NBME Review #1

What are key characteristics of fibrocystic change in the breast?

Clear yellow fluid, disappearance on aspiration, tense and smooth.

List key features of fibroadenoma in the breast.

Firm, movable, well-defined edges, often painless, rubbery consistency.

What are the key indicators of breast cancer?

Irregular shape, hard mass, may or may not be painful, fixation to underlying tissue, potential lymphadenopathy.

How does neostigmine affect bradycardia?

It will worsen bradycardia and should be used cautiously in patients with underlying cardiac conditions.

What risk is associated with administering 3 liters of LR, especially in elderly patients?

Fluid overload, leading to complications such as pulmonary edema or heart failure.

What symptoms are associated with gastric distension?

Abdominal pain, bradycardia, and hypotension due to vagal stimulation.

What is the purpose of inserting a nasogastric tube in cases of gastric distension?

To decompress the stomach, relieve distension, and alleviate vagal stimulation effects.

When is a Whipple procedure indicated?

Diagnosis of pancreatic adenocarcinoma or other resectable tumors of the head of the pancreas, with absence of significant local vascular invasion or distant metastasis.

What is the triangle of Calot?

An anatomical landmark where the gallbladder is located right under the liver, crucial for surgeries to identify the cystic artery and duct

What are key characteristics of primary sclerosing cholangitis (PSC)?

'Beads on a string' appearance, history of ulcerative colitis, association with cholangiocarcinoma.

What are notable symptoms of cholangiohepatitis?

History of hepatitis virus, potential progression to cirrhosis, symptoms including jaundice and abdominal pain.

What is the recommendation regarding safety when attempting to remove a bullet from a gunshot wound?

It is only recommended if it can be done safely and without further injury to the patient.

What type of biopsy is often preferred for cancer diagnosis?

Core needle biopsy due to its ability to obtain a larger tissue sample for more accurate diagnosis.

What imaging studies are used to stage cancer?

CT scans, MRIs, or PET scans to determine the extent of disease spread.

What defines an open-book pelvic fracture?

Disruption of the pelvic ring, involving a break in the pubis and/or ischium, often requiring surgical intervention.

What is the function of a pelvic binder in an open-book pelvic fracture?

To close the fracture and help stabilize the pelvic ring, reducing the risk of further injury and hemorrhage.