Pediatric Surgery History and Urogenital Symptoms

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Which artery arises from the External iliac artery and runs upward to supply the lower part of the rectus abdominis muscle?

Common iliac artery

Superior epigastric artery

Inferior epigastric artery (correct)

Internal thoracic artery

In which condition would it be relevant to ask about circumcision according to the provided text?

Redness and swelling around the left big toe

Anxiety disorder exacerbating distress

Persistent pain in the left big toe

Incomplete emptying, frequency, urgency, and weak stream (correct)

What is the immediate intervention for the case of the 24-year-old athlete with persistent pain, redness, and swelling around her left big toe?

Ungiectomy under general anesthesia

Partial nail avulsion procedure (correct)

Toe amputation

Ungiectomy under local anesthesia

What is the lateral border of the Hesselbach’s triangle also known as?

Inferior epigastric artery Signup and view all the answers

Which artery supplies the upper part of the rectus abdominis muscle?

Internal thoracic artery Signup and view all the answers

What must be elicited in the past medical history unless the chief complaint (CC) of the patient is related to lower urinary tract symptoms (LUTS)?

Surgical procedures including circumcision Signup and view all the answers

Which artery is a continuation of the internal thoracic artery and runs upward to supply the upper part of the rectus abdominis muscle?

Superior epigastric artery Signup and view all the answers

What should be the response in the physical examination form under Chest when there was no examination of the patient's chest?

NOT APPLICABLE Signup and view all the answers

In the case of a female patient with an initial diagnosis of cholecystitis, should the genitourinary system be examined?

No, unless there are complaints related to this system Signup and view all the answers

What is the formula for calculating the ideal body weight for obese male patients?

$50 + (0.91 × [height in cm − 152.4])$ Signup and view all the answers

When examining obese female patients, what formula is used to calculate their ideal body weight?

$45.5 + (0.91 × [height in cm − 152.4])$ Signup and view all the answers

What should be recorded in the physical examination form for a system or part that was not examined?

NOT APPLICABLE Signup and view all the answers

Do clerks need to examine a patient for conditions not elicited during history taking?

No, unless there are complaints related to the condition Signup and view all the answers

What is the implication of labeling unexamined systems or parts as 'NORMAL' on the physical examination form?

It is incorrect and misleading Signup and view all the answers

Why is it important not to label unexamined systems or parts as 'NORMAL' on the physical examination form?

To avoid medico-legal implications Signup and view all the answers

What is the significance of a comprehensive history and physical examination in the art and science of medicine?

It provides a narrative of the patient's health and offers clues for accurate diagnosis, treatment, and care. Signup and view all the answers

Why is it important to avoid the 'Copy Paste phenomenon' during history taking and physical examination?

To prevent missing important clues and information that are unique to each patient. Signup and view all the answers

In what way does a comprehensive history and physical examination contribute to the accurate diagnosis of a patient's health?

By meticulously gathering and interpreting clues beyond the symptoms and signs. Signup and view all the answers

What is the most common type of tumor that originates from the protective layers covering the brain and spinal cord?

Meningioma Signup and view all the answers

In cases of epidural bleeding, what is the primary purpose of a craniotomy?

To evacuate the blood clot, control bleeding, and relieve intracranial pressure Signup and view all the answers

What is the cause of subdural bleeding?

Trauma causing shearing of bridging veins Signup and view all the answers

Which surgical procedure is used to evacuate the blood clot, control bleeding, and alleviate increased intracranial pressure in cases of subdural bleeding?

Craniotomy Signup and view all the answers

What is the location of subarachnoid hematoma?

Between the arachnoid mater and pia mater Signup and view all the answers

In cases of subarachnoid hematoma, what can cause the bleeding into the subarachnoid space?

Rupture of aneurysm Signup and view all the answers

For neurosurgical procedures, what factors determine the surgical approach for tumor resection?

Tumor size, location, and impact on neurological function Signup and view all the answers

What is the most common site for hypertensive intracerebral bleeding?

Basal Ganglia Signup and view all the answers

Which of the following is a specific surgical procedure to address a ruptured aneurysm?

Coiling Signup and view all the answers

What causes spontaneous bleeding due to the fragility of brain blood vessels?

Cerebral Amyloid Angiopathy Signup and view all the answers

What is the primary intervention for large hematomas or ongoing bleeding within the brain tissue?

Surgical evacuation Signup and view all the answers

What is the leading cause of ruptured small blood vessels in intracerebral bleeding?

Elevated blood pressure Signup and view all the answers

What is the most common indication for surgery in cases of intracerebral bleeding?

Unresolved condition through medical treatment Signup and view all the answers

Why might an awake craniotomy be performed?

To allow real-time assessment and preservation of language capabilities during brain surgery Signup and view all the answers

Why is it important to elicit any considerations that are risks before a hypertensive patient on antiplatelet medications undergoes surgery?

To identify potential risks of excessive bleeding during surgery Signup and view all the answers

In what scenario might an awake craniotomy typically be employed?

For the removal of a brain tumor affecting language function Signup and view all the answers

What is the main objective of performing an awake craniotomy?

To safeguard critical functions like speech, motor skills, or sensory perception during brain surgery Signup and view all the answers

What is a common use case for an awake craniotomy?

For specific brain surgeries where maintaining brain function is crucial Signup and view all the answers

In what type of surgery might an awake craniotomy be beneficial?

Surgeries involving specific brain procedures where maintaining brain function is crucial Signup and view all the answers

What surgical procedures are commonly performed by both ENT and general surgeons?

Thyroidectomy and excision biopsy Signup and view all the answers

Who is involved in reconstructive breast surgeries?

Reconstructive surgeons Signup and view all the answers

Which type of surgeon does not perform chest tube insertions?

Pulmonologists Signup and view all the answers

What is the main difference between thoracentesis and chest tube insertions?

The level of invasiveness Signup and view all the answers

What is the most common emergent procedure performed by general surgeons?

Appendectomy Signup and view all the answers

Who typically performs open cholecystectomy?

General surgeons Signup and view all the answers

What is the primary reason for avoiding chest tube insertions unless confident and mindful of the case?

Potential complications Signup and view all the answers

What is the main difference between core needle biopsy and excision biopsy?

The approach to tissue extraction Signup and view all the answers

How do thoracic surgeons differ from pulmonologists in the management of pneumothorax?

Their referral practices for thoracostomy insertions Signup and view all the answers

What is the appropriate way to determine the insertion length of the NG tube for chest tube insertion?

Measure from the nose to the ear lobe and then down to 5 cm below the xiphisternum Signup and view all the answers

During the chest tube insertion, what does withdrawal of stomach contents indicate?

Correct placement in the stomach Signup and view all the answers

What should be done before advancing the NG tube if resistance is encountered during chest tube insertion?

Rotate the NG tube to aid insertion Signup and view all the answers

What does coughing during NG tube insertion indicate?

NG tube in the trachea Signup and view all the answers

What is the primary purpose of connecting the NGT to a syringe and gently aspirating gastric contents during chest tube insertion?

To assess correct placement in the stomach Signup and view all the answers

What should be avoided if the patient becomes distressed during NG tube insertion?

Grant time for patient recovery Signup and view all the answers

What is a common discomfort experienced by patients during NG tube insertion?

Discomfort in nasopharynx Signup and view all the answers

What is the primary concern when encountering resistance during nasogastric tube insertion?

The tube may be in the trachea Signup and view all the answers

What is the significance of post-operative adhesions in patients with a history of abdominal surgery?

They can result in chronic pain or fertility issues Signup and view all the answers

What is the primary reason for avoiding nasogastric tube insertion in patients with head trauma or HEENT surgeries?

Possibility of aspirating brain matter Signup and view all the answers

Under what conditions should orogastric insertion be performed instead of nasogastric insertion?

Tumors present in the nose Signup and view all the answers

What is the main consideration when dealing with patients below 3 years old for tube insertion?

Need for orogastric insertion instead of nasogastric Signup and view all the answers

What are the contraindications for nasogastric tube insertion according to the text?

Recent nasal or facial surgery Signup and view all the answers

What potential complications can arise from post-operative adhesions?

Bowel obstruction and fertility issues Signup and view all the answers

"Why do orthopedic surgeons have the biggest egos?"

"Because we deal with the 'big bones'— it's basically a flex every time we operate!" Signup and view all the answers

What is the primary purpose of the minimally invasive surgeries mentioned in the text?

To offer options for open or laparoscopic techniques Signup and view all the answers

What is the significance of the lateral umbilical fold as described in the text?

It indicates the location of a fetal internal iliac artery branch Signup and view all the answers

What is the most likely indication for the intervention of bypassing colonic contents first, as mentioned in the text?

Presence of large and attached sigmoid colon tumor Signup and view all the answers

What is the role of the medial umbilical fold as explained in the text?

It is associated with obliterated urachus Signup and view all the answers

In what scenario might an awake craniotomy typically NOT be employed based on the provided text?

For cases of large hematomas or ongoing brain bleeding Signup and view all the answers

What is the most common malignant tumor among pediatrics according to the text?

Nephroblastoma Signup and view all the answers

What is the primary concern regarding the 4-year-old girl's condition based on the text?

Palpable mass in the left upper quadrant of the abdomen Signup and view all the answers

What diagnostic evaluations revealed a large, heterogeneous mass originating from the left kidney?

CT scans Signup and view all the answers

Which surgical subspecialty would typically perform lung resection according to the text?

Thoracovascular surgery Signup and view all the answers

In the context of pediatric surgery, what does intussusception refer to?

Telescoping or invagination of one portion of the intestine into another Signup and view all the answers

What is the most common indication for circumcision?

Phimosis Signup and view all the answers

What is the primary concern during sexual intercourse for a patient with abnormally located external urethral opening?

Possible difficulty in ejaculation Signup and view all the answers

What management technique does a general surgeon use to reconstruct the urethral opening in a patient with abnormal external urethral opening?

Utilizing prepuce Signup and view all the answers

What is the expected penis length during erection for a normal adult male?

> 5 cm Signup and view all the answers

In what condition is circumcision indicated based on penis length during erection?

< 3 cm Signup and view all the answers

What is the most important reason for exposing the glans penis in a male patient?

To locate the external urethral opening Signup and view all the answers

In what condition does majority of the semen flow out without spurting or force during ejaculation?

Epispadias Signup and view all the answers

Which surgical procedure may be used to reconstruct the urethral opening in patients with abnormally located external urethral opening?

Prepuceplasty Signup and view all the answers

What is the expected length of a micropenis during erection?

< 2 cm Signup and view all the answers

What is the common consequence of abnormally located external urethral opening during ejaculation?

'Flowing' of semen without spurting Signup and view all the answers

What is the primary reason for administering a dorsal penile nerve block during circumcision?

To block the dorsal nerves by injecting a local anesthetic solution Signup and view all the answers

What is the composition of the local anesthetic solution used for a dorsal penile nerve block in adults?

0.5% bupivacaine 10mls and 1% lignocaine 10mls without adrenaline Signup and view all the answers

What is the depth to which the needle is redirected during the administration of the dorsal penile nerve block?

3-5 millimeters deeper than the depth to the pubic symphysis Signup and view all the answers

What is the role of Buck's fascia during the administration of a dorsal penile nerve block?

To administer anesthesia by injecting a local anesthetic solution Signup and view all the answers

What are the branches of the pudendal nerves responsible for innervating?

The foreskin of the penis Signup and view all the answers

What is the significance of performing circumcision as a day case procedure?

It has little mortality Signup and view all the answers

In circumcision, what method is used to achieve anesthesia?

Administering a dorsal penile nerve block with or without a ring block Signup and view all the answers

What type of anesthesia is typically used for circumcision?

General anesthetic Signup and view all the answers

What is the depth to which a needle is inserted for dorsal penile nerve block during circumcision?

$3-5$ millimeters deeper than the depth to the pubic symphysis Signup and view all the answers

Which type of animal bite requires immediate vaccination and local treatment of the wound?

Nibbling of uncovered skin Signup and view all the answers

In the case of pesticide intake, who will attend to the patient if the chemical is acidic or basic in nature?

General surgery Signup and view all the answers

What is the expected action if a chemical with antimicrobial or antifungal properties is ingested?

NGT insertion and lavage administration Signup and view all the answers

What is the post-exposure prophylaxis for Category I animal bites?

None Signup and view all the answers

What is the post-exposure prophylaxis for Category II animal bites?

Immediate vaccination and local treatment of the wound Signup and view all the answers

What is the appropriate intervention for perianal hemorrhoids that are not prolapsed?

No intervention required Signup and view all the answers

What is the expected outcome if basic substances such as liquid Sosa are ingested?

Esophagus burn and melt Signup and view all the answers

What does the presence of perianal fistulas/abscesses indicate?

Infection in the anal region Signup and view all the answers

What information should be sought when a patient has suffered trauma due to a caustic substance?

Composition of the drink ingested, Date of incidence Signup and view all the answers

What action should be taken when dealing with pesticide intake where the chemical is not acidic/basic but with antimicrobial or antifungal properties?

NGT insertion and lavage administration Signup and view all the answers

What would be the appropriate response if an individual touches feeding animals or receives licks on intact skin?

No post-exposure measures required Signup and view all the answers

In what situation would both family medicine and general surgery attend to a patient who has ingested a caustic substance?

The chemical is not acidic/basic but with antimicrobial or antifungal properties. Signup and view all the answers

What is the expected healing time for superficial (first degree) level of injuries, as mentioned in the text?

3 to 6 days Signup and view all the answers

What are the clinical features associated with superficial (first degree) level of injuries?

Dry, red: blanches; painful Signup and view all the answers

What is the result/treatment for superficial (first degree) level of injuries, as per the text?

Healing time 3 to 6 days, no scarring Signup and view all the answers

What is the expected healing time for injuries at the superficial partial thickness level?

7-21 days Signup and view all the answers

What are the clinical features of injuries at the superficial partial thickness level?

Moist, red, weeping; severe pain to touch; blanches Signup and view all the answers

What is the result/treatment for injuries at the superficial partial thickness level?

Topical agent; sterile dressing Signup and view all the answers

What is the primary difference in clinical features between deep partial thickness and superficial partial thickness injuries?

Presence of blisters and decreased pain sensation to touch Signup and view all the answers

What is the main implication of reduced blanching in deep partial thickness injuries?

Increased likelihood of infection Signup and view all the answers

What is the recommended treatment option for deep partial thickness injuries?

Topical agent and sterile dressing Signup and view all the answers

What are the clinical features of full thickness (third degree) burns?

Waxy white to leathery dry and inelastic; does not blanch; absent pain sensation Signup and view all the answers

What is the recommended treatment for full thickness (third degree) burns?

Surgical excision and grafting at the earliest possible time Signup and view all the answers

What is the likely outcome if full thickness (third degree) burns are not grafted and left untreated?

Increased scarring and functional limitation Signup and view all the answers

What is the primary treatment requirement for injuries at the fourth degree level?

Surgical intervention Signup and view all the answers

Which of the following best describes the clinical features of injuries at the fourth degree level?

Pain to deep pressure in the area of burn, increased pain in surrounding areas of second-degree burn Signup and view all the answers

What is involved in injuries at the fourth degree level?

Fascia, muscle, and bone Signup and view all the answers