CRAM SAEM Test 2 Questions With complete Solutions
63 views 0 purchase
Course
SAEM
Institution
SAEM
what is the obturator sign? what diagnosis is it associated with? correct answer: a/w appendicitis
obturator sign = pain upon flexion and internal rotation of the hip#$/images/upload-flashcards//_
what is Rovsing's sign? what diagnosis is it associated with? correct answer: a/w appendicitis...
CRAM SAEM Test 2 Questions With
complete Solutions
what is the obturator sign? what diagnosis is it associated with? correct answer: a/w appendicitis
obturator sign = pain upon flexion and internal rotation of the hip#$/images/upload-flashcards/601487/854522_m.jpg
what is Rovsing's sign? what diagnosis is it associated with? correct answer: a/w appendicitis
Rovsing's sign= pain in the RLQ upon palpation of the LLQ#$/images/upload-flashcards/601487/854525_m.jpg
Early in the course of acute appendicitis, are vital signs usually abnormal? correct answer: no - early in its course, vital signs including temperature may be normal. Once perforation has occurred, the rate of low-grade fever (<38 C) increases to about 40%.
what is the psoas sign? what diagnosis is it associated with? correct answer: a/w appendicitis
psoas sign = pain upon extension of the hip.#$/images/upload-
flashcards/601487/854528_m.jpg explain what rebound in the setting of acute appendicitis means correct answer: Rebound is usually elicited only after the appendix has ruptured or infarcted.
In establishing a differential diagnosis of abdominal pain, the onset of PAIN prior to the occurrence of N/V is more often suggestive of correct answer: surgical etiology of the pain, such as small bowel obstruction
what bug should you think of in patients with sickle cell anemia who present with abdominal pain and diarrhea? correct answer: salmonella (not shigellosis)
Radiation of pain to the scapula is suggestive of correct answer: acute choleycystitis (NOT hepatitis)
Diverticulitis pain is generally located correct answer: in the LLQ
Describe the pain patterns a/w with peptic ulcer disease (PUD) correct answer: pain that is worse preceding a meal
non-radiating, burning epigastric pain
pain that awakens a patient in the middle of the night
relief of abdominal pain with antacids
note: unrelenting pain over a period of weeks should suggest an alternative diagnosis
A 78 year old female presents to the E.D. with a sensation of LLQ abdominal pain, accompanied by some irregular bowel movements and loss of appetite. Her abdominal CT (two images) is shown in the Figure. What is the most likely diagnosis? correct answer: /images/upload-flashcards/601487/854531_m.jpg#$A patient with this general picture is most likely to have diverticulitis, which is revealed on the CT scan as diverticular disease with inflammation (wall thickening and stranding).#$/images/upload-
flashcards/601487/854534_m.jpg
A mother brings her 6 week old boy to the emergency room. She
states the baby has been vomiting everything she's tried to feed him for the past 12 hours. She states that he usually eats readily and completes an entire feeding, but he is unable to keep anything down. The emesis is non-bloody and non-bilious, however it is projectile in nature. What is the most likely condition in this patient? correct answer: pyloric stenosis
The answer is C. Hypertrophic pyloric stenosis typically presents in the second to sixth week of life and is four times more common in males than females. Infants with hypertrophic pyloric stenosis typically are vigorous eaters but shortly afterward regurgitate the entire feeding contents in a projectile fashion. The emesis is non-bilious. The classic finding on exam is an "olive" palpable in the abdomen, and diagnosis is typically via ultrasound. Intussusception typically presents between the ages of 5 and 12 months. Gastroenteritis is characterized by diarrhea as well as vomiting. Neither constipation nor appendicitis typically present with protracted vomiting, though the latter condition tends to present atypically in young children (and elderly adults). 46yo F c/o abrupt onset of intermittent severe pain in L flank & abdomen that woke her from sleep. She is pacing & appears extremely uncomfortable. She has never experienced this type of
pain previously and denies fevers or other symptoms. Renal calculus is suspected. Some questions - What is the best diagnostic test (KUB, IVP, Helical CT, U/S)?
How helpful is a Urinalysis? correct answer: Helical CT scan is greater than 95% sensitive and specific for renal calculi
Helical CT scan has been shown to be both highly sensitive and specific in the diagnosis of renal calculi. It is the preferred modality for evaluation in many centers. Although urinalysis typically demonstrates hematuria in patients with renal calculi, hematuria is not specific enough to confirm the diagnosis, and imaging is warranted in all first-time presenters. KUB detects approximately 60-70% of calculi (though studies addressing this
issue are somewhat methodologically flawed). Ultrasound is not reliable for detecting small calculi, but is 85-94% sensitive and 100% specific at demonstrating hydronephrosis. IVP is contraindicated in patients with renal insufficiency due to the dye load necessary to perform the study.
50 yo M p/w 1 day of gradually worsening, intermittent, LLQ pain a/w loose stools. No fevers or bloody bowel movements. Similar sxs in the past were self-limited. Vital signs wnl. PE shows mild tenderness in LLQ, +BS and no masses or peritoneal
signs. His PCP can see him tomorrow in his clinic. What should be done next in the E.D.? correct answer: Discharge home on high-fiber diet, laxatives and stool softeners
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Classroom. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
