Surgery Flashcards
- It is defined as dependence on Assistance with activities of Daily living.
a. Frailty
b. Disability
c. Comorbidities
d. Complication
B. Disability
- 59 y/o male was rushed to the emergency room after an accident. Patient was unconscious but with an available companion. The following are the important initial information you as the doctor on duty need to ask, except?
a. None of the above
b. Time of Injury
c. Mechanism of Injury
d. Area where the accident happened.
A. None of the above
- Order of abdomen examination:
a. Inspection, percussion, palpation, auscultation,
b. Inspection,auscultation,percussion,palpation
c. Inspection, percussion, auscultation, palpation
d. Auscultation, percussion, palpation, inspection,
B. Inspection, auscultation, percussion, palpation
- Renal complications are increased in elderly surgical patients in the perioperative period. This is an insensitive indicator of renal function in the elderly.
a. Creatinine clearance
b. Serum Creatinine
c. Glomerular filtration rate
d. Serum Albumin
Answer: B. Serum Creatinine
- Which communication strategy can make telephone orderslessmisunderstood?
a. SBAR
b. Handover or handoff
c. Call out
d. Checkback
D. Checkback
- Renal complications are increased in elderly surgical patients in the perioperative period. This is an insensitive indicator of renal function in the elderly.
A. Creatinine clearance
B. Serum creatinine
C. GFR
D. Serum albumin
B. Serum creatinine
- Part of the history taking that includes any additional information in the patient’s profile that might be helpful in the diagnosis.
A. Personal and Social History
B. History of Present Illness
C. Chief complaint
D. Past Medical History
A. Personal and Social history
- A patient came into the ER complaining of severe abdominal pain. In order to do something, OPQRST questions can be used. Which is not included:
A. Onset
B. Palliating
C. Quality
D. Recurrence
D. Recurrence
- A 59 y/o male was rushed to the emergency room after an accident. Patient was unconscious but with an available companion. The following are the important initial information you as the doctor on duty need to ask, except?
A. Time of Injury
B. Area where the accident happened.
C. Mechanism of Injury
D. None of the above
D. None of the above
- A 60-year-old man was transported to the emergency room due to a few hours of history of fall. The following are forming key to get your history, except;
a. Any history of alcohol intake or intoxication
b. Any known comorbidities such as Epilepsy, Diabetes or Hypertension
c. Any medication the patient is currently taking
d. None
D. None
- The HEENT (Head, Eyes, Ears, Nose and Throat) exam is usually the initial part of General Physical examination, after the vital signs. The usual sequence is:
A. Inspection, Percussion and Auscultation
B. Inspection, Auscultation and Percussion
C. Inspection, Auscultation and Palpation
D. Inspection, Palpation and Auscultation
D. Inspection, Palpation and Auscultation
- A 66 year old female came in with a 3 yrs enlarging patch on the back. Which of the following is not a feature of Malignant melanoma?
A. Asymmetry
B. Multiple color
C. Even Border
D. Lesion Greater than 6 mm
C. Even Border
- An 18 y/o male came in at the emergency department under the influence of alcohol. During physical examination, there is bluish discoloration noted at the postauricular area. This is suspicion of basal skull fracture.
A. Cullen sign
B. Racoon’s sign
C. Tillex sign
D. Battle’s sign
D. Battle’s sign
- Tongue Blade Test is used to screen
a. Lefort
b. Zygomatic fracture
c. Mandibular fracture
d. Maxillary frature
c. Mandibular fracture
During neck palpation, palpable mass on the deep middle cervical lymph node is under what level?
a. Level II
b. Level III
c. Level IV
d. Level V
b. Level III
Carotid bruits characterized by blowing and swishing sound can be auscultated in what area?
a. Angle of the jaw
b. Posterior base of the SCM
c. Anterior cervical
d. Upper sternal notch
a. Angle of the jaw
The following are Pulmonary examination findings of pneumothorax:
a. Decreased breath sound, Decreased tactile fremitus, dullness on percussion
b. Decreased breath sound, Increased tactile fremitus, dullness on percussion
c. Decreased breath sound, Decreased tactile fremitus, hyperresonant on percussion
d. Decreased breath sound, Increased tactile fremitus, hyperresonant on percussion
c. Decreased breath sound, Decreased tactile fremitus, hyperresonant on percussion
Axillary lymph node assessment level I except:
a. Axillary
b. Extramammary region
c. Subscapular
d. Scapular
C. Subscapular
- A 25 year old female with right breast mass came for consult. Which indicates benign lesion?
a. Firm with irregular borders
b. Movable breast mass with skin dimpling and bloody nipple discharge.
c. Movable breast mass with distinct border
d. Firm breast mass with regular border and bloody nipple discharge
c. Movable breast mass with distinct border
Sequence of Abdominal Exam:
a. Inspection, Auscultation, Palpation, Percussion
b. Inspection, Auscultation, Percussion, Palpation
c. Inspection, Percussion, Auscultation, Palpation
d. Inspection, Percussion, Palpation, Auscultation
ANSWER: B. Inspection, Auscultation, Percussion, Palpation
- 33 year old male, has been in a motor vehicular accident. He was rushed into the emergency room. Upon palpation to his abdomen, this finding described as board-like guarding of the abdominal wall that warrants emergent surgery.
a. Voluntary guarding
b. Involuntary guarding
c. Rigidity
d. Rebound tenderness
c. Rigidity
This maneuver is done by flexing the hip and knee and pulling your leg laterally causing internal rotation of the hip while maintaining knee position. Positive sign for appendicitis.
a. Psoas sign
b. Obturator sign
c. Sitkovsky sign
d. Rosenstein sign
b. Obturator sign
A 10 year old boy complains of scrotal swelling and pain. His parents noted that the size of his scrotum seems to fluctuate. On P.E., it is non-tender, translucent mass. What is the probable diagnosis?
a. Acute epididymitis
b. Hydrocele
c. Spermatocele
d. Testicular tumor
a. Acute epididymitis
32-year-old male complained of occasional dull ache scrotal pain. Examination on upright position revealed a left- sided scrotal engorge veins and feel like a bag of worms. The most likely diagnosis is
a. Hematocoele
b. Epididymoorchitis
c. Torsion of the spermatic cord
d. Varicocele
d. Varicocele
Cauliflower like mass near perianal
A. HSV
B. HPV
C. Gonorrhea
D. Chlamydia
B. HPV
A tense, hot, very tender labial swelling on the posterior third of the labia majora is suggestive of:
A. Urethritis
B. Bartholin gland abscess
C. Genital herpes
D. Femoral hernia
B. Bartholin gland abscess
An 8-week-old boy presents with his parents to your clinic due to abnormal urethral meatus position. On examination, the meatus is on the ventral surface just below the glans penis. What is the most likely diagnosis?
A. chordee
B. hypospadias
C. epispadia
D. phimosis
B. hypospadias
Common cause of death following transplantation is
A. Rejection and acute renal failure
B. MI
C. Malignancy
D. Sepsis
B. MI
- Leading cause of graft loss following renal transplant is
A. Recipient Death
B. Acute Rejection
C. Chronic Nephropathy
D. Pyelonephritis
A. Recipient Death
Highest posing risk of death in patients awaiting for renal transplant
A. COPD
B. Smoker
C. Black race
D. Cerebrovascular accident
E. CHF
E. CHF
Contraindication of kidney transplant
A. History of melanoma with wide resection 10 years ago
B. History of low grade glioblastoma multiforme 4 months ago
C. Current UTI
D. Recent meningococcemia with negative blood culture
C. Current UTI
- 28/F diagnosed with CKD 5 with Lupus nephritis… on post op day 2, urine output was depleted from 180cc to 4cc in the last hour. IFC is flushing well. What is the most appropriate next step?
A. GotoOR
B. UTZ
C. MRA
D. CT scan
E. U/A
B. UTZ
Which of the following tumor markers is the best to monitor the recurrence of colorectal cancer?
a. Carcinoembryonic antigen
b. CA 19-9
c. Cancer antigen 15-3
d. Calcitonin
a. Carcinoembryonic antigen
Responsible in immunologic response against donor cells
A. Neutrophil
B. Eosinophil
C. Lymphocyte
D. Plasma cell
C. Lymphocyte
What is the moa of AZA
A. Inhibition with DNA synthesis
B. Binding of FK-506 binding proteins
C. Inhibition of P7056 kinase
D. Inhibition of calcineurin
A. Inhibition with DNA synthesis
Following transplantation, patients are at risk for which of the following
A. Kaposi’s sarcoma
B. Melanoma
C. Colon cancer
D. Follicular carcinoma of the thyroid
A. Kaposi’s sarcoma
Post transplantation lymphoproliferative disorder is caused by:
A. Induction of lymphocyte antigens by immunosuppression
B. Poorly controlled immunosuppression
C. EBV infection
D. CMV infection
C. EBV infection
In the donabedian model, it refers to the application of tools, equipment, policies/procedures to patient.
A. Structure
B. Process
C. Outcome
D. Concept
B. Process
Individual benefits of effective teamwork
A. Enhanced communication and professional diversity
B. Efficient use of health care services
C. Enhance patient satisfaction
D. Improved coordination of care
C. Enhance patient satisfaction
Stage of team development whereby there maybe conflict between the team members and some rebellion against task assigned.
A. Forming
B. Storming
C. Norming
D. Performing
B. Storming
Care that falls below a recognized level of standard of care.
A. Sentinel events
B. Newer events
C. Adverse effect
D. Negligence
D. Negligence
An serious physical or psychological injury to the patient unexpected occurrence involving death or
A. Never events
B. Sentinel events
C. Negligence
D. Adverse event
B. Sentinel events
Errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients and that indicate a real problem in the safety and credibility of a healthcare facility:
a. Negligence
b. Adverse event
c. “Never events”
d. Sentinel event
c. “Never events”
Retained needles have been reported to cause severe injury in the intra abdominal compartment
A. True
B. False
A. True
The root cause in 70% in wrong-site surgery:
a. No labeling
B. No images taken in operating room
c. No markings
d. Miscommunication
e. NOTA
d. Miscommunication
The following statements are true about blame culture as a rationale for managing human error EXCEPT:
a. With skilled, experienced and largely well-intentioned workforce, situations are more amenable to improvement than people
b. Human actions are always constrained and governed by factors beyond an individual’s immediate control
c. People cannot easily avoid those actions that they did not intend to perform
d. Errors have multiple causes: personal, tasks-related, situational and organization factors
b. Human actions are always constrained and governed by factors beyond an individual’s immediate control
One form of error is unnecessary or excessive medical treatment, this accounts for 90% of all medical treatment (?) received in the United States?
A. True
B. False
A. True
The most important determinant of malpractice claims against a physician is:
a. Transparency
b. Sympathy
C. Patient rapport
d. Empathy
C. Patient rapport
Under the BELIEF model of Dobbie and colleagues on cultural competence, under letter “F” is:
a. Creating a FAMILY relationship
b. Establishing the FACTS
c. Understanding the FEELINGS of the patient
d. FACING adversities
c. Understanding the FEELINGS of the patient
Altruism is the unselfish concern for other people doing things simply out of a desire to help, not because you feel obligated to out of duty, loyalty, or religious reasons. It involves acting out of concern for the well-being of other people
a. True
b. False
a. True
93.The Future Physician Circle has a medical mission project in Cervantes supervised by the FPC Adviser (a medical practitioner). Each member were given tasks to perform during the mission. In one of the patients undergoing circumcision, the patient collapsed due to anesthetic adverse reaction. Who is accountable?
a. Attending medical student who operated on the patient
b. FPC President
c. FPC Adviser
d. None of the above - it was just an accident
c. FPC Adviser
Future Physicians Circle members can conduct surgical missions without the presence of a licensed physician as this is not considered practice of medicine.
a. True
b. False
b. False
Professionalism is important because of the following EXCEPT:
a. Patients expect medical personnel to be professional
b. Patients place their trust and confidence in those they deem to be professional
c. If one exhibits professionalism, they will have more patients, thus, earn more
d. Attitudes are conservative in the medical field, mandating professionalism
c. If one exhibits professionalism, they will have more patients, thus, earn more
What is the goal of palliative care?
A. Improve outcome of treatment of the patient
B. Improve the quality of life of the family of the patient
C. improve the quality of life of the patient and their families
D. Improve the quality of remaining life of the patient
C. improve the quality of life of the patient and their families
A “DO NOT RESUSCITATE’ consent can be given by the patient in advance.
a. False
b. True
b. True
Among the attributes under professionalism, updating one’s skills and knowledge is under:
a. Responsibility
b. Education
c. Accountability
d. Clinical competence
e. Altruism
d. Clinical competence
Is withdrawing life-sustaining therapy considered euthanasia?
a. No
b. Yes
a. No
The principles of medical ethics based on the Principles Approach are the following EXCEPT:
a. A practitioner should act in the best interest of the patient, without regard to physician’s self-interest.
b. Rendering what is due to others affecting the distribution of medical care among patients.
c. Patient must follow the physician’s plan of management.
d. A physician should avoid treatments that harm the patient.
c. Patient must follow the physician’s plan of management.
A complete history taking is crucial, the following are true except:
A. It’s the critical first step in determining the etiology of a patient’s illness
B. With the information gained it will be useful in deciding the diagnostic needed to perform prior to diagnosing patient condition.
C. A proper history taking would focus completely on the chief complaint of the patient
D. The basis of a true history is good communication between doctor and patient.
C. A proper history taking would focus completely on the chief complaint of the patient
The following are good approach to proper history taking except:
A. Introducing yourself and dressing appropriate
B. Assure to the patient that as the doctor you’ll be the only one to control the flow of the interview
C. Involve the patient in the history taking process
D. Ensure consent has be gained prior to starting the interview
B. Assure to the patient that as the doctor you’ll be the only one to control the flow of the interview
Part of the history taking that describes the main purpose of the patient’s consult.
A. Past Medical History
B. Personal and Social History
C. Chief complaint
D. History of Present Illness
C. Chief complaint
In performing a comprehensive History of Present Illness, The symptoms can be elaborated in terms of the following, except.
A. Course and duration of disease
B. Other Symptoms aside from the main complaint
C. Special character and effects
D. Mode and cause of onset
B. Other Symptoms aside from the main complaint
37 year old female complaining of vague hypogastric pain . Which of the following key information would be least likely to be prioritize during your history taking.
A. Sexual History: Are you sexually active, when was your last sexual encounter , number of previous sexual partner
B. Past Medical History: Do you have previous history of the same abdominal pain, Any previous hospitalization or surgery?
C. Personal and Social History: Are you currently employed, Do you have exposure to chemicals that would cause the said symptoms?
D. Menstrual history: When does your menstruation start, It’s duration and frequency
C. Personal and Social History: Are you currently employed, Do you have exposure to chemicals that would cause the said symptoms?
Part of Oropharynx includes the following except:
A. Uvula
B. Lateral and posterior pharyngeal wall
C. Posterior third of the tongue
D. Soft palate
A. Uvula
Pectus excavatum is also called
A. Pigeon chest
B. Box-type chest
C. Barrel chest
D. funnel chest
D. funnel chest
66 year old female came in at the Out-patient department. While performing Clinical breast examination which of the following is not a suspicious finding for Breast cancer:
A. Gradually enlarging nipple-areolar rash
B. Yellow to greenish nipple discharge
C. Breast skin dimpling
D. Fungating, ulcerated breast mass
B. Yellow to greenish nipple discharge
47 y/o assessment there were noted reddish to bluish discoloration along the periumbilical area. With this finding, the following are possible differential diagnoses, except
A. Ruptured Ectopic Pregnancy
B. Ruptured Aneurysm
C. Ruptured hollow viscus
D. Pancreatitis
C. Ruptured hollow viscus
Before performing Digital rectal examination, as a medical student, you need to be familiarized with the anatomy of the anorectal region. This is defined as the distance from Anal verge up to Anorectal ring.
A. Anatomic Anal Canal
B. Surgical Anal Canal
C. Valve of Houston
D. Rectal Ampulla
B. Surgical Anal Canal
40 year old male present with 5 month history of intermittent anal pain . You are considering Anal fissure. Which of the following comprises the Golligher triad of Chronic anal fissure.
A. Ulcer, Anal tag, Hypotrophied papilla
B. Rectal laceration, Sentinel pile, anal tag
C. Hypertrophied papilla, Ulcer, Sentinel pile
D. Hypotrophied papilla, Sentinel pile, Ulcer
C. Hypertrophied papilla, Ulcer, Sentinel pile
The following are different position of the patient prior to rectal examination, except.
A. Dorsal recumbent position
B. Knee-elbow position
C. Sims (right lateral) position
D. Lithotomy position
C. Sims (right lateral) position
In Pelvic examination, the following can be examined thru Internal Examination, except.
A. Cervix
B. Vaginal wall
C. Vaginal introitus
D. Pelvic muscle
C. Vaginal introitus
23 y/o female complains of Vaginal pruritus and thick white vaginal discharge, Upon pelvic examination, what could be the possible cause of infection.
A. Cervical polyps
B. Trichomonas vaginalis infection
C. Gonorrhea
D. Yeast infection
D. Yeast infection
23 y/o male complains of fever, malaise and arthralgia. Further history revealed painful penile region with presence of small vesicles along the shaft of penis. what could be the possible cause of infection.
A. Herpes simplex virus
B. HPV type 6,11
C. Haemophilus ducreyi
D. Treponema pallidum
A. Herpes simplex virus
63 y/o intermittency . to rule out possible sign of Benign Prostatic Hyperplasia, you performed DRE which revealed Bilobar rounded surface, well delinated median sulcus with approximately two fingertip of length. Ultrasound revealed 45 grams. What could be the possible Grade of the Prostate
A. Grade III
B. Grade II
C. Grade IV
D. Grade I
B. Grade II
