Term
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Definition
- flexion of the hip against resistance eliciting significant abdominal pain
- This test, when positie, suggests a psoas abscess, a complication of a perforated appendix. |
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Term
| What is trochanteric bursitis? |
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Definition
- Inflammation of the bursa surrounding the insertion of the gluteus medius onto the femur's greater trochanter.
- Excessive frictional forces 2/2 overuse, trauma, joint crystals, or infection are responsible.
- Pts complain of hip pain when pressure is applied, as well as with external rotation or resisted abduction. |
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Term
| Trauma patient presents with paraplegia and loss of pain and temperature in his legs with intact proprioception. What kind of fracture is most likely, and what syndrome is this? |
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Definition
- This is an anterior cord syndrome most likely caused by a burst fracture of the vertebra.
- Next step: MRI |
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Term
| Posterior urethral injuries are most commonly a/w? |
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Definition
- Fractures of the pelvis.
- Pts classically complain of suprapubic pain and an inability to void following major trauma.
- Exam shows blood at the meatus, a high-riding prostate due to displacement of the prostate by a pelvic hematoma, scrotal hematoma, and signs and symptoms of a pelvic fracture. |
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Term
| Why would you see hematuria in a patient with a ruptured AAA? |
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Definition
| - A ruptured AAA can bleed into the retroperitoneum and create an aorto-caval fistula, causing venous congestion in the retroperitoneal organs. The fragile veins in the bladder can rupture and cuase gross hematuria. |
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Term
| What do you do for radial wrist pain after FOOSH? |
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Definition
| - Initial x-ray looking for a scaphoid fracture. If the initial x-ray is negative, still proceed with thumb immobilization in a spia cast and repeat x-rays in 7-10 days. |
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Term
| How are medial meniscus injuries usually aquired? |
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Definition
| - forceful torsion of the knee while the foot is planted. |
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Term
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Definition
- a palpable or audible snap occuring while slowly extending the leg at the knee from full flexion while simultaneously applying tibial torsion.
- Indicitave of a medial meniscus tear. |
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Term
| What procedure is often done at the same time as gastric bypass? |
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Definition
- cholecystectomy for symptomatic patients.
- Patients who do not have cholecystectomy get prophylactic ursodeoxycholic acid for six months. |
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Term
| I say severe retrosternal and upper epigastric pain, you say _______ in your differential. |
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Definition
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Term
| I say air in the mediastinum, you say: |
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Definition
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Term
| Obese adolescent boy presents with 2 weeks of right groin and knee pain, with limping. Knee exam is WNL, but the hip has decreased passive ROM and is externally rotated. No systemic signs of infection or inflammation. Dx? |
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Definition
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Term
| Adolescent boy presents with joint pain after trauma that has gone on longer than expected and does not respond to NSAIDs, in fact, it is getting worse. He has a normal ESR and an elevated alk phos. X-ray shows an osteolytic lesion of the distal femur with periosteal inflammation. Dx? |
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Definition
- Osteosarcoma. Presentation after trauma is common; this is the most common primary maligancy of bone.
- These x-ray findings are consistant with Codman's triangle. A spiculated 'sunburst' pattern mayb also be seen. |
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Term
| What do you do when you see blood at the meatus and suspect urethral injury? |
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Definition
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Term
| What do 'numerous punctate hemorrhages with blurring of the gray-white matter interface' mean? |
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Definition
- Diffuse axonal injury. This is the most significant cause of morbidity in patients with TBI.
- CT will show them, but MRI is more sensitive. |
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Term
| What is a potiential cranial nerve complication of osteitis deformans (Paget's disease)? |
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Definition
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Term
| fat globules and foaomy histiocytes (or macrophages) on biopsy of a breast mass: |
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Definition
| - Fat necrosis of the breast; this is not a pre-malignant lesion and will resolve with time. |
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Term
| What does a nasogastric tube in the pulmonary cavity mean? |
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Definition
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Term
| What is the management of dumping syndrome? |
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Definition
| - Dietary modification first, and then octreotide in resistant cases. Reconstructive surgery is reserved for intractable cases. |
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Term
| wtf is Volkmann's ischemic contracture? |
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Definition
| - The final sequel of compartment syndrome in which the dead muscle has been replaced with fibrous tissue. |
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Term
| What is a morton neuroma? |
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Definition
- a mechanically induced degenerative neuropathy commonly seen in runners that presents with pain b/w the 3rd and 4th toes reproducible with palpation. Treatment is with shoe inserts, and surgery is reserved for those who fail conservative mgmt.
- PE shows pain b/w the 3rd and 4th toes with a clicking sensation (Mulder sign) when simultaneously palpating this space and squeezing the metatarsal joint. |
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Term
| Pt wakes up from surgery with N/V, abdominal pain, hypoglycemia, and hypotension. On further investigation she has a h/o SLE. |
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Definition
| - Acute adrenal insufficiency. Be suspicious of this in any case where the patient may have been on steroids prior to surgery, and therefore has adrenal hypoplasia and is unable to mount a stress response. |
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Term
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Definition
| - RLQ pain with deep palpation of the LLQ |
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Term
| Pt has a classical presentation of appendicitis; does she get a CT? |
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Definition
- according to qbank: studies have shown that further imaging with either CT or ultrasound can delay treatment in patients who have classic clinical presentation of appendicitis.
- Imaging is helpful in suspicious cases.
- Women of childbearing age and older adults have higher rates of laparotomies with negative appendiceal findings. |
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Term
| The _____ nerve innervates the muscles of the anterior compartment of the thigh and is responsible for knee extension and hip flexion. This nerve also provides sensation to the anterior thigh and medial leg via the ________ branch. |
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Definition
| - Femoral nerve; saphenous branch |
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Term
| The ______ nerve supplies the muscles of the posterior compartment of the thigh, posterior compartment of the leg, and plantar muscles of the foot. It also provides sensation to the leg (except the medial side) and the plantar foot. |
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Definition
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Term
| The _________ nerve innervates the medial compartment of the thigh and controls adduction. It provides sensation over the medial thigh. |
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Definition
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