Still nailing every pimp question? Thumbs up
Over the last four years, I’ve started a small collection of questions that I repeatedly gotten pimped on by various attendings from many different services. We at QuickHits decided to empower the med student by starting a weekly post with a number of high yield questions along with some you-know-it-or-you-don’t type questions that you can impress some attendings with.
We hope this allows our readers to continue to build a thorough knowledge base. Give a shot at this week’s volume of pimp notes.
See how many you get right. Leave some comments!:
- Most common elbow fracture in adults? In pediatrics?
- How much fluid is needed to see a pulmonary effusion on radiograph?
- Characteristics needed to diagnose appendicitis on abdominal ultrasound?
- What are the types of den’s fractures?
- What is a Segond fracture? What other injury is associated w/ Segond fractures?
- Pediatric patient presents at birth with cyanosis that is cyclical. When baby cries, his respiratory distress resolves. Dx?
- Four basic interventions to lower ICP?
- Diagnosis, complications, and basic management:
CONTINUE READING FOR ANSWERS
Most common elbow fracture in adults: radial head fracture
Most common elbow fracture in peds: supracondylar fracture
Amount of fluid needed to see effusion on radiograph
- Need 175 cc of fluid to see effusion on AP view of chest
- Need 5 cc of fluid to see effusion on lateral view of chest
Characteristics needed to diagnose appendicitis on abdominal ultrasound?
- >6 mm distance from wall to wall
- hypervascular on Doppler
Types of dens fractures:
What is a Segond fracture? What other injury is associated w/ Segond fractures?
- avulsion fracture of the knee which involves the lateral aspect of the poximal tibial plateau
- 75% are associated w/ ACL tear –> MRI is essential in management
Pediatric patient presents at birth with cyanosis that is cyclical. When baby cries, his respiratory distress resolves. Dx? = Choanal atresia
- Membranous/bony septum between nose and pharynx
- Baby is blue and pinks up when stimulated and starts crying
- Unilateral =Asymptomatic until first URI
- Bilateral = Classic newborn presentation (turns pink when crying allowing air into lung)
- Dx: Can’t pass catheter 3-4 cm
- Tx: surgical repair
Four basic intervenstions to lower ICP?
- Head elevation = increased venous outflow from head
- Sedation = decreased metabolic demand and control of HTN
- Intravenous mannitol = extraction of free water out of brain tissue à osmotic diuresis
- Hyperventilation = CO2 washout à cerebral vasoconstriction
Diagnosis of hand x-ray = Scaphoid bone fracture
- Most common bone fractured among carpals
- Presentation = young adults following fall on outstretched hand, pain at wrist joint, **tender snuff box**,
- Tx = wrist immobilization for all nondispalced scaphoid fractures (fractures w/ <2mm of displacement and no angulation)
- If initial x-rays are negative in pt. with suspected fracture à immobilization w/ subsequent x-ray in 7-10 days or immediate advanced imaging (e.g. CT scan)
- Fracture displacement tx = open reduction and internal fixation
- Complication = Avascular necrosis of the scaphoid
- Almost always involves proximal pole
- The more proximal is he fracture line, the risks of avascular necrosis increase
Miss anything? Forgot to include something important? Leave a comment and help us improve our knowledge base for medical students!