V

Question 1

when do you do a diagnostic peritoneal lavage

Answer 1

if FAST examination in ER is inconclusive

Question 2

next step for hemodynamically unstable patients with sharp penetrating abdominal trauma and GSW

Answer 2

immediate laparotomy

Question 3

signs of posterior urethral injury

Answer 3

blood in urethral meatus, inability to void and high riding prostate on DRE

Question 4

next step if suspect urethral injury

Answer 4

assess with a retrograde urethrogram prior to insertion of foley catheter

Question 5

32 year old female with blood staining on bra from left breast. no lumps

Answer 5

intraductal papilloma

Question 6

US findings for intraductal papillomas

Answer 6

if >1cm then can detect

so usually US is unremarkable because masses are so tiny

Question 7

fibroadenoma

Answer 7

solitary breast lesion presents as painless firm mobile breast lump averaging about 2 cm in size

Question 8

ductal carcinoma in situ

Answer 8

most common in postmenopausal women
incidental finding on mammography
nipple discharge and breast mass are most frequent complaints

Question 9

leriche sydrome

Answer 9

aortoiliac peripheral vascular disease that may cause buttock, thigh or hip pain and claudication and causing ED

Question 10

which rotation of hip worsens hip osteoarthritis

Answer 10

internal

Question 11

causes of gastric outlet obstruction

Answer 11

gastric malignancy, peptic ulcer disease, crohns, strictures

Question 12

succusiion splash

Answer 12

placing stethoscope over upper abdomen and rocking patient back and forth at hips the retained gastric material will generate a sound

Question 13

how t confirm pyloric stricture

Answer 13

endoscopy

Question 14

most common risk factor for aortic dissection

Answer 14

hypertension

Question 15

mutation in marfans

Answer 15

fibrillin gene

Question 16

most common peripheral artery aneurysms

Answer 16

1 popliteal

2 femoral artery

Question 17

Tx uncomplicated diverticulitis

Answer 17

antibiotics bowel rest and observation

Question 18

Tx for complicated diverticulitis

Answer 18

fluid collection >3cm drained by CT guided imaging. surgery if in 5 days not resolving

Question 19

supracondylar fracture of humerus are common with what type injury

Answer 19

entrapement brachial atery or median nerve

Question 20

what causes volkmann contracture

Answer 20

ischemia and infarction from compartment syndrome

Question 21

what fractures can lead to limb length discrepencies

Answer 21

proximal humerus and distal forearm fractures

Question 22

axillary nerve is damaged in what fractures

Answer 22

proximal humerus

Question 23

brachial plexus injuries occur in what scnearios

Answer 23

neonatal clavicle fracture or high impact trauma to neck/shoulder area

Question 24

metabolic acidosis in septic shock

how to correct levels?

Answer 24

IV normal saline

Question 25

when to use IV sodium bicarb in acidosis

Answer 25

severe when pH

Question 26

after IV saline give, in septic shock what is next to restore BP

Answer 26

dopamine IV. (vasopressors)

Question 27

signs of mechanical small bowel obstruction

Answer 27

vomiting, decreased oral intake, dehydration, orthostasis, abdominal pain

Question 28

signs of strangulated bowel obstructions

Answer 28

peritoneal signs (rigidity, signs of shock

Question 29

most common cause small bowel obstruction

Answer 29

adhesions

Question 30

charcots triad

Answer 30

fever severe jaundice and RUQ pain

Question 31

worsening abdominal pain and hypotension despite treatment for acute cholangitis

Answer 31

need to do ERCP for bilary drainage

Question 32

distended neck veins after trauma are a sign of what

Answer 32

pneumothorax or cardiac tamponade

Question 33

where to put needle for pneumothorax

Answer 33

second intercostal space Left MCL

Question 34

symptoms of hypoCa

Answer 34

perioral tingling and numbness, muscle cramps, tetany, carpopedal spasms and seizures

Question 35

causes of primary hypoPTH

Answer 35

``` post surgical autoimmune congnital absence defective Ca sensing R non-autoimmune destruction of parathyroid gland ```

Question 36

characterization hypoparathyroidism

Answer 36

hypoCa hyper phosphate normal renal function

Question 37

oliguria, azotemia and elevated BUN/Cr in post operative state

Answer 37

acute prerenal failure from hypovolemia | need to rule out urinary catheter obstruction

Question 38

lab findings in acute mesenteric ischemia

Answer 38

leukocytosis, elevated amylase levels, metabolic acidosis from increased serum lactate levels

Question 39

gold standard for Dx acute mesenteric ischemia

Answer 39

mesenteric angiography