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