MCQS

All of the following are true about neurogenic shock

except:
A. There is a decrease in systemic vascular resistance and
an increase in venous capacitance.
B. Tachycardia or bradycardia may be observed, along
with hypotension.
C. The use of an alpha agonist such as phenylephrine is
the mainstay of treatment.
D. Severe head injury, spinal cord injury, and high spinal
anesthesia may all cause neurogenic shock.

All of the following statements about hemorrhagic shock are
true except:
A. Following hemorrhagic shock, there is an initial interstitial fluid
volume contraction.
B. Dopamine, or a similar inotropic agent, should be given
immediately for resuscitation from hemorrhagic shock, to increase
cardiac output and improve oxygen delivery to hypoperfused
tissues.
C. The use of colloid solutions or hypertonic saline solutions is
contraindicated for treatment of hemorrhagic shock.
D. In hemorrhagic shock, a narrowed pulse pressure is commonly
seen before a fall in systolic blood pressure.
3. All of the following are components of
the MEN type 2B syndrome except:
A. Multiple neuromas on the lips, tongue,
and oral mucosa.
B. Hyperparathyroidism.
C. MTC.
D. Pheochromocytoma.
4.Hyperparathyroidism can affect which of the
following organs and body systems?
A. Gastrointestinal tract.
B. Kidneys.
C. Skeleton.
D. Neuromuscular system.
E. Cardiovascular system.
F. All of the above
5. Hyperthyroidism can be caused by all
of the following except:
A. Graves' disease.
B. Plummer's disease.
C. Acute thyroiditis.
D. Hashimoto's disease.
E. Medullary carcinoma of the thyroid.
.Radioactive iodine is effective
treatment for metastatic lung disease
for which of the following thyroid
neoplasms?
a) Papillary carcinoma
b) Follicular carcinoma
c) Medullary carcinoma
d) Anaplastic carcinoma
7. A 50-year-old male has undergone an ipsilateral
thyroid lobectomy and isthmus resection for what
appeared on frozen section to be a benign nodular
lesion 2.0 cm in diameter. Seventy-two hours later the
final pathology returns and the diagnosis is a high-
grade angioinvasive follicular carcinoma. What do
you recommend?

a) 99mTc bone scan to rule out occult bone metastases
b) Ipsilateral radical neck dissection
c) Total thyroidectomy
d) Observation with sequential 131I scans every 3 months
8. Nasotracheal intubation:
A. Is preferred for the unconscious patient
without cervical spine injury.
B. Is preferred for patients with suspected
cervical spine injury.
C. Maximizes neck manipulation.
D. Is contraindicated in the patient who is
breathing spontaneously.
9. Which of the following statements about
head injuries is/are false?
A. The majority of deaths from auto accidents are
due to head injuries.
B. Head injury alone often produces shock.
C. A rapid and complete neurologic examination
is part of the initial evaluation of the trauma
patient.
D. Optimizing arterial oxygenation is part of
initial therapy.
10. Which of the following statements or descriptions typically
characterizes the syndrome of overwhelming postsplenectomy
sepsis?
A. A syndrome of fulminant gram-negative bacteremia and septicemia
in asplenic individuals, characterized by the presence of as many as 10
6 bacterial organisms per cu. mm. circulating in the bloodstream.
B. A syndrome caused primarily by impaired host ability to mount an
effective humoral (immunoglobulin) response to infection.
C. A syndrome that occurs in 5% to 7% of patients following
traumatic splenectomy.
D. A syndrome of rapidly appearing septic shock unresponsive to
antibiotic therapy, with an average mortality of 50%.
E. The syndrome may be prevented by preserving as little as 15% of
splenic mass in adult trauma victims.
11. An untreated or an unrecognized compartment
syndrome produces nerve and muscle damage and
prevents good functional recovery despite the patency
of vascular repair. Which of the following factors
suggests the need for a fasciotomy?

a) A period of 6 hours or more between injury and restoration of
perfusion
b) Combined arterial and venous injuries
c) Postoperative signs of muscle pain or pain on passive stretch
d) Elevated compartment pressures
12. A middle-aged man is undergoing laparotomy for blunt
abdominal trauma. The spleen and liver are both found to be
injured. Which of the following statement(s) is/are true concerning
the management of these injuries?

a) If the patient has multiple other abdominal injuries and hypotension,
splenic salvage should not be attempted
b) The incidence of life-threatening sepsis in the adult following
splenectomy is no greater than in the normal population
c) All liver injuries regardless of their depth require external drainage
d) The Pringle maneuver should control all bleeding from hepatic
parenchymal vessels
e) If concern for a biliary fistula from the liver parenchyma exists, a T-tube
should be placed even if the common bile duct is otherwise normal
13. There are a number of injuries associated with
common orthopedic injuries. Which of the following
diagnosed orthopedic injuries is associated with the
injury listed?
a) Sternal fracturecardiac contusionb.
b) Posterior dislocation of the kneepopliteal artery
thrombosis.
c) Pelvic fractureruptured bladder or urethral
transection.
d) Posterior dislocation of hip-sciatic nerve injury.
14. The most common hernia in females
is:
A. Femoral hernia.
B. Direct inguinal hernia.
C. Indirect inguinal hernia.
D. Obturator hernia.
E. Umbilical hernia.

15. In advising a patient preoperatively of potential
complications of operative treatment of an inguinal
hernia, which of the following statement(s) is/are true?
a) Severe symptoms due to sensory nerve entrapment or
injury can occur
b) The most common vascular structure injured during the
course of a groin hernia repair is the femoral artery
c) Recurrent hernia after primary groin repair should occur
in less than 10% of cases
d) Wound infection increases the risk of recurrent hernia