Regarding Rotator Cuff Injury...

A 23-year-old man presents following a fall onto his left shoulder whilst playing rugby. He complains of pain throughout the shoulder and on examination has weakness when testing internal rotation of the arm compared to the contralateral side.
Radiographs are negative.

Injury to which tendon would explain his symptoms?
A Deltoid
B Infraspinatus
C Subscapularis
D Supraspinatus
E Teres minor

Answer:

A 50-year-old patient presents with symptomatic nephrolithiasis. ..

A 50-year-old patient presents with symptomatic nephrolithiasis. He reports that he underwent a
jejunoileal bypass for morbid obesity when he was 39.
One would expect to find
a. Pseudohyperparathyroidism
b. Hyperuric aciduria
c. “Hungry bone” syndrome
d. Hyperoxaluria
e. Sporadic unicameral bone cysts

Answer:

A 70 year old man in the surgical ward 24 hours after a colon resection...

Twenty-four hours after colon resection, urine output in a 70-year-old man is 10 mL/h.
Blood chemistry analysis reveals sodium, 138 mEq/L; potassium, 6 mEq/L; chloride, 100 mEq/L; bicarbonate, 14 mEq/L.
His metabolic abnormality is characterized by which of the following?
(A) Abdominal distension
(B) Peaked T waves
(C) Narrow QRS complex
(D) Cardiac arrest in systole
(E) J wave or Osborne wave

Answer:

A 14-year-old boy comes to the office because his breasts have recently become tender and slightly swollen...

A 14-year-old boy comes to the office because his breasts have recently become tender and slightly
swollen. He is worried that he is undergoing feminization and will grow up to become a “freak.” Upon examination a tender, 2-cm mass is found to be palpable in the subareolar region of both breasts. Which of the following describes the best course of action?
(A) Excise the masses by performing a subcutaneous mastectomy.
(B) Incise and drain the masses.
(C) Treat the masses with topical steroids.
(D) Aspirate the masses for culture and cytology.
(E) Leave the masses alone.

Answer:

Management of Hyponatremia..

Five days after an uneventful cholecystectomy, an asymptomatic middle-aged woman is found to have a serum sodium level of 120 meq/L.
Proper management would be
a. Administration of hypertonic saline solution
b. Restriction of free water
c. Plasma ultrafiltration
d. Hemodialysis
e. Aggressive diuresis with furosemide

Answer:

Effect on Kidneys After a Massive Blood loss

A 35-year-old man is admitted with systolic blood pressure (BP) of 60 mm Hg and a heart rate (HR) of 150 bpm following a gunshot wound to the liver (CT scan shown in picture below).

Axial image of Computed tomography (CT) scan of abdomen at level of both kidneys shows dense nephrogram, which is attributed to decrease in renal perfusion

What is the effect on the kidneys?
(A) They tolerate satisfactorily ischemia of 3–4 hours duration.
(B) They undergo further ischemia if hypothermia is present.
(C) They can become damaged, even though urine output exceeds 1500 mL/d.
(D) They are affected and cause an increased creatinine clearance.
(E) They are prevented from further damage by a vasopressor.

Answer:

Prostate Cancer: Management

A 72-year-old man is diagnosed with prostate cancer and goserelin (Zoladex) is prescribed. Which one of the following is it most important to co-prescribe for the first three weeks of treatment?
A. Tamoxifen
B. Lansoprazole
C. Allopurinol
D. Cyproterone acetate
E. Tamsulosin

Answer:

A 5 Year Old Dehydrated Boy Needs Fluid Resustication

A 5-year-old boy presents to the paediatric surgery department with a 24-hour history of abdominal pain. His history and examination findings are consistent with a diagnosis of acute appendicitis. He is dehydrated with an estimated fluid deficit of 15%.
Which of the following is the most appropriate resuscitation fluid?

A:  Packed red blood cells
B:  5% dextrose and 0.45% sodium chloride
C:  10% dextrose and 0.18% sodium chloride
D:  0.9% sodium chloride
E:  3% sodium chloride

Answer And Explanation:

A Patient Presents With An Injury And An Extradural Hemorrhage On CT Scan

A 25-year-old man, a football player, presents to the emergency department after having lost consciousness during a game. He is very drowsy, with a Glasgow Coma Score of 13. A CT scan shows an extradural haemorrhage.

Which blood vessel is the patient bleeding from?
A Internal carotid artery
B Middle cerebral artery
C Middle meningeal artery
D Superficial temporal artery
E Superior sagittal sinus