301.A 22-year-old college student presents to the ED with a painful,
swollen finger. He states that he was playing with a roommate’s dog and was
bitten 3 days earlier. On physical examination, his heart rate (HR) is 70 beats
per minute, blood pressure (BP) is 115/65 mm Hg, respiratory rate (RR) is
16 breaths per minute, and temperature is 101.6°F. Bilaterally, the radial
pulses remain equal, and the hands and fingers are intact to sensation. His
right second finger is held in flexion, and is symmetrically swollen from the
distal tip to the MCP joint. Both your attempt to extend the digit passively
and palpate the flexor tendon sheath produce great pain. Based on these
findings you make your diagnosis and notify the hand surgeon immediately.
What name is given to the criteria used to make the diagnosis?
a. Finkelstein
b. Trousseau
c. Tinel
d. Kanavel
e. Phalen
302.A 41-year-old office worker presents to the ED with pain in her right
wrist and fingers that is associated with a tingling sensation. The pain occa-
sionally awakens her from sleep and improves when the hand is shaken. She
recalls falling on her wrist 2 years ago while she was ice-skating. Her symp-
toms are reproducible when her wrist is held in flexion for 60 seconds.
Which of the following nerves is affected in patients with this syndrome?
a. Ulnar
b. Median
c. Axillary
d. Radial
e. Musculocutaneous
322 Emergency Medicine