2nd Sem, SY: 23-24

BATCH HARINAWA
Quizzes

Surgery

PRELIMS

Quiz 1

1. Treatment of Thyroid Storm:

A.Methimazole
B. Lugol’s Solution
C. All of the above
D. Esmolol

2. True about post-operative infection.

a. Gas gangrene is common but life-threatening.
b. Infectious complications is main cause of post-operative morbidity in abdominal surgery.
c. Abscesses may also be managed by antibiotics or observation for two weeks.
d. Wound sinus is an early infectious complication from a superficial acute abscess that
can occur after apparently normal healing.

3. True regarding thyroidectomy complications.

a. Completion thyroidectomy has lower rate of complications.
b. RLN injury is best prevented by identifying the RLN intraoperatively.
c. Permanent hypocalcemia is common.
d. Control of heart rate prevents bleeding.

4. Treatment of urinary problems post-operatively:

a. None of the above
b. All of the above
c. Increase Fluid Intake.
d. Antibiotics and analgesia.

5. True regarding Aspiration pneumonitis.

a. Requires treatment with bronchial suction, positive pressure. Ventilation after 2
weeks of onset.
 b. Prophylactic antibiotics are not warranted.
c. Mortality is less than 10%.
d. Non-starved patient undergoing emergency surgery is at risk.

6. Which of the following may be helpful in diagnosing Ileus?

a. MRI
b. Physical Examination
c. Ultrasound
d. Culture and sensitivity tests
7. The following are the factors which may affect healing rate except:
a. Severe connective tissue diseases
b. Bleeding Diathesis
c. Malnutrition and vitamin deficiency
d. Immunosuppressive therapy

8. Most common complication of thyroid surgery:

a. Tracheal Injury
b. Superior Laryngeal Nerve Injury
c. Hypokalemia
d. Bleeding
9. Manifestations of thyroid storm, except:
a. Dysrhythmias
b. Hyperpyrexia
c. CHF
d. HR < 90
10. Initial management of Wound Dehiscence:

a. Opiate analgesia
b. Wound GSCS
c. TPN
d. CT Scan
QUIZ 2 SURGICAL CRITICAL CARE

1. A 92-year-old patient was admitted to the surgical intensive care unit after urgent
laparotomy for perforated right colon cancer with fecal peritonitis. She is intubated and
mechanically ventilated. Her family reports that the last time she was in the intensive
care unit, she developed severe delirium. Which of the following intravenous infusions
for endotracheal tube tolerance has the lowest risk of delirium?
a. Lorazepam
b. Dexmedetomidine
c. Ketamine
d. Midazolam
e. Propofol
2. The most precise single predictor of operative mortality at 30 days in patients with liver
cirrhosis is the:
a. Child-Pugh class
b. American Society of Anesthesiologists (ASA) score
c. Model of End-Stage Liver Disease (MELD) score
d. Frailty index
e. Acute Physiology and Chronic Health Evaluation IV (APACHE IV) score
3. In patients with severe traumatic brain injury, venous thromboembolus (VTE) prophylaxis
with low molecular weight heparin compared with unfractionated heparin results in
a. decreased VTE rate.
b. decreased bleeding complications.
c. increased unplanned returns to operating room.
d. increased mortality.
e. increased incidence of heparin-induced thrombo-cytopenia.
4. Which of the following most accurately describes the use of proton pump inhibitors
(PPIs) as compared to H2 antagonists in prevention and treatment among the critically
ill?
a. PPIs are superior to H2 antagonists for routine prophylaxis in the ICU.
b. None of the choices is true.
c. PPIs are superior to H2 antagonists when prescribed in all patients receiving
steroid therapy.
d. PPIs are superior to H2 antagonists for the prevention of rebleeding in
stress-related mucosal injury in the critically ill.
e. PPIs should be prescribed routinely in all patients admitted to the ICU with
nothing-by-mouth status.
5. A 10-year-old child has third-degree burns over 30% of the body. Changes in which
nutritional component are most important for this patient?
a. Vitamin A
b. Immunonutrition
c. Carbohydrates
d. Essential fatty acids
e. Protein
6. In an agitated patient who refuses to lay down,
a. None of the choices.
b. assessment of airway adequacy may include suctioning.
c. patient restraints are needed.
d. intoxication should be assumed.
e. sedation is indicated.
7. Which of the following statements is true for enteral nutrition in the critically ill patient?
a. The routine use of probiotics improves patient survival.
b. Growth hormone supplementation increases survival in ventilated patients.
c. Total protein intake should be 2 to 2.5 g/kg of ideal body weight per day.
d. Total caloric intake for the obese patient is 25 to 30 kCal/kg.
e. Postpyloric feedings result in decreased mortality compared with gastric
feedings.
8. What RASS score would you give a patient that has been in a persistent vegetative
state?
Eyes open and roll about
Eyes don’t move to your voice and no eye contact
Normal wake sleep cycle
a. -5
b. -3
c. -4
d. -2
e. 0
9. A 65-year-old woman (BMI 24) is admitted to the ICU following complications after her
pancreaticoduodenctomy. She has not had significant nutritional intake in 10 days. A CT
guided drain was placed and she was resuscitated with fluids over 12 hours. She is now
hemodynamically normal and off pressors. What would be the most reasonable caloric
and protein goal?
a. 20 kcal/kg/day and 0.5 g protein/kg/day
b. 18 kcal/kg/day and 0.5 g protein/kg/day
c. 25 kcal/kg/day and 1.5 g protein/kg/day
d. 35 kcal/kg/day and 2.5 g protein/kg/day
e. 15 kcal/kg/day and 2.5 g protein/kg/day
10. Noninvasive ventilation is indicated as an alternative to mechanical ventilation in
postoperative patients with:
a. upper airway obstruction.
b. hemodynamic instability.
c. unstable cardiac arrhythmias.
d. severe encephalopathy.
e. hypoxic respiratory failure.