Surg. ~ Extended Matching

Question 1.

Options List

A.)  C-reactive protein

B.)  CT abdomen with angiogram

C.)  CT abdomen with oral and IV contrast

D.)  Erect and supine AXR

E.)  Full blood count

F.)  Lipase

G.)  Liver function tests

H.)  Ultrasound abdomen

I.)  Ultrasound abdomen with graded compression

J.)  Urea and electrolytes

K.)  Urinalysis

 

Lead-in statement

For each clinical scenario pick the most appropriate investigation

 

Stems

1.) A 54 year old man presents with acute onset of severe, constant epigastric pain radiating to his back. He is also nauseous and vomiting. He is tender in his epigastrium. He has a background of biliary disease. His HR is 128, BP 154/88, O2 sats 95% RA, RR 20 bpm, temp 37.8°C

Show Answer

Answer: F

 

2.) A 67 year old man presents with acute onset severe central constant abdominal pain. He is extremely tender throughout his abdomen. His vitals are HR 88-94 in atrial fibrillation, BP 138/78, O2 sats 96% RA, RR 14 bpm, temp 36.6°C

Show Answer

Answer: B

 

3.) A 48 year old man presents with a few days of colicky left lower quadrant pain which today has become severe and sharp. He has localised peritonism in his left lower quadrant. His vitals are HP 96 bpm, BP 138/72, Rr 16, Sats 96% RA, temp 38.2°C

Show Answer

Answer: C

 

4.) A 78 year old man presents with central colicky abdominal pain, vomiting and distention. He has a background of previous colon cancer treated surgically. His vitals are HR 102, BP 146/75, O2 sats 96% RA, RR 20, temp 37.6°C

Show Answer

Answer: D

Author: J Haire

Ref: Tintinalli p. 523-524


 

 Question 2.

Options list

A.)  Appendageal torsion

B.)  Testicular torsion

C.)  Epididymitis

D.)  Epididymoorchitis

E.)  Haemorrhage into testicular malignancy

F.)  Orchitis

G.)  Prostatitis

H.)  Testicular malignancy

 

Lead-in statement

For each clinical scenario select the most likely diagnosis.

 

Stems

  1. A 16 year old boy presents with acute onset of severe pain in the left groin, nausea and vomiting. On examination his left testis is firm, tender and the cremasteric reflex on that side is absent.

Show Answer

Answer: B

 

  1. A 21 year old man presents with acute onset of severe left testicular pain. ON exam he is tender in the upper pole of his testicle with an area of blue discolouration visible.

Show Answer

Answer: A

 

  1. A 25 year old man presents with onset of the pain and swelling in the left testicle which has progressed over the last few days and is associated with dysuria. He is tender throughout the testicle but the pain is partially relieved by elevation.

Show Answer

Answer: D

 

  1. A 35 year old man presents with acute pain in the left testicle. On exam he has one testicle larger than the other with a tender firm mass.

Show Answer

Answer: E

Author: J Haire

Ref: Tintinalli p. 649-50


 

Leave a Reply

Your email address will not be published. Required fields are marked *