Question #1 QID: 15401 Topic: Ranulas Subject: Surgery
A 17 year old white male presents with a concerning finding on the floor of his mouth. The rounded mass in seen under his tongue. It is not tender and is not fixed. See picture:
What is the name of this finding? a) Ranula b) Simple cyst c) Cavity d) Frenulum The correct answer is a)
Explanation: Ranulas present as a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland duct, which is usually caused by local trauma. Ranulas are usually asymptomatic. Treatment of ranulas involves excision of the top of the lesion in a procedure known as marsupialization.
Question #2 QID: 15406 Topic: Sigmoid Volvulus Subject: Surgery
A 58-year-old man presents to the ED with severe abdominal pain in his left lower quadrant. A plain film x-ray shows a sigmoid volvulus. What i s the appropriate management? management? a) Sigmoidectomy b) Decompression Decompression by sigmoidoscope sigmoidoscope c) Hydrostatic Hydrostati c barium enema d) Antibiotics The correct answer is b)
Explanation: Decompression and untwisting of the sigmoid loop may be achieved by the passage of a sigmoidoscope per rectum. This procedure allows for rapid decompression of the distended colon, with the immediate relief of symptoms. Most patients are elderly persons, and they may be treated conservatively with this tube decompression.
Surgery is reserved for patients in whom tube decompression fails to alleviate the patient's symptoms or for those in i n whom signs of ischemia are suggested. suggested.
