III

Question 1

management of rib fractures

Answer 1

pain management and respiratory support

Question 2

TB radiograph findings

Answer 2

patchy or nodular opacity, multiple nodules, cavity in apical posterior segments of upper lobes

Question 3

patient with massive hemoptysis >600ml

next step?

Answer 3

bronchoscopy

Question 4

what position do you put a patient in with massive hemoptysis

Answer 4

bleeding lung side down to preevnt bleeding into opposite lung

Question 5

when to use pulmonary arteriography with massive hemoptysis

Answer 5

when bronchoscopy fails to localize source

Question 6

initial XR for scaphoid fracture

Answer 6

unremarkable or radiolucent lines in nondisplaced spachoid fracture

Question 7

what to do with amputated finger

Answer 7

wrap with saline moistened gauze and put in bag on ice

Question 8

most common respiratory complication in first 24 hours post surgery

Answer 8

atelectasis

Question 9

what methods are used to increase FRC post surgery

Answer 9

chest physiotherapy, incentive spirometry, coughing and frequent respositioning

Question 10

how do AAA differ from thoracic AA

Answer 10

all aortal layers are involved, no flaps or false lumens

Question 11

how can AAA cause hematuria

Answer 11

rupture into retroperitoneum and cause aortocaval fistula with IVC leading to venous congestion in the bladder and the distended veins in bladder can rupture

Question 12

how can ruptured AAA cause lower extremity weakness

Answer 12

dissection into spinal arteries causing spinal cord ischemia

Question 13

how to confrim ruptured AAA

Answer 13

contrast chest CT or transesophageal echo

Question 14

presentation of mediastinal tumor

Answer 14

slow onset retrosternal chest pain, dysphagia or dyspnea

Question 15

why is diaphragmatic ruture more common on L side

Answer 15

because liver is on Right

Question 16

signs of tension pneumothorax

Answer 16

tympanic percussion, tracheal deviation to contralateral side, jugular venous distension, hypotension

Question 17

Tx tension pneumo

Answer 17

emergency needle thoracostomy in 2nd intercostal space in MCL

Question 18

becks triad

Answer 18

hypotension, pulsus paradoxus, JVD and muffled heart sounds

cardiac tamponade!

Question 19

what not to do in tension pneumo

Answer 19

positive pressure ventilation because can cause one way valve increasing intrathoracic P and worsening hemodynamic collapse

Question 20

signs of retroperitoneal abscess

Answer 20

fever chills and deep abdominal pain

Question 21

how to detect pancreatic laceration

Answer 21

serial CT. abdominal CT at first may miss it

Question 22

dx splenic injury

Answer 22

CT

Question 23

XR for gastric perforation

Answer 23

free air under diaphragm

Question 24

common causes of infected aortic aneurysms

Answer 24

staph and salmonella

Question 25

early dumping syndrome

Answer 25

postgastrectomy complication | rapid empyting of hypertonic gastric content into duodenum and small intestine

Question 26

signs early dumping syndrome

Answer 26

diaphoresis, craminging and weakness and lightheadedness

Question 27

knee hurts with twisting and has popping sound

Answer 27

meniscus

Question 28

Dx test for meniscal injury

Answer 28

MRI

Question 29

anterior dislocation humeral head | what nerve can be damaged

Answer 29

axillary

Question 30

damage to axillary nerve will cause what

Answer 30

paralysis of deltoid and teres minor muscles and loss of sensation over lateral upper arm

Question 31

damage to radial nerve will cause what

Answer 31

wrist drop and senosry loss posterior arm forearm and lateral dorsal hand

Question 32

damange to ulnar nerve will cause what

Answer 32

claw hand from paralysis intrinsic mucles

Question 33

damage to musculocutaneous will cause what

Answer 33

loss innervation to biceps, brachialis and coracobrachialis

Question 34

signs of long thoracic nerve injury

Answer 34

winged scapula

Question 35

how to confirm Dx psoas abscess

Answer 35

abdominal CT

Question 36

AP and lateral lumbar films are used for what

Answer 36

ureteral stones, bowel obstruction and perforated abdominal viscus

Question 37

what can cause psoas abscess from continguosu spread

Answer 37

potts disease( TB)

Question 38

gastroschisis

Answer 38

protrusion red intestines to right side of normal umbilicus

Question 39

omphalocele

Answer 39

protrustion of abdominal contents into base of umbilical cord. covered with peritoneum and overlying skin

Question 40

umbilical granuloma and Tx

Answer 40

umbilical mass in newborns, soft moist pin and pedunculated | silver nitrate is Tx

Question 41

what vv are damaged in subdural hematoma

Answer 41

bridging veins

Question 42

what can cause hypoxemia

Answer 42

reduced inspirted oxygen tension, hypoventilation, diffusion limitation, shunt and V/Q mistmatch

Question 43

normal A-a gradient and respiratory acidosis

Answer 43

hypoventilation

Question 44

how do you calculate A-a gradeint

Answer 44

PAO2-PaO2

Question 45

what are causes of alveolar hypoventilation

Answer 45

pulmonary/thoracic diseases neuromuscular diseases drug induced by anesthetics, narcotics and sedatives primary central nervous system dysfunction-- brainstem lesion, infection and stroke

Question 46

signs of duodenal hematoma

Answer 46

blunt trauma, epigastric pain and vomiting

Question 47

Tx for duodenal hematoma

Answer 47

nasogastric suction and parenteral nutrition

Question 48

electrical alterans (varying peaks of Q wave)

Answer 48

tamponade