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    General Surgery 2ndS

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    General Surgery 2ndS

    Uploaded by

    SRO oO
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    General%20Surgery%202ndS%20(1)

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    5 views21 pages

    General Surgery 2ndS

    Uploaded by

    SRO oO

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 21

    GENERAL

    SURGERY
    2nd semester
    The best blood products for management of hemophilia A is

    A. Fresh frozen plasma


    B. Cryoprecipitate
    C. Fresh Whole Blood
    D. Packed Red Cells
    E. Factor VIII

    Complication of massive blood transfusion is

    A. Thrombocytosis
    B. Hypercalcaemia
    C. Hyperkalaemia & hypocalcemia
    D. Hypokalaemia
    E. Hyperthermia

    All of the following cause hyponatremia EXCEPT

    A. Heart failure
    B. Liver cirrohosis
    C. Hypothyroidism
    D. Lasix
    E. Corticosteroids
    A patient manifests signs and symptoms of facial muscle twitching and prolonged QT on ECG. What
    electrolyte disorder is most likely
    A. Hyponatremeia
    B. Hypokalemia
    C. Hyperkalemia
    D. Hypocalcemia
    E. Hypercalcemia

    Prolong Prothrombin Time (PT) and normal Partial Thromboplastin Time (PTT) indicates
    A. Deficiency of factors I
    B. Deficiency of factor II
    C. Deficiency of factor VII
    D. Deficiency of factor VIII
    E. Deficiency of factor IX

    Hysterectomy procedure is
    A. Clean wound
    B. Clean-contaminated wound
    C. Contaminated wound
    D. Dirty
    E. None of the above
    The contraindication for enteral nutrition is

    A. Oesophageal stricture
    B. Bowel obstruction
    C. Anorexia
    D. Post cerebrovascular accident
    E. Head injury

    Assessment of nutrition include all of the following


    EXCEPT
    A. Anthropometric measurements
    B. Serum albumin
    C. Serum creatinine
    D. body mass index
    Which of the following statements regarding abscesses are true
    A. Aerobic bacteria are the most common causative organisms.
    B. The site of infection should be fluctuant if there is abscess
    C. Abscess have diffuse borders
    D. Antibiotics should be used if the abscess cavity is closed after drainage
    E. Lymphangitis is type of abscess formation along lymph vessels
    All of the following may be used in treatment of Hemolytic transfusion reaction due to
    incompatibility EXCEPT

    A. Mannitol
    B. Intravenous fluid
    C. Sodium bicarbonate
    D. Calcium
    E. Dialysis
    Initial fluid resuscitation in traumatic pediatric patient is

    A. 20 mL/kg of body weight lactated Ringer's solution


    B. 20 mL/kg of body weight Dextrose (D5W) solution
    C. 2 L intravenous bolus of isotonic crystalloid
    D. None of the above

    Which of the following statements regarding 0.9% normal saline are true

    A. It has the same sodium concentration as plasma.


    B. It has equal concentration of sodium and chloride.
    C. It is low in potassium.
    D. It contains dextrose.
    E. It is the best fluid to be used in hypovolaemia
    liver failure causes

    A. Hypovolemia and hyponatremia


    B. Hypovolemia and hypernatremia
    C. Hypervolemia and hyponatremia
    D. Hypervolemia and hypernatremia

    All of the following is indication for enteral nutrition EXCEPT

    A. Post- Cerebrovascular accident


    B. Anorexia nervosa
    C. Inflammatory bowel syndrome
    D. intestinal obstruction

    Which of the following statements regarding water homeostasis are true

    A. The total body water (TBW) content in an adult male is 70% of body weight.
    B. Two-thirds (40%) of TBW is intracellular.
    C. An average 70-kg adult has approximately 3 L of blood.
    D. Water moves freely across cell membranes by oncotic pressure
    A 25 kg weight child with Christmas disease (factor IX deficiency) requires multiple
    deciduous carious teeth extraction. How much fresh frozen plasma (FFP) would you
    give this child to control suspected bleeding

    A. 25 ml
    B. 50 ml
    C. 250 ml
    D. 500 ml

    Signs and symptoms of hemolytic transfusion reactions include


    A. Hypothermia
    B. Hypertension
    C. Polyuria
    D. Abnormal bleeding

    Which of the following about blood transfusion are false

    A. A haemoglobin level of 10 g/dL or less is now considered a typical indication.


    B. Fresh frozen plasma (FFP) is considered in massive transfusion.
    C. storage life of banked whole blood is 5 weeks (35 days)
    D. Patients can pre-donate blood up to 3 weeks before surgery for autologous transfusion.
    Regarding cellulitis and abscess, which is true

    A. Cellulitis is a suppurative, invasive infection of tissues


    B. Lymphangitis is type of abscess formation which presents as painful red streaks in affected
    lymphatics draining the source of infection.
    C. Abscess has doughy or indurated palpation in contrast to cellulitis which is fluctuant
    D. Cellulitis can be drained in specific situations.

    Regarding the use of Antibiotics in surgical infections, all of the following is true EXCEPT

    A. Initially, start definitive antibiotic treatment depending on presenting identifications and clinical
    judgment.
    B. Prior to treatment, pus should be drained and collected for culture and sensitivity
    C. Assessment of renal and hepatic functions is recommended before antibiotic treatment
    D. Ineffective antibiotic treatment may be caused by wrong route of administration

    Which of the following is NOT a complication of massive blood transfusions


    A. Coagulopathy
    B. Hypercalcaemia
    C. Hyperkalaemia
    D. Hypothermia.
    Regarding parenteral nutrition, which is true

    A. It is a method for feeding the patient intramuscularly


    B. Total Parenteral nutrition (TPN) is usually given peripherally
    C. Contraindicated in patients with heart failure
    D. Hypoglycemia is one of complication of parenteral nutrition

    Which one of the following cases is considered a clean-contaminated wound


    A. Open cholecystectomy for cholelithiasis
    B. Herniorrhaphy with mesh repair
    C. Lumpectomy of breast mass
    D. Gunshot wound to the abdomen with injuries to the small bowel

    The surgeon should be particularly concerned about which coagulation function in


    patients receiving anti- inflammatory or analgesic medications such as NSAIDS
    A. PTT
    B. PT
    C. Bleeding time
    D. Thrombin time
    Banked blood is deficient in all of the following except

    A. Platelets.
    B. White cells.
    C. Oxygen-carrying capacity of Hb.
    D. Potassium.
    E. Anti-hemophilic globulin.

    The highest concentration of K+ occurs in


    A. Urine.
    B. Succus entericus.
    C. Semen.
    D. Saliva.
    E. Tissue

    Among Contraindications of parenteral nutrition


    A. Heart failure
    B. Severe liver disease
    C. Uncontrolled diabetes
    D. GIT disease
    E. peptic ulcer
    Hypernatremia can present by
    A. irritability.
    B. Twitches.
    C. Convulsions.
    D. Hypeneflexia.
    E. fluid retention

    A 30-year-old man with multiple injuries has severe renal insufficiency. On the third day of
    hospitalization, he is lethargic with generalized weakness and decreased deep tendon reflexes. An
    electrocardiogram (ECG) reveals a widened QRS complex with elevated T waves. What is the most
    likely cause of the patient's condition?
    A. Hypokalemia
    B. Hyponatremia
    C. Hypermagnesemia
    D. Hypocalcemia
    E. the
    Hypophosphatemia
    initial best fluid which should be given to hypovolemic patient during resuscitation is

    A. Normal saline
    B. Ringer lactate
    C. Blood
    D. Dextrose water
    A 70-year-old woman has a small-bowel fistula with output of 1.5 L/d. Replacement of daily
    losses should be handled using the fluid solution that has the following composition in .mEq/L
    .

    A. Na 130 K 4 CI 109 HCO328


    Na 154 K 0 CI 154 HCO340
    A. Na 77 K 0 CI 77 HC030
    B. Na 167 K 0 CI 0 HCO3167
    C. Na 513 K 0 CI 513 HCO3
    A patient with a history of congestive heart failure is on lasix and digoxin. He is admitted for
    maxillofacial surgery. Perioperatively, what is the most important electrolyte to check and
    adjust

    A. Sodium
    B. Potassium
    C. Calcium
    D.
    TheNone
    best of the above
    initial management of Hypercalcemia is
    A. NaCl 0.9% and loop diuretics
    B. calcitonin, in conjunction with adequate hydration
    C. Pamidronate, in conjunction with adequate hydration
    D. Plicamycins
    The infection rate in mastectomy procedure is

    A. 2%
    B. <10%
    C. 20%
    D. 28-70%

    The most common fluid and electrolyte disorder in surgery is dehydration. which is NOT true
    regarding dehydration
    A. May be caused by fluid loss from insensible routes such as skin and lung
    B. skin turgor is increased
    C. the patient is tachycardic
    D. severe dehydration requires infusion of i.v. isotonic solution such as N/S

    urgent surgery what is the best fastest treatment


    A. Administration of vitamin K
    B. Administration of fresh whole blood
    C. Administration of protamine sulfate
    D. Administration of fresh frozen plasma
    the most common nosocomial infection is
    A. wound infections
    B. ventilator-associated pneumonia
    C. urinary tract infection
    D. bacteremia

    All of the following is surgical infection EXCEPT


    A. Peritonitis
    B. suppurative pericarditis
    C. Air embolism
    D. nosocomial infections

    The following would cause hypokalemia EXCEPT


    A. Dehydration
    B. Diarrhea
    C. Metabolic acidosis
    D. Lasix
    Addison's disease (adrenal :insufficiency) cause
    A. Hyponatremia and hypokalemia
    B. Hyponatremia and hyperkalemia
    C. Hypernatremia and hypokalemia
    D. Hypernatremia and hyperkalemia

    Which of the following is not used in irrigation of wounds


    A. Normal saline
    B. Ringer lactate
    C. Dextrose water
    D. Chlorinated solution

    All of the following is indication of Cryoprecipitate EXCEPT


    A. Von Willebrand disease
    B. Hemophilia A
    C. Uremic patients
    D. Hemophilia B
    Calcium depletion could cause
    A. Perioral numbness
    B. Tachycardia
    C. Trousseau's sign
    D. All of the above

    In a hemolytic reaction caused by an incompatible blood transfusion, the treatment that is most
    likely to be helpful is
    A. Stopping the transfusion immediately
    B. Treating anuria with fluid and potassium replacement
    C. Acidifying the urine to prevent hemoglobin precipitation in the renal tubules
    D. Removing foreign bodies, such as Foley catheters, which may cause hemorrhagic complications
    Patient on warfarin therapy and need urgent surgery, what is the best fastest treatment
    A. Administration of vitamin K
    B. Administration of fresh whole blood
    C. Administration of protamine sulfate
    D. Administration of fresh frozen plasma
    The most common cause of hemolytic reaction is
    A. Air embolism
    B. Unusual circulating antibodies
    C. Human errors
    D. Infection

    the characteristic ECG changes in hyperkalemia is


    A. Elevated T waves
    B. Narrowing of the QRS
    C. ST-depression
    D. Prolong PR
    Mastectomy operation is
    A. Clean surgery
    B. Clean contaminated
    C. Dirty
    D. Contaminated
    A 38-year-old man requires several units of blood transfusion due to multiple injuries sustained as
    a result of a fall. He develops tetany and complains of circumoral tingling.What is the cause
    A. Hypocalcemia
    B. Hemolytic transfusion reaction due to incompatibility
    C. Infection
    D. Disseminated intravascular coagulation (DIC)

    surgical infections include all of the following EXCEPT


    A. Emphysema
    B. necrotizing soft tissue
    C. infections peritonitis,
    D. hospital-acquired pneumonia

    Advantages of blood auto-transfusion include all of the following except


    A. Utilized in surgeries where there is expected a large volume blood loss
    B. used in cases of restricted homologous blood
    C. No need to blood compatibility tests
    D. low risk of infection transmission
    All of the following should be used in treatment of Haemolytic transfusion reaction due to
    incompatibility EXCEPT
    A. Intravenous fluid
    B. Sodium bicarbonate
    C. Mannitol
    D. Calcium

    Regarding cellulitis and lymphangitis, which is true


    A. cellulitis should be treated by antibiotics only in all cases
    B. Cellulitis is a well localized swelling with doughy consistency
    C. Cellulitis is a suppurative, invasive infection of tissues
    D. Lymphangitis presents as painful red streaks in affected lymphatic vessels draining the source
    of infection.
    Initial fluid resuscitation for injured patient is
    A. 10 ml/kg normal saline
    B. 2 L Dextrose
    C. 2 L ringer lactate
    D. 2 L blood
    During cholecystectomy in a 67-year-old woman, there is severe bleeding from accidental injury
    to the hepatic artery. The patient requires transfusion of 2000 mL of blood. After the operation, 24-
    hour urine output varies between 1250 and 2700 mL/d. She was adequately hydrated, but BUN
    levels continue to rise 10-12 mg daily over a 5-day period Metabolic changes likely to occur
    include which of the following
    A. Hyperkalemia
    B. Hypomagnesemia
    C. Hypophosphatemia
    D. Hyponatremia
    E. Metabolic alkalosis
    A 70 years old male with facial fractures and need blood transfusion. The best blood product
    should be used
    A. Fresh whole blood
    B. Packed red cells
    C. Fresh frozen plasma
    D. Platelet concentrates
    The specific test to identify the cause of transfusion reaction for the patient is which of the
    following
    A. PT
    B. Free plasma hemoglobin
    C. Platelet count
    D. Bleeding time
    E. PTT
    A 60-year-old man with carcinoma of the esophagus is admitted with severe malnutrition.
    Nutritional support is to be initiated.What should be his daily caloric intake
    A. 1 kcal/kg body weight/day
    B. 5 kcal/kg body weight/day
    C. 15 kcal/kg body weight/day
    D. 30 kcal/kg body weight/day
    E. 100 kcal/kg body weight/day

    Concerning postoperative wound infection, which of the following Statements is wrong


    A. Is most often due to dead space.
    B. Can always be prevented by prophylactic antibiotics.
    C. Frequently tokes the form of stitch abscess.
    D. May precipitate fatal secondary hemorrhage.
    E. May end fatally by septic shock.

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