pestana: questions

Question 1

what should you suspect if people present with septic shock, get treated and initially respond then suffer a relapse

Answer 1

adrenal insufficiency

Question 2

management of linear skull fracture

Answer 2

leave alone

Question 3

treatment of subdural hematoma: if midline deviated or not

Answer 3

if deviated: craniotomy

if not: prevent ICP damage (head elevation, hyperventilate, diuresis)

Question 4

presentation of urethral injury

Answer 4

pelvic fracture –> blood at meatus, scrotal hematoma, cant void

Question 5

urethral injury diagnosis

Answer 5

retrograde urethrogram

Question 6

what prophalyxis does gun shot wounds need

Answer 6

tetanus

Question 7

what degree burn can excision and grafting be used for?

Answer 7

3rd degree

Question 8

do kids with angular fracture will have remodeling?

Answer 8

yes, wont create permanent deformity

Question 9

intertrochanteric fractures of hip treatment

Answer 9

open reduction and internal fixation (less likely to lead to avascular necrosis)

and anticoagulation for immobilization

Question 10

what is this: squamous cell carc of skin developing in a chronic leg ulcer that has undergone cycles of healing and breaking down. that needs to be bipsied and excised

Answer 10

marjolin ulcer

Question 11

what to do if fistula from GI tract but no fever and no peritoneal signs?

Answer 11

fluid and electrolyte replacement, nutritional support, and protect abdominal wall till fistula heals

Question 12

which murmur of addicts who develop CHF suddenly?

Answer 12

acute aortic insuff.

Question 13

treatment for acute aortic insuff

Answer 13

emergency valve replacement and long term abx

Question 14

what do you think: painful, pale, pulseless, parasthetic, poikothermic suddenly

Answer 14

arterial embolization from a distant source

Question 15

how to treat early incomplete occlusions vs complete occlusions of arterial emboli?

Answer 15

incomplete: clot blusters
complete: embolectomy with fogarty catheter, + fasciotomy

Question 16

best diagnostic for dissecting aneurysm

Answer 16

emergency MRI angiogram

Question 17

white pupils, even if from congential cataracts, should be dealt with how and when?

Answer 17

surgery ASAP to avoid ambylopia

Question 18

what do you suspect when 1 year old has mass in RUQ that moves up and down with respiration?

Answer 18

malignant tumor of liver

Question 19

how to treat ARDS

Answer 19

PEEP

Question 20

breast tumors right under nipple/areola and take up most of the room in a small breast need what surgical resection?

Answer 20

mastectomy and sentinel node axillary samping

Question 21

persistent HA or back pain in women who recently had breast cancer suggests what and what test to do?

Answer 21

metastasis- MRI

Question 22

brain abscess diagnosis

Answer 22

CT

Question 23

____ ml.h ringer lactate is a good predetermined rate of fluid in an adult who has burns of 20% body surface

Answer 23

1000

Question 24

what is this: late 20s woman presents with breast mass over many years and becomes large but doesnt invade. and what test to do?

Answer 24

cystosarcoma phyllodes

core or incisional biopsy

Question 25

expensive treatment for ARDS-refractory to PEEP

Answer 25

ECMO

Question 26

management for someone who has ureteral stone and sudden fever spike

Answer 26

IV abx

emergent decompression- nephrostomy or stent

Question 27

ogilvie syndrome management

Answer 27

place c-scope and suck out all the air

place long rectal tube