Master the board step 3

Master the Boards: USMLE Step 3
Intussusception
Meckel Diverticulum
This presents as lower GI bleeding in a child of pediatric age.
Basic Science Correlate
Meckel diverticulum is a true diverticulum consisting of all 3 layers of the
bowel wall: mucosa, submucosa, and muscularis propria.
Diagnosis is with a radioisotope scan, which looks for gastric mucosa in the
lower abdomen. Surgical resection is the best therapy.
Orthopedics
Always worry about gas
gangrene in any deeppenetrating
or dirty
wounds. Three days later,
the patient will be septic
with a tender, swollen
injury site with gas
crepitus. Treatment is large
doses of IV penicillin and
hyperbaric oxygen.
Common Adult Orthopedic Injuries
General Rules about Fractures
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When you suspect a fracture, order 2 views at 90° to one another and always
include the joints above and below the broken bone.
··
Always x-ray other sites “in the line of force” (e.g., lumbar spine for someone
who falls and lands on the feet, hips in a patient who has been in a motor
vehicle accident with force of knees against the dashboard).
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