Thread Rating:
  • 0 Vote(s) - 0 Average
  • 1
  • 2
  • 3
  • 4
  • 5
clinical mastery Surgery Form 3 & 4 Please help! - coke170
#11
55YOM brought to emergency

Dx. aortic dissection, txConfusedurgery
my answer 3


42 YOW emergency 17 min (what´s mean MVC?)
flank pain + gross hematuria=urolithiasis
perform CT
my answer 2
Reply
#12
thank you fuser00,

I didn't know that toxic synovitis and transient synovitis are synonymous.

here's what I found on wiki for those who didn't know that toxic synovitis is also known as transient synovitis.

Toxic synovitis is a temporary condition that causes hip pain in children. It's also known as transient synovitis. It mainly occurs in children between 3 and 8 years old. It's two to four times more common in boys than girls.
Reply
#13
to fuser:

for 18 -- you chose C , can you explain, or it is a typo.

for 39 -- agree on LUPUS and steroid treatment. (it is more frequent than other rare reactions)

38. toxic synovitis -- diagnosis of exclusion. nice catch.


for 55YO -- 3. it is BOERHAAVE . 100% lethal if you don't do surgery.

for 42YO -- MVC (probably motor vehicle collision, waiting for Violetta to confirm)
because she is STABLE, then agree on CT choice 2.
Reply
#14
yep was a tipo the fact is protect airway : b) Endotracheal intubation
Reply
#15
thank you fuser00
Reply
#16
A few more questions from form 4

37 yo F comes to physician because of a 2-day history of increasing shortness of breath and fatigue. At the age of 5 years, she underwent succesful repair of VSD. She has no other history of serious illness and takes no medications. She does not smoke cigarettes. her pulse is 110/min and irregularly irregular. Respirations are 28, BP is 110/60. Examination shows perioral cyanosis. Lungs are clear to auscultation. On cardiac exam, there is a grade 4/6 soft holosystolic murmur head best at the left sternal border. There is 3+ pretibial edema. Which of the following is the most likely explanation for this patients symptoms?

A) Decreased pulmonary artery flow
B) Decreased pulmonary vascular resistance
C) Decreased systemic vascular resistance
D) Increased pulmonary artery blood flow
E) Increased pulmonary vascular resistance
F) Increased systemic vascular resistance.

Its not D. Most likely A given perioral cyanosis and edema?


An unconscious 27 y/o M is brought to the emergency department immediately after being involved in a motor vehicle collision. he was the unrestrained driver of a vehicle that struck a tree. At the scene, he was unconscious. He was not breathing spontaneously and was intubated and mechanically ventilated. On arrival, his GSC was 9/15. He breathes spontaneously when mechanical ventilation is d/cd. Temp 98.6, pulse 125, RR: 16, palpable systolic bp of 100. Exam shows copious bleeding from a laceration over scalp. There is a pool of blood around his head. There is an obvious fracture of the left humerus. Breath sounds are heard bilaterally. The abdomen is soft. The pelvis is stable. In addition to IV administration of crystalloid, which of the following is the most appropriate next step?

A) Direct pressure to bleeding laceration
B) CT abdomen
C) IV administration of vasopressor
D) Transfusion of packed RBCs
E) Closed reduction of fracture.

Not B, I'm guessing A.


67 year old woman has required mechanical ventilation to maintain adequate tissue oxygenation since she sustained a severe head injury 2 weeks ago. Several x-rays of chest during hospitalization show findings consistent with ARDS. Culture of bronchial washings have grown numerous organisms for which she is receiving broad spectrum antibiotic therapy. A current xray of the chest shows a cavitary lesion in the right upper lobe of the lung. Which of the following is the most likely diagnosis?

A) Aspergillosis
B) Atelectasis
C) Lung Abscess
D) Pneumatocele
E) Tuberculosis.

D is wrong (I figured it might have been ventilator associated injury. I'm guessing C?
Reply
#17
correct answers:
C) increased pulmonary vascular resistance
A) direct pressure on laceration--- you guessed it right!!
the last one could be C); not sure
Reply
#18
Thanks for the reply palivizumab. The letter and the response from the first one don't match up. If its increased pulmonary vascular resistance, does this mean that she just had primary pulmonary hypertension and all the other stuff about VSD was just filler?
Reply
#19
E) Increased pulmonary vascular resistance: Tricuspid regurg 2/2 Pulm HTN(increased pulm vasc resistance)
A) Direct pressure to bleeding laceration
C) Lung Abscess
Reply
#20
39- give hydrocortisone. H/o steroids and hypotensive.....need steroids again to pick up BP
Reply
« Next Oldest | Next Newest »


Forum Jump: