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Med and Surg Test 3.1 > Med and Surg Test 3.1 > Flashcards

Med and Surg Test 3.1 Flashcards

1
Q
  1. 7 year old is being seen at an orthopeadics outpatient clinic for assessment of a limb length
    discrepancy. She has a history of acute osteomyelitis that was difficult to treat. Which regarding
    osteo is not correct.
    a) It usually occurs in children under 10 years of age
    b) Immune compromise (HIV-related) may increase susceptibility to the condition
    c) The condition is more common in girls
    d) Appropriate antimicrobial therapy has decreased mortality to lt:1%
A

c) The condition is more common in girls

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2
Q
  1. Regarding pathogenesis of acute osteomyelitis is not correct
    a) The metaphyseal part of the bone was likely affected in this case
    b) Rapid circulation and flow of blood in the affected region plays an important role in
    development of acute osteomyelitis
    c) There is limited ability to phagocytose organisms in the affected region
    d) Infection may spread causing abscess and/or a sinus tract
A

b) Rapid circulation and flow of blood in the affected region plays an important role in
development of acute osteomyelitis

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3
Q

. Following organisms would not likely be in acute osteomyelitis
a) Mycobacterium tuberculosis
b) Streptococcus
c) Haemophilus influenzae
d) Staphylococcus

A

a) Mycobacterium tuberculosis

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4
Q
  1. Which one of the following test results would not be likely in acute osteomyelitis
    a) High erythrocyte sedimentation rate
    b) Low circulating level of C reactive protein
    c) Raised white cell count
    d) Normal x-ray during the first week of presentation with the condition
A

b) Low circulating level of C reactive protein

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5
Q
  1. Not be likely at the time of presentation
    a) Reluctance to bear weight
    b) Fever
    c) Cellulitis
    d) Pseudo-paralysis
A

Cellulitis

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6
Q
  1. A woman has been referred to the orthopaedic surgeons hand clinic for assessment of pain that is
    interfering with her ability to work. The possibilities appear to be carpal tunnel syndrome or rheumatoid
    arthritis. If this is rheumatoid arthritis which statement is not correct?
    a) one would investigate for bone loss in the hands
    b) tendon rupture is a possibility
    c) ligament rupture is a possibility
    d) there would be ulnar deviation of the wrist and radial deviation of the fingers
A

d) there would be ulnar deviation of the wrist and radial deviation of the fingers

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7
Q
  1. Which of the following is not a risk factor for carpal tunnel syndrome?
    a) Diabetes
    b) Gout
    c) hyperthyroidism
A

c) hyperthyroidism

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8
Q

regarding CTS is not correct
a) the syndrome involved 5 tendons and the median nerve
b) CTS is the most common nerve entrapment syndrome
c) Presentation may be associated with water retention during pregnancy
d) CTS may be a manifestation of inflammatory synovitis

A

a) the syndrome involved 5 tendons and the median nerve

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9
Q
  1. Symptoms of CTS is not correct
    a) Pain is experienced after an activity such as knitting
    b) There is tingling in the regions innervated by the median nerve
    c) The 5th finger is usually affected
    d) the tinel sign involves pressure or tapping on the median nerve
A

c) The 5th finger is usually affected

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10
Q
  1. Regarding CTS is not correct
    a) The condition is unlikely to respond to non-steroidal anti-inflammatory drugs
    b) splinting may be a useful form of conservative treatment
    c) specific treatment for a related medical condition may relieve symptoms
    d) cortisone injections may be helpful
A

a) The condition is unlikely to respond to non-steroidal anti-inflammatory drugs

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11
Q
  1. you are attending a foot clinic and discussing a patient who has been diagnosed with plantar fasciitis
    (PF), which is not correct
    a) The plantar fasciitis is the principal static and dynamic stabilizer of the longitudinal arch of the foot
    b) The fascia acts a shock absorber
    c) PF is an indication of chronic inflammation
    d) PF is caused by the formation of a calcaneal spur
A

d) PF is caused by the formation of a calcaneal spur

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12
Q

12) Not a typical feature of PF?
a) Swelling
b) Antalgic gait (shortened stance, phase vs swing phase)
c) Pain is relieved by standing on tiptoes
d) First steps after inactivity are the most painful

A

c) Pain is relieved by standing on tiptoes

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13
Q
  1. Regarding aetiology of PF is not correct
    a) PF is associated with obesity
    b) A lax Achilles tendon results in excessive action of the plantar fascia
    c) excessive foot pronation may play a role
    d) repetitive mirco-tearing of the fascia may occur
A

b) A lax Achilles tendon results in excessive action of the plantar fascia

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14
Q
  1. Not included in the differential diagnosis of PF
    A) Tarsal tunnel syndrome
    b) hypertrophic heel fat pad
    c) tibialis posterior tendonitis
    d) stress fracture
A

b) hypertrophic heel fat pad

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15
Q
  1. Regarding management of PF is not correct
    a) Both steroidal and non-steroidal anti-inflammatory drugs are used
    b) Stretching of the achillies tendon should be avoided
    c) Ice and heat may both be helpful
    d) Botulinum toxin may be helpful
A

b) Stretching of the achillies tendon should be avoided

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16
Q
  1. A nurse at a municipal clinic is showing a mother that her 6 month old baby has consistently grown
    below the normal trajectory for weight and length. She tells the mother that this is called failure to
    thrive. Not a typical prenatal cause of FTT
    A) Postmaturity
    B) Maternal malnutrition
    c) Maternal exposure to alcohol during pregnancy
    d) Transmission of a maternal infection to the foetus
A

A) Postmaturity

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17
Q
  1. Not a non-organic cause of FTT
    a) Food insecurity and inadequate child nutrition
    b) Wet nursing I.e breastfeeding by someone other than the mother
    c) Family dysfunction and stress
    d) Emotional deprivation syndrome
A

b) Wet nursing I.e breastfeeding by someone other than the mother

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18
Q
  1. Not an organic cause of FTT
    a) Iron deficiency anaemia
    b) Gastro-oesophageal reflux
    c) Inability to suck following birth asphyxia
    d) Tongue tie i.e. short frenulum
A

d) Tongue tie i.e. short frenulum

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19
Q
  1. Not associated with the abnormal absorption of nutrients
    a) Chronic diarrhea
    b) Cystic fibrosis
    c) Diabetes insipidus
    d) Hypothyroidism
A

c) Diabetes insipidus

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20
Q
  1. Which one of the following causes of FTT is not associated with increased metabolic demands
    a) Hypothyroidism
    b) Congenital heart disease
    c) Malignancy
    d) Chronic inflammation conditions
A

a) Hypothyroidism

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21
Q
  1. the mother of a teenager is discussing her child’s complaint of constant backache. She has searched
    the internet for causes and wants to know about conditions such as curvature of the spine and disc
    prolapse.
A

incomplete

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22
Q
  1. Regarding scoliosis is not true
    a) Involves lateral deviation of the spinal column
    b) Assumes an S shape or C shape
    c) Condition can only involve thoracic spine
    d) Leg length discrepancy may be a cause
A

c) Condition can only involve thoracic spine

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23
Q
  1. Regarding disc herniation is not correct
    a) The nucleus pulposus protrudes between vertebrae
    b) It is the anterior/forward protrusion of the nucleus pulposus that causes symptoms
    c) Nerves are compressed by the bulging nucleus pulposus
    d) Symptoms typically include numbness and pain
A

b) It is the anterior/forward protrusion of the nucleus pulposus that causes symptoms

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24
Q
  1. Regarding backache is not correct
    a) It is mechanical in the vast majority of cases
    b) In a post-menopausal woman the pain may be the consequence of vertebral fracture
    c) The pain may be due to infection such as tuberculosis
    d) Back pain is a highly reliable sign of spinal problems and is very seldom referred from elsewhere
A

d) Back pain is a highly reliable sign of spinal problems and is very seldom referred from elsewhere

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25
Q
  1. regarding treatment for lumbar disc prolapse is not correct
    a) Conservative treatment is appropriate for acute prolapse
    b) With chronic backache from a prolapse the recommended immediate treatment is surgery
    c) If the backache is associated with neurological signs one should proceed to discectomy
    d) In an elderly patient one should consider discectomy together with spinal fusion
A

b) With chronic backache from a prolapse the recommended immediate treatment is surgery

26
Q
  1. A patient is being assessed at the orthopaedic clinic. After several tests of shoulder power and range
    of movement, the conclusion is that the patient has significant pathology of the rotator cuff. Regarding
    epidemiology of rotator cuff tears is not correct
    a) Smoking is a risk factor
    b) Hypercholesterolaemia is a risk factor
    c) It is safe to say that 100% will progress to full-thickness tears over time
    d) A family history is not unusual
A

c) It is safe to say that 100% will progress to full-thickness tears over time

27
Q
  1. Which muscles is not involved in the mechanics of rotator cuff tears?
    a) supraspinatus
    b) infraspinatus
    c) teres major
    d) subscapularis
A

c) teres major

28
Q

28, Regarding signs and symptoms of rotator cuff tears is not correct
a) Functional deficits include difficulty with overhead activities and reaching
b) Range of motion is affected
c) Affected muscles typically undergo hypertrophy in order to overcome the functional deficit
d) Night discomfort is common

A

c) Affected muscles typically undergo hypertrophy in order to overcome the functional deficit

29
Q
  1. Regarding invasions is not correct
    a) Ultrasound has no place in the assessment
    b) X-rays are able to show associated degeneration of the gleno-humeral joint
    c) MRI is a useful modality
    d) Arthroscopy is the ‘gold standard’ for assessment of the pathology
A

a) Ultrasound has no place in the assessment

30
Q
  1. Reagrding treatment is not correct
    a) One should adhere to the dictum of “treat the patient, not the tear”
    b) In the acute phase of a tear there is a significant role for physical therapy involving passive and active
    movement
    c) Surgical intervention may include total joint replacement
    d) Corticosteroids may reduce inflammation but also result in further tendon degeneration
A

b) In the acute phase of a tear there is a significant role for physical therapy involving passive and active
movement

31
Q
  1. A 2 year old child is brought into the emergency department with a short history of diarrhea. The
    doctor is concerned about the degree of dehydration and admits the child for intravenous rehydration.
    Regarding diarrhea is not correct
    a) frequency of stools is important in the diagnosis (> 3 per day)
    b) Consistency of the stools is inconsequential in making the diagnosis
    c) diarrhea may be viral in origin
    d) diarrhea may be fungal in origin
A

b) Consistency of the stools is inconsequential in making the diagnosis

32
Q
  1. Small children are more prone to dehydration than adults, which of the following is not correct
    a) small children are dependent on others for their fluid intake
    b) renal immaturity may result in poor conservation of fluid
    c) percentage of total body water is higher than in adults
    d) children have a lower surface area to body weight ratio than adults
A

d) children have a lower surface area to body weight ratio than adults

33
Q
  1. This child is regarded as being severely dehydrated. Which is not a sign of severe dehydration
    a) Depressed level of consciousness
    b) Increased heart rate
    c) Sunken fontanelle
    d) capillary refill time 2-4 seconds
A

d) capillary refill time 2-4 seconds

34
Q
  1. If the child has been less dehydrated the doctor would have considered oral rehydration. In this
    regard, which one of the following statements is not correct
    a) if one is considering oral rehydration, one must include a drug such as loperamide to cut down stool
    losses
    b) when given in appropriate circumstances, oral rehydration fails in less than 5% of cases
    c) Sodium and glucose are the key components of oral rehydration solutions
    d) Normal feeds should be restarted as soon as tolerated
A

a) if one is considering oral rehydration, one must include a drug such as loperamide to cut down stool
losses

35
Q
  1. Which one of the following statements regarding prevention of diarrhea is not correct
    a) Breastfeeding reduces the risk of diarrhea in infants
    b) Vitamin D should be routinely supplemented to prevent diarrhea
    c) Immunization plays an important role in prevention of diarrhea in infants
    d) Handwashing reduces the risk of acute gastroenteritis by 30-35%
A

b) Vitamin D should be routinely supplemented to prevent diarrhea

36
Q
  1. A 7 year old boy who has been referred to the respiratory clinic Is being seeing by the pulmonologist
    for investigation and management of suspected asthma. He has a temperature and is coughing, but
    does not appear to be particularly uncomfortable or distressed. Regarding signs of respiratory distress in
    children is not correct
    a) By definition, any paediatric patient breathing at a rate of 60 per minute has respiratory distress
    b) Cyanosis is due to inadequate oxygenation of haemoglobin
    c) Flaring of the nostrils is indicative of increased central respiratory drive
    d) recession/s may be seen between the ribs, below the rib cage and above the sternum
A

a) By definition, any paediatric patient breathing at a rate of 60 per minute has respiratory distress

37
Q
  1. Wheezing is a cardinal feature of asthma. Regarding wheezing is not correct
    a) the sound is the result of turbulent flow through partially obstructed airways
    b) obstruction is below the thoracic inlet
    c) Wheezing is typically heard during both inspiration and expiration
    d) Wheezing is often associated with atopy/allergy
A

c

38
Q
  1. Regarding asthma is not correct
    a) Airway obstruction in asthma is typically recurrent and reversible
    b) Symptoms are relieved during sleep and do not occur at night
    c) Asthma may impact negatively on daily activities
    d) The chest x-ray typically shows hyperinflation during an attack
A

b) Symptoms are relieved during sleep and do not occur at night

39
Q
  1. Management of asthma is not correct
    A) Symptom relief is a principal objective
    b) Airway function should be restored to normal or as near normal as possible
    c) Treatment should aim to reduce severe attacks
    d) Because of potential for mortality, hospital admission is mandatory for all confirmed attacks
A

d) Because of potential for mortality, hospital admission is mandatory for all confirmed attacks

40
Q
  1. Not indicated for treatment of asthma
    a) Beta – 2 agonists
    b) Beta blockers
    c) Ipratropium bromide
    d) Inhaled corticosteroids
A

b) Beta blockers

41
Q
  1. Case study 3 – polytrauma
    Which one of the following statements regarding shock is not correct
    a) Significant damage to the heart, for example related to myocarditis,, may result in cardiogenic
    shock
    b) Anaphylactic shock is the result of an immune – mediated hypersensitivity reaction
    c) The end result of shock is impaired tissue perfusion and tissue hypoxia
    d) Haemorrhagic shock results in a reduction of effective circulatory blood volume whereas septic
    shock does not
A

d

42
Q
  1. regarding manifestations of shock is not corrct
    a) effects of the progressive phase may be reversed by administration of oxygen and generation of
    superoxide
    b) during the progressive phase there is worsening tissue perfusion and hypoxaemia
    c) disseminated intravascular coagulation may accompany shock, resulting in significant haemorrhage
    from various sites
    d) during the initial stage vital organ perfusion is maintained by the body’s compensatory mechanisms
A

a) effects of the progressive phase may be reversed by administration of oxygen and generation of
superoxide

43
Q
  1. Regarding effects of shock is not correct
    a) preservation of the cerebral circulation is a primary goal of the body’s compensatory response
    b) compensatory mechanisms such as tachycardia may add to strain on the heart
    c) the kidneys are typically resistant to shock related ischemia and hypoxia
    d) pulmonary oedema may develop and interfere with gas exchange.
A

c) the kidneys are typically resistant to shock related ischemia and hypoxia

44
Q
  1. regarding clinical presentation of shock is not correct
    a) hypotension is a characteristic of all types of shock
    b) tachypnea represents the body’s efforts to correct hypoxia and or acidosis
    c) tachycardia represents the bodys efforts to maintain the compromised circulation
    d) cold/clammy skin is a characteristic of all types of shock
A

d

45
Q
  1. regarding management of TBI is not correct
    a) Analgesia has no place because patients are usually unconscious
    b) seizures may occur and should be treated with anticonvulsants
    c) management of cerebral oedema includes drugs that are osmotically acive
    d) both hypo and hyperglycaemia may adversely affect the brain in such patients
A

a) Analgesia has no place because patients are usually unconscious

46
Q
  1. regarding immediate trauma death is not correct
    a) brainstem injury may affect both cardiac and respiratory functions
    b) high spinal cord injury has no impact on cardiac function
    c) immediate trauma death represents the first of three peaks of death
    d) high spinal cord injury adversely affects respiration
A

b) high spinal cord injury has no impact on cardiac function

47
Q
  1. regarding classification of brain injury is not correct
    a) low Glasgow coma scale correlates well with longer loss of consciousness (LOC)
    B) with LOC & gt 24 hours one ecpects amnesia for gt 7 days
    c) with LOC of 12 hours one expects amnesia up to 7 days
    d) With LOC & lt 30 minutes one expets amnesia of lt 24 hours
A

c) with LOC of 12 hours one expects amnesia up to 7 days

48
Q
  1. Regarding secondary brain injuries is not correct
    a) secondary brain injuries are the main cause of morbidity in head injuries but do not impact on
    mortality
    b) such injuries are a consequence of the primary trauma
    c) intracranial factors play a role
    d) extracranial factors play a role
A

a) secondary brain injuries are the main cause of morbidity in head injuries but do not impact on
mortality

49
Q
  1. regarding classification of haemorrhage is not correct
    a) a 70 kg male typically has a circulating blood volume of 100ml/kg I.e. 7 litres
    b) one can lose 15% of blood volume without a significant change in BP
    C) A loss of 15-30% of blood volume results in an increase in heart rate but may not impact on
    measured BP
    D) With 30-40% loss of blood volume, one expects tachycardia, hypotension and impaired mental status
A

a

50
Q
  1. do not apply to bone and/or fracture
    a) bone is a brittle combination of cortical and cancellous elements
    b) a fracture is classically defined as a break in the structural continuity of bone
    c) excessive compressive force to one side of a long bone (femur) will typically result in an oblique (30o)
    fracture
    d) a fracture may also be defined as a soft tissue injury with an associated break in the structural
    continuity of bone
A

c) excessive compressive force to one side of a long bone (femur) will typically result in an oblique (30o)
fracture

51
Q
  1. following types of fractures is usually not regarded as a complete fracture
    a) greenstick
    b) impacted
    c) spinal
    d) transverse
A

a) greenstick

52
Q
  1. case study 4 asphyxia and cerebral palsy. Which of the following regarding CP is not correct
    a) CP implies a progressive disorder of the nervous system
    b) epilepsy may be a prominent feature
    c) it is often accompanied by disturbances of cognition
    d) movement and posture are involved
A

a) CP implies a progressive disorder of the nervous system

53
Q
  1. combinations of birth weight and gestational age is not correct in terms of risk for CP
    A) 28 wks 1500g – risk high
    b) 37-38 wks 3000g – risk low
    c) 36 wks 1500 g – risk low
    d) 32-36 wks 1500-2499 g – risk moderate
A

c) 36 wks 1500 g – risk low

54
Q
  1. statements regarding aetiology of CP is not correct
    a) almost all cases are due to intrapartum problems
    b) intrapartum events may influence a pre-existing abnormality
    c) hypoxic ischaemia injury occurs in a minority of cases
    d) CP is usually multifactorial
A

a) almost all cases are due to intrapartum problems

55
Q
  1. not regarded as a sign of an at-risk foetus
    a) Oligohydramnios
    b) polyhydramnios
    c) poor foetal growth
    d) increased foetal movements
A

d) increased foetal movements

56
Q
  1. regarding a baby born through meconium stained liquor is not correct
    a) chest compressions provide circulatory support
    b) if intubation is unsuccessful one should suction as much as possible from the nose mouth and
    pharynx
    c) immediate intubation is mandatory for all babies born through meconium stained liquor
    d) if intubation is unsuccessful one should proceed with resuscitation.
A

c) immediate intubation is mandatory for all babies born through meconium stained liquor

57
Q
  1. statements regarding perinatal asphyxia is not correct
    a) there may be associated renal failure
    b) brain damage is related to cerebral hypoxia and/or ischaemia
    c) by definition the term includes an insult occurring until the end of the neonatal period (28 days)
    d) the brain is the major organ of concern
A

c) by definition the term includes an insult occurring until the end of the neonatal period (28 days)

58
Q
  1. regarding induced hypothermia therapeutic is not correct
    a) treatment is considered in all asphyxiated neonates, irrespective of gestational age
    b) treatment has been shown to reduce mortality in asphyxiated neonates
    c) cooling should be continued for 72 hours
    d) treatment has been shown to reduce disability in asphyxiated neonates
A

c) cooling should be continued for 72 hours

59
Q
  1. not a criterion used to decide whether cooling should be initiated
    a) absent pupillary response to light
    b) decreased activity
    c) hypertonia
    d) poor or absent moro reflex
A

c) hypertonia

60
Q
  1. regarding frequency if problems associated with CP is not correct
    a) intellectual problems 50%
    b) communication and swallowing 50%
    c) vision and hearing – 50%
    d) epilepsy – 50%
A

c) vision and hearing – 50%

Med and Surg Test 3.1 (1 decks)

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