surgery nbme

serious side effect of AV fistula
high output heart failure
– JVD, S3 S4

ecchymosis of R flank
gross blood on urination
following MVA
– Next step?
CT w/ contrast of abdomen

If pt consented to ectopic pregnancy surgery, but was found to have appendicitis?
you are allowed to remove the appendix b/c it is life threatening

– GERD symptoms
– difficulty swallowing solid and liquids
– barretts
– endoscopy showed stricture
sliding hiatal hernia

difference between symptoms of sliding and paraesophogeal hiatal hernia
reflux symptoms

anterior nose bleeds
kesselbachs plexus

posterior nose bleeds
sphenopalatine artery

tt of APC gene positive
familial adenomatous polyposis
prophylactic colectomy

temporal bone fracture causes….
middle meningeal artery laceration= epidural hematoma

slipped capital femoral epiphysis
MC hip disorder in pre teens and teens
MC in boys
unknown cause

in renal artery stenosis, what will be elevated

lung mass and hypercalcemia
squamous cell lung cancer

charcot joint
neuropathy/ lack of normal joint sensation leading to micro trauma and micro fractures in the joint
eg diabetics

6 stippled new micro calcifications in the L outer breast, tt?
needle localized biopsy

>50% drop in platelets
necrotic skin lesions
limb ischemia

causes of bloody discharge from nipple
intraductal papilloma

development of PE, paritcularly in someone with recent surgery
how to tt
administer heparin, never fibrolytics

hepatic mass with central scar
benign- no further work up
focal nudular hyperplasia

hip pain after transient upper respiratory infection, especially in children
toxic synovitis

trauma > fever, beefy red, red streaks and axillary LAN
streptococcus pyogenes

intussiception symptoms
current jelly stools
colicky pain
usually < 5yo

meckels diverticulum
painless dark stools
dx with radioisotopes

anuria despite fluid bolus
gross hematuria
no blood at urethral meatus
lower abdomen peritoneal signs
bladder rupture

painless ulcer
tender inguinal adenopathy

chronic painless ulcer eg > 6m
firm inginal adenopathy
penile cancer

subperiosteal bone resorption
specific radiologic finding for hyperPTH

hyper PTH labs
high Ca
low P

post MVA
3 days later vomits billows fluid + blood
x ray positive for large gastric bubble
duadenal hematoma

choledoco cyst
aberrant bile duct dilation
RUQ mass

tt of choleric cyst
Roux en Y cystojejeunostomy

high P
low Ca
in renal failure
bone weakness
secondary hyperPTH

MOA of secondary hyperPTH
renal failure> high P> vit D def> low Ca> high PTH> bone resorption

cannot extend the knee
ligaments are intact
started when getting up from low chair
torn meniscus

necrotizing migratory erythema

worse with fasting

indomethacin MOA in PDA
COX inhibitor dec prostaglandins
increase NE which causes vasoconstriction

hydradinitis supperativa
inflammation of apocrine glands of groin and axilla
acne like, sinus tracts and abscesses

exploratory celiotomy

likley mesenteric ischemia approach

POD1 cause of SOB

symptomatic enlarged cystic ovarian mass tt
ex lap

tender adenexal mass consider…
ovarian torsion, surgical emergency

hematuria during a blood transfusion is due to
1) acute hemolytic reaction or 2) urinary tract bleeding

what to do if there is dark urine during transfusion?
repeat cross match of transfused blood

SE of giant cell artheritis

tt of palpable and tender temporal artery
prednisone and biopsy immediately

cause of cachexia in cancer patients
increase TNF

radionuclide scan with thallium and dypiridamole
nuclear cardiac stress test

best measure of adequate resuscitation
urine output

intraparenchymal hemorrhage cause

after pancreaticoduodenectomy, drain is draining amylase rich fluid.
NGT is draining a lot of fluid.
Pt also has a metabolic acidosis, why?
Pancreatic fluid is being released
HCO3 rich
loss of bicarb = metabolic acidosis

high NGT drainage usually causes…
metabolic alkalosis

pearly surfaced papule on the upper lip

hemodynamically unstable
elderly lady who fell and broke hip
cause of unstability

spleen rupture may cause referred pain to… splenic laceration can irritate the diaphragm which can refer pain to the shoulder potential lab values in splenic rupture Hgb of 10, mild leukocytosis (e.g. 11,000) WE WILL WRITE A CUSTOM ESSAY SAMPLE …

– PTH secreting tumor (hypercalcemia) is squamous cell Ca || 67 YO postal worker with a 5 min episode of weakness and numbness in his hand. Ni sequelae and has smoked 1ppd x 45 years. Carotid bruits are heard bilaterally. …

What is the differential for masses in the groin? Malformation, infection, neoplasm, trauma Most often, a mass in the inguinal region represents what? Enlarged lymph nodes WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR …

Burr Hole Opening into the cranium with a drill. Used to remove localized fluid and blood beneath the Dura. Craniotomy Opening into cranium with removal of bone flap and opening the Dura to remove a lesion, repair damage, drain blood, …

general What type of anesthesia is associated with more pulmonary complications? inhibit COX, prevent PG synth –> plt dysfunc. 7-10 d What is the effect of aspirin/NSAIDs and how long prior to surgery do they need to be stopped? WE …

62yo male with poorly characterized epigastric/sub-sternal pain which sounds sometimes like GERD and sometimes not; u/s of gallbladder, EKG, and CEs are negative Confirm reflux with esophageal pH monitoring (shows that time of pain coincides with episodes) 54yo obese man …

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