Step II Q

[blueey]

Anyone who knows the answers please share your knowledge...

1. Acute SDH - why Ipsilat dilated pupil ?

2. OCP decreases Breast Ca ( Yes- Kaplan- does it make sense ?)

3. Meconium - what happens in CF/ Hishprungs ?

4.What does Ringers lactate fluid consist of ?

5. When do you do HIDA scan before ERCP?

Thanks heaps...

 

[chimp]

1. SDH may cause a mass effect on brain, leading to uncal herniation on the same side. The uncus is herniated through the tentorium cerebelli into the midbrain. this compresses the 3rd CN leading to loss of the parasympathetics, and a dilated 'blown' pupil.

2. ocp contain progesterone which decreases breast cancer risk by countering some of the effects of estrogen. ocp also decrease endometrial cancer by the same method. Although you are right, the effect on breast cancer is not as well established. ocp also sig decrease ovarian CA and cysts. Tamoxifen increases endometrial CA

3. would take to long

4 look up in surgical recall

5. this depends more on what hosp your at, prob not a usmle ques. but hida would be better for suspected perforated gall bladder, cholecystitis without stones . ERCP better for looking at pancreatic ducts. many other scenarios.