mdsc 5555 exam (5)
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7/25/2019 Mdsc 5555 Exam (5)
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7/25/2019 Mdsc 5555 Exam (5)
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2. A 3 year old man trans"erred "rom a nursin! ome complains o"intermittent s arp a%dominal pain$ e as passed no stool or 4atus "or days and as a istory o" c ronic constipation. On e(amination istemperature is 5 C$ pulse 100 %pm. T ere is !ross a%dominal distensionand tenderness most mar7ed in t e le"t iliac "ossa.
a) hat is your clinical diagnosis%
b) hat imaging test(s) would you order N* what &ndings would you e+pect%
On palpation his abdomen is rigid with generalized guarding and reboundtenderness. You do not think he would be a candidate for conservativemanagement.
c) 'ow would you prepare this patient preoperatively%
d) hat surgical operation(s) should be o,ered%
e) If the patient had presented earlier with obstipation but no signs ofperitonitis, what conservative treatment option would you consider
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-. / year old man presents to the emergency room complaining of a severely painful non0healing wound to the right leg. $he wound as made by minor traumaand has since been enlarging. 1 cm+ cm punched out ulcer is seen overlyingthe tibia. $he right leg also appears cooler than the left and distal pulses aredi2cult to appreciate on the right.
a) hat is the most likely diagnosis%
b) hat points in the history would you consider asking about%
c) hat investigations would you re3uest%
d) In addition to the investigations outlined above e+plain how you wouldmanage this patient
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