This Week’s EMCQs – Week 6

QUESTION 1

A 65-year-old female presents with epigastric pain, vomiting and melena for 2 days.

Her abdominal X-ray is replicated below:

Xray abdomen 6-1

Which one of the following options is TRUE?

A: Free air is present under the diaphragm

B: Extra luminal air is present

C: There is evidence of bacterial peritonitis

D: Intussusception is likely

A: Free air is present under the diaphragm

B: Extra luminal air is present (Correct answer)

C: There is evidence of bacterial peritonitis

D: Intussusception is likely

Commentary

Rigler’s sign positive. Ligamentum teres outlined by gas. No free air under diaphragm.

QUESTION 2

Which one of the following is the most common carpal bone to fracture in young men?

A: Lunate

B: Pisiform

C: Trapezoid

D: Triquetrum

A: Lunate

B: Pisiform

C: Trapezoid

D: Triquetrum (Correct answer)

Commentary

Most common isolated carpal bone fractures are of the scaphoid which account for 82-89% of all carpal bones. Most other isolated carpal fractures are Triquetral fractures.

Reference: Textbook of adult emergency medicine, Cameron P et al, 4th edition. Page 177.