Test
Heart sounds - 🧠 ANSWER ✔✔- *S1:* mitral and tricuspid valve closure
- *S2:* aortic and pulmonary valve closure
- *S3:* in early diastole
---- During rapid ventricular filling phase
---- Large amount of blood striking a very compliant left ventricle (LV)
---- Normal in children, pregnant women
- *S4:* last diastole
---- "atrial kick"
,---- Blood flowing against noncompliant LV
Corneal abrasion - 🧠 ANSWER ✔✔- Pain, photophobia, tearing
- Fluorescein stain: epithelial injury
- Foreign body sensation
- Topical abx
- Antipseudomonal for contact lens wearers
- Most abrasions are self-limiting
Small bowel obstruction - 🧠 ANSWER ✔✔- Causes: adhesions (pelvic
surgery) > tumor > hernia (inguinal)
- Proximal: bilious vomiting
- Distal: feculent vomiting
- High pitched bowel sounds
- X-ray: dilated bowel, air fluid levels, "stack of coins" or "string of pearls"
sign
- Modality of choice: *CT*
- NGT, surgery
,Large bowel obstruction - 🧠 ANSWER ✔✔- CRC > diverticulitis, volvulus,
strictures
- High-pitched bowel sounds
- Abdominal distension
- NGT, surgery
Balanoposthitis - 🧠 ANSWER ✔✔- Patient will be an *uncircumcised male*
- Complaining of *burning and itching* of the penis
- PE will show *erythema* and *inflammation* with scant *white discharge*
- Most commonly caused by Candida
- Recurrent balanitis is seen in diabetics
- Treatment is topical antifungal
What is the INR range in a patient taking warfarin for atrial fibrillation? - 🧠
ANSWER ✔✔2-3
Glasgow coma scale - 🧠 ANSWER ✔✔- All patients have ≥ 3
- Intubate if ≤ 8
- Eye response (1-4)
COPYRIGHT©NINJANERD 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
3
, - Verbal response (1-5)
- Motor response (1-6)
Intussusception - 🧠 ANSWER ✔✔- 5 months to 3 years of age (most
common)
- Abdominal pain + vomiting + hematochezia (*"currant jelly" stools*)
- RUQ mass, absence of bowel sounds in RLQ
- Intermittent paroxysms of pain alternating with pain-free periods or
lethargy
- Abdominal XR: "Dance's sign"
- Ultrasound: *target sign*
- Children: *air/barium enema* is diagnostic and therapeutic
- Adult rx: surgery
When should the nail be removed in a patient with a subungal hematoma?
- 🧠 ANSWER ✔✔The nail may be removed if it is split, avulsed or a
laceration extends to the skin.
Trephination of nail - 🧠 ANSWER ✔✔- Indication: acute, not spontaneously
draining, intact nail folds, painful