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Free STEP3 Exam Braindumps (page: 61)

Page 60 of 202
PDF with 804 Questions

Patients with septic arthritis of the hip joint usually present with which position?

  1. internal rotation and flexion
  2. internal rotation and extension
  3. internal rotation and abduction
  4. external rotation and flexion
  5. external rotation and abduction

Answer(s): D

Explanation:

The joint space is most relaxed when the hip is flexed and externally rotated. This tends to be the least painful position for patients with septic arthritis



Which of the following structures can be found outside of the spermatic cord during a hernia repair?

  1. direct hernia sac
  2. indirect hernia sac
  3. vas deferens
  4. testicular artery
  5. ovary

Answer(s): A

Explanation:

A direct hernia comes through the medial inguinal canal floor and is found behind the spermatic cord. An indirect hernia passes though the internal inguinal ring, and thus can be found within the spermatic cord. The spermatic cord also contains the vas deferens, the testicular artery, lymphatics, and nerve fibers.



A 30-year-old male is brought to the ED after being hit in the head by a baseball. He is making incomprehensible sounds, but no words. He opens his eyes and withdraws to painful stimuli. His Glasgow Coma Scale score is:

  1. 10
  2. 9
  3. 8
  4. 7
  5. 6

Answer(s): C

Explanation:

The Glasgow Coma Scale is used to quantify a neurologic examination in patients with a head injury. It is based on three elements: eye opening, motor response, and verbal response. The total score ranges from 3 (worst) to 15 (best) with a score of 8 or lower indicating a coma. The scale is shown below. This patient has a score of 2E. + 4(M) + 2(V) = 8. This patient has evidence of a severe head injury. The initial step should be to protect his airway and prevent hypoxia, which could adversely affect his head injury. Thus, the initial step should be endotracheal intubation. Neurosurgical expertise, imaging to define the injury, and screens to rule out drugs or alcohol as contributions are all important, but should be performed after airway, breathing, and circulation are addressed. Mannitol is indicated in patients with evidence of herniation, such as those with pupillary dilatation.



A 30-year-old male is brought to the ED after being hit in the head by a baseball. He is making incomprehensible sounds, but no words. He opens his eyes and withdraws to painful stimuli.

The most appropriate next step in the treatment of this patient is:

  1. neurosurgery consultation
  2. intubation and mechanical ventilation
  3. CT scan of head to evaluate for intracranial blood
  4. administration of mannitol to prevent cerebral herniation
  5. blood and urine toxicology screens

Answer(s): B

Explanation:

The Glasgow Coma Scale is used to quantify a neurologic examination in patients with a head injury. It is based on three elements: eye opening, motor response, and verbal response. The total score ranges from 3 (worst) to 15 (best) with a score of 8 or lower indicating a coma. The scale is shown below. This patient has a score of 2E. + 4(M) + 2(V) = 8. This patient has evidence of a severe head injury. The initial step should be to protect his airway and prevent hypoxia, which could adversely affect his head injury. Thus, the initial step should be endotracheal intubation. Neurosurgical expertise, imaging to define the injury, and screens to rule out drugs or alcohol as contributions are all important, but should be performed after airway, breathing, and circulation are addressed. Mannitol is indicated in patients with evidence of herniation, such as those with pupillary dilatation.






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