Speculum - University of Melbourne

SPECULUM 67
ANSWERS TO DIAGNOSTIC QUIZ
SURGERY
1. He had sustained a fracture of the
middle fossa and a fistulous communication
between the carotid artery and the cavernous
sinus.
2. She had sustained a brachial plexus
injury when the arm was brought out at
right angles to the table on an arm board,
the patient being in the Trendelenberg position
and with shoulder rests to restrict
scapular rotation.
3. The pentothal had been injected inadvertently
into the brachial artery. This
is surprisingly easy to do, especially in old
people. Gangrene of the hand is a not uncommon
sequel.
4. Mediastinal emphysema and tension
pneumothorax are infrequent sequelae of
thyroidectomy. The latter may cause very
urgent symptoms.
5. He had fat embolism from which he
fortunately made a spontaneous recovery.
6. He had gout, which had plagued him
in the past. It is not very uncommon as a
post-operative complication.
7. The tablets were, of course, chloropromazine.
She was, however, still jaundiced
six weeks later and at this stage we felt
constrained to operate. Although there
had been no pain, a stone was firmly impacted
in the common duct.
8. He had periostitis, which is one of the
less frequent sequelae of . typhoid fever
during the convalescent period. It usually
resolves without suppuration.
9. The story is only too familiar these
days. He had an inoperable carcinoma of
the left lower lobe bronchus with an area of
collapsed lung.
10. He had a liver hydatid, which had
become infected and broken through the
diaphragm to communicate with the bronchial
tree. The grapeskins were daughter
cysts. The occupation was totally irrelevant:
he spent his boyhood on a farm in the Western
District.
11. She had a depressed fracture of the
malar bone with damage to the infra-orbital
nerve. The diagnosis was masked in the
first instance by the swelling.
12. We were far too clever! We plumped
for gallstone ileus. It was only when we
were preparing the skin on the table that
the resident spotted a swelling in the right
groin. It was a strangulated femoral hernia
all right!
13 He was wearing police uniform.
MEDICINE
1. Constrictive pericarditis.
2. Phaeochromocytoma.
3. Nephrotic syndrome due to amyloid
disease.
4. Peripheral neuritis due to isoniazid.
5. Patent ductus arteriosus with a reversed
shunt due to pulmonary hypertension.
6. Polycystic kidneys.
7. Raised.
Reduced or normal.
Raised or normal.
Reduced.
Reduced or normal.
8. Chlorpromazine.
9. Infective hepatitis.
10. Bronchial carcinoma with secondary
cerebral deposits and involvement
of the cervical sympathetic ganglia.
11. Scurvy.
12. Arsenic poisoning.
13. Pre-eclamptic toxaemia of pregnancy
14. (a) Post partum necrosis of the pituitary.
(b) She has spontaneous hypoglycaemia.
15. Amyotrophic lateral sclerosis.
16. Sub Arachnoid Haemorrhage due to
Cerebral Vascular Anomaly.
X Sacro-coccygeal teratoma.
At a meeting of the Loddon Region
Medical Advisory Committee at Bendigo,
Country Practitioners were discussing Reserve
Equipment to be held at the Base for
emergency and replacement use for hospi- .
tals in that area. The advisability of having,
a sigmoidoscope on the list was debated.
Dr. N.T. suggested that the sigmoidoscope
be retained!