Surgery 1 Finals Pretest
Surgery 1 Finals Pretest
Surgery 1 Finals Pretest
Finals Pretest
2. The chief surgical risk to which patients with polycythemia vera are exposed is
that due to:
a. Acidosis c. Hypomagnesemia
b. Shortened QT interval d. Myocardial irritability
SURGERY 1
Finals Pretest
e. Hyperproteinemia
7. Which of the following characteristics of this patient might increase the risk of a
wound infection?
Items 8–10
8. Which of the following changes could make this wound a less favorable
environment for infection?
9. Which of the following characteristics of this patient might increase the risk of a
wound infection?
d. Receipt of chemotherapy
e. Asthma
10. Which of the following changes in the care of this patient could decrease the
chance of a postoperative wound infection?
a. Respiratory acidosis
b. Decreased cardiac output
c. Hypoglycemia
d. Increased arteriovenous oxygen difference
e. Cutaneous vasodilation
a. Hypoventilation
b. Incomplete alveolar oxygen diffusion
c. Ventilation-perfusion inequality
d. Pulmonary shunt flow
e. Elevated erythrocyte 2,3-diphosphoglycerate level (2,3-DPT)
a. Hypoxemia
b. Increased pulmonary compliance
c. Increased resting lung volume
d. Increased functional residual capacity
e. Decreased dead space ventilation
SURGERY 1
Finals Pretest
a. Intubation
b. Epinephrine
c. Beta blockers
d. Iodine
e. Fluid challenge
a. ABO incompatibility
b. Minor blood group incompatibility
c. Rh incompatibility
d. Transfusion through Ringer’s lactate
e. Transfusion through 5% dextrose and water
16. Among patients who require nutritional resuscitation in an intensive care unit,
the best evidence that nutritional support is adequate is:
a. Hypothermia
b. Hypokalemia
c. Hyperglycemia
d. Hyponatremia
e. Hypervolemia
a. Aspiration
b. Atelectasis
SURGERY 1
Finals Pretest
19. Treatment for clostridial myonecrosis (gas gangrene) includes which of the
following measures?
21. With regard to wound healing, which one of the following statements is correct?
22. 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:
24. 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:
25. Blunt trauma to the abdomen most commonly injures which of the following
organs?
a. Liver
b. Kidney
c. Spleen
d. Intestine
e. Pancreas
26. 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
SURGERY 1
Finals Pretest
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
a. Expanding hematoma
b. Dysphagia
c. Dysphonia
d. Pneumothorax
e. Hemoptysis
30. 143. 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
SURGERY 1
Finals Pretest
c. Duodenal resection
d. TPN to increase the size of the retroperitoneal fat pad
e. Duodenojejunostomy
31. 144. Following traumatic peripheral nerve transection, regrowth usually occurs at
which of the following rates?
33. A 30-year-old man is stabbed in the arm. There is no evidence of vascular injury,
but he cannot flex his three radial digits. He has injured the:
35. An elderly pedestrian collides with a bicycle-riding pizza delivery man and
suffers a unilateral fracture of his pelvis through the obturator foramen. You
would manage this injury by:
a. Knee dislocation
b. Closed posterior elbow dislocation
c. Midclavicular fracture
d. Supracondylar femur fracture
e. Tibial plateau fracture
SURGERY 1
Finals Pretest
38. Regarding myocardial contusion from blunt chest trauma, which of the
following statements is correct?
41. Correct statements regarding blunt trauma to the liver include which of the
following?
43. The response to shock includes which of the following metabolic effects?
44. Appropriate treatment for an acute stable hematoma of the pinna of the ear
includes which of the following measures?
45. Animal and clinical studies have shown that administration of lactated Ringer’s
solution to patients with hypovolemic shock may:
SURGERY 1
Finals Pretest
47. Rapid fluid resuscitation of the hypovolemic patient after abdominal trauma is
significantly enhanced by which of the following?
48. Tissue injury or infection results in the release of tumor necrosis factor (TNF) by
which of the following cells?
a. Fibroblasts
b. Damaged vascular endothelial cells
c. Monocytes/macrophages
d. Activated T lymphocytes
e. Activated killer lymphocytes
SURGERY 1
Finals Pretest
a. Interleukin 1
b. Interleukin 2
c. Interleukin 3
d. Interleukin 4
e. Interferon
51. Which of the following cells cause immunologically restricted tumor cell lysis?
a. Macrophages
b. Cytotoxic T lymphocytes
c. Natural killer cells
d. Polymorphonuclear leukocytes
e. Helper T lymphocytes
a. Heart transplants are matched by size and ABO blood type rather than
tissue typing
b. Cadaveric graft survival is significantly lower with heart transplants as
compared with renal transplants
c. Cold ischemia time for donor hearts should not be more than 48 h
d. The upper age limit for heart transplant eligibility is 55 years
e. The leading cause of death after the first year of cardiac transplantation is
chronic rejection
a. Performing an angiogram
b. Decreasing steroid and cyclosporine dose
c. Beginning intravenous antibiotics
d. Performing renal biopsy, steroid boost, and immunoglobulin therapy
e. Beginning FK 506
a. Plyelonephritis
b. GI ulceration and hemorrhage
c. Cholecystitis
d. Intraabdominal abscess
e. Parotitis
55. In centers with experienced personnel, 1-year liver transplant survival is now
approximately:
a. 95%
b. 80%
c. 65%
d. 50%
e. 35%
56. Graft-versus-host disease has occurred with the transplantation of which of the
following?
a. Kidney
b. Lung
c. Heart
d. Bone marrow
e. Pancreas
57. Which of the following diseases is appropriately treated with combined heart-
lung transplantation?