Surgery Final (Part 2) Flashcards
The treatment of choice in malignant lymphoma is/are:
B. Radiotherapy and/or chemotherapy
The earliest sign of carcinoma of the larynx is
C. Hoarseness
The most common histologic type of carcinoma in the head and neck area is
C. Squamous cell carcinoma
The most commonly benign salivary gland tumor in children:
B. Hemangioma
Knowledge of the lymphatic drainage is important because it will:
B. Give an idea where the primary lesion is
A neoplasm that occurs primarily in the parotid gland, more commonly seen in males in the older age group and is also known as papillary cystadenoma lymphomatosum
C. Warthin’s tumor
Sudden facial paralysis associated with vesicles in the external audiotory canal and pinna:
C. Ramsay hunt syndrome
The opening of the parotid duct is at level:
C. 2nd upper molar
In which of the following conditions is the cornea most opacified? MPL = 0.25
b. Leukoma
A condition that gives painless blurring of vision is: MPL = 1.0
a. Central retinal vein occlusion
The most important factor for developing diabetic retinopathy is: MPL = 0.25
a. Duration of the diabetes
In hyperopia, the axial length is: MPL = 1.0
a. Too short
The leading cause of avoidable and reversible blindness worldwide is/are … MPL = 0.5
a. …Cataracts.
The most useful chart attractive to preschool illiterate children: MPL = 0.5
c. Allen Chart
One advantage of Direct Ophthalmoscopy over Indirect Ophthalmoscopy is: MPL = 1.0
b. Magnification
Flouresecin dye when viewed using a cobalt blue light will appear as: MPL = 0.5
d. Luminous green
Blind spot on a normal visual field is also known as: MPL = 1.0
a. Scotoma
Most accidental eye injuries can be prevented by… MPL = 0.5
a. …a good pair of protective goggles
The most important consideration in Testing Near Acuity: MPL = 0.25
a. Age
Determination of Visual Field Extent is best demonstrated by: MPL = 0.25
a. Octopus Perimetry
In performing Direct Ophthalmoscopy, the first element that must be observed: MPL = 0.5
b. Red reflex
In the three-part step-wise sequence in external eye examination, one procedure that is not usually included: MPL = 1.0
d. Percussion
The patient was not able to see hand movement. What is the next step to check his visual acuity?MPL= 0.5
a. Check light perception*
A patient is only able to read the first line of the Jaeger chart. His near visual acuity is recorded as…MPL=0.3
b. J16 -2 lines*
In assessing facial sensation, the three branches of the cranial nerve V that is being tested are…MPL=0.3
d. Ophthalmic n., maxillary n., mandibular n.*
Which of the following is/are true of the corneal blink reflex? MPL=0.3
b. The afferent arm of the reflex is the trigeminal nerve*
Which of the following is a term used to describe normal binocular eye movement in the same direction? MPL=0.5
b. Versions*
Giant papillary reaction is common in… MPL = 1.0
a. Contact lens overuse
Ophthalmia Neonatorum is usually a bacterial cause of conjunctivitis: MPL =0.3
a. True
The spread of epidemic viral conjunctivitis is best curtailed by: MPL =0.25
d. Frequent hand washing
Which is not an anatomic locale description of the conjunctiva? MPL =0.5
c. Limbal
Adenoviral conjunctivitis may cause: MPL =0.3
a. a true membrane on the tarsal conjunctiva
Which of the following statements regarding the use of steroid eye drops for red eyes is correct? MPL =0.3
c. The possible complications of steroid use include Glaucoma AND Cataract formation
The medication specifically used against adenovirus conjunctivitis currently is: MPL =0.3
d. There is no specific medication against adenovirus
The definitive management of gonococcal conjunctivitis is: MPL =0.3
b. Ceftriaxone 1gram intramuscular injection once only.
Which of the following conjunctivitides is almost always bilateral? MPL =0.5
d. Allergic
Fusion of the bulbar and tarsal conjunctiva as a result of prolonged inflammation and scarring is termed: MPL =0.3
b. Symblepharon
Painful blurring of vision can be due to: MPL = 1.0
b. Acute angle closure glaucoma
Glaucoma is characterized by: MPL = 0.25
d. Damage to optic nerve head
Secondary glaucoma may occur in: MPL = 0.25
a. Hyphema
The hallmark of Grade IV hypertensive retinopathy associated with malignant hypertension is: MPL = 0.25
c.optic disc edema
The systemic condition that presents with the most complications in the posterior pole of the eye: MPL = 0.25
b. Diabetes Mellitus
In testing for strabismus, the corneal light reflex did not fall at the same relative position on each eye instead it was located at the temporal borders of the pupils, the patient has: MPL = 0.5
b. Esotropia
In cover testing, the uncovered eye moves inward to fixate, the patient has: MPL = 0.5
c. Exotropia
A 5 year old child was brought to an ophthalmologist because his family had noticed a strange, white reflection that appeared in one of his eyes in photographs while the rest have red eyes due to the flash. Further examination disclosed Retinoblastoma.
b. leucocoria
Computed Tomogram of the above child showed a unilateral tumor filling the left eye. Nasal third of the tumor is calcified. Impression of Retinoblastoma is confirmed with the following histologic features: MPL=0.5
a. Islands of blue cells in a sea of pink necrosis / b. Cuboidal cells circled around a central luman: Flexner-Wintersteiner rosettes/ c. Flower like grouping of tumor cells which look like photoreceptors: Fleurettes/ d. All of the above
A 23/M consulted the OPD because anterior eyelid crusting of 3 days duration. The resident requested for a gram-stain which revealed Gram-positive cocci in clusters. Which statement is consistent with the impression of Staphylococcal blepharitis? MPL =
a. Coagulase production specifies etiologic agent to be Staphylococcus aureus
Which of the following viruses is transmissible even after medical instrumentation is cleaned with alcohol? MPL = 0.5
b. Adenovirus
A newborn was admitted to the NICU because of mucopurulent eye discharge at birth. The mother had a documented chlamydial genito-urinary tract infection. What bacterial features are consistent with the neonatal ocular finding? MPL = 0.5
c. The outer cell wall resembles the cell-wall of gram-negative bacteria
A 50/M farmer consulted the OPD because of right corneal opacity of 3 weeks duration. He claimed his right eye was hit by a palay strand while harvesting. Clinical history alone leads to a strong suspicion of fungal keratitis. Which of the following st
b. The cell wall polysaccharides are uniquely stained by periodic acid-Schiff (PAS)
A 43/F consulted because of a sessile mass at the limbus. The excision biopsy revealed squamous papilloma. Which of the following is true about the association of the Human Papilloma Virus (HPV) with squamous papilloma? MPL = 0.5
c. HPV DNA induces cellular proliferation and can lead to malignancy
A 30/M consulted the OPD because of foreign body sensation with mucopurulent discharge of 6 days duration. A detailed slit-lamp biomicroscopic examination demonstrated clinical features of trachoma. Which are features of an adult trachoma compared to a ne
d. Follicular response is greater
Condition in which there is discoloration of the eyelashes MPL = 0.5
d. Poliosis
The condition in which an extra row of lashes exists is MPL =0.5
b. Distichiasis
A white pupillary reflex is called: MPL = 1.0
c. leukocoria
An infant born less than 31 weeks, weighing less than 1500g (3 lb 5 oz) plus exposure to supplemental oxygen, one should screen the eyes for: MPL = 1.0
d. Retinopathy of Prematurity (ROP)
This is the second most common mode of presentation in Retinoblastoma which account for about 20 % of cases: MPL =0.5
d. strabismus
The following are treatment options for Retinoblastoma except MPL = 1.0
d. Evisceration
The following are correct in visual acuity testing in a child EXCEPT MPL=0.5
c. At 8 years old, test with an Amsler grid chart
Leukocoria caused by the presence of red cells in the vitreous secondary to birth trauma MPL=0.5
c. Vitreous Hemorrhage
A biconves, avascular, colorless structure that focuses light rays to the retina, an opacity of which will cause leukocoria MPL=0.5
a. Lens
Ophthalmological examination that would identify presence of an intraocular mass MPL=0.5
b. Indirect Ophthalmoscopy
The most common presenting sign of retinoblastoma is MPL=1.0
c. White pupil
Due to the inheritance pattern of retinoblastoma, a vital part of treatment would incude: MPL=0.5
b. Genetic counseling
A surgical procedure involving removal of intraocular contents: MPL=0.5
b. evisceration
Management of CRAO includes MPL =0.5
a. “Brown bagging” / b. Alternate compression and decompression of the globe/ d. A and B only
Characteristic findings in Central Retinal Artery Occlusion MPL = 0.25
b. Cherry red spot in the macula
The TRUE statement regarding chemical burns MPL = 1.0
d. In copious irrigation of the eye, the fluid used need not be sterile, provided the chemical is diluted properly
EOM movement of one eye is called MPL =0.5
a. Ductions
Absence of venous pulsations on funduscopy MPL =0.3
a. May indicate increase intracranial pressure/ b. May be normal / d. A and b
To examine the optic nerve binocularly, use MPL = 0.3
a. Indirect ophthalmoscope/ b. Non contact fundus lens / d. A and B
What ancillary procedures should you do if suspecting optic nerve toxicity? MPL = 0.25
a. Visual field exam / b. Visual evoked potential / c. Color test / d. All of the above
One of the most common reasons for Neuroophtha referral … MPL = 1.0
a. …unexplained vision loss
Which of the following is true regarding viewing the fundus… MPL = 1.0
c. Direct ophthalmoscopy provides greater detail of the fundus
What is the most important adverse effect of local anesthetic overdosage? MPL = 0.25
c. convulsion
Cortocosteroid stops the inflammatory process by inhibiting prostaglandin synthesis through the following mechanism: MPL = 1.0
b. blockage of the enzyme phospholipase A
Which of the following statements regarding papilledema is not true? MPL =0.3
a. Loss of venous pulsation is always present
Most common visual field finding in papilledema MPL = 0.3
d. Enlargement of the blind spot
Typically the onset of visual loss in demyelinating optic neuritis is noted MPL = 0.25
a. Upon arising in the morning
One of the following findings is not a characteristic of true disc edema MPL = 0.25
b. abnormal branching of vessels around the disc
Most common cause of optic disc swelling in children MPL = 0.3
a. Infectious optic neuritis
One of the following is not a characteristic finding of optic neuritis in children MPL = 0.25
d. Always resistant to steroids
Most common condition associated with nonarteritic anterior ischemic optic neuropathy MPL = 0.5
d. Hypertension
Which of the following is the most common optic neuropathy in patients over the age of 50? MPL = 0.3
d. Nonarteritic anterior ischemic optic neuropathy
- An obese 26 year old woman presents with headaches and transient visual obscurations. Bilateral papilledema is documented. The next step should be which of the following MPL = 0.3
d. Do CT or MRI of the brain
Exophthalmos is a term used specifically in which of the following conditions? MPL = 1.0
a. Thyroid disease
The most commonly observed Cumulative Trauma disorder is
C. Carpal tunnel syndrome
The ff. is an indirect cost of injury among workers
C. Training replacements
The ff. is an indication for surgical release of CTS
A. Severe causalgia
The ff. is a feature of Impingement Syndrome
C. Limited active abduction of the shoulder
In Reflex sympathetic dystrophy the ff. is true
B. Autonomic changes
The most common lump on the hand is
B. Ganglion cyst
The Following can lead to Frozen Shoulder EXCEPT
D. Trigger finger
Avascular necrosis of the Lunate
B. Keinbocks
A worker comes with a lump on the dorsal elbow, it is movable, soft with tenderness. He has a habit on putting his weight at the elbow , he has
D. Student’s elbow
The best thing to do in acute tendenitis is
B. To rest it in a splint
The grip strength of a dominant hand is usually stronger than the non dominant hand by
A. 10 lb.
A functional non organic sensation deficit is evident if there is
B. sensory deficit in the whole leg
To prevent overvaluation and subjection to potential risk of tests. The following will suggest a non organic findings in back pain
B. light pinch tenderness of skin on vast area of the back
The most common type of muscular dystrophy is
A. Limb Girdle
Cramps is the usual complain of
B. Myotonic
Spinal dysraphism can be detected in utero after 18 weeks by taking the
B. Amniotic Alpha feto protein
A positive Gowers sign is
B. Present in pelvic and proximal leg weakness
Ischemic Compression Test is for
D. McArdle’s Disease
A dive bomber sound on EMG is seen in
B. Myotonia
Fasciculation’s of the tongue and limb muscles is frequently seen in
D. SMA
Most of children with this condition cannot reach adulthood except
B. Fascioscapulohumeral dystrophy
The most common cause of death of children with myopathies is
C. Pulmonary problem
This reflex is integrated in the spinal cord
C. Flexor withdrawal
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
Patient with Spina bifida should be examined for
C. Presence of hip dislocation
This instrument is used to measure range of motion of joints:
B. goniometer
Which of the following is considered as a deep heating modality:
C. ultrasound
On stimulation the baby extend and abduct the limbs followed by flexion and adduction
A. If this is a normal baby he is less than four months
Stroke rehabilitation may be started:
A. as soon as the patient’s neurological and medical condition stabilizes
This reflex is integrated in the spinal cord
C. Flexor withdrawal
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
At four months of age the child is expected to
D. Rolls over from supine
A child of 3 years is expected to
C. Walks up stairs alternating feet
A dyskenitic Cerebral palsy is frequently associated with
A. Bilirubin encephalopathy
True of a geriatric individual
· They prefer to be independent
Some of the changes in the elderly is
A. Decline in the number of motor units
Crystallized intelligence is preserved in elderly this is
C. comprehension
Elderly has tendency to fall. One reason is a sudden drop of blood pressure which can be due to
B. Sudden change in position or abrupt standing
Exercise prescription for an osteoporotic patient is
C. Walking
Osteoporosis has an earlier onset in women . And this is usually evident during
C. 5 to 7 years after menopause
Elderly patient is prone to bed sore because of
A. Loss of subcutaneous fat
Cardiorespiratory changes in elderly
A. Lower maximal heart rate
To prevent hypotension in elderly it is best to observe
C. Standing slowly while holding to a bar
A spinal cord injury with weaker upper extremities than lower extremities is
C. A bilateral brachial plexus injury
An SCI patient states that he has intact sensation up to the umbilicus, without movement over his legs. This means
A. His sensory level is T10
The most common site of heterotrophic ossification among burn patient is at the
C. Elbow
A bedridden quadriplegic has painful inflamed thigh . The working diagnosis is DVT , it is best to differentiate this with
B. Heterotopic ossification
The most common tumor of the bone
C. Metastatic
The most common cause of Traumatic brain injury is
A. Vehicular accident
A C-curve scoliosis is common in
D. Paralytic scoliosis
Physical finding in scoliosis on convexity side
D. Prominent scapula
Physical finding in scoliosis on concavity side
B. Prominent front chest
This syndrome of massive sympathetic discharge associated with the SCI patients with lesions at T6 level, characterized by headache, hypertension, diaphoresis and reflex bradycardia is known as:
C. autonomic dysreflexia
This is the most important aspect to consider in the management of decubitus ulcer:
A. relief of pressure
What is the key muscle for testing C7 myotome, according to the American Spinal Injury Association?
A. triceps
This level is generally the highest level of injury at which spontaneous ventilation can be sustained. Injuries above this level generally require mechanical ventilation:
A. C4
This is referred to as an ectopic bone formation occurring within 6 months after spinal cord injury:
A. heterotopic ossification
This is generally considered the drug of choice for spasticity in SCI:
B. Baclofen
The most commonly observed Cumulative Trauma disorder is
C. Carpal tunnel syndrome
The ff. is an indirect cost of injury among workers
C. Training replacements
The ff. is an indication for surgical release of CTS
A. Severe causalgia
The ff. is a feature of Impingement Syndrome
C. Limited active abduction of the shoulder
In Reflex sympathetic dystrophy the ff. is true
B. Autonomic changes
The most common lump on the hand is
B. Ganglion cyst
The Following can lead to Frozen Shoulder EXCEPT
D. Trigger finger
Avascular necrosis of the Lunate
B. Keinbocks
A worker comes with a lump on the dorsal elbow, it is movable, soft with tenderness. He has a habit on putting his weight at the elbow , he has
D. Student’s elbow
The best thing to do in acute tendenitis is
B. To rest it in a splint
The grip strength of a dominant hand is usually stronger than the non dominant hand by
A. 10 lb.
A functional non organic sensation deficit is evident if there is
B. sensory deficit in the whole leg
To prevent overvaluation and subjection to potential risk of tests. The following will suggest a non organic findings in back pain
B. light pinch tenderness of skin on vast area of the back
The most common type of muscular dystrophy is
A. Limb Girdle
Cramps is the usual complain of
B. Myotonic
Spinal dysraphism can be detected in utero after 18 weeks by taking the
B. Amniotic Alpha feto protein
A positive Gowers sign is
B. Present in pelvic and proximal leg weakness
Ischemic Compression Test is for
D. McArdle’s Disease
A dive bomber sound on EMG is seen in
B. Myotonia
Fasciculation’s of the tongue and limb muscles is frequently seen in
D. SMA
Most of children with this condition cannot reach adulthood except
B. Fascioscapulohumeral dystrophy
The most common cause of death of children with myopathies is
B. C. Pulmonary problem
This reflex is integrated in the spinal cord
C. Flexor withdrawal
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
Patient with Spina bifida should be examined for
C. Presence of hip dislocation
This instrument is used to measure range of motion of joints:
B. goniometer
Which of the following is considered as a deep heating modality:
C. ultrasound
On stimulation the baby extend and abduct the limbs followed by flexion and adduction
A. If this is a normal baby he is less than four months
Stroke rehabilitation may be started:
A. as soon as the patient’s neurological and medical condition stabilizes
This reflex is integrated in the spinal cord
C. Flexor withdrawal
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
At four months of age the child is expected to
D. Rolls over from supine
A child of 3 years is expected to
C. Walks up stairs alternating feet
A dyskenitic Cerebral palsy is frequently associated with
A. Bilirubin encephalopathy
True of a geriatric individual
C. They prefer to be independent
Some of the changes in the elderly is
A. Decline in the number of motor units
Crystallized intelligence is preserved in elderly this is
C. comprehension
Elderly has tendency to fall. One reason is a sudden drop of blood pressure which can be due to
B. Sudden change in position or abrupt standing
Exercise prescription for an osteoporotic patient is
C. Walking
Osteoporosis has an earlier onset in women . And this is usually evident during
C. 5 to 7 years after menopause
Elderly patient is prone to bed sore because of
A. Loss of subcutaneous fat
Cardiorespiratory changes in elderly
A. Lower maximal heart rate
To prevent hypotension in elderly it is best to observe
C. Standing slowly while holding to a bar
A spinal cord injury with weaker upper extremities than lower extremities is
A. A posterior cord syndrome B. Central cord syndrome C. A bilateral brachial plexus injury D. A hemi section of the spinal cord
An SCI patient states that he has intact sensation up to the umbilicus, without movement over his legs. This means
A. His sensory level is T10
The most common site of heterotrophic ossification among burn patient is at the
C. Elbow
A bedridden quadriplegic has painful inflamed thigh . The working diagnosis is DVT , it is best to differentiate this with
B. Heterotopic ossification
The most common tumor of the bone
C. Metastatic
The most common cause of Traumatic brain injury is
A. Vehicular accident
A C-curve scoliosis is common in
D. Paralytic scoliosis
Physical finding in scoliosis on convexity side
D. Prominent scapula
Physical finding in scoliosis on concavity side
B. Prominent front chest
This syndrome of massive sympathetic discharge associated with the SCI patients with lesions at T6 level, characterized by headache, hypertension, diaphoresis and reflex bradycardia is known as:
C. autonomic dysreflexia
This is the most important aspect to consider in the management of decubitus ulcer:
A. relief of pressure
What is the key muscle for testing C7 myotome, according to the American Spinal Injury Association?
A. triceps
This level is generally the highest level of injury at which spontaneous ventilation can be sustained. Injuries above this level generally require mechanical ventilation:
A. C4
This is referred to as an ectopic bone formation occurring within 6 months after spinal cord injury:
A. heterotopic ossification
This is generally considered the drug of choice for spasticity in SCI:
B. Baclofen
A female cancer patient is in constant pain which is severe, radiating, shooting and electric like in character. Most likely cause of her pain is:
B. Compression of a nerve by the enlarged mass
Gate’s Control Theory of pain is the basis for all the following non pharmacologic pain management EXCEPT:
D. Biofeedback
A peripheral type of pain:
A. Myofascial pain syndrome
Management of pain due to excision of mass in the anterior abdominal wall:
A. Non-steroidal anti inflammatory agents (NSAIDs)
Chronic use or prolonged intermittent administration of this opioids. Results in neurotoxicity due to its metabolite.
A. Meperidine
Major toxicity of short term use of NSAIDs:
B. C. Gastro duodenal irritation
Effective in neuropathic pains:
D. D. Anticonvulsants
Acupuncture based on traditional Chinese medicine.
B. Solid needles inserted along meridians
A focussed concentration used as a guide to patients to focuss away from their pain.
B. Hypnosis
Which of the following NSAIDs act on the central cyclooxygenase?
B. Paracetamol
The gold standard to which all of the other opioids are being compared to.
B. Morphine
Which of the following opioids is an agonist-antagonist.
C. Nalbuphine
Mechanism of action of ketamine.
C. Prevents the removal of magnesium from the NMDA receptor in the post-synaptic nerve
Opioids receptor responsible for the respiratory depressant effect of opioids
B. Mu 2 receptor
The following local anesthesic exhibit vasoconstricting effect at low and high doses.
D. Cocaine
One of the following is on objective sign of CNS toxicity:
A.Convulsion
Local anesthetic that belongs to amide group.
B. Lidocaine
Local anesthetic that is converted to O-toluidine in the liver:
C. Prilocaine
Local anesthetic with arrtiarrhythmic effect
C. Lidocaine
Addition of vasoconstrictors to local anesthetics will:
B. Prolong the duration of action of local anesthetic
Local anesthetic that causes unidirectional block and re-entry type of cardiac arrhythmia.
A. Bupivacaine
The median nerve originates from the:
A. Lateral cord / B. Medial cord/ C. Both A & B
The Dorsalis Pedis Artery is used as landmark to block the:
B. C. Deep Peroneal nerve
The nerve blocked, when local anesthetic is injected between the palmaris longus and tendon longus and flexor carpi radialis at the wrist.
B. Median nerve
Caudal anesthesia is a form of:
D. Epidural block
Boundaries of the anatomic Snuff Box EXCEPT:
D. Abductor Pollicis Brevis
The nerve blocked posterior to the lateral malleolus.
A. Sural nerve
Complication of pudendal nerve block during vaginal delivery:
B. C. Puncture of fetal head
Delayed complication of spinal anesthesia
B. Urinary retention
The nerve found at the anatomic snuff box nerve
C. Radial nerve
Nerve blocked in Retrobulbar nerve block
B. Ciliary Ganglion
Branch of intercostals nerve often spared when injection of local anesthetic is done at the anterior axillary line:
D. D. Lateral cutaneous branch
Landmark in doing superficial cervical plexus block.
C. Sternocleidonastoid muscle
Approach in doing brachial plexus block that anesthetize the entire plexus:
C. Infraclavicular Approach
Post spinal headache as a delayed complication of spinal anesthesia is due to:
C. CSF leakage
T6 level of sensory blockade is at the level of :
D. Xiphoid process
The line joining the highest points of iliac crest (ASIS) crosses:
C. L4 interspace
In adult the spinal cord ends at the level of:
C. L1
Drug administration that allows patient to titrate analgesics according to their needs:
A. Patient controlled analgesia (PCA)
A patient can be discharged from the Postoperative care unit if he is:
D. Pulse oximeter reading is 97% at room air.
CASE: LA, 35 years old female is schedule for appendectomy: BP=130/80 PR=88/min anesthesia given is subarachnoid block: What is the ideal level of the block?
B. Midspinal
Upon doing the pinprick test, the sensory block is at the level of the nipple (T4). Give the level of motor block:
A. T6
Five minutes after assuming the supine position; the BP because 90/60 PR=50/min. Give the reason for hypotension:
B. C. Sympathetic block
What is the immediate management? Of hypotension
C. Increase IV fluid infusion
What is the immediate management of the bradycardia?
C. Atropine sulfate
Intake of an agent by the body and the uptake of the agent by the tissues is termed.
C. Absorption
Distribution of general anesthetic drugs is influenced by:
C. Regional blood flow
Discovered oxygen and nitrous oxide:
B. Joseph Priestly
Muscle relaxation is the result of :
C. Motor block
True of nondepolarizing muscle relaxant:
A. Competetive inhibition with acetylcholine
Last CNS structure depressed by general anesthesia is:
C. Medullary center
A 16 year old healthy patient with incarcerated inguinal hernia, for inguinal herviorhaphy the American Society of Anesthesiologists risks classification under:
A. Class I
Cardiovascular intolerance to changes in position after anesthesia is a sign of:
B. C. Excessive depth of anesthesia
Heat and cold sensations are transmitted through this type of nerve fibers:
B. C. A beta fibers
Sharp cut on the skin are transmitted mostly through this type of nerve fibers:
A. C-fibers
Referred pain occurs due to convergence of nerve fibers in this neurons:
C. Wide dynamic range neurons
Which of the following is an excitatory nerve transmitter for the pain pathway:
A. Glutamate
In the dorsal horn of the spinal cord, the opioid receptor are found in:
B. Lamina II
First order neuron are found in:
D. D. Dorsal root ganglion
Primary afferent fibers with fastest conduction velocity:
C. A beta fibers
Known as carrier gas:
B. Oxygen
True of ketamine HCL effect:
B. C. Increase intraocular pressure
Which of the following is a belladona alkaloid?
C. Atropine sulfate
An inherited abnormality resulting from exposure of patient to certain anesthesic:
C. Malignant hyperthermia
One of the following is a weak anesthetic but a potent analgesic.
A. Nitrous oxide
Local anesthetic with vasoconstriction effect:
D. Cocaine
Systemic toxicity to local anesthesia is manisfested by:
A. Convulsions
Causes methemoglobinemia because it is degraded in the liver to otoluidine w/c causes oxidation of hemoglobine.
C. Prilocaine
Factors that affect absorption of local anesthetic.
C. pKA
Duration of action of local anesthetic correlates with :
B. Protein buiding
Potency of a local anesthetics correlates with.
A. Lipid solubility
Onset of action of a local anesthetic correlates with.
C. pKA
When asked about the pain he categorically says it is minimal. Numerical score is.
A. 1 to 3
Tramadol and Meperidine should not be given in patients receiving.
D. D. Monoamineoxydase inhibitor
Mechanism of action of tramadol.
A. A weak mu receptor agonist / B. Inhibits nor adrenalin receptor/ C. Inhibits serotonin receptor/ D. All of the above
Mechanism of action of NSAIDs
A. Inhibition of lipooxygenase/ B. Inhibition of cyclioxygenase inhibitor/ C. Inhibition of phospholipase /D. All of the above
Common complication of retrobulbar block in extremely myopic eye.
A. Globe perforation
The landmark for doing deep peroneal nerve block.
C. Dorsalis pedis artery
Most common complication of intercostals nerve block.
A. Pneumothorax
Local anesthetic technique which uses lidocaine spray 10%.
D. Topical
Needle puncture during spinal anesthesia can be made safely at the interspace.
C. L4 – L5
Mechanism of chronic pain which is often referred to as “nociceptive pain”.
A. Peripheral
Management for central type pf pain:
B. Opioids
Nerve missed in doing the axillary approach in brachial plexus block
D. Musculo cutaneous nerve
Nerve blocked posterior to the medial malleolus.
B. Tibial nerve
The anesthetic potency of volatile liquid anesthetic is measured by:
B. Minimum alveolar concentration
The most common cause of airway obstruction is general anesthesia is:
C. Falling back of the tongue
Green is the standard color code for :
C. Oxygen
Elimination of general inhalation anesthetics is mainly thru:
D. Lungs
Part of the anesthesia machine that releases gas to the atmosphere.
B. C. Pop-off value
A patient with severe systemic disease that is a constant threat to life, will have a physical status classification.
D. ASA IV
Lowest intensity at which a given stimulus is perceived as painful.
B. Pain threshold
One of the following is an example of acute pain.
D. Post-operative pain
This gas is known as a “Laughing Gas”
C. Nitrous oxide
Type of ventilation used for apneic patient.
B. Controlled ventilation
Transduction occurs in the :
A. Peripheral terminals of primary afferent neurons
Characteristics of acute pain:
A. Generate reflexes
The nerve fiber is freely permeable to:
C. Na + ions
Which of the following layers of the retina does not terminate at the optic disc margin:
B. Nerve fiber layer
The adult orbital measurement is attained at this age:
C. 9th year
The orbital space formed by the recti muscles and their intermuscular membrane with the Tenon’s capsule:
A. Central surgical space
The condensation of fibrous tissues that thickens to form a sling (hammock) upon 39 which the globe rests:
C. Ligament of Lockwood
Which of the following does not pass thru the Superior orbital fissure:
D. Optic nerve
The extrinsic muscle that is not inserted in front of the equator:
B. Superior rectus
The adult size of the cornea is attained at:
A. 6th year of life
Which of the following is not TRUE of the Meibomian gland:
C. Modified sweat gland
True of the Optic nerve, except:
B. Emerges from the posterior aspect of the globe.
True of Conjunctival injection:
B. Vessels constrict with a drop of 1:1,000 epinephrine
Marked enlargement of the optic disk is rarely seen, but its occurrence suggests:
A. Myopia/ B. posterior staphyloma/ C. Both
Any opacity in the lens is called:
A. Cataract
The optic nerve is actually a collection of axons of the:
D. ganglion cells
As it courses through the orbit, the optic nerve derives its blood supply from the:
D. d. central retinal artery
The center of the visual field corresponds to visual perception from the following anatomic structure:
B. the fovea
Mass lesions of the pituitary gland classically produce the following field pattern:
C. bitemporal hemianopsia
To enable stereoscopic vision, the visual fibers are so arranged that fibers over the nasal retina decussate while temporal fibers continue ipsilaterally to their corresponding lateral geniculate body. The crossover of fibers occur at the:
A. optic chiasm
Despite the seemingly horrendous appearance of the optic disc in acute papilledema, vision remains fairly good and the only deficit in the visual field is a:
B. enlarged blind spot
The following is true of optic nerve meningiomas:
B. symptoms are different from that of sphenoid wing meningiomas
Ischemic optic neuritis presents with this classical field defect:
B. cecocentral scotoma
True of pinguecula:
A. benign degenerative tissue
True of symblepharon:
A. chief cause is chemical burn/ B. keratitis occurs because of exposure / C. obliterate conjunctival cul-de-sac/ D. all of the above
Middle coat of the eye is composed of the following, except:
C. Retina
Structure that regulates the amount of light reaching the visual receptors of the eye:
D. Iris
The embryologic tertiary vitreous is known as what structure in the adult eye:
B. Vitreous body
Portion of the Tenon capsule that forma a sling upon which the globe rests:
A. ligament of lackwood
The type of conjunctivitis characterized by a localized whitish nodule with a necrotic excavated center surrounded by conjunctival injection:
c. phlyctenular conjunctivitis (Espiritu etal, p. 54)
The virus that can cause congenital cataract:
c. rubella (Newell, p. 377)
Carbonic anhydrase inhibitors are given as a treatment for glaucoma. Its mechanism of action is:
b. to decrease aqueous humor production (Espiritu, p. 101)
While cutting grass in his garden, a 50-year old male felt a small piece enter his left eye. He experienced foreign body sensation and eye redness. No consult was done and no medications were instilled. A few days later, he noted a fluffy, grayish white e
c. corticosteroids (Newell, p. 249)
Softening of the cornea associated with malnourishment:
b. keratomalacia (Espiritu etal, p. 60)
An ophthalmic emergency characterized by sudden blurring or complete loss of vision with a characteristic cherry-red spot on funduscopy:
d. central retinal artery occlusion (Espiritu, p. 88)
A 45-year old female suddenly experienced blurring of vision, with a sensation of a curtain in a part of the field of vision. The primary consideration in this patient is:
b. retinal detachment (Espiritu, p. 92)
A 2-year-old boy was brought in for consultation because the mother noted a “white pupil”. Which of the following is NOT a differential diagnosis for this case?
a. congenital glaucoma (Newell, p. 326)
Which of the following is responsible for scotopic vision or dim illumination:
a. rods only (Espiritu, p. 86)
The ocular lesion in congenital toxoplasmosis is characterized as:
c. single choroidoretinal scar prominently in the posterior fundus (Espiritu, p.126)
A 45-year-old male presents with a painless mass on the upper outer portion of his upper eyelid. There was moderate proptosis. Which is true of his condition?
c. It contains mesenchymal elements and double-layered tubular epithelial units (Newell, p. 263)
A chronic inflammatory lipogranuloma of a meibomian gland, characterized by a gradual painless swelling of the gland without other external signs of inflammation:
b. chalazion (Newell, p. 204)
The palpebral fissure among Filipinos measures:
d. 8-10 mm in height and 26-29 mm in length ( Espiritu, p. 9)
Passive swelling of the optic nerve occurring secondary to increased pressure in the subarachnoid space of the meningeal coverings of the brain and optic nerves:
a. papilledema (Newell, p. 357)
