Block 1-2 Flashcards
Who developed the first cardiac catheterization procedures for diagnosis of cardiac diseases?
Werner Forssman
•Werner Forssman -Cardiac Catheterization (1956)
•Dr. Christiaan Bernard -First successful heart transplant in 1967
•Dr. Michael DeBakey -Developed artificial artery for arterial bypass operations
•Joseph Muray -Kidney organ transplantation in 1954 Trans1.1
Which of the following statements is false about the Fabrica by Vesalius which was published in 1543?
It was the first textbook of anatomy published
Which is the earliest known document about surgery?
Edwin Smith papyrus
The development of asepsis was one of the most important advances in surgery, was primarily due to the work of:
Joseph Lister
In the middle ages, which of the following problems did not hamper the growth of surgery?
Nutrition
What is the role of the French physiologist Claude Bernard in the development of surgery?
Bernard’s physiologic concepts and experiments led to our understanding of the body’s internal regulating systems
who was the first president of the philippine college of surgeons and what year was the association founded?
Gregorio Singian, 1935
The physician during 2nd century AD whose teachings were accepted as dogma by his followers so that ni advances in medicine were made for the next 1,500 year is:
galen
what type of suture is polyglactin?
Absorbable synthetic
Which of the following statements is correct concerning electrocautery?
A bipolar cautery is more precise and usually confines the damage to the tissue between the tips of cauterizing forceps.
Sump suction drainage is best required in:
enteric fistula
The operating room (OR) should provide an environment that is as free of bacterial contamination as possible. This is achieved by:
use of high efficiency particulate filters that can remove bacteria
The primary credit for the development of general anesthesia is given to:
Crawford Long
The credit for the development and use of extracorporeal circulation is attributed to:
John Gibbon
Polyglactic acid:
absorbable suture
Cyanoacrylate
not a suture
Polypropelene
non-absorbable suture
Which of the following statement is true about William Halstead?
He began a residency training that trained generation of surgeons for academic positions
Nobel prize was given to the physician for his work fundamental work on vascular anastomosis:
Carrel
Nobel prize was given to the physician for his pioneering work on renal transplantation
Murray
Water constitutes approximately what percentage of the total body weight?
50-60%
Intracellular water makes up approximately 40% of the person’s total body weight, with the largest proportion located in the?
Skeletal muscle
Which of the following has the highest percentage of water in proportion to total body weight?
Newborns
What is the most common fluid disorder in surgical patients and can either be acute or chronic?
Extracellular volume deficit
Which of the following is not a cation?
Chloride
Causes of Hyperkalemia except :
Hyperaldosteronism
Hyponatremia is associated with what?
Hyperglycemia
Hypernatremia is associated with:
Cushing’s Disease
Daily water losses include 250 ml in the stool and 1200 ml in the urine. What is the most approximate amount of insensible water loss?
600 ml
- The osmolality of both the intracellular and extracellular fluids is maintained between what amounts in each compartment?
290–310 mOsm
Cardiovascular signs of tachycardia and orthostasis accompanied by oliguria and hemoconcentration predominate with what type of volume loss?
Acute volume loss
What is the medication that causes hyperkalemia?
Spironolactone
Volume excess is a common disorder in the post-operative period. What is the earliest sign of volume overload?
Weight gain
All of the following statements are true
a. TBW is divided into three functional fluid
compartments
b. Sodium is the principal cation
Typical individual consumes approx. 3 to
5 g of dietary salt per day
The Classic Signs of Hypovolemic Hypernatremia include:
a. Hypotension
b. Orthostasis
c. Tachycardia
T/F. Superfeeding results from overestimation of caloric needs, as occurs when actual body weight is used to calculate the BEE in patient populations such as the critically ill with significant fluid overload and the obese.
False
T/F. Overfeeding increases oxygen consumption and suppression of leukocyte function.
True
Starvation cannot be tolerated for 10 days by patients.
False
T/F. Cessation of feeding should be stopped in a 4- to 6-hour period or abdominal distention 200ml or less residuals
True
T/F. The most abundant amino acid in the body is Glutamine.
True
- Which of the following solutions is usually considered to be the standard or first-line formulas for stable patients with an intact gastrointestinal tract and contain no fiber bulk?
Low residue isotonic formulas
Which of the following contain soluble and insoluble fiber which delay intestinal transit
time?
a. Isotonic formulas with fiber
Which of the following is fortified with special nutrients with additives such as Glutamine, Arginine and omega 3 fatty acids?
Immune enhancing formulas
- This is suitable for patients requiring fluid restriction or those unable to tolerate large- volume infusions:
d. Calorie–Dense Formulas
Contain predigested nutrients and provide proteins in the form of small peptides with ease of absorption:
Elemental formulas
Formula with low fluid volume and concentrations of potassium, phosphorus, and magnesium:
Renal Failure formulas
Formula with a fat content is usually increased to 50% of the total calories, with a corresponding reduction in carbohydrate content to reduce carbon dioxide production is:
a. Pulmonary Failure Formulas
- Close to 50% of proteins are branched-chain amino acids to reduce aromatic amino acid levels and increase the levels of branched- chain amino acids, which can potentially reverse encephalopathy. These are called:
Hepatic Failure Formulas
- Enteral feeding access is/are:
a. PEG tube
b. NGT
d. Gastrostomy
What is the enteral feeding access that is used for short term but with high risk for aspiration?
NGT
What is given through continuous infusion of a hyperosmolar solution containing carbohydrates, proteins, fat, and other necessary nutrients through an indwelling central line catheter?
d. Parenteral Nutrition
What is the type of nutritional feeding that requires access to a large-diameter vein to deliver the entire nutritional requirements of the individual?
Total Parenteral Nutrition
Which of the following vitamins is water soluble?
Vitamin C
Which of the following is a long term complication of parenteral nutrition?
Sepsis thru catheter
What is the complication of parenteral nutrition
that that is due to lack of intestinal stimulation,
reduced IgA production and bacterial
overgrowth?
Intestinal atrophy
Which of the following statements with regard to diathermy is false?
Shave the patient’s hair over the site for the diathermy plate the day before the operation.
In scrubbing, which of the following statement is false?
The first scrub of the day should take about 3 min from start to drying.
Which of the following statements regarding D5 0.9% normal saline is true?
It has equimolar concentration of
sodium and chloride.
Severe post-traumatic response is detrimental. This can be modified by:
careful use of epidural anesthesia instead of general anesthesia
The operating room (OR) should provide an environment that is as free of bacterial contamination as possible. This is achieved by:
use of high efficiency particulate filters that can remove bacteria
The operating room (OR) should provide an environment that is as free of bacterial contamination as possible. This is achieved by:
use of high efficiency particulate filters that can remove bacteria
What is the most important cause when errors and complications occur in health care?
Communicate failures or losses
National Quality from “never events” include:
Retained surgical items
What is an example of patient’s disease and its complication?
Post-operative abscesses following perforated viscus repair
The failure of communication is therefore a common etiology for what?
Poor quality control
What is an error that does not result in patient’s harm?
Near Miss
Who is the primary physician provider for surgical patients during management of their disease process?
Surgeons
- What is the science that promotes the use of evidence –based medicine to minimize the impact of human error on delivery of services?
Patient’s Safety
whatis a sentinel event?
Injury involves loss of limb or Function
What is the core concept of any effective organization that is the key element to ensuing patient’s safety in the operating room?
Strong Teamwork
whatis the main reason why patient contacts for all types of interactions should be recorded?
To provide optimal documentation in medical record
Checklist or Briefing:
Preprocedure discussion of requirement and special issues of the procedure
“How often are patients harmed?”
Outcome
Negligence
Care that falls below a recognized standard of care
Sign Outs:
dunno
what is a validated survey instrument that can be used to measure a health care setting?
Safety Altitude Questionnaire
What is the most common cause of lawsuits in surgery
Failure to diagnose or delayed diagnosis
- What is the injury caused by medical management rather than the underlying condition of the patient?
Adverse Event
What is the most important risk factor for Retained Surgical Sponges?
Multiple procedures performed on
same patient
What is the most important process that must be included in the Operating Room briefing?
Error prone evaluation
What is the model that identifies three main types of improvements in structure, process and outcome?
Donabedian Model
A 70-kg -man with a laceration to the brachial artery loses a total of 800 mL of blood. What ACS (American College of Surgeons) class of hemorrhage would this represent?
Class II hemorrhage - 750-1500 mL
Glasgow Coma Scale is very useful in evaluating of consciousness. Which of the following findings is consistent with the score of 8?
eye opening to pain(2), inappropriate words(3), decorticate posture(3) = 8
Surgical exploration of the neck in trauma is indicated in:
A. radiographic evidence of narrowed mediastinum B. expanding pulsatile hematoma
C. sucking neck wound
A 24 year old male patient was hit by fast moving car. In the emergency room of a hospital, initial physical examination revealed that the patient was disoriented, there was eye opening on verbal stimulation, but obeys commands. Based on the initial GCS, after two hours the patient’s GCS decreased by 3 points. The right pupil became bigger by 2 mm than the left pupil and weakness was noted on the left arm. The injury is most likely due to:
epidural hematoma
A 30 year old female was brought to the emergency room after sustaining injuries to the head after being punched. She opens her eyes with painful stimuli (2), is confused (4), and localizes pain (5). What is the Glasgow Coma Score?
11
A non bleeding stab wound in the anterior triangle of the neck that has penetrated the platysma should be explored in order not to miss ocult injury even with stable vital signs.
True
A patient arrives in the ER following a severe vehicular accident with multiple injuries. Hypotension in this patient is defined as systolic blood pressure less than:
110
What are the “ABC’s” of the primary survey
Airway, Breathing, Circulation
Which of the following statements is correct about nasotracheal intubation?
is preferred for the unconscious patient without cervical spine injury
Paradoxical rib motion in flail chest will least likely produce: *
Increased alveolar oxygen level
Findings suggestive of major vascular injury:
R pupil 4mm, L pupil 2mm, weakness L upper extremity
In Von Willebrand’s disease
platelet function is depressed
What Glasgow coma scale is considered as moderate head injury? *
10
What is the most common indication for intubation in a trauma patient?
altered mental status
