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Surgery p5(200-250)

A detailed illustration of a surgical operation in a modern operating theatre, with medical professionals and surgical instruments, showcasing a focus on neurology and surgery.

Surgical and Neurological Quiz

Test your knowledge on surgical and neurological conditions with this comprehensive quiz that covers a range of topics. Designed for medical professionals, students, and enthusiasts alike, this quiz will challenge your understanding of critical concepts in surgery and neurology.

Features:

50 multiple choice questions
Diverse topics including trauma, infections, and surgical techniques
Score tracking to monitor your progress

50 Questions12 MinutesCreated by HealingHand123

Which of the following statements about craniopharyngiomas is true?

A. The tumors are uniformly solid

B. The tumors are usually malignant

C. Children with these tumors often develop signs and symptoms of acromegaly

D. The tumors may cause compression of the optic tracts and visual symptoms

E. The primary mode of treatment is radiation therapy

Which of the following statements regarding cerebral contu- sions is true?

A. They occur most frequently in the occipital lobes

B. They may occur opposite the point of skull impact

C. They are rarely accompanied by parenchymal bleeding

D. They may occur spontaneously in patients receiving anticoagulants

E. Anticonvulsants have no role in the early management of this disorder

True statements regarding meningiomas include that they

A. Are malignant in 50% of cases

B. Occur predominantly in men

C. Are treated primarily by surgical excision

D. Are cured, when properly treated, in nearly 95% of cases

E. Arise from the dura

While watching a golf tournament, a 37-year-old man is struck on the side of the head by a golf ball. He is conscious and talkative after the injury, but several days later he is noted to be increas- ingly lethargic, somewhat con- fused, and unable to move his right side. (SELECT 1 DIAGNOSIS). For description above, select the type of vascular event with which it is most likely to be associated.

A. Subdural hematoma

B. Epidural hematoma

C. Carotid dissection

D. Brain contusion

E. Ruptured intracranial aneurysm

A 42-year-old woman complains of the sudden onset of a severe headache, stiff neck, and photophobia. She loses consciousness. She is later noted to have a dilated pupil. (SELECT 1 DIAGNOSIS). For description above, select the type of vascular event with which it is most likely to be associated.

A. Subdural hematoma

B. Epidural hematoma

C. Carotid dissection

D. Brain contusion

E. Ruptured intracranial aneurysm

A25 year-old known substance abuser is brought to the ED with a suspected overdose. Which of the following is not considered a universal antidote?

A. glucose

B. oxygen

C. Calcium gluconate

D. naloxone

E. thiamine

Which of the following is not a classic sign of a basal skull fracture?

A. Battle sign

B. Racoon eyes

C. hemotympanum

D. Freedman sign

E. CSF rhinnorhea/ottorrhea

A19 year-old female with a traumatic head injury is brought to the ED by EMS. She is hemodynamically stable but requires assisted ventilation through an endotracheal tube. She does not open her eyes to painful stimuli and maintains an abnormal extension posture. Which of the following is incorrect?

A. her GCS is 3

B. a GCS of 8 is an indication for intubation

C. Isolated head injuries can cause shock

D. She should be ventilated to a pCO2 of 30-35 mm Hg

E. All are incorrect

Conductive hearing loss is a symptom of:

A. presbycusis

B. Meniere disease

C. cholesteatoma

D. Bell palsy

E. Acoustic neuroma

The following statements regarding epistaxis are false EXCEPT:

A. Epistaxis rarely occurs in children

B. It commonly results from rupture of posterior placed nasal vessels

C. It may be treated by ligation of the ipsilateral internal carotid artery

D. Epistaxis may be treated by cautery of Little’s area with silver nitrate

E. It is not a common cause of emergency admission to ENT wards

A52 year-old dentist comes to your office complaining of severe bilateral buttock cramps and thigh fatigue during a tennis match and recent onset of impotence The most likely diagnosis is:

A. Lumbosacral disc problem

B. Multiple sclerosis

C. Leriche syndrome

D metastatic carcinoma of the spine

Patients with an organic cause for impotence are often characterized by all of the following EXCEPT:

A. diabetes

B. Older age

C. Intermittent difficulty

D. Nocturnal penile tumescence absent

E. None of the above

Which of the following is not a sign or symptom of carpal tunnel syndrome :

A. Loss of sensation to the proximal palm

B. positive Phalen test

C. positive Tinel sign

D. Pain involving the thumb, index, long, and part of the ring digits

E. Delayed transit time on nerve conduction study

In which of the following are systemic antibiotics not indicated :

A. Animal bite to hand

B. Laceration over metacarpal-phalangeal joint sustained after punching someone in a fight

C. positive Finkelstein test

D. Burn wound to 75% of the dorsal aspect of the hand

E. Acute suppurative tenosynovitis

Prolonged vomiting is associated with what electrolyte abnormality?

A. Hypochloremic hypokalemic metabolic acidosis

B. Hypochloremic hypokalemic metabolic alkalosis

C. Hyperchloremic metabolic acidosis

D. hyperkalemia

E. None of the above

Indications for immediate operative intervention rather than conservative management for arterial insufficiency include all the following EXCEPT:

A. Nocturnal limb pain

B. Ischemic ulceration

C. Absent pulse

D. Ischemic neuropathy

E. Toe gangrene

Surgical indications for diverticulitis include all of the following EXCEPT:

A. peritonitis

B. Persisting hemorrhage

C. fistula

D. Greater than two severe attacks

E. Palpable abdominal mass in left lower quadrant

All of the following radiologic abdominal plain film findings are consistent with mechanical bowel obstruction except:

A. a "step ladder" pattern

B. Dilated small bowel loops

C. air-fluid levels at uniform height in same bowel loop

D. Absence of gas in large bowel

E. Rows of small gas accumulations in valvulae conniventes (i.e."string of pearls")

After a weekend of heavy drinking, a 28 year-old male presents with abdominal pain radiating to the back. What is the investigative and prognostic modality of choice for the suspected diagnosis?

A. Abdominal ultrasound

B. abdominal CT

C. Abdominal plain film

D. Endoscopic retrograde cholangiopancreatography

E. laparoscopy

An 18 year-old motorcyclist presents in the emergency department following an accident. He has a compound tibia and fibula fracture of the right leg and on examination the right leg has no pulses. Your immediate treatment should be:

A. Immediate angiogram

B. Immediate surgery

C. Casting and/or splinting

D. Reduction and splinting

E. x-ray

Which of the following is the most serious complication of a dis placed supracondylar fracture of the humerus?

A compartment syndrome of the forearm

B. Failure to heal

C. Healing in a non-anatomical position

D. Injury to the median nerve

E. Significantly limited range of elbow motion

Which of the following is not a complication of untreated otitis media?

A. cholesteatoma

B. meningitis

C. Tympanic membrane perforation

D. Trigeminal neuralgia

E conductive hearing loss

With respect to control of micturition, all of the following are true EXCEPT:

A. Damage to the cerebral cortex results in hyperactivity of the detrusor

B. The basal ganglia inhibits bladder overactivity

C. The cerebellum coordinates emptying of the bladder

D. Damage to the cerebellum results in hypotonicity of the detrusor

E. Injury above the brainstem results in hyperactive bladder only

Which of the following drugs will not promote urine retention?

A. sympathomimetics

B. anticholinergics

C. Cholinergic agonists

D. TCAs

E. Smooth muscle depressants

A patient with a subarachnoid hemorrhage (SAH) caused by a right anterior communicating artery aneurysm undergoes successful surgery 2 days after the hemorrhage. Three days later, right arm weakness develops. The most likely diagnosis is:

A. hydrocephalus

B. meningitis

C. Repeat hemorrhage

D. vasospasm

E. None of the above

Complications of tonsillectomy include all of the following EXCEPT:

A. Secondary hemorrhage

B. Severe otalgia

C. Quinsy

D. Nasopharyngeal stenosis

E. None of the above

Features characteristic of acute tonsilitis include all of the following EXCEPT:

A. odynophagia

B. cough

C. Referred otalgia

D. Cervical lymphadenopathy

E. dysphagia

A 6 month-old baby has had mild inspiratory stridor for the last 2 months. The most likely cause of this is:

A. laryngomalacia

B. Acute epiglottitis

C. croup

D. Tonsillar hypertrophy

E. Foreign body aspiration

A 48 year-old male is brought to the ED with CPR being administered. The ECG shows electrical activity present but you cannot palpate a carotid pulse. Which of the following is not on the differential for pulseless electrical activity?

A. hypotension

B. hypokalemia

C. Cardiac tamponade

D. hypothermia

E. Tension pneumothorax

A 37 year-old male arrives at the Emergency Department unconscious. He is warm and sweaty. His heart rate is 52 bpm, his BPis 90/60. His pupils are constricted, his eyes are teary, and he is drooling. You assume he is suffering from a toxidrome. What antidote will you give him?

A. Flumazenil

B. Naloxone

C. Glucagon

D. Atropine

E. Ethanol

A 83 year-old man has fallen while walking down stairs. He is brought to the emergency department with a 3-part intertrochanteric hip fracture. Which of the following procedures would you choose to perform?

A. hemiarthoplasty

B. Total hip replacement

C. Multiple pin fixation

D. Bipolar arthroplasty

E. Pin and plate

A 45 year-old man with a history of polycystic kidney disease presents with painless gross hematuria. You order:

A. No investigation is required since the hematuria is most likely due to the rupture of renal cyst(s)

B. No investigation at this time. Investigate if gross hematuria persists

C. U/S

D. U/S, urine C&S, cystosco

A 75 year-old man with a history of nocturia has not micturated for the last 10 hours, and is complaining of severe lower abdominal pain. The most likely cause is:

A. BPH

B. Prostate cancer

C. Renal failure

D. UTI

E. prostatitis

A43 year-old woman is brought to the Emergency Department after being burned in a house fire. You estimate first degree burns to 20% of her body, second degree burns to 11% of her body, and third degree burns to 9% of her body. She weighs 60 kg and is 120 cm tall. What IV therapy would you begin immediately?

A. Normal saline at 200 cc/hr for 24 hours

B. Normal saline at 400 cc/hr for 24 hours

C. Normal saline at 150 cc/hr for 8 hours, then 75 cc/hr for the next 16 hours

D. Normal saline at 300 cc/hr for 8 hours, then 150 cc/hr for the next 16 hours

E.normal saline at 600 cc/hr for 8 hours, then 300 cc/hr for the next 16 hours

Risk factors for hepatocellular carcinoma include all of the following EXCEPT:

A hepatitis A

B. cirrhosis

C. Exogenous steroid use

D. hemochromatosis

E. smoking

Which of the following is associated with biliary colic?

A. Epigastric pain

B. Rebound tenderness

C. jaundice

D. Murphy sign

E. All of the above

A16 year-old female fell while roller-blading on her outstretched right hand. At a nearby emergency department X rays confirmed the diagnosis of a closed Colles fracture. The proper reduction technique for this wrist fracture is which of the following:

A. Slight extension, full pronation, and full ulnar deviation

B. Slight flexion, full supination, and full radial deviation

C.slight extension, full supination, and full ulnar deviation

D. Slight flexion, full pronation, and full ulnar deviation

E. Slight extension, full pronation, and full radial deviation

Which of the following is least likely to cause avascular necrosis:

A. Sickle cell disease

B. Septic arthritis

C. Steroid use

D. Constrictive dressings

E. post-traumatic fracture

Which of the following is true regarding mandibular fractures?

A. They are predominantly unilateral

B. Compound fractures are rarely intraoral

C. They may manifest with numbness in the V2 facial nerve distribution

D. Malocclussion of teeth is a common sign

E. They seldom result in trismus

With respect to painful scrotal swelling, all of the following are true EXCEPT:

A. Torsion of testicular appendages will usually subside without surgical intervention

B. nausea/vomiting is very common in epididymitis

C. Ultrasound is helpful in determining the cause of hematocele

D. Torsion most commonly occurs in young males

E. Orchitis may result in testicular atrophy

Which is following statement about PSA is true?

A. Every man past the age of 50 should have an annual PSA test as a primary screen for prostate cancer

B. PSA is best used to follow disease progression or recurrence post-operatively

C. PSA is a useless test

D. Increased complex PSA to total PSA ratio favors BPH over prostate cancer

E. All of the above

A 40 year-old women presents to the ER with fever, no nausea or vomiting, and left flank pain radiating to the groin. Body CT reveals 8 mm stone in the left proximal ureter. You should:

A. Send her home because renal stone is benign disease

B. Send her home with oral analgesics and ask her to come back if the pain does not resolve in the next 24 hours

C. admit, close monitoring, hydration and analgesics

D. admit, hydration, analgesics and IV antibiotics. (e.g. Amp and Gent), and consider stenting if the symptom persists

Nasopharyngeal carcinoma:

A. Is most common in people from Cambodia

B. Presents early with nasal pain

C. Is treated by wide surgical excision

D. Is monitored by measurement of Epstein-Barr virus antibodies

E. Is curable in 90% of patients

Factors which contribute to the development of squamous cell cancers of the head and neck include all of the following EXCEPT:

A. Cigarette smoking

B. Alcohol ingestion

C. aging

D. Exposure to particular emission from diesel engines

E. Solar irradiation

Which of the following statements about aspiration of a peanut into the tracheobronchial tree is FALSE?

A. The peanut is more likely to be in the left lower lobe bronchus.

B. Expiratory wheeze is the most likely finding on physical exam

C. The peanut should be removed with the patient under general anesthesia through an open bronchoscope with forceps designed to grasp peanuts

D. A chest x-ray may show atelectasis distal to the blocked bronchus

E. Pneumonia may be a complication

A60 year-old man presents to your office with back and leg pain and trouble urinating. On examination, he has decreased sensation over the buttocks, normal motor power and absent ankle jerks bilaterally. How should this patient be managed:

A. Plain films of the lumbar spine

B. CT myelogram of the lumbar spine

C. Bedrest for 2 weeks with early mobilization

D. Emergency discectomy

E. NSAIDs and physiotherapy

A72 year-old man on physical examination is found to have expressive dysphasia and mild right arm weakness. The most probable location of his lesion is:

A. Right parietal lobe

B. Left frontal lobe

C. Right frontal lobe

D. Left parietal lobe

E. Basal ganglia

Initial management of any patient with coma of undetermined cause includes all except:

A. Clear and secure the airway

B. naloxone

C. D50W 50 mL IV

D. dexamethasone 16 mg IV

E. thiamine

A16 year-old girl is brought to hospital by her frantic parents after a bee sting. Vitals sings are BP 70/40, RR 30 and laboured, HR 140, T 37.5. Which of the following would not be an option in her management?

A. epinephrine

B. diphenhydramine

C. methylprednisolone

D. salbutomol

E. atropine

A 24 year-old woman arrives at the Emergency Department unconscious. Her BP is 90/60, her heart rate is 60 bpm, she is breathing at 8 breaths per minute and her O2 sat is 86%. Her eyes remain closed even after pain stimulation and the only sounds she makes are incomprehensible. Her elbows and wrists are flexed with her feet extended. This patient’s GCS score is:

A. 3

B. 4

C. 5

D. 6

E. 7

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