SURGERY-II
Sub topics
Indication for surgery
Q1. Indication for surgery?
a) Asthma
b) Pneumonia
c) Emphysema
d) Endocarditis
Answer: D
Wounds and its type, factors effecting wound healing
Q2. Acute wounds are those that heal?
a) Without any complications
b) With complications
c) In unpredicted amount of time.
d) Uncertain time
Answer: A
Q3. Chronic wounds, on the other hand, are those that take?
a) Relatively long time to heal with some complications
b) Relatively short time to heal without complications
c) Relatively average time to heal without complications
d) Relatively average time to heal with complications
Answer: A
Classify burn, type and degree of burns in pediatric and adults
Q4. First degree burn?
a) Deep burn
b) Affects Dermis
c) Inner layer of the skin
Q5. Second degree burn?
a) Often looks wet or moist
b) Often looks dry
c) Affect dermis and sub dermis
d) Pain is not severe
Answer: A
Q6. Third degree burn?
a) Partial thickness burn
b) Full thickness burn
c) Destroys the outer layer of skin (epidermis)
d) Partial layer beneath (or dermis).
Answer: D
Trauma and metabolic response, chest and abdominal trauma
Q7. Metabolic response to trauma?
a) Hyper/Hypo thermal
b) Bradycardia
c) Dyspnea
d) Leukocytosis
Answer: A
Q8. Shock is a systemic state of?
a) High tissue perfusion
b) Low tissue perfusion
c) Shock is similar to hypertension
d) Perfusion is adequate for normal respiration
Answer: B
Q9. Hypovolemic shock
a) Volume depletion
b) Balance Electrolytes
c)
Acid base normal
d) Orthostatic hypertension
Answer: A
Different types of tumors and their classification
Q10.classification of Tumor based on?
a) Cell/ Muscle origin
b) Cell/Bone origin
c) Cell/ Vessels origin
d)
Cell/ soft tissue origin
Q11. Types of cancerous tumors includes:
a)
b)
c)
d)
Malignant soft tissue tumors and sarcomas.
Organ tumors such as heart cancer and liver cancer.
Testis germ cell tumors.
Skin tumors (such as columnar cell carcinoma)
Answer: A
Preoperative assessment (precautions for surgery in diabetic paients)
Q12. Precaution in diabetic patient for surgery are:
a) Diabetic patients should preferably be scheduled for surgery late in the day
b) Check the blood glucose in the postoperative area.
c) Hypoglycemia (BG less than 70 mg/dl) treatment is with glucose tablets/gels or
intravenous dextrose solutions.
d) Check the blood glucose in the perioperative area
Answer: C
Anesthesia and its types complications and recovery
Q13. There are three types of anesthesia
a) General
b) Regional
c) Local
d) Mixed
Q14. General anesthesia is used for
a) Major operations, such as a knee replacement
b) Such as from the waist down.
c) spinal blocks and epidurals
d) C-sections.
Answer: A
Q15. Anesthetic drugs can stay in your system for up to
a) 21 hours
b) 23 hours
c) 24 hours
d) 25 hours
Answer :24
Pain management and post-operative care
Q16. Post-surgical pain control helps?
a) Speed up your recovery
b) Increase chances of complications
c) Such as Typhoid
d) Such as blooding
Answer: A
Ulcers, sinuses, fistula
Q17. A peptic ulcer is a sore on the lining of your
a) Colon
b) Rectum
c) Esophagus
d) Large intestine.
Answer: C
Describe operation performed on: esophagus, stomach, intestine, gall bladder
Q18. In Trans hiatal Vs Trans thoracic esophegtomy most common complication associated
with the (Trans Hiatal esophegtomy) is
a) Pulmonary complication
b) Anastomotic leak
c) Bleeding
d) Injury to recurrent laryngeal nerve
Answer: D
Q19. The usual incision given for surgery zenker,s diverticulum of esophagus is?
a) Left cervical
b) Right cervical
c) Super hyoid
d) Midline
Answer: A
Q20. Most common complication of esophagostomy is
a) Arrhythmia
b) Pulmonary collapse and consolidation
c) Recurrent laryngeal nerve injury
d) Massive bleeding
Answer: B
Indication for Transplantation post-operative complications
Q21. Indication for Transplantations?
a) Chronic hepatic fulminant failure.
b) Intrahepatic biliary atresia or hypoplasia.
c) Inborn errors of metabolism including: Alpha-I antitrypsin.
d) Hepatic artery thrombosis (Budd-Chiari)
Answer: C
PULMONARY SURGERY
Indication of pulmonary surgery, types of incision, complication of drains
Q22. Important risk factors for postoperative pulmonary complications (PPCs):
(a). Lower abdominal surgery
(b). Lean body
(c). Obstructive sleep apnoea (OSA)
(d). Acute obstructive pulmonary disease (COPD).
Answer: C
Q23. A 45-year-old man is scheduled for right hemicolectomy. He is obese (BMI 40 kg m−2 ) and a
smoker of 20 cigarettes per day.
(a). Continuing smoking may increase the likelihood of acquiring a postoperative pulmonary
complication.
(b). Neuromuscular blocking agents should be used
(c). Inspiratory muscle training would be beneficial.
(d). Open surgery is preferable to Laparoscopic
Answer: C
Pneumonectomy, lobectomy, thoracoplasty, and operation on pleura
Q24. A pneumonectomy is an invasive procedure used as a management option for patients with
advanced malignant and non-malignant lung disease.
a) Proper doctor selection
b) Proper medical staff selection
c) Proper patient selection
d) Appropriate postoperative testing
Answer: C
Q25. The anatomic resection of an entire lobe of a lung is called a lobectomy.
a)
It is usually done with the help of the video scope
b) With less than an 12 cm incision
c) Although done for few benign and malignant pulmonary conditions
d) Lung cancer remains the leastt common indication
Answer: A
Recognize the type of chest injury, causes, management procedure
26. A hemothorax results from blood collecting in the pleural space form
a) A bleeding rib cage
b) A bleeding lung
c) A bleeding great vessel
d) A bleeding heart
Answer: C
Disease of chest wall and pleura, Disease of bronchi
Q27. ___________ is located between two pleural sacs and is the central compartment of the thoracic cavity?
(a) Hilum
(b) Pleura
(c) Mediastinum
(d) Thoracic cage
Answer C
Q28. Which of the following is the function of the trachea?
(a) Gaseous Exchange
(b) Filters the air we breathe
(c) Exhales the air from the body
(d) All of the above
Answer: B
Types of the lung tumor and their classification, lung abscess
Q29. Which one of the following statements is true of lung cancer?
a) Most are small cell in type
3
b) b) Approximately 25% of lung cancers are large cell anaplastic in histological type
c) 80% are due to smoking
d) Screening has proved beneficial
Answer: C
Q30. Which one of the following is true regarding lung cancer?
a) Adenocarcinomas tend to grow quickly
b) 5% of patients with lung cancer present with, or develop complications of non-metastatic
paraneoplastic syndromes
c)
Syndrome of inappropriate antidiuretic hormone (SIADH) is associated with hypernatraemia
d) 80-90% of small cell carcinomas have spread beyond the thorax at the time of diagnosis
Answer: D
Q31. Which one of the following statements is true of small cell lung cancer (SCLC)?
a) Surgery is the most important treatment modality
b) Limited stage disease describes disease less than T2 N1 M0
c)
Approximately 80% of patients respond to chemotherapy
d) Prophylactic cranial irradiation has been shown to prolong survival
Answer: C
CARDIAC SURGERY
Indications
Q32. The key objective in coronary artery bypass graft is to:
a)
Extend life
b)
Improve blood flow and oxygen supply to the heart
c)
Improve blood flow and oxygen supply to the lungs
d)
Relieve pain
Q33. A patient with complete heart block has had a permanent demand pace maker inserted. The
pacemaker function is considered to be proper, if ECG rhythm strip shows presence of pacemaker spikes
A. Just after each T wave
B. Before each QRS complex
C. Just after each P wave
D. Before each P wave
ANSWER:C
Q34. Cardiac Toponin level helps in the diagnosis of
A. Myocardial infarction
B. Congestive heart failure
C. Ventricular tachycardia
D. Atrial fibrillation
ANSWER A
Special investigation procedures in cardiac surgery
Q35. The physiological change most likely to be associated with infra renal cross-clamping of the aorta is
A. decreased coronary blood flow
B. decreased renal blood flow
C. increased cardiac output
D. increased heart rate
Answer B
Q36. A 40-year-old man with Marfan's syndrome has undergone successful thoraco abdominal aortic
reconstruction for aortic dissection. He has a CSF (cerebrospinal fluid) drain in situ. 48 hours postoperatively the CSF is noted to be bloodstained and he becomes obtunded. The most
appropriate urgent investigation is
a) CSF microscopy and culture
b) RI (magnetic resonance imaging) brain
c) MRI spine
d) non-contrast head CAT scan
Answer: D
Q37. The key objective in coronary artery bypass graft is to:
a)
Extend life
b)
Improve blood flow and oxygen supply to the heart
c)
Improve blood flow and oxygen supply to the lungs
d)
Relieve pain
Answer: B
Complication of cardiac surgery
Q38. Which of the following are potential complications of untreated coarctation of the aorta?
A. Endocarditis.
B. Hepatic vascular disease.
C. Cardiovascular accident.
D. MI
Answer: A
Q39.The ASD most commonly associated with mitral insufficiency is:
A. Secundum defect
B. Sinus venosus defect
C. Ostium primum defect.
D. Coronary sinus defect.
Answer: C
Cardiac Transplantation (indications, complication and precautions)
Q40, In the selection of donors and recipients for heart transplantation:
a)
b)
c)
d)
HIV positive status in the recipient is an absolute contraindication
Pulmonary hypertension in the donor is a relative contraindication
Body size is an important consideration in matching donor and recipient
Medical history of tuberculosis in the recipient is a contraindication
Answer: A
VASCULAR SURGERY
Indications and types of vascular surgery
Q41. 61-year-old is admitted to A&E with sudden onset of a painful, cold, white right leg. His radial
pulse rate is 86 bpm and its rhythm follows no discernable pattern throughout 30 seconds of palpation.
Abdominal examination is normal. No pulses are palpable in the right leg and ankle Doppler signals are
absent. An ECG confirms the arrythmia but shows no signs of acute ischaemia. Which is the single most
likely diagnosis?
a)
Abdominal aortic aneurysm
b)
Aorto-iliac dissection
c)
Atrial fibrillation
d)
DVT
ANSWER: A
Q42. Q2. A 70-year-old woman develops a cold, painful, right leg. No pulses are palpable throughout the
right leg. She has several risk factors for atherosclerotic disease. A medical student asks how best to
differentiate between acute and chronic ischemia. Which is the single most appropriate advice?
a) History of 40 pack-years of smoking
b) History of intermittent claudication
c) History of thrombotic stroke
d) Presence of femoro-popliteal bypass scar in the left leg
ANSWER: D
Q43. A 65-year-old woman with a 40-pack-year smoking history and type 2 diabetes presents with
cramp-like pain in her right calf after walking 500 metres, relieved by rest. Her symptoms are aggravated
by walking up steep hills. Which is the single most appropriate management?
a) Amputation
b) Diagnostic angiography
c) Endovascular stent
d) Modification of risk factors
ANSWER: D
Investigation in vascular disease
Q44. A 23-year-old medical student returning from her elective in Australia develops a tender, warm,
swollen right calf within 12h of her flight. She smokes five cigarettes daily and takes the oral
contraceptive pill. She has no chest pain or shortness of breath. Which single investigation is the most
appropriate?
a) Ascending venography
b) CT pulmonary angiography
c) D dimer
d) Duplex ultrasound scan
ANSWER: D
Complication of vascular surgery
45. The appropriate treatment in most situations of an aortic abdominal graft that has become
infected is:
A. Intravenous antibiotics and observation for future complications.
B. Catheter drainage at the site of infection.
C. Replacement of the infected graft with another prosthetic graft.
D. Excision of the entire graft and insertion of axillobifemoral grafts.
Answer: D
CRANIAL SURGERY
Indication of cranial surgery special investigation types and complications
Q46. Indication of cranial surgery
a) Infection
b) Non-Congenital
c) Trauma
d) Vascular
Answer: B
Q47. Complication of cranial surgery
a) Stroke
b) Seizures
c) Swelling of the brain
d) No nerve damage
Answer: D
48. posterior triangle. You would test nerve function by asking the patient to
a) Extend their neck against resistance.
b) Extend their neck without impairment.
c) Lift their shoulders against resistance.
d) Lift their shoulders without impairment.
Answer: C
Traumatic brain injury, intracranial tumors hematoma, fracture of skull
Q49. A 10-year-old boy is brought to the emergency department via ambulance after he was involved in
a motor vehicle collision. The patient is unconscious on arrival. Glasgow Coma Scale (GCS) score is 8.
CT scan does not show any specific lesion. The patient remains unconscious for the next 7 hours. Based
on these findings, which of the following is the most likely diagnosis?
a) Subdural hematoma
b) Diffused axonal injury
c) Epidural hematoma
d) Subarachnoid hemorrhage
Answer: B
Q50. Which of the following is not one of the factors that determine the type of TBI?
a)
b)
c)
d)
Genetic variation
Nature of the external force
Motivation of the patients
Strength of the force
Answer: A
Q51. A patient is admitted after a head injury and sinks rapidly into a coma. An MRI scan
indicates an extradural haemorrhage because extravasated blood can be detected between
the
a) Skull bones and dura mater.
b) Dura mater and arachnoid.
c) Arachnoid and pia mater.
d) Pia mater and brain surface
Answer: A
Intracranial abscess, intracranial tumor, intracranial aneurism and hydrocele
Q52. A brain abscess is a pocket of pus in the brain. Which of the following is NOT a common cause of a
brain abscess?
a) An infection caused by bacteria that entered the brain from a penetrating head wound
b) infection that began in another part of the head
c) A stroke
d) infection that started elsewhere in the body and spread to the brain
Answer: C
SURGERY OF THE VERTIBRAL COLUNM, SPINAL CORD, PERIPHERAL NERVE
Dislocation and management of dislocation
Q53. With the high incidence of neurologic deficits associated with dislocation fractures
a) surgical management remains a primary tool for the recovery of these patients
b) Non-surgical management remains a primary tool for the recovery of these patients
c) If the neurologic deficit is incomplete with return of reflex function, recovery is unlikely,
and surgery is performed to expedite rehabilitation
d) If the neurologic deficit is incomplete with return of reflex function, recovery is unlikely,
and surgery is performed to expedite rehabilitation
Answer: A
Q54. In Lumbar Spine Fractures and Dislocations Treatment & Management. The decision
whether to perform surgery in the acute setting is made by:
a) The doctors, depending on the stability of the fracture
b) The non-radiologic evidence of spinal cord
c) Cauda equina compression
d) The patient's non neurologic examination, and the overall status of the patient.
Answer: C
Explain prolapse IV disc, the disc protrusion, spondylosis and spondylolisthesis
Q55. Four stages of Disc protrusion, except
a)
b)
c)
d)
Annular tear
Disc protrusion
Extrusion
Intrusion
Answer: D
Classify spinal cord injuries and syndrome
Q56. How many types of spinal cord injuries
a) One
b) Two
c) Three
d) Four
Answer: B
Assess the level complete and incomplete spinal cord injuries and rehabilitation 2
Q57. How many level of spinal cord injuries
a)
b)
c)
d)
One
Two
Three
Four
Answer: D
Q58. Thoracic spinal cord injuries effects? Except
a)
b)
c)
d)
Upper chest
Mid back
Abdominal muscles
Legs and hips
Describe the surgical, medical management and post-operative care of surgery 1
Q59. Post-operative care means?Except
a)
b)
c)
d)
Managing pain
Supporting oxygenation
Cardiovascular stability
Fluid imbalance
Describe tumors of spinal cord types of operation, nerve injuries and surgical management 1
Q60. How many types of spinal cord tumor? Excapt
a)
b)
c)
d)
Ependymoma
Meningioma
Astrocytoma
Neuroblastoma
Describe lesions of CN and SN, and the management 2
Q61. When testing the sensory innervation on the face, it is important to remember that the skin on tip of
the nose is supplied by which nerve?
a)
b)
c)
d)
Zygomatic branch of facial nerve
Maxillary division of the trigeminal nerve
Ophthalmic division of the trigeminal nerve
Buccal branch of the facial nerve
Answer: C
Q62. The brain stem does not include the
a)
b)
c)
d)
Medulla oblongata
Pons
Diencephalon
Substantia Negara
Answer: D