Question ID 14489 (Surgery) – Study Guide and Clinical Review
Patient has Basal cell carcinoma, likely Nodular type (80%)
Treatment is Mohs procedure which is *surgical excision with narrow margins* - correct answer
✔✔A 62 year old woman with skin lesion growing in her neck. Image as shown. What is it and
what is the treatment?
Refeeding syndrome - correct answer ✔✔A 58 year old who had a gastrojujunectomy has
ventricular tachycardia and labs showed hypophosphetemia on post-op day 2. What is the cause
of his worsening condition?
Decompensation after catheter placement is *venous air embolism*.
Treat with hyperbaric oxygen - correct answer ✔✔An 85 year old who gets a IVC catheter
placed becomes SOA and has a heart attack. What is the diagnosis and how to treat?
lateral decubitus positioning
high flow oxygen - correct answer ✔✔management of venous air embolism?
Mesalamine
total proctosigmodectomy is only done for refractory cases. - correct answer ✔✔In a patient
with UC what is the first step in treatment?
Rectus Sheath Hematoma - correct answer ✔✔What disease do you suspect in a man who is
being treated with blood thinners who suddenly gets abdominal pain.
,Otosclerosis - correct answer ✔✔Young patient in her 30s presents with gradual hearing loss
and red color in her ears what is she getting?
Pt has a septa hematoma. Treatment is incision and drainage of the septum - correct answer
✔✔A 20 year old Basketball player is hit in the face with the ball and his nose bled and stopped
bleeding. Now his septum is swollen but not bleeding what is the treatment?
Septal abscess (superinfection)
Avascular necrosis of septum - correct answer ✔✔Complication of septal hematoma
Ascariasis Lumbercoides (Roundworm) - correct answer ✔✔A patient from Asia or Africa with
SBO and eosinophilia most likely is infected with __________
Upper extremity venous thrombosis
Ultrasounds - correct answer ✔✔A patient with peripheral line is at risk for what complication?
How is it diagnosed?
Peritoneal stretching caused reflex bradycardia - correct answer ✔✔Patient undergoing CO2
insufflation gets bradycardia. What is the etiology?
Get an X-ray
(then if >30o we may do brace. Otherwise just monitor) - correct answer ✔✔A 13 year old girl is
noted to have spinal curvature. What is the next step?
,Immune mediated pericardial effusion (DRESSLER SYNDROME)
Colchicine - correct answer ✔✔Fluid accumulation in a person post-cardiac surgery is likely due
to post-op _____ ______
Treat with _____
cardiac tamponade
hypotension - correct answer ✔✔Hemopericardium is associated with _____ which causes
_____
Iliotibial band syndrome - correct answer ✔✔Runners with lateral knee pain have ____ ____
Renal abscess (occurs 1-2 months after UTI and may or may not have bacteruria) - correct
answer ✔✔65 year old woman with R flank pain, fatigue, sweats and weight loss 1 week after
resolved UTI likely has what condition?
AV malformation rupture leading to IVH - correct answer ✔✔A 30 year old man comes in due to
gradually worsening R sided headache that becomes a coma. What is the cause?
limb length discrepancy (because its at level of growth plate) - correct answer ✔✔A 12 year old
boy is brought to the emergency room by his parents to because he jumped and fractured his
tibia distally. What problem will a distal tibial fracture cause?
Fixed teardrop pupil (or any change in pupil) - correct answer ✔✔What findings are suggestve
of globe perfof the eye following trauma to eye?
, Oglive syndrome (colon pseudoobstruction due to dehydration) - correct answer ✔✔A 67 year
old man on diuretics has history of GI infection along with his wife. His mucus membranes are
dry and CT shows colonic dilation. What is the patient's condition due to?
Duodenal hematoma (contained bleed)
Diagnose with CT - correct answer ✔✔11 year old girl hits her abdomen with a gymnast board.
She can't eat or drink without vomiting (persistent vomiting) and there are bruises on her
abdomen. FAST is negative. What does she have and how to diagnose?
Fluorescein - correct answer ✔✔In case of trauma to the eye that causes corneal abrasion what
is the stain that allows you to localize the damage?
Foot imaging (pt has osteomyelitis even if no evidence of soft tissue infection) - correct answer
✔✔A 58 year old pt with diabetes as an ulcer on his R foot with no trauma, no redness, swell or
fever. He has diabetic neuropathy and nephropathy. What is the next step?
bowel rest and serial exam (because its self resolving) - correct answer ✔✔Prolonged postop
ileus is managed by _____
needle decompression - correct answer ✔✔Normally if a patient can't breathe we intubate. In
cases of pneumothorax though, we need to first do ____ ____
Ischemic Hepatitis ("shock liver") - correct answer ✔✔In a patient with MI who develops
hepatitis what is the cause?
A neuroma
- not hematoma bc no swelling
- not osteomyelitis because no fever, chills etc - correct answer ✔✔64 year old man comes in
for evaluation of leg pain with below knee amputation and non healing ulcer with osteomyelitis.
Patient has Basal cell carcinoma, likely Nodular type (80%)
Treatment is Mohs procedure which is *surgical excision with narrow margins* - correct answer
✔✔A 62 year old woman with skin lesion growing in her neck. Image as shown. What is it and
what is the treatment?
Refeeding syndrome - correct answer ✔✔A 58 year old who had a gastrojujunectomy has
ventricular tachycardia and labs showed hypophosphetemia on post-op day 2. What is the cause
of his worsening condition?
Decompensation after catheter placement is *venous air embolism*.
Treat with hyperbaric oxygen - correct answer ✔✔An 85 year old who gets a IVC catheter
placed becomes SOA and has a heart attack. What is the diagnosis and how to treat?
lateral decubitus positioning
high flow oxygen - correct answer ✔✔management of venous air embolism?
Mesalamine
total proctosigmodectomy is only done for refractory cases. - correct answer ✔✔In a patient
with UC what is the first step in treatment?
Rectus Sheath Hematoma - correct answer ✔✔What disease do you suspect in a man who is
being treated with blood thinners who suddenly gets abdominal pain.
,Otosclerosis - correct answer ✔✔Young patient in her 30s presents with gradual hearing loss
and red color in her ears what is she getting?
Pt has a septa hematoma. Treatment is incision and drainage of the septum - correct answer
✔✔A 20 year old Basketball player is hit in the face with the ball and his nose bled and stopped
bleeding. Now his septum is swollen but not bleeding what is the treatment?
Septal abscess (superinfection)
Avascular necrosis of septum - correct answer ✔✔Complication of septal hematoma
Ascariasis Lumbercoides (Roundworm) - correct answer ✔✔A patient from Asia or Africa with
SBO and eosinophilia most likely is infected with __________
Upper extremity venous thrombosis
Ultrasounds - correct answer ✔✔A patient with peripheral line is at risk for what complication?
How is it diagnosed?
Peritoneal stretching caused reflex bradycardia - correct answer ✔✔Patient undergoing CO2
insufflation gets bradycardia. What is the etiology?
Get an X-ray
(then if >30o we may do brace. Otherwise just monitor) - correct answer ✔✔A 13 year old girl is
noted to have spinal curvature. What is the next step?
,Immune mediated pericardial effusion (DRESSLER SYNDROME)
Colchicine - correct answer ✔✔Fluid accumulation in a person post-cardiac surgery is likely due
to post-op _____ ______
Treat with _____
cardiac tamponade
hypotension - correct answer ✔✔Hemopericardium is associated with _____ which causes
_____
Iliotibial band syndrome - correct answer ✔✔Runners with lateral knee pain have ____ ____
Renal abscess (occurs 1-2 months after UTI and may or may not have bacteruria) - correct
answer ✔✔65 year old woman with R flank pain, fatigue, sweats and weight loss 1 week after
resolved UTI likely has what condition?
AV malformation rupture leading to IVH - correct answer ✔✔A 30 year old man comes in due to
gradually worsening R sided headache that becomes a coma. What is the cause?
limb length discrepancy (because its at level of growth plate) - correct answer ✔✔A 12 year old
boy is brought to the emergency room by his parents to because he jumped and fractured his
tibia distally. What problem will a distal tibial fracture cause?
Fixed teardrop pupil (or any change in pupil) - correct answer ✔✔What findings are suggestve
of globe perfof the eye following trauma to eye?
, Oglive syndrome (colon pseudoobstruction due to dehydration) - correct answer ✔✔A 67 year
old man on diuretics has history of GI infection along with his wife. His mucus membranes are
dry and CT shows colonic dilation. What is the patient's condition due to?
Duodenal hematoma (contained bleed)
Diagnose with CT - correct answer ✔✔11 year old girl hits her abdomen with a gymnast board.
She can't eat or drink without vomiting (persistent vomiting) and there are bruises on her
abdomen. FAST is negative. What does she have and how to diagnose?
Fluorescein - correct answer ✔✔In case of trauma to the eye that causes corneal abrasion what
is the stain that allows you to localize the damage?
Foot imaging (pt has osteomyelitis even if no evidence of soft tissue infection) - correct answer
✔✔A 58 year old pt with diabetes as an ulcer on his R foot with no trauma, no redness, swell or
fever. He has diabetic neuropathy and nephropathy. What is the next step?
bowel rest and serial exam (because its self resolving) - correct answer ✔✔Prolonged postop
ileus is managed by _____
needle decompression - correct answer ✔✔Normally if a patient can't breathe we intubate. In
cases of pneumothorax though, we need to first do ____ ____
Ischemic Hepatitis ("shock liver") - correct answer ✔✔In a patient with MI who develops
hepatitis what is the cause?
A neuroma
- not hematoma bc no swelling
- not osteomyelitis because no fever, chills etc - correct answer ✔✔64 year old man comes in
for evaluation of leg pain with below knee amputation and non healing ulcer with osteomyelitis.
