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Surgery EOR Exam PA Easy With Complete Solutions.
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Surgery EOR Exam PA Easy With CompleteSolutions
A nn54-year-old nnman nnpresents nnto nnthe nnemergency nndepartment nnwith nncrampy nnabdominal nnpain,
nnnausea, nnand nnvomiting. nnThe nnpatient nnhas nnnot nnpassed nngas nnor nnhad nna nnbowel nnmovement nnfor nnat
nnleast nn10 nnhours. nnOn nnexamination, nnthe nnabdomen nnis nndistended nnand nnthere nnare nnhigh-pitched nnbowel
nnsounds nnwith nnrushes. nnA nnplain nnradiograph nnof nnthe nnabdomen nnreveals nncecal nndistension nnto nn12 nncm.
nnWhat nnis nnthe nnmost nnappropriate nndefinitive nnmanagement nnfor nnthis nnpatient?
A
nn Intravenous nnfluids nn
B
nn Nasogastric nnsuction nn
C
nn Observation nn
D
nn Surgical nnexploration nn- nnANSWER: nn✔ nnThe nnCorrect nnAnswer nnis: nnD nn
Massive nndistention nnof nnthe nncecum, nnas nndetected nnon nnplain nnradiograph, nnis nntypically nnseen nnin nn"closed
nnloop" nnobstructions nnwhere nnthe nnileocecal nnvalve nnis nncompetent. nnWhen nndistention nnapproaches nn12
nncm, nnthere nnis nnan nnincreased nnrisk nnof nnperforation nnand/or nngangrene. nnExpedient nnsurgical nnintervention
nnis nnindicated. nnAlthough nnobservation nnwith nnintravenous nnfluids nnand nnnasogastric nndecompression nnare
nnimportant nnadjuncts nnto nnmanagement, nnsurgical nnexploration nnis nnthe nnonly nnway nnto nnrapidly nnaddress
nnthis nnemergent nnsituation.
When nna nnbone nnis nnfractured, nnthere nnare nnthe nn3 nnstages nnof nnhealing. nnWhat nnis nnthe nnproper nnorder nnin
nnwhich nnthe nnhealing nnoccurs?
A
nn Inflammatory, nnRemodeling, nnReparative nn
B
nn Inflammatory, nnReparative, nnRemodeling nn
C
nn Remodeling, nnInflammatory, nnReparative nn
,D
nn Remodeling, nnReparative, nnInflammatory nn
E
nn Reparative, nnInflammatory, nnRemodeling nn- nnANSWER: nn✔ nnThe nnCorrect nnAnswer nnis: nnB nn
Inflammatory nnchanges nnhappen nnafter nnfractures nnand nnthis nnis nnfollowed nnby nna nnreparative nnphase nnand
nnultimately, nna nnremodeling nnphase. nnThe nnhealing nnfrom nnacute nninjuries nngenerally nnstarts nnwith
nninflammation,. nnOnce nnthe nnintegrity nnof nnthe nnbone nnhas nnbeen nnrestored nnon nnthe nnmacro nnlevel, nnbone
nnremodeling nncontinues nnuntil nnfull nnhealing nnhas nnoccurred.
What nnis nnthe nnmost nncommon nnembolic nnsource nnof nnacute nnarterial nnocclusion nnin nnthe nnlower
nnextremities?
A
nn Atrial nnfibrillation nn
B
nn Aortic nnaneurysm nn
C
nn Myocardial nninfarction nn
D
nn Prosthetic nncardiac nnvalve nn
E
nn Iliac nnartery nnthrombus nn- nnANSWER: nn✔ nnThe nnCorrect nnAnswer nnis: nnA nn
The nnheart nnaccounts nnfor nn80% nnof nnall nnemboli, nnwith nnatrial nnfibrillation nnmaking nnup nn70% nnof nnthat.
nnAortic nnaneurysms nnare nnfrequently nnlined nnwith nnthrombus nnbut nninfrequently nnembolize; nnaneurysmal
nndisease nnonly nnaccounts nnfor nn6% nnof nnall nnacute nnarterial nnocclusion. nnAcute nnmyocardial nninfarction
nn(especially nnthose nnassociated nnwith nnleft nnventricular nnthrombus) nnaccounts nnfor nn25% nnof
nncardioembolism, nnwith nnperipheral nnembolization nnoften nnthe nnfirst nnsign nnof nna nnpreviously nn"silent" nnMI.
nnProsthetic nncardiac nnvalves nnmake nnup nna nnstill nnsmall nnbut nnincreasingly nnprevalent nnsource nnof nnemboli.
nnPeripheral nnarterial nnthrombi nnaccount nnfor nnonly nn3% nnof nnacute nnocclusion.
Following nnemergent nnappendectomy, nna nn58-year-old nnobese nnmale nndevelops nna nntemperature nnof
nn102.4F̊, nn18 nnhours nnpostoperatively. nnHis nnrespiratory nnrate nnis nn26 nnand nnhis nnpulse nnis nn116bpm. nnA
nnphysical nnexam nnreveals nnscattered nnfine nnrales. nnWhat nnis nnthe nnmost nnlikely nndiagnosis?
A
,nn Atelectasis nn
B
nn Aspiration nnpneumonitis nn
C
nn Pleural nneffusion nn
D
nn Pneumonia nn
E
nn Pulmonary nnembolus nn- nnANSWER: nn✔ nnThe nnCorrect nnAnswer nnis: nnA nn
Pulmonary nnalveoli nncollapse, nnalso nnknown nnas nnatelectasis, nnoccurs nnduring nnoperative nnprocedures nnfor
nna nnvariety nnof nnreasons, nnincluding nndecreased nnclearance nnof nnsecretions nnand nndecreased nnintra-alveolar
nnpressure. nnPostoperatively, nnoften nndue nnto nnpain, nnpatients nnmay nnnot nnmobilize nnsecretions
nnappropriately, nnalso nncontributing nnto nnatelectasis. nnAtelectasis nnis nnthe nnmost nncommon nnpostoperative
nnpulmonary nncomplication, nnand nnis nnoften nnassociated nnwith nnemergent nnand nnprolonged nnsurgeries,
nnespecially nnthose nnof nnthe nnthorax nnand nnabdomen. nnAtelectasis nnis nnassociated nnwith nnfever, nnan
nnincreased nnrespiratory nnrate, nnan nnincreased nnpulse, nnand nnlung nnexam nnfindings nnranging nnfrom nnnormal
nnto nnrales nnand nndecreased nnbreath nnsounds. nnSymptoms nnusually nnpresent nnwithin nnthe nnfirst nn48 nnhours
nnpostoperatively. nnPulmonary nnaspiration nnpneumonitis, nnalthough nnpossible, nnis nnless nnlikely nndue nnto
nnappropriate nnpreoperative nnand nnintraoperative nnmeasures nnbeing nnutilized nnto nndecrease nnrisk.
nnPneumonia nnis nnalso nna nncommon nnpostoperative nncomplication, nndue nnto nnthe nnsame nncontributing
nnfactors nnas nnatelectasis. nnPhysical nnexam nnfindings nnmay nnalso nnbe nnsimilar. nnHowever, nnpostoperative
nnpneumonia nnis nnlikely nnto nnbecome nnevident nnbetween nn24 nnand nn96 nnhours nnpostoperatively.
During nna nnpre-surgical nnworkup, nna nnpatient nnreports nnthat nnshe nnhad nnreceived nnDesmopressin nnfollowing
nnthe nnbirth nnof nnher nnson. nnHer nnCBC nnis nnwithin nnnormal nnrange, nnas nnwell nnas nnher nnPT nnand nnaPTT. nnWhat
nnis nnthe nnmost nnlikely nncause nnof nnher nnneeding nnthis nnmedication?
A
nn Allo nnimmunization nnfollowing nnvaginal nndelivery nn
B
nn Hemolytic nnanemia nn
C
nn Iron nndeficiency nnanemia nn
D
nn Thalassemia nn
, E
nn Von nnWillebrand's nndisease nn- nnANSWER: nn✔ nnThe nnCorrect nnAnswer nnis: nnE nn
Desmopressin nnis nnthe nnmainstay nnof nntherapy nnfor nnpeople nnwith nnvon nnWillebrand's nndisease. nnHemolytic
nnanemia, nniron nndeficiency nnanemia, nnand nnthalassemia nnwould nnall nnhave nnabnormal nnfindings nnon nnthe
nnCBC. nnAllo nnimmunization nndoes nnnot nnrequire nndesmopressin nntherapy.
What nnabsolute nntissue nnpressure nngenerally nnis nnused nnas nna nnguideline nnfor nndiagnosing nncompartment
nnsyndrome?
A
nn 10 nnmm nnHg nn
B
nn 20 nnmm nnHg nn
C
nn 30 nnmm nnHg nn
D
nn 40 nnmm nnHg nn
E
nn 50 nnmm nnHg nn- nnANSWER: nn✔ nnThe nnCorrect nnAnswer nnis: nnC nn
Many nntrauma nnsurgery nnservices nnuse nnan nnabsolute nntissue nnpressure nnof nnapproximately nn30 nnmm nnHg
nnas nnthe nnthreshold nnfor nndiagnosing nncompartment nnsyndrome. nnBased nnon nnthe nnentire nnclinical nnpicture,
nnpatients nnwith nnnumbers nnin nnthat nnrange nnor nnhigher nnwill nnlikely nnrequire nnsurgical nndecompression nnwith
nna nnfasciotomy, nnwhile nnlower nnnumbers nnwill nnprobably nnbe nnmanaged nnwith nna nnmore nnconservative
nnapproach.
What nnis nnthe nnmost nncommon nnsite nnof nnan nnacute nnarterial nnocclusion nndue nnto nnembolic nndisease?
A
nn Iliac nnartery nn
B
nn Aortic nnbifurcation nn
C
nn Mesenteric nnarteries nn
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