Download surgery questions midterm and more Study notes Commercial Law in PDF only on Docsity!
Final General surgery
1. Postoperative pain can lead to the following EXCEPT: A. Fat embolism B. Myocardial infarction C. Bleeding D. Stroke 2. After abdominal surgery the sequence of bowel motility restoration is: (!!!) ❖ Small gut ❖ Stomach ❖ Right colon ❖ Left colon 3. Methods of mechanical hemostasis are all of the following EXCEPT: A. Vascular clamp Simple ligature (transfixion suture) Direct pressure applied by packs B. Application of the tourniquet C. Bipolar electrocautery D. Direct digital pressure over a bleeding site 4. Risk of postoperative myocardial infarction includes All of the following EXCEPT: A. Hypertension B. Hypotension C. Age under 30 D. Postoperative pain 5. Prevention of the postoperative thromboembolism includes all of the following measures EXCEPT: A. Compression stockings B. Low molecular weight heparin C. Early walking **D. Oxygen therapy
- Severe sepsis is differentiated from sepsis by:** A. Positive blood cultures for bacteria and fungs B. Acute organ failure such as renal insufficiency C. A history of the premotoid condition such as diabetes D. Prolonged arterial hypotension 7. Neurotmesis Is: A. Interruption of axonal continuity but preservation of Schwann cell basal lamina B. Complete transection of nerve C. Congenital absence of nerve D. Focal demyelination of nerve 8. Commonest cause of the Metabolic alkalosis in surgical patient is: A. Gastric outlet obstruction
B. Antacid therapy C. Steroid treatment D. Hyperventilation because of the head injury
9. The commonest cause of the metabolic alkalosis is: A. Pyloric stenosis B. Peptic ulcer C. Diuretics D. Small-bowel obstruction 10. Prevention of postoperative parotitis includes all of the following EXCEPT: A. Adequate fluid intake B. Good oral hygiene C. Preoperative fasting D. Stimulation of salivary flow 11. All of the following points are true for the necrotizing fasciitis EXCEPT: A. Characterized by high mortality rate B. Treatment - Oral antibiotics C. Treatment - Removal of all necrotized skin and fascia D. Is caused by the septic thrombosis of the vessels 12. Treatmet of superficial wound infection is: A. Removal of drains B. Oral steroids C. Heparin ointment **D. Opening the small segment of incision and draining of purulent content
- A postoperative patient with a potassium of 2.9 is given 1 mEq/kg replacement** with potassium chloride. Repeat tests after the replacement show the sere 3.0. Most likely diagnosis is: A. Metabolic alkalosis B. Hypocalcemia C. Metaboloc acidosis **D. Hypomagnesemia
- Neurapraxia is:** A. Congenital absence of nerve B. Interruption of axonal continuity but preservation of Schwann cell basal lamina C. Focal demyelination of nerve D. Complete transection of nerve 15. Which of the following is the treatment of the hyperkalemia? A. Insulin and glucose
C. Oral steroids D. Removal of drains
22. Best vein for total parenteral nutrition is: A. Femoral B. Brachial C. Subclavian D. Saphenous 23. Preventing measures for the postoperative lung atelectasis are all of the following EXCEPT: A. Swan-Ganz catheter B. Splinting of wound when coughing C. Incentive deep breathing exercises D. Frequent change of patient's position 24. Immediate postoperative complications could be all of the following EXCEPT: A. Myocardial infarction B. Basal atelectasis C. Hemorrhage **D. Incisional hernia
- Major surgical procedures can be performed when platelet count is above:** A. 10,000/ μL B. 50,000/mL C. 75,000/ μL D. 25000/ μL 26. Which of the following is an important mediator of wound healing? A. α-interferon B. TGFα C. β-Defensin D. Interleukin 12 27. Elective cholecystectomy is: A. Dirty B. Clean C. Contaminated **D. Clean contorninated
- Blood loss during surgery is best estimated by: (V)** A. Suction bottles. B. Cardiac output by thermodilution
C. Doppler ultrasound D. Visual assessment
29. A chronic pain of an healed wound can be caused by: A. Occult incisional hernia B. Scare formation C. Peritonitis D. Vitamin B12 deficiency 30. A chronic pain of an healed wound can be caused by: A. Stitch abscess or granuloma B. Pneumonia C. Dehydration D. Petitonitis 31. A chronic pain of an healed wound can be caused by: A. Peritonitis B. Urticaria C. Respiratory failure **D. Nerve entrapment in suture
- Which of the following is the lardest fluid compartment in the body?** A. Plasma B. Intracellular fluid C. Interstitial fluid D. Central spinal fluid 33. The following drug shoul be discontinued prior to surgery A. Prednisolone B. Antibiotic C. Warfarin D. Insulin 34. How many calories per day are required to maintain basal metabolosm in a healthy adult? A. 10-15 kcal/kg/day B. 20-25 kcal/kg/day C. 30-35 kcal/kg/day D. 40-45 kcal/kg/day 35. Wound reepithelisation occurs by: A. Covering the granulation tissue with epithelial cells migrating from wound edges B. Replacement of epithelium with connective tissue (scar) 36. There is a risk of dangerous internal bleeding when platelet count is: A. <100,000/μL B. <10,000/μL C. <150,000/μL
D. Lung atelectasis
44. Treatment options of gastric dilation includes following: A. Gastrectomy B. Sellick's maneuver C. Antibiotics D. Diuretics 45. Keloids are characterized by the following points EXCEPT: A. Rive above the skin level as well, but extend beyond the border of the original wound B. Often regress over time C. Is more common in darker pigmented ethnicities, with individuals of African, Spanish, and Asian ethnicities D. Excision alone of keloids is subject to a high recurrence rate, ranging from 45 to 100% 46. The main peculiarity of fetal wound healing is: A. Absence of scarring B. Excess healing C. Stow healing D. Absence of healing 47. Acute is a wound which heals earlier then: A. 10 weeks B. 3 months C. 2 months **D. 6 weeks
- During remodeling phase of wound healing the tensile strength of the scar** tissue gradually increases because of: A. Collagen type Ill is gradually replaced by stronger type I collagen B. Number of blood vessels in the scar is reduced C. The fibroblasts start to disappear D. Scar shrinkage 49. Symptoms of a superficial wound infection are EXCEPT: A. Hyperthermia B. Hyperemia C. Wound swelling **D. Vomitus
- Which method is NOT used for the treatment of the postoperative seroma:** A. Compression dressing B. Evacuation by needle aspiration C. Exploration in the operating room and ligation of lymphatic vessels
D. Diuretic administration
51. First line treatment in an adult with idiopathic thrombocytopenic purpura includes A. Retuximan B. IV immunoglobulin C. Desmopressin D. Splenectomy 52. Prevention of postoperative pneumonia includes: A. Maintaining the airway clear of secretions B. Early oral feeding C. Suppressing the cough D. Liquid diet 53. Prevention of postoperative pneumonia includes: A. Administration of diuretics B. Liquid diet C. Encourage coughing D. Plasma transfusion 54. Folowing factors affect wound healing EXCEPT: A. Antibiotics B. Hypoperfusion of tissues C. Advanced age D. Steroid use 55. Wounds could be classified as all of the following EXCEPT: A. Mechanical B. Caused by radiation C. Thermal **D. Congenital
- What percentage of the body is made up of water?** A. 30-40% B. 70-80% C. 10-20% **D. 50-60%
- Shaving of the operative field is recommended:** A. Before hospitalization at patients home **B. Immediately before the operation
- Best scars are seen in:** A. Infants B. Children C. Very old people D. Adults
D. Urine output
66. Delayed wound healing is expected in following patient group: A. Receiving large doses of ascorbic acid B. Diabetes mellitus C. Constipation D. Wrestlers 67. Delayed wound healing is expected in following patient group: (Preoperative care II) A. Protein depletion B. Receiving large doses of corticosteroids C. Epilepsy D. Chemotherapy 68. High risk of thromboembolism has a patient with all of the following condition EXCEPT: A. Cancer B. Obesity C. Myocardial infarction **D. INR>2.
- In the usual preparation for general surgery, the patient may be:** A. Given specifically ordered oral medications with couple glasses of water B. Given ice chips C. NPO for 12 to 14 hours before D. Allowed to brush teeth and swallow water 70. All vegetative bacteria and most resistant dry spores are destroyed by the following methods of sterilization EXCEPT: A. Autoclaving B. Dry heat C. Ethylene oxide gas **D. Boiling
- Which of the following can be used to mitigate cortisol effects on wound healing?** A. Vitamin E B. Vitamin A C. Vitamin B D. Vitamin C 72. Transfusion therapy means the intravenous administration of all the following fluids EXCEPT: A. Plasma B. Red blood cells C. Ringer-Lactate solution
D. Cryoprecipitate
73. Delayed wound healing is NOT associated with the following: A. Receiving large doses of corticosteroids B. Pneumothorax C. Protein depletion D. Chemotherapy 74. The following points are tue for Split-thickness skin graft EXCEPT: A. Is harvested using dermatomes B. Needs vascular anastomosis for blood supply C. Consists of epidermis and part of dermis D. May be "meshed" to cover larger area 75. Signs of postoperative wound hematoma are all of the following EXCEPT: A. Blood leakage between stitches B. Vomitus C. Discoloration of the wound edges D. Swelling of wound area 76. Wound heals by secondary intention when: A. Wound edges are separated B. The wound is suture C. Incised or cut wounds D. There is no infection 77. Early postoperative complications are all of the following EXCEPT: A. Pneumonia B. Urinary tract infection C. Keloid formation D. Postoperative wound infection 78. Which of the following conditions is NOT a risk factor for the wound dehiscence: A. Corticosteroids B. Arterial hypertension C. Obesity D. Microcirculatory disorders diabetes Melius., uremia. Immunosuppression. jaundice. sepsis. hypoalbuminemia., cancer 79. Failure of healing of the gastrointestinal wall sutures could lead to the following complications EXCEPT: A. Peritonitis B. Intrastiominalabscees C. Fistula formation
87. Treatment options of gastric dilation includes following: A. Opioids B. Antibiotics C. Steroids **D. Decompression with nasogastric tube
- Pulmonary aspiration could be caused by:** A. Sellik's maneuver B. Preoperative fasting C. Tracheal intubation **D. Head down position
- Phases of bone healing are all of the following EXCEPT:** A. Soft callus formation B. Remodeling C. Hard callus formation **D. Epithelisation
- Hemophilia C is caused by deficiency of** A. Factor XI B. Factor X C. Factor VIll D. Factor IX 91. Autoclaving parameters are: A. 2 atm ( o C) 45 min B. 11atm ( o c) 25 min C. 1 atm (100oC) 15 min **D. 2 atm (121oC) 15 min
- The correct sequence of management for nonemergency cases is:** ❖ History ❖ Physical examination ❖ Laboratory & instrumental examination ❖ Treatment & Follow-Up 93. Joseph Lister, british surgeon was a pioneer of: A. Plastic surgery B. Anatomy C. Anesthesia D. Antiseptics
94. Most frequent sequence of patient transfer after surgery is: ❖ Operating room ❖ Post-anesthesia care unit ❖ Ward ❖ Home 95. Examples of deep wound infections are following EXCEPT: A. Abscess in the Douglass pouch B. Abscess under the axillary skin C. Abscess under diaphragm D. Abscess under fiscal 96. For most elective (nonemergency) cases the correct sequence of patient management is: 1. History 2. Physical examination 3. Laboratory & instrumental examination 4. Treatment & follow-up 97. Wound heals by secondary intention during following circumstances EXCEPT: A. The wound is infected B. Wound is clean and sutured C. Wound is packed with sterile gauze D. Sutures are applied after granulation tissue formation 98. Folowing factors affect wound healing EXCEPT: A. Wound irrigation B. Diabetes mellitus C. Malnutrition D. Vitamin deficiencies 99. Folowing factors affect wound healing EXCEPT: A. Steroid use B. Hypoperfusion of tissues C. Advanced age **D. Antibiotics
- Folowing factors affect wound healing EXCEPT:** A. Cancer B. Cardiac failure C. Vitamins D. Chemotherapeutic antimetabolite drugs 101. Axonotmesis is:
❖ Temporary hemostasis ❖ Anesthesia ❖ Wound toilet ❖ Debridement/Definite hemostasis ❖ Proper approximation of wound edges ❖ Wound dressing
109. Compromised immune competence is expected in all of the following groups EXCEPT: A. Having joint dislocated B. Receiving corticosteroids C. Malnutrated patients D. Organ transplant recipients 110. Symptoms of Class III hypovolemia (loss of 30-40% of blood volume) are: A. Face hyperemia, bradycardia B. Dry mouth, normal pulse pressure C. Tachycardia and decreased pulse pressure but, normal BP (Class II) **D. Tachycardia, tachypnea, hypotension, oliguria, and changes in mental status
- A patient presents to the emergency room with a temperature of 39°C, heart** rate of 115, and respiratory rate of 25. There are no localised simptoms and the work-up does not reveal any specific source for fever. Which of the following best discribes the patient's condition? A. SIRS B. Septic shock C. Infectin D. Sepsis 112. Which of the following is an early ECG change seen in hyperkalemia? A. Flattened P wave B. Peaked T waves C. Sine wave formation D. Prolonged PR interval 113. Surgeon should receive an immunization to protect them from infection with A. Hepatitis A B. Hepatitis B C. Hepatitis C D. Human immunodeficiency virus No. Question Correct Answer 1 Phases of bone healing are all of the following EXCEPT: Epithelisation 2 Treatmet of superficial wound infection is: Opening the small segment of incision and 3 High risk of thromboembolism has a patient with all of the following condition EXCEPT: INR>2. 4 Examples of deep wound infections are following EXCEPT: Abscess under the axillary skin
5 Transfusion therapy means the intravenous administration of all the following fluids EXCEPT: Ringer-Lactate solution 6 A chronic pain of an healed wound can be caused by: Occult incisional hernia 7 Shaving of the operative field is recommended: Immediately before the operation 8 Autoclaving parameters are: 2 atm (121°C) 15 min 9 For most elective (nonemergency) cases the correct sequence of patient management is: 10 Folowing factors affect wound healing EXCEPT: Antibiotics 11 Symptoms of a superficial wound infection are EXCEPT: Vomitus 12 Following points are true for the necrotizing fasciitis EXCEPT: Treatment - Oral antibiotics 13 Neurapraxia is: Focal demyelination of nerve 14 Treatment options of gastric dilation includes following: Gastrectomy 15 Treatment of superficial wound infection is: Opening the small segment of incision and 16 Keloids are characterized by the following points EXCEPT: Often regress over time 17 A chronic pain of an healed wound can be caused by: Stitch abscess or granuloma 18 Which of the following studies is most helpful in evaluating a patient's risk for a routine operative procedure: History 19 Transfusion of one unit of RBCs generally increases hemoglobin level by: 1 g/dL 20 The correct sequence of management for nonemergency cases is: History 21 Major surgical procedures can be performed when platelet count is above: 75,000/μL 22 Methods of mechanical hemostasis are all of the following EXCEPT: Bipolar electrocautery 23 Pulmonary aspiration could be caused by: Head down position 24 Failure of healing of the gastrointestinal wall sutures could lead to the following complications EXCEPT: Intestinal obstruction 25 Immediate postoperative complications could be all of the following EXCEPT: Incisional hernia 26 Fresh frozen plasma is used for the all of the following conditions EXCEPT: Correct anemia 27 Postoperative pain can lead to the following EXCEPT: Fat embolism 28 Wound reepithelisation occures by: Covering the granulation tissue with epitheli 29 Which method is NOT used for the treatment of the postoperative seroma: Diuretic administration 30 Wound heals by secondary intention when: Wound edges are separated 31 There is a risk of dangerous internal bleeding when platelet count is: <10,000/μL 32 Delayed wound healing is NOT associated with the following: Pneumothorax 33 Most frequent sequence of patient transfer after surgery is: 34 Early postoperative complications are all of the following EXCEPT: Keloid formation 35 Which of the following conditions is NOT a risk factor for the wound dehiscence: Arterial hypertension 36 Adverse effects of opioids are all of the following Hypoglycemia
27 After abdominal surgery the sequence of bowel motility restoration is: 28 Delayed wound healing could be associated with all of the following conditions EXCEPT: Pneumothorax 29 The neck hematoma can cause: Airway obstruction 30 During the hemostasis phase of wound healing main cell type found in the wound is: Platelets 31 Neurotmesis is: Complete transection of nerve 32 All of the following points are true for the necrotizing fasciitis EXCEPT: Treatment - Oral antibiotics 33 Folowing factors affect wound healing EXCEPT: Vitamins 34 Risk factors for pulmonary aspiration of the gastric contents are EXCEPT: Lung atelectasis 35 The following points are tue for Split-thickness skin graftEXCEPT: Needs vascular anastomosis for blood supply 36 Symptoms of Class III hypovolemia (loss of 30-40% of blood volume) are:^ Tachycardia, tachypnea, hypotension, oliguria, and changes in mental status 37 Signs of postoperative wound hematoma are all of the following EXCEPT: Vomitus 38 Wound reepithelisation occurs by: Covering the granulation tissue with epitheli 39 All vegetative bacteria and most resistant dry spores are destroyed by the following methods of sterilization EXCEPT: Boiling 40 During the proliferation phase of wound healing the main cell type found in the wound is: Fibroblasts
General surgery
MIDTERM 1- 29.04.
1. Risk of the thromboembolism is increased in the patients with the following conditions EXCEPT: (Preoperative care II) A. Cancer B. Prior history of thrombosis C. Obesity *D. Parotitis
- Physical examination of the patient is the part of the: (Preoperative care I)** A. Objective examination B. Subjective examination 3. This question is not from the 'Wound healing' chapter. Delayed wound healing is NOT associated with the following: (Preoperative care II) A. Protein depletion B. Receiving large doses of corticosteroids C. Pneumothorax D. Chemotherapy 4. After surgery, convalescent period of recovery usually occurs in: (Postoperative care)
A. ICU
B. Patirnt's home C. Wards D. PACU
5. Gastric dilation is prevented by one of the following methods: (Postoperative complications II) A. Nasogastric tube placement B. Smoking casation C. Laxatives D. Preoperative low calory diet 6. Pulmonary aspiration is prevented by all of the following methods EXCEPT: (Postoperative complications I) A. Smoking cesation B. Selliks maneuver C. Preoperative fasting D. Proton pump inhibitor administration 7. For most elective (nonemergency) cases the correct sequence of patient management is: (Preoperative care I) 1. History 2. Physical examination 3. Laboratory & instrumental examination 4. Treatment & follow-up 8. Shaving of the operative field is recommended: (Preoperative care II) A. Before hospitalization at patients home **B. Immediately before the operation
- The sterilization device is: (Preoperative care II)** A. Cleaner B. Boiler C. Autoclave D. Steamer 10. General medical state ASA1 means: (Preoperative care I) A. Mild diseases only without substantive functional limitations. B. Healthy, non-smoking, no or minimal alcohol use C. Constant threat to life D. Not expected to survive without the operation
