SURGERY TERM EXAMS Flashcards
It is the most common fluid disorder in surgical patients.
None of the choices is correct
R.M, a 46 year-old alcoholic male underwent total thyroid surgery. During the first postoperative day, he presented with positive Chvostek sign. What may be true about his current status.
All of the choices are correct
The barbers and the surgeons were integrated into one guild in:
1540
Causes of hypocalcemia except:
Hyperparathyroidism
He developed a system of surgery termed a school of surgery that aimed to developed surgeons of the highest type:
William Halsted
He stressed the importance of identifying the recurrent laryngeal nerve during the course of thyroid surgery
Frank Lahey
Stress released ADH and acts on the kidneys resulting to:
Increase water absorption
In anaerobic respiration, the primary fuel utilized is:
Pyruvate
The following is/are correct regarding volume control in maintaining fluid balance:
None of the choices is correct
ADH is released from the ______ during surgical stress.
Posterior pituitary
Aldosterone is an important hormone released during the stress response. It comes from the adrenals, specifically from the:
Zona glomerulosa
He reversed the church’s long-standing ban of human dissection and sanctioned the study of anatomy from the cadaver:
Pope Clement VII
Metabolic disturbances that occurs when large numbers of neoplastic cells are killed rapidly during the initiation of chemotherapy, leading to the release of intracellular ions and metabolic byproducts into the systemic circulation:
Tumor lysis syndrome
He created an early version of what became the Mobile Army Surgical Hospital (MASH) unit.
Michael DeBake
He recognized that the elimination of bacteria by excessive heat could not be applied to a patient. Instead, he turned to chemical antisepsis:
Joseph Lister
Positive Chvostek sign is present in:
Hypocalcemia and hypomagnesemia
During injury, the afferent sensory stimulus is received by:
X Vagus Both
True regarding management of hyperkalemia:
None of the choices is correct
B.L, a 41 year old male was admitted because of severe hyponatremia. IV repletion of sodium was started. About 12 hours after he was noted to have confusion, horizontal gaze paralysis and spastic quadriplegia. He may have developed:
Central pontine myelinosis
He performed the first surgical operation during which a blood transfusion was used:
George Crile
During injury, the afferent sensory stimulus is received by the:
Hypothalamus
Catecholamines play a very important role during the stress response. They are released from the:
Adrenal medulla
The heart-lung machine which paved way for successful open heart surgery, including congenital heart defects, was invented by
John Gibbon
Instead of putting boiling oil to wound, pure blended a concoction made of the following:
None of the choices is correct
During stress, catecholamines cause all of the following, excpet:
Glycogenesis
The following statement/s about insensible water loss is/are correct except:
Profuse sweating is the most common cause
He devised an operative dermatome that allowed calibration of the thickness of skin:
Earl Padgett
The oldest and readily available method of bleeding cessation is:
Direct pressure
The following is not true regarding platelets:
Platelet cyclooxygenase is reversibly inhibited by aspirin
Positive Chvostek sign is present in:
Hypocalcemia and hypomagnesemia
The following will have thromboembolic events as their end results:
Factor V resistance to cleavage
Metabolic effect of shock except:
Increased intracellular pH
Goals of proper management of hyerkalemia:
IV glucose administration to shift potassium to the ICF compartment
Andreas Vesalius came out with a great anatomic treatise which provided fuller and more detailed descriptions of human anatomy than any of his illustrious predecessors:
De Humani Corporis Fabrica Libri Septem
He did not emphasize hand scrubbing because he was convinced that scrubbing created crevices in the palms of the hands were bacteria would proliferate:
Joseph Lister
All a stromal feeding alternatives, except:
Duodenostomy
R.M, a 34 year old healthy female. She weighs 60 kg and 160 cm tall. How much water does she has in her interstitial space?
7.5 liters
Hypovolemic shock hemodynamic response
Increase cardiac index
An adult male patient has an adamantimoma of the mandible. He will undergo elective excision and mandibular reconstruction using a free vascularized fibular graft. You computed his TCR at 1,670 kcal/day. The weight of CHO will be approximately _____ grams.
250
The component/s of damage control resuscitation is/are:
Permissive hypotension
Potent mesenteric vasoconstrictor/s:
Anti-diuretic hormone
In October 1846, the first public demonstration of the use of anesthesia in surgery took place in Boston, William Morton used _____ as anesthetic.
Sulfuric ether
An adult male patient has an adamantimoma of the mandible. He will undergo elective excision and mandibular reconstruction using a free vascularized fibular graft. You computed his TCR at 1,670 kcal/day. The ____% of the TCR will be the CHOH requirement.
20
An adult male patient has an adamantimoma of the mandible. He will undergo elective excision and mandibular reconstruction using a free vascularized fibular graft. You computed his TCR at 1,670 kcal/day. The weight of CHOH will be approximately ____ grams.
334
An adult male patient has an adamantimoma of the mandible. He will undergo elective excision and mandibular reconstruction using a free vascularized fibular graft. You computed his TCR at 1,670 kcal/day. The ___% of the TCR will be the CHO requirement.
60
According to the Ancient Greek, the following are humors in the body except:
Green bile
The following are Tenets of Halsted except:
Approximate wound edges and suture tightly to ensure closure
An adult male patient has an adamantimoma of the mandible. He will undergo elective excision and mandibular reconstruction using a free vascularized fibular graft. You computed his TCR at 1,670 kcal/day. The weight of CHON will be approximately ____ grams.
84
An adult male patient has an adamantimoma of the mandible. He will undergo elective excision and mandibular reconstruction using a free vascularized fibular graft. You computed his TCR at 1,670 kcal/day. The ___% of the TCR will be the CHON requirement.
20
According to Claudius Galenus, the most dominant humor was:
None of the choices
In lieu of using boiling oil as a means of cauterzing fresh gunshot wounds, Ambroise Pares use of a less irritating emollient of egg yolk, rose oil and ____ brought him lasting fame and glory.
Turpentine
The following can be treated alone with Chemotherapy is/are:
All of the choices are correct (Leukemia, lymphoma and choriocarcinoma)
When electrodes are placed at the LA & RA, the expected reading will be from:
Lead 1 of a standard 3-lead ECG
Mechanisms whereby an anesthetic agent or surgical procedure may interfere with maternal or fetal physiology and in doing so harm the fetus.
Indirect effect
For the diagnosis of sarcoma and lymphoma, the best biopsy of choice is:
Core needle biopsy
Advantage of laparascopy over laparatomy during pregnancy except:
Increased uterine blood flow
A child sustained acute burns and is being resuscitated in the ER. The monitoring of the _____ is a measure of the adequacy of fluid rescuscitation.
Urine output
To measure CO2 in the airway throughout the respiratory cycle, _______ is used.
Capnography
In the usual monitoring sheets, time is plotted in _______ orientation.
Horizontal
The most common site of metastasis for breast cancer is:
Bone
True about safety guidelines for laparascopic surgery during pregnancy
Abdominal access is attained using open technique
Pre-operative assessment in elderly patients, except:
Emotional status
30% of patients 70 years and above who have liver or pancreatic cancer are being referred for cancer directed surgery. True or False?
False
Body composition of the elderly, except:
Decreased fat mass
A trauma patient is being monitored for abdominal compartment syndrome by measuring the:
Urine output
The following are considered solid organ tumors except:
Acute leukemia
The most common vascular complication in liver transplantation:
Hepatic artery thrombosis
The following is/are high risk for breast cancer except:
Early menopause
Nephrologic changes in the elderly will predispose to:
All of the choices are correct:
Hypovolemia
Hyperglycemia
Electrolyte imbalance
The following are advances laparoscopic procedures:
None of the choices
The most common arrythmia seen in CO2 pneumoperitoneum is:
Sinus bradycardia
The following are normal physiologic events in a pregnant patient except:
Decreased small bowel transit time
The following drugs are used for humoral rejection, except:
Belatacept
True about acute appendicitis in the elderly patients, except:
More than half has fever
John Hopkins frialty criteria:
Unintentional weight loss
The following statements regarding laparoscopic procedure is/are correct:
The laparascopic surgeon can influence cardiovascular performance by reducing or removing the CO2 pneumoperitoneum.
Vaginal bleeding in a pregnant patient involved in a trauma may indicate:
All of the choices are correct:
Preterm labor
Abruptio placentae
Placenta previa
The following organs are transplanted orthotopically except:
Pancreas
Benzene, a chemical carcinogen is associated with what condition?
Acute leukemia
It is the most common type of rejection, usually occurs within a few days or weeks posttransplant
Acute rejection
The following statements/regarding access for minimally invasive procedures is are correct:
All of the choices are correct
In the usual monitoring sheets, vital signs are plotted in ______ orientation.
Vertical
The following tumor marker is specifically used for surveillance for patients with colorectal cancer:
CEA
The classic pathognomic characteristic of a malignant cell is:
Can spread everywhere
A female adult patient presents to you in the ER. She claims to have undergone major abdominal surgery for cancer but was lost to follow-up. She remembered being told that she must have a CA 19-9 monitoring to determine recurrence of cancer. She must have undergone surgery.
Pancreatic
Giving of Hepatitis B vaccination and improved sanitation and lifestyle will prevent which cancer
Liver cancer
Elective surgical procedures should be delayed until:
None of the choices
A form of rejection in xenotransplantation which is mediated by the presence of natural xenoantibodies in humans:
Hyperacute rejection
A male adult patient presents to you in the ER. He claims to have undergone major abdominal surgery for cancer but was lost to follow-up. He remembered being told that he must have a CEA monitoring to determine recurrence of cancer. He must have undergone _______ surgery.
Rectal
Due to the low risk of complication, the most preferred site to insert a PAC is in the right:
Internal jugular vein
The following cancer are curable if detected early and treated adequately is/are:
All choices are correct:
Cervical cancer
Prostate cancer
Breast cancer
Why is the pancreas graft placed preferrably on the right?
Iliac vessels are in a more shallow position on the right than on the left
The following are steps in tumorigenesis except:
Metastasis
True about pregnant patients, except:
Incidence of symptomatic cholelithiasis is higher as compared to non pregnant patients of the same age group
It is one of the most devastating postoperative complications in kidney recipients:
Graft thrombosis
These are drugs that pose risk to the fetus based in human studies, but potential benefits may warrant use of the drug in pregnant women despite potential risks:
Category D
It is a surgical procedure in which a failing organ is replaced by a functioning one
Organ transplant
It is the transfer of cells, tissue, or an organ from one person to another of the same species
Allotransplant
The most common cause of fetal death in blunt trauma to the abdomen
Abruptio placentae
The accepted maximum dose of ionizing radiation during the entire pregnancy in mGy:
50 mGy (5 rads, 5 cGy)
Laparoscopy during pregnancy is best performed in the:
2nd
Tumor in which the malignant cells appear to lie exclusively above the basement membrane is referred to as:
In situ cancer
It is the spread of cancer cells from the primary site and the formation of new tumors in distant sites
Metastasis
In minimally invasive surgery, NOTED stand for:
Natural orifice transluminal endoscopic surgery
An immunosuppressive agent which mechanism of action is as a T-cell blocker, but its adverse effect is the increased risk in bacterial infections
belatacept
It refers to radiation therapy and systemic therapies, including chemotherapy, done before surgical therapy
Adjuvant therapy
Infection with the this liver fluke may lead to local inflammation and cholangiocarcinoma.
Opistorchis viverrini
The following conditions are pre malignant and or may indicate malignancy except:
Hyperplasia
Common in the elderly who has head trauma
Subdural hematoma
Catecholamines
Peak within 24-48 hours
Causes of hypocalcemia:
Tumor necrosis factor
The following is/are true regarding hypernatremia:
Symptoms are usually not present, but may manifest in patients with impaired thirst mechanism
The blood clot is made up of the following except:
Vitronectin
A 12-year-old boy is brought to the emergency department with a soft-tissue injury to the left knee after falling while playing football. Which of the following types of cells is most likely to appear first at the wound site?
Neutrophils
Jacksons burn zone that can be preserved with adequate fluid resuscitation and wound care
Zone of stasis
The following are common bacterial pathogen in surgical patients, except:
Coccidioides immitis
Granulation tissue plays an important role in wound healing. All of the following cell types are associated with granulation tissue except which one of the following?
Neutrophils
True of inhalation injury, except
Has a 25% mortality rate
Wound healing triggers release of various types of cells into the wound for achieving specific objectives. Which one of the following is the last cell to appear in a wound?
Lymphocytes
Cause/s of SIRS are the following
All are correct
These cytokines govern the differentiation of monocytes into macrophages, except
Interleukin 8
Criteria for admission to the burn unit, except
34-year-old female with 3% TBSA superficial partial thickness scald burn involving the forearm
This is the most important cell type in wound healing
Macrophages
The following are Gram-positive anaerobe except
Bacteroides fragilis
True of management of electric burn injury, except
Perform emergent escharotomy for impending compartment syndrome
Interleukin-1 (IL-1) is released from
Neutrophils
Characteristics of a full thickness burn injury, except
Heals by epithelization
Nidus of infection, include the following, except
Vital tissue
Burn shock occurs as a result of propagation of histamine, prostaglandins, thromboxanes, and nitric oxide. These mediators are produced from which area of the burn wound?
Zone of hyperemia
Percutaneous drainage of intra-abdominal abscess is modality of choice for the following
Presence of multiple abscesses
The main goal of fluid management in burn injury
Maintain adequate tissue perfusion
The primary precept of surgical infectious disease therapy consists of the following, except
Evacuation of abscess cavity followed by primary closure of wound
Most common cause of mortality in the first 48 hours of burn
Hypovolemic shock
It is mediated by the production of a cascade of pro- inflammatory mediators produced in response to exposure to microbial products
Sepsis
15-year-old male came to your clinic with a tender mass on his gluteal area. He was afebrile and seems comfortable. The mass was erythematous, fluctuant, and tender to touch. This outcome is an example of
None of the choices
The presence of persistent hypotension despite adequate fluid resuscitation, without other identifiable causes in a patient with a documented infection
Septic shock
A patient presents with an 8-cm linear laceration to the forearm from a bicycle accident. Compared with typical suturing techniques, which of the following outcomes is more likely with a cyanoacrylate glueonly closure?
Dehiscence
An acute wound is defined as the one that has occurred within which one of the following timelines?
Within past 3-4 weeks
Factors that determine the outcome of a microbial invasion include the following, except
Access of entry of pathogen
Hallmark of partial thickness burns 4
Blister formation
Which one of the following characteristics would differentiate a keloid from a hypertrophic scar?
Scarring beyond the original scar
Pathophysiologic changes in a burn patient, except
Hypoglycemia
True about trauma in pregnant patients
a. Emergent cesarian delivery is indicated at any time of the gestational period
b. Vaginal bleeding is the earliest sign of abruption placentae
c. In all stages of pregnancy, uterine compression of the vena cava may result in hypotension from diminished venous return
d. None of the choices
d. None of the choices
An adult male patient sustained a head injury from a fall. He is in the ER ICU waiting for a cranial CT scan. You are asked to monitor for the Glasgow coma status of the patient every 15 minutes. Its components would include
Motor response and eye opening
You are looking at a post-appendectomy wound at the right lower quadrant. It is on its 3rd post-operative day and has signs of a surgical site infection. The sign that is least observed in this case will be
Tumor
An adult male underwent intestinal wedge resection & anastomosis for a Meckels diverticulum. Feeding will commence if the patient
Has passes flatus
Measures to prevent respiratory complications in the elderly, except
Hyperalgesia
Respiratory issues in the elderly
Aspiration
Try about true about the surgeons workload in the elderly, except:
a. 60% of surgeons workload
b. 75% - mortality
c. 50% - emergency operations
d. None of the choices
d. None of the choices
Physiologic age, which equals burden of disease, is known for
Decreased functional organ reserve
The following are normal physiologic changes in pregnancy, except
Dilation of the hemorrhoidal veins caused by decreased in portal venous pressure
A child sustained acute burns & is being resuscitated in the ER. The monitoring of the _____ is a measure of the adequacy of fluid resuscitation
Urine output
A female adult patient presents to you in the ER. She claims to have undergone major abdominal surgery for cancer but was lost to follow-up. She remembered being told that she must have a CA 19-9 monitoring to determine recurrence of cancer. She must have
undergone _____ surgery
Pancreatic
A male adult patient presents to you in the ER. He claims to have undergone major abdominal surgery for cancer but was lost to follow-up. He remembered being told that he must have a CEA monitoring to determine recurrence of cancer. He must have undergone ____ surgery.
Rectal
The following is/are true about laparoscopy during pregnancy
Safe abdominal access is attained using open technique
Cardiovascular findings in the elderly
Reliance on end-diastolic volume
A post total thyroidectomy patient complains of abdominal cramps 1 day after surgery. With the complication you are most likely to consider and the intervention done, you will prioritize monitoring of
Both heart rate and blood pressure
True about indications for emergency cesarean delivery in a pregnant trauma patient
Gravid uterus interferes with trauma related surgical intervention
An adult female underwent emergency abdominal surgery for a perforated peptic ulcer. If atelectasis needs to be prevented, monitoring will be intensely done on the _____ post-operative day
1st
For most part, the fetus experiences as a consequence of anesthetic agents administered to the mother
Passive effect
True about maternal uterine circulation:
a. Uterine circulation is autoregulated
b. Vasopressors, like phenylephrine, have little or no effect in maintaining maternal blood pressure
c. None of the choices
d. During the third trimester, uterine circulation represents almost 30% of cardiac output
c. None of the choices
True about thermoregulation in the elderly, except
Predisposition to hyperthermia
True about body composition of the elderly, except
a) Decreased muscle mass
b) Erosion of muscle mass
c) Decreased fat mass
d) Altered volumes of drug distribution
c) Decreased fat mass
The following are part of pre-operative assessments in the elderly, except
a. Emotional
b. Cognitive
c. Nutritional
d. Co-morbid conditions
a. Emotional
True about acute appendicitis and cholecystitis in the elderly, except:
a. Rule of thirds
b. Two-thirds have elevated leukocyte count
c. More than half has fever
d. One-third has no peritoneal finding
b. Two-thirds have elevated leukocyte count
On PE of a 29 y.. G2P1 pregnant patient, 36 weeks AOG at the Emergency Room, she was noted to have clear fluid actively oozing through her vaginal canal. She could be experiencing
Premature rupture of amniotic membrane
Johns Hopkins Frailty Criteria
a. unintentional weight loss
b. Slowness while running
c. Exhaustion and muscles stiffness
d. High levels of activity
a. unintentional weight loss
A burn patient is receiving silver sulfadiazine as dressing for wounds for about a month now. Knowing of its possible complication, you request for _____ and specifically look for
a. ABG Metabolic alkalosis
b. ABG Metabolic acidosis
c. CBC lymphocytosis
d. CBC neutropenia
d. CBC neutropenia
A 34-year-old pregnant patient 22 weeks AOG was brought to the ER because of a possible fracture of her right femur after a fall. She was awake and coherent. Her vital signs are normal. Fetal heart rate was slight elevated. Appropriate management includes the following
Start IV fluid and do fluid resuscitation
A trauma patient is being monitored for abdominal compartment syndrome by measuring the
a. Arterial blood gas
b. NGT output
c. Central venous pressure
d. Urine output
d. Urine output
A 28 year old pregnant female, 24 weeks AOG was ran over by a speeding motor vehicle while she was crossing the street. At the ER, she was examined to have a bulging hematoma on her perineal area. A pelvic x-ray was done. The estimated fetal radiation exposure in doing plain x-ray of the pelvis in cGy
0.06
