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Free notes, MCQs, tables & flowcharts for USMLE Step 3 Surgery
A 36-year-old male is taken to the emergency room after jumping from a building. Bilateral fractures to the femur were stabilized at the scene by emergency medical technicians. The patient is lucid upon questioning and his vitals are stable. Pain only at his hips was elicited. Cervical exam was not performed. What is the best imaging study for this patient?
AAP and lateral radiographs of hips
BLateral radiograph (x-ray) of hips
CMagnetic resonance imaging (MRI) of hips, knees, lumbar, and cervical area
DAnterior-posterior (AP) and lateral radiographs of hips, knees, lumbar, and cervical area
EComputed tomography (CT) scan of cervical spine, hips, and lumbar area
A 5-year-old boy is brought to the emergency department by his stepmother because of multiple injuries. She says that he sustained these injuries while playing. Radiographic findings show multiple fractures in various stages of healing. Physical examination shows the findings in the image below. What is the most likely diagnosis in this patient?
AChild abuse
BOsteogenesis imperfecta
CMarfan syndrome
DWilson disease
EOsteochondritis dissecans
A 56-year-old man presents to the emergency room after being in a motor vehicle accident. He was driving on an icy road when his car swerved off the road and ran head on into a tree. He complains of severe pain in his right lower extremity. He denies loss of consciousness during the accident. His past medical history is notable for poorly controlled hypertension, hyperlipidemia, and major depressive disorder. He takes enalapril, atorvastatin, and sertraline. His temperature is 99.1°F (37.3°C), blood pressure is 155/85 mmHg, pulse is 110/min, and respirations are 20/min. On exam, he is alert and fully oriented. He is unable to move his right leg due to pain. Sensation is intact to light touch in the sural, saphenous, tibial, deep peroneal, and superficial peroneal distributions. His leg appears adducted, flexed, and internally rotated. An anteroposterior radiograph of his pelvis would most likely demonstrate which of the following findings?
AFracture line extending between the greater and lesser trochanters
BFemoral head larger than contralateral side and inferior to acetabulum
CFracture line extending through the femoral neck
DFracture line extending through the subtrochanteric region of the femur
EFemoral head smaller than contralateral side and posterior to acetabulum
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