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Free notes, MCQs, tables & flowcharts for USMLE Step 3 Surgery
On physical examination and imaging, a 3-year-old male shows evidence of multiple healed fractures and bruising. On eye exam, the child's sclerae appear blue, and results of a fundoscopic exam are shown in Image A. What is the most appropriate next step in the care of this patient?
AHearing test
BGenetic testing for collagen synthesis disorder
CIntravenous vitamin C
DBone marrow transplant
ECall child protective services
A 6-week-old boy is brought for routine examination at his pediatrician’s office. The patient was born at 39 weeks to a 26-year-old G1P1 mother by normal vaginal delivery. External cephalic version was performed successfully at 37 weeks for breech presentation. Pregnancy was complicated by gestational diabetes that was well-controlled with insulin. The patient’s maternal grandmother has early onset osteoporosis. On physical examination, the left hip dislocates posteriorly with adduction and depression of a flexed femur. An ultrasound is obtained that reveals left acetabular dysplasia and a dislocated left femur. Which of the following is the next best step in management?
APavlik harness
BClosed reduction and spica casting
CObservation
DPhysiotherapy
EOpen reduction and femoral osteotomy
A 65-year-old man presents to the emergency department with a complaint of intense pain in his right foot for the past month, along with fever and chills. He denies any traumatic injury to his foot in recent memory. He has a medical history of poorly-controlled type II diabetes and is a former smoker with extensive peripheral vascular disease. On physical exam, the area of his right foot around the hallux is swollen, erythematous, tender to light palpation, and reveals exposed bone. Labs are notable for elevated C-reactive protein and erythrocyte sedimentation rate. The physician obtains a biopsy for culture. What is the most likely causative organism for this patient’s condition?
APasteurella multocida
BMycobacterium tuberculosis
CStaphylococcus aureus
DPseudomonas aeruginosa
ENeisseria gonorrhoeae
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