Flashcards in USMLE 3 Deck (32):
GCS Score breakdown: Eyes.
4 - opens spontaneously.
3 - opens to verbal command.
2 - opens to pain.
1 - does not open.
GCS Score breakdown: Verbal.
5 - oriented.
4 - confused.
3 - inappropriate words.
2 - sounds.
1 - no sounds.
GCS Score breakdown: Motor.
6 - obeys commands.
5 - localizes to pain.
4 - withdraws from pain.
3 - flexion (decorticate).
2 - extension (decerebrate).
1 - no movement.
Non bleeding esophageal varices are managed by?
Beta adrenergic antagonists - propranolol.
An elderly man presents with bone pain, the only remarkable finding is elevated Alkaline phosphatase and increased uptake in bone scans? Complications?
Paget disease of the bone. Fractures, arthritis, HEARING LOSS.
A patient presents after a MVC and looks SHOCKY. FAST and DPL find no abdominal bleeding. They have a pelvic fracture, how do you assess retroperitoneal bleeding?
How does Nursemaid elbow happen? How do you fix it?
Pulling on a child's arm causes subluxation of radial head at elbow joint. Flex the elbow and supinate the forearm (the very thing they don't want you to do).
In hypovolemic shock, what are the first physiological changes to occur.
Tachycardia (increased pulse rate) and peripheral vascular constriction.
Abdominal complications from AAA surgery? Presentation? What will CT elicit?
Ischemic colitis. Dull abdominal pain and bloody diarrhea. Thickening of the bowel wall.
You note edema, stasis, dermatitis and venous ulcerations on the medial leg that stretches from the ankle to the knee. What is the cause? First physical sign?
Venous valvular incompetence. Xerosis (dry skin).
A man presents flank pain, hematuria, and vomiting. How does a PMH of Chrohns make the diagnosis?
Nephrolithiasis. Poor absorption of fats leads to excessive absorption of oxalate, which contributes to stone formation.
A patient has an edematous lower extremity that gets more swollen throughout the day. Cause? First complication noticed on PE?
Venous valve incompetence. Xerosis.
In a post-op recovery room, a patient becomes hypoglycemic, hypotensive, with vomiting, nausea, and abdominal pain. Main cause?
Acute adrenal insufficiency. Preoperative steroid use.
An asian adult patient presents with epistaxis. You note a mass in the posterior nasal cavity? Most important risk factor?
Nasopharyngeal carcinoma. EBV.
An elderly patient suffers a displaced femoral neck fracture. Treatment?
Baby has a scalded bottom. What should you do?
Admit the baby and do a full skeletal survey. This child is being abused.
Treatment of duodenal hematoma?
NG tube and parenteral nutrition.
A patient presents several days after the signs of appendicitis with abdominal tenderness? Treatment?
Perforated appendicitis. Antibiotics, IV fluids, bowel rest.
Best test to confirm the diagnosis of retroperitoneal air?
CT w/ contrast.
A patient after MVC who already receives a chest tube develops subcutaneous emphysema and pneumomediastinum?
Trachea or Bronchi rupture.
Deviated mediastinum with a mass in the lower left chest on CXR?
A patient with widened mediastinum, fever, chest pain, and leukocytosis. AAA has been ruled out? Treatment?
Acute mediastinitis. Thoracotomy for debridement, drainage. Antibiotics.
A patient suffers severe head trauma, grows drowsy, weak on the right side of the body. What nerve is most likely to be damaged?
Oculomotor - from transtentorial herniation.
Two years after a whiplash injury, a patient develops decreased strength and loss of temperature/pain sensation? Cause? Diagnostic test?
Syringomelia. CSF retention. MRI.
A patient presents with non bilious vomiting of partially digested food, weight loss, early satiety, and a history of GERD? What if he ingested acid as part of a suicide attempt?
Gastric outlet obstruction. Pyloric stricture.
What blood loss is required to necessitate blood transfusion?
One week after open heart surgery, a patient develops fever, substernal chest pain, and mediastinal widening on CXR. AAA is ruled out? Treatment?
Acute mediastinits. Surgical debridement, drainage, and antibiotics.
Septic knee joint within 3 months of surgery. What is the offending agent? What is the offending agent if has been more than 3 months.
Staph Aureus. Staph Epidermidis.
A patient presents with right anterior thigh pain that is worse with walking. PE shows a small pulsatile mass in the right groin area?
Femoral artery aneurysm.
A man is actively bleeding from esophageal varices. What do you do first? Then what do you do?
Establish vascular access and fluid resuscitation. Control the bleeding.
Retropharyngeal abscess can lead to what complication?
Infection to the mediastinum, acute necrotizing mediastinitis.