Make your own quiz Manage my Quizzes Plans / Features Guides and Help Contact Privacy & Security

Sugery(1_50)

Create an image of a surgeon in a hospital setting reviewing surgical charts and instruments, with a digital quiz interface in the background, illustrating the theme of medical knowledge assessment.

Surgical Knowledge Assessment

Test your expertise in surgical principles and practices with our comprehensive quiz designed for medical professionals and students alike. This quiz focuses on various surgical scenarios, postoperative care, and critical decision-making processes.

With 50 challenging questions, you'll explore:

Postoperative management
Complications and transfusion reactions
Fluid and electrolyte balance
Indications for surgical interventions
Clinical assessment and patient management

50 Questions12 MinutesCreated by HealingDoctor321

A patient with a nonobstructing carcinoma of the sigmoid colon is being prepared for elective resec- tion. To minimize the risk of post- operative infectious complications, your planning should include

A. A single preoperative parenteral dose of antibiotic effective against aerobes and anaerobes

B. Avoidance of oral antibiotics to pre- vent emergence of Clostridium difficile

C. Postoperative administration for 2–4 days of parenteral antibiotics effective against aerobes and anaer- obes

D. Postoperative administration for 5–7 days of parenteral antibiotics effective against aerobes and anaer obes

E. Operative time less than 5 h

A 78-year-old man with a history of coronary artery disease and an asymptomatic reducible inguinal hernia requests an elective hernia repair. You explain to him that valid reasons for delaying the proposed surgery include

A. Coronary artery bypass surgery 3 mo earlier

B. A history of cigarette smoking

C. Jugular venous distension

D. Hypertension

E. Hyperlipidemia

Following celiotomy, normal bowel motility can ordinarily be presumed to have returned

A. In the stomach in 4 h, the small bowel in 24 h, and the colon after the first oral intake

B. In the stomach in 24 h, the small bowel in 4 h, and the colon in 3 days

C. In the stomach in 3 days, the small bowel in 3 days, and the colon in 3 days

D. In the stomach in 24 h, the small bowel in 24 h, and the colon in 24 h

E. In the stomach in 4 h, the small bowel immediately, and the colon in 24 h

Which of the following surgical interventions is least likely to provide acceptable prolongation of life for patients with AIDS?

A. Splenectomy for AIDS-related idio- pathic thrombocytopenic purpura

B. Colonic resection for perforation secondary to cytomegalovirus infection

C. Cholecystectomy for acalculous cholecystitis

D. Tracheostomy for ventilator- dependent patients with respira tory failure

E. Gastric resection for a bleeding gastric lymphoma or Kaposi’s sarcoma

A cirrhotic patient with abnor- mal coagulation studies due to hepatic synthetic dysfunction requires an urgent cholecystec- tomy. A transfusion of fresh frozen plasma is planned to minimize the risk of bleeding due to surgery. The optimal timing of this transfusion would be

A. The day before surgery

B. The night before surgery

C. On call to surgery

D. Intraoperatively

E. In the recovery room

On postoperative day 3, an otherwise healthy 55-year-old man recovering from a partial hepatec- tomy is noted to have scant serosanguineous drainage from his abdominal incision. His skin sta- ples are removed, revealing a 1.0- cm dehiscence of the upper midline abdominal fascia. Which of the following actions is most appropriate? Pre- and Post-operative Care

A. Removing all suture material and packing the wound with moist ster- ile gauze

B. Starting intravenous antibiotics

C. Placing an abdominal (Scultetus) binder

D. Prompt resuturing of the fascia in the operating room

E. Bed rest

Five days after a sigmoid colec- tomy for cancer, a patient’s skin sta- ples are removed and a large gush of serosanguineous fluid emerges. Examination of the wound reveals an extensive fascial dehiscence. The most appropriate management is

A. Wide opening of the wound to assure adequate drainage

B. Smear and culture of the fluid and appropriate antibiotics after the smear is reviewed

C. Careful reapproximation of the wound edges with tape

D. Immediate return to the operating room

E. Application of a Scultetus binder

Signs and symptoms of hemo- lytic transfusion reactions include

A. Hypothermia

B. Hypertension

C. Polyuria

D. Abnormal bleeding

E. Hypesthesia at the transfusion sit

The surgeon should be particu- larly concerned about which coagu- lation function in patients receiving anti-inflammatory or analgesic med- ications?

A. APTT

B. PT

C. Reptilase time

D. Bleeding time

E. Thrombin time

The substrate depleted earliest in the postoperative period is

A. Branched-chain amino acids

B. Non-branched-chain amino acids

C. Ketone

D. Glycogen

E. Glucose

Diagnostic abdominal laparo- scopy is contraindicated in which of the following patients?

A. A patient with rebound tenderness following a tangential gunshot wound to the abdomen

B. A stable patient with a stab wound to the lower chest wall

C. A patient with a mass in the head of the pancreas

D. A young female with pelvic pain and fever

E. An elderly patient in the intensive care unit suspected of having intestinal ischemia

A 23-year-old woman under- goes total thyroidectomy for carcinoma of the thyroid gland. On the second postoperative day, she begins to complain of tingling sen- sation in her hands. She appears quite anxious and later complains of muscle cramps. Initial therapy should consist of

A. 10 mL of 10% magnesium sulfate intravenously

B. Oral vitamin D

C. 100 μg of oral Synthroid

D. Continuous infusion of calcium Gluconate

E. Oral calcium gluconate

Hypocalcemia is associated with

A. Acidosis

B. Shortened QT interval

C. Hypomagnesemia

D. Myocardial irritability

E. Hyperproteinemia

The enteric fluid with an elec- trolyte (Na+, K+, C1−) content simi- lar to that of Ringer’s lactate is

A. Saliva

B. Contents of small intestine

C. Contents of right colon

D. Pancreatic secretions

E. Gastric juice

The two solutions most commonly used to maintain fluid and electrolyte balance in the postoper ative management of patients are 5% dextrose in 0.9% sodium chloride and lactated Ringer’s solution. A correct statement regarding 5% dextrose in 0.9% saline is which of the following?

A. It contains the same concentration of sodium ions as does plasma

B. It can be given in large quantities without seriously affecting acid- base balance

C. It is isosmotic with plasma d. It has a pH of 7.4

D. It may cause a dilutional

The two solutions most commonly used to maintain fluid and electrolyte balance in the postoper ative management of patients are 5% dextrose in 0.9% sodium chloride and lactated Ringer’s solution. Correct statements regarding lactated Ringer’s solution include which of the following?

A. It contains a higher concentration of sodium ions than does plasma

B. It is most appropriate for replacement of nasogastric tube losses

C. It is isosmotic with plasma

D. It has a pH of less than 7.0

E. It may induce a significant metabolic acidosis

Signs and symptoms associated with early sepsis include

A. Respiratory acidosis

B. Decreased cardiac output

C. Hypoglycemia

D. Increased arteriovenous oxygen difference

E. Cutaneous vasodilation

The most common physiologic cause of hypoxemia is

A. Hypoventilation

B. Incomplete alveolar oxygen diffusion

C. Ventilation-perfusion inequality

D. Pulmonary shunt flow

E. Elevated erythrocyte 2,3-diphos- phoglycerate level (2,3-DPT)

Generally accepted indications for mechanical ventilatory support include

A. PaO2 of less than 70 kPa and PaCO2 of greater than 50 kPa while breathing room air

B. Alveolar-arterial oxygen tension difference of 150 kPa while breathing 100% O2

C. Vital capacity of 40–60 mL/kg

D. Respiratory rate greater than 35 breaths/min

E. A dead space:tidal volume ratio (VD/VT) less than 0.6

In a hemolytic reaction caused by an incompatible blood transfusion, the treatment that is most likely to be helpful is

A. Promoting a diuresis with 250 ml of 50% mannitol

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

E. Stopping the transfusion immediately

Which of the following inhalation anesthetics accumulates in air-filled cavities during general anesthesia?

A. Diethyl ether

B. Nitrous oxide

C. Halothane

D. Methoxyflurane

E. Trichloroethylene

Dopamine is a frequently used drug in critically ill patients because

A. At high doses it increases splanchnic flow

B. At high doses it increases coronary flow

C. At low doses it decreases heart rate

D. At low doses it lowers peripheral resistance

E. It inhibits catecholamine release

Compensatory mechanisms during acute hemorrhage include

A. Decreased cerebral and coronary blood flow

B. Decreased myocardial contractility

C. Renal and splanchnic vasodilation

D. Increased respiratory rate

E. Decreased renal sodium resorption

An 18-year-old woman develops urticaria and wheezing after an injection of penicillin. Her blood pressure is 120/60 mm Hg, heart rate is 155 beats/min, and respiratory rate is 30 breaths/min. Immediate therapy should include

A. Intubation

B. Epinephrine

C. Beta blockers

D. Iodine

E. Fluid challenge

During blood transfusion, clotting of transfused blood is associated with

A. ABO incompatibility

B. Minor blood group incompatibility

C. Rh incompatibility

D. Transfusion through Ringer’s lactate

E. Transfusion through 5% dextrose and water

Among patients who require nutritional resuscitation in an intensive care unit, the best evidence that nutritional support is adequate is

A. Urinary nitrogen excretion levels

B. Total serum protein level

C. Serum albumin level

D. Serum transferrin levels

E. Respiratory quotient

The accidental aspiration of gastric contents into the tracheobronchial tree should be initially treated by

A. Tracheal intubation and suctioning

B. Steroids

C. Intravenous fluid bolus

D. Cricothyroidotomy

E. High positive end expiratory pressure

In performing a tracheostomy, authorities agree that

A. The strap muscles should be divided

B. The thyroid isthmus should be preserved

C. The trachea should be entered at the second or third cartilaginous ring

D. Only horizontal incisions should be usedv

E. Formal tracheostomy is preferable to cricothyroidotomy as an emergency procedure

Central venous pressure (CVP) may be decreased by

A. Pulmonary embolism

B. Hypervolemia

C. Positive-pressure ventilation

D. Pneumothorax

E. Gram-negative sepsis

Wasting of the intrinsic muscles of the hand can be expected to follow injury of the

A. Ulnar nerve

B. Radial nerve

C. Brachial nerve

D. Axillary nerve

E. Thenar and hypothenar nerves

With regard to wound healing, which one of the following statements is correct?

A. Collagen content reaches a maximum at approximately 1 wk after injury

B. Monocytes are essential for normal wound healing

C. Fibroblasts appear in the wound within 24–36 h after the injury

D. The function of the monocyte in wound healing is limited to phagocytosis of bacteria and debris

E. Early in wound healing, type I collagen is predominant

While you are on duty in the emergency room, a 12-year-old boy arrives with pain and inflammation over the ball of his left foot and red streaks extending up the inner aspect of his leg. He remembers removing a wood splinter from the sole of his foot on the previous day. The most likely infecting organism is

A. Clostridium perfingens

B. Clostridium tetani

C. Staphylococcus

D. Escherichia coli

E. Streptococcus

The true statement regarding tendon injuries in the hand is

A. Flexor digitorum superficially inserts on the distal phalanx

B. Flexor digitorum profundus inserts on the middle phalanx

C. The tendons of flexor digitorum superficialis arise from a common muscle belly

D. The best results for repair of a flexor tendon are obtained with injuries in the fibroosseous tunnel (zone 2)

E. The process of healing a tendon injury involves formation of a tenoma

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

A. Open cholecystectomy for cholelithiasis

B. Herniorrhaphy with mesh repair

C. Lumpectomy with axillary node dissection

D. Appendectomy with walled-off abscess

E. Gunshot wound to the abdomen with injuries to the small bowel and sigmoid colon

A 25-year-old man is brought to the emergency room after sustaining burns during a fire in his apartment. He has blistering and erythema of his face, left upper extremity, and chest with frank charring of his right upper extremity. He is agitated, hypotensive, and tachycardiac. Which one of the following statements concerning this patient’s initial wound management is correct?

A. Topical antibiotics should not be used, as they will encourage growth of resistant organisms

B. Early excision of facial and hand burns is especially important

C. Escharotomy should only be per- formed if neurologic impairment is imminent

D. Excision of areas of third-degree or of deep second-degree burns usually takes place 3–7 days after injury

E. Split-thickness skin grafts over the eschar of third-degree burns should be performed immediately in order to prevent fluid loss

A. High-dose penicillin should be administered prophylactically

B. Tetanus prophylaxis is not necessary if the patient has been immunized in the previous 3 years

C. This burn can be estimated at 60% total body surface area using the “rule of nines”

D. The most sensitive indicator of adequacy of fluid resuscitation is heart rate

E. This patient should undergo immediate intubation for airway protection and oxygen administration

Which of the following statements regarding carpal tunnel syndrome is correct?

A. It is rarely secondary to trauma

B. It may be associated with pregnancy

C. It most often causes dysesthesia during waking hours

D. It is often associated with vascular compromise

E. Surgical treatment involves release of the extensor retinaculum

Management of leukoplakia of the oral cavity includes

A. Excisional biopsy of all lesions

B. Application of topical antibiotics

C. Low-dose radiation therapy

D. Ascertaining that dentures fit properly

E. Application of topical chemotherapeutic agents

A teenage boy falls from his bicycle and is run over by a truck. On arrival in the emergency room, he is awake and alert and appears frightened but in no distress. The chest radiograph suggests an air- fluid level in the left lower lung field and the nasogastric tube seems to coil upward into the left chest. The next best step in management is

A. Placement of a left chest tube

B. Immediate thoracotomy

C. Immediate celiotomy

D. Esophagogastroscopy

E. Removal and replacement of the nasogastric tube; diagnostic peritoneal lavage

Which of the following conditions is most likely to follow a compression type abdominal injury?

A. Renal vascular injury

B. Superior mesenteric thrombosis

C. Mesenteric vascular injury

D. Avulsion of the splenic pedicle

E. Diaphragmatic hernia

A 65-year-old man who smokes cigarettes and has chronic obstructive pulmonary disease falls and fractures the 7th, 8th, and 9th ribs in the left anterolateral chest. Chest x-ray is otherwise normal. Appropriate treatment might include

A. Strapping the chest with adhesive tape

B. Immobilization with sandbags

C. Tube thoracostomy

D. Peritoneal lavage

E. Surgical fixation of the fractured ribs

Blunt trauma to the abdomen most commonly injures which of the following organs?

A. Liver

B. Kidney

C. Spleen

D. Intestine

E. Pancreas

A 27-year-old man sustains a single gunshot wound to the left thigh. In the emergency room he is noted to have a large hematoma of his medial thigh. He complains of paresthesias in his foot. On examination there are weak pulses palpable distal to the injury and the patient is unable to move his foot. The appropriate initial management of this patient would be

A. Angiography

B. Immediate exploration and repair

C. Fasciotomy of anterior compartment

D. Observation for resolution of spasm

E. Local wound exploration

A 25-year-old woman arrives in the emergency room following an automobile accident. She is acutely dyspneic with a respiratory rate of 60 breaths/min. Breath sounds are markedly diminished on the right side. The first step in managing the patient should be to

A. Take a chest x-ray

B. Draw arterial blood for blood gas determination

C. Decompress the right pleural space

D. Perform pericardiocentesis

E. Administer intravenous fluids

A 25-year-old woman arrives in the emergency room following an automobile accident. She is acutely dyspneic with a respiratory rate of 60 breaths/min. Breath sounds are markedly diminished on the right side. A chest x-ray of this woman before therapy would probably reveal

A. Air in the right pleural space

B. Shifting of the mediastinum toward the right

C. Shifting of the trachea toward the right

D. Dilation of the intrathoracic vena cava

E. Hyperinflation of the left lung

Among the physiologic responses to acute injury is

A. Increased secretion of insulin

B. Increased secretion of thyroxine

C. Decreased secretion of vasopressin (ADH)

D. Decreased secretion of glucagon

E. Decreased secretion of aldosterone

In a stable patient, the management of a complete transection of the common bile duct distal to the insertion of the cystic duct would be optimally performed with a

A. Choledochoduodenostomy

B. Loop choledochojejunostomy

C. Primary end-to-end anastomosis of the transected bile duct

D. Roux-en-Y choledochojejunostomy

E. Bridging of the injury with a T tube

No operative management of penetrating neck injuries has been advocated as an alternative to mandatory exploration in asymptomatic patients. Which of the following findings would constitute a relative, rather than an absolute, indication for formal neck exploration?

A. Expanding hematoma

B. Dysphagia

C. Dysphonia

D. Pneumothorax

E. Hemoptysis

Following blunt abdominal trauma, a 12-year-old girl develops upper abdominal pain, nausea, and vomiting. An upper gastrointestinal series reveals a total obstruction of the duodenum with a “coiled spring” appearance in the second and third portions. Appropriate management is

A. Gastrojejunostomy

B. Nasogastric suction and observation

C. Duodenal resection

D. TPN to increase the size of the retroperitoneal fat pad

E. Duodenojejunostomy

Following traumatic peripheral nerve transection, regrowth usually occurs at which of the following rates?

A. 0.1 mm per day

B. 1 mm per day

C. 5 mm per day

D. 1 cm per day

E. None of the above

{"name":"Sugery(1_50)", "url":"https://www.quiz-maker.com/QPREVIEW","txt":"Test your expertise in surgical principles and practices with our comprehensive quiz designed for medical professionals and students alike. This quiz focuses on various surgical scenarios, postoperative care, and critical decision-making processes.With 50 challenging questions, you'll explore:Postoperative managementComplications and transfusion reactionsFluid and electrolyte balanceIndications for surgical interventionsClinical assessment and patient management","img":"https:/images/course8.png"}