Block 1-2 Flashcards
1
Q
Who developed the first cardiac catheterization procedures for diagnosis of cardiac diseases?
A
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
2
Q
Which of the following statements is false about the Fabrica by Vesalius which was published in 1543?
A
It was the first textbook of anatomy published
3
Q
Which is the earliest known document about surgery?
A
Edwin Smith papyrus
4
Q
The development of asepsis was one of the most important advances in surgery, was primarily due to the work of:
A
Joseph Lister
5
Q
In the middle ages, which of the following problems did not hamper the growth of surgery?
A
Nutrition
6
Q
What is the role of the French physiologist Claude Bernard in the development of surgery?
A
Bernard’s physiologic concepts and experiments led to our understanding of the body’s internal regulating systems
7
Q
who was the first president of the philippine college of surgeons and what year was the association founded?
A
Gregorio Singian, 1935
8
Q
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:
A
galen
9
Q
what type of suture is polyglactin?
A
Absorbable synthetic
10
Q
Which of the following statements is correct concerning electrocautery?
A
A bipolar cautery is more precise and usually confines the damage to the tissue between the tips of cauterizing forceps.
11
Q
Sump suction drainage is best required in:
A
enteric fistula
12
Q
The operating room (OR) should provide an environment that is as free of bacterial contamination as possible. This is achieved by:
A
use of high efficiency particulate filters that can remove bacteria
13
Q
The primary credit for the development of general anesthesia is given to:
A
Crawford Long
14
Q
The credit for the development and use of extracorporeal circulation is attributed to:
A
John Gibbon
15
Q
Polyglactic acid:
A
absorbable suture
16
Q
Cyanoacrylate
A
not a suture
17
Q
Polypropelene
A
non-absorbable suture
18
Q
Which of the following statement is true about William Halstead?
A
He began a residency training that trained generation of surgeons for academic positions
19
Q
Nobel prize was given to the physician for his work fundamental work on vascular anastomosis:
A
Carrel
20
Q
Nobel prize was given to the physician for his pioneering work on renal transplantation
A
Murray
21
Q
Water constitutes approximately what percentage of the total body weight?
A
50-60%
22
Q
Intracellular water makes up approximately 40% of the person’s total body weight, with the largest proportion located in the?
A
Skeletal muscle
23
Q
Which of the following has the highest percentage of water in proportion to total body weight?
A
Newborns
24
Q
What is the most common fluid disorder in surgical patients and can either be acute or chronic?
A
Extracellular volume deficit
25
Which of the following is not a cation?
Chloride
26
Causes of Hyperkalemia except :
Hyperaldosteronism
27
Hyponatremia is associated with what?
Hyperglycemia
28
Hypernatremia is associated with:
Cushing’s Disease
29
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
30
30. The osmolality of both the intracellular and extracellular fluids is maintained between what amounts in each compartment?
290–310 mOsm
31
Cardiovascular signs of tachycardia and orthostasis accompanied by oliguria and hemoconcentration predominate with what type of volume loss?
Acute volume loss
32
What is the medication that causes hyperkalemia?
Spironolactone
33
Volume excess is a common disorder in the post-operative period. What is the earliest sign of volume overload?
Weight gain
34
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
35
The Classic Signs of Hypovolemic Hypernatremia include:
a. Hypotension
b. Orthostasis
c. Tachycardia
36
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
37
T/F. Overfeeding increases oxygen consumption and suppression of leukocyte function.
True
38
Starvation cannot be tolerated for 10 days by patients.
False
39
T/F. Cessation of feeding should be stopped in a 4- to 6-hour period or abdominal distention 200ml or less residuals
True
40
T/F. The most abundant amino acid in the body is Glutamine.
True
41
41. 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
42
Which of the following contain soluble and insoluble fiber which delay intestinal transit
time?
a. Isotonic formulas with fiber
43
Which of the following is fortified with special nutrients with additives such as Glutamine, Arginine and omega 3 fatty acids?
Immune enhancing formulas
44
44. This is suitable for patients requiring fluid restriction or those unable to tolerate large- volume infusions:
d. Calorie–Dense Formulas
45
Contain predigested nutrients and provide proteins in the form of small peptides with ease of absorption:
Elemental formulas
46
Formula with low fluid volume and concentrations of potassium, phosphorus, and magnesium:
Renal Failure formulas
47
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
48
48. 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
49
49. Enteral feeding access is/are:
a. PEG tube
b. NGT
d. Gastrostomy
50
What is the enteral feeding access that is used for short term but with high risk for aspiration?
NGT
51
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
52
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
53
Which of the following vitamins is water soluble?
Vitamin C
54
Which of the following is a long term complication of parenteral nutrition?
Sepsis thru catheter
55
What is the complication of parenteral nutrition
that that is due to lack of intestinal stimulation,
reduced IgA production and bacterial
overgrowth?
Intestinal atrophy
56
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.
57
In scrubbing, which of the following statement is false?
The first scrub of the day should take about 3 min from start to drying.
58
Which of the following statements regarding D5 0.9% normal saline is true?
It has equimolar concentration of
sodium and chloride.
59
Severe post-traumatic response is detrimental. This can be modified by:
careful use of epidural anesthesia instead of general anesthesia
60
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
61
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
62
What is the most important cause when errors and complications occur in health care?
Communicate failures or losses
63
National Quality from “never events” include:
Retained surgical items
64
What is an example of patient’s disease and its complication?
Post-operative abscesses following perforated viscus repair
65
The failure of communication is therefore a common etiology for what?
Poor quality control
66
What is an error that does not result in patient’s harm?
Near Miss
67
Who is the primary physician provider for surgical patients during management of their disease process?
Surgeons
68
67. 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
69
whatis a sentinel event?
Injury involves loss of limb or Function
70
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
71
whatis the main reason why patient contacts for all types of interactions should be recorded?
To provide optimal documentation in medical record
72
Checklist or Briefing:
Preprocedure discussion of requirement and special issues of the procedure
73
“How often are patients harmed?”
Outcome
74
Negligence
Care that falls below a recognized standard of care
75
Sign Outs:
dunno
76
what is a validated survey instrument that can be used to measure a health care setting?
Safety Altitude Questionnaire
77
What is the most common cause of lawsuits in surgery
Failure to diagnose or delayed diagnosis
78
77. What is the injury caused by medical management rather than the underlying condition of the patient?
Adverse Event
79
What is the most important risk factor for Retained Surgical Sponges?
Multiple procedures performed on
same patient
80
What is the most important process that must be included in the Operating Room briefing?
Error prone evaluation
81
What is the model that identifies three main types of improvements in structure, process and outcome?
Donabedian Model
82
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
83
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
84
Surgical exploration of the neck in trauma is indicated in:
A. radiographic evidence of narrowed mediastinum B. expanding pulsatile hematoma
C. sucking neck wound
85
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
86
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
87
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
88
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
89
What are the “ABC’s” of the primary survey
Airway, Breathing, Circulation
90
Which of the following statements is correct about nasotracheal intubation?
is preferred for the unconscious patient without cervical spine injury
91
Paradoxical rib motion in flail chest will least likely produce: *
Increased alveolar oxygen level
92
Findings suggestive of major vascular injury:
R pupil 4mm, L pupil 2mm, weakness L upper extremity
93
In Von Willebrand’s disease
platelet function is depressed
94
What Glasgow coma scale is considered as moderate head injury? *
10
95
What is the most common indication for intubation in a trauma patient?
altered mental status
96
A male medical student slipped and accidentally fell from a 4 storey boarding house building. He was brought immediately to the emergency room of Iloilo Doctors Hospital. He had multiple fractures in both lower extremity and possibly had compression fracture in the lumbar spines. Initial survey showed that the patients was not breathing. What is the most appropriate and immediate action?
cricothyroidotomy
97
A 2 year old female infant came in the emergency room severely dehydrated because of severe diarrhea. The patient was pale, cold and lethargic. The patient was having tachycardia, barely perceptible pulse, sunken eyeballs. Attempt at IV access was unsuccessful. What should be done next?
intraosseous catheter insertion
98
Which of the following is required for platelet adherence to exposed areas of an injured blood vessel?
von Willebrand factor
99
Hemophilia C is caused by a deficiency of:
D. Factor XI
100
Trauma is the most common cause of death for all individuals between the ages of 1 and 44 years In USA?
TRUE
101
Following blunt or penetrating trauma to the chest, it is NOT indicated to do an open Thoracotomy in:
flail chest
102
Of the following positions, which is preferred for the patient suffering from hypovolemic shock?
patient supine with elevation legs only
103
Prompt correction of fluid deficit is essential in treating patients suffering from septic shock. The preferred intravenous fluid to be used is:
balanced salt solution
104
The most frequent source of gram negative infections in hospitalized patients is:
C. genito-urinary system
105
Which of the following statements concerning the use of steroids in the treatment of septic shock is incorrect?
steroids may protect the cells from endotoxins
106
Neurogenic shock is characterized by the presence of:
warm skin
107
For control of pain in shock states, the preferred route of administration narcotic analgesic is:
intravenous
108
This is not a characteristic of a fully developed hypovolemic shock:
bradycardia
109
The earliest manifestations of serious gram negative infections include
tachypnea, hypotension and altered sensorium
110
A patient has a blood pressure of 70/50. Cardiac output is 1.9 liters/min and CVP is 2 cm water. What is the most likely diagnosis?
B. cardiogenic shock
111
Hemophilia B is a deficiency in:
IX
112
A 30 year old man was stabbed in the epigastric area. In the emergency room, his blood pressure is 80/50mm hg and his neck veins are distended. He is most likely bleeding into the:
peritoneal cavity
113
Which of the following drugs used to treat cardiogenic shock has effect on Beta receptors only?
dobutamine
114
A 20 year old man was stabbed causing a laceration of his right femoral artery. Upon arrival to the emergency room the estimated blood loss of the patient is about 900 cc. What class of hemorrhage does the patient belong?
Class II
115
As thrombin generation proceeds, the body has natural anticoagulant systems that oppose further thrombus formation. Which of the following is not a natural anticoagulant?
activated protein C
116
Which of the following statements is correct concerning neurogenic shock?
cardiac function is depressed regardless of the level of injury
117
If an abnormal PTT (partial thromboplastin time) is detected, what part of the clotting mechanism is involved?
intrinsic pathway
118
The clotting factor which is not present in stored plasma is:
factor V
119
The clotting factor which is not present in stored plasma is:
factor V
120
Prothrombin time could not be used to evaluate the following clotting factor. *
D. Factor IX
121
A potential bleeder is best identified by:
complete history and physical examination
122
The mode of inheritance of Hemophilia A is:
sex linked recessive
123
Which of the following is most likely to be transmitted by blood transfusion? *
viral hepatitis
124
The important aspect of blood compatibility is: *
D. donor cell compatible with patient’s serum
125
The following is NOT a complication of massive blood transfusion.
a leftward shift in the oxyhemoglobin dissociation curve
126
Vitamin K is necessary for the formation of:
prothrombin
127
Hemolytic transfusion reaction occurring in a patient undergoing major surgery is most often suspected on the basis of :
hemoglobinuria
128
A patient has a blood pressure of 70/50. Cardiac output is 1.9 liters/min and CVP is 2 cm water. What is the most likely diagnosis?
cardiogenic shock
129
Which of the blood clotting factors is NOT synthesized by the liver?
factor VIII
130
What is the he most common cause of abnormal bleeding encountered in surgical patients?
congenital bleeding disorders
131
A 24 year old male patient had a big bruise on the anterior thigh after colliding with a player during a basketball game. After evaluation and reviewing the family history, the attending physician suspected a bleeding problem. The factor VIII level of 8% was obtained. This is considered as:
mild hemophilia
132
A 70 kg man receives one unit of platelet transfusion. What is the most likely increase in the circulating platelet count?
10,000
133
Following caustic injury to the skin with an alkaline agent the affected area should initially be
Treated with running water or saline for 2 hours
134
The area most amenable to salvage by resuscitative and wound management techniques following thermal injury is called
Zoneofstasis
135
Tissue ischemia resulting in wounds that area characterized as partial –thickness injury with blister formation is
SecondDegree
136
54.A 3mm basal cell carcinoma (BCCA) of the skin should be treated with *
excision with 2 to 4 mm margin
137
Trichilemmal cysts
c.are typically found in the scalp of females
138
56.More than half of patients treated for BCCA will experience a recurrence within *
3 years
139
57.The primary risk factor for the development of squamous cell carcinoma ( SCCA ) is *
UV exposure
140
58.In the ABCDE of melanoma , the D stands for diameter greater than *
c.6mm
141
The most common distant metastasis for melanoma is
lung
142
The most common subtype of melanoma is
superficial spreading
143
61.A 22 year old man is brought to the emergency room after a house fire. He has burns around his mouth and his voice is hoarse , but breathing is not labored. What is the most appropriate next step is:
Immediate endotracheal intubation
144
62.What percentage burn does a patient have who has suffered burns to 1 lower extremity (circumferential) and the anterior trunk ? *
36%
145
63.Which of the following is a common sequelae of
electrical injury ? *
brain damage
146
An 8 year old boy was brought to the ER after accidentally touching a hot iron with his forearm . On examination , the burned area was weeping blisters and is very tender to the touch . What is the burn depth ?
Second degree
147
Which of the following is FALSE regarding silver sulfadiazine ?
safe to use on full and partial thickness burn wounds , as well as skin grafts
148
66.Successful antibiotic penetration of a burn eschar can be achieved with
Silver sulfadiazine
149
67.A 14 year – old girl sustains a steam burn measuring 10 x12 cm over the ulnar aspect of her right forearm . Blisters develop over the entire area of the burn wound , and by the time the patients was seen 6 hours post injury some of the blisters have ruptured spontaneously . All of the following therapeutic regimens might be considered appropriate for this patient EXCEPT
Heterograft application with sutures to secure it in place and daily wound care
150
A forty two year old 70 kg man sustained multiple flame burns which includes superficial partial thickness burns in the face and neck , circumferential full thickness burn in both upper extremities except the hands , deep partial thickness burn in the anterior aspect of both lower extremities and superficial partial thickness burn half of anterior trunk. What is the the extent of total body surface area involve *
54
151
A forty two year old 70 kg man sustained multiple flame burns which includes superficial partial thickness burns in the face and neck , circumferential full thickness burn in both upper extremities except the hands , deep partial thickness burn in the anterior aspect of both lower extremities and superficial partial thickness burn half of anterior trunk. What is the total fluid requirement for 24 hours? *
15.12 L
152
A forty two year old 70 kg man sustained multiple flame burns which includes superficial partial thickness burns in the face and neck , circumferential full thickness burn in both upper extremities except the hands , deep partial thickness burn in the anterior aspect of both lower extremities and superficial partial thickness burn half of anterior trunk. What is the fluid requirement in the first 8 hours?
7.56 L
153
A forty two year old 70 kg man sustained multiple flame burns which includes superficial partial thickness burns in the face and neck , circumferential full thickness burn in both upper extremities except the hands , deep partial thickness burn in the anterior aspect of both lower extremities and superficial partial thickness burn half of anterior trunk. What is the fluid rate for the first 8 hours? *
945 cc /hour
154
A forty two year old 70 kg man sustained multiple flame burns which includes superficial partial thickness burns in the face and neck , circumferential full thickness burn in both upper extremities except the hands , deep partial thickness burn in the anterior aspect of both lower extremities and superficial partial thickness burn half of anterior trunk. What is the fluid requirement in the next 16 hours
7560cc
155
Formulas for fluid resuscitation in burn patients *
evans, slater, brooke
156
A technique in removing burn eschar in layers until all of the necrotic tissue has been excised and a viable bed is present
debridement
157
Which of the following types of melanoma has equal predilection in Caucasian Americans and African Americans?
Acral lentiginous melanoma
158
p photograph since birth. The lesion first became raised at puberty, and she is concerned about its appearance. This patient should be informed that she is at 10 % increased risk for development of
melanoma
159
Histologic examination of a biopsy specimen of an expanding hemangioma is most likely to show
anomalous vasculature
160
Mohs’ micrographic surgery is most appropriate in the management of which of the following types of basal cell carcinoma?
Sclerosing
161
The most sensitive sign in hypovolemic shock is:
tachycardia
162
Which level of the axillary lymph nodes is not included in the axillary dissection *
3
163
When doing a modified radical mastectomy, the base should include
Pectoralis major fascia
164
A 9 year old complained of a tender mass on the periareolar area, you suggest
Ultrasound
165
A 25 year old female complained of a tender not well circumscribed doughy mass on the left upper outer quadrant of the breast a week prior to menses on tele-consult, you suggest
Self breast exam
166
A 30 year on breast feeding suddenly noted pain, swelling and errythema on the left breast, the first thing that should be done is
b. Stop breastfeeding on involved breast
167
The gold standard in the ancillary diagnostics for breast cancer is
Mammogram
168
A 50 year old female complained of a 2 cm well-circumscribed movable on-tender mass on the right upper outer quadrant of the breast, you recommend
Mammogram
169
The development of the breast during puberty is the response to
Increase production of estrogen
170
A 25 year old female complained of a 5 cm fluctuant tender mass on the peri-areolar area noted three days prior to menses, this is managed by *
Incision and drainage
171
20 year old complained a 4 cm well circumscribed movable non-tender mass on the lower quadrant of the left breast, you recommend
Ultrasound
172
50 year old complained of bloody nipple discharge, this is most likely
Ductal papilloma
173
After undergoing excision biopsy, the patient noted a tender cord like structure at the proximity of the incision site, you recommend
Re-excision
174
A 35 year old had a needle biopsy of her 7 cm mass which showed high stromal activity and cellular anaplasia and leaf like clefts. Management is *
Wide Excision
175
32 year old female diagnosed to have cStage III-B invasive ductal carcinoma, triple negative tumor, this is best managed by
Neo-adjuvant radiothrapy
176
34 year old presented with a 2 cm right breast mass with a palpable axillary lymph node on the same side, with mammogram findings of clustered micro-calcification on the mass biopsy is done by
Ultrasound guided core needle biopsy of the breast mass
177
Which is NOT part of breast conservation surgery for breast cancer (QuARt)
Chemotherapy
178
70 year old female diagnosed to have Invasive Ductal Carcinoma pStage II-B, ER/PR- positive; HER 2/Neu negative should receive what adjuvant treatment
Aromatase inhibitor
179
45 year old presented with a 3 cm mass on the right breast, no palpable axillary nodes, core needle biopsy showed Invasive ductal carcinoma, grade 2; Triple positive after neoadjuvant chemotherapy. What is the stage
Stage II-A
180
Gene assays like Oncotype DX are done as a predictor of
Recurrence
181
Which is a proliferation gene
. KI-67
182
Who is considered the Father of Modern Surgery?
Joseph Lister
183
In getting a urinalysis the expected microflora should be
Gram negative
Gram Positive
Anaerobe
None-answer
184
What prevents the bacteria to proliferate in the small intestines
Sucus entericus
185
What prevents the bacteria to proliferate in the small intestines
Sucus entericus
186
What is the largest host defense
Integument
187
An elevated errythematous tender mass was noted on the forearm with presence of axillary lymph nodes, this is considered
Loco-regional spread
188
In combatting the CORONA virus, we are recommended to do regular exercises and sleep at least seven hours a day, what factor is being addressed *
Host defence potency
189
After undergoing surgery for multiple gun shot wounds, at the Post anesthesia care (PACU) unit the patient had a T- 39 C, BP- 60/50, CR- 110/min, oliguria and Oxygen saturation of 89%. CBC showed; Hgb 10 and WBC of 20 The patient is having
Systemic inflammatory response syndrome
190
55 year old hypertensive diabetic was admitted because of non-healing wound on the left lower leg. Physical examination revealed a presence of purulent and brown-gray watery discharge with crepitus. Which organism is responsible for these findings *
Methicillin Resistant Staphylococcus aureus (MRSA)
191
Patient was seen at the Emergency Room because of dog bite on the face and arm, after doing local wound care and giving anti-rabies and anti-tetanus prophylaxis, these wounds should be closed
Secondary intention
192
Patient was brought to the emergency room with multiple abrasions on the knee, and arm due to a motorcycle accident, you would classify the wounds as class:
1
193
What class of wound does a patient undergoing open cholecystectomy for Acute Calculous Cholecycstitis
2
194
Prophylactic antibiotic should be administered
One hour prior to surgery
195
Patient undergoing excision of breast mass, choice of antibiotic is
No need
196
Which of the following is NOT true regarding the renin-angiotensin system?
Angiotensin I is converted to angiotensin II primarily in the kidney
197
Following acute blood loss, which of the following will NOT be elevated in the bloodstream?
insulin
198
Immediately after wounding, which of the following is not stimulated:
D. thyrotropin
199
Metabolic effects of neuroendocrine response to injury does NOT include: *
glycogen synthesis
200
Hormone receptors are present on or within the target cells and allow signal transduction to progress intracellularly through the following, except:
there is no exception
201
Cytokines are endogenous signals that mainly stimulate:
A. local cell proliferation within the wound
B. central nervous system to initiate fever C. production of acute phase proteins
202
The cytokine that oppose the inflammatory process after injury is:
Interleukin 10
203
Which of the following is NOT true about Eicosanoids?
secrete mainly by lymphocytes
204
The oxidative derivative of arachidonic acid via the lipooxygenase pathway eventually
produce:
leukotrienes and HETE
205
Protein loss after injury:
is commensurate with the protein catabolism needed to supply energy
206
Which of the following statement is correct regarding IL-1?
expression is autoregulated in part
207
During injury the skeletal muscle breakdown predominantly cause the liberation
of which amino acid?
Alanine
208
In “catabolic” surgical patients, which of the following changes in body composition do not
occur?
A. Lean body mass increases
209
The hormonal alterations that follow operation and injury favor accelerated gluconeogenesis. This new glucose is consumed by which of the following tissues?
D. Tissue in the healing wound.
210
Which of the following statements regarding cytokines is incorrect?
Platelet-activating factor (PAF) is a major cytokine that results in platelet aggregation, bronchoconstriction, and increased vascular permeability.
211
All of the following are the blood supply of the thyroid, except?
middle thyroid artery ( from the internal Carotid artery)
212
The left recurrent nerve arise from the vagus nerve and loops around to what structure?
Ligamentum Arteriosum
213
RLNs innervate all the intrinsic muscles of the larynx, except:
cricothyroid muscles
214
What is the 1st step in the process of thyroid hormone synthesis?
Iodide trapping
215
A phenomenon is which excessively large doses of iodide may lead to initial increased organification followed by suppression
Wolff-Chaikoff effect
216
Decreased TSH, Elevated T3 and T4
Primary hyperthyroidism
217
57. A 31 year old female underwent thyroid scan with 2 cm nodule at the right thyroid on Neck UTZ. The scan showed that the nodule trapped less radioactivity than the surrounding gland. What is the term for this nodule?
Cold Nodule
218
It is an antithyroid drug that is safe to be given in pregnant patient *
PTU
219
What medication you give to hypothyroid patient
Levothyroxine
220
Struma lymphomatosa is also known as?
Hashimoto’s Thyroiditis
221
A 40 year old female with a 3cm mass at the left lobe of the thyroid, sought consultation to a surgeon. FNAB was requested which showed follicular neoplasm. What is the risk of malignancy of FN?
15-35%
222
The above patient underwent thyroidectomy, final histopath on microscopic view showed cells are cuboidal with pale, abundant cytoplasm, crowded nuclei that may demonstrate “grooving,” and intranuclear cytoplasmic inclusions (leading to the designation of Orphan Anne nuclie). What will be your diagnosis to this patient?
Papillary carcinoma
223
Prior to operation, patient had cough associated with of hyperthyroidism, fever, seizure, and hypertension. What do you call this condition?
Thyroid Storm
224
Prior to operation, patient had cough associated with of hyperthyroidism, fever, seizure, and hypertension. What do you call this condition?
What will be the T scoring of the above patient?
T2
225
The following are complications of gastroesophageal reflux except
Cancer
226
are the anatomic results of disordered motility function
Radiographic abnormalities such as segmental spasm, corkscrewing, compartmentalization, and diverticulum
227
The most common type of cancer in the lower esophagus is
Adenocarcinoma
228
The most common site of esophageal cancer is at
Middle thoracic esophagus
229
The following is/are true regarding esophageal perforation
Primary closure of the esophageal perforation should be done early
230
The following is are true regarding caustic injury to the esophagus
A. Lyeandalkaliarebestneutralizedbe orange juice , half strength vinegar
231
The following is/are true regarding esophageal hernia.
Paraesophageal hernia requires surgery
232
Which of the following caustic agents causes coagulative necrosis of the esophageal mucosa? *
Acids
233
Surgery is not initially indicated on the following diaphragmatic hernias
Sliding hernia
234
Caustic agent that causes full thickness injury to the esophagus
Alkali
235
The following are considered to be secondary to motility disorders of the esophagus.
C. Zenker’s Diverticulum
236
Which hormone is produced in the Zona Reticularis of the Adrenal Cortex?
Androgens
237
Which drug can cause Cushing’s Disease?
Prednisone
238
Pheochromocytoma is usually caused by
Malignant adrenal tumor
239
Adrenalectomy is outright recommended for
Adrenocorticalcancer
