1 Venous be used to determine acid base disorder
04 pH units LOWER THAN
based on this principle
- Venous pH is 0.02-0.04 pH units LOWER THAN
arterial pH
- Venous pCO2 is 2-3 mEq/L higher than arterial
pCO2
- Venous pH is 0.04-0.06 pH units LOWER THAN
arterial pH
- Venous HCO3 is 6-8 mmHg HIGHER THAN the
arterial HCO3
- Venous pCO2 is 8-10 mmHg HIGHER THAN the
arterial pCO2
2 The following statements regarding neutrophils are
correct except:
- It is the group of cells that are first to enter the
wound site
- Its primary roles are phagocytosis of bacteria
and it facilitates collagen deposition
- Presence of bacterial products in the wound
stimulate neutrophil migration
- It releases proteases such as collagenases
- A source of TNFa3
3 The following is/are an absolute contraindications in
ABG sampling EXCEPT:
- Impaired coagulation
- Active Raynaud’s Phenomenon
- Severe peripheral vascular disease of the artery
selected for sampling
- Inadequate collateral circulation at puncture site
- Local infection or distorted anatomy at puncture
site
4 The following signs and symptoms of extremity
compartment syndrome, except:
- Tremor
- Decreased capillary refill
- Pain
- Paresthesia
5 The following statements regarding rehab are
correct, except:
- Patients who are unable to actively participate
should have passive range of motion done at
least twice a day
- Physical occupational therapy is mandatory to
prevent functional loss
- Venous pH is 0.02-0.
arterial pH
- Venous HCO3 is 2-3 mEq/L HIGHER THAN arterial
HCO3
- Venous pCO2 is 6-8 mmHg HIGHER THAN the
arterial pCO2
p272 Schwartz’ 11th edition
- PMNs – first infiltrating cells, peaking at 24-48h
- Phagocytosis of bacteria and tissue debris
- Major source of TNF-a3 (influences collagen
synthesis and angiogenesis)
- Release proteases such as collagenases
- Do not have a role in collagen deposition or
acquisition of mechanical wound strength
Additional Absolute Contraindication:
- AVF
Relative contraindications:
- Anticoagulation therapy
- Liver disease
- Low platelets <50
- Compartment syndrome involves acute increase in
pressure inside a closed space  impairs blood flow
to structures within
- Pain – prominent symptom in conscious patients
o Active and passive motion in involved
compartment increases pain
- Paresthesias – numbness b/n first and second toes is
the hallmark of early compartment syndrome
- Progression to paralysis can occur
Warning signs of impending compartment syndrome:
- Paresthesias
- Pain
- Decreased capillary refill
- Progression to loss of distal pulses
P 237, 259 Schwartz’ 11th ed
- Immediate and ongoing physical and occupational
therapy is mandatory to prevent functional loss
- Passive ROM at least twice a day = includes px w/
burns over joints
o Taught exercises they can do themselves
- Foot and extremity burns – walk independently w/o
assistive devices
 - Rehabilitation is an integral part of the clinical - When px are not ambulating, they must elevate
care plan for the burn patient and should be affected extremity to minimize swelling
initiated as soon as the burn wound has been - Graft w/ postop immobilization  check graft
healed frequently so active exercise can be resumed early
- Patients should be taught exercises they can do - Tight-fitting pressure garments – provide vascular
themselves to maintain full range of motion support
- NOTA p. 260 Schwartz’ 11th ed
6 In a chest radiograph (chest x-ray), the bony
structures are
- Radiolucent
- Echolucent
- Echogenic
- Radiopaque
An 18-year-old male sustained scald burns when the lid of a tub of hot liquid he was carrying accidentally came off. He
sustained erythema and slight swelling on his face, neck and entire right upper extremity. He also has severe swelling,
bullae and blisters on his anterior chest, abdomen, and genital area. The anterior aspect of both left upper and lower
extremity were also swollen and covered with bullae and blisters. He was inextreme pain.

Vital signs: CR 112/min, RR 22/min, BP 140/85 mmHg, T: 36.7C

Body weight: 70 kg
7 How much is the estimated percentage of total body
surface area of burn in this patient?
- 12%
- 42%
- 22%
- 32%
8 How much are you going to give in the 1 st 8 hours?
- 2.5 L
- 6L
- 4.5L
- 8L
- 3.5L - Do not include first-degree burns
9 Using Parkland formula, how much fluid are you - Cleaning of soot and debris is mandatory to avoid
going to give the patient in 24 hours? confusing soiled skin with burns
- 15 L Parkland:
- 5L 1. 3-4 mL * wt * %TBSA = total requirement in 24
- 12 L hours (4 mL * 70 * 32% = 8,960~ 9L)
- 7L 2. 1st half in 8 hours (9L/2 = 4.5L)
- 9L 3. Remaining in 16 hours (4.5L=16 = 0.2815 or
10 After 8 hours, what will be your IV fluid rate? ~280 cc in the next 16 hours)
- 160 cc/hr. in the next 8 hours
- 300 cc/hr. in the next 16 hours
- 180cc/hr. in the next 24 hours
- 280 cc/hr. in the next 16 hours
- 280 cc/hr. in the next 8 hours
11 In respiratory alkalosis, the mechanism involves Respiratory alkalosis – reduces the arterial pCO2 and
- CO2 retention elevates the pH
- CO2 washout
- Both
- Neither
12 In a normal chest radiograph, the MINOR FISSURE is “Left major fissure usually begins more superiorly and
found in which level? has a slightly more vertical course than the right major
 - T8 fissure.”
- T12 “The minor fissure projects at the level of the right
- T4? fourth rib”
- NOTA? p. 626 Fundamentals of Diagnostic Radiology (2018)
13 In metabolic acidosis, compensatory response is/are Metabolic disorders
- Decrease in pCO2 Derangement Compensation
- Increase in pCO2 Alkalosis Dec HCO3 Dec PaCO2
- Increase HCO3 Acidosis Inc HCO3 Inc PaCO2
- Decrease HCO3 - Both: Rapid compensation w/in 30 minutes
- Complete w/in 12-24 hours
14 Which of the following ABG results would you most
likely see for a patient who is having a mild asthma
attack?
- pH= 7.30 PaCO2 = 49 PaO2 = 61
- pH = 7.45 PaCO2 = 42 PaO2 52
- pH = 7.47 PaCO2 = 30 PaO2 = 61
- pH = 7.41 PaCO2 = 51 PaO2 = 51
15 Distended neck veins
- ECV volume excess
- ECF volume deficit
- Both
- Neither
16 Hyperkalemia is much more common than
hypokalemia in the surgical patient: FALSE
17 An AST:ALT ratio >2 suggests which liver disorder?
- Viral hepatitis
- Hemolysis
- Alcoholic hepatitis
- Drug-induced hepatitis
18 A chest PA view of patient Y reveals a density in the
right lower lung fields creating blurring of the right
cardiac border. A chest lateral view of the same
patient shows a wedge-shaped density
superimposed on the cardiac shadow. What
pulmonary lobe is involved in this case?
- Right upper lobe
- Right middle lobe
- Right lower lobe
- NOTA
- AOTA
19 In a chest radiograph, if the distance between
medial ends of the clavicle and the central lines are
unequal, this could be due to:
- Overpenetration
- Obliquity of the patient
- Inadequate penetration
- AOTA
- NOTA

20 Hyponatremia - Occurs when there is excess extracellular water

- Diuretic use - Extracellular volume can be high, normal, or low
- Loss of water Dilutional HypoNa Depletional HypoNa
- Use of enteral feeds Excessive water intake Dec Na intake – low-
- NOTA IV excess free water sodium diet or enteral
- AOTA Post-op = inc ADH feeds
Antipsychotics GI loses – vomiting,
Tricyclic antidepressants prolonged nasogastric
ACEi suctioning, diarrhea
Renal – diuretic use or
primary renal disease
21 Which is the test of choice for evaluating most
patients of intermediate risk for coronary artery
disease?
- Pharmacologic stress testing
- Echocardiographic imaging
- Myocardial imaging
- Exercise stress testing?
22 Hypernatremia Results from:
- ECF volume excess - Loss of free water
- ECF volume deficit - Gain of sodium in excess water
- Both Can be associated w/: increased, normal, or decreased
- NOTA Extracellular volume
23 What is the first line diagnostic test for patients with For acute pericarditis: “Echocardiography is the most
constrictive pericarditis? widely used imaging technique”
- Echocardiography p. 1842 Harrison’s 20th ed
- Troponin
- ECG 12 leads
- Chest X-ray
24 A patient has been admitted at the emergency
department with the following ABG results: pH 7.24
PaCO2 29 PaO2 81 HCO3 13
- Uncompensated compensated metabolic
acidosis
- Partially compensated metabolic acidosis
- Partially compensated metabolic alkalosis
- Uncompensated compensated metabolic
alkalosis
- Fully compensated metabolic acidosis

25 Which assay is used for detecting post-infarct

ischemia?
- Myoglobin
- LDH
- CK-MB?
- Troponin
26 If enlarged, the cardiac chamber may cause
widening of the carinal angle
- Left ventricle
- Left atrium
- Right atrium
- Right ventricle
- NOTA
27 The thymus is located in which mediastinal
compartment?
- Anterior
- Posterior
- Superior
- Middle
- NOTA
28 The following parameters suggest intrinsic renal
failure except:
- Urine Cr/Plasma Cr <20
- Urine osmolarity <350
- FeNa<1
- Urine Na >40
29 Chest radiograph of a patient showing pleural fluid in
the left lung base would show loss of the normal
outlines (obliteration) of which structure/s?
- Left hemidiaphragm
- Left pulmonary vascular markings
- Right cardiac border
- NOTA
30 In a chest radiograph of posterior projection, the “On chest radiography, the trachea is seen as a
following structure/s appear/s as a vertical vertically oriented cylindrical lucency extending from
radiolucency at the midline the cricoid cartilage superiorly to the main bronchi
- Tracheal column inferiorly”
- Left mainstem bronchus p. 619 Fundamentals of Diagnostic Radiology (2018)
- Right compensated bronchus
- Gastric bubble
- NOTA
31 In a normal chest posteroanterior radiograph, the - Each hilum contains major bronchi and pulmonary
 left hilum in relation to the right hilum is vessels
- Same level - Hilar lymph nodes are not visible unless abnormal
- Higher - Left hilum is commonly higher than the right
- Lower - Chest position, size, and density of each hilum
- NOTA (source: radiologymasterclass.co.uk)
32 The thoracic vertebral bodies and intervertebral -
joint spaces are best assessed in which projection?
- Lateral
- Oblique
- Anteroposterior
- NOTA
- AOTA
33 The pulmonary lobe that is adjacent to the right
cardiac border:
- Right upper lobe
- Right lower lobe
- Right middle lobe
- NOTA

34 The following statements about managing burn Initial mgt:

patients is/are correct, except:
- Chest X-ray, if needed, can be done in the ICU to
prevent hypothermia or delay in fluid
resuscitation
- Pediatric patients with burn larger than 15% may
require intraosseous access in emergent
situations if venous access cannot be attained
- IV resuscitation is indicated in patients with
severe facial mandibular fractures with burns
<15% TBSA
- All statements are correct
- Airway mgt – anticipating need for intubation and
establishing an early airway are critical
o Orotracheal intubation – preferred
o Nasotracheal intubation – for those w/ facial
trauma
- Evaluation of other injuries
- Estimation of burn size
- Diagnosis of CO and cyanide poisoning
Concurrently w/ primary survey:
- Large-bore peripheral IV cath for resuscitation
o If TBSA larger than 40% - two large-bore IVs
o Rarely, IV resuscitation is indicated in burns
smaller than 15% who can usually hydrate orally
- Pediatric px w/ burns >15% may require
intraosseous access (IO) in emergent situations if
venous access cannot be attained
Secondary survey:
- Especially those w/ associated mechanical trauma
- Urgent radiology studies, such as chest X-ray, should
be performed in emergency department, but
nonurgent skeletal evaluation (extremity X-rays) can
be done in ICU to avoid hypothermia and delayed
resuscitation
o Wrap in clean blankets in transport to avoid
hypothermia
Management:
- Should never receive prophylactic antibiotics
- Tetanus booster must be administered
- Pain management
p. 252 Schwartz’ 11th ed
35 In this type of injury there is interruption of axonal Three types of nerve injuries:
continuity but preservation of Schwann cell basal - Neuropraxia – focal demyelination
lamina - Axonotmesis – interruption of axonal continuity but
- Diffuse axonal injury preservation of Schwann cell and basal lamina
- Neurotmesis - Neurotmesis – complete transection
- Axonotmesis p 281 Schwartz’ 11th ed
- Neurpraxia
- NOTA
36 Correct statement/s with regards to inhalation injury Inhalational Injury:
and its management: - Pneumonia – 3x higher
- Inhalation injury increases lung compliance - Increased length of stay, increased ventilator days,
leading to air trapping and need for tracheostomy
- Risk of pneumonia and ARDS are likely - ARDS is common
following inhalational injury - Causes injury in two ways: direct heat injury to URT
- The most common physiologic derangement is and inhalation of combustion product in LRT
decreased fluid requirement during resuscitation o Direct injury  airway swelling  edema (24-
because of airway edema 48h)  requires short course endotracheal
- AOTA intubation
o Combustion products (most commonly from
synthetic products found in smoke)  mucosal
injury  sloughing  edema  reactive
bronchoconstriction  obstruction
- Physiologic effects
o Decreases airway compliance and increases
airway resistance work of breathing
o Increases overall metabolic demand
o Most common derangement – increased fluid
requirement during resuscitation
p. 256 Schwartz’ 11th ed
37 Which age is screening for hypercholesterolemia Bates? IM?
should beginning? Screening for colorectal cancer: 50 years old
- 20 years old
- 40 years old
- 45 years old
- 35 years old
38 True about collagen synthesis in wound healing - Wound strength and mechanical integrity in fresh
- Collagen type III is the final matrix wound is determined by QUANTITY and quality of
- The mechanical strength of the scar is the same newly deposited collagen
as that of uninjured tissue - Deposition of matrix follows pattern:
- Glycosaminoglycans and proteoglycans o Fibronectin and collagen type III – early matrix
constitute early matrix remodeling o Glycosaminoglycans and proteoglycans – next
- Mechanical integrity in the fresh wound are o Collagen type I – final matrix
determined by quality of newly deposited - Several weeks post injury – amount of collagen
collagen reaches plateau but tensile strength increases for
- NOTA more months
- Fibril formation and fibril cross-linking – dec
collagen solubility, inc strength, and inc resistance
to enzymatic degradation
- Scar remodeling – continues (6-12) months post
injury
- Mechanical strength of scar never achieves that of
uninjured tissue
P 275 Schwartz’ 11th ed
39 Symptomatic hypernatremia usually occurs in
patients with impaired thirst or restricted access to
fluid, because thirst will result in increased water
intake: TRUE

40 The following are systemic factors that affect wound

healing, except:
- Malignancy
- Diabetes Mellitus (Metabolic disease)
- Obesity (Metabolic disease)
- Necrosis (Ischemic/necrotic tissue)
- Smoking

41 The expected change to HCO3 in acute respiratory 1, 2, 3, 4 rule:

disorders is _ units above 24 mEq for every _ units Acute respiratory alkalosis:
increase in PCO2 above the baseline - HCO3 decreases by 2 units every 10 units of
- 1,15 decrease in pCO2 from baseline of 40 mmHg
- 2,10 Chronic respiratory Acidosis
- 2,15 - HCO3 increases by 4 units from 24 mEq/L for every
- 1,10 10 units increase in pCO2 above baseline of 40
- 3,10 mmHg
Chronic respiratory Alkalosis
- HCO3 decreases by 5 units for every 10 units of
decrease in pCO2 from the baseline of 40 mmHg
Metabolic acidosis
- 1 mEq decrease HCO3 = 1.2 mmHg decrease in
PaCO2
Metabolic alkalosis
- 1 mEq increase HCO3 = 0.7 mmHg increase in PaCO2
42 Enlargement of this cardiac chamber causes fullness
of the retrosternal lucency/space of the chest in a
lateral chest radiograph
- Left atrium
- Right atrium
- Right ventricle
- Left ventricle
- NOTA
43 High anion gap is caused by---? Causes of increase anion gap metabolic acidosis
- Renal tubular acidosis - Accumulation of lactic acid (most common)
 - Pregnancy - Abnormal accumulation of keto-acids, B-
- Cushing’s Syndrome hydroxybutyric acid, and acetoacetic acid
- Diabetic ketoacidosis - Decreased excretion of endogenous acids and their
- COPD anions
- Formation of glycolic and formic acid
44 The diagnosis of anaphylaxis is based primarily on
history taking and physical examination with
confirmation provided by:
- Radioallergosorbent testing
- ImmunoCAP
- B-tryptase level
- Epicutaneous skin testing
45 It is the layer that imparts the greatest tensile “The submucosa is the layer that imparts the greatest
strength and greatest suture-binding capacity in the tensile strength and greatest suture-holding capacity”
GI “Serosal healing is essential for quickly achieving a
- Muscularis mucosa watertight seal from the luminal side of the bowel”
- Mucosa p 279 Schwartz’ 11th Ed
- Serosa
- Submucosa
- NOTA
46 What is the possible etiology of normal PT, normal
aPTT, prolonged bleeding time with normal platelet
count
- Thrombocytopenia
- Vitamin K deficiency
- Uremia
- DIC
47 What is the possible etiology of a prolonged PT,
normal aPTT, a normal bleeding time?
- Uremia
- DIC
- Vitamin K deficiency
- Thrombocytopenia

48 In a chest postero-anterior radiograph, the position

of the posterior portion of a rib is _ compared to the
anterior portion of the same rib
- Higher
- Same level
- Lower
- AOTA
- NOTA
49 In an upright chest radiograph, this it the most
dependent (lowest) area of the chest
- Cardiophrenic recess
- Costophrenic recess
- Minor fissure
- Oblique fissure
- NOTA
50 In normal chest radiograph, right hilum is __
compared to left hilum
- Lower
 - Higher
- Same level
- NOTA
51 In a normal upright chest radiograph in
posteroanterior projection, the following structures
are expected to be seen:
- Loss of outlines of left cardiac border
- Loss of outlines of the right cardiac border
- Loss of outlines of aortic knob
- Air-fluid level in the left subdiaphragmatic region
- NOTA
52 The movement of water across a cell membrane is
from the compartment of more solute to the
compartment of less solute thus equalizing the
concentrations on each side of the membrane:
FALSE
53 In case of significant lobar atelectasis, the Pleural effusion – away from side of opacified
mediastinal structures shift __ to the affected lobe hemithorax
- Toward Pneumonia – no shift
- Away from Pneumothorax
- NOTA - None – simple pneumothorax
- Both - Away – tension
- NEVER a shift towards side of pneumothorax
Clinical Correlation Thoracic Radiology (3rd yr lec)
54 True regarding management of hyperkalemia
- Protecting cells from effects of increased
potassium by giving kayexalate
- Glucose and insulin administration to shift
potassium to the ECF compartment
- Reducing total body potassium by giving Calcium
gluconate
- NOTA
- AOTA

- Albuterol (B adrenergic agonist)

- Dialysis – in severe hyperkalemia
55 Ideally, routine chest X-rays should be taken with
the patient in
- Full inspiration
- Mid inspiration
- Full inspiration
- NOTA
- AOTA
56 In lateral chest radiograph, which of the following is
not visualized?
- Diaphragm
- Heart
- Sternum
- Clavicle
- NOTA
57 What is the classic ECG finding in amyloidosis?
- Nonspecific ST and T wave abnormalities
 - Low voltage ECG
- ST segment depression
- Electrical alternans
58 What is the gold standard for evaluating epicardial “CAD is defined by the presence of atherosclerotic
coronary anatomy? plaque in the epicardial vessel, and thus has an intrinsic
- MRI anatomic basis. It is for this reason that invasive
- Coronary angiography coronary angiography (ICA) has remained the gold
- Cardiac CT standard upon which other diagnostic tests are
- Myocardial perfusion imaging measured.” -google
59 At any age, a paO2 of <40 mmHg indicates severe Room air, patient <60 yo
hypoxemia: TRUE Mild hypoxemia paO2 <80 mmHg
Moderate hypoxemia paO2 <60 mmHg
Severe hypoxemia paO2 <40 mmHg
For each year >60, subtract 1 mmHg for limits of mild
and moderate hypoxemia
60 In assessing the internal consistency of values using
Henderson-Hasselbach equation, when the pH is at
7.35, the approximate H should be:
- 35
- 45
- 50
- 30

61 The most common and widely used imaging

modality for the thorax
- Radiography
- Ultrasonography
- CT
- Angiography
62 Which of the following approach utilizes arterial pH, Coppenhagen Approach:
pCO2, HCO3, anion gap and compensation rules? - Utilizes arterial pH, pCO2 and base excess
- Boston approach Stewart Approach
- Coppenhagen Approach - Utilizes arterial pH, pCO2, calculated strong ion
- Stewart Approach difference (SID), total weak acids and strong ion gap
(SIG)
63 The following factor/s differentiate keloids from Both:
hypertrophic scars: - Represent abundance of fibroplasia in dermal
- Demonstrate increased thickness of the healing presence
epidermis with an absence of rete ridges - Occurs after trauma to skin
- Occurs after surgery - Demonstrate thickness of epidermis with absence of
- An over-abundance of fibroplasia in the dermal rete ridges
healing process - Abundance of collagen and glycoprotein deposition
- NOTA
- AOTA
64 Factors that contributes to formation of diabetic Major contributors to formation:
ulcers except - Neuropathy – secondary to persistently elevated
- Neuropathy glucose levels
- Hyperglycemia???? - Foot deformity
- Foot deformity - Ischemia
- Ischemia p 291 Schwartz’ 11th ed
- All choices are contribution factors
65 Activities of macrophage in wound healing
- Phagocytosis
- Cell recruitment and activation
- Debridement
- AOTA
66 The following ABG results were obtained on a 28-
year-old, female patient pH 7.28 PaCO2 22 HCO3 12
BE-13 PaO2. Her ABG results indicate which of the
following?
- Acute metabolic alkalosis
- Partially compensated metabolic acidosis
- Partially compensated respiratory alkalosis
- Acute respiratory acidosis

67 Arterial blood gas measures the following, EXCEPT: An ABG measures:

- Bicarbonate (HCO3) concentration in arterial - Oxygen tension (PaO2)
blood - Carbon dioxide tension (PaCO2)
- Carbon dioxide tension (PaCO2) - Acidity (pH)
- Acidity (pH) - Oxyhemoglobin saturation (SaO2)
- Oxyhemoglobin saturation (SaO2) - Bicarbonate (HCO3) concentration in arterial blood
- NOTA
68 Complete for Anion gap Na 139 mmol/L K 4 mmol/L =Na – (Cl+HCO3)
Cl 103 mmol/L HCO3 26 mmol/L =139 – (103+26)
- 9 =139 – 129
- 13 =10
- 10 Normal: 8-16 mEq/L (12 mEq/L)
- 12
- 11
69 In a lateral chest radiograph, the area overlying the
cardiac shadow corresponds to which pulmonary
lobe?
- Left hilum
- Right upper lobe
- Right middle lobe
- Right lower lobe
- Right hilum
70 Patient Ys radiograph shows 1 cm round opacity
overlying second anterior rib on the left. The
opacity’s location in relation to the first anterior rib
also in the left is:
- Lower (caudad)
- Higher (cephalad)
- Same level
- NOTA
71 In a recumbent/supine position, the width of the
vascular pedicle is
- Unchanged
- Widened?
- Narrowed
- NOTA
72 The idea on continuous IV fluid resuscitation in burn Concept behind continuous fluid requirements:
patients after an IV fluid bolus is that - The burn (and/or inhalation injury) drives an
- Burn patients should not have an oral intake inflammatory response  capillary leak
during the first 8 hours - Plasma leak in extravascular space  crystalloid
- To provide electrolytes and nutrients while the administration
body in a hypercatabolic state - If patient has received large fluid bolus, fluid has
 - It will dispel the heat the body absorbed from likely leaked into interstitium – px still requires
the burns ongoing burn resuscitation
- The fluid the patient receives in a prehospital Children under 20 kg – additional requirement since
setting or emergency department has likely they do not have sufficient glycogen stores
leaked into the interstitial space and the patient - Weight-based maintenance IV fluid with glucose
still requires ongoing burn resuscitation supplementation + calculated resuscitation w/
- NOTA lactated Ringer’s
Continuation of fluid volume should depend on:
- Time since injury
- Urine output
- MAP
p. 254 Schwartz’ 11th ed
73 What is the lowest acceptable pO2 at room air for a If age is <60 years old:
70-year-old? Desired PaO2 = 104-(0.43xage)
- 60 mmHg
- 65 mmHg If age is >=60:
- 70 mmHg Desired PaO2 = 80-(age-60)
- 75 mmHg
- 80 mmHg =80-(75-60) = 80-15 = 65
74 The following ABG results obtained on a 54-year-old
female patient that is breathing room air pH 7.30
PaCO2 57 PaO2 61 HCO3 24. Which of the following
best describes the given results?
- Acute uncompensated respiratory acidosis with
mild hypoxemia
- Normal blood gas with mild hypoxemia
- Acute respiratory alkalosis with mild hypoxemia
- Fully compensated metabolic acidosis with mild
hypoxemia

75 Common complication for ABG sampling: Less common:

- Local pain, local nerve injury, vasovagal response - Vasovagal response
- Local minor bleeding, local nerve injury, infection - Local hematoma from moderate or major bleeding
at the puncture site Rare
- Local paresthesia, bruising, local minor bleeding - Infection at the puncture site
- Local pain, local nerve injury, local minor - Arterial occlusion from a local hematoma
bleeding - Air or thrombus embolism
- Local minor bleeding, bruising, vasovagal - Local anesthetic anaphylactic reaction
response - Local nerve injury
- Needle stick injury to health care personnel (limited
due to use of ABG kits)
- Pseudoaneurysm formation
76 In patients with asthma, which is a sign of impending
respiratory failure?
- Increased PaCO2
- Increased pH
- Decreased HCO3
- Decreased pO2
77 Cardiac chamber that forms the radiographic apex
- Left ventricle
- Right ventricle
- Right atrium
- Left atrium
 - AOTA
78 Which level of serum BNP is consistent with heart IM?
failure?
- 50-200
- <50
- >400
- 200-400
79 R waves in V1 and V2 in an ECG 12-leads may
represent
- Inferior wall MI
- Lateral wall MI
- Septal wall MI
- Posterior wall MI
80 The following statements is/are ABG collection Collection pH pCO2 pO2
errors that will affect paO2, EXCEPT Error
- Venous admixture Dilution w/ Inc Dec No
- Failure to cool down blood heparin change
- Air contamination Air Inc Dec Inc
- Dilution with heparin contamination
- NOTA Venous Dec Inc Dec
admixture
Failure to cool Dec Inc Dec
blood
81 What is the gold standard test for diagnosis of “The gold standard for diagnosis of OSA is attended
obstructive sleep apnea-hypopnea syndrome? polysomnography (level I study)” – google
- MRI
- Polysomnography
- Electroencephalogram
- Epworth sleepiness scale
82 True about insensible water loss, except: Sensible water losses:
- Increased by such factors as hypermetabolism - Sweating, urination, pathologic loss of GI fluids,
- Profuse sweating is the most common cause wound drainage
- About 25% occur through the lungs Insensible water loss: both skin (75%) and lungs (25%)
- About 75% occur through the skin - Can be increased by fever, hypermetabolism, and
- AOTA hyperventilation
83 What ECG finding is suggestive of cardiac
tamponade?
- Brady-Tachy syndrome
- Electric alternans
- ST and T wave abnormalities
- Peaked T waves
84 In chest normal radiograph, the right
hemidiaphragm is _ compared to the left diaphragm
- Higher
- Lower
- Same level
- NOTA

Clinical Correlation Thoracic Radiology (3rd yr lec)

85 In a chest radiograph at posteroanterior projection,
 which structure/s is NOT normally visible
- Breast (female)
- Scapulae
- Trachea
- Sternum
- NOTA?
86 The normal retrosternal airspace is best seen in
which projection?
- Oblique
- Posteroanterior
- Lateral
- NOTA
87 Acidosis will have this picture
- Increase in H, increase in pCO2, decrease in
HCO3, decrease in pH
- Increase in H, increase in pCO2, increase in
HCO3, Decrease in pH
- Increase in H, decrease in pCO2, decrease in
HCO3, decrease in Ph
- Decrease in H, decrease in PCO2, increase in
HCO3, increase in pH
- Decrease in H, increase in pCO2, increase in
HCo3, decrease in pH
88 Clinical condition where the visceral pleura is seen
separate from parietal pleura of the chest
- Atelectasis
- Pneumothorax
- Pleural effusion
- Pneumonia
- NOTA

89 How should type II DM patients screen for Type I DM – when they have had DM for longer than 5
microalbuminuria years
- When they had DM for 3 years How to screen?
- At the time of the diagnosis of type II DM - Annual urine spot albumin-to-creatinine ratio
- 1 year after the time of diagnosis - Microalbuminuria: 30-299 ug albumin/mg creatinine
- When they have had DM for longer than 10 and must be confirmed on repeated examinations
years - Clinical albuminuria >=300 ug albumin/mg
creatinine
90 This indicates that a radiograph was taken with the
patient in an upright position:
- Tracheal air column is midline
- Scapula drawn to the sides
- Gastric air-fluid level
- NOTA
91 The most common and widely used imaging
modality for the thorax
- NOTA
 - Radiography
- Ultrasonography
- CT
- Angiography
92 Most common ECG abnormality/ies in patients with
hypertrophic cardiomyopathy?
- Biventricular cardiomegaly
- LV hypertrophy
- ST and T wave abnormalities
- RV hypertrophy
93 Which of the following ABG indices is NOT directly
measured?
- HCO3
- pCO2
- pH
- pO2
94 A 60 year old female patient has been admitted to
the emergency department following results pH
7.48, pCO2 41, paO2 98, HCO3 52
- Metabolic acidosis
- Metabolic acidosis
- Respiratory alkalosis
- Metabolic alkalosis
95 Long-standing non-healing ulcers that undergo “Any wound that does not heal for a prolonged period
malignant transformation of time is prone to malignant transformation”
- Venous stasis - Malignant wound – has overturned wound edges
- Marjolins ulcer - Biopsy of wound edges must be performed to rule
- Chronic ulcer out malignancy
- Carcinoma in situ ulcer p 290 Schwartz’ 11th ed
- Venous stasis
96 Routine sampling should, initially, be attempted Radial, brachial, axillary, dorsalis pedis: 30-40-degree
from: angle
- Axillary artery of the non-dominant arm Femoral artery: 90-degree angle
- Radial artery of the non-dominant arm
- Brachial artery of the non-dominant arm
- Femoral artery of the non-dominant arm
- Dorsalis pedis artery of the non-dominant arm
97 The following are the correct sequence in the Predictable pattern of changes involving 3 crucial steps:
healing of nerve injuries (Letter C)
- Hemostasis, migration and connection of Phagocytes – remove degenerating axons and myelin
regenerating nerve ends to appropriate nerve sheath from distal stump (Wallerian degeneration)
ends, survival of axonal bodies p. 281 Schwartz’ 11th ed
- Survival of axonal bodies, hemostasis, migration
and connection of regenerating nerve ends to
appropriate nerve ends
- Survival of axonal cell bodies, regeneration of
axons that grow across the transected nerve,
migration, and connection of the regenerating
nerve ends to appropriate organ targets
- Regeneration of axons that grow across the
transected nerve, survival of axonal cell bodies,
migration, and connection of regenerating nerve
ends to appropriate nerve ends
98 Normal basic densities found in radiographic imaging
of the thorax are the following EXCEPT
- Bone
- Metal
- Air
- Water
- NOTA
99 Causes of normal anion gap hyperchloremic Causes:
metabolic acidosis is/are - Diarrhea
- Diarrhea - Pancreatic, intestinal, biliary fistulas
- Intestinal fistula - Renal tubular acidosis
- Hypoaldosteronism - Ammonium chloride (NH4Cl) ingestion
- AOTA - Adrenal insufficiency (hypoaldosteronism)
- NOTA
100 In a lateral chest radiograph, the vertical lucent
structure seen in the superior mediastinum
posterosuperior to the cardiac shadow is:
- Gastric bubble
- Tracheal air column
- Right hemidiaphragm
- NOTA
- Left hemidiaphragm
101 What are the indications for ABG sampling? Indications:
- Detection and quantification of the levels of - Identification and monitoring of acid-base
abnormal hemoglobins disturbances
- Identification and monitoring of acid-base - Measurement (PaO2) and (PaCO2)
disturbances - Assessment of the response to therapeutic
- Procurement of a blood sample in an acute interventions
emergency setting when venous sampling is not - Detection and quantification of the levels of
feasible abnormal hemoglobins
- NOTA - Procurement of blood sample in an acute
- AOTA emergency setting when venous sampling is not
feasible
102 The following are the benefits of administering “Bicarbonate treats the underlying acidosis and
bicarbonate in managing electrical burn injury alkalinizes the urine, making myoglobin more soluble.”
- It alkalinizes the urine
- It makes the myoglobin more soluble emedicine.medscape.com
- It corrects underlying acidosis
- AOTA
- NOTA
103 Pathologic GI losses
- Hypokalemia
- Both ECF volume excess and Hypokalemia
- ECF volume deficit
- ECF volume excess

104 Cardiac chamber that is nearest to the sternum

- Left atrium
- Left ventricle
 - Right ventricle
- Right atrium
105 The heart is located in which mediastinal
compartment?
- Middle
- Posterior
- Anterior
- NOTA
106 The cardiac chamber which forms the right border of
the cardiac shadow
- RV
- LA
- RA
- LV
- NOTA
107 The portion of a chest radiograph that shows the
greatest and therefore shows clear borders
- Lung-stomach interface
- Lung-soft tissue interface
- Bone-soft tissue interface
- Bone-lung interface
- AOTA
108 The term that describes structures in the body that
provide the greatest attenuation of x-ray beams and
are therefore white appearing structures seen
- Echolucent
- NOTA
- AOTA
- Radioopaque
- Radiolucent
109 The following are contraindications to stress testing,
EXCEPT
- Cardiac arrhythmia causing hemodynamic
compromise
- Asymptomatic heart failure
- Pericarditis
- Acute MI within 2 days
110 Which ABG collection errors will falsely elevate the Collection pH pCO2 pO2
pH? Error
- Failure to cool down blood and venous Dilution w/ Inc Dec No
admixture heparin change
- Venous admixture and air contamination Air Inc Dec Inc
- Failure to cool down blood and air contamination
contamination Venous Dec Inc Dec
- Venous admixture and dilution with heparin admixture
- Dilution with heparin and air contamination Failure to cool Dec Inc Dec
blood
111 In a chest radiograph, the cardiac shadow is the least
magnified in which projection?
- Postero-anterior projection
- Anteroposterior projection
- Lateral projection
 - Oblique projection
- NOTA
112 The cardiac chamber that is most adjacent to the
carina
- LV
- RV
- RA
- LA
- NOTA
113 To clear products of metabolism, the kidneys excrete Kidneys must excrete a minimum of 500-800 mL of
urine depending on the amount of oral intake: False urine per day, regardless of the amount of oral intake
114 Which condition is described as painful, diffusely
enlarged thyroid with decreased radioiodine uptake?
- Subacute thyroiditis
- Hashimoto thyroiditis
- Toxic adenoma
- Multinodular toxic goiter