QUESTION: 105

A 41-year-old woman awoke from a nap with severe pain in her index finger and found it to be flexed while all other fingers were extended. When she tried to pull it free she heard a loud popping sound and the pain subsided. The following day she comes to her doctor's office concerned about the sound and pain.
What is the most appropriate next stop in the management of this patient?

Steroid injection
Admit to the hospital.
NSAID therapy
Amputate the finger
Rehabilitate the finger

Answer(s): A

Explanation:

Trigger finger is an acutely flexed and painful finger. Steroid injections have been shown to decrease pain and recurrence of trigger finger. It is the most cost- effective treatment, and studies have shown a trial of steroids should be attempted prior to surgery. Trigger finger is caused by a stenosis of the tendon sheath leading to the finger in question. If steroids fail, surgery to cut the sheath that is restricting the tendon is the definitive treatment.

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QUESTION: 106

In breast cancer, all true except:

Chemotherapy is must for pre-menopausal with +ve axilla
Yearly mammogram for contra-lateral breast
Radical mastectomy is the choice of surgery
2 cm mass with free axilla is stage I

Answer(s): C

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QUESTION: 107

Pneumothorax is a complication of which of the following blocks?

Brachial
Epidural
High spinal

Answer(s): A

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QUESTION: 108

A 6-year-old girl presents with her 3rd episode of pallor and mildly icteric sclera associated with symptoms of mild upper RTI. On examination, she has an easily tipped spleen.
Which one of following investigations is most likely to confirm her diagnosis?

Eosin-5-maleimide (E5M) staining test
Hb electrophoresis
Howell-jolly bodies in a RBC smear
Reticulocyte count

Answer(s): B

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