CEBU DOCTORS’ UNIVERSITY COLLEGE OF MEDICINE
Medical Education Unit
LEVEL III
EXAM BY SUBJECT – SURGERY
1. A 45/M came in for severe abdominal pain over the right upper quadrant. Ultrasound
shows mul?ple gallbladder stones with a 4 cm abscess over the right lobe of the liver.
What is the most likely type of abscess of the liver?
a. Pyogenic abscess
b. Fungal abscess
c. Amoebic abscess
d. TB abscess
2. The type of hernia repair wherein the superior transversals fascia/flap is aJached to the
Cooper ligament
a. Mcvay Repair
b. Shouldice Repair
c. Bassini Repair
d. Lichtenstein Repair
3. A 35/M came to the emergency room for anal mass and bleeding. Upon rectal
examina?on, hemorrhoids were palpated and there was blood on the examining finger.
The mass prolapsed but reduced spontaneously. What is the classifica?on of the
hemorrhoids of the pa?ent
a. First-degree
b. Second-degree
c. Third-degree
d. Fourth-degree
4. What is the Ranson Criteria for a 67/F with white blood cell count of 20,000 blood
glucose of 250mg/dI, serum aspartate of 300U/dI?
a. Predicted mild
b. Predicted moderate
c. Predicted Uncomplicated
d. Predicted Severe
5. A 45/M came in at the ER for dyspnea and fever. Pa?ent had a CT-scan of the chest which
showed lung abscess. Which of the following are indica?ons to drain the abscess?
a. Abscess diameter <4cm
b. Presence of Hemoptysis
c. Persistence of fever
d. Failure of medical therapy
6. Which of the following pa?ents should be referred for Cholecystectomy?
a. A 25 year old male with 0.5 cm polyp of the gallbladder
b. A 45 year old woman with recurrent bouts of biliary colic and documented stones
c. A 75 year old female with asymptoma?c gallstones
d. A 78 year old man with choledocholithiasis and cholelithiasis
7. The most common type of gallbladder Carcinoma is
a. Anaplas?c
b. Adenocarcinoma
c. Squamous Cell
d. Oat Cell
8. What would be the ini?al considera?on for a 55/M complaining of frequency, nocturia,
incomplete emptying and urinary reten?on.
a. Benign Prosta?c Hypertrophy
b. Bladder cancer
c. Hydrocele
d. Prosta?c cancer
9. A 65/M pa?ent was diagnosed with Renal Cell Carcinoma. The pa?ent was scheduled for
Radical Nephrectomy. Radical Nephrectomy includes:
a. Removal of kidney, ipsilateral adrenal gland, and hilar nodes
b. Removal of kidney and adrenal gland
c. Removal of kidney, bilateral adrenal gland
d. Removal of kidney and lymph nodes
10. A pa?ent with liver cirrhosis was evaluated using the Child-TurcoJe-Pugh classifica?on.
On Physical examina?on and ultrasound of the abdomen, the pa?ent had poorly
controlled ascites. Bilirubin levels are >3mg/dl, albumin level below 3 g/dl. What would
be his Child's classifica?on?
a. Class A
b. Class B
c. Class C
d. Class D
11. A 50/F pa?ent underwent modified radical mastectomy for breast cancer of the right
breast. Pathology report showed 3 cm mass with axillary lymph nodes. What is her
clinical staging
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
12. The most common anomaly of splenic embryology is the accessory spleen. Where is it
commonly found?
a. Gerota's Fascia
b. Splenic Hilum
c. Gastrocolic ligament
d. Large bowel Mesentery
13. The re?culoendothelial system of the spleen is responsible for
a. clearance of damaged red blood cells
b. clearance of encapsulated bacteria from the bloodstream
c. ini?a?on of adap?ve immune response
d. removal of erythrocyte inclusions such as Heinz bodies
14. Laparoscopic splenectomy has become the favored procedure versus open splenectomy.
Its primary advantage is
a. OPSI is lesser post splenectomy
b. does not need vaccina?on before surgery
c. associated with no blood loss
d. associated with shorter hospital stay and decreased morbidity
15. Which type of choledochal cyst is characterized by fusiform dilata?on of the bile duct?
a. Type 1
b. Type 2
c. Type 3
d. Type 4
16. A 2/M presented with bulging mass over the right inguinal and scrotal area which is non
reducible but he has a sof abdomen. Which type of surgery is appropriate for the
pa?ent?
a. Mesh repair
b. Herniotomy
c. Herniorrhaphy
d. Pa?ent
17. Nyhus classifica?on for hernia wherein there is an indirect inguinal hernia, internal ring
enlarged without impingement on the floor of the inguinal canal and does not extend to
the scrotum
a. Type 1
b. Type 2
c. Туре 3
d. Type 4
18. Which of the following blood vessels supplies the stomach, usually arises direct from the
celiac trunk and is consistently the largest arterial supply to the stomach?
a. lef gastric
b. Lef gastroepiploic
c. Right gastric
d. Right gastroepiploic
19. What drugs are used for the ini?al medical treatment of Benign Prosta?c Hypertrophy?
a. Furosemide
b. Beta receptor blockers
c. Alpha Adrenergic receptor blockers
d. Potassium Citrate
20. A 60/M came in the emergency room for gross hematuria and urinary reten?on. On
rectal exam prostate was stony hard with nodules, PA taken was 15 ng/ml. What would
be the pa?ent's most likely diagnosis?
a. Benign Prosta?c Hypertrophy
b. Prosta?c Cancer
c. Renal CA
d. Bladder CA
21. Physiologic reflux happens most commonly when a person is
a. asleep and semi erect
b. awake and supine
c. asleep and supine
d. awake and upright
22. A 60/F with a 2 cm breast mass had a core needle biopsy taken which was reported as
inflammatory carcinoma. What is the T staging for this pa?ent
a. T1
b. T2
c. T3
d. T4
23. Following Antrectomy for bleeding PUD which of the following gastrointes?nal
con?nui?es is Billroth 1?
a. Gastroduodenostomy
b. Loop with Roux-en y gastrojejunostomy
c. Roux-en y gastrojejunostomy
d. Loop gastrojejunostomy
24. A 65/F had her annual colonoscopy done and was found to have a polyp in the
descending colon. Which type of colonic polyp is highly associated with malignancy?
a. Tubular adenoma
b. Adenomatosis
c. Villous adenoma
d. Tubulovillous adenoma
25. Which of the following regimens is the most effec?ve in preven?ng Overwhelming Post
Splenectomy Infec?on (OPSI)?
a. Vaccina?on 2 weeks afer splenectomy
b. 2 weeks an?bio?c therapy
c. Vaccina?on 1 month before splenectomy
d. Vaccina?on 2 weeks before splenectomy
26. A 70/M presented with a non-painful lump in the right tes?s. Ultrasound showed a
tes?cular tumor. What is the most common type of tes?cular cancer
a. Teratocarcinoma
b. Seminoma
c. Leydig cell tumor
d. Embryonal cell carcinoma
27. A 30/M was diagnosed with a fistula in ano, the external opening of which was seen 2cm
from the anal verge anteriorly. For this fistula in ano following the Goodsall's Rule the
tract leading to the internal opening of this fistula will be commonly seen as
a. long curve tract
b. curve toward posterior midline
c. straight toward posterior midline
d. short direct tract
28. The most common primary site for female pa?ents with malignant pleural effusion is
a. Gastrointes?nal tract
b. Urinary tract
c. Breast
d. Lung
29. A pocket-like outpouching on the an?mesenteric distal ileum is called
a. internal hernia?on
b. plicae circularis
c. Meckel diver?culum
d. Intussuscep?on
30. A 50/M pa?ent was admiJed for Gastric Cancer located at the antrum which is
resectable. The surgeon decided to do a D2 resec?on. D2 resec?on involves which of the
following?
a. removal of perigastric lymph nodes
b. removal of perigastric lymph nodes and right and lef gastric lymph nodes
c. removal of gastric lymph nodes along the hepatoduodenal ligament, pancrea?c
head, root of the small bowel mesentery
d. removal of gastric lymph nodes beyond 3cm margin along the lef gastric, celiac
axis, common hepa?c artery, splenic artery and hilum
31. Which of the following hernia repair will yield a lower recurrence rate?
a. Shouldice repair
b. Lichtenstein Repair
c. McVay repair
d. Bassini repair
32. Which of the following benign liver lesions carry a significant risk of spontaneous
rupture?
a. Hemangioma
b. Hamartoma
c. Adenoma
d. Hepa?c Cyst
33. Which of the following is an indica?on for surgical interven?on for admiJed pa?ents with
bleeding pep?c ulcer?
a. Bleeding persistent with > 4 packed RBC transfused
b. Visible vessel on endoscopy
c. All pa?ents as long as they are admiJed
d. Stable pa?ents with stable vital signs
34. Adequate treatment for gallbladder lesions involving the lamina propria of the
gallbladder includes
a. cholecystectomy plus chemotherapy
b. cholecystectomy alone
c. neoadjuvant chemoradiotherapy followed by surgical resec?on
d. cholecystectomy and segmental liver resec?on
35. Relaxa?on of the sphincter of Oddi in response to a meal is largely under the control of
which hormone?
a. Secre?n
b. Mo?lin
c. Cholecystokinin
d. Gastrin
36. Most surgeons now use the toupet fundoplica?on in trea?ng pa?ents with reflux. This
Involves
a. A 180 degree anterior wrap
b. A 90 degree posterior wrap
c. A 180 degree posterior wrap
d. A 270 degree posterior wrap
37. A disease seen in children which presents as par?al or complete obstruc?on due to the
absence of ganglion cells in the Auerbach plexus and hypertrophy of associated nerve
trunks
a. Hirschsprung disease
b. Malrota?on disease
c. Nelson disease
d. Intussuscep?on
38. The most common complica?on of chronic pancrea??s is
a. pancrea?c necrosis
b. pancrea?c duct stricture
c. pancrea?c stone forma?on
d. pseudocyst
39. Which is the most common site for small bowel primary malignancy?
a. Duodenum
b. Jejunum
c. Ligament of Treitz
d. Ileum
40. Which of the following supplies the descending colon, sigmoid colon and upper rectum?
a. Inferior mesenteric artery
b. Celiac axis
c. Superior mesenteric artery
d. Ileocolic artery
41. A 45/M pa?ent had a rou?ne ultrasound of the liver which showed liver cirrhosis. What is
the annual conversion rate to Hepatocellular Carcinoma for pa?ents with cirrhosis?
a. less than 1%
b. 1-2%
c. 2-5%
d. 6-10%
42. The arterial supply of the gallbladder is derived from the cys?c artery and is commonly
derived from the
a. right hepa?c artery
b. portal vein
c. gastroduodenal artery
d. lef hepa?c artery
43. A 60/M is admiJed to the hospital for abdominal pain and fever. CT scan showed
Diver?culi?s with colonic inflamma?on with an associated pericolic abscess. What is his
Hinchey Stage?
a. Stage I
b. Stage Il
c. Stage Ill
d. Stage IV
44. Chronic Calcific pancrea??s is commonly caused by
a. Sjogren syndrome
b. Ductal Strictures
c. Gallstone induced
d. Hyperlipidemia
45. Whipple's procedure, the surgical treatment for pancrea?c head carcinoma involves the
following procedure?
a. resec?on of the pylorus of the stomach, duodenum, head and body of pancreas
b. resec?on of the duodenum, pancrea?c head and body and spleen
c. resec?on of the stomach, duodenum and pancrea?c head
d. resec?on of the antrum of the stomach, duodenum, common bile duct and
pancrea?c head
46. The most common solid benign lesion of the liver is the
a. adenoma
b. liver abscess
c. hemangioma
d. hamartoma
47. 65/M is diagnosed with Gastrointes?nal stromal tumor 2cm in size by CT-scan. Which of
the following is the best op?on treatment for the pa?ent?
a. Surgical wedge resec?on
b. Subtotal gastrectomy
c. Can be treated with Ima?nib
d. Endoscopic abla?on
48. Which of the following decreases the risk of breast cancer?
a. Early Menarche
b. Nulliparity
c. Mul?parity
d. Late Menopause
49. The most common cause of small bowel obstruc?on is
a. postopera?ve adhesions
b. TB ilei?s
c. malignancy
d. incarcerated hernia
50. A 70/M was diagnosed with squamous cell carcinoma of the esophagus. This type of
esophageal cancer usually occurs
a. in the lower thoracic esophagus
b. evenly distributed in the esophagus
c. in the cervical and thoracic esophagus
d. at the gastroesophageal junc?on
12/14/21, 12:44 PM
: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
Quiz Submissions - SURGERY PART 1
Mariel Abatayo (username: MarielAbatayo)
Attempt 1
Written: Dec 14, 2021 10:04 AM - Dec 14, 2021 10:48 AM
Submission View
Released: Dec 14, 2021 12:00 PM
Available until: Dec 14, 2021 10:48 PM
Question 1
1 / 1 point
The function of the orbicularis muscle in the eyelid is to :
Remove excess dirt in the eye
Produce tears
Open the eyelid
Close the eyelid
Question 2
1 / 1 point
The orbicularis muscle is supplied by what nerve :
Trochlear nerve
Facial nerve
Optic nerve
Abduccens nerve
Question 3
1 / 1 point
What is the main lid retractor of the eye or the muscle most responsible for eyelid opening :
Levator palpebrae superioris muscle
Frontalis muscle
Mueller's muscle
Orbicularis oculi muscle
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
Question 4
1 / 1 point
The lacrimal secretory system is composed of what structure:
Lacrimal gland
Lacrimal duct
Lacrimal sac
Punctum
Question 5
1 / 1 point
The roof of the orbit is composed primarily of what bone:
Frontal bone
Ethmoid bone
0Zygomatic bone
Maxillary bone
Question 6
1 / 1 point
What is the principal artery of the orbit and its structures :
Ophthalmic aretery
Central retinal artery
Maxillary artery
Optic artery
Question 7
1 / 1 point
The four rectus muscles originate from what structure that surrounds the optic nerve:
Annulus of zinn
Arcus marginalis
Whitnall's ligament
Lockwoods ligament
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
Question 8
1 / 1 point
The trochlear nerve supplies what muscle :
Superior rectus
Inferior oblique
Superior oblique
Inferior rectus
Question 9
0 / 1 point
The abducens nerve supplies what muscle:
Superior rectus
Lateral rectus
Medial rectus
Inferior rectus
Question 10
1 / 1 point
What fibrous outer protective coating of the eye consisting mostly of collagen, is continuous
with the cornea anteriorly and the dura of the optic nerve posteriorly:
Iris
Conjunctiva
Ciliary body
Sclera
Question 11
1 / 1 point
The iris, ciliary body and the choroid comprise the middle layer of the eye otherwise known as :
Conjunctiva
Sclera
Uvea
Retina
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
Question 12
1 / 1 point
What intraocular structure of the eye is biconvex, avascular, colorless, and completely
transparent:
Retina
Optic nerve
Lens
Pupil
Question 13
1 / 1 point
The retina receives its blood supply from what structures:
Central retinal artery and muscular arteries
Major retinal artery and muscular arteries
Major retinal artery and minor retinal arteries
Central retinal artery and choriocapillaries
Question 14
1 / 1 point
What are the two (2) main refractive surfaces of the eye :
Cornea and lens
Lens and vitreous humor
Aqueous and vitreous humor
Cornea and retina
Question 15
1 / 1 point
What refractive condition occurs if the axial length of the eye is too long for the refractive
power of the eye :
Myopia
Hyperopia
Astigmatism
Amblyopia
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
Question 16
0 / 1 point
Which of the following has no Innervations the external ear :
Cranial nerve X
Cranial nerve V
Cranial nerve VIII
Cranial nerve VII
Question 17
1 / 1 point
The average length of the external auditory canal is :
24 mm
22 mm
26 mm
28 mm
Question 18
1 / 1 point
Arnold's nerve is a branch of what nerve :
Cranial nerve XII
Cranial nerve IX
Cranial nerve XI
Cranial nerve X
Question 19
1 / 1 point
The cochlea is a snail-like structure that makes _____ turns ?
4½
3½
2½
1½
Question 20
0 / 1 point
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
The eustachean tube connects the middle ear and the nasopharynx. It is lined by what type of
epithelium :
Simple columnar ciliated
Pseudostratified columnar ciliated
Simple cuboidal
Simple squamous
Question 21
0 / 1 point
The organ of corti is located almost the entire length of the cochlea. Which part of the cochlea is
the organ of corti absent:
Reisner's membrane
Helicotrema
Saccule
Basilar portion
Question 22
1 / 1 point
Which of the these sinuses drain into the superior meatus :
Frontal
Posterior ethmoid
Anterior ethmoid
Maxillary
Question 23
1 / 1 point
Which of the following artery has no contribute to the blood supply of the nose :
Lacrimal
Internal maxillary
Facial
Ophthalmic
Question 24
1 / 1 point
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
Which of the following statements is/are TRUE :
The maxillary artery is also known as the antrum of highmore.
The sinuses present at birth are the maxillary and ethmoid
All of the paranasal sinuses are paired sinuses
Only the ethmoid sinuses is present at birth.
Question 25
1 / 1 point
The nasolacrimal duct opens into the :
Inferior meatus
Superior meatus
Middle meatus
Supreme meatus
Question 26
1 / 1 point
The rhinologist's artery is also known as :
Internal maxillary artery
Superior labial artery
Sphenopalatine artery
Keiselbach's plexus
Question 27
1 / 1 point
Which of the following is the primary function of the nose:
Olfaction
Air-conditioning
Particle filtration
Particle control
Question 28
1 / 1 point
The lateral wall of the middle ear cavity is :
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Eustachean tube
Tympanic membrane
Promontory
Facial canal
Question 29
1 / 1 point
Membranous wall of the cochlea on which rests the delicate organ of hearing (organ of corti)
Saccule
Basement membrane
Vestibule
Basilar membrane
Question 30
1 / 1 point
The cone of light of the tympanic membrane normally points :
Upward and forward
Downward and backward
Upward and backward
Downward and forward
Question 31
1 / 1 point
The type of transplant where there is transfer of cells, tissue or organ from one part of the body
to another part in the same person
Allotransplant
Xenotransplant
Autotransplant
Orthotopic transplant
Question 32
1 / 1 point
The type of transplant where there is transfer of cells, tissue or organ from one organism to
another of a different species
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
orthotopic transplant
autotransplant
xenotransplant
allotransplant
Question 33
1 / 1 point
Which type of immunosuppressive drugs are anti metabolites
rituximab
atgam
azathioprine
cyclosporine
Question 34
1 / 1 point
The type of rejection in transplantation which results in irreversible damage and graft loss within
minutes to hours after organ repurfusion
Chronic rejection
Acute Rejection
Subacute rejection
Hyperacute rejection
Question 35
1 / 1 point
Immunologic rejection is mediated by the recipient's
Lymphocytes
Plasma cells
Eosinophils
Neutrophils
Question 36
1 / 1 point
Which of the following is considered an early infection in transplantation
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
viral infection
herpes simplex infection
wound infection
fungal infection
Question 37
0 / 1 point
This skin lesion is a benign pedunculated lesion on the skin made up of epidermal keratinocytes
surrounding a collagenous core
inclusion cyst
lipomas
achrocordons
Dermatofibromas
Question 38
1 / 1 point
The most common subcutaneous neoplasm which present as a painless slow growing mobile
mass of the subcutaneous tissue.
Dermatofibromas
inclusion cyst
Achrocordons
Lipomas
Question 39
0 / 1 point
.The chronic inflammatory disease presenting as painful subcutaneous nodules
Hidradenitis suppurativa
Steven Johnson syndrome
Pyoderma gangrenosum
Toxic epidermal necrolysis syndrome
Question 40
1 / 1 point
Skin infection which includes the deeper dermis and subcutaneous tissue
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
cellulitis
furuncles
Impetigo
folliculitis
Question 41
0 / 1 point
Which of the following skin infection needs to be incised and drained
cellulitis
folliculitis
Impetigo
furuncles
Question 42
1 / 1 point
A complicated skin infection which extends below the dermis and has a large surface area of
more than 75cm
Steven Johnson syndrome
stage 2 burns
necrotizing fasciitis
abscess
Question 43
1 / 1 point
A 20 year old CDU student underwent excision of lipoma in the right forearm at the CDUH
minor operating room. What type of wound will the student have.
clean wound
clean contaminated wound
contaminated wound
dirty wound
Question 44
0 / 1 point
What is type of dressing will the student need after the surgery?
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Semi-occlusive dressing
Hydrophilic dressing
Hydrogel dressing
Alginate dressing
Question 45
1 / 1 point
What type would of healing will the student's incision site undergo?
Delayed primary closure
Tertiary intention
Secondary intention
Primary intention
Question 46
0 / 1 point
If ever the surgical site will have a surgical site infection on which post-op day will you expect
the infection to occur.
2-3 days post-op
3-4 days post -op
7-10 days post-op
1-2 days post-op
Question 47
0 / 1 point
Which type of Epidermolysis Bullosa will present as multiple blisters throughout different layers
of the skin
Dystrophic Epidermolysis
Junctional Epidermolysis
Epidermolysis simplex
Kindler's syndrome
Question 48
1 / 1 point
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: Quiz Submissions - SURGERY PART 1 - Basic Biomedical Sciences II - CeLo+
Bacterial growth on a chronic wound that is encapsulated by a protective layer made up of the
host and bacterial proteins.
Keloid
Biofilm
Collagen plate
Marjolin's ulcer
Question 49
0 / 1 point
Excess healing which represents overabundance of fibroplasia in the dermal healing process rise
above the skin level but stays within the confines of the original wound
Marjolin's ulcer
hypertrophic scar
keloid
biofilm
Question 50
0 / 1 point
Which of the following are TRUE with regards to keloid.
Neck and chest are the most common site predilection
Not associated with genetic dominance
No predilection to ethnic groups
Respects wound confines
Attempt Score:38 / 50 - 76 %
Overall Grade (highest attempt):38 / 50 - 76 %
Done
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Surgery
1. What is another name for Christmas Disease?
= Hemoglobin B (⬇️ Factor IX)
2. Refers to en bloc resection of tumor with adequate margins of normal tissues and regional lymph
nodes as necessary:
= Primary surgical therapy
3. A 28 year old male nurse presents for a pre-employment physical exam at Cebu Doctors University
Hospital. What will be the largest component of his mass?
= Water
4. The eustachean tube connects the middle ear and the nasopharynx. It is lined by what type of
epithelium:
= Pseudostratified columnar ciliated
5. The four rectus muscles originate from what structure that surrounds the optic nerve:
= Annulus of zinn
6. Which of the following can initiate afferent impulses to the CNS which triggers the neuroendocrine
response of shock
= Hypothermia
7. A 70kg with a laceration to the brachial artery loses a total of 800 ml of blood. What ACS class of
hemmorhage would this represent?
= Class II hemorrhage (15% 750-1500)
8. The rhinologist's artery is also known as:
= Sphenopalatine artery
9. What is the major intracellular Anion?
= Phosphate
10. The orbicularis muscle is supplied by what nerve:
= Facial Nerve
11. What is the largest fluid compartment of the body?
= Intracellular Fluid
12. Expressed by endothelial cells, and has important function in physiologic and pathologic of
vascular tone
= Nitric Oxide
13. Septic shock is defined as:
= Sepsis + cardiovascular collapses
14. The abducens nerve supplied what muscle:
= Central rectus
15. Which of the following causes abnormal anion gap?
= Lactic Acidosis
16. The lacrimal secretory system is composed of what structure:
= Lacrimal gland
17. Which of the following is an anti-inflammatory cytokine?
= IL-10
18. Which of the following is the primary function of the nose:
= olfaction
19. What is the other name for coagulation factor I.
= fibrinogen
20. Which of the 4 physiologic events in hemostasis is the initial response to vessel injury?
= Vascular phase
21. The organism plays a major role in development of gastric cancer:
= H-Pylori
22. What is the daily physiologic range of biliary secretion?
= 500-1,000cc
23. The average length of the external auditory canal is:
= 24 mm
24. A 75 year old female presents with ductal carcinoma in situ for simple mastectomy. She has
marked muscle wasting on examination and admits to a poor diet. Which of the following values is
most predictive of post operative mortality?
= serum albumin
25. What fibrous outer protective coating of the eye consisting mostly of collagen, is continuous with
the cornea anteriorly and the dura of the optic nerve posteriorly:
= Sclera
26. These are TRUE to Systemic Inflammatory response syndrome.
= PaCO2 less than 32 mmH
27. Fatty acyl-Coa cannot enter the jnner mitochondria without this shuttle
= Camitine
28. A patient develops a high output fistula following abdominal surgery. The fluid is sent for
evaluation with the following results: Na 135, K 5, Cl 70. Which of the following is the most likely to
source of the fistula?
= small bowel
29. Most common cancer causing death in men:
= Prostate
30. The primary goal is treatment of distant foci of subclinical disease to prevent distant recurrence of
cancer:
= Adjuvant chemotherapy
31. Which transfusion is best for patients who have been previously sensitized?
= PRBC
32. What is the other name for coagulation factor X.
= stuart factor, stuart-prower factor
33. Vasoconstriction is one of the initial physiologic responses to hypovolemic shock. This is mediated
by
= Activation of alpha adrenergic receptors on the arterioles
34. This is used to estimate the basal energy expenditure
= Harris-benedict equation
35. What percentage of the blood volume is normally in the splanchnic circulation?
= 20%
36. What is the main enzyme that degrades fibrin during fibrinolysis.
= Plasmin
37. What are the two (2) main refractive surfaces of the eye:
= Cornea and lens
38. What is the other name for coagulation factor III.
= tissue factor/tissue thromboplastin
39. The trochlear as nerve supplies what muscle:
=Subterior oblique
40. The nasolacrimal duct opens into the:
= Inferior meatus
41. Hypoxia at the cellular level decreases ATP production (also called dysoxia). This results in
= Changes in intracellular calcium signaling
42. This are disorganized sequence of intracellular molecular releases with the subsequent immune
activation and inflammatory response.
= Cell necrosis
43. What is the other name for coagulation factor II.
= prothrombin
44. What are the principal mediators in platelet aggregation?
= adenosine diphosphate and thromboxane a2
45. The retina receives its blood supply from what structures.
= Central retinal artery and choriocapillaries
46. What retractive condition occurs if the axial length of the eye is too long for the refractive power
of the eye:
= myopia
47. A patient in the ER following a motor vehicular accident with multiple injuries. Hypotension in this
patient is defined as SBP less than
= 90
48. Which if these sinuses drain into the superior meatus:
= Posterior ethmoid
49. Are small molecular that are highly reactive due to unpaired outer orbit electrons
= Reactive oxygen species
50. A 24-year-old arrives at the emergency room with multiple stab wounds to the abdomen, severe
blunt trauma to the head (GCS10), and a SBP of 80mmHg. An appropriate goal for resuscitation in the
ER would be a SBP of:
=90-100 mmHg
51. What is the other name for coagulation factor VIII.
= Antihemophilic Factor A
52. Which of the following cytokines is released immediately after a major injury?
= TNF-alpha
53. The iris, ciliary body and the choroid comprise the middle layer of the eye otherwise known as:
= Urea
54. 2 hours following major surgery with significant blood loss, a patient has a base deficit of -6. This
would be classified as
= mild base deficit
Class I ('no shock') was defined by a BD of not more than 2 mmol/L, class II ('mild shock')
by a BD of more than 2.0 to 6.0 mmol/L, class III ('moderate shock') by a BD of more than
6.0 to 10.0 mmol/L, and class IV ('severe shock') by a BD of more than 10 mmol/L.
55. What is the major intracellular Cation?
= Potassium
56. The type of access for enteral nutrition that is short-term and reserved for instinct mentation
= Nasogastric tube
57. Which among of patients require greatest kcal requirement per day
= Major burns
58. The Initiating event in shock is
= Hypotension
59. These hormones will increase in response to inflammatory response
= Cortisol
60. Which of the following artery has no contribute to the blood supply of the nose:
= Ophthalmic
61. What is the advantage of fresh whole blood transfusion?
= It provides greater units of RBC
62. Toll-like receptors play a role in the "danger signaling" pathway which modulates the immune
response to injury. Stimulations of these receptors is by molecules released from
= macrophages
63. Membranous wall of the cochlea on which rests the delicate organ of hearing (organ of corti)
= basilar membrane
64. The function of the orbicularis muscle in the eyelid is to:
= Close the eyelid
65. An unconscious patient with SBP of 80mmHg and a HR of 80 most likely has
= Hemorrhagic shock
66. The cone of the light of the tympanic membrane normally points:
= Downward and forward
67. Most common cancer causing death in women:
= Breast
68. The probability of death for a patient with a base deficit of -6 is approximately
= 15%
69. What is the main lid retractor of the eye or the muscle most responsible for eyelid opening:
= Levator palpcorae superioris muscle
70. What is the principal artery of the orbit and its structures:
= Ophthalmic artery
71. Which among the sources releases more kcal per gram
= Fat
72. An energy-dependent organized mechanism for clearing senescent or dysfunctional cells.
= Apoptosis
73. The organ of corti is located almost the entire length of the cochlea. Which part of the cochlea is
the organ of corti absent:
= saccule
74. Anti-diuretic hormone (ADH) is secreted in response to shock and remains elevated for
approximately 1 week. Which of the following is seen as a result of this increased level of ADH?
= Increased sodium loss in the distal tubule
75. Shock following severe carbon monoxide poisoning is most commonly
= Vasodilatory shock
76. Major risk factor for liver cancer:
= Hepatitis C
77. What intraocular structure of the eye is biconvex, avascular,colorless, and completely transparent:
= Lens
78. Which part of the colon has the widest diameter?
= Cecum
79. Which if the following has no Innervations the external ear:
= Cranial nerve X
80. The lateral wall of the middle ear cavity is:
= tympanic membrane
81. Most common cancer in men:
= Prostate
82. Which bleeding parameter is best to identify problems in the extrinsic arm in coagulation?
= PT
83. In a patient with ongoing hemorrhage, the risk of death increases 1%
= Every 3 minutes in the ER
84. Which phase promotes hemostatic plug and contributes to thrombin formation?
= Vascular phase
85. Von Willebrand Factor is categorized into type is has total deficiency?
= Type 3
86. What is the total daily requirement for calcium intake?
= 1-3 gm
87. Which of the following best describes the hemodynamic response to neurogenic shock?
= Increased cardiac index, unchanged venous capacitance
88. Which of the following is a type of nutrition, which are peptide based diets which can maintain
nutritional sustenance.
= Caloric dense
89. Which of the following statements is/are TRUE:
= the sinuses present at birth are the maxillary and ethmoid/ all of the paranasal sinuses are paired
sinuses
The frontal sinuses are absent at birth, but are generally well developed, and functional
between the sixth and eighth years, though they continue to grow slower until reaching
their maximum size after puberty.
90. This type of enteral access requires operator dependent endoscopic skills:
= Percutaneous endoscopic gastrostomy
91. Which of the following is not component of the Harris-Benedict equation?
= % lean body mass
92. The cochlea is a snail-like structure that makes ___ turns?
= 2/2.5
93. Which of the following is true regarding tetanus infection?
= Tetanus prone wounds include contaminated wounds, crush wounds or burn
94. How many calories are provided in one 500 ml bottle of 20% intravenous fat solution?
= 1000kcal
500 ml of 10% lipid
500 ml x 1.1 kcal/ml = 550 kcal
500 ml 20% lipid
500 ml x 2.0 kcal/ml = 1000 kcal
95. These are the first responders of infection
= Neutrophils
96. A 62-year-old man is involved in a MVA. He suffered significant blunt trauma to the sternum
during the accident. He has a SBP of 95mmHg on arrival to the ER. His CVP is 15 and his CXR is normal.
= myocardial infarction
97. Which bleeding parameters is best to identify problems in the intrinsic arm in coagulation?
= APTT
98. The root of the orbit is composed primarily of what bone:
= Frontal bone
99. Arnold's nerve is a branch of what nerve:
= CN X or 10
100. Which of the following can be used to indirectly estimate the oxygen dept incurred during shock?
= base deficit
IX
d Factor
15%
750-1500
1500 -2000
30%
< 15 't
>
.
1750mL
40 's
.
> 2000
t
t
( in)
intrinsic