USMLE Forum Archives - USMLE Step 3 - trauma
trauma
bingousmle - 05-18-10 08:07
A 14-year-old boy is brought to the walk-in clinic by his father late on Saturday afternoon because his left ear is swollen and painful. The boy’s ear has been black and blue since he injured it in a wrestling match 3 days ago. Symptoms have increased significantly following a repeat injury 3 hours ago. On physical
examination, his left ear is markedly swollen and tender to palpation. The most appropriate next step is to
(A) reassure him and start aspirin therapy
(B) reassure him and start codeine therapy
(C) recommend that he apply cold packs to the ear for the next 12 hours
(D) recommend that he apply hot packs to the ear for the next 12 hours
(E) refer him to a surgeon for immediate drainage of the lesion
bingousmle - 05-18-10 08:07
A 14-year-old boy is brought to the walk-in clinic by his father late on Saturday afternoon because his left ear is swollen and painful. The boy’s ear has been black and blue since he injured it in a wrestling match 3 days ago. Symptoms have increased significantly following a repeat injury 3 hours ago. On physical
examination, his left ear is markedly swollen and tender to palpation. The most appropriate next step is to
(A) reassure him and start aspirin therapy
(B) reassure him and start codeine therapy
(C) recommend that he apply cold packs to the ear for the next 12 hours
(D) recommend that he apply hot packs to the ear for the next 12 hours
(E) refer him to a surgeon for immediate drainage of the lesion
The correct answer and explanation will be available after you answer.
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#1
Re: trauma fugeran - 05-18-10 10:31 My answer is: a.
I would give Aspirin 4 anti-inflammatory effect and analgesia as well. It doesn't look he has abscess so no drainage.
#5
Re: trauma babbu5508 - 05-25-10 02:32 My answer is: e.
If the external portion of the ear suffers a blow, a blood clot or other fluid may collect under the perichondrium. This separates the cartilage from the overlying perichondrium that is its source of nutrients, causing the cartilage to die. This leads to a formation of fibrous tissue in the overlying skin. When this happens, the outer ear becomes permanently swollen and deformed, resembling a cauliflower.
#28
Re: trauma pth4usmle - 07-18-11 00:45 My answer is: e.
hematoma and causing severe pain so need immediate decompression
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