"It's History"
"Let's Get PHYSICAL"
"Order Up!"
"Pick Your Poison"
"It's Complicated"
100
This is an event or activity that classically precedes testicular torsion.
What is vigorous exercise or testicular trauma?
100
Loss of this reflex on PEx is specific for testicular torsion.
What is the Cremasteric reflex?
100
This is the most useful diagnostic test in the ED for diagnosis of testicular torsion.
What is Ultrasound with Doppler? (Findings will show hypoechoic testis with decreased blood flow)
100
This is the definitive treatment for testicular torsion.
What is surgical detorsion? (extra 100 pts if included bilateral orchiopexy for prevention of recurrence)
100
This complication can occur even if only a single testis is infarcted by torsion.
What is Infertility? (extra 100 pts if you can state mechanism for infertility)
200
A sexually active 23 yo F with LMP 6 wks ago and recent hx of IUD placement presents with N/V and acute lower abdominal pain, so you proceed to order THIS TEST, plus TVS or transabdominal US, and perform a pelvic exam due to concern for THESE among your DDx.
What is order B-hCG and include ECTOPIC PREGNANCY versus PID in DDx?
200
Auscultating the abdomen in a patient with this diagnosis can reveal high-pitched "tinkly" sounds or hypoactive bowel sounds (which is not very helpful...).
What is bowel obstruction?
200
When plain abdominal films are obtained in a patient with SBO, these two findings are helpful in making the diagnosis.
What are air-fluid levels and dilated loops?
200
Although SBO can often be managed with observation and conservative therapy, prompt surgical intervention is warranted if there is clinical or CT suspicion of this.
What is strangulation of the bowel?
200
All cases of SBO that receive this form of treatment are at increased risk of future SBO.
What is surgical intervention?
300
Patients with a history of this disease notable for LLQ abdominal pain are at increased risk of bowel perforation.
What is Diverticulosis?
300
When performing a bimanual exam on a female with suspected PID, eliciting THIS SIGN both fulfills a diagnostic criterion and brings a funny image to mind.
What is CHANDELIER SIGN, or cervical motion tenderness?
300
This is the most useful imaging modality for locating an ectopic pregnancy (for some reason also often debated in political discussions).
What is TVUS?
300
Once a diagnosis of viscus perforation and peritonitis is made, a consult to this service is needed for treatment.
What is Surgery?
300
This is the most feared sequela of an ectopic pregnancy, the leading cause of first trimester maternal death, and accounting for 4-10% of all pregnancy related deaths.
What is rupture and hemorrhage?
400
The pain classically precedes (as opposed to follows) this symptom in acute appendicitis.
What is Vomiting?
400
Psoas sign or Obturator Sign (you pick) for acute appendicitis can be elicited in this manner.
What is Pain with active flexion/passive extension of R hip or internal rotation of flexed R hip
400
Though a CT is the study of choice for appendicitis, for these two populations, ultrasound is the preferred imaging study.
What is Pediatric and Pregnant Patients?
400
Antibiotics are often used in appendicitis, but this event would cause you to choose broad-spectrum antibiotics.
What is appendiceal rupture/perforation?
400
Delayed appendectomy preceded by an IR procedure and antibiotics are favored when this complication occurs.
What is abscess formation?
500
Patients with a history of this gastrointestinal disease are at an increased risk of developing SBO due to strictures.
What is Crohn's Disease?
500
In order for your physical exam to be complete for a suspected ectopic pregnancy, you must perform these two exams to assess for pelvic tenderness and adnexal fullness.
What are bimanual exam and speculum exam?
500
Due to the serious life- and fertility- threatening complications of PID, coupled with the wide spectrum of clinical findings, including no symptoms at all, the CDC recommends EMPIRIC ANTIBIOTICS for the otherwise unexplained combo of THESE 3 FINDINGS on pelvic exam.
What are UTERINE TENDERNESS, ADNEXAL TENDERNESS, and CERVICAL MOTION TENDERNESS?
500
An ectopic pregnancy almost always is treated to avoid catastrophic complications. Treatment options include surgery or medical treatment with this drug.
What is Methotrexate?
500
If treated properly, cases of surgically correctable peritonitis (perforated peptic ulcer, appendicitis, diverticulitis) have this mortality rate in otherwise healthy patients (Up to 40% with elderly or underlying illness).
What is <10%?
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