail chest
92
Otorrhea (clear) and Battle's sign
Basilar skull fracture
93
Ulcer and decreased pain with food
Duodenal ulcer
94
- Vomiting
- Retching
- Epigastric pain
Mallory-Weiss tear
95
Fever on POD#1, with "Bronze" weeping, tender wound
Clostridial wound infection
96
Hematochezia and tenesmus
Rectal Cancer
97
- Upper GIB
- Jaundice
- RUQ pain
Hemobilia
98
- Gallstones
- Epigastric pain radiating to back
- Nausea
Gallstone pancreatitis
99
18 yr old woman with Bloody nipple discharge
Ductal papilloma
100
- Irritability
- Diaphoresis
- Weakness
- Tremulousness
- Palpitations
Insulinoma
