Medical Anatomy and Surgical Complications
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Questions and Answers

What ligament is most likely injured in a knee injury scenario?

  • Medial collateral ligament (correct)
  • Patellar ligament
  • Meniscal
  • PCL

What is the likely cause of the inability to extend the interphalangeal joint after thumb stabilization?

  • Common flexor tendon rupture
  • Radial nerve injury
  • Carpal tunnel syndrome
  • EPL tendon injury (correct)

External spermatic fascia is a modification of which anatomical structure?

  • External oblique (correct)
  • Rectus muscle
  • Transversalis fascia
  • Internal oblique

Ludwig's angina primarily involves which anatomical space?

<p>Submandibular space (C)</p> Signup and view all the answers

What could be a possible cause for worsening pain at the site of a surgically repaired midtarsal dislocation 10 years later?

<p>Avascular necrosis (B)</p> Signup and view all the answers

What is the most likely reason for experiencing sweating, dizziness, and nausea after surgery for gastric outlet obstruction?

<p>Hypoglycemia (A)</p> Signup and view all the answers

What should a patient experiencing sweating and palpitations after gastric bariatric surgery be advised to do?

<p>Eat regular small meals (C)</p> Signup and view all the answers

What is the histological appearance typically associated with osteoporosis?

<p>Decreased calcified bone volume (D)</p> Signup and view all the answers

What is the most appropriate initial management for a pre-tibial flap laceration that cannot be approximated?

<p>Oppose wound edges without tension + remaining area cover with SSG (A)</p> Signup and view all the answers

What histological finding is characteristic of amyloidosis?

<p>Congo red positive + green under polarised light (C)</p> Signup and view all the answers

In the context of splenectomy, which hematological feature would not typically be observed at one week post-operation?

<p>Howell-Jolly bodies (B)</p> Signup and view all the answers

What is the appropriate classification of a patient who has spontaneous eye opening, obeys commands but is confused, according to the Glasgow Coma Scale?

<p>GCS 13 (C)</p> Signup and view all the answers

What should be suspected in a patient presenting with increased ventilatory demand, elevated pulmonary wedge pressure, dilated neck veins, and low blood pressure following aortic aneurysm repair?

<p>Pulmonary edema due to heart failure (D)</p> Signup and view all the answers

What is the first-line treatment for a patient presenting with bloody diarrhea and passing ova and cysts?

<p>Metronidazole (A)</p> Signup and view all the answers

Which anesthetic is most appropriate for an upper limb Bier's block?

<p>0.5% prilocaine (B)</p> Signup and view all the answers

In a knee injury scenario with tenderness and swelling above the medial joint line after immobilization, what condition is most likely?

<p>Meniscal injury (D)</p> Signup and view all the answers

What is the primary indication for renal replacement therapy in patients with severe burns?

<p>Full Thickness Burns &gt; 30% (B)</p> Signup and view all the answers

Which diagnosis is likely for a patient presenting with oliguria and hematuria with slough in urine?

<p>Acute tubular necrosis (D)</p> Signup and view all the answers

In cases of temporal bone fracture with otorrhea, damage to which structure typically causes CSF leakage?

<p>Tegmen tympani (A)</p> Signup and view all the answers

What is the most appropriate form of iron replacement for a patient with anemia before planned elective surgery?

<p>Intravenous iron (C)</p> Signup and view all the answers

Following debridement of a burn, what is the recommended management for a 3% burn with crusting and loss of sensation?

<p>Split thickness skin graft (B)</p> Signup and view all the answers

For a patient with a swollen, painful knee but no hemarthrosis, which investigation would provide a definitive diagnosis?

<p>Aspiration and send for C&amp;S and Cytology (D)</p> Signup and view all the answers

Which enzyme is primarily responsible for the autolysis of the pancreas in cases of pancreatitis?

<p>Trypsin (D)</p> Signup and view all the answers

In a case of pancreatitis showing non-enhancing regions on CT, what does this typically indicate?

<p>Pancreatic necrosis (C)</p> Signup and view all the answers

What lung disorder is indicated by a FEV1 of 1.8 liters and FVC of 2.1 liters in the presence of a restrictive pattern?

<p>Pulmonary fibrosis (C)</p> Signup and view all the answers

Which thyroid cancer is characterized by rapid spreading and could cause stridor in recurrence?

<p>Anaplastic Carcinoma (A)</p> Signup and view all the answers

What is the anatomical relationship between the biceps tendon and the brachial artery?

<p>Biceps tendon is lateral to the brachial artery (D)</p> Signup and view all the answers

Which type of hernia is associated with a pleuroperitoneal membrane defect?

<p>Bochdalek Hernia (C)</p> Signup and view all the answers

What is the correct classification of the carpometacarpal joint of the thumb?

<p>Saddle (B)</p> Signup and view all the answers

In a patient with hypotension after a trauma, which hormone would be released first in response?

<p>Renin (A)</p> Signup and view all the answers

In a head injury case involving bradycardia, which physiological response is likely responsible?

<p>Decreased activity of carotid sinus (D)</p> Signup and view all the answers

What tumor can be expected to cause sensorineural hearing loss if located at the cerebellopontine angle?

<p>Vestibulocochlear Nerve Tumor (D)</p> Signup and view all the answers

Which type of lung cancer is most commonly linked to high smoking rates?

<p>Small Cell (A)</p> Signup and view all the answers

What indicates the presence of a yolk sac in a testicular teratoma?

<p>Raised B-HCG (B)</p> Signup and view all the answers

Which condition is characterized by heartburn and food sticking in the throat without chest pain?

<p>Achalasia (B)</p> Signup and view all the answers

What histological feature is characteristic of squamous cell carcinoma (SCC)?

<p>Keratin pearls (C)</p> Signup and view all the answers

Which type of lung cancer typically presents with peripheral lung mass and ground-glass opacity?

<p>SCC (A)</p> Signup and view all the answers

What is a known paraneoplastic syndrome associated with squamous cell lung cancer?

<p>Hypercalcemia (A)</p> Signup and view all the answers

A smoker presents with a biopsy-confirmed malignancy in the lung. What is the most likely type if they have a peripheral mass?

<p>Adenocarcinoma (B)</p> Signup and view all the answers

Which potential diagnosis should be considered in a patient experiencing significant gastrointestinal bleeding with a history of vomiting?

<p>Mallory-Weiss tear (B)</p> Signup and view all the answers

What is the initial management for a patient with hypoxia, hypotension, and urticaria after using a new hair dye product?

<p>IV Adrenaline (B)</p> Signup and view all the answers

What is the likely diagnosis for a 40-year-old female experiencing sudden left forearm pain with echocardiogram findings of superiorly displaced mitral valve leaflets during systole?

<p>Brachial Artery Embolism (A)</p> Signup and view all the answers

In subclavian steal syndrome, retrograde blood flow occurs in which vessel?

<p>Vertebral artery (C)</p> Signup and view all the answers

Which tendon is likely injured in a deep laceration on the palmar aspect of the middle phalanx, resulting in an inability to flex the distal interphalangeal joint (DIP)?

<p>Flexor digitorum profundus (C)</p> Signup and view all the answers

What is the most likely lesion for a patient presenting with radial deviation of the wrist and mild clawing of the fingers, particularly affecting the 4th and 5th digits?

<p>Ulnar nerve damage at the elbow (C)</p> Signup and view all the answers

In a left skewed Gaussian distribution, how is the mean related to the median?

<p>Left of the median (D)</p> Signup and view all the answers

Which nerve is likely injured in a patient with a history of fall and hyperacusis?

<p>Facial (C)</p> Signup and view all the answers

Which of the following is not classified as a facial muscle?

<p>Anterior belly of digastric (B)</p> Signup and view all the answers

Flashcards

What is Pulmonary Edema?

A condition caused by fluid buildup in the lungs, often seen after aortic aneurysm repair. Symptoms include increased respiratory effort, elevated pulmonary wedge pressure, distended neck veins, low blood pressure, and bilateral lung opacities on X-ray.

What are Leukocytes?

A type of blood cell that increases in number after a splenectomy. They are usually seen as a normal part of the blood, but their increase after removing the spleen suggests the spleen was filtering them out.

What is a 4 Compartment Release?

A surgical procedure to relieve pressure in the compartments of the lower leg. This is typically done for compartment syndrome, a serious condition where pressure builds up within the muscles.

What is a GCS score of 13?

A scoring system used to assess the level of consciousness. A score of 13 indicates that the patient opens their eyes spontaneously, obeys commands, but shows confusion.

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What is the best management for a pre-tibial flap laceration that cannot be closed?

An injury to the skin flap over the shinbone (tibia). Since the skin flap is unable to be closed, the best management is to bring the wound edges together without tension and cover the remaining area with a skin graft.

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How does amyloid stain?

A type of protein that accumulates abnormally in tissues. It stains a characteristic apple-green color when viewed under polarized light after staining with Congo red.

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What type of local anesthetic is used for a Bier's block?

A type of local anesthetic used for Bier's block. This type of block involves injecting the anesthetic into a vein in the arm, causing temporary numbness in the hand.

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What is the causative organism for pruritus ani in a child?

A common intestinal parasite that causes pruritus ani (itching around the anus) in children. The diagnosis is confirmed by finding eggs on a tape swab.

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Medial Collateral Ligament Injury

A sprain or tear of the ligament on the inside of the knee, usually caused by a direct blow to the outside of the knee.

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EPL Tendon Injury

Injury to the Extensor Pollicis Longus (EPL) tendon, responsible for extending the thumb. This leads to the inability to lift the thumb off the table and extend the thumb joint (IPJ).

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External Spermatic Fascia Origin

The external spermatic fascia is a continuation of the external oblique fascia. This fascia surrounds the spermatic cord as it travels through the inguinal canal.

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Ludwig's Angina Space Involvement

Ludwig's angina is a serious infection of the floor of the mouth. It involves three compartments: the submandibular, sublingual, and submental spaces. This infection can quickly spread and cause airway obstruction.

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Secondary Osteoarthritis after Dislocation

Osteoarthritis is a degenerative joint disease that can develop after an injury, like a midtarsal dislocation. It causes pain, stiffness, and decreased joint function.

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Posterior Hip Dislocation Characteristics

A posterior hip dislocation occurs when the femur is dislocated backward. It causes the leg to shorten and rotate inwards. The injury often damages the sciatic nerve, leading to a loss of motor function and sensation in the leg.

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Gastric Dumping Syndrome

Gastric dumping syndrome is a condition that can occur after certain surgeries, like gastric bypass or gastric banding. Symptoms include rapid emptying of the stomach, sweating, dizziness, nausea, and hypoglycemia.

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Osteoporosis Histological Appearance

Osteoporosis is a condition where bone density decreases. This is due to the increased activity of osteoclasts (bone-resorbing cells) and a decrease in bone formation by osteoblasts, leading to weaker bones.

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Restrictive Lung Function Test

A type of lung function test that shows a restrictive pattern when the FEV1 (forced expiratory volume in one second) is less than 80% of the predicted value and the FVC (forced vital capacity) is also reduced.

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Medullary Thyroid Cancer

A type of cancer that arises from the parafollicular C cells of the thyroid gland and is often associated with a family history of the disease.

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Bochdalek Hernia

A type of hernia that occurs when the pleuroperitoneal membrane doesn't fully close, allowing abdominal organs to protrude into the chest cavity.

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Vestibulocochlear Nerve

A nerve that can be affected by a tumor located at the cerebellopontine angle, leading to sensorineural hearing loss.

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System Based Audit

A type of audit that assesses the performance of a system or process within an organization, such as the time taken for a hospital to send discharge summaries to GPs.

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Saddle Joint

A type of joint that allows movement in two planes, like the carpometacarpal joint of the thumb, allowing opposition.

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Renin

The initial hormone released in response to a drop in blood pressure, activating the renin-angiotensin-aldosterone system.

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Decreased Carotid Sinus Activity

A condition characterized by a decrease in the activity of the carotid sinus, leading to bradycardia (slow heart rate).

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What is the likely diagnosis in a patient with diabetes presenting with oliguria, hematuria, and slough in urine?

Renal papillary necrosis occurs when the tips of the renal papillae die, often due to poor blood flow or chronic infections. This results in sloughing of the affected areas, which can be seen in the urine.

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Post-debridement, what kind of graft would you use for a 3% burn on the forearm with crusting, dryness, and loss of sensation?

A split-thickness skin graft involves taking a layer of skin from a donor area, which includes the epidermis and a portion of the dermis. This type of graft is often used for burns and is able to heal quicker than a full-thickness graft.

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What is a mainstay treatment for hypercalcemia?

Bisphosphonates are drugs that inhibit the activity of osteoclasts, the cells responsible for breaking down bone, which can lead to a decrease in calcium levels in the blood.

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Which enzyme is responsible for the autolysis of the pancreas in pancreatitis?

Trypsin is a proteolytic enzyme produced by the pancreas that plays a crucial role in digesting proteins. In acute pancreatitis, trypsin can become activated within the pancreas itself, leading to autodigestion.

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In a patient with chronic pancreatitis, angiography reveals an aneurysm of a tortuous vessel arising directly from the celiac trunk. Which structure does this vessel supply?

The head of the pancreas is supplied by the gastroduodenal artery, a branch of the common hepatic artery, which arises from the celiac trunk. A tortuous aneurysm is a bulging, weak area in a winding vessel.

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During a CT scan for pancreatitis, a diffuse fluid collection is observed surrounding the head, body, and tail of the pancreas, with non-enhancing areas. What is the likely diagnosis?

A pseudocyst is a fluid-filled collection outside the pancreas, formed as a result of inflammation and tissue breakdown. It does not have a true lining, as opposed to an abscess which has a more defined wall.

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Fibroadenoma

A type of breast tumor that is benign and composed of fibrous and glandular tissue. Often feel like a firm, rubbery lump.

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Malignancy

A general term for any cancer that is characterized by the uncontrolled growth and spread of abnormal cells.

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Squamous cell carcinoma of the lung

A type of lung cancer characterized by the formation of keratin pearls and palisading cells. More likely to be related to smoking.

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Achalasia

A condition where the lower esophageal sphincter fails to relax properly, leading to difficulty swallowing and food getting stuck in the esophagus.

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Urethral Stricture

A condition characterized by a narrowing of the urethra, often caused by scar tissue formation. Results in difficulty with urination.

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Boerhaave syndrome

A condition that results from the rupture of the esophagus, often caused by forceful vomiting or retching. This is a serious medical emergency.

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Hiatal hernia

A condition where the lining of the stomach protrudes through a weakened area in the diaphragm. This can lead to heartburn and other digestive problems.

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Excessive Pain Despite Adequate Analgesia

A condition where there is excessive pain despite adequate pain relief, suggesting something more serious than just pain.

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Pain On Passive Stretch

Pain experienced when a limb is passively stretched, indicating potential muscle damage or inflammation.

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Absent Dorsalis Pedis Pulse

Absence of the dorsalis pedis pulse, a key indicator of potential blood flow problems in the lower leg.

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Increased Compartment Pressures

Elevated pressure within the compartments of a limb, damaging muscles and nerves. It's a medical emergency.

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Paraesthesia

A tingling or prickling sensation, often a symptom of nerve damage or compression.

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Anaphylaxis

A potentially life-threatening allergic reaction causing low blood pressure, breathing difficulties, and skin rash.

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Brachial Artery Embolism

A condition where the mitral valve leaflets move upwards during the contraction of the heart, often caused by a blood clot in the brachial artery.

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Subclavian Steal Syndrome

A condition where blood flow to the brain is reversed, often caused by a blockage in the subclavian artery, resulting in symptoms like dizziness and weakness.

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Flexor Digitorum Profundus

The tendon responsible for flexing the DIP joint of the index finger, its injury leads to difficulty flexing the fingertip.

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Ulnar Nerve Damage at the Elbow

A condition characterized by weakness and numbness in the hand, and the 4th and 5th digits are less affected, suggesting damage to the ulnar nerve at the elbow.

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Left Skewed Gaussian Distribution

A type of distribution where the mean value is less than the median value, suggesting a skew towards the left side of the distribution.

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Facial Nerve Injury

A nerve injury that can lead to facial paralysis and hearing difficulties.

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Frontalis Muscle

A muscle in the face, responsible for raising the eyebrows.

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Catheter Angiography

The most definitive investigation for severe renal disease affecting blood flow to the foot.

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Vestibular Schwannoma

A non-cancerous tumor that originates from the vestibulocochlear nerve, causing hearing loss and balance problems.

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Study Notes

Q1. Half-life of platelets?

  • 7 days

Q2. Bullet shot, organ affected?

  • Gallbladder

Q3. Paneth cells present in?

  • Crypts of Lieberkühn

Q4. In COPD patient?

  • PCO2 increased and HCO3- decreased

Q5. COPD + morphine, ABG values?

  • Low pH, high PCO2, high HCO3- (acute on chronic respiratory acidosis).

Q6. Warfarin and bleeding?

  • Prothrombin factor deficiency (factors 2, 7, 9, 10).

Q7. Female RA, symptoms, treatment?

  • 250ml colloid and reassess.

Q8. 70-year-old male, angina on going uphill?

  • Aortic stenosis

Q9. 8-year-old child, harsh continuous murmur under the clavicle, Hypertension?

  • Coarctation of aorta

Q10. Primigravida with 36 week pregnancy, sudden chest pain, cyanosis?

  • Acute massive pulmonary embolism.

Q11. After RTA, hypotensive patient?

  • Propofol

Q12. Post op anterior resection, shortness of breath?

  • CXR

Q13. After aortic aneurysm repair, high potassium, low urine output?

  • Give 1 liter of Hartmann.

Q14. Child with sudden scrotal pain?

  • Analgesic, block, and manipulation.

Q15. After aortic aneurysm repair, increased ventilatory demand?

  • ARDS

Q16. Post splenectomy blood film at 1 week?

  • Decreased WBC.

Q17. Management of lower leg compartment syndrome?

  • 4 compartment release

Q18. GCS, spontaneous eye opening?

  • GCS 14

Q19. Pre-tibial flap laceration?

  • Oppose wound edges without tension + allow granulation

Q20. Amyloid histology?

  • Congo red positive + blue under polarised light

Q21. Upper limb Biers block anesthetic?

  • 0.5% prilocaine

Q22. A Mother of 3 children with pruritus ani?

  • Enterobius vermicularis

Q23. Patient passing ova and cysts, bloody diarrhoea treatment?

  • Mebendazole

Q24. Knee injured during football match?

  • Medial collateral ligament

Q25. After cast removal 4 weeks of undisplaced fracture?

  • EPL tendon injury

Q26. External spermatic fascia?

  • External oblique

Q27 - Q60: (Questions 27-60): (Summarized)

  • The remaining questions from 27 to 60 vary greatly in subject matter. Each is addressed individually and concisely.

Q61. Acutely swollen and painful knee, no hemarthrosis ?

  • Aspirate and send for C&S and Cytology.

Q62. Autolysis of the pancreas in pancreatitis?

  • Trypsin.

Q63. Pancreatitis, CT imaging?

  • Pancreatic necrosis.

Q64. Chronic pancreatitis on angiography?

  • First part of duodenum.

Q65. Management of hypercalcaemia?

  • Bisphosphonates.

Q66. Structure at risk when preparing tibia for knee replacement?

  • Common peroneal nerve

Q67. Inward catheterization resistance?

  • Membranous urethra

Q68. 11-day old baby with bile-stained vomiting?

  • Necrotising enterocolitis.

Q69. Overweight 12-year-old, hip pain?

  • Slipped Upper Femoral Epiphysis.

Q70. 5-year-old, unilateral hip pain?

  • Transient synovitis.

Q71. Young child with abdominal distension?

  • Intussusception.

Q72. 2-day old baby, vomiting?

  • Intussusception.

Q73. Nerve passing from upper lateral side of Psoas Major?

  • Ilioinguinal nerve.

Q74 - Q175 (Questions 74-175): (Summarized)

  • The remaining questions from 74 to 175 are diverse; each focused on specific issues. They are each addressed concisely.

Q176. 25-year-old man with impaired tear secretion?

  • Greater petrosal nerve.

Q177. Furosemide action?

  • Ascending limb of Henle's loop.

Q178. Nuclei of CN 9/10?

  • Medulla.

Q179. 21-year-old with severe headache?

  • Vertebral venous plexus.

Q180. Low SVR, high CO, high CVP?

  • Septic shock.

Q181. Bleeding from Little's area?

  • Sphenopalatine artery

Q182. Difficulty swallowing, altered voice?

  • Vagus nerve.

Q183. Loss of blood supply to scaphoid?

  • Distal radial artery.

Q184. Head injury with increased ICP?

  • Altered mental status.

Q185. Location of arterial baroreceptors?

  • Carotid sinus and aortic arch

Q186. Distinguishing upper/lower motor neuron facial nerve lesion?

  • Raise eyebrows

Q187. Thyroglossal cyst removal?

  • High risk of malignant change.

Q188. Bruising at knee, no hemarthrosis, cold and pale?

  • Supracondylar fracture

Q189. Delayed complications of blood transfusion?

  • Fever.

Q190. Bilateral inguinal lymph nodes?

  • Vaginal vault.

Q191 - Q247 (Questions 191-247): (Summarized)

  • The remaining questions from 191 to 247 are diverse, focused on specific diseases and conditions. Concise answers are provided for each.

Q248. Autoclave sterilisation efficacy?

  • Clostridium.

Q249. 42-year-old with thigh pain?

  • Lateral cutaneous nerve of the thigh.

Q250. Varicocele?

  • Left gonadal vein.

Q251- Q290 (Questions 251-290): (Summarized)

  • The rest of the questions, from 251 to 290, are diverse in subject matter and are each answered concisely.

Q291. Female with multiple extra and intrahepatic bile duct strictures and mild jaundice?

  • Ulcerative colitis.

Q292. 45-year-old with severe head injury?

  • Nasogastric tube.

Q293-Q335 (Questions 293-335): (Summarized)

  • The remaining questions, from Q293 to 335, are diverse but are concisely answered as separate points.

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Description

This quiz covers various topics related to medical anatomy and complications resulting from surgical procedures. You will encounter questions on ligaments, anatomical spaces, histological appearances, and post-operative symptoms. Test your knowledge on critical concepts essential for medical professionals.

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