Trauma

Q12) a 50 year old man with road side accident and injuries on right chest and femoral fracture, He is conscious,  BP is 80/60 , Pulse 104/min, and chest expansion is reduced. JVP is not visible and heart sounds are normal. Respiratory rate is 22/min

What does he have

a) Left heart failure

b) Fat Embolism

c) Pneumothorax

d) Fluid loss

Answer 

MRCS Neurosurgery

Q)  A 35 year old lady has severe vomiting accompanied with headache and becomes unconscious. She has no similar history in the past and is not on any medicines.

She has a GCS of 11/15, BP 140/90, Pulse of 86/min. No cardiac or respiratory cause is noted for the symptoms.She has mild nuchal rigidity and b/l extensor plantar response. 

CT scan of the brain is equivocal .Lumbar puncture studies show high RBcs in the aspirate? What is the next step in management?

a) MRI brain

b) Cerebral Angiogram

c) MR angiogram

d) IV broad spectrum antibiotic and anti virals

Answer

Esophagus perforation

Q) A 45 year old man who has been drinking regularly for the past 15 years vomits after a large meal and complains of severe chest pain. Cardiac cause is ruled out and boerhavve's syndrome is suspected. Which of the following is not true about this condition

a) Gastrograffin tests will confirm the diagnosis

b) Perforation is most common in the left lower end

c) Exploration and full thickness suturing of perforation should be done

d) This condition has a high morbidity and mortality if not diagnosed at time

Answer for premium members  - Discussion on Boerhaave's syndrome

Reno vascular hypertension

Q) Which of the following is true about reno vascular hypertension

a) Seen in young age group

b) Both kidneys are of same size

c) It is familial

d) Diuretics will control the hypertension

Answer for free

a

Renal artery occlusion creates ischemia of the kidney which releases renin. Hypereninemia leads to secondary hypertension. This further leads to conversion of angiotensin I to angiotensin II and vasocontriction and eventually release of aldosterone.

It is a disease of young adults and children

Size of the kidneys vary and diuretics do not control hypertension because the mechanism is high renin secretion which is unresponsive to diuretics.

 

Colon Bleeding

Q) True statement about  colonic bleeding:

a) Bleeding from diverticulitis is severe and often requires interventional procedures to stop it

b) In colitis risk of brisk bleeding is less and diarrhea is absent

c) In haemaorrhoids haemodynamic compromise is rare

d) Bleeding from angiodysplasia is always slight and managed endoscopically

Answer