Professional Documents
Culture Documents
1.
A man sustained severe blunt injuries in a car crash twelve hours ago. The
activity of this hormone is now expected to be decreased in this patient:
A. insulin
B. cortisol
C. epinephrine
D. aldosterone
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 25-29)
2.
A man with chronic prepyloric ulcer appears weak after repeated bouts of
non-bilious vomiting over the past 3 days. Fluid therapy should be started
using:
A. Normosol M
B. Lactated Ringers solution
C. Normal saline solution
D. Hypertonic saline solution
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 51-52)
6.
A multiply injured patient has persistently low urine output. The oliguria is
most likely due to prerenal failure rather than acute tubular necrosis if the
tests reveal:
A. low urine specific gravity
B. low urinary excretion of sodium
C. low BUN/creatinine ratio
1
C. furosemide
D. sodium bicarbonate
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 79-80)
13.
Seven days after surgery for a perforated appendicitis, the primarily closed
incision is noted to be erythematous, slightly swollen and tender. The
appropriate treatment is:
A. local heat therapy
B. topical antibiotics
C. new systemic antibiotics
D. incision and drainage
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 119-120)
16.
A man is brought to the E.R. with blood spurting from a hacking wound in
the in the distal right thigh. He is alert and has a systolic BP of 100 mmHg.
What is the initial management step?
A. apply direct pressure on the wound with sterile gauze
B. apply digital pressure on proximal femoral artery
C. apply a thigh tourniquet above the wound
D. open the wound and clamp the bleeders
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): p. 74)
17.
A young man presents to the E.R. with a stab wound in the left chest.
Examination reveals subcutaneous emphysema and absent breath
sounds on the left chest; the trachea is shifted to the right. What is the
probable diagnosis?
A. massive hemothorax
B. tension pneumothorax
C. cardiac tamponade
D. flail chest
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): p. 131)
18.
D. neurogenic
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 95-100)
24.
For the past 6 weeks, a 67-year-old man has been asymptomatic except
for constipation after a course of antibiotic therapy for left lower quadrant
abdominal pain. He should undergo:
A. CEA determination
B. barium enema
C. colonoscopy
D. abdominal CT scan
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 1082-1083)
25.
C. ureter
D. diaphragm
(Classification - Recall; Source Schwartzs Textbook of Surgery (8th edition):
pp. )
30.
A 59 year old woman has discomfort in the posterior part of her tongue. A
biopsy confirms that the lesion is a carcinoma. What is true in carcinoma
of the posterior third of the tongue?
A. lymphoid tissue is absent
B. lymph gland spread is often encountered
C. there is an excellent prognosis
D. the tissue is well differentiated
(Classification - Recall; Source Schwartzs Textbook of Surgery (8th edition):
pp.)
35.
A 20-year-old woman consults for a 2-cm mass in her left breast. The
mass is movable, non-tender and has a rubbery consistency and smooth
borders. The probable diagnosis is:
A. fibroadenoma
B. fibrocystic disease
C. carcinoma
D. cystosarcoma phyllodes
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 463-464)
44.
46.
A 45-year-old woman has a recent onset bloody nipple discharge from her
right breast. No palpable breast mass is noted. What diagnostic test is
indicated?
A. breast ultrasound
B. mammography
C. ductography
D. cytology of discharge
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): p. 493)
48.
A premenopausal woman undergoes modified radical mastectomy for a 3cm breast cancer. No axillary node and distant metastases are detected.
Test for this biomarker is currently recommended to facilitate the selection
of adjuvant chemotherapy:
A. c-fos
B. c-myc
C. p53
D.AHER2/neu
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): p. 493)
49.
A 63-year-old man with chronic atrial fibrillation has sudden onset of pain,
weakness, and paresthesia in his left leg, which appears cool, cyanotic,
and without femoral and distal pulses. The right leg has normal pulses.
The most likely diagnosis is:
A. arterial embolism
B. aortoiliac thrombosis
C. Buergers disease
D. Raynauds disease
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 759-762)
50.
Coronary angiogram reveals a triple-vessel disease in a diabetic 55-yearold man presenting with unstable angina. The recommended treatment is:
A. catheter-directed thrombolysis
B. balloon angioplasty
C. coronary artery bypass grafting
D. Transmyocardial revascularization
(Class;ification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 652-653)
51.
A. cessation of smoking
B. long-term anticoagulant therapy
C. multiple toe amputations
D. angiography followed by bypass surgery
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 792-793)
52.
57.
B. splenic flexure
C. hepatic flexure
D. cecum
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 1089-1090)
61.
During surgery for a large right indirect inguinal hernia, the cecum is noted
to form part of the wall of the hernia sac. The patient has this type of
hernia:
A. sliding
12
B. Richters
C. interstitial
D. Spigelian
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): p. 1358)
67.
A previously asymptomatic 45-year-old obese woman consults for a nontender swelling below her right inguinal ligament just lateral to the pubic
tubercle. A warranted diagnostic procedure for this patient is:
A. fine needle aspiration
B. ultrasound
C. MRI
D. herniography
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 1364-1366)
68.
A 54 year old male taking anticoagulant for the fast 4 weeks developed 3
day history of abdominal pain. On physical examination there was a
palpable mass at the supraumbilical area with direct tenderness.
Fothergill sign way positive. What is your impression?
A. desmoid tumor
B. rectus sheath Hematoma
C. omental torsion
D. omental infarction
(Classification - Application; Source Schwartzs Textbook of Surgery (8th
edition): pp.)
69.
A 59-year-old man presents with 4-cm firm mass in the left lobe of the
thyroid associated with a firm occipital mass that is 6 cm in its widest
diameter, which he has neglected for the past 9 months. Family history is
negative for thyroid malignancy. He probably has this type of thyroid
cancer:
A. papillary
13
B. follicular
C. medullary
D. anaplastic
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 1420-1421)
72.
14
77.
A young man just admitted for blunt injuries from a car accident is
stuporous. CT scan shows cerebral contusion. What should be avoided as
it can cause secondary brain injury to this patient through its deleterious
effect on intracranial pressure?
A. elevation of the head
B. respiratory acidosis
C. hypovolemia even of mild degree
D. sedation of agitated patient
(Classification - Recall; Source Schwartzs Textbook of Surgery (8 th edition): pp.
1613-1614)
15
82.
A 10-week-old baby with cleft lip and palate has undergone a successful
cleft lip repair. It is recommended that cleft pate repair be done before the
baby reaches this age:
A. 6 months
B. 12 months
C. 2 years
D. 4 years
(Classification - Recall; Source Schwartzs Textbook of Surgery (8 th edition): pp.
1797-1799)
84.
86.
D. volvulus neonatorum
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 1486-1487)
88.
A 3-day old infant who has not passed meconium presents with abdominal
distention and bilious vomiting. The most likely diagnosis is:
A. duodenal atresia
B. malrotation
C. midgut volvulus
D. Hirschprungs disease
(Classification - Application; Source Schwartzs Textbook of Surgery (8 th
edition): pp. 1496-1497)
91.
94.
100.
A 5-month old baby boy was seen at the ER with complaints of non-bilous
vomiting that became increasingly projectile over several days to weeks
and cannot tolerate liquid intake. Abdominal examination revealed
palpation of typical olives in the right upper quadrant with visible gastric
waves. What is the correct diagnosis?
A. Meconium ileus
C. Hypertrophic pyloric stenosis
Hirschprungs disease
D. Intussusception
Schwartzs: Pediatric Surgery p.1486
101.
A 35 y/o male presents with 1 year history of early satiety and right upper
abdominal discomfort. CT scan shows a 6 x 8 cm cystic lesion in the right
lobe of the liver. Ultrasound of cyst show no internal echoes. The
appropriate management is:
A. cryoablation of cyst
C. unroofing of the cyst
B. right hepatic lobectomy
D. percutaneous aspiration of cyst
Schwartzs: p. 1159
104.
An imaginary line that divides the liver into right and left lobe that runs
from the inferior vena cava to the tip of the gallbladder fossa:
C
A. Catlie line
B. Calots line
C. Cantlies line
D. Charcots line
Schwartzs: p. 1140
105.
19
108.
A 36 y/o female complain of an acute pain at the lateral aspect of her left
breast. A tender firm cord is found on the same site on physical
examination. It was diagnosed as a Mondors disease. This lesion is best
managed with:
A. Radiotherapy
B. Anti-inflammatory medication, warm compress and rest of
ipsilateral extremity
C. Immediate excision of the lesion is needed
D. Total mastectomy
Schwartzs: p. 463
113.
Breast lesion that can be treated with close observation with or without
tamoxifen:
early invasive breast carcinoma
lobular carcinoma in situ
ductal carcinoma in situ
inflammatory carcinoma of the breast
Schwartzs: p.481
114.
115.
116.
Lymph node in the posterior triangle of the neck is within what level:
A. Level II
B. Level IV
C. Level V
D. Level VI
Schwartzs: p. 534
118.
This form of shock has a low blood pressure, low urine output but has an
elevated central venous pressure:
A.Vasodilatory shock
B. Obstructive shock
C. Neurogenic shock
D. Traumatic shock
Schwartzs: p. 95-102
119.
55 y/o male who has been in the ward for the past 4 days and is receiving
IV fluid of D5W is complaining on his 5th hospital day of headache,
nausea, vomiting, anorexia, body malaie and watery diarrhea. Give the
most probable electrolyte imbalance the patient might have:
A. Hypernatremia
B. Hyperkalemia
C. Hyponatremia
D. Hypokalemia
Schwartzs: p. 48
120.
angiotensin II
endothelins
epinephrine
serotonin
Schwartzs: p. 23
124.
Branched chain amino acids are used in parenteral nutrition for what
specific type of patients?
A. renal failure patients
B. diabetic patients
C. pulmonary failure patients
D. hepatic failure patients
Schwartzs: p.33
126.
The appendeceal flora remains constant throughout life with the exception
of what bacteria, which appears only in adults?
A. Porphyromonas gingivalis
B. Pseudomonas aeruginosa
C. Peptostreptococci
D. Streptococcus anginosus
Swhartzs: p. 1121
128.
The most significant factor associated with both fetal and maternal deaths
in pregnant patients with acute appendicitis is
A. formation of a phlegmon
B. appendeceal perforation
C. appendeceal tip near the uterus
D. retrocecal appendix
Schwartzs: p. 1129
129.
23
137.
Cytokines that are produced by one cell and affect an adjacent cell such
as transforming growth factor beta (TGF-B) are called;
A. endocrine factors
B. paracrine factors
C. autocrine factors
D. intacrine factors
Schwartz 7th ed., p. 266 / Ans. B
149.
The genetic disorder arising from mutations in the genes for type I
collagen causing increase propensity for the bones to break under minimal
stress is;
A. ehlers-danlos syndrome
B. osteogenesis imperfecta
C. marfans syndrome
D. epidermolysis bullosa
25
/ Ans. B
151.
Skin lesions that extend beyond the boundaries of the original wound, do
not regress with time and recur after excision;
A. hypertrophic scars
B. keloids
C. diabetic ulcers
D. decubitus ulcers
Schwartz 7th ed., p. 281-282 / Ans. B
153.
The most common cause of intestinal obstruction for all age group
combined is;
A. strangulated hernia
B. volvulus
C. adhesive bands
D. neoplasm
26
Which of the following diagnostic modalities consistently localizes the site of bleeding in
cases of lower GI bleeding;
A. colonoscopy
B. CT scan
C. Angiography
D. Barium enema
Schwartz 7th ed., p. 1066 / Ans. C
159.
A 50 y/o male with history of alcoholism was admitted because of history of progressive
jaundice, associated with tea-colored urine, achlic stools, weight loss and mild
epigastric pain. The simplest and most non-invasive method in the diagnosis of this
patient is;
A. percutaneous transhepatic cholangiography (PTC)
B. ERCP
C. Ultrasonography
D. HIDA scan
Schwartz 7th ed., p. 1071 / Ans. C
161.
A. spingelian hernia
B. femoral hernia
C. littres hernia
D. richters hernia
Schwartz th ed., p. 1249 / ans. C
164.
165.
In children with history of URTI 3 days prior to development of RLQ pain, the differential
diagnosis most often confused with appendicitis is;
A. meckels diverticulitis
B. perforated peptic ulcer
C. acute gastroenteritis
D. acute mesenteric adenitis
Schwartz 7th ed., p. 1387 / Ans. D
166.
The recommended treatment for patients with adenocarcinoma of the appendix is;
A. appendectomy
B. right hemicolectomy
C. total colectomy
D. subtotal colectomy
Schwartz 7ht ed., p. 1392 / Ans. B
167.
The most common anaerobic bacteria that is isolated in intraabdominal infection is;
A. clostridium specios
B. peptococcus specios
C. bacteroides specios
D. fusobacterium specios
Schwartz 7th ed., p. 1524-1525 / Ans. C
170.
A 45 year old female came in because of right upper quadrant pain, colicky aggravated
by fatty food intake 4 hours ptc. Physical exam showed a palpable mass at the right
subcostal margin non-movable tender, midinspiratory arrest was illicited while the
palpating hand was on the right subcostal area . the most likely condition is/are
A. acute appendicitis
B. acute cholecystitis
C. perforated peptic ulcer
D. acute ascending cholangitis
Schwartz / Ans. B
171.
The laboratory examination of a 45 year old female came in with the following results ;
sgpt was elevated, direct bilirubin increased, alkaline phosphatase increased, protime
prolonged . utz showed a hyperechoic mass at he neck of the gallbladder with posterior
shadowing. The most likely diagnosis is
A. acute appendicitis
B. acute infectious hepatitis
C. acute calculous cholecystitis
D. ascending cholangitis
Schwartz / Ans. C
172.
A patient s/p cholecystectomy and cbde with t-tube choledochostomy showed a distal
cbd stone on t-tube cholangiography , management would be
A. daily irrigation with nss
B. ercp
C. choledococopy and basket extraction of the stone
D. repeart explore lap and cbde
Schwartz / Ans. C
174.
A 25 year old male came in with chronic draining lesion at the perianal area of 2 years
duration. Physical exam showed a draining lesion about 4 cm from the anal verge at the
3:00 position. The internal opening is probably
A. anterior midline
B. posterior midline
C. radially directly opposite
D. variable
Schwartz / Ans. B
175.
30 year old female came in because of painfull perianal mass 2 days ptc, physical exam
showed a tender mass at the right lateral position w/c precludes rectal exam with a
bulging tender mass adjacent to it. The most likely condition is
A. thrombosed external hemorrhoids
B. prolapsed internal hemorrhoid
C. perianal abscess
D. rectal polyp
Schwartz / Ans. C
176.
A 50 year old male came in because of loss of weight about 30% of his previous body
weight. Associated with on and off colicky abdominal pain. He also noticed that his
stools have diminish in caliber just like a goat stool,the single most important
examination would be
A. fecalysis
B. ba enema
C. colonoscopy w/ biopsy
D. ct scan
Schwartz / Ans. C
177.
A 25 year old female came in with a palpable breast mass noted 2 weeks ptc, the mass
is about 2.5 cm well delineated border, movable, non-tender at the right upper outer
quadrant, no familial history of ca.the most likely diagnosis would be
A. fibroadenoma
B. fibrocystic disease
C. breast ca
D. galactocoele
Schwartz / Ans. A
178.
179.
180.
A patient was operated on for acute cholecystitis. After 24h postop, the patient
developed fever. What is the most likely cause of his fever?
A. Cathether sepsis
B. Drug-related conditions
C. Aspiration pneumonia
D. Atelectasis
181.
The basic problem in poor wound healing regardless of the underlying factor is:
A. Poor local hemostasis
B. Anemia
C. Low 02 tension
D. Impaired inflammatory response
182.
Ileus following abdominal surgery is expected to last for at least how many days?
A. 3
B. 4
C. 5
D. 6
183.
For every degree rise in temperature, the insensible water loss in cm 3 per day is
approximately:
A. 100
B. 150
C. 200
D. 250
184.
Which ion if altered determines the shift of fluid from one compartment to another?
A. Sodium
B. Potasium
C. Chloride
D. Bicarbonate
185.
Which of the following cytokines may help control keloids and hypertrophic scars?
A. Pdgf
B. Egf
C. TNF
D. TGB-B
186.
187.
188.
A 54yo male patient with 3rd degree burn approximately 40%TBSAdeveloped abdominal
pain on the 4th hospital day. What is the least likely cause of the abdominal pain?
A. Acalculous cholecystitis
B. Acute pancreatitis
C. Superior mesenteric artery syndrome
D. Renal colic
189.
Convulsions if present during the resucitative phase of burn injury may be due to
A. Hypoxemia
B. Hyponatremia
C. Infection
D. Hypokalemia
190.
191.
192.
Which of the following statements is not a sound principle in the fluid and electrolyte
therapy post operatively?
A. Thorough evaluation of the pre and intra-op fluid status
B. Urine volume is replaced on a mililiter to mililiter basis
C. It is not necessary to give potassium with in the first 24 hour
D. Insensible water loss is considered in the fluid therapy
193.
The average potassium (in meq/l) content of the bile per day is
A. 5
B. 10
C. 15
D. 18
194.
195.
196.
197.
198.
199.
A patient underwent upper gastrointestinal endoscopy for gastric outlet obstruction. The
endoscopist noted a lesion at the antrum and took biopsy. It turned out to be gastric
cancer. What type of gastric cancer has favorable prognosis?
A. Superficial spreading
B. Polypoid
C. Ulcerative
D. Linitis plastica
200.
A patient diagnosed to have perforated peptic ulcer disease had his symptoms 8 hours
prior to admission. He was prepared for surgery. Which of the following best describes
the required operation?
A. Repair of perforation and selective vagotomy
B. Repair of perforation and truncal vagotomy
C. Suture of perforation
D. Omental patch
201.
After truncal vagotomy for peptic ulcer disease, the patient may develop the following
except:
A. Gastric stasis
B. Megaloblastic anemia
C. Diarrhea
D. Gallstone formation
202.
C. Leiomyosarcoma
D. Squamous cell carcinoma
203.
A 77 year old, male, chronic smoker on NSAIDs for arthritis presents with an acute
abdomen and pneumoperitoneum. What could be the most likely cause of this?
A. Severe abdominal pain due to chronic
gastritis
B. Acute pancreatitis
C. Acute cholecystitis with cholangitis
D. Perforated peptic ulcer disease
204.
Increased venous pressure , decreased pulse pressure and decrease heart sound are
pathognomonic of:
A. Acute myocardial infarction
B. Pneumothorax
C. Cardiac tamponade
D. Aneurysm of the arch of aorta
205.
206.
A 32 yo male was brought to the ER because of blunt abdominal trauma due to fall. The
patient had hematoma and abrasions on his RUQ and R flank. Your resident assessed
that the patient has surgical abdomen and needs immediate surgery. He requested oneshot intravenous pyelography en route to or. The reason for such procedure is to:
A. Find out extravasation of urine
B. Localize site of obstruction
C. Determine function of either kidneys
D. Quantify volume of urine output
207.
A 23 yo female, medical student, was brought to the ER because of VA. Patient was
GCS 13-14 with blunt abdominal trauma following a motor vehicular accident.
Diagnostic peritoneal lavage was done & showed negative results. The assessment of
negative result signifies:
A. No hollow viscus injury
B. Absent blood in peritoneal cavity
C. Needle did not reach the peritoneal cavity
D. Does not rule out abdominal organ injury
208.
209.
Whether its diverticulization or exclusion, the principle behind these procedures for the
doudenal injuries is to
A. Prevent fistula formation
B. To rest or isolate the injure doudenum
C. Prevent leakage
D. Contain the inflammation at the RUQ
210.
C. Postero midline
D. Anterolateral
211.
212.
213.
Which of the following is the most important prognostic determination of survival after
treatment of colorectal cancer
A. Lymph node involvement
B. Transmural extension
C. Tumor size
D. Histologic differentiation
214.
A 60 y.o. male is admitted to the hospital after passing out large amount of marooncolored stools. At the ER, he again passed out more bloody stools as well as clots. He
is pale and tachycardic, NGT aspirate is bilious. After resuscitation, which of the ff is the
most appropriate initial test:
A. Barium enema
B. Rigid proctoscopy
C. Colonoscopy
D. RBC tag scan
215.
Which is the most important stimulus for triggering endocrine response to injury
A. Hypovolemia
B. Afferent nerve stimulation from the injured area
C. Tissue acidosis
D. Local wound factors
216.
217.
Pellagra, dermatitis, glossitis, & peripheral paresthesias with spinal cord symptoms are
due to deficiency of
A. Folic acid
B. Vitamin a
C. Pantothenic acid
D. Zinc
218.
219.
A.
B.
C.
D.
Glycerol
Cholesterol
Arachidonic acid
Glutamine
220.
The reason why approximately one half of breast cancer are located at the upper outer
quadrant is
A. Its lymphatics
B. The predeliction of cancers superiorly
C. The larger volume of breast tissue
D. Abundance of blood supply
221.
222.
Carcinoma of the breast among the elderly presenting as a bulky, colloid tumor is
A. Mucinous
B. Medullary
C. Adenoid
D. Apocrine
223.
224.
Which of the following structures which when encroached by cancer gives rise to the
orange-peel appearance of the breast?
A. glands of Montgomery
B. Ductal ampulla
C. Lobules
D. Subdermal lymphatics
225.
A 34 female patient came at the OPD with 2cm palpable mass, moveable, nontender.
No axillary nodes noted. Patient has an elder sibling who died of breast ca last 2 years
ago. What will be your initial diagnostic procedure?
A. Needle or open biopsy
B. Mammography
C. Open biopsy ultrasound of the breast
D. Magnetic resonance imaging
226.
227.
228.
Which of the following steroids useful in the treatment of scars and keloids
A. Betamethasone
B. Triamcinolone
C. Prednisolone
D. Cortisone
229.
Most common cause of hospital acquired infections are coming from the
A. Respiratory tract
B. Intraabdominal
C. Urinary tract
D. Blood
230.
45 male came in to the ER with a 3 cm lacerated wound at the left leg after he was
bitten by a pig. He has received tetanus toxoid and tetanus immunoglobulin 10 1/2
years ago. What would be the appropraite management at the ER?
A. Toxoid + tetanus immunoglobulin+antibiotics
B. Tetanus immunoglobulin only
C. Debridement, leave wound open + tetanus immunoglobulin
+toxoid+antibiotics
D. Tt+ats+cloxacillin
231.
232.
233.
234.
235.
236.
237.
The main parameter for determining the clinical stage of head and neck tumors is
A. Size of primary tumor
B. Lymph node involvement
C. Metastasis
D. Functional loss
238.
239.
240.
241.
242.
243.
244.
245.
A normal to low CVP that does not rise with rapid administration of crystalloids
indicates:
A. Inadequate rate of infusion
B. Improper placement of CVP
C. Continuing hypovolemia
D. Improper choice of crystalloids
246.
Recurrent laryngeal nerve is preserved in thyroid surgery. What is false with regards to
this nerve:
A.
B.
C.
D.
247.
Among the types of thyroid cancer, which one is the most aggressive?
A. Follicular
B. Papillary
C. Hurthle
D. Anaplastic
248.
A 45yo female patient underwent total thyroidectomy for follicular ca. 24 H after
surgery, the patient developed numbness around the lips and fingers. What could have
caused this?
A. Transection of recurrent nerve
B. Ischemia to the parathyroids
C. Hematoma
D. Transection of superior laryngeal nerve
249.
250.
A 23yo male patient came in at ER with irreducible inguinal hernia of >16hours duration.
Patient complained of abdominal pain with BP of 100/70, CR 120, & RR 30. The
appropriate management is:
A. Observe for progression of pain
B. Sedate patient and reduce the hernia
C. Apply ice pack over the hernia
D. Schedule patient for surgery
251.
At the ER, a patient complained of renal colic. The following are the minimal laboratory
evaluation you would request except:
A. CBC and electrolytes
B. IVP
C. Bun and creatinine
D. Urinalysis
252.
In the medical treatment of BPH, which among the drugs acts by reducing the
intraprostatic dihydrotestosterone levels without lowering the plasma testosterone level?
A. Doxazosin
B. Finasteride
C. Terazosin
D. Tamsulosin
253.
A 48hour old baby boy was brought to the ER due to vomiting of bilious vomitus,
abdominal distention, and failure to pass out meconium. What is the most likely cause?
Tracheo-esophageal atresia
Ileal atresia
Pyloric stenosis
Rectal mass
254.
A 28 kg child with ruptured appendicitis has the following laboratory results: BP=90/60;
PR=110; RR=25; Na=125; Cl=95; K=3; ph=7.35; pCO2=35; pO2=100; HCO3=24.
Which of the following is TRUE?
A.
B.
C.
D.
255.
256.
257.
258.
259.
260.
261.
262.
263.
264.
A patient has a blood pressure of 70/50 mmHg and a serum lactate level of 30-mg/100
ml (normal: 6 to 16). His cardiac output is 1.9 L/min, and his central venous pressure is
2 cmH2O. The most likely diagnosis is:
A. congestive heart failure
C. cardiac tamponade
B. hypovolemic shock
D. pulmonary embolus
During compensation for hypovolemic shock, blood flow to which of the following area/s
is under sympathetic nervous system control?
A. brain
C. small bowel
B. heart
D. liver
265.
266.
In a multiply injured patient with acute blood loss, adequate preload to the heart is
maintained initially by the:
A. increase in systemic vascular resistance
B. development of tachycardia
C. hormonal effects of angiotensin
D. hormonal effects of antidiuretic hormone
267.
C. carpopedal spasm
D. involuntary fine tremors
268.
269.
270.
271.
272.
Injury to the intima of blood vessels exposes the subendothelial collagen which initiates:
A. fibrinolysis
C. release of cyclic AMP
B. platelet aggregation
D. vasoconstriction
273.
A 77-year old man is scheduled to undergo sigmoid colectomy. He denies any history
of prolonged bleeding. Preoperative evaluation of hemostasis should include:
A. no screening tests
B. prothrombin time (PT) and partial thromboplastin time (PTT)
C. platelet count, blood smear, and PTT
D. platelet count, PT, and PTT
274.
275.
276.
C. severe burns
D. elective surgery
277.
278.
A 38-year-old male had abdominal exploration for multiple gunshot wounds. He is febrile
T 38.5 C on the 2nd post-op day; HR is 98 bpm, BP 100/80. WBC count is 13000. The
patient is hooked to a ventilator. The patient is developing what condition;
A. SIRS
C. severe sepsis
B. sepsis
D. septic shock
279.
On the 5th day post-op the patient in addition to the above findings now shows
erythema and draining pus from the abdominal incision site. The patient now is
developing;
A. SIRS
C. severe sepsis
B. sepsis
D. septic shock
280.
On the 10th day post-op, the patient is persistently febrile with increase in WBC count
(18000) and this time with oliguria that is unresponsive to fluid resuscitation. The patient
now is developing;
A. SIRS
C. severe sepsis
B. sepsis
D. septic shock
281.
The above patient was given pressor agents to improve his condition, despite this he
remains oliguric. The patient now has:
A. SIRS
C. severe sepsis
B. sepsis
D. septic shock
282.
Immediately after mastectomy your patient asks if any of the following promotes wound
healing, which one wills you advise your patient?
A. Vitamin C
C. Vitamin B
B. Zinc supplementation
D. carbohydrate rich foods
283.
Severe cases of hidradenitis suppurativa in the groin area are best managed by
excision of the involved area and:
A. closure by secondary intention
B. delayed primary closure
C. primary closure
D. partial thickness skin grafts
284.
An elderly cancer patient fell and sustained a deep lacerated wound over the right
forehead about 9 cm length. If wound infection later develops in this patient. The major
cause of impaired wound healing is:
A. anemia
C. DM
B. local wound infection
D. all of the above
285.
286.
287.
288.
Infection in the above wound is partly controlled by the presence of what cells;
A. macrophages
C. endothelial cells
B. fibroblast
D. T lymphocytes
289.
290.
291.
A 25-year-old male is brought to the ER after he sustained a stab wound to the 5th
intercostals space.
PE: conscious, stretcher-borne, vitals are as follows: blood
pressure 90/50, pulse 110/min and respiratory rate 30/min. Which of the following
statements is true:
A. primary survey and initial resuscitation should be instituted one after the other
B. a complete detailed physical exam should be performed so as not to miss any
injury
C. large-bore IV lines should be inserted
D. blood for CBC and x-matching should be drawn
292.
An 8-year old boy has a closed angulated deformity of his right forearm. VS: BP = 99
mm Hg systolic and PR = 110 Identify the most emergent problem of the victim. Write
any of the following:
A. Airway or Cervical Spine
C. Circulation
B. Breathing
D. Disability or Neurologic Injury
293.
A 7-year old boy is gasping for breath. He can speak clearly, but complains of chest
pain and an inability to get his breath. He is becoming increasingly anxious.
VS:
BP = 100 mm Hg systolic and PR = 110 Identify the most emergent problem of the
victim. Write any of the following:
A. Airway or Cervical Spine
C. Circulation
B. Breathing
D. Disability or Neurologic Injury
294.
A 25-year-old man is unconscious, withdraws from painful stimuli, eyes are closed, but
they open in response to pain, and he is making unintelligible sounds. His pupils are
equal, and both react sluggishly to light. His Glasgow coma scale score is:
A. 5
C. 11
B. 8
D. 14
295.
After control of this patient's airway is achieved, the first diagnostic study to obtain is:
A. x-rays of the skull
C. x-rays of the cervical spine
B. CT scan of the head
D. carotid angiography
296.
297.
298.
299.
A 6-year-old is having episodes of watery diarrhea for the past three days. She is
lethargic, irritable and restless. The heartbeat is rapid but the pulses are weak. The child
should:
A. stay home and call the pediatrician for advice
B. stay home and have a cold bath
C. proceed to the nearest hospital emergency room
D. get a glass of cold fruit-juice to drink
300.
301.
302.
The most common type of inguinal hernia in both males and females is:
A. Indirect
B. Direct C. Femoral D. Mixed.
303.
The Coopers ligament repair for direct or femoral hernia is popularized by:
A. Bassini B. McVay
C. Halsted D. Ferguson
304.
A 22 year old female consulted a physician because of a 2x2x2 cms, movable, well
circumscribed, non tender mass, noted accidentally while taking a bath. Physical
examination was consistent with the findings above. Most likely diagnosis is:
A. Breast Ca
B. Fibrocystic change
C. Fibroadenoma
D. Phylloides tumor
305.
306.
Ivory an 18 year old female consulted because of breast tenderness becoming more
severe just before menses. PE showed asymmetric nodularities on the upper outer
quadrant of both breasts with no dominant mass . Menstrual cycle is monthly and
regular. Most likely diagnosis is:
A. Sclerosing adenosis
C. Fibrocystic change
B. Normal premenstrual tension
D. Breast Ca
307.
Sarah Jane a 35 year old female consulted because of an intermittent bloody nipple
discharge on the right breast PPE- no mass noted on the right breast Most likely
diagnosis is:
A. Papillary cancer
C. Bleeding galactocoele
B. Mammary duct ectasia
D. Intraductral papilloma
308.
309.
Breast malignancy that is known to have the highest incidence of bilaterality and
multicentricity:
A Pagets disease of the breast
C. Papillary carcinoma
B. Lobular carcinoma
D. Medullary carcinoma
310.
The next appropriate thing to do in managing the above case will be:
A. Local wound exploration
B. CT Scan
C. Immediate surgery
D. Triple angiography of the abdomen
311.
312.
The most commonly injured intraabdominal organ following a blunt abdominal trauma;
A. Pancreas
B. spleen
C. small intestine D. colon
313.
A 55 y/o male, smoker underwent FNAB for a 4cm preauricular mass. Results showed
(+) for malignant cells .The patient is most probably suffering from:
A. Pleomorphic adenoma
C. mucoepidermoid carcinoma
B. Follicular carcinoma
D. papillary carcinoma
314.
315.
B. papillary carcinoma
D. Adenosquamous carcinoma
316.
The most common causative agent being implicated in head-neck cancers is:
A. UV radiation
B. Tobacco
C. nitrates
D. alcohol
317.
A 60 year old woman with chronic renal failure and undergoing hemodialysis 2-3x/week
develops tumoral calcinosis. Her parathyroid hormone is markedly elevated while her Ionized
Calcium is normal.
318.
319.
The course of papillary thyroid cancer is best described by which of the following
statements?:
A. Metastases are rare; local growth is rapid
B. Local invasion and metastases almost never occur
C. Metastases frequently occur to cervical lymph nodes, distant metastases
and local invasion are rare
D. Rapid widespread metastatic involvement of the liver ,lungs and bone results in
a 10% 5 yr survival rate
320.
321.
43 years old female present with diffuse enlargement of the thyroid gland accompanied
by palpitation, heat intolerance and weight loss. She is most probably suffering from :
A. Follicular Cancer
C. Graves disease
B. Plummer Vinsons disease
D.Colloid goiter
322.
A 50 years old male has just undergone a total thyroidectomy for follicular cancer of the
thyroid. On the third hour post-op, he experienced circumoral numbness. He is probably
suffering from
A. Freys syndrome
C. hypocalcemia
B. hypothyroidism
D. hypokalemic acidosis
A 16 year old high school student came to you with a complaint that her friends took notice of
an anterior neck enlargement since she started on her weight reduction program. You were
indecisive as to whether there really was a thyromegaly. The rest of the P.E. were normal
323.
324.
A 72-year old male consults because of change in bowel habits for the last 2 weeks. On
rectal exam, a hard, irregular mass was noted at 6 cm from the anal verge The most
likely diagnosis here is:
A. Rectal carcinoid
B. Rectal carcinoma
C. Rectal Polyp
D. Anal canal carcinoma
325.
326.
327.
A 48 year old company manager who has been taking proton pump inhibitor irregularly
for the past 2 years because of on & off epigastric discomfort presents in the emergency
room with hematemesis and melena. This patient should be:
A. Aggressively resuscitated with fluids and measures to localize site of
bleeding should be done in preparation for possible surgery
B. Explored immediately because bleeding is an indication for surgery
C. Give massive doses of anti-ulcer medications
D. Watchful waiting for 24-48 hours.
328.
A 43 year old male patient with on & off epigastric pain during the past 15 months
complains of sudden severe epigastric pain later on becoming generalized. An upright
chest file taken at the ER shows a strip of lucency underneath the right hemidiaphragm.
This patient has:
A. Penetrating peptic ulcer
B. Acute pancreatitis
C. Perforated diverticulitis
D. Perforated peptic ulcer.
329.
330.
A 30 y/o male who usually has dripping fresh blood after defecation suddenly had anal
pain and a smooth, tender, 1 cm diameter rounded mass coming out of the anus. This is
most likely:
A. peri-anal abscess
B. internal hemorrhoids 3rd degree
C. Anal wart
D. thrombosed internal hemorrhoids
331.
A 65 y/o female was referred for surgical consult because of abdominal pain and
distention. Findings in the scout film of the abdomen that will be highly suggestive of
intestinal obstruction:
A. Air in the distal rectum
B. Pneumatosis intestinales
C. luscency beneath the right hemidiapragm
D. step ladder abnormality
332.
A 75 y/o female is being worked up for paralytic ileus The electrolyte that is usually
below normal is:
A. Potassium
C. calcium
B. Sodium
D. Magnesium
333.
334.
Hepatic resection should be considered for localized metastatic spread from which of
the following primary site?
A. colorectal
C. Lungs
B. stomach
D. Breast
335.
The standard of treatment for patient with biliary colic and cholecystolthiasis by
ultrasound is
A. Cholecystectomy
C. Stone Dissolution
B. Cholecystostomy
D. Endoscopic Stone removal
336.
In an infected obstructed common bile duct producing cholangitis which of the following
is the best option for drainage in a very poor risk patient ?
A. cholecystostomy
B. operative CBD exploration and T tube choledochostomy
C. ERCP and stenting
D. MRICP
337.
338.
339.
340.
A 45 year old jaundiced patient who has been diagnosed to have gallbladder and common bile
duct stones by ultrasound 6 months ago is brought to the ER because of abdominal pain ,
chills, high grade fever and hypotension. PE: icteric sclerae , abdomen slightly tender with
guarding RUQ.
341.
342.
D. ruptured gallbladder
The most likely diagnosis in a 70 y/o male presenting with significant weight loss
accompanied by progressive jaundice, anorexia, pruritus and tea colored urine. PPE
showed a palpable non tender gallbladder?
A. hepatoma
C. pancreatic head cancer
B. gallbladder cancer
D. gallbladder empyema
344.
The severity of pancreatitis, particularly in those patient who is not improving after 24
hours of medical management can be assessed using:
A. Angiography
C. Dynamic CT Scan
B. Scout film of the abdomen
D. MRICP
345.
346.
347.
This is the BEST procedure for a patient with acute head injury secondary to a vehicular
accident:
A. CT scan
C. Plain skull x-rays
B. Angiography
D. Electroencephalogram
348.
349.
350.
351.
A massively bleeding posterior duodenal ulcer, which of the following is most likely
involved:
A. Left gastric artery
B. Gastroduodenal artery
C. Short gastric artery
D. Left gastroepiploic artery
352.
353.
354.
The typical visual field deficit caused by a pituitary adenoma with suprasellar
extension is:
A. Bitemporal hemianopsia
B. Homonymous hemianopsia
C. Superior quadrantanopsia
D. Inferior quadrantanopsia
355.
356.
The radial nerve is at greatest risk for injury with which fracture:
A. Fracture of the surgical neck of the humerus
B. Fracture of the shaft of the humerus
C. Supracondylar fracture of the humerus
D. Olecranon fracture
357.
358.
359.
360.
A 68-year old man presents with crampy abdominal pain and distention vomiting.
Findings on PE are positive for healed abdominal scars. X-ray reveals multiple gas
fluid levels. The WBC count is 12,000. The most likely diagnosis is:
A. Small bowel obstruction due to adhesions
B. A hernia
C. Appendicitis
D. Gallstones and ascites
361.
A 56-year old man has suffered from intermittent claudication for 5 years. He has
recently developed cramping abdominal pain that is made worse by eating. He has a
history of a 15-lb weight loss. The most likely diagnosis is:
A.
B.
C.
D.
Chronic cholecystitis
Chronic intestinal ischemia
Peptic ulcer
Abdominal aortic aneurysm
A 28-year old man with a history of emotional disturbance enters the hospital with a history of
weight loss and regurgitation of food. Regurgitation is worse when he lies down. The most
likely diagnosis is:
A. Hiatal hernia
B. Cancer of the esophagus
C. Duodenal ulcer
D. Achalasia
A 38-year old man with a history of fever associated with abdominal pain of several weeks
duration presents now with a sudden onset of explosive abdominal pain and vomiting. Flat
plate x-rays reveals air under the diaphragm. CT scan shows mesenteric lymphadenopathy
and splenomegaly. The most likely diagnosis is:
A. Tuberculosis enteritis
B. Typhoid enteritis
C. Primary peritonitis
D. Ulcerative colitis
Splenectomy is often indicated in the management of:
A. Hereditary spherocytosis
B. Hereditary neurofibromatosis
C. Aplastic anemia
D. Hashimotos disease
A painless distended gallbladder palpable on PE of a jaundiced patient is strongly suggestive
of:
A. Empyema of the gallbladder
B. Mirizzis syndrome
C. Gallstone impacted in the ampulla
D. Pancreatic carcinoma
Which of the following suggest unresectability of a left upper lobe lung cancer:
A. Hemoptysis
B. Malignant pleural effusion
C. A cough specimen with positive sputum cytology
D. Clubbing and blueness of fingers
Which of the following studies is contraindicated in a drowsy patient with papilledema whom
one suspects of having acute closed head trauma:
A. Carotid arteriography
B. Lumbar puncture
C. CT scan
D. Echoencephalography
The appropriate antibiotic for a patient with a cellulitis of a leg due to streptococcus is:
A. Penicillin
B. Erythromycin
C. 3rd generation cephalosphorins
D. Cloxacillin
Massive bleeding from the lower GI tract (beyond the ligament of Treitz) is most often due to:
A. Diverticulosis
B. Meckels diverticulum
C. diverticulitis
D. colonic carcinoma
A 54-year old male has been complaining of recurrent hypogastric pain for almost 6
months. For almost 3 weeks prior to consult, he had noticed that he is passing air during
micturition. The most common cause of the above condition is:
A. carcinoma of the bladder
B. tuberculosis of the urinary tract
C. carcinoma of the sigmoid colon
D. diverticulitis of the colon
A 42-year old woman has been complaining of intermittent gross hematuria. On urinalysis, she
has significant pyuria but without bacilluria. The condition is most commonly due to:
A. urethritis
B. bladder stone
C. perinephric abscess
D. tuberculosis of the kidney
A 25-year old male had episodes of severe vomiting due to a gastric outlet obstruction. He
appears pale and dehydrated. The likely metabolic abnormality the patient would have is:
A. hypochloremic acidosis
B. hyponatremic acidosis
C. hypochloremic alkalosis
D. hypernatremic alkalosis
A 1week old infant presents with moderate respiratory distress and tympany in only one
hemithorax. The most likely diagnosis is:
A. spontaneous pneumothorax
B. eventration of the diaphragm
C. Bochdalek hernia
D. Atelectasis
A little boy aspirated a peanut. He is cyanotic. On expiration, his mediastinum shifts to the
right. The peanut most likely is lodged in the:
A. right main stem bronchus
B. left main stem bronchus
C. trachea
D. esophagus
A 40-year old man is hit by a car and sustains an injury to the pelvis. Which of the following is
most indicative of a urethral injury:
A. hematuria
B. high-riding prostate on rectal examination
C. oliguria
D. scrotal ecchymosis
A 64-year old man has mild upper abdominal pain. On contrast CT-scan, a 5 cm lesion in the
left lobe of the liver enhances and then decreases over a 10-minute period from without to
within. The most likely lesion is a:
A. hepatic adenoma
B. amoebic abscess
C. fatty infiltration
D. carvernous hemangioma
A 28-year old male has had a nonseminomatous testicular cancer treated. In following this
patient for possible recurrent tumor, the most useful serum marker would be:
A. carcinoembryonic antigen
B. alpha fetoprotein
C. prostate specific antigen
D. alkaline phosphatase
The most common cause of esophageal rupture or perforation:
A. Endoscopic injury
B. Blunt chest trauma
C. Boarhaaves syndrome
D. Carcinoma
The superior mesenteric artery communicates with the celiac artery via the:
A. Pancreatico-duodenal artery
B. Splenic artery
C. Hepatic artery
D. Dorsal pancreatic artery
The most common offending organism in pyogenic osteomyelitis is:
A. Escherichia coli
B. Staphylococcus aereus
C. Pseudomonas aeruginosa
D. Entococcus
In patients who developed a documented episode of deep vein thrombosis, the most frequent
and significant long term sequela is:
Claudication
Recurrent foot infection
Development of stasis ulcer
Pulmonary embolism
In an arterial stenosis, the most critical factor is:
A. The length of the stenosis
B. The cross-sectional area of the stenosis
C. The length and area are equally important
D. Whether the stenosis is smooth or has an irregular countour
A 60-yr old man with a history of atrial fibrillation is found to have a cyanotic cold right lower
extremity. The embolus most probably originated from:
A. An atherosclerotic plaque
B. Deep vein thrombosis
C. Lungs
D. Heart
Which of the following elements is not a component of venous thrombogenesis:
A. Incompetent valves in perforating vein
B. Disruption of endothelial intima
C. Venostasis
D. Hypercoagulability
In a patient suffering from an acute arterial embolic phenomenon, if the ischemia is not
relieved, which of these following tissues is the first to be irreversibly damaged:
A. muscle
B. nerve
C. fat
D. synovial membrane
Which of the following clinical manifestation may suggest tentorial herniation:
A.
B.
C.
D.
contralateral mydriasis
decorticate rigidity
contralateral hemiparesis
ipsilateral hemianopsia
50-57
A 60-year old female, post mastectomy for breast cancer, presents with headache backache
and frequent vomiting. She is extremely thirsty and stuporous. The test most likely to identify
the cause is:
A. Serum calcium determination
B. Serum sodium determination
C. Serum potassium determination
D. Serum glucose determination
The Trendelenburgs (head down) position is beneficial in the initial management of which type
of shock:
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock
The most common form of burn is:
A. scald burns
B. flame burns
C. chemical burn
D. electrical burn
A 20 year old man has lymphadenopathy behind and inferior to his right ear. Biopsy shows the
lesion to be a lymphosarcoma. The most likely site of the primary tumor is:
A. Floor of the mouth
B. Nasopharynx
C. Buccal mucosa
D. Mediastinum
The most frequent organism in highest density that can be isolated from contamination
following colon perforation are:
A. Gram positive aerobes
B. Gram negative aerobes
C. Gram positive anaerobes
D. Gram negative anaerobes
The most clinically significant early physiologic abnormality in post traumatic pulmonary
insufficiency is:
A. Increased physiologic shunt
B. Increased dead space
C. Cardiogenic pulmonary edema
D. Pulmonary fibrosis
354.
A.
B.
C.
D.
A.
B.
C.
D.
After multiple myeloma, the most common primary malignant bone tumor is:
Osteosarcoma
Ewings sarcoma
Answer: A; Schwartz 8th ed p.1661
Chodrosarcoma
Fibrosarcoma
355.
356.
A.
B.
C.
D.
357.
A.
B.
C.
D.
358.
A.
B.
C.
D.
359.
A.
B.
C.
D.
360.
A.
B.
C.
D.
361.
A.
B.
C.
D.
c. Nasal polyp
d. Fibrous dysplasia
Ans. A
page 245 Boise funadamental of otolaryngology
16.This is a autosomal recessive trait characterized by situs invesus, bronchiectasis,
sinusitis:
a. cystic fibrosis
b. kartagener syndrome
c. Albrights syndrome
d. Pierre robin syndrome
Ans. B page 269 Boise funadamental of otolaryngology
17. This is a cellulitis or phlegmonous inflammation of the superior compartment
of the suprahyoid space . The most common cause is odontogenic in origin
a. Vincents Angina
b. Ludwigs angina
c. Trench mouth
d. Retropharyngeal abscess
Ans. B page 359 Boise funadamental of otolaryngology
19.the cricothyroid muscle is innervated by :
a. recurrent laryngeal mnerve
b. external br. of superior laryngeal nerve
c. internal branch of superior laryngeal nerve
d. vagus nerve
Ans B page 387 Boise funadamental of otolaryngology
20.The most common benign gland tumor of children of parotid gland is:
a. lymphangioma
b. hemangioma
c. pleomorphic adenoma
d. mucoepidermoid CA
ANS B page 325 Boise funadamental of otolaryngology
21.A 22 year old construction worker comes for consult because an unknown liquid got into
his eyes. The very first thing to do is:
a) instill antiseptics
b) do copious water irrigation
c) assess vision
d) put topical antibiotics
23. A 65 year old filipino male comes in for bilateral insidious painless progressive visual
deterioration. The most likely diagnosis would be:
a) cataracts
b) age related macular degeneration
c) central retinal artery occlusion
d) congestive angle closure glaucoma
24.A 55 year old male known diabetic with moderately severe non proliferative retinopathy
comes in for 6 months blurring of vision not corrected with pinhole. The most likely
diagnosis is:
a) macular edema
b) traction retinal detachment
c) incipient cataract
d) vitreous hemorrhage
25.A 41 year old female complains of slightly congested eyes with headache after
prolonged near work, relieved by rest. She may need
a) concave lenses
b) convex lenses
c) intraocular lenses
d) binocular lenses
26.A patient complains of poor vision at distance, good vision at near. She may need
a) convex lenses
b) cylindrical lenses
c) concave lenses
d) binocular lenses
30.A chronic granulomatous inflammation of the meibomian gland is a
a) cyst
b) stye
c) chalazion
d) dermoid
1. Following Goodsalls rule, a fistula in-ano with an external opening located 4 cm
from the anal verge would have its internal opening located :
A.
B.
C.
D.
2. 70-90% of primary gastrinomas are located in the area defined by a triangle with
points located at the junction of the cystic duct and common bile duct, the second and
third portion of the duodenum, and the neck and body of the pancreas. This area is
known as the Triangle of
A. Calot
B. Hesselbach
C. Passaro
D. Bermuda
1. Histologic examination of a thyroid gland tumor reveals psammoma bodies. This
finding indicates that the lesion is:
A. Follicular Carcinoma
B. Medullary Carcinoma
C. Papillary Carcinoma
D. Hurtle Cell Carcinoma
2. A 40 year old female was diagnosed with Papillary Thyroid Carcinoma. She presents with
a hard thyroid
mass, cervical lymphadenopathies, and several coin lesions on chest x-ray. Clinical
staging for this patient
would be:
A. Stage I
B. Stage II
C. Stage III
E. Stage IV
3. A 45 year old woman has a mobile lump in the upper outer quadrant of her right breast.
An open
excisional biopsy reveals a 1.5 cm lobular carcinoma in situ with negative margins. With
regards to further management, which of the following statements is true?
A. Careful clinical follow-up without further surgical intervention is sufficient
at this time.
B. Mirror image biopsy of the contralateral breast is warranted.
C. Total mastectomy, without axillary dissection, is indicated.
D. Lumpectomy with radiation therapy is the recommended treatment.
1. During the initial assessment of the multiply injured patient, the main goal and objective
of the Primary Survey Is to:
A.
B.
C.
D.
inability of the ipsilateral lung to expand due to the herniated abdominal viscera
recurrent aspiration pneumonia due to concomitant gastroesophageal reflux
splinting of the contralateral diaphragm from distention of the intestinal tract
incomplete development of the lung resulting in inadequate area for gas
exchange
Answer
questions
page
46
82
The most common etiology of acute otitis media in all age group
A. Staphylococcus sp.
B. Streptococcus
C. H. Influenzae
D. Moraxella catarrhalis
MPL : 1.00
99
91
The most common intracranial complication from supurative Otitis Media is:
A. epidural abscess
B. subdural abscess
C. brain abscess
D. meningitis
MPL: 0.75
118
10
67
11
82
12
Sudden hearing loss with concurrent dizziness while scuba diving suggests:
A. Acoustic neuroma
B. Barotrauma
C. Menieres disease
D. Benign Positional Paroxysmal Vertigo
MPL: 0.75
94
14
100
21
A 3 year old boy was refered to the ENT service due to edema of the eyelids.
Pertinent physical examination: normal visual acuity, (-) chemosis, (-) proptosis, full
extraocular muscles, (+) profuse purulent nasal discharge. What is your assessment?
A. Periorbital cellulitis
B. Orbital cellulitis
C. Subperiosteal abscess
D. Orbital abscess
236-264
MPL: 0.75
B
22
236
27
202
28
29
203
30
245
31
297
33
A 50-year old female presents clinically with globus hystericus. This is usually
associated with a/an:
A. A normal PE and barium swallow
B. Lesion of the upper esophagus
C. Abnormal direct laryngoscopy
D. Structure of the upper esophagus
MPL: 0.75
392
34
A 20-year old sailor has a persistent sorethroat and is found to have a pharyngitis
with enlarged tonsils and cervical adenophaty . Gram stain of pharyngeal secretions
shows gram- negative diplococci. These findings support a diagnosis of:
A. Streptococcal pharyngitis
B. Gonococcal pharyngitis
C. Haemophilus influenza
D. Bacteroides pharyngitis
MPL: 1.00
344
35
346
225
36
350-351
37
38
352
39
362
40
The region of the pharynx that extends from the base of the skull to the level of
hard palate:
A. Epipharynx
B. Mesopharynx
C. Hypopharynx
D. Laryngopharynx
MPL: 0.50
274
41
475
471
A 1 1/2 month-old baby girl was brought to your clinic because of stridor. There was no associated cough.
The patient was delivered to a G8P7 40 year old laundrywoman from
payatas via NSD. Birthweight
was 6.5lbs with APGAR score of 9 and 10. She was sent
home after 2 days with no perinatal
complications. She has a good suck with normal swallowing, good cry and weight gain. Stridor is slightly
relieved by putting her in a supine position. T=37.2 C ; RR= 40/min.
D
43
44
The best thing to do in this patient for your initial evaluation is/are:
A. Request for a plain chest x-ray
B. Tracheostomy
C. Request for CT scan of the neck
D. Direct laryngoscopy
MPL: 0.75
393-394
393
A 6 year-old boy was brought in to the clinic because of cough associated with moderate-grade fever and
sorethroat characterized by painful swallowing few days PTC. The patient was sent home with antibiotics,
cough syrup and antipyretics. The following day, patient was brought to the ER because of stridor associated
with cyanosis. Patient was relieved by sitting up with mouth open and chin forward. He was restless and
cyanotic with flaring of alae nasi, substernal and intercostal retractions. T=40C ; RR=36/min.
B
45
399
46
The best thing to do in this patient as your initial evaluation and management is/are:
A. Chest X-ray
B. Tracheostomy
C. Laryngoscopy
D. Antibiotics
MPL: 0.75
399
A 62 year old farmer from Iriga City came in because of dyspnea. His condition started 10 months PTC as
hoarseness associated with hemoptysis. One month PTC, he developed persistent dyspnea accompanied by
a lump on the right side of the neck. Patient is a chronic alcoholic and smoker. On PE, patient is obese,
afebrile, and in respiratory distress.
D
47
461
48
461
A 3 year-old girl was taken to the ER because of stridor and cyanosis. Few hours PTC, patient was playing in
the sala while her daddy was eating peanut while watching world meeting of families. The patient was
restless with audible slap and palpable thud.
B
49
484
50
484
51
384-385
53
392
54
384
55
390
62
532
63
528
64
535
65
531
66
535
67
531
68
532
D. d. Zygomatic fracture
MPL: 1.00
B
69
537
70
537
72
288
73
96
76
517
77
514
78
In wound healing, during the stage of injury, which of the following occurs:
A. PMN leukocytes predominate the population of inflammatory cells in wound
B. wound is filled with extracellular matrix
C. fibroblasts fill up the wound
D. formation of hemostatic plug composed of fibrin and platelet
MPL: 0.75
505
79
The most usual donor site for split thickness skin graft
A. neck
B. thigh
C. abdomen
D. post-auricular area
MPL: 0.50
512
80
Which of the following grafts has a better chance of take(survival of the graft) ?
A. Full thickness skin graft
B. Split thickness skin graft
C. Free bone graft
D. Autogenous graft
MPL: 0.75
516
81
A 54-year-old patient presented with a midline mass that moves with deglutition.
Your primary diagnostic impression would be, that maybe its a/an:
439-440
82
The most logical question to ask when probing whether the mass is congenital,
would be:
A. What is the age of the patient?
B. Is the mass growing rapidly?
C. Is the mass cystic or solid?
D. Is there any source of infection?
MPL: 1.00
431
83
A 30 year old female comes in with fever, pains in the right pre-auricular area. On
examination, you see a swollen, tender, erythematous right parotid area. The orifice
of the stensens duct is also swollen with minimal purulent material coming out. What
is the diagnosis?
A. Sialolithiasis
B. Chronic sialadenitis
C. Acute bacterial sialadenitis
D. Mumps
MPL: 1.00
319
84
327
85
A 20 y/o male came to the clinic with a mass at the left submandibular area.
Primary consideration as to the nature of the mass would probably be:
A. Neoplastic
B. Congenital
C. Cystic
D. Inflammatory
MPL: 1.00
319
A 60 y/o female teacher from Iriga City came in for a right pre-auricular mass of 2 months duration. Initially
the patient palpated a tender 1 X 0.5 cm mass which progressively enlarged to its present size. On P.E there
is 3 X 4 X 2 cm tender, movable, firm to stony hard, nodular mass on the right pre-auricular area. The
overlying skin is not indurated and moves freely over the mass. No cervical lymphadenopathy was noted.
D
86
The finding in the above patient which supports the possibility of a parotid gland
malignancy:
A. The age of the patient
B. The absence of cervical lymphadenopathy
C. The presence of pain and duration of the mass
D. The age of the patient and duration of the mass
MPL: 0.75
Surgical treatment of choice for thyroglossal duct cyst is
A. Marsupialization procedure
B. Excision of cyst tract and portion of hyoid bone
C. Excision of cyst and tract
D. Removal of hyoid bone
MPL: 0.50
431
91
93
437
94
444
434
B. Dysphagia
C. Hoarseness
D. Dyspnea
MPL: 0.75
C
95
The most common histologic type of carcinoma in the head and neck area is
A. Adenocarcinoma
B. Basal cell carcinoma
C. Squamous cell carcinoma
D. Sarcoma
MPL: 0.75
445
96
325
97
448
98
A neoplasm that occurs primarily in the parotid gland, more commonly seen in
males in the older age group and is also known as papillary cystadenoma
lymphomatosum
A. Oncocytoma
B. Pleomorphic adenoma
C. Warthins tumor
D. Hemangioma
MPL: 0.75
327
99
83
100
317
1. In which of the following conditions is the cornea most opacified? MPL = 0.25
a. Macula
b. Leukoma
c. Nebula
d. Corneal abrasion
2. A condition that gives painless blurring of vision is: MPL = 1.0
a. Central retinal vein occlusion
b. Orbital cellulitis
c. Optic neuritis
d. scleritis
3. The most important factor for developing diabetic retinopathy is: MPL = 0.25
a. Duration of the diabetes
b. Poor metabolic control of diabetes
13. In performing Direct Ophthalmoscopy, the first element that must be observed: MPL =
0.5
a. Media Clarity
b. Red reflex
c. Macular changes
d. Cup / Disc features
14. In the three-part step-wise sequence in external eye examination, one procedure that is
not usually included: MPL = 1.0
a. Inspection
b. Auscultation
c. Palpation
d. Percussion
15. The patient was not able to see hand movement. What is the next step to check his
visual acuity?MPL= 0.5
a. Check light perception*
b. Have the patient walk closer to the Snellen chart and ask if he can see the
biggest letter
c. Do counting fingers
d. Check color perception test
16. A patient is only able to read the first line of the Jaeger chart. His near visual acuity is
recorded asMPL=0.3
a. J16
b. J16 -2 lines*
c. J16 +2 lines
d. J16 +2
17. In assessing facial sensation, the three branches of the cranial nerve V that is being
tested areMPL=0.3
a. Supraorbital n., infraorbital n., intraorbital n.
b. Facial n., abducens n., trochlear n.
c. Frontal n., zygomatic n., lacrimal n.
d. Ophthalmic n., maxillary n., mandibular n.*
18. Which of the following is/are true of the corneal blink reflex? MPL=0.3
a. Test is done by touching the eyelashes lightly with a wisp of cotton
b. The afferent arm of the reflex is the trigeminal nerve*
c. The efferent arm of the reflex is the optic nerve
d. Visual startle reflex should be stimulated
19. Which of the following is a term used to describe normal binocular eye movement in the
same direction? MPL=0.5
a. Ductions
b. Versions*
c. Vergence
d. Convergence
20. Giant papillary reaction is common in MPL = 1.0
a. Contact lens overuse
b. Preseptal cellulitis
c. Orbital cellulitis
d. Chalazion
21. Ophthalmia Neonatorum is usually a bacterial cause of conjunctivitis: MPL =0.3
a. True
b. False
c. Only rarely of bacterial cause
d. Real causative organism is unknown
22. The spread of epidemic viral conjunctivitis is best curtailed by: MPL =0.25
a. Putting prophylactic medication on the eyes
b. Avoiding crowded places
c. Avoid touching ones own eyes
d. Frequent hand washing
23. Which is not an anatomic locale description of the conjunctiva? MPL =0.5
a. Tarsal
b. Fornix
c. Limbal
d. Bulbar
24. Adenoviral conjunctivitis may cause: MPL =0.3
a. a true membrane on the tarsal conjunctiva
b. a pseudomembrane
c. never forms any membrane
d. may develop keratinized conjunctiva
25. Which of the following statements regarding the use of steroid eye drops for red eyes is
correct? MPL =0.3
a. Patients may self medicate with steroids when they have red eyes.
b. Steroids may be used so long as the dosage is less than 4 times a day.
c. The possible complications of steroid use include Glaucoma AND Cataract
formation
d. Ocular complications of steroid eye drops are independent of dosage and
duration of use
26. The medication specifically used against adenovirus conjunctivitis currently is: MPL
=0.3
a. Steroid antibiotic combination eye drops.
b. 4th generation flouroquinolone eye drops (moxifloxacin)
c. Interferon eye drops
d. There is no specific medication against adenovirus
27. The definitive management of gonococcal conjunctivitis is: MPL =0.3
a. Tobramycin eye drops every hour to affected eye for 10 days.
b. Ceftriaxone 1gram intramuscular injection once only.
c. Gentamycin intravenous, 200mg q 6hrs for one week.
d. Oral amoxicillin, 500mg t.i.d. for one week
28. Which of the following conjunctivitides is almost always bilateral? MPL =0.5
a. Viral
b. Bacterial
c. Toxic
d. Allergic
29. Fusion of the bulbar and tarsal conjunctiva as a result of prolonged inflammation and
scarring is termed: MPL =0.3
a. Ankyloblepharon.
b. Symblepharon
c. Eryblepharon
d. Blepharitis
38. Computed Tomogram of the above child showed a unilateral tumor filling the left eye.
Nasal third of the tumor is calcified. Impression of Retinoblastoma is confirmed with
the following histologic features: MPL=0.5
a. Islands of blue cells in a sea of pink necrosis
b. Cuboidal cells circled around a central luman: Flexner-Wintersteiner rosettes
c. Flower like grouping of tumor cells which look like photoreceptors: Fleurettes
d. All of the above
e. B and c only
39. A 23/M consulted the OPD because anterior eyelid crusting of 3 days duration. The
resident requested for a gram-stain which revealed Gram-positive cocci in clusters.
Which statement is consistent with the impression of Staphylococcal blepharitis? MPL
= 0.5
a. Coagulase production specifies etiologic agent to be Staphylococcus
aureus
b. Catalase negative reaction identifies normal flora Staphylococcus epidermidis
c. All staphylococcus species are catalase negative
d. B-lactamase production increases susceptibility to penicillins
40. Which of the following viruses is transmissible even after medical instrumentation is
cleaned with alcohol? MPL = 0.5
a. Herpes simplex virus
b. Adenovirus
c. Human immunodeficiency virus
d. Epstein-Barr virus
41. A newborn was admitted to the NICU because of mucopurulent eye discharge at birth.
The mother had a documented chlamydial genito-urinary tract infection. What bacterial
features are consistent with the neonatal ocular finding? MPL = 0.5
a. Elementary bodies stain blue with Giemsa in contrast to the purple of the host
cell cytoplasm
b. Chlamydia trachomatis strains synthesize folates thus are resistant to
sulfonamides
c. The outer cell wall resembles the cell-wall of gram-negative bacteria
d. Chlamydiae are obligate intracellular parasites that need to exist within host cells
to synthesize ATP
42. A 50/M farmer consulted the OPD because of right corneal opacity of 3 weeks duration.
He claimed his right eye was hit by a palay strand while harvesting. Clinical history
alone leads to a strong suspicion of fungal keratitis. Which of the following statements
is a recommended diagnostic management of fungal keratitis? MPL = 0.5
a. Fungi can easily be visualized using the routine hematoxylin and eosin (H&E)
preparation
b. The cell wall polysaccharides are uniquely stained by periodic acid-Schiff
(PAS)
c. The gold standard for morphologic classification is blood agar at room
temperature
d. Corneal scrapings are best collected at the center of the main lesion rather than
the small satellite lesions
43. A 43/F consulted because of a sessile mass at the limbus. The excision biopsy
revealed squamous papilloma. Which of the following is true about the association of
the Human Papilloma Virus (HPV) with squamous papilloma? MPL = 0.5
a. HPV DNA induces cellular necrosis leading to a secondary papilloma growth
b. HPV subtypes 6 and 11 have been identified in hypertrophic papillomas
c. HPV DNA induces cellular proliferation and can lead to malignancy
d. HPV RNA integrates with epithelial genome leading to squamous cell carcinoma
44. A 30/M consulted the OPD because of foreign body sensation with mucopurulent
discharge of 6 days duration. A detailed slit-lamp biomicroscopic examination
demonstrated clinical features of trachoma. Which are features of an adult trachoma
compared to a neonatal chlamydial conjunctivitis is TRUE? MPL = 0.5
a. The amount of mucopurulent discharge is greater
b. Membranes develop almost immediately
c. The percentage of intracytoplasmic inclusions is greater
d. Follicular response is greater
45. Condition in which there is discoloration of the eyelashes MPL = 0.5
a. Madarosis
b. Proptosis
c. Trichiasis
d. Poliosis
46. The condition in which an extra row of lashes exists is MPL =0.5
a. Trichiasis
b. Distichiasis
c. Entropion
d. Ectropion
47. A white pupillary reflex is called: MPL = 1.0
a. leukoma
b. glaucoma
c. leukocoria
d. anisocoria
48. An infant born less than 31 weeks, weighing less than 1500g (3 lb 5 oz) plus exposure
to supplemental oxygen, one should screen the eyes for: MPL = 1.0
a. Persistent Hyperplastic Primary Vitreous (PHPV)
b. congenital cataract
c. a retinal astrocytoma
d. Retinopathy of Prematurity (ROP)
49. This is the second most common mode of presentation in Retinoblastoma which
account for about 20 % of cases: MPL =0.5
a. leukocoria
b. secondary glaucoma
c. proptosis
d. strabismus
50. The following are treatment options for Retinoblastoma except MPL = 1.0
a. Cryotherapy
b. Radio Therapy
c. Enucleation
d. Evisceration
51. The following are correct in visual acuity testing in a child EXCEPT MPL=0.5
a. At 6 months, test for ocular fixation and ocular movement
b. At 4 years old, test with tumbling E chart picture chart
c. At 8 years old, test with an Amsler grid chart
d. At 16 years old, test with a Snellen chart
52. Leukocoria caused by the presence of red cells in the vitreous secondary to birth
trauma MPL=0.5
a. Retinopathy of prematurity
b. Persistent Hyperplastic Primary Vitreous
c. Vitreous Hemorrhage
d. Posterior Uveitis
53. A biconves, avascular, colorless structure that focuses light rays to the retina, an
opacity of which will cause leukocoria MPL=0.5
a. Lens
b. Vitreous
c. Retina
d. Optic Nerve
54. Ophthalmological examination that would identify presence of an intraocular mass
MPL=0.5
a. Visual acuity testing
b. Indirect Ophthalmoscopy
c. Pupillary examination
d. Sit lamp examination
55. The most common presenting sign of retinoblastoma is MPL=1.0
a. Red eye
b. Visual loss
c. White pupil
d. Strabismus
56. Due to the inheritance pattern of retinoblastoma, a vital part of treatment would incude:
MPL=0.5
a. Psychological counseling
b. Genetic counseling
c. Psychotherapy
d. Rehabilitation counseling
57. A surgical procedure involving removal of intraocular contents: MPL=0.5
a. enucleation
b. evisceration
c. exenteration
a. retrobulbar alcohol
58. Management of CRAO includes MPL =0.5
a. Brown bagging
b. Alternate compression and decompression of the globe
c. Oxygen inhalation
d. A and B only
e. B and C only
59. Characteristic findings in Central Retinal Artery Occlusion MPL = 0.25
a. Cotton wool spots
b. Cherry red spot in the macula
c. Vitreous floaters
d. Papilledema
60. The TRUE statement regarding chemical burns MPL = 1.0
a. Acid burns cause more extensive damage than alkali burns
b. The first thing to do in cases of chemical burns is to check the visual acuity
c. Neutralization should be achieved, so that an alkali burn can be treated by
instilling an acidic substance and vice versa
d. In copious irrigation of the eye, the fluid used need not be sterile, provided
the chemical is diluted properly
61. EOM movement of one eye is called MPL =0.5
a. Ductions
b. Versions
c. Nystagmus
d. Diplopia
62. Absence of venous pulsations on funduscopy MPL =0.3
a. May indicate increase intracranial pressure
b. May be normal
c. Is a sign of glaucoma
d. A and b
63. To examine the optic nerve binocularly, use MPL = 0.3
a. Indirect ophthalmoscope
b. Non contact fundus lens
c. Intraocular lens
d. A and B
64. What ancillary procedures should you do if suspecting optic nerve toxicity? MPL = 0.25
a. Visual field exam
b. Visual evoked potential
c. Color test
d. All of the above
65. One of the most common reasons for Neuroophtha referral MPL = 1.0
a. unexplained vision loss
b. cataracts
c. retinal disorders
d. none of the above
66. Which of the following is true regarding viewing the fundus MPL = 1.0
a. Indirect ophthalmoscopes provides a monocular view of the fundus
b. Direct ophthalmoscopes provides a Binocular view of the fundus
c. Direct ophthalmoscopy provides greater detail of the fundus
d. none of the above
67. What is the most important adverse effect of local anesthetic overdosage? MPL = 0.25
a. bronchoconstriction
b. renal failure
c. convulsion
d. skin rashes
68. Cortocosteroid stops the inflammatory process by inhibiting prostaglandin synthesis
through the following mechanism: MPL = 1.0
a. blockage of the enzyme cyclooxygenase
b. blockage of the enzyme phospholipase A
c. blockage of GABA pain receptors
d. regulation of endorphin levels in the blood
69. Which of the following statements regarding papilledema is not true? MPL =0.3
a. Loss of venous pulsation is always present
b. Symptoms accompanying papilledema may include visual loss and diplopia
c. Nerve fiber layer hemorrhages around the disc are often present
d. Blurring of the peripapillary vessels
70. Most common visual field finding in papilledema MPL = 0.3
a. Central scotoma
b. Cecocentral scotoma
c. Altitudinal defect
d. Enlargement of the blind spot
71. Typically the onset of visual loss in demyelinating optic neuritis is noted MPL = 0.25
a. Upon arising in the morning
b. Mid-day
c. At the end of the day
d. There is no temporal pattern for visual loss
72. One of the following findings is not a characteristic of true disc edema MPL = 0.25
a. capillary dilation
b. abnormal branching of vessels around the disc
c. disc hemorrhages
d. blurring of disc vessels along the margin
73. Most common cause of optic disc swelling in children MPL = 0.3
a. Infectious optic neuritis
b. Demyelinating optic neuritis
c. Leber optic neuropathy
d. Non arteritic anterior ischemic optic neuropathy
74. One of the following is not a characteristic finding of optic neuritis in children MPL =
0.25
a. Often present simultaneously as a bilateral condition
b. More often anterior in location with optic disc edema seen on exam
c. Occurs 1-2weeks after a known or presumed viral infection
d. Always resistant to steroids
75. Most common condition associated with nonarteritic anterior ischemic optic neuropathy
MPL = 0.5
a. Diabetes mellitus
b. Carotid artery disease
c. Coagulopathies
d. Hypertension
76. Which of the following is the most common optic neuropathy in patients over the age of
50? MPL = 0.3
a. Compressive
b. Demyelinating
c. Traumatic
d. Nonarteritic anterior ischemic optic neuropathy
77. 10. An obese 26 year old woman presents with headaches and transient visual
obscurations. Bilateral papilledema is documented. The next step should be which of
the following MPL = 0.3
a. advised weight reduction
b. do lumbar tap
c. Start on acetazolamide
d. Do CT or MRI of the brain
78. Exophthalmos is a term used specifically in which of the following conditions? MPL =
1.0
a. Thyroid disease
b. Anemia
c. Keratoconus
d. Myopia
1. The most commonly observed Cumulative Trauma disorder is
A. De Quervains
B. Trigger finger
C. Carpal tunnel syndrome
D. Tennis elbow
2. The ff. is an indirect cost of injury among workers
A. medical Cost
B. Lost Time Wages
C. Training replacements
D. Compensation Premiums
3.The ff. is an indication for surgical release of CTS
A. Severe causalgia
B. Weak Abductor Pollicis brevis
C. Atrophy of hypothenar eminence
D. edema on the wrist
4. The ff. is a feature of Impingement Syndrome
A. Limited Passive ROM of the shoulder
B. Pain active on shoulder flexion
C. Limited active abduction of the shoulder
D. Positive Spurling sign
5. In Reflex sympathetic dystrophy the ff. is true
A. Pathology originates at the fingers
B. Autonomic changes
C. Complete shoulder ROM
D. Splinting the shoulder helps a lot
6. The most common lump on the hand is
A. Trigger finger
B. Ganglion cyst
C. Tendenitis
D. Dupuytrens contracture
7. The Following can lead to Frozen Shoulder EXCEPT
A. Rotator cuff Tear
B. Bicipital tendenitis
C. Carpal Tunnel Syndrome
D. Trigger finger
8. Avascular necrosis of the Lunate
A. Panners
B. Keinbocks
C. Dupuytrens
D. Osgood
9. A worker comes with a lump on the dorsal elbow, it is movable, soft with tenderness. He has
a habit on putting his weight at the elbow , he has
A. Golfers elbow
B. Tennis elbow
C. Tendinitis
D. Students elbow
10. The best thing to do in acute tendenitis is
A. To stretch it to increase tensile strength
B. To rest it in a splint
C. To move it to prevent contracture
D. To apply hot moist pack
11. The grip strength of a dominant hand is usually stronger than the non dominant hand by
A. 10 lb.
C. 30 lbs
B. 20 lb.
D. 40 lbs
12. A functional non organic sensation deficit is evident if there is
A. vibratory deficit in the upper arm
B. sensory deficit in the whole leg
C. numbness of the thumb
D. numbness on the right side of the face
13. To prevent overvaluation and subjection to potential risk of tests. The following will suggest
a non organic findings in back pain
A. Pain on straight leg raising at 30 degrees
B. light pinch tenderness of skin on vast area of the back
C. Sensory deficit on the lateral thigh
D. weak extensor hallucis longus
14. The most common type of muscular dystrophy is
A. Limb Girdle
B. Duschenne
C. Facioscapulo-humeral
D. Beckers
15. Cramps is the usual complain of
A. Duschenne
B. Myotonic
C. SMA
D. Limb Girdle
16. Spinal dysraphism can be detected in utero after 18 weeks by taking the
A. Amniotic C -reactive protein
B. Amniotic Alpha feto protein
C. Amniotic phosphofructokinase
D. Amniotic amylase
17. A positive Gowers sign is
A. Pathognomonic in muscular dystrophy
B. Present in pelvic and proximal leg weakness
C. seen in hip flexion contracture
D. a feature of McArdles disease
C.
D.
47. An SCI patient states that he has intact sensation up to the umbilicus, without movement
over his legs. This means
A. His sensory level is T10
B. His corresponding motor level is T12
C. His lesion is over T10 vertebra
D. He is a quadriplegic
48.The most common site of heterotrophic ossification among burn patient is at the
A. Hip
B. Knee
C. Elbow
D. Shoulder
49.A bedridden quadriplegic has painful inflamed thigh . The working diagnosis is DVT , it is
best to differentiate this with
A. Fracture of the hip
B. Heterotopic ossification
C. Osteomylitis
D. TB arthritis
50.The most common tumor of the bone
A. Osteosarcoma
B. Multiple Myeloma
C. Metastatic
D. Osteod osteoma
51.The most common cause of Traumatic brain injury is
A. Vehicular accident
B. Fall
C. Gunshot wound
D. Sports injury
52.A C-curve scoliosis is common in
A. Idiopathic scoliosis
B. Scoliosis secondary to leg length discrepancy
C. Scoliosis due to hemivertebra
D. Paralytic scoliosis
53.Physical finding in scoliosis on convexity side
A. Prominent front chest
B. Rotation of the spine
C. Lower shoulder level
D. Prominent scapula
54. .Physical finding in scoliosis on concavity side
A. Rotation of the vertebral body
B. Prominent front chest
C. Wider rib Space
D. Better chest excursion
55.. This syndrome of massive sympathetic discharge associated with the SCI patients with
lesions at T6 level, characterized by headache, hypertension, diaphoresis and reflex
bradycardia is known as:
A. areflexia
C. autonomic dysreflexia
B. sacral sparing
D. cauda equina
56. This is the most important aspect to consider in the management of decubitus ulcer:
A. relief of pressure
B. use of transcutaneous nerve stimulation
57. What is the key muscle for testing C7 myotome, according to the American Spinal Injury
Association?
A. triceps
C. biceps
B. deltoids
D. first dorsal interossei
58. . This level is generally the highest level of injury at which spontaneous ventilation can be
sustained. Injuries above this level generally require mechanical ventilation:
A. C4
C. C6
B. C5
D. C7
59. This is referred to as an ectopic bone formation occurring within 6 months after spinal cord
injury:
A. heterotopic ossification
C. osteoporosis
B. degenerative joint disease
D. compression deformities of the spine
60. This is generally considered the drug of choice for spasticity in SCI:
A. Diazepam
C. Dantrolene sodium
B. Baclofen
D. Clonidine
61. The most commonly observed Cumulative Trauma disorder is
A. De Quervains
B. Trigger finger
C. Carpal tunnel syndrome
D. Tennis elbow
62. The ff. is an indirect cost of injury among workers
A. medical Cost
B. Lost Time Wages
C. Training replacements
D. Compensation Premiums
63.The ff. is an indication for surgical release of CTS
A. Severe causalgia
B. Weak Abductor Pollicis brevis
C. Atrophy of hypothenar eminence
D. edema on the wrist
64. The ff. is a feature of Impingement Syndrome
A. Limited Passive ROM of the shoulder
B. Pain active on shoulder flexion
C. Limited active abduction of the shoulder
D. Positive Spurling sign
65. In Reflex sympathetic dystrophy the ff. is true
A. Pathology originates at the fingers
B. Autonomic changes
C. Complete shoulder ROM
D. Splinting the shoulder helps a lot
66. The most common lump on the hand is
A. Trigger finger
B. Ganglion cyst
C. Tendenitis
D. Dupuytrens contracture
67. The Following can lead to Frozen Shoulder EXCEPT
A. Rotator cuff Tear
B. Bicipital tendenitis
C. Carpal Tunnel Syndrome
D. Trigger finger
68. Avascular necrosis of the Lunate
A. Panners
B. Keinbocks
C. Dupuytrens
D. Osgood
69. A worker comes with a lump on the dorsal elbow, it is movable, soft with tenderness. He
has a habit on putting his weight at the elbow , he has
A. Golfers elbow
B. Tennis elbow
C. Tendinitis
D. Students elbow
70. The best thing to do in acute tendenitis is
A. To stretch it to increase tensile strength
B. To rest it in a splint
C. To move it to prevent contracture
D. To apply hot moist pack
71. The grip strength of a dominant hand is usually stronger than the non dominant hand by
A. 10 lb.
C. 30 lbs
B. 20 lb.
D. 40 lbs
72. A functional non organic sensation deficit is evident if there is
A. vibratory deficit in the upper arm
B. sensory deficit in the whole leg
C. numbness of the thumb
D. numbness on the right side of the face
73. To prevent overvaluation and subjection to potential risk of tests. The following will suggest
a non organic findings in back pain
A. Pain on straight leg raising at 30 degrees
B. light pinch tenderness of skin on vast area of the back
C. Sensory deficit on the lateral thigh
D. weak extensor hallucis longus
74. The most common type of muscular dystrophy is
A. Limb Girdle
B. Duschenne
C. Facioscapulo-humeral
D. Beckers
75. Cramps is the usual complain of
A. Duschenne
B. Myotonic
C. SMA
D. Limb Girdle
76. Spinal dysraphism can be detected in utero after 18 weeks by taking the
A.
B.
C.
D.
120. This is generally considered the drug of choice for spasticity in SCI:
A. Diazepam
C. Dantrolene sodium
B. Baclofen
D. Clonidine
_____ 1. A female cancer patient is in constant pain which is severe, radiating, shooting
and electric like in character. Most likely cause of her pain is:
A. The enlarged mass itself
B. Compression of a nerve by the enlarged mass
C. Bone metastasis
D. Treatment related
_____ 2. Gates Control Theory of pain is the basis for all the following non
pharmacologic pain management EXCEPT:
A. Transcutaneous electrical nerve stimulation C. Cold compress
B. Massage
D. Biofeedback
_____ 3. A peripheral type of pain:
A. Myofascial pain syndrome
B. Reflex sympathetic dystrophy
_____ 4. Management of pain due to excision of mass in the anterior abdominal wall:
A. Non-steroidal anti inflammatory agents (NSAIDs)
B. Opioids
C. Opioids and NSAIDs
D. NSAIDs, opioids plus anti depressants
_____ 5. Chronic use or prolonged intermittent administration of this opioids. Results in
neurotoxicity due to its metabolite.
A. Meperidine
B. Morphine
C. Fentanyl
D. Oxycodone
B. Lidocaine
D. Tetracaine
B. T8
D. T10
_____ 43. Five minutes after assuming the supine position; the BP because 90/60
PR=50/min
Give the reason for hypotension:
A. Para sympathetic block
C. Sympathetic block
B. Motor block
D. Sensory block
_____ 44. What is the immediate management? Of hypotension
A. Head up position
C. oxygenation
B. Increase IV fluid infusion
D. Give vasoconstrictors
_____ 45. What is the immediate management of the bradycardia?
A. Ephedrine sulfate IV
C. Intravenous fluid infusion
B. Atropine sulfate
D. Midazolam IV
_____ 46. Intake of an agent by the body and the uptake of the agent by the tissues is
termed.
A. Circulation
C. Absorption
B. Elimination
D. Metabolism
_____ 47. Distribution of general anesthetic drugs is influenced by:
A. Route of administration
C. Bioavailability
B. Regional blood flow
D. Metabolites
_____ 48. Discovered oxygen and nitrous oxide:
A. John snow
C. Crawford T. Long
B. Joseph Priestly
D. Henry Hickman
_____ 49. Muscle relaxation is the result of :
A. Mental block
C. Motor block
B. Sensory block
D. Block of reflexes
_____ 50. True of nondepolarizing muscle relaxant:
A. Competetive inhibition with acetylcholine
B. Prolonged depolarization
C. Reduced sensitivity to post junctional membrane
D. Action is reversed by acetylcholinesterases
_____ 51. Last CNS structure depressed by general anesthesia is:
A. Cortical center
C. Medullary center
B. Spinal cord
D. Basal ganglion & cerebellum
_____ 52. A 16 year old healthy patient with incarcerated inguinal hernia, for inguinal
herviorhaphy the American Society of Anesthesiologists risks classification
under:
A. Class I
C. Class III
B. Class II
D. Class IV
_____ 53. Cardiovascular intolerance to changes in position after anesthesia is a sign of:
A. Insufficient depth of anesthesia
C. Excessive depth of anesthesia
B. Sufficient depth of anesthesia
D. All of above
_____ 54. Heat and cold sensations are transmitted through this type of nerve fibers:
A. C- Fibers
C. A beta fibers
B. A- Delta fibers
D. All of the above
_____ 55. Sharp cut on the skin are transmitted mostly through this type of nerve fibers:
A. C-fibers
C. A beta fibers
B. A delta fibers
D. All of the above
_____ 56. Referred pain occurs due to convergence of nerve fibers in this neurons:
A. Nociceptive specific neurons
C. Brain stem neurons
B. Wide dynamic range neurons
D. All of the above
_____ 57. Which of the following is an excitatory nerve transmitter for the pain pathway:
A. Glutamate
C. Acetylcholine
B. Serotonin
D. Norepinepherine
_____ 58. In the dorsal horn of the spinal cord, the opioid receptor are found in:
A. Lamina I
C. Lamina III
B. Lamina II
D. Lamina V
_____ 59. First order neuron are found in:
A. Dorsal horn
C. Thalamus
B. Ventral root ganglion
D. Dorsal root ganglion
_____ 60. Primary afferent fibers with fastest conduction velocity:
A. C type fiber
C. A beta fibers
A delta nerve fiber
D. D. fibers
_____ 61. Known as carrier gas:
A. Nitrous oxide
B. Oxygen
C. Carbon dioxide
D. Carbogen
C. Inhibition of phospholipase
D. All of the above
_____ 83. Mechanism of chronic pain which is often referred to as nociceptive pain.
A. Peripheral
C. Central peripheral
B. Central
D. Psychophysiologic
_____ 84. Management for central type pf pain:
A. NSAIDs
C. Aspirin
B. Opioids
D. Steroids
_____ 85. Nerve missed in doing the axillary approach in brachial plexus block
A. Axillary nerve
C. Ulnar nerve
B. Lateral rectoral nerve D. Musculo cutaneous nerve
_____ 86. Nerve blocked posterior to the medial malleolus.
A. Sural nerve
C. Superficial peroneal nerve
B. Tibial nerve
D. Saphenous nerve
_____ 87
A.
B.
C.
D.
_____ 89. The most common cause of airway obstruction is general anesthesia is:
A. Salivary secretions
C. Presence of enlarged adenoids
B. Falling back of the tongue D. Enlarged tonsils
_____ 90. Green is the standard color code for :
A. Carbon dioxide
C. Carbogen
B. Oxygen
D. Nitrous oxide
_____ 91. Elimination of general inhalation anesthetics is mainly thru:
A. Kidney
C. Blood
B. Liver
D. Lungs
_____ 92. Part of the anesthesia machine that releases gas to the atmosphere.
A. Vaporizer
C. Pop-off value
B. Pressure reducing value
D. Flow meter
_____ 93. A patient with severe systemic disease that is a constant threat to life, will have
a physical status classification.
A. ASA I
C. ASA III
B. ASA II
D. ASA IV
_____ 94. Lowest intensity at which a given stimulus is perceived as painful.
A. Pain tolerance
C. Pain suffering
B. Pain threshold
D. All of the above
_____ 95. One of the following is an example of acute pain.
A. Arthralgia
C. Headache
B. Low back pain
D. Post-operative pain
_____ 96. This gas is known as a Laughing Gas
A. Carbon dioxide
C. Nitrous oxide
B. Ethylene
D. Oxygen
_____ 97. Type of ventilation used for apneic patient.
A. Spontaneous ventilation
C. Assisted ventilation
B. Controlled ventilation
Which of the following layers of the retina does not terminate at the optic disc
margin:
A. Retinal pigment epithelium
B. Nerve fiber layer
C. Ganglion cell layer
D. Layer of rods and cones
23-24
35
The orbital space formed by the recti muscles and their intermuscular membrane
with the Tenons capsule:
A. Central surgical space
B. Subperiosteal space
C. Episcleral space
D. Peripheral surgical space
36
The condensation of fibrous tissues that thickens to form a sling (hammock) upon
which the globe rests:
A. Whitnalls ligament
B. Check ligament
C. Ligament of Lockwood
D. Annulus of Zinn
39
Which of the following does not pass thru the Superior orbital fissure:
A. Abducens
B. Trochlear
C. Oculomotor
D. Optic nerve
37
40
10
46
20
21
211-212
Vessels most numerous at the limbus and fade toward
Vessels constrict with a drop of 1:1,000 epinephrine
Associate with keratitis, iridocyclitis, and angle closure
Cornea cloudy, pupils distorted, vision reduced
22
Marked enlargement of the optic disk is rarely seen, but its occurrence
suggests:
A.
myopia
B.
posterior staphyloma
C.
both
D.
neither
33
34
35
369
Cataract
Leukoma
Nebula
None of the above
353
cells of the inner nuclear
cells of the outer nuclear
photoreceptors
ganglion cells
As it courses through the orbit, the optic nerve derives its blood supply from the:
352
A.
pial vessels
B.
arachnoid vessels
C.
vessels of the dura
D.
d. central retinal artery
36
The center of the visual field corresponds to visual perception from the
295
following anatomic structure:
A. the optic nerve
B. the fovea
C. the ora serrata
D. none of the above
C
531
353-354
37
A.
B.
C.
D.
Mass lesions of the pituitary gland classically produce the following field pattern:
quadrantic hemianopsia
binasal hemianopsia
bitemporal hemianopsia
centrocecal scotoma
A
38
To enable stereoscopic vision, the visual fibers are so arranged that fibers over
66-67
the nasal retina decussate while temporal fibers continue ipsilaterally to their
corresponding lateral geniculate body. The crossover of fibers occur at the:
A. optic chiasm
B. orbit
C. cannaliculus
D. none of the above
39
Despite the seemingly horrendous appearance of the optic disc in acute
papilledema, vision remains fairly good and the only deficit in the visual field is a:
A. cecocentral scotoma
B. enlarged blind spot
C. bitemporal hemianopsia
D. central scotoma
357
41
364
42
360
50
True of pinguecula:
A. benign degenerative tissue
B. tumor of the eyelids
C. more common in the young
D. all of the above
214
51
True of symblepharon:
215
A. chief cause is chemical burn
B. keratitis occurs because of exposure
C. obliterate conjunctival cul-de-sac
D. all of the above
74
Iris
Ciliary body
Retina
Choroid
75
Structure that regulates the amount of light reaching the visual receptors
20
of the eye:
A.
Cornea
B.
Aqueous
C.
Vitreous
D.
Iris
76
The embryologic tertiary vitreous is known as what structure in the adult eye:
72
A.
Ora
serrata
B.
Vitreou
s body
C.
Zonules
D.
None of
the above
90
Portion of the Tenon capsule that forma a sling upon which the globe rests:
39
A.
ligament of lackwood
B.
lower tendon of zinn
C.
whitnalls ligament
D.
check ligament
OPHTHALMOLOGY QUESTIONS
Conjunctivitis
1. The type of conjunctivitis characterized by a localized whitish nodule with a necrotic
excavated center surrounded by conjunctival injection:
a. epidemic keratoconjunctivitis
b. corneal ulcer
c. phlyctenular conjunctivitis (Espiritu etal, p. 54)
d. vernal conjunctivitis
Cataract
2. The virus that can cause congenital cataract:
a. adenovirus
b. picornavirus
c. rubella (Newell, p. 377)
d. rubeola
Glaucoma
3. Carbonic anhydrase inhibitors are given as a treatment for glaucoma. Its mechanism of
action is:
a. to increase the aqueous humor outflow facility
b. to decrease aqueous humor production (Espiritu, p. 101)
c. to decrease production of aqueous and enhance its exit
d. to increase aqueous humor production
Cornea
4. While cutting grass in his garden, a 50-year old male felt a small piece enter his left eye.
He experienced foreign body sensation and eye redness. No consult was done and no
medications were instilled. A few days later, he noted a fluffy, grayish white elevation on
the center of his eye. Blurring of vision was also noted. Which of the following
medications is contraindicated?
a. atropine sulfate
b. 5% natamycin
c. corticosteroids (Newell, p. 249)
d. amphotericin B
5. Softening of the cornea associated with malnourishment:
a. keratoconus
b. keratomalacia (Espiritu etal, p. 60)
c. Moorens ulcer
d. Staphyloma
Retina
6. An ophthalmic emergency characterized by sudden blurring or complete loss of vision
with a characteristic cherry-red spot on funduscopy:
a. central retinal vein occlusion
b. branched retinal artery occlusion
c. branched retinal vein occlusion
d. central retinal artery occlusion (Espiritu, p. 88)
7. A 45-year old female suddenly experienced blurring of vision, with a sensation of a
curtain in a part of the field of vision. The primary consideration in this patient is:
a. diabetic retinopathy
b. retinal detachment (Espiritu, p. 92)
c. central serous chorio-retinopathy
d. hypertensive retinopathy
8. A 2-year-old boy was brought in for consultation because the mother noted a white
pupil. Which of the following is NOT a differential diagnosis for this case?
a. congenital glaucoma (Newell, p. 326)
b. retrolental fibroplasias
c. persistent hyperplastic primary vitreous
d. toxocariasis
9. Which of the following is responsible for scotopic vision or dim illumination:
a. rods only (Espiritu, p. 86)
b. cones only
c. both A & B
d. none of the above
Systemic Ophthalmology
10. The ocular lesion in congenital toxoplasmosis is characterized as:
a.
b.
c.
d.
Lacrimal apparatus
11. A 45-year-old male presents with a painless mass on the upper outer portion of his upper
eyelid. There was moderate proptosis. Which is true of his condition?
a. It is the second most common epithelial tumor of the lacrimal gland
b. It has the worst prognosis
c. It contains mesenchymal elements and double-layered tubular epithelial units
(Newell, p. 263)
d. It is composed of aggregates of small undifferentiated neoplastic cells separated
by small and large cystoid spaces with mucin
Eyelids
12. A chronic inflammatory lipogranuloma of a meibomian gland, characterized by a gradual
painless swelling of the gland without other external signs of inflammation:
a. external hordeolum
b. chalazion (Newell, p. 204)
c. meibomianitis
d. internal hordeolum
13. The palpebral fissure among Filipinos measures:
a. 8-12 mm in height and 25-29 mm in length
b. 9-12 mm in height and 26-29 mm in length
c. 8-10 mm in height and 25-29 mm in length
d. 8-10 mm in height and 26-29 mm in length ( Espiritu, p. 9)
Neuro-ophthalmology
14. Passive swelling of the optic nerve occurring secondary to increased pressure in the
subarachnoid space of the meningeal coverings of the brain and optic nerves:
a. papilledema (Newell, p. 357)
b. pseudo-papilledema
c. drusen
d. optic neuritis