NBME Review #2

Even if a trauma patient is unstable, you need to do FAST exam to find the source of bleeding urgently before ex-lap

GCS score eye mnemonic: "Four Eyes = Spontaneous, Talk = 3, Pain = 2, None = 1"

• GCS score motor mnemonic: “Our Lazy Wife Fought Every Night”

• GCS score verbal mnemonic: "Our Confused Inmate Is Not verbalizing"

Nerve tissue is the most susceptible to ischemia, followed by organs such as the heart and kidneys that also rely heavily on continuous blood supply.

Asymptomatic and recurrent pneumothorax really matters if involved in situations with pressure differences, like flying or scuba diving

• If you have someone who presents like this, plan for video assisted thoracic surgery

Radical mastectomy not only takes out breast and lymph nodes, but also the chest muscles

Once you name a cancer, you need to stage through biopsy

• Once staged, need to find a treatment

• Name → stage → treat

MRI of breast is only done if the results of the biopsy indicate the need for further evaluation of the tumor size or to assess for any potential local spread.

• That is, physical exam and mammogram is discordant

• Also if BRCA gene is identified, MRI may be recommended due to the increased risk of breast cancer.

Cellulitis: erythema, induration

• Abscess: fluctuant and erythema

• Furuncle: a tender, swollen nodule that can evolve from a folliculitis with localized erythema and purulent drainage.

• Carbuncle: a collection of furuncles that form a painful, interconnected abscess usually accompanied by systemic symptoms such as fever.

  • From MRSA

• Necrotizing soft tissue infection: erythema, induration, pain out of proportion to physical exam, blisters, and necrosis of the skin and subcutaneous tissue, often necessitating urgent surgical intervention and broad-spectrum intravenous antibiotics.

• Fournier’s gangrene: necrotizing fasciitis of perineum

Complications of pancreatitis:

• Infection: Development of infected pancreatic necrosis or abscess can occur.

• Organ failure: The patient may experience respiratory, renal, or cardiovascular failure.

• Pseudocyst formation: Fluid collections can develop within or adjacent to the pancreas.

• Hemorrhage: Hemorrhagic pancreatitis may result from erosion of blood vessels.

• Fistula: pancreas will connect to the small intestine

• Ascites: The accumulation of fluid in the abdominal cavity, which can occur in conjunction with pancreatic disease.

Mesenteric ischemia gets systemic heparinization

Reflux is normal in infants less than 6 months

With gastrochisis, the complication is dehydration because the exposed intestines are unable to properly function, leading to fluid loss and requiring careful management to maintain hydration.

• Omphalocele can lead to cardiac defects because of the association with chromosomal abnormalities, such as trisomy 13 and 18, which are known to impact cardiovascular development.

If testicular torsion occurs on one side, it is very likely it will occur on the other

• Best to do bilateral orchiopexy

Crohn’s disease leads to increased oxalate absorption in the intestines, which can result in the formation of calcium oxalate kidney stones.

Raised red and purple nodules after a radical mastectomy = lymphangiosarcoma