USMLE Sugery (Eleetor)

A n otherwise well 57-year-old male is 45 minutes post transurethral resection of the prostate gland for benign prostatic hyperplasia. The procedure was performed under general anaesthesia and lasted one and a half hours. You are asked to see the patient due to the fact that he has become acutely confused and drowsy. Initial observation showed an oxygen saturation of 98 % on 2 litres of oxygen per minute, respiratory rate of 18 breaths per minute, pulse rate of 40 beats per minute, blood pressure of 90/70 mmHg and temperature of 37 .30C. From the list below, choose the most likely cause for this patient's deterioration?

A 56-year-old lady is having a total thyroidectomy for Graves' disease. During the operation she develops thyroid storm and the anaesthetist informs you that the patient has developed a tachycardia. From the list below, please choose a feature not likely to be associated with thyroid storm?

You are reviewing the blood test results of a SO-year-old man who has been admitted following a crush injury to his right leg. His serum potassium is found to be low at 2.9mmol/L following earlier correction of hyperkalaemia. You request an ECG for this patient. Which one of the following ECG changes is not characteristic of hypokalaemia?

A 45-year-old railway worker is admitted following a crush injury to his left leg. He is talking in full sentences and complaining of pain in his leg. Further examination reveals a blood pressure of 90/58 mmHg, pulse of 99beats/min, and a swollen and bruised left leg. Intravenous access is gained, routine blood samples are taken and fluid resuscitation is commenced. In addition, the patient is catheterized for monitoring purposes but passes only a small volume of redbrown urine, which, on microscopy, is confirmed to contain myoglobin. The admitting physician makes a working diagnosis of rhabdomyolysis. Which one of the following metabolic abnormalities is not associated with this condition?

A 62-year-old man is admitted to the emergency department with abdominal pain. The patient has a past history of ischaemic heart disease and atrial fibrillation. Computed tomography scan features are highly suggestive of ischaemic bowel. The patient's blood gases are as follows: pH= 7.25, pa02 = 10, pa CO2= 2.8, HC03 = 18, Base excess= -8. Which of the following best describes the patient's acid-base status?

You are asked to assist in theatre during an emergency appendicectomy. The consultant asks you to locate McBurney's point. From the list below, which answer best describes the location of McBurney's point?

A 70 kg patient is 1 day following total hip replacement. He has not started eating and drinking. He is being rehydrated with dextrose/saline (4% dextrose and 0.18% saline). Which one of the following best describes this type of fluid therapy?

A postoperative patient is being managed on a high-dependency unit following a subtotal colectomy. Blood results show the phosphate level is 0.25 mmol/L. Which one of the following statements regarding intravenous phosphate is incorrect?