Postoperative Care Challenge
Postoperative Care Challenge
Test your knowledge with our comprehensive quiz on postoperative care and surgical outcomes. This quiz includes 72 questions covering essential topics such as pain management, wound healing, and complications following surgery.
Features of the quiz:
- Multiple-choice questions
- Focused on clinical scenarios
- Ideal for medical students and professionals
Postoperative pain can lead to the following EXCEPT
Fat embolism
Myocardial infarction
Bleeding
Stroke
Methods of mechanical hemostasis are all of the following EXCEPT:
A. Vascular clamp Simple ligature (transfixion suture) Direct pressure applied by packs
B. Application of the tourniquet
C. Bipolar electrocautery
D. Direct digital pressure over a bleeding site
Risk of postoperative myocardial infarction includes All of the following EXCEPT
A. Hypertension
B. Hypotension
C. Age under 30
D. Postoperative pain
5. Prevention of the postoperative thromboembolism includes all of the following measures EXCEPT:
A. Compression stockings
B. Low molecular weight heparin
C. Early walking
D. Oxygen therapy
Severe sepsis is differentiated from sepsis by:
A. Positive blood cultures for bacteria and fungs
B. Acute organ failure such as renal
C. A history of the premotoid condition such as diabetes
D. Prolonged arterial hypotension
Neurotmesis Is:
A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Complete transection of nerve
C. Congenital absence of nerve
D. Focal demyelination of nerve
Commonest cause of the Metabolic alkalosis in surgical patient is:
A. Gastric outlet obstruction
B. Antacid therapy
C. Steroid treatment
D. Hyperventilation because of the head injury
9. The commonest cause of the metabolic alkalosis is:
A. Pyloric stenosis
B. Peptic ulcer
C. Diuretics
D. Small-bowel obstruction
Prevention of postoperative parotitis includes all of the following EXCEPT:
A. Adequate fluid intake
B. Good oral hygiene
C. Preoperative fasting
D. Stimulation of salivary flow
All of the following points are true for the necrotizing fasciitis EXCEPT:
A. Characterized by high mortality rate
B. Treatment - Oral antibiotics
C. Treatment - Removal of all necrotized skin and fascia
D. Is caused by the septic thrombosis of the vessels
Treatmet of superficial wound infection is:
A. Removal of drains
B. Oral steroids
C. Heparin ointment
D. Opening the small segment of incision and draining of purulent content
A postoperative patient with a potassium of 2.9 is given 1 mEq/kg replacement with potassium chloride. Repeat tests after the replacement show the sere 3.0. Most likely diagnosis is:
A. Metabolic alkalosis
B. Hypocalcemia
C. Metaboloc acidosis
D. Hypomagnesemia
The treatment of the coagulopathy caused by liver disease includes the following:
A. Vitamin K, FFP
B. Aspirin
C. Heparin
D. Warfarin
Warfarin dose is controlled by the following test
A. Bleeding time
B. aPTT
C. Factor 8
D. INR/PT
Excess healing after gastrointestinal surgery could lead to the following complications:
A. Diarrhea
B. Stricture formation
C. Gastrointestinal bleeding
D. Fistula formation
All of the following principles are important for seccessful healing of the bowel anastomosis EXCEPT:
A. Absence of tension
B. Adequate blood supply
C. Depressed bowel motility
D. Adequate nutrition
The symptom of superfitial wound infection is:
A. Hypothermia
B. Hyperemia
C. Muscle spasm
D. Cyanosis
Major types of chronic wound are EXCEPT:
A. Pressure ulcers
B. Arterial ulcers
C. Diabetic ulcers
D. Post appendectomy wound
Which medication is used as antidote in case of the heparin overdose:
A. Protamine sulphate
B. Platelet concentrate
C. FFP
D. Aspirin
9. During remodeling phase of wound healing the tensile strength of the scar tissue gradually increases because of:
E. Collagen type Ill is gradually replaced by stronger type I collagen
F. Number of blood vessels in the scar is reduced
G. The fibroblasts start to disappear
H. Scar shrinkage
Marjolin ulcer is:
A. Chronic venous ulcer
B. Malignant transformation of chronic wound
C. Chronic arterial ulcer
D. Chronic diabetic ulcer
Damage control resuscitation means all the following principles EXCEPT:
A. O-negative uncrosmathched RBC is used before typing results are available
B. Initial transfusion of red blood cells
C. In case of massive transfusion plasma, platelets and red blood cells are transfused in a 1:1:1 ratio
D. Initial infusion of normal saline
12. Following factors affect wound healing EXCEPT
E. Wound irrigation
F. Diabetes mellitus
G. Malnutrition
H. Vitamin deficiencies
13. Flowing factors affect wound healing EXCEPT:
E. Steroid use
F. Hypoperfusion of tissues
G. Advanced age
H. Antibiotics
14. Flowing factors affect wound healing EXCEPT:
E. Cancer
F. Cardiac failure
G. Vitamins
H. Chemotherapeutic antimetabolite drugs
Wounds could be classified as following EXCEPT
A. Puncture
B. Preoperative
C. Chronic
D. Closed
Wounds could be classified as following EXCEPT
A. Thermal
B. Congenital
C. Caused by radiation
D. Mechanical
Wounds could be classified as following EXCEPT
A. Partial
B. Penetrating
C. Missile
D. Crushed
Tests necessary for RBC transfusion are the following EXCEPT:
A. Human leukocyte antigen (HLA) typing
B. Cross matching
C. Rh typing
D. ABO typing
Treatmet of superficial wound rection is
A. Removal of drains
B. Oral steroids
C. Heparin ointment
D. Opening the small segment of incision and draining of purulent content
The extrinsic pathway of hemostasis is initiated by:
A. Tissue thromboplastin
B. Thrombin
C. Red blood cells
D. Plasmin
Keloids are characterised by the following points EXCEPT:
A. Excision alone of keloids is subject to a high recurrence rate, ranging from 45 to 100%
B. Is more common in darker-pigmented ethnicities, with individuals of African, Spanish, and Asian ethnicities
C. Rise above the skin level as well, but extend beyond the border of the original wound
D. Often regress over time
22. Wound reepithelisation occurs by:
A. Replacement of epithelium with connective tissue (scar)
B. Covering the granulation tissue with epithelial cells migrating from wound edges
Examples of deep wound infections are following EXCEPT:
A. Abscess under diaphragm
B. Abscess under the axillary skin
C. Abscess under fascia
D. Abscess in the Douglass pouch
Neurapraxia is:
A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Congenital absence of nerve
C. Focal demyelination of nerve
D. Complete transection of nerve
Main enzyme causing thrombosis is:
A. Tissue thromboplastin
B. Heparin
C. Plasmin
D. Von Willebrand's factor
Phases of bone healing are all of the following EXCEPT:
A. Remodeling
B. Epithelisation
C. Soft callus formation
D. Hard callus formation
Laparotomy belongs to the following wound types EXCEPT
A. Incision
B. Mechanical
C. Abrasion
D. Open
Axonotmesis is:
A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Complete transection of nerve
C. Focal demyelination of nerve
D. Congenital absence of nerve
Wound heals by primary intention when:
A. There is a little gap between wound edges
B. Wound is packed with sterile gauze
C. The wound is infected
D. After wound dehiscence
Wound heals by secondary intention during following circumstances EXCEPT:
A. The wound is infected
B. Wound is clean and sutured
C. Wound is packed with sterile gauze
D. Sutures are applied after granulation tissue formation
Wound heals by secondary intention when:
A. Wound edges are separated
B. The wound is sutured
C. Incised or cut wounds
D. There is no infection
Chronic Granulomatous Disease is caused by
A. Malnutrition
B. Vitamin deficiency
C. Defective connective tissue
D. The congenital defect of phagocyte function.
Symptoms of a superficial wound infection are EXCEPT
A. Wound swelling
B. Hyperemia
C. Vomitus
D. Hyperthermia
Failure of healing of the gastrointestinal wall sutures could lead to the following complications EXCEPT:
A. Peritonitis
B. Fistula formation
C. Intestinal obstruction
D. Intraabdominal abscess
Neurotmesis is:
A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Complete transection of nerve
C. Congenital absence of nerve
D. Focal demyelination of nerve
36. The main pecularity of fetal wound healing is:
A. Absence of healing
B. Absence of scarring
C. Slow healing
D. Excess healing
During the hemostasis phase of wound healing main cell type found in the wound is
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils
During the late inflamation phase of wound healing the main cell type found in the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils
During the early inflamation phase of wound healing the main cell type found in the wound is
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils
During the proliferation phase of wound healing the main cell type found in the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils
Following points are true for the necrotizing fasciitis EXCEPT
A. Treatment - Oral antibiotics
B. Characterized by high mortality rate
C. Is caused by the septic thrombosis of the vessels
D. Treatment - Removal of all necrotized skin and fascia
Main components of the extracellular matrix are all EXCEPT
A. Glycosaminoglycan
B. Proteoglycans
C. Collagen
D. Myosin
Symptoms of Class III hypovolemia (loss of 30-40% of blood volume) are:
A. Face hyperemia, bradycardia
B. Dry mouth, normal pulse pressure
C. Tachycardia and decreased pulse pressure but, normal BP (Class II
D. Tachycardia, tachypnea, hypotension, oliguria, and changes in mental status
Acute is a wound which heals earlier then:
A. 6 weeks
B. 10 weeks
C. 3 months
D. 2 months
The following points are tue for Split-thickness skin graft EXCEPT
A. May be "meshed" to cover larger area
B. Is harvested using dermatomes
C. Consists of epidermis and part of dermis
D. Needs vascular anastomosis for blood supply
Hypertrophic scars are
A. Rise above the skin level as well, but extend beyond the border of the original wound and rarely regress spontaneously
B. Rise above the skin level but stay within the confines of the original wound and often regress over time
Methods of mechanical hemostases are the following EXCEPT:
A. Application of the tourniquet
B. Bipolar electrocautery
C. Direct digital pressure over a bleeding site
D. Vascular clamp Simple ligature (transfixion suture) Direct pressure applied by packs
Bleeding from cut bone can be controlled by:
A. Ligature
B. Tourniquet
C. Packing a wax
D. Vascular clamp
In the gastrointestinal surgery serosa-to-serosa approximation is important because:
A. Serosal epithelium releases growth factors for faster healing
B. Serosal epithelium releases growth factors for faster healing
C. Serosa releases fibrin which makes suture line watertight.
D. Serosa has the greatest tensile strength and suture-holding capacity
All of the following contribute for the development of the lung atelectasis EXCEPT:
A. Prolonged posture
B. Thick bronchial discharge
C. Lack of the deep breath
D. Breathing exercises
2. Autoclaving parameters are:
A. 2 atm (121°C) 15 min
B. 2 atm (140°C) 45 min
C. 1 atm (100°C) 15 min
D. 1 atm (161°C) 25 min
Who can give Operative Permit (Consent
A. Only the patient
B. Patient's lawyer only
C. Hospital manager
D. Emergency lifesaving operations or procedures may have to be done without a permit.
4. Delayed wound healing is expected in following patient group:
A. Receiving large doses of ascorbic acid
B. Diabetes mellitus
C. Constipation
D. Wrestlers
In the usual preparation for general surgery, the patient may be:
A. Given ice chips
B. Given specifically ordered oral medications with couple glasses of water
C. Allowed to brush teeth and swallow water
D. NPO for 12 to 14 hours before
Signs of the postoperative paralytic ileus resolution are
A. Distended abdomen
B. Lack of the audible peristalsis
C. Passage of flatus
D. Loss of the appetite
Opioid narcotics could aggravate postoperative period by causing
A. Respiratory stimulation
B. Decreased peristalsis
C. Diarrhea
D. Wound dehiscence
Markers of malnutrition during preoperative evaluation are EXCEPT:
A. Serum albumin of <3 g/dL
B. Serum transferrin <150 mg/dL
C. Elevated free thyroxin
D. Weight loss >20%
Dry heat sterilisation parameters are
A. 100°C 4hr
B. 120°C 1hr
C. 130°C. 2hr
D. 160°C 1hr
High risk of thromboembolism has a patient with all of the following condition EXCEPT
A. Obesity
B. Cancer
C. Myocardial infarction
D. INR>2.5
Melena or melæna means:
A. Black stools
B. Bloody vomitus
C. Nasal bleeding
D. Bloody urine
Disadvantage of ethylene oxide sterilization is
A. It is expensive
B. It is flammable and toxic
C. Short sterilization time
D. Spoils metal instruments
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