SAQ 617 – General Surgery – vomiting with shock and abnormal abdominal X-ray

A 65-year-old man with no significant past medical or surgical history is brought to the emergency department by his wife after three days of vomiting. His vital signs and X-ray are shown below.

Observation	Result
HR	120 bpm
BP	80/50 mmHg
RR	28 /min
O2 saturation	95% room air
Temperature	38.6 degrees C
GCS	14 (E3 V5 M6)

State three (3) important steps in managing his shock.

(Marked out of 3.0)

/ 3

State three (3) abnormalities on the X-ray and give one (1) significance for each.

(Marked out of 3.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Abnormality</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Significance</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">1.</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">2.</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">3.</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 3

List two (2) important differential diagnoses causing the above findings.

(Marked out of 2.0)

/ 2

His venous blood gas shows moderate lactic acidosis. State the Cohen-Woods classification for lactic acidosis and one cause for each group.

(Marked out of 2.0)

/ 2

Total Score: 0 / 10

Percentage: 0%