117 Questions
Which artery arises from the External iliac artery and runs upward to supply the lower part of the rectus abdominis muscle?
Inferior epigastric artery
In which condition would it be relevant to ask about circumcision according to the provided text?
Incomplete emptying, frequency, urgency, and weak stream
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?
Partial nail avulsion procedure
What is the lateral border of the Hesselbach’s triangle also known as?
Inferior epigastric artery
Which artery supplies the upper part of the rectus abdominis muscle?
Internal thoracic artery
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
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
What should be the response in the physical examination form under Chest when there was no examination of the patient's chest?
NOT APPLICABLE
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
What is the formula for calculating the ideal body weight for obese male patients?
$50 + (0.91 × [height in cm − 152.4])$
When examining obese female patients, what formula is used to calculate their ideal body weight?
$45.5 + (0.91 × [height in cm − 152.4])$
What should be recorded in the physical examination form for a system or part that was not examined?
NOT APPLICABLE
Do clerks need to examine a patient for conditions not elicited during history taking?
No, unless there are complaints related to the condition
What is the implication of labeling unexamined systems or parts as 'NORMAL' on the physical examination form?
It is incorrect and misleading
Why is it important not to label unexamined systems or parts as 'NORMAL' on the physical examination form?
To avoid medico-legal implications
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.
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.
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.
What is the most common type of tumor that originates from the protective layers covering the brain and spinal cord?
Meningioma
In cases of epidural bleeding, what is the primary purpose of a craniotomy?
To evacuate the blood clot, control bleeding, and relieve intracranial pressure
What is the cause of subdural bleeding?
Trauma causing shearing of bridging veins
Which surgical procedure is used to evacuate the blood clot, control bleeding, and alleviate increased intracranial pressure in cases of subdural bleeding?
Craniotomy
What is the location of subarachnoid hematoma?
Between the arachnoid mater and pia mater
In cases of subarachnoid hematoma, what can cause the bleeding into the subarachnoid space?
Rupture of aneurysm
For neurosurgical procedures, what factors determine the surgical approach for tumor resection?
Tumor size, location, and impact on neurological function
What is the most common site for hypertensive intracerebral bleeding?
Basal Ganglia
Which of the following is a specific surgical procedure to address a ruptured aneurysm?
Coiling
What causes spontaneous bleeding due to the fragility of brain blood vessels?
Cerebral Amyloid Angiopathy
What is the primary intervention for large hematomas or ongoing bleeding within the brain tissue?
Surgical evacuation
What is the leading cause of ruptured small blood vessels in intracerebral bleeding?
Elevated blood pressure
What is the most common indication for surgery in cases of intracerebral bleeding?
Unresolved condition through medical treatment
Why might an awake craniotomy be performed?
To allow real-time assessment and preservation of language capabilities during brain surgery
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
In what scenario might an awake craniotomy typically be employed?
For the removal of a brain tumor affecting language function
What is the main objective of performing an awake craniotomy?
To safeguard critical functions like speech, motor skills, or sensory perception during brain surgery
What is a common use case for an awake craniotomy?
For specific brain surgeries where maintaining brain function is crucial
In what type of surgery might an awake craniotomy be beneficial?
Surgeries involving specific brain procedures where maintaining brain function is crucial
What surgical procedures are commonly performed by both ENT and general surgeons?
Thyroidectomy and excision biopsy
Who is involved in reconstructive breast surgeries?
Reconstructive surgeons
Which type of surgeon does not perform chest tube insertions?
Pulmonologists
What is the main difference between thoracentesis and chest tube insertions?
The level of invasiveness
What is the most common emergent procedure performed by general surgeons?
Appendectomy
Who typically performs open cholecystectomy?
General surgeons
What is the primary reason for avoiding chest tube insertions unless confident and mindful of the case?
Potential complications
What is the main difference between core needle biopsy and excision biopsy?
The approach to tissue extraction
How do thoracic surgeons differ from pulmonologists in the management of pneumothorax?
Their referral practices for thoracostomy insertions
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
During the chest tube insertion, what does withdrawal of stomach contents indicate?
Correct placement in the stomach
What should be done before advancing the NG tube if resistance is encountered during chest tube insertion?
Rotate the NG tube to aid insertion
What does coughing during NG tube insertion indicate?
NG tube in the trachea
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
What should be avoided if the patient becomes distressed during NG tube insertion?
Grant time for patient recovery
What is a common discomfort experienced by patients during NG tube insertion?
Discomfort in nasopharynx
What is the primary concern when encountering resistance during nasogastric tube insertion?
The tube may be in the trachea
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
What is the primary reason for avoiding nasogastric tube insertion in patients with head trauma or HEENT surgeries?
Possibility of aspirating brain matter
Under what conditions should orogastric insertion be performed instead of nasogastric insertion?
Tumors present in the nose
What is the main consideration when dealing with patients below 3 years old for tube insertion?
Need for orogastric insertion instead of nasogastric
What are the contraindications for nasogastric tube insertion according to the text?
Recent nasal or facial surgery
What potential complications can arise from post-operative adhesions?
Bowel obstruction and fertility issues
"Why do orthopedic surgeons have the biggest egos?"
"Because we deal with the 'big bones'— it's basically a flex every time we operate!"
What is the primary purpose of the minimally invasive surgeries mentioned in the text?
To offer options for open or laparoscopic techniques
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
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
What is the role of the medial umbilical fold as explained in the text?
It is associated with obliterated urachus
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
What is the most common malignant tumor among pediatrics according to the text?
Nephroblastoma
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
What diagnostic evaluations revealed a large, heterogeneous mass originating from the left kidney?
CT scans
Which surgical subspecialty would typically perform lung resection according to the text?
Thoracovascular surgery
In the context of pediatric surgery, what does intussusception refer to?
Telescoping or invagination of one portion of the intestine into another
What is the most common indication for circumcision?
Phimosis
What is the primary concern during sexual intercourse for a patient with abnormally located external urethral opening?
Possible difficulty in ejaculation
What management technique does a general surgeon use to reconstruct the urethral opening in a patient with abnormal external urethral opening?
Utilizing prepuce
What is the expected penis length during erection for a normal adult male?
> 5 cm
In what condition is circumcision indicated based on penis length during erection?
< 3 cm
What is the most important reason for exposing the glans penis in a male patient?
To locate the external urethral opening
In what condition does majority of the semen flow out without spurting or force during ejaculation?
Epispadias
Which surgical procedure may be used to reconstruct the urethral opening in patients with abnormally located external urethral opening?
Prepuceplasty
What is the expected length of a micropenis during erection?
< 2 cm
What is the common consequence of abnormally located external urethral opening during ejaculation?
'Flowing' of semen without spurting
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
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
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
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
What are the branches of the pudendal nerves responsible for innervating?
The foreskin of the penis
What is the significance of performing circumcision as a day case procedure?
It has little mortality
In circumcision, what method is used to achieve anesthesia?
Administering a dorsal penile nerve block with or without a ring block
What type of anesthesia is typically used for circumcision?
General anesthetic
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
Which type of animal bite requires immediate vaccination and local treatment of the wound?
Nibbling of uncovered skin
In the case of pesticide intake, who will attend to the patient if the chemical is acidic or basic in nature?
General surgery
What is the expected action if a chemical with antimicrobial or antifungal properties is ingested?
NGT insertion and lavage administration
What is the post-exposure prophylaxis for Category I animal bites?
None
What is the post-exposure prophylaxis for Category II animal bites?
Immediate vaccination and local treatment of the wound
What is the appropriate intervention for perianal hemorrhoids that are not prolapsed?
No intervention required
What is the expected outcome if basic substances such as liquid Sosa are ingested?
Esophagus burn and melt
What does the presence of perianal fistulas/abscesses indicate?
Infection in the anal region
What information should be sought when a patient has suffered trauma due to a caustic substance?
Composition of the drink ingested, Date of incidence
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
What would be the appropriate response if an individual touches feeding animals or receives licks on intact skin?
No post-exposure measures required
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.
What is the expected healing time for superficial (first degree) level of injuries, as mentioned in the text?
3 to 6 days
What are the clinical features associated with superficial (first degree) level of injuries?
Dry, red: blanches; painful
What is the result/treatment for superficial (first degree) level of injuries, as per the text?
Healing time 3 to 6 days, no scarring
What is the expected healing time for injuries at the superficial partial thickness level?
7-21 days
What are the clinical features of injuries at the superficial partial thickness level?
Moist, red, weeping; severe pain to touch; blanches
What is the result/treatment for injuries at the superficial partial thickness level?
Topical agent; sterile dressing
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
What is the main implication of reduced blanching in deep partial thickness injuries?
Increased likelihood of infection
What is the recommended treatment option for deep partial thickness injuries?
Topical agent and sterile dressing
What are the clinical features of full thickness (third degree) burns?
Waxy white to leathery dry and inelastic; does not blanch; absent pain sensation
What is the recommended treatment for full thickness (third degree) burns?
Surgical excision and grafting at the earliest possible time
What is the likely outcome if full thickness (third degree) burns are not grafted and left untreated?
Increased scarring and functional limitation
What is the primary treatment requirement for injuries at the fourth degree level?
Surgical intervention
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
What is involved in injuries at the fourth degree level?
Fascia, muscle, and bone
This quiz covers the importance of eliciting pediatric surgical history in the context of lower urinary tract symptoms (LUTS) and urogenital concerns. It also includes information on when to ask about circumcision in the medical history.
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