Rosh Surgery Exam Final Questions and Correct Solutions 100%

Rosh Surgery Exam Final Questions and Correct Solutions 100% A 22-year-old woman on her first postoperative night in the hospital complains of constant chest tightness and shortness of breath for the past hour. She has wellcontrolled asthma and is a lifelong nonsmoker. Vitals include a temperature of 98.8 0 F, heart rate 64 beats per minute, blood pressure 116/78 mm Hg, and oxygen saturation 99%. Physical exam reveals bilateral expiratory wheezing. Bedside chest radiograph and chest computed tomography are unremarkable. What medication is the best therapy for the most likely diagnosis? - CORRECT ANSWER-Albuterol (for bronchospasm, a common postop complication) A 28-year-old man with hemophilia A presents to the clinic for presurgical consultation for an epidermal inclusion cyst removal. His hematology records reveal a mild severity of his hemophilia for which he is not taking any daily prophylactic therapy. Which medication therapy should be employed prior to his surgery? - CORRECT ANSWERDesmopressin (promotes factor Vlll and VWF release from storage pools) A 28-year-old woman is brought into the emergency room by ambulance from home, after sustaining a head injury when riding her bike in traffic without a helmet earlier this morning. The patient's boyfriend reports that she initially had told him that she "came to" on the sidewalk after the accident and that a pedestrian had offered to call for an ambulance, but she declined. The boyfriend reports when at home, she had initially complained of a headache, but was acting normally up until three hours ago when she was difficult to arouse from a nap and became disoriented while slurring her speech. On physical examination, the patient is found to have a GCS of 6, a left dilated pupil, a heart rate of 48 beats per minute, and a blood pressure of 168/92 mm Hg. After intubating the patient, she is brought to CT scan which reveals a lenticular shaped collection. What is the most likely diagnosis? - CORRECT ANSWER-Epidural hematoma (middle meningeal artery) A 30-year-old man who weighs 75 kg presents to the emergency department for burns to his left arm and left leg after a large container of boiling water spilled on him just prior to arrival. There is white, peeling skin on the entirety of both his left arm and left leg. He has severe pain along the borders of the burn, but no sensation to the burned areas. Distal pulses are intact. After ensuring there is no airway or breathing compromise and removal of overlying materials and clothes, what is the next step in treatment? CORRECT ANSWER-Ringer's lactate solution 4 liter infusion over 8 hours (fluid resuscitation is the most important initial intervention for severely burned pts) A 31 -year-old man presents to the emergency department after an episode of syncope following sexual intercourse. Upon regaining consciousness at home, patient began complaining of a severe headache and started to vomit. Physical examination reveals an uncomfortable man with positive meningeal signs. Blood pressure is 162/94 mm Hg. CT scan of the head without contrast reveals no acute pathology. Based on the most likely diagnosis, what would you expect on the patient's lumbar puncture? - CORRECT ANSWER-Hemoglobin degradation products (xanthochromia) d/t subarachnoid hemorrhage A 32-year-old woman presents to the office with a concerning skin lesion on her arm. The lesion is biopsied and she is diagnosed with melanoma that is less than 1 mm in thickness. What is the next best step in caring for this patient? - CORRECT ANSWERWide excision with a 1 cm margin of normal tissue A 34-year-old nulliparous woman presents to the clinic out of concern for possible pregnancy. She reports she is sexually active with her husband and has not had her menstrual period in seven months. The woman states that she has taken multiple home pregnancy tests over the past few months that all indicate that she is not pregnant. The patient states that her breasts have been more sensitive lately and have been secreting a large amount of milky fluid. She has been putting pads in her bra to soak up the discharge. On further questioning, the patient reports frequent headaches and changes to her vision. The patient's thyroid function tests come back within normal range and a prolactin value returns at 163 ng/mL. MRI reveals an eight millimeter sellar mass. What