Los principios específicos de la Administración

1. The following statements are true EXCEPT

a. Pleomorphic adenomas have a very small risk of malignant transformation.

b. Warthin's tumor is also known as papillary cystadenoma lymphomatosum.

c. Basal cell and canalicular adenomas arc varieties of pleomorphic adenoma.

d. Oncocytoma is also known as oxyphilic adenoma.

2. The malignant salivary tumor most likely to invade surrounding nerve tissue is:

a. Mucoepidermoid carcinoma b. Acinic cell carcinoma c. Adenoid cystic carcinoma d. Squamous cell carcinoma

3. The following lesion(s) has potential for distant metastasis to the lungs and bones:

a. Polymorphous low-grade adenocarcinoma b. Adenoid cystic carcinoma

c. Acinic cell carcinoma d. All of the above

4.A plunging ranula occurs when the mucocele herniates beneath which muscle into the submental space?

a. Genioglossus

b. Mylohyoid

c. Geniohyoid

d. Platysma

5. All of the following statements are TRUE except

a. The auriculotemporal segment of the trigeminal nerve lies in close proximity to the superior aspect of the parotid and is generally not visible at surgery.

b. The facial nerve should always be sacrificed during parotidectomy for malignant lesions.

c. The tympanomastoid fissure is a reliable landmark in locating the main trunk of the facial nerve.

d. Within the parotid, the facial nerve divides into the temporofacial and cervicofacial branches.

19. Thoracic Surgery QUESTIONS Select one answer.

1. Which predicted FEV1 value contraindicate pulmonary resection?

a. Above 0.8 L.

b. Below 0-ft I c. Above 1.2 L.

d. Below 1.2 L

2. Seven days after insertion of a chest tube for a spontaneous pneumothorax, several attempts to reposition the chest tube did not decrease the air leak. What is the next step?

a. Insert a new chest tube.

b. Reposition the chest tube.

c. Chemical pleurodesis.

d. Surgically close the air leak plus pleurodesis

3. The initial workup of a newly found lung mass in a 30־year־old man does not include a. Sputum cytology,

b. Bronchoscopy.

c. Review of old films, d. Open lung biopsy.

4. A 50 ־year-old female cigarette smoker was found to have a 3-cm lung mass not present 1 year before. Cytologic and bronchoscopic examination results were negative. The next step should be

a. Radiotherapy alone.

b. Radiotherapy and chemotherapy.

c. Resection.

d. Follow-up after 3 months.

5. A lung abscess measuring 4 cm in the superior segment of the right lower lobe is best treated with a. Antibiotics and physiotherapy.

b. Percutaneous drainage.

c. Resection.

d. Chest tube drainage.

6. A postpneumonic empyema is best treated with a. Antibiotics and physiotherapy.

b. Chest tube drainage and antibiotics.

c. Decortication if more than 7 days old.

d. Thoracentesis and pleural injection of streptokinase.

7. Small cell carcinoma is different from other bronchogenic carcinomas in that a. It is always incurable.

b. It is not seen in female subjects.

c. it is has a predilection for early spread to other organs.

d. it is not responsive no chemotherapy

8. The presence of a thymoma

a. ls always associated with myasthenia gravis b. ls never associated with myasthenia gravis c. Is indication for resection

d. Can he diagnosed by radiographic appearance only.

9. treatment of an apical tumor with horner syndrome is a. radiotherapy.

b. Surgery.

c. Radiotherapy and chemotherapy followed by surgery d. Radiotherapy and chemotherapy alone.

10. The initial treatment for a patient with multiple bilateral rib fracturesand flail chest with CO, retention is a. Endotracheal intubation and positive- pressure ventilation.

b. Surgical fixation of ribs.

c. Chest wall immobilization with sand bags.

d. Intercostal nerve blocks.

20. Management of Burns

1. Burns characterized by painful blistering are best characterized as a. First degree burns.

b. Second degree burns.

c. Third- degree burns.

d. Fourth- degree burns.

2. the initial symptoms of carbon monoxide poisoning include:

a. Fatigue.

b. Headache.

c. Disorientation.

d. Lethargy.

e. e. All the above.

3. Hydrofluoric acid burns are typically treated with topical, intra-arterial, and/or subcutaneous administration of:

a. Calcium carbonate.

b. Sodium bicarbonate.

c. Calcium gluconate.

d. Calcium phosphate.

e. Potassium gluconate.

4. Burns to ears are best treated with what medication to prevent chondritis:

a. Silver sulfadiazine.

b. Mafenide acetate.

c. Bacitracin.

d. Silver nitrate.

e. Chlorhexidine.

5. Split-thickness skin grafts typically are defined as “mature” after what period of time:

a. 1 month.

b. 3 months.

c. 6 months.

d. 9 months.

e. 12 months or longer.

21. Surgical critical care

QUESTIONS

1. The net result of aerobic metabolism of 1 mol of glucose is a. ATP (18 mol), lactate,

b. ATP (38 mol), carbon dioxide, and water, c. ATP (38 mol), lactate,

d. ATP (2 mol), lactate.

2. An estimated blood loss of 35% of blood • olume reflects a. Class I hemorrhage.

b. Class II hemorrhage.

c. Class III hemorrhage d. Class IV hemorrhage.

3. Swan ganz parameters include a PCWP of 12 mm Hg a cardiac index of 2.7 l/min/m The patient is

a. Normal.

b. Hyperdynamic.

c. Hypodynamic

d. Requires more information to determine

4. An arteriovenous difference of 2.0 mL is most consistent with a. Septic shock.

b. Cardiogenic shock.

c. Hemorrhagic shock.

d. Spinal shock.

5. Cardiac output is Not affected by a. Contractility b. Heart rate c. Hemoglobin d. Afterload

6. A patient in being mechanically ventilated on assist/control mode. His arterial blood gases are: pH 7.55, Pco2 24, P02 79, saturation 92%. The set rate is 12 breaths per minute; the patient is breathing 20 times per minute. What should be done?

a. Increase the Fio2 b. Sedate the patient.

c. Add dead space to the circuit.

d. Increase the rate of ventilation.

7. low levels of erythrocyte 2,3-DPG a. Increase oxygen affinity.

b. Decrease oxygen affinity.

c. Increase acidosis.

d. Increase alkalosis.

8. Appropriate treatment of a septic patient includes the following except a. Fluid resuscitation.

b. Narrow spectrum antibiotics.

c. Appropriate cultures.

d. early institution of goal directed therapy.

9. A patient has ARDS with an Fio2 of 75% on 10 cm H2o PEEP, the Po2 is only 50 mm Hg, Pc02 is 39 mm Hg, and pH is 7.28.

What would you do?

a. Increase the Fi02 to 100%.

b. Increase the PEEP.

c. Increase the ventilatory rate.

d. Give bicarbonate.

10. a postoperative patient has a platelet count of 50,000/mm* and no clinically apparent bleeding. You would a. Transfuse 6 units Hla matched platelets.

b. Transfuse 6 units of banked platelets.

c. do not transfuse unless the platelet count falls to 20,000/mm3 d. administer cryoprecipitate

Chaptar22 ٠ Neurosurgarv QUESTIONS

Select one answer.

1. The lesion most likely to cause neurologic injury and permanent sequelae is a. Basilar skull fracture.

b. Subdural hematoma.

c. Epidural hematoma.

d. Brain stem shear injury.

2. Subdural hygromas:

a. Are common following head injury.

b. Are made up of a blood collection.

c. Show as hyperdense lesions in a CT scan.

d. treated with burr holes or twist drill trephination.

3. A complete spinal cord lesion is seen in which or the following?

a. Anterior spinal syndrome.

b. central cord syndrome, c. Brown - Sequard syndrome.

d. spinal shock.

4. Jefferson fracture is a fracture of the a. odontoid process

b. Ring of Cl.

c. Pedicle of C2

d. Pars interarticularis of C3.

5. which of the following is the most common brain tumor in an adult?

a. ependymoma. ٠ b. low - grade astrocytoma.

c. Glioblastoma multiforme.

d. pituitary adenomas.

6. Cushing’s disease is associated with an increase of which of the following hormones? . a. Somatostatin.

b. ACTH.

c. TSH.

d. GnRH.

7. Hangman’s fracture refers to a fracture of which of the following?

a. Odontoid process.

b. Ring of Cl.

c. Pedicle of C2.

d. Pars interarticularis of C3.

8. Which of the following is the most common type of myelodysplasia?

a. Encephalocele.

b. Dermal sinus tracts.

c. Myelomeningocele.

d. Meningocele.

؛

23 Chapter Orthopedic Surgery

QUESTIONS Select one answer.

1.Early fracture stabilization of long bone and pelvic fractures in polytrauma patients reduces the risk of all of die following Except:

a. Sepsis

b. Negative nitrogen balance c. ARDS

d. Fat embolism e. Malunion or nonunion

2. Principles for managing high-grade complex open fractures include all of the following EXCEPT a. Intravenous antibiotics.

b. Thorough irrigation and debridement.

c. Cast immobilization.

d. Meticulous soft tissue care.

e. Careful assessment of compartment pressures.

3.The nerve most commonly injured in anterior shoulder dislocations is the a. Suprascapular nerve.

b. Ulnar nerve.

c. Median nerve, d. Axillary nerve.

e. Long thoracic nerve.

4.Posterior dislocations of the hip most commonly injure which nerve?

a. Femoral nerve.

b. Obturator nerve.

c. Sciatic nerve.

d. Peroneal nerve.

e. Interosseous nerve.

5. Vascular compromise has been associated with all of the following injuries EXCEPT a. Clavicle fracture.

b. Knee dislocation.

c. Patella fracture.

d. Sternoclavicular joint dislocation.

e. Supracondylar fracture of the humerus.

6. Which of the following scenarios warrants operative exploration of the radial nerve after closed manipulation of a fracture of the shaft of the humerus?

a. No radial nerve function at the time of the initial physical examination.

b. No radial nerve function on presentation and without improvement after closed manipulation.

c. Intact radial nerve function at presentation and after closed reduction, but no function at the initial office visit 1 week after the fracture.

d. Intact radial nerve function on presentation but no function after closed reduction.

e. Intact radial nerve function on presentation, after manipulation, and at subsequent office visits.

7. A 23-year-old male motorcyclist presents to the emergency department with bilateral closed femoral fractures. He is placed in bilateral traction and admitted. Twenty-four hours later, he is confused and tachypneic. The most likely diagnosis is

a. Pulmonary embolism.

b. Myocardial infarction.

c. Fat embolism.

d. Urinary tract infection.

e. Stroke.

8. The most common primary bone malignqn a. Osccosarcuma.

b. Synovial sarcoma.

c. Multiple mycloma.

d. Malignan fibrous hisniocymm e. Chondrosarcorna.

9. The position in which a patient with a posterior dislocation ofthe hip holds the affected extrem. ity is a. Abducted, flexed, and externally rotated,

b. Abducted, flexed, and internally rotated, c. Adducted, flexed, and internally rotated, d. Adducteti, flexed, and extcrna y rotated.

e. Abducted, extended, and internally rorated

10. Which of the following types of childhood Salter fractures of long bones is associated wkh the highest likelihood of subsequent growth arrest?

a. Type l.

b. Type Il.

c. Type Ill.

d. Type IV.

e. Type V.

11. The most important diagnostic test in an adolescent with knee pain and normal knee radiographs is a. Ipsilateral hip radiographs.

b. Ipsilateral femur radiographs.

c. AP pelvis.

d. Bilateral hip radiographs.

e. Ipsilateral tibia radiographs.

12. A young female patient presents with pain with an L5 radiculopathy and weakness of the extensor hallucis longus on the right. The level of the herniated disc most likely is

a. L2-3.

b. L3-4.

c. L4-5.

d. L5-S1.

13. An osteosarcoma of the distal femur that has been shown by MRI to have broken through into the surrounding muscle would be classified as a

a. I B b. II A c. II B d. III B

14.the following regarding scapular fractures are true:

a. Uncommon injuries.

b. May be associated with additional ipsilateral fractures.

c. Are associated with pneumothorax pulmonary contusions. And spine fractures.

d. Ofter treated nonoperatively.

e. All of the above.

15. All of the following are indications to surgically fix midshaft humerus fractures except:

a. Open fracture.

b. Polytrauma.

c. Young patient.

d. Segmental fracture.

e. Floating elbow.

16. All of the following regarding hip fracture true EXCEPT a. More common in women.

b. Often occur from low-energy trauma in the elderly.

c. Patients arc able to bear weight as tolerated postoperatively with modern implants.

d. Is defined as a fracture of the proximal femur.

e. Later stabilization of the fracture has the same 1-year mortality as early fracture stabilization (<48 hours).

17. the following are true regarding intra-articular fractures:

a. Require surgical fixation if more than minimally displaced, b. Have low morbidity.

c. Heal well with prolonged immobilization of die involved joint.

d. Patients can be weight bearing as tolerated immediately.

e. All of the above.

18. Of the following regarding knee dislocations are true EXCEPT

a. They are often undiagnosed an estimated , 50% to 60% of the time.

b. Require amputation.

c. associated with multiple ligament

d. May be associated with peroneal nerve injury uP to 25%.

e. Are a devastating injury.

19.A 13-month-old boy is seen in the emergency department with a complaint Of redness and swelling of his right leg. The child appears in Pain. He is not yet walking as per the parents, and they did not observe any trauma He has a spiral fracture of his right femur on radiographs you should:

a. Indicate the child for surgery.

b. Apply a splint and instruct the parents to Follow-up with an orthopaedic surgeon.

c. Perform a skeletal survey

d. Obtain a more detailed account of the occurernce and consult orthopaedics and child services.

e. Apply a hip spica cast.

20. Patients diagnosed with slipped capital femoral epiphysis:

a. Arc often obese.

b. Present with inability to ambulate and complain of knee pain.

c. May often have bilateral disease.

d. Usually treated surgically e. All of the above.

24. Selected Principles of Plastic Surgery

1.A 50-year -old female presents to the emergency department with a felon. She can flex and extend her finger without pain.

What is the most appropriate treatment?

a. IV antibiotics and hand elevation

b. A hockey stick incision for drainage at fingertip and IV antibiotics c. warm soaks and IV antibiotics

d. Close observation and acyclovir

2. A 32-year-old healthy pregnant female comes to your office complaining of tingling In her fingers and wrist pain .You expect the patient to have:

a. A positive tinel's sing --- symptoms when her hands are held in flexion for 1 minute.

b. A positive tinel's sing --- electric shock sensetoms when the wrist is tapped.

c. A positive phalen's sign --- resolution of symptoms when her hand is held in flexion for 1 minute.

d. A positive phalens sign --- electric shoch sensation when the wrist is tapped.

3. You are asked to evaluate a 16-year-old male with an abscess on the dorsum of his hand. During the medical history interview he tells you that his cat bit him there 1 week ago. what Is the most likely organism causing this infection?

a. bacteroides b. Eikenella c. Streptococcus d. P. multocida

4.Which finger is most crucial in a replant for the patient to have good hand function?

a. Thumb.

b. Ring finger c. Index finger

d. They are all equally important

5. What are the most common bacteria found in hand infections?

a. Bacteroides b. pasteurella c. Staphylococcus.

d. Eikenella.

6. The patency of the radial and ulnar arteries and collateral circulation to the hand can be evaluated by:

a. Finkelstein maneuver.

b. Addison maneuver.

c. Allens test.

d. Phalen's test.

7. Rupture of the extensor tendon at its insertion at the distal phalanx may result in:

a. Mallet finger deformity.

b. Swan-neck deformity.

c. Both of the above.

d. Neither of the above.

8. Two days following a puncture wound :0 Lhc right ring finger a 45-year-old healthy male comes to the emergcncy department for care.His finger is swollen and flexed and he has severe pain with passive extension. Which statement is true?

a. Examination is consistent with a Felon and surgical drainage and antibiotics are indicated.

b. Examination is consistent with acute suppurative tenosynovitis and surgical drainage and antibiotics are indicated.

c. . S. viridians is the most likely causative bacteria.

d. intravenenous antibiotics alone are adequate treatment.

9. Contraindications to replantation of amputated digits include:

a. A thumb in a young patient.

b. A thumb in a 20-year-old manual laborer.

c. A complete amputation of the hand at the level of the wrist.

d. A complete amputation of the index finger at the level of the proximal phalanx.

e. A gunshot wound to the hand.

10. Dupuytren contracture:

a. occurs most frequently in the ring and little finger.

b. is frequently thought to be a work-related condition.

c. is frequently quite painful.

d. prevents the patient from making a full fist.

25 • Urologic Surgery QUESTIONS

The following questions may have more than one answer.

1. The most common renal mass is a:

a. Renal cell carcinoma.

b. Adenoma.

c. Benign cyst.

d. Angiomyolipoma.

2. During a routine right hemicolectomy a right renal mass is noted one should:

a. Expose the mass and perform a wedge biopsy.

b. Needle-aspirate the mass.

c. Perform a nephrectomy.

d. palpate carefully and then Work up postoperatively..

e. Excise the mass with adequate margin.

3. Which of the following modalities is not useful of maximizing early direction of prostate Cancer.

a. prostate-specific antigen.

b. prostatic acid phosphatase.

c. Transrectal ultrasonography.

d. digital rectal examination.

e. Clinical symptomatology.

4. BCG bladder instillations are useful in patients with:

a. Solitary, superficial urothelial bladder card- noma.

b. Squamous cell carcinoma of the bladder.

c. Superficial, recurrent urothelial bladder carcinoma.

d. Carcinoma in situ.

e. Recurrent urothelial bladder carcinoma with superficial muscle invasion.

5. What percentage of patients with stage I testicular carcinoma eventually progress without further treatment after radical orchiectomy?

a. 10.

b. 20.

c. 30.

d. 40.

e. 50.

6. Symptoms and signs related to benign prostatic hyperplasia can be successfully treated pharmacologically.

a. True.

b. False.

7. Which testicular tumor has the worse prognosis?

a. Seminoma.

b. Embryonal carcinoma.

c. Yolk Cac tumor.

d. Choriocarcinoma.

e. Teratocarcinoma.

8. which of the following parameters necessitate radiographic imaging of the urinary tract in the Patient with blunt trauma?

a. Adult patient.

b. Microscopic hematuria.

c. Systolic blood pressure higher than 90 mm Hg.

d. Fracture of a lumbar transverse process.

e. History of renal cysts.

9. proper ureteral repair in after trauma requires all of the following except:

a. Tension-free anastomosis.

b. Adequate urinary diversion.

c. Adequate wound drainage.

d. Watertight closure.

e. Use of absorbable suture.

10. Which of the following findings obviate the need for scrotal exploration in a Patient with suspected testicular torsion?

a. Positive prehn's sign.

b. Normal urinalysis.

c. Normal color Doppler ultrasound.

d. No history of scrotal trauma.

e. Shortened spermatic cord.

27 Minimally Invasive Surgery

QUESTIONS

1. Which of the following is not an indication for open cholecystectomy a. Poor pulmonary or cardiac reserve

b. Third-trimester gestation c. Childs's class C liver disease d. Suspected gall bladder cancer e. Previous gastric bypass procedure

2. Which of the following regarding laparoscopic appendectomy is true a. It is contraindicated in the face of diffuse peritonitis

b. It is less likely to result in post-operative small bowel obstruction c. It is contraindicated in the elderly or immunocompromised d. The conversion rate to open appendectomy is over 50%

e. Compared to open approaches, the laparoscopic approach has a higher rate of hospital morbidity

3. Indications for intra-operative cholangiogram include which of the following a. Poor visualization of the anatomy

b. Pre-operative jaundice c. Dilated common bile duct d. Biliary pancreatitis e. All the above

4. Laparoscopy for blunt abdominal trauma is contraindicated in which of the following scenarios a. Suspicion for pancreatic injury

b. A positive FAST study c. Pneumoperitoneum d. Previous abdominal surgery e. Suspicion for a diaphragmatic injury

5. Which of the following approaches can be used to performed a minimally invasive inguinal her¬nia repair a. Totally extraperitoneal approach

b. Intraperitoneal approach

c. Transabdominal preperitoneal approach d. All the above

Chapter 28 •Bariatric Surgery

In document REVISTA DE DERECHO (página 93-96)