Surg E2 Flashcards
This congenital pathology of the pulmonary system is inherently caused by the fact that the
posterolateral communication of the pleura (chest) and coelomic (abdominal) cavities is the last to
be closed by the developing diaphragm. Chest x-ray findings are herniated abdominal viscera
and mediastinal shift away from the herniated viscera. This type of hernia is called
A. Morgagni
B. Bochdalek
C. Congenital cystic adenomatoid malformation
D. Pulmonary sequestration
B
Urinary incontinence in women isinitiated by A. Internal sphincter B. Middle circular layer of the bladder C. Lower bladder pressure D. External sphincter
D
In the pathology of nephrolithiasis that emboli to the urinary tract, which of the following is not a
common site of impaction of kidney stone?
A. Ureteral pelvic junction
B. Pelvic brim
C. Ureteral vesical junction
D. NOTA
D
The Allen Test checks for the arterial flow of A. Deep palmar circumflex artery B. Branchial C. Radial artery D. Dorsalis pedis artery
C
A 1-month old baby boy has a 2x1 cm capillary of the cheek. The best mode of management A. Observation B. Excision C. Sclerosant injection D. Laser therapy
A
A 2-year old boy has a recurrent right inguinal area mass since birth. The mother claims the
mass appears when the child is straining or crying and disappears when he is quiet or sleeping.
PE shows a soft, reducible right inguinal mass, nontender and nonerythematous. The abdomen is
flat, soft, and nontender, without any palpable mass. The external genitalia are normal. Best
mode of treatment?
A. Observation
B. Incision and drainage
C. Herniotomy
D. Herniorraphy
C
TRUE regarding Hirschsprung’s disease
A. Parasympathetic innervation of the intestines are absent
B. The most common affected segment of the bowel is the rectosigmoid region
C. The markedly dilated bowel on barium enema is the abnormal segment of intestine
D. Successful nonsurgical management of the condition requires judicious use of suppositories
B
A 1 month old infant was brought to the clinic for an intermittent bulge on the right scrotum.
You do not appreciate the bulge on the sleeping post-prandial baby. There are 2 palpable testes
but no transillumination of the scrotum. Your advice would be
A. Do transillumination at home when the bulge shows up
B. Request for scrotal ultrasound
C. Recommend surgery
D. Make the baby cry
D
The definitive management of thyroglossal duct cysts involves A. Removal of the thyroid isthmus B. Removal of the hyoid bone C. Simple cyst excision D. Thyroidectomy
B
The most common type of imperforate anus in females is A. IA with cloacal malformation B. IA with rectovestibular fistula C. IA with perineal fistula D. Low IA with covered anus
B
Among the vascular tumors of the head and face, this group has increased mitotic activity and
as such may be considered true neoplasms. They are typically absent at birth or may be present
as a faint vascular blush, and undergo rapid proliferative phase. Most undergo spontaneous
involution by age 7
A. Hemangiomas
B. AV vascular malformation
C. Cystic hygromas
D. Lymphatic malformation
A
A 5-month old male infant has a urine output of less than 0.1 ml/kg/hr shortly after undergoing
major surgery. On examination, he has generalized edema. His BP is 94/48, PR 140, abdominal
respirations 20/min. His BUM is 38 mg/dl and serum creatinine is 1.4 mg/dl. Initial urinalysis
shows a specific gravity of 1.018 and 2+ protein. Microscopic examination of the urine sample
reveals 1 WBC per HPF, 18 RBCs per HPF. What is the appropriate next step in diagnosis?
A. CT of the abdomen and pelvis
B. IVP
C. KUB UTZ
D. Cystourethrography
C
A 52/M diabetic with a history of claudication presented with a non-healing wound involving the left big toe of 2 months duration. Results of arterial pressure obtained at the clinic are as follows Right Left Brachial 160 140 Radial 130 130 Dorsalis pedis 130 80 Posterior tibial 180 60
The ankle brachial index (ABI) on the left lower extremity is? A. 0.375 B. 0.43 C. 0.5 D. 0.57
C
Diffuse calcification of the lower extremity arteries results in
A. Normal ABI due to incompressible arteries
B. Low ABI due to incompressible arteries
C. Elevated ABI due to incompressible arteries
D. Unobtainable ABI due to absence of adequate flow
C
Allen’s test is useful in evaluating A. Integrity of the palmar tract B. Digital blood flow C. Thoracic outlet compression D. Acute effort thrombosis
A
5-alpha reductase inhibitors are used to treat patients with benign prostatic obstruction
because they
A. Inhibit the receptors on the smooth muscles of the prostate
B. Cause a decrease in the intraprostatic pressure
C. Decrease the stromal bulk of the prostate
D. Prevent conversion of testosterone to active form di-hydroxytestosterone
D
Whom of the following may not resort to vascular revascularization?
A. A soldier with a non-healing wound of the big toe
B. A postman who has pain whenever he delivers mail
C. A cook with gangrene of the middle toe
D. An executive who has leg pain whenever he plays golf
D
The presence of Simonart’s band characterizes this type of cleft A. Complete cleft lip B. Incomplete cleft lip C. Complete cleft palate D. Incomplete cleft palate
B
Most common primary cardiac tumor in infants A. Fibroma B. Myxoma C. Rhabdomyoma D. Sarcoma
C
Pericardial cysts are often found in which compartment of the mediastinum A. Superior compartment B. Anterior compartment C. Middle compartment D. Posterior compartment
C
Midface instability or fracture is elicited by this sign A. Racoon’s eye sign B. Telecanthus C. Drawer’s sign D. Malocclusion
C
To achieve good occlusion the following is essential drug or prior to fracture fixation A. Coaptation of the fracture segments B. Intra-oral fixation C. Maxillo-mandibular fixation D. Interdental fixation
C
Pleural effusion is the accumulation of liquid in the pleural space. A concave meniscus or
“blunting” in the costophrenic angle suggests the presence of at least _____ of pleural effusion
A. 100 ml
B. 175 ml
C. 250 ml
D. 300 ml
C
In the analysis of pleural effusion, it is important to differentiate if it is a transudate or exudate.
Knowledge of the quality of the effusion leads to the diagnosis of the possible pathology and will
affect management. Characteristics that distinguish exudates from transudates includes the
following EXCEPT
A. pH > 7.2
B. High protein content
C. Foul smelling
D. Sterile fluid
D
Chylothorax is a milky, odorless effusion consisting of leaking lymphatic fluid from the thoracic duct. The most common cause is A. Iatrogenic B. Malignancy C. Spontaneous disruption D. NOTA
A
TRUE of lung anatomy EXCEPT
A. Right lung has 2 lobes, left has 3
B. Right contains 10 segments, left has 9
C. There are 2 groups of lymph nodes: pulmonary and mediastinal
D. AOTA
A
One of the most common co-morbidity for developing abdominal aortic aneurysm is Marfan
syndrome. This disease is caused by an abnormality in which of the following proteins?
A. Elastin
B. Metalloproteinase
C. Collagen
D. Fibrillin
D
The most common presenting symptom in patients with an ascending thoracic aneurysm is A. Anterior chest pain B. Posterior chest pain C. Aortic valve insufficiency D. Sudden death
A
The most common primary cardiac tumor is A. Fibromas B. Rhabdomyoma C. Myxoma D. Teratoma
C
This is a relatively common congenital heart disease (5-8%) and results from the abnormal
division of the bulbar trunk, where the aorta originated from the right ventricle and the pulmonary
artery from the left ventricle
A. Double outlet right ventricle
B. Transposition of the great vessels
C. Truncus arteriosus
D. Total anomalous pulmonary venous return
B
As a follow-up to the previous question, this congenital disease is classically represented by which chest x-ray findings A. Boot shape B. Egg on a string C. Calcification on pericardium D. Massive pleural effusion
B
True of the anatomy of the chest wall EXCEPT
A. Skeletal support consists of the sternum, 12 thoracic vertebrae, 10 pairs of ribs, and 2 pairs of
floating ribs
B. Pectoralis major and pectoralis minor constitutes the principal musculature of the anterior
thorax
C. The parietal and visceral pleura is well-endowed with nerve endings
D. The pleural space extends above the clavicles, increasing the risk for pulmonary injury for
supraclavicular trauma
C
Which incision is optimal for anterior mediastinal and cardiac surgeries? A. Median sternotomy B. Midlateral thoracotomy C. Lateral thoracotomy D. Posterolateral thoracotomy
A
In the evaluation of patients about to undergo major thoracic surgery, this value may be the
most useful test to monitor patients with marginal pulmonary function, it is reduced in obstructive
airway disease
A. Forced expiratory volume in 1 sec (FEV1)
B. Vital capacity
C. Maximal oxygen consumption
D. Respiratory rate
A
True of pectus excavatum EXCEPT
A. 2nd most common congenital deformity of the chest wall (next to pectus carinatum)
B. Attributed to the overgrowth of the lower costal cartilages and ribs
C. Anomaly is 3x more common in males
D. Operative correction is recommended between 18 months to 5 years
A
Characteristic of the pleural effusion that distinguishes exudates from transudates
A. pH
E
Though more common in the upper lobes, this bronchogenic carcinoma develops in all parts
of the lung. They are relatively slow growing, are late to metastasize, and may present as central
bulky masses with bronchial obstruction (evidence of its association with smoking). This is the
leading pulmonary neoplasm
A. Bronchoalveolar carcinomas
B. Small cell lung CA
C. Squamous cell carcinomas
D. Carcinoid tumors
C
The mediastinum is the central cavity of the thorax bounded by the pleural cavities, inferiorly
by the diaphragm, and superiorly by the thoracic inlet. Where is the thymus organ located
(thymoma being the most common mass in this area)?
A. Anterior
B. Middle
C. Posterior
D. Superior
A
Known risk factor for developing patent ductus arteriosus
A. Rubella infection in the first trimester
B. Radiation with xray during the second trimester
C. Intake of nitrates during the third trimester
D. NOTA
A
Fetal circulation is characterized by the following EXCEPT
A. Elevated vascular resistance and little pulmonary blood flow
B. Shunting of blood from right atrium to left atrium
C. Shunting of blood from pulmonary artery into aorta
D. NOTA
D
