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Gs Flashcards

(44 cards)

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1
Q

Diagnosis of wrist swelling with +ve transillumination test?

A

Ganglion cyst

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2
Q

What is the next step for a euthyroid patient with a 3 cm hypoechoic thyroid nodule?

A

A: FNA

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3
Q

Q: What is the most effective intervention to reduce the risk of AAA in a smoker with strong family history?

A

A: Smoking cessation

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4
Q

What is the first-line oral antibiotic for mild, nonpurulent cellulitis of the leg in adults?

A

A: Dicloxacillin

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5
Q

Q: What is the most likely cause of chronic constipation, thin stools, and positive occult blood with apple-core lesion on imaging?

A

A: Rectal cancer

💡 Think of “apple-core” lesion and pencil-thin stool as hallmarks of distal colorectal cancer.

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6
Q

Q: Firm groin mass below inguinal ligament, lateral to pubis, no cough impulse or pressure change—most likely?

A

A: Femoral hernia

Note:

watchful waiting is usually avoided in women with groin hernias unless imaging confirms it is a reducible inguinal hernia.

Watchful waiting is more commonly appropriate in asymptomatic men with inguinal hernias.

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7
Q

23F with RLQ tenderness, guarding, vomiting, high WBC. Next step?

A

A: US

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8
Q

What is the management of asymptomatic gallstones in a chronic hepatitis B carrier?

A

Reassurance and follow-up — no intervention is needed if asymptomatic.

Extra:
Medication dissolves cholesterol stone in 6-12 month Ursodeoxycholic acid (ursodiol)

indication for cholecystectomy:

1 Symptomatic Gallstones

Cancer suspicion
2 Gallbladder polyps > 1 cm (or any size with symptoms or risk factors)

-Porcelain gallbladder (calcified wall) → ↑ risk of gallbladder cancer

-Gallbladder cancer or suspicion on imaging

-Large gallstones (>3 cm) in elderly → higher cancer risk

special
3 Children with symptomatic gallstones

  • Sickle cell disease with gallstones (even if asymptomatic)
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9
Q

Patient with chronic painless rectal bleeding & itching now presents with acute anal pain and mass – most likely diagnosis?

A

A: Thrombosed hemorrhoid
✅ Chronic → painless → now sudden painful mass = thrombosed hemorrhoid

Acutely thrombosed hemorrhoids < 72 hours can be excised in the ED or some clinics

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10
Q

Q: A post-gastric sleeve patient develops dizziness, fatigue, vomiting, and abdominal pain shortly after eating. Diagnosis?

A

A: Dumping Syndrome – due to rapid gastric emptying after surgery.

Extra:

Late Dumping Syndrome
• Onset: 1–3 hours after eating
• Mechanism: Rapid glucose absorption → transient hyperglycemia → exaggerated insulin response → hypoglycemia and catecholamine release
• Symptoms:
• Hypoglycemic: hunger, tremors, lightheadedness
• GI discomfort
• Management:
1. Dietary changes (as above)
2. Octreotide
3. Surgical revision

Late dumping syndrome should be suspected in patients with gastric surgery who experience postprandial hypoglycemia.

⸻

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11
Q

Patient with history of abdominal surgery presents with abdominal pain, vomiting, constipation, abdominal distension, and hyperactive bowel sounds. Next Mx?

A

A: Keep NPO, start IV fluids, and insert a nasogastric tube for decompression.

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12
Q

Child with midline neck mass that moves with swallowing and tongue protrusion. Most likely diagnosis?

A

A: Thyroglossal duct cyst

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13
Q

What is the next step in a stable elderly male with pulsatile abdominal mass and bruit on auscultation?

A

A: Abdominal ultrasound.

Extra

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14
Q

Middle-aged patient with chronic constipation, thin stools, positive occult blood, normal DRE — most likely diagnosis?

A

A: Sigmoid cancer/recal

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15
Q

What is the most appropriate step for a patient with RUQ pain, fever, and labs showing cholestatic LFT pattern (↑ALP, ↑bilirubin)?

A

A: ERCP — diagnostic and therapeutic for choledocholithiasis or cholangitis.

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16
Q

Q: What is the diagnosis of a painless, fluctuant, bluish mass under the tongue, often due to blocked salivary gland duct?

A

A: Mucocele

🧠 Explanation: Mucoceles are mucus-retention cysts of minor salivary glands. When under the tongue, they are called ranulas and present as painless, bluish swellings due to saliva accumulation.

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17
Q

Q: What is the most likely cause of hoarseness after thyroidectomy?

A

A: Injury to the recurrent laryngeal nerve.

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18
Q

Q: What is the best management for confirmed breast fat necrosis after trauma with only mild symptoms?

Study These Flashcards
A

A: Reassurance

🧠 Explanation:

Fat necrosis of the breast is a benign condition often resulting from trauma or surgery. It can present as:
• A palpable mass
• Mild tenderness
• Bruising or skin retraction
• Sometimes calcifications on imaging

19
Q

Q: Patient with BMI 45, poorly controlled DM (HbA1c 11%), HTN, and OA—most appropriate next step?

Study These Flashcards
A

A: Bariatric surgery

🧠 Main point:
Bariatric surgery is indicated for:
BMI ≥40, or BMI ≥35 with comorbid conditions (DM, HTN, OA)

20
Q

22F with bilateral cyclical breast pain and multiple mobile nodules. What is the next best step?

Study These Flashcards
A

A: Ultrasound

21
Q

Q: A woman presents with spontaneous, unilateral, bloody nipple discharge and normal breast exam. Most likely diagnosis?

Study These Flashcards
A

A: Intraductal papilloma

22
Q

Q: 40-year-old woman with sister diagnosed with breast cancer at 56 has a normal mammogram. Next step?

🧠

Study These Flashcards
A

A: Mammogram annually

Screen breast cancer:
The USPSTF recommends biennial screening mammography for women aged 40–74 years.

This recommendation is applicable to both average-risk women and women with factors associated with an increased risk of breast cancer, including having dense breasts or a positive family history of breast cancer

Extra
genetic testing is considered when there is:
1. Breast cancer in a first-degree relative <50 years
2. Multiple relatives with breast/ovarian cancer

23
Q

Q: A patient develops pleuritic chest pain and shortness of breath on day 5 post-cholecystectomy. Most likely diagnosis?

Study These Flashcards
A

A: Pulmonary embolism
🔍 Explanation: Classic presentation for PE in the postoperative setting due to increased thrombotic risk.

24
Q

Acute appendicitis sign ?

25
Q: What is the preferred treatment for BPH in a patient with orthostatic hypotension due to autonomic dysfunction (e.g., diabetic neuropathy)?
***A: Finasteride*** 🧠 Explanation: Alpha-blockers (like doxazosin) can worsen hypotension. Finasteride is preferred as it avoids BP effects and treats BPH safely in these patients.
26
Q: What is the most appropriate next step in an elderly diabetic male with scrotal erythema, fluctuance, and fever?
A: Immediate surgical referral for debridement (Fournier’s gangrene).
27
Q: 27-year-old man with dysuria and testicular tenderness, no sexual history reported — most likely organism?
?Chlamydia trachomatis On abscent of sexual activity - E.coli?
28
Q: Middle-aged man with flank pain radiating to testicle, vomiting, hematuria, and no tenderness on exam. Next step?
A: NSAID (e.g. ketorolac) ***Pain control before imaging in stable patient*** Note : ***Preferred Initial Imaging*** Non-contrast CT (abdomen and pelvis): First-line in non-pregnant patients Alternative Imaging Ultrasound (abdomen and pelvis): ***Used for pregnant or pediatric patients, or to avoid radiation***
29
Q: Teenager with testicular pain, pain relieved by lifting, normal cremasteric reflex — most likely diagnosis?
A: Epididymitis Explanation: Positive Prehn’s sign and intact cremasteric reflex suggest inflammation (epididymitis), not torsion.
30
Q: 14-year-old with sudden testicular pain, N/V, absent cremasteric reflex, pain worsens with elevation — most likely diagnosis?
***A: Testicular torsion*** Key clue: Acute onset, absent cremasteric reflex, negative Prehn sign.
31
Q: Male with post-trauma tense scrotal swelling, non-tender, testes not easily palpable — most likely diagnosis?
***A: Hydrocele*** – fluid collection around testis; often post-trauma, painless, and obscures testicular exam.
32
Q: Patient fell on outstretched hand with tenderness at base of thumb and suspicious scaphoid X-ray. What’s the initial management?
A: Forearm thumb spica 🧠extra : ***Scaphoid Fracture*** ***Risks***: fall on an outstretched hand (FOOSH) ***Sx***: dorsal radial wrist pain with decreased range of motion ***PE***: anatomical snuffbox tenderness ***Dx***: clinical X-ray, CT, bone scan, (MRI most accurate) Many fractures will be missed on X-ray immediately after the injury ***Tx***: thumb spica splint
33
Q: What is the most likely diagnosis in a teenage female with abnormal posture and spinal curvature on X-ray?
***A: Idiopathic scoliosis*** Extra : Scoliosis - Definition: Lateral curvature of the spine - Diagnosis: Made by Cobb angle ≥ 10° on radiography. - Most common type: Idiopathic scoliosis.
34
Q: What is the definitive treatment for severe bilateral knee osteoarthritis not responding to conservative therapy?
***A: Referral to bilateral Total Knee Replacement (TKR)***
35
Q: What is the next appropriate step in a young male with shoulder pain after pulling something ?
***A: Reduction*** Explanation: The lateral-Y view X-ray shows a posterior shoulder dislocation, evidenced by the “light bulb sign” (humeral head appears rounded and symmetric). ***Management involves:*** 1. Analgesia/sedation 2. Closed reduction 3. Immobilization Referral is not first unless closed reduction fails or complications arise.
36
Q: Best treatment for complete displaced midshaft fracture of radius and ulna in a 12-year-old?
***A: Open reduction and internal fixation***
37
Q: Teen athlete with anterior knee pain worse with stairs, relieved by rest, tender over tibial tuberosity — most likely diagnosis?
***Osgood-Schlatter disease*** Extra: ***Osgood-Schlatter Disease *** ***Age group: *** Young adolescent athletes, 10–15 years old ***Symptoms: *** Knee pain with activities that cause quadriceps contractions (e.g., running, jumping) ***PE findings: *** Tenderness over the tibial tubercle and pain with knee extension against resistance ***Management: *** Ice, NSAIDs, acetaminophen, quadriceps stretching
38
Q: What ligament is most likely injured with a positive Lachman test?
***A: Anterior Cruciate Ligament (ACL)*** ***A positive Lachman test*** is highly specific and sensitive for injury to the ***anterior cruciate ligament (ACL).***
39
Q: What is the next step in a 2-week-old infant with positive Barlow and Ortolani tests suggesting DDH?
**Ultrasound of the hips** Extra:
40
Q: What is the next step in a 2-week-old infant with positive Barlow and Ortolani tests suggesting DDH?
***Ultrasound of the hips*** Extra: ***Developmental Dysplasia of the Hip (DDH)***: ***RF***: Breech at > 34 weeks, FH of DDH, Hx of clinical instability on examination ***PE***: Flexing the infant’s hips and knees shows uneven knee heights (Galeazzi test), Barlow and Ortolani maneuvers ***Dx***: Screening tests revealing hip instability, asymmetry or limited abduction ***Imaging***: Use imaging in infants with inconclusive exam or normal examination with RFs ***Screening***: Normal examination with RF ***or*** positive screening test = screening U/S at 4–6 weeks of age (radiographs can be used at ≥ 3 months of age) ***Tx***: Pavlik harness, surgical reduction
41
What is the appropriate management for a Colles fracture?
A: Close reduction and cast ***Colles Fracture:*** Distal radius fracture with ***dorsal*** displacement (***dinner fork*** deformity) ***Cause:*** Fall onto an outstretched hand (***FOOSH *** injury) ***Assessment:*** Assess neurovascular status and for possible associated injuries (***snuffbox tenderness*** ) ***Treatment: Closed reduction, splint, orthopedic follow-up
42
Q: Shoulder pain at night + limited passive ROM + trauma history — most likely diagnosis?
***Adhesive capsulitis*** Adhesive Capsulitis (Frozen Shoulder) Predisposing conditions: diabetes, thyroid disease Presentation: ***Diffuse shoulder pain*** that is worse at night ***Progressive stiffness*** that results in ***severe range of motion limitations*** Treatment: ***Gentle range of motion exercise*** that increases in intensity ***Physical therapy*** ***Intra-articular corticosteroid injections*** for severe symptoms Course: Self-limited but may persist for years
43
Q: A boy fell on an extended arm while playing football and developed shoulder pain. What is the most likely complication?
***A: Axillary nerve injury*** ***Anterior Shoulder Dislocation*** ***Cause:*** Most commonly caused by trauma from a fall or forceful throwing motion ***PE:*** arm ***abducted*** and ***externally rotated***, positive apprehension test result ***Dx:*** Diagnosis is made by ***anteroposterior*** and ***axillary shoulder X-rays*** ***Displacement:*** ***Humeral head*** displaced ***inferiorly*** and ***medially*** ***Complications:*** ***Axillary nerve damage***, ***Bankart lesion*** (glenoid labrum disruption), ***Hill-Sachs deformity*** (cortical depression in the humeral head)
44
Q: What is the most likely diagnosis in a patient post-RTA (Dashboard) with a shortened, adducted, and internally rotated leg?
**Posterior hip dislocation** Dashboard = PHD ***Hip Dislocation***: Posterior more common than anterior **Posterior**: *internally rotated, sciatic nerve injury* **Anterior**: *externally rotated, femoral artery, vein, nerve injury* ***Tx***: emergent **reduction** under conscious sedation ***Complications***: avascular necrosis of the femoral head

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