Neuro. & Gastro. ~ Extended Matching

Question 1.

Options List

A.)  Daily plain films to document passage and surgery if symptoms of perforation or delayed passage

B.)  Discharge with advice to watch for foreign body to pass

C.)  Discharge with advice to watch for foreign body to pass and return if any signs of obstruction

D.)  Discharge with advice to watch for foreign body to pass and return if any symptoms

E.)  Endoscopy in the next 24 to 48 hours

F.)  Foley catheter technique to remove the foreign body

G.)  Give proteolytic enzymes to enhance passage of foreign body

H.)  Urgent endoscopy to remove the foreign body

 I.)   Watch for passage of the foreign body, review in 24 hours and repeat x-ray in 48 hours

J.)  Watch for passage of the foreign body, review in 48 hours and repeat x-ray in 72 hours

K.)  Weekly plain films to document passage and surgery if symptoms of perforation or delayed passage

 

Lead-in statement

For each foreign body ingestion select the most appropriate management

Stems

  1. A 2 year old boy presents after swallowing a 20c coin 2 hours ago. He is becoming increasingly distressed, crying when he tries to swallow and drooling. A CXR shows the coin in the upper half of his oesophagus.

Show Answer

Answer: H

 

  1. A 2 year old boy presents after swallowing a button battery 3 days ago. Today he started to vomit and is refusing food. A CXR shows the battery in the stomach.

Show Answer

Answer: H

 

  1. A 2 ½ year old girl presents after swallowing a 50c piece 4 hours ago. She is asymptomatic and drinking well. A CXR shows the coin in the small intestine.

Show Answer

Answer: D

 

  1. A 10 year old intellectually impaired boy presents after swallowing a loose Stanley knife blade. On CXR the blade can be seen in the stomach.

Show Answer

Answer: H

 

  1. A 4 year old girl presents after ingesting a button battery some hours ago. She is asymptomatic. A CXR shows the battery in the stomach.

Show Answer

Answer: I

 

  1. A 23 year old female with borderline personality disorder presents stating that she has swallowed a razor blade 12 hours ago. AXR shows the razor blade in the small intestine.

Show Answer

Answer: A

 

  1. A 5 year old boy presents after swallowing a button battery 4 hours ago. He is asymptomatic. A CXR shows the battery in the lower oesophagus.

Show Answer

Answer: H

Ref: Tintinalli p. 552-554


 

Question 2.

Options List

A.)  Brain tumour

B.)  Cerebral venous thrombosis

C.)  Glaucoma

D.)  Malignant hypertension

E.)  Meningitis

F.)  Migraine

G.)  Pre-eclampsia

H.)  Sinusitis

 I.)   Subarachnoid haemorrhage

 J.)  Subdural haematoma

K.)  Temporal arteritis

 

Lead-in statement

Stems

  1. A 40 year old woman presents with sudden-onset severe occipital pain whilst coughing.

Show Answer

Answer: I

 

  1. A 25 year old woman presents with gradual onset severe pulsatile right temporal headache that has been present for 24 hours with associated vomiting.

Show Answer

Answer: F

 

  1. A 32 year old woman who is 28 weeks pregnant presents with gradual onset dull headache for the last 4 days. She has noticed some blurred vision today.

Show Answer

Answer: G

 

  1. A 55 year old woman presents with a throbbing temperofrontal headache and jaw pain when chewing.

Show Answer

Answer: K

Ref: Tintinalli p.1113-1115


 

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