Final General surgery

1. Postoperative pain can lead to the following EXCEPT:

A. Fat embolism
B. Myocardial infarction
C. Bleeding
D. Stroke

2. After abdominal surgery the sequence of bowel motility restoration is: (!!!)
 Small gut
 Stomach
 Right colon
 Left colon

3. Methods of mechanical hemostasis are all of the following EXCEPT:

A. Vascular clamp Simple ligature (transfixion suture) Direct pressure applied by packs
B. Application of the tourniquet
C. Bipolar electrocautery
D. Direct digital pressure over a bleeding site

4. Risk of postoperative myocardial infarction includes All of the following EXCEPT:

A. Hypertension
B. Hypotension
C. Age under 30
D. Postoperative pain

5. Prevention of the postoperative thromboembolism includes all of the following

measures EXCEPT:
A. Compression stockings
B. Low molecular weight heparin
C. Early walking
D. Oxygen therapy

6. Severe sepsis is differentiated from sepsis by:

A. Positive blood cultures for bacteria and fungs
B. Acute organ failure such as renal insufficiency
C. A history of the premotoid condition such as diabetes
D. Prolonged arterial hypotension

7. Neurotmesis Is:
A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Complete transection of nerve
C. Congenital absence of nerve
D. Focal demyelination of nerve
8. Commonest cause of the Metabolic alkalosis in surgical patient is:
 A. Gastric outlet obstruction
B. Antacid therapy
C. Steroid treatment
D. Hyperventilation because of the head injury

9. The commonest cause of the metabolic alkalosis is:

A. Pyloric stenosis
B. Peptic ulcer
C. Diuretics
D. Small-bowel obstruction

10. Prevention of postoperative parotitis includes all of the following EXCEPT:

A. Adequate fluid intake
B. Good oral hygiene
C. Preoperative fasting
D. Stimulation of salivary flow

11. All of the following points are true for the necrotizing fasciitis EXCEPT:
A. Characterized by high mortality rate
B. Treatment - Oral antibiotics
C. Treatment - Removal of all necrotized skin and fascia
D. Is caused by the septic thrombosis of the vessels

12. Treatmet of superficial wound infection is:

A. Removal of drains
B. Oral steroids
C. Heparin ointment
D. Opening the small segment of incision and draining of purulent content

13. A postoperative patient with a potassium of 2.9 is given 1 mEq/kg replacement

with potassium chloride. Repeat tests after the replacement show the sere 3.0.
Most likely diagnosis is:
A. Metabolic alkalosis
B. Hypocalcemia
C. Metaboloc acidosis
D. Hypomagnesemia

14. Neurapraxia is:

A. Congenital absence of nerve
B. Interruption of axonal continuity but preservation of Schwann cell basal lamina
C. Focal demyelination of nerve
D. Complete transection of nerve

15. Which of the following is the treatment of the hyperkalemia?

 A. Insulin and glucose
B. Diuretic administration
C. Inravenous Ringer solution
D. Vitamin C

Which of the following should be the first treatment administered to a patient

with a potassium-level of 6.3 and flattened P waves on their ECG?
A. Kayexalate
B. Insulin and glucose
C. Calcium gluconate
D. Inhaled albuterol

16. Which of the following studies is most helpful in evaluating a patient's risk for
a routine operative procedure:
A. Electrocardiogram
B. History
C. Chest x-ray
D. Physical examination

17. When do we have to start antibiotics to prevent postoperative infection?

A. 2 days before surgery
B. 1 hour before surgery and continue after surgery
C. Immediately after surgery
D. 1 week before surgery

18. Marjolin ulcer is:

A. Chronic arterial ulcer
B. Chronic diabetic ulcer
C. Chronic venous ulcer
D. Malignant transformation of chronic wound

19. Albumin infusion for parenteral use is restricted because:

A. Does not rise oncotic pressure
B. It is carcinogenic
C. it is Costly
D. Is hypotonic

20. Phases of bone healing are all of the following EXCEPT:

A. Soft callus formation
B. Epithelisation
C. Remodeling
D. Hard callus formation

21. Treatment of superficial wound infection is:

 A. Opening the small segment of incision and draining of purulent content
B. Heparin ointment
C. Oral steroids
D. Removal of drains

22. Best vein for total parenteral nutrition is:

A. Femoral
B. Brachial
C. Subclavian
D. Saphenous

23. Preventing measures for the postoperative lung atelectasis are all of the
following EXCEPT:
A. Swan-Ganz catheter
B. Splinting of wound when coughing
C. Incentive deep breathing exercises
D. Frequent change of patient's position

24. Immediate postoperative complications could be all of the following EXCEPT:

A. Myocardial infarction
B. Basal atelectasis
C. Hemorrhage
D. Incisional hernia

25. Major surgical procedures can be performed when platelet count is above:
A. 10,000/ μL
B. 50,000/mL
C. 75,000/ μL
D. 25000/ μL

26. Which of the following is an important mediator of wound healing?

A. α-interferon
B. TGFα
C. β-Defensin2
D. Interleukin 12

27. Elective cholecystectomy is:

A. Dirty
B. Clean
C. Contaminated
D. Clean contorninated

28. Blood loss during surgery is best estimated by: (V)

 A. Suction bottles.
B. Cardiac output by thermodilution
C. Doppler ultrasound
D. Visual assessment

29. A chronic pain of an healed wound can be caused by:

A. Occult incisional hernia
B. Scare formation
C. Peritonitis
D. Vitamin B12 deficiency

30. A chronic pain of an healed wound can be caused by:

A. Stitch abscess or granuloma
B. Pneumonia
C. Dehydration
D. Petitonitis

31.A A chronic pain of an healed wound can be caused by:

A. Peritonitis
B. Urticaria
C. Respiratory failure
D. Nerve entrapment in suture

32. Which of the following is the lardest fluid compartment in the body?
A. Plasma
B. Intracellular fluid
C. Interstitial fluid
D. Central spinal fluid

33. The following drug shoul be discontinued prior to surgery

A. Prednisolone
B. Antibiotic
C. Warfarin
D. Insulin

34. How many calories per day are required to maintain basal metabolosm in a healthy adult?
A. 10-15 kcal/kg/day
B. 20-25 kcal/kg/day
C. 30-35 kcal/kg/day
D. 40-45 kcal/kg/day

35. Wound reepithelisation occurs by:

A. Covering the granulation tissue with epithelial cells migrating from wound edges
B. Replacement of epithelium with connective tissue (scar)
36. There is a risk of dangerous internal bleeding when platelet count is:
 A. <100,000/μL
B. <10,000/μL
C. <150,000/μL
D. <200,000/μL

37. In the gastrointestinal surgery serosa-to-serosa approximation is important

because:
A. Serosal epithelium releases growth factors for faster healing
B. Serosa releases fibrin which makes suture line watertight
C. Serosa contains blood vessels supplying bowel wall
D. Serosa has the greatest tensile strength and suture-holding capacity

38. Postoperative thromboembolism can be prevented by:

A. Avoid walking
B. Low molecular weight heparin
C. Steroids
D. Wearing loose clothes

39. Delayed wound healing could be associated with all of the following conditions
EXCEPT:
A. Protein depletion
B. Chemotherapy
C. Receiving large doses of corticosteroids
D. Pneumothorax

40. Which of the following is a common initiating event for disseminated

intravascular coagulation (DIC)?
A. Amniotic fluid embolization
B. Spider bite
C. depressed scull fracture
D. Type A influenza

41. Late death in burns are due to:

A. Sepsis
B. Contractures
C. Neurogenic
D. Hypovolemia

42. Fresh frozen plasma is used for the all of the following conditions
EXCEPT: A. Correct anemia
B. Replacement of coagulation factors
C. Warfarin overdose
D. During an active bleeding

43. Risk factors for pulmonary aspiration of the gastric contents are EXCEPT:
 A. Pregnancy
B. Food in the stomach
C. Deprensed consclousness
D. Lung atelectasis

44. Treatment options of gastric dilation includes following:

A. Gastrectomy
B. Sellick's maneuver
C. Antibiotics
D. Diuretics

45. Keloids are characterized by the following points EXCEPT:

A. Rive above the skin level as well, but extend beyond the border of
the original wound
B. Often regress over time
C. Is more common in darker pigmented ethnicities, with individuals
of African, Spanish, and Asian ethnicities
D. Excision alone of keloids is subject to a high recurrence rate, ranging from
45 to 100%

46. The main peculiarity of fetal wound healing is:

A. Absence of scarring
B. Excess healing
C. Stow healing
D. Absence of healing

47. Acute is a wound which heals earlier then:

A. 10 weeks
B. 3 months
C. 2 months
D. 6 weeks

48. During remodeling phase of wound healing the tensile strength of the scar
tissue gradually increases because of:
A. Collagen type Ill is gradually replaced by stronger type I collagen
B. Number of blood vessels in the scar is reduced
C. The fibroblasts start to disappear
D. Scar shrinkage

49. Symptoms of a superficial wound infection are EXCEPT:

A. Hyperthermia
B. Hyperemia
C. Wound swelling
D. Vomitus
50. Which method is NOT used for the treatment of the postoperative seroma:
 A. Compression dressing
B. Evacuation by needle aspiration
C. Exploration in the operating room and ligation of lymphatic vessels
D. Diuretic administration

51. First line treatment in an adult with idiopathic thrombocytopenic purpura includes
A. Retuximan
B. IV immunoglobulin
C. Desmopressin
D. Splenectomy

52. Prevention of postoperative pneumonia includes:

A. Maintaining the airway clear of secretions
B. Early oral feeding
C. Suppressing the cough
D. Liquid diet

53. Prevention of postoperative pneumonia includes:

A. Administration of diuretics
B. Liquid diet
C. Encourage coughing
D. Plasma transfusion

54. Folowing factors affect wound healing EXCEPT:

A. Antibiotics
B. Hypoperfusion of tissues
C. Advanced age
D. Steroid use

55. Wounds could be classified as all of the following EXCEPT:

A. Mechanical
B. Caused by radiation
C. Thermal
D. Congenital

56. What percentage of the body is made up of water?

A. 30-40%
B. 70-80%
C. 10-20%
D. 50-60%

57. Shaving of the operative field is recommended:

A. Before hospitalization at patients home
B. Immediately before the operation
58. Best scars are seen in:
 A. Infants
B. Children
C. Very old people
D. Adults

59. Adverse effects of opioids are all of the following EXCEPT:

A. Decreased peristalsis
B. Nausea & vomiting
C. Hypoglycemia
D. Respiratory depression

60. Bleeding from cut bone can be controlled by:

A. Tourniquet
B. Packing a wax
C. Ligature
D. Vascular clamp

61. The correct sequence of wound healing phases is:

 Hemostasis
 Inflammation
 Proliferation
 Remodeling/Maturation

62. Choose and match the correct diagnosis: A 7-year-old boy with nut allergy
develops stridor and collapses after eating a snack. He requires airway and
breathing support. His BP is 60/38 mmHg.
A. Septic shock
B. Anaphylactic shock
C. Hypovolernic shock – hemorrhagic
D. Cardiogenic shock

63. In Glasgow Coma Scale all of the following are considered EXCEPT:
A. Motor response
B. Verbal response
C. Eye movement
D. Sensory response

64. Following points are true for the necrotizing fasciitis EXCEPT:
A. Treatment - Oral antibiotics
B. Treatment - Removal of all necrotized skin and fascia
C. Characterized by high mortality rate
D. Is caused by the septic thrombosis of the vessels

65. The shock is clinically best assessed by:

 A. Central vein pressure
B. Sweeting
C. Blood pressure
D. Urine output

66. Delayed wound healing is expected in following patient group:

A. Receiving large doses of ascorbic acid
B. Diabetes mellitus
C. Constipation
D. Wrestlers

67. Delayed wound healing is expected in following patient group: (Preoperative

A. Protein depletion
B. Receiving large doses of corticosteroids
C. Epilepsy
D. Chemotherapy

68. High risk of thromboembolism has a patient with all of the following condition
EXCEPT:
A. Cancer
B. Obesity
C. Myocardial infarction
D. INR>2.5

69. In the usual preparation for general surgery, the patient may be:
A. Given specifically ordered oral medications with couple glasses of water
B. Given ice chips
C. NPO for 12 to 14 hours before
D. Allowed to brush teeth and swallow water

70. All vegetative bacteria and most resistant dry spores are destroyed by the
following methods of sterilization EXCEPT:
A. Autoclaving
B. Dry heat
C. Ethylene oxide gas
D. Boiling

71. Which of the following can be used to mitigate cortisol effects on wound healing?
A. Vitamin E
B. Vitamin A
C. Vitamin B12
D. Vitamin C
72. Transfusion therapy means the intravenous administration of all the following
fluids EXCEPT:
A. Plasma
B. Red blood cells
C. Ringer-Lactate solution
D. Cryoprecipitate

73. Delayed wound healing is NOT associated with the following:

A. Receiving large doses of corticosteroids
B. Pneumothorax
C. Protein depletion
D. Chemotherapy

74. The following points are tue for Split-thickness skin graft EXCEPT:
A. Is harvested using dermatomes
B. Needs vascular anastomosis for blood supply
C. Consists of epidermis and part of dermis
D. May be "meshed" to cover larger area

75. Signs of postoperative wound hematoma are all of the following EXCEPT:
A. Blood leakage between stitches
B. Vomitus
C. Discoloration of the wound edges
D. Swelling of wound area

76. Wound heals by secondary intention when:

A. Wound edges are separated
B. The wound is suture
C. Incised or cut wounds
D. There is no infection

77. Early postoperative complications are all of the following EXCEPT:

A. Pneumonia
B. Urinary tract infection
C. Keloid formation
D. Postoperative wound infection

78. Which of the following conditions is NOT a risk factor for the wound dehiscence:
A. Corticosteroids
B. Arterial hypertension
C. Obesity
D. Microcirculatory disorders diabetes Melius., uremia.
Immunosuppression. jaundice. sepsis. hypoalbuminemia., cancer
79. Failure of healing of the gastrointestinal wall sutures could lead to the
following complications EXCEPT:
A. Peritonitis
B. Intrastiominalabscees
C. Fistula formation
D. Intestinal obstruction

80. Which layer of the intestine has the greatest tensile strength (i.e. ability to hold
sutures)?
A. Muscularis
B. Serosa
C. Mucosa
D. Submucosa

81. Which of the following shoul be performed in a patient with a suspected

Marjolin ulcer?
A. Zinc supplementation
B. Oral tetracycline for 6 weeks
C. Hyperbaric therapy
D. Biopsy

82. Transfusion of one unit of RBCs generally increases hemoglobin level by:
A. 0.5 g/dL
B. 5 g/dL
C. 3 g/dL
D. 1 g/dL

83. Which of the following is the cation present in largest amounts in intracellular
fluid?
A. Sodium
B. Chloride
C. Potassium
D. Calcium

84. Which of the following is the treatment of the severe hyperkalemia?

A. Oral glucose
B. Dialysis
C. Vitamin A
D. NPO

85. Physical examination of the patient is the part of

A. Subjective examination
B. Objective examination
86. there are 18 types of collagen in human body. Which two are the most
important in wound healing?
A. Type VI and VII
B. Type III and VIII
C. Type I and III
D. Type II and X

87. Treatment options of gastric dilation includes following:

A. Opioids
B. Antibiotics
C. Steroids
D. Decompression with nasogastric tube

88. Pulmonary aspiration could be caused by:

A. Sellik's maneuver
B. Preoperative fasting
C. Tracheal intubation
D. Head down position

89. Phases of bone healing are all of the following EXCEPT:

A. Soft callus formation
B. Remodeling
C. Hard callus formation
D. Epithelisation

90. Hemophilia C is caused by deficiency

of A. Factor XI
B. Factor X
C. Factor VIll
D. Factor IX

91. Autoclaving parameters are:

A. 2 atm (140oC) 45 min
B. 11atm (161oc) 25 min
C. 1 atm (100oC) 15 min
D. 2 atm (121oC) 15 min

92. The correct sequence of management for nonemergency cases is:

 History
 Physical examination
 Laboratory & instrumental examination
 Treatment & Follow-Up
93. Joseph Lister, british surgeon was a pioneer of:
A. Plastic surgery
B. Anatomy
C. Anesthesia
D. Antiseptics

94. Most frequent sequence of patient transfer after surgery is:

 Operating room
 Post-anesthesia care unit
 Ward
 Home

95. Examples of deep wound infections are following EXCEPT:

A. Abscess in the Douglass pouch
B. Abscess under the axillary skin
C. Abscess under diaphragm
D. Abscess under fiscal

96. For most elective (nonemergency) cases the correct sequence of patient
management is:
 1. History
 2. Physical examination
 3. Laboratory & instrumental examination
 4. Treatment & follow-up

97. Wound heals by secondary intention during following circumstances EXCEPT:

A. The wound is infected
B. Wound is clean and sutured
C. Wound is packed with sterile gauze
D. Sutures are applied after granulation tissue formation

98. Folowing factors affect wound healing EXCEPT:

A. Wound irrigation
B. Diabetes mellitus
C. Malnutrition
D. Vitamin deficiencies

99. Folowing factors affect wound healing EXCEPT:

A. Steroid use
B. Hypoperfusion of tissues
C. Advanced age
D. Antibiotics

100. Folowing factors affect wound healing EXCEPT:

 A. Cancer
B. Cardiac failure
C. Vitamins
D. Chemotherapeutic antimetabolite drugs

101. Axonotmesis is:

A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Complete transection of nerve
C. Focal demyelination of nerve
D. Congenital absence of nerve

102. Laparotomy belongs to the following wound types EXCEPT:

A. Incision
B. Mechanical
C. Abrasion
D. Open

103. During the hemostasis phase of wound healing main cell type found in the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils

104. During the late inflamation phase of wound healing the main cell type found
in the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils
105. During the early inflamation phase of wound healing the main cell type found
in the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils

106. During the proliferation phase of wound healing the main cell type found in
the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils

107. Disatvantages of dry heat sterilisation are all of the following EXCEPT:
 A. Dulls sharp and cutting instruments
B. Burn fabric, plastic or rubber material
C. Spoils metal instruments
D. Does not destroy dry spores

108. The correct sequence of acute wound treatment is:

 Temporary hemostasis
 Anesthesia
 Wound toilet
 Debridement/Definite hemostasis
 Proper approximation of wound edges
 Wound dressing

109. Compromised immune competence is expected in all of the following groups EXCEPT:
A. Having joint dislocated
B. Receiving corticosteroids
C. Malnutrated patients
D. Organ transplant recipients

110. Symptoms of Class III hypovolemia (loss of 30-40% of blood volume) are:
A. Face hyperemia, bradycardia
B. Dry mouth, normal pulse pressure
C. Tachycardia and decreased pulse pressure but, normal BP (Class II)
D. Tachycardia, tachypnea, hypotension, oliguria, and changes in mental status

111. A patient presents to the emergency room with a temperature of 39°C, heart
rate of 115, and respiratory rate of 25. There are no localised simptoms and
the work-up does not reveal any specific source for fever. Which of the
following best discribes the patient's condition?
A. SIRS
B. Septic shock
C. Infectin
D. Sepsis

112. Which of the following is an early ECG change seen in hyperkalemia?

A. Flattened P wave
B. Peaked T waves
C. Sine wave formation
D. Prolonged PR interval

113. Surgeon should receive an immunization to protect them from infection with
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Human immunodeficiency virus
No. Question Correct Answer
1 Phases of bone healing are all of the following EXCEPT: Epithelisation

2 Treatmet of superficial wound infection is: Opening the small segment of incision and

Incisional
High risk of thromboembolism has a patient with all of the following condition EXCEPT:
3 INR>2.5

4 Examples of deep wound infections are following EXCEPT: Abscess under the axillary skin

Transfusion therapy means the intravenous administration of all the following fluids EXCEPT:
5 Ringer-Lactate solution

6 A chronic pain of an healed wound can be caused by: Occult incisional hernia

7 Shaving of the operative field is recommended: Immediately before the operation

8 Autoclaving parameters are: 2 atm (121°C) 15 min

9 For most elective (nonemergency) cases the correct sequence

of patient management
10 Folowing factors affect wound healing EXCEPT: Antibiotics

11 Symptoms of a superficial wound infection are EXCEPT: Vomitus

12 Following points are true for the necrotizing fasciitis EXCEPT: Treatment - Oral antibiotics

13 Neurapraxia is:
Focal demyelination of nerve
14
15 Treatment of
Treatment options of gastric
superficial dilation
wound includes
infection is: following: Gastrectomy
Opening the small segment of incision and

16 Keloids are characterized by the following points EXCEPT: Often regress over time

17 A chronic pain of an healed wound can be caused by: Stitch abscess or granuloma

Which of the following studies is most helpful in evaluating a

18 patient's risk for a routine operative procedure: History

19 Transfusion of one unit of RBCs generally

increases 1
The correct sequence of management for nonemergency cases is:
20 History

21 Major surgical procedures can be performed when

platelet 75,000/

22 Methods of mechanical hemostasis are all of the Bipolar electrocautery

following
23 Pulmonary aspiration could be caused by: Head down position

24 Failure of healing of the gastrointestinal wall sutures Intestinal obstruction

could
Immediate postoperative complications could be all of the
25
following EXCEPT:

26 Fresh frozen plasma is used for the all of the Correct anemia
following
27 Postoperative pain can lead to the following EXCEPT: Fat embolism

28 Wound reepithelisation occures by: Covering the granulation tissue with epitheli

29 Which method is NOT used for the treatment of

the Diuretic
30 Wound heals by secondary intention when: Wound edges are separated
 There is a risk of dangerous internal bleeding when
platelet <10,000/μL
31 count is:

32 Delayed wound healing is NOT associated with the following:

33 Most frequent sequence of patient transfer after surgery is:

Early postoperative complications are all of the following EXCEPT:

34 Keloid formation

Which of the following conditions is NOT a risk factor for the wound dehiscence:
35 Arterial hypertension

36 Adverse effects of opioids are all of the following EXCEPT: Hypoglycemia

37 Physical examination of the patient is the part of Objective examination

Prevention of the postoperative thromboembolism includes all

38 of the following measures EXCEPT: Oxygen
Prevention of postoperative parotitis includes all of the
39 following EXCEPT: Preoperative
40 Joseph Lister, british surgeon was a pioneer of: Antiseptics

No.
Question Correct Answer

1 In the usual preparation for general surgery, the patient NPO for 12 to 14 hours before
may
2 Treatment options of gastric dilation includes following: Decompression with a nasogastric tube

3 Acute is a wound which heals earlier then: 6 weeks

In the gastrointestinal surgery serosa-to-serosa

4 Serosa releases fibrin which makes suture
approximation is important because:
line watertight.
5
Wound heals by secondary intention during following
Wound is clean and sutured
circumstances
6
Wounds could be classified as all of the following EXCEPT:
The management of small pleural effusion after upper
7 abdominal operations includes: Leave undisturbed (observation)

Risk of postoperative myocardial infarction includes All of Age under

8
the
9 Preventing measures for the postoperative lung Swan-Ganz catheter
atelectasis
10 Following factors affect wound healing EXCEPT: Wound irrigation

11 Axonotmesis is: Interruption of axonal continuity but preser

12 The main peculiarity of fetal wound healing is: Absence of scarring

13 The correct sequence of wound heasling phases is:

14Bleeding from cut bone can be controlled by: Packing a wax

15 Laparotomy belongs to the following wound types EXCEPT:

16 Prevention of postoperative pneumonia includes : Encourage coughing

17 Disatvantages of dry heat sterilisation are all of the

following Does not destroy dry
18 Prevention of postoperative pneumonia includes : Maintaining the airway clear of secretions

19 The correct sequence of acute wound treatment is:

 During the late inflamation phase of wound healing the main cell type found in the wound is:
20 Macrophages

21 During remodeling phase of wound healing the tensile Collagen type III is gradually replaced
strength of the scar tissue gradually increases because by stronger type I collagen
22Postoperative thromboembolism can be prevented by: Low molecular weight heparin

23 A chronic pain of an healed wound can be caused by: Nerve entrapment in suture

24 Compromised immune competence is expected in all of Having joint dislocated

the
25 Delayed wound healing is expected in following patient group: Diabetes
26 Marjolin ulcer is: Malignant transformation of chronic wound

After abdominal surgery the sequence of bowel motility

27
restoration is:
Delayed wound healing could be associated with all of the
28
following conditions EXCEPT: Pneumothor

29
Airway obstruction
The neck hematoma can cause:
During the hemostasis phase of wound healing main cell type
30
found in the wound is:
31
Platel
Neurotmesis is:
Complete transection of nerve
All of the following points are true for the necrotizing fasciitis
32
EXCEPT: Treatment - Oral antibiotics
33
Folowing factors affect wound healing EXCEPT: Vitamins

34 Risk factors for pulmonary aspiration of the gastric Lung atelectasis

contents

35 The following points are tue for Split-thickness Needs vascular anastomosis for
skin graftEXCEPT: blood supply
Symptoms of Class III hypovolemia (loss of 30-40% of blood
36 Tachycardia, tachypnea,
volume) are: hypotension,

37 Signs of postoperative wound hematoma are all of

the Vomit
38 Wound reepithelisation occurs by: Covering the granulation tissue with epitheli

All vegetative bacteria and most resistant dry spores are

39 destroyed by the following methods of sterilization EXCEPT:

During the proliferation phase of wound healing the main cell type found in the wound is:
40 Fibroblasts

General surgery
MIDTERM 1- 29.04.2021
1. Risk of the thromboembolism is increased in the patients with the following
conditions EXCEPT: (Preoperative
A. Cancer
B. Prior history of thrombosis
C. Obesity
D. Parotitis*
2. Physical examination of the patient is the part of the: (Preoperative care I)
B. Subjective examination
A. Objective

3. This question is not from the 'Wound healing' chapter.

Delayed wound healing is NOT associated with the following: (Preoperative care II)
A. Protein depletion
B. Receiving large doses of corticosteroids
C. Pneumothorax
D. Chemotherapy

4. After surgery, convalescent period of recovery usually occurs in: (Postoperative

A. ICU
B. Patirnt's home
C. Wards
D. PACU

5. Gastric dilation is prevented by one of the following methods: (Postoperative

A. Nasogastric tube placement

B. Smoking casation
C. Laxatives
D. Preoperative low calory diet

6. Pulmonary aspiration is prevented by all of the following methods EXCEPT:

(Postoperative complications I)

A. Smoking cesation
B. Selliks maneuver
C. Preoperative fasting
D. Proton pump inhibitor administration

7. For most elective (nonemergency) cases the correct sequence of patient

management is: (Preoperative care I)
 1. History
 2. Physical examination
 3. Laboratory & instrumental examination
 4. Treatment & follow-up

8. Shaving of the operative field is recommended: (Preoperative care II)

A. Before hospitalization at patients home
B. Immediately before the operation
9. The sterilization device is: (Preoperative

A. Cleaner
B. Boiler
C. Autoclave
D. Steamer

10. General medical state ASA1 means: (Preoperative

A. Mild diseases only without substantive functional limitations.
B. Healthy, non-smoking, no or minimal alcohol use
C. Constant threat to life
D. Not expected to survive without the operation

11. The severity of pain is estimated by: (Preoperative

A. Blood pressure
B. All of these methods
C. Asking the patient
D. Puls rate

12. When using the incentive spirometer the patient must: (Postoperative

A. Blow
B. Aspirate

13. Multiple clotting factor deficiencies are corrected by one of the following:
A. Fresh frssen plasma transfusion
(Postoperative

B. Granulocyte mass transfusion

C. Red blood cell transfusion
D. Platelet concentrate transfusion

14. Negative effects of the opioids are all of the following EXCEPT: (!!!)
A. Respiratory depression
B. Altered mental state
C. Constipation
D. Diarrhea

15. Delirium tremens is the postoperative complication of the following: (Postoperative

A. Alcoholism
B. Malnutrition
C. Diabetes
D. Appendicitis
16. Complications of the subclavian catheter are all of the following EXCEPT: (!!!)
A. Cardiac arrhithmias
(Postoperative

B. Arterial damage
C. Pneumothorax
D. Melena

17. Highest temperature is used during sterillisation with:

A. Ethilen oxide
B. Boiling
C. Dry heat
D. Autoclave

18. The reason of the pressure ulcer is: (!!!)

A. Failure to turn the patient from side to side*
B. Burn
C. Bone fracture
D. Diabetes mellitus

19. Opioid narcotics could aggravate postoperative period by causing:

A. Respiratory stimulation
B. Decreased peristalsis
C. Diarrhea
D. Wound dehiscence

20. Melena or melana is the sign of:

A. Upper Gl bleeding
B. Lung injury
C. Anal bleeding
D. Goiter

21. Urinary retention after surgery is treated by:

A. Bladder catheterization
B. Diuretics

22. Prevention of the postoperative thromboembolism includes: (Preoperative

A. Subclavian vein catheterization

B. Long stay in bed
C. 5% glucose
D. Low molecular weight heparin
23. Disadvantages of dry heat sterilization are all of the following EXCEPT: (Preoperative
A. Dulls sharp and cutting instruments
B. Burn fabric, plastic or rubber material
C. Spoils metal instruments
D. Does not destroy dry spores
24. Markers of malnutrition during preoperative evaluation are EXCEPT: (Preoperative
A. Serum albumin of <3 g/dL
B. Serum transferrin <150 mg/dL
C. Elevated free thyroxin
D. Weight loss >20%

25. Which symptom does indicate upper Gl bleeding EXCEPT:

A. Acholic (nonbilious) vomitus
B. Hematemesis
C. Melena
D. Coffee-ground vomitus

26. High risk of thromboembolism has a patient with all of the following condition
EXCEPT:
A. Obesity
B. Cancer
C. Myocardial infarction
D. INR>2.5

27. Postoperative thromboembolism can be prevented by:

A. Wearing loose
clothes B. Steroids
C. Avoid walking
D. Low molecular weight
28. Signs of the postoperative paralytic ileus resolution are:
A. Distended abdomen
B. Lack of the audible peristalsis
C. Passage of flatus
D. Loss of the appetite

29. Autoclaving parameters are:

A. 2 atm (121°C) 15 min
B. 2 atm (140°C) 45 min
C. 1 atm (100°C) 15 min
D. 1 atm (161°C) 25 min
30. This question is not from the 'Wound healing' chapter.
Delayed wound healing is expected in following patient group: (Preoperative care II)
A. Protein depletion
B. Receiving large doses of corticosteroids
C. Epilepsy
D. Chemotherapy

MIDTERM 1- 26.10.2021
1. All of the following contribute for the development of the lung atelectasis
EXCEPT:
A. Prolonged posture
B. Thick bronchial discharge
C. Lack of the deep breath
D. Breathing exercises

2. Autoclaving parameters are:

A. 2 atm (121°C) 15 min
B. 2 atm (140°C) 45 min
C. 1 atm (100°C) 15 min
D. 1 atm (161°C) 25 min

3. Who can give Operative Permit (Consent)?

A. only the patient
B. Patient's lawyer only
C. Hospital manager
D. Emergency lifesaving operations or procedures may have to be done
without a permit.

4. Delayed wound healing is expected in following patient group:

A. Receiving large doses of ascorbic acid
B. Diabetes mellitus
C. Constipation
D. Wrestlers

5. In the usual preparation for general surgery, the patient may be:
A. Given ice chips
B. Given specifically ordered oral medications with couple glasses of
water C. Allowed to brush teeth and swallow water
D. NPO for 12 to 14 hours before
6. Signs of the postoperative paralytic ileus resolution are:
A. Distended abdomen
B. Lack of the audible peristalsis
C. Passage of flatus
D. Loss of the appetite

7. Opioid narcotics could aggravate postoperative period by causing:

A. Respiratory stimulation
B. Decreased peristalsis
C. Diarrhea
D. Wound dehiscence

8. Markers of malnutrition during preoperative evaluation are EXCEPT: (Preoperative care II)
A. Serum albumin of <3 g/dL
B. Serum transferrin <150 mg/dL
C. Elevated free thyroxin
D. Weight loss >20%

9. Dry heat sterilisation parameters are:

A. 100°C 4hr
B. 120°C 1hr
C. 130°C. 2hr
D. 160°C 1hr

10. Physical examination of the patient is the part of the: (Preoperative care I)
B. Subjective examination
A. Objective

11. High risk of thromboembolism has a patient with all of the following condition
EXCEPT:
A. Obesity
B. Cancer
C. Myocardial infarction
D. INR>2.5

12. Shaving of the operative field is recommended: (Preoperative care II)

A. Before hospitalization at patients home
B. Immediately before the operation
13. Melena or melæna means:
A. Black stools
B. Bloody vomitus
C. Nasal bleeding
D. Bloody urine

14. Disadvantage of ethylene oxide sterilization is:

A. It is expensive
B. It is flammable and toxic
C. Short sterilization time
D. Spoils metal instruments

15. Disadvantages of dry heat sterilization are all of the following EXCEPT: (Preoperative care II)
E. Dulls sharp and cutting instruments
F. Burn fabric, plastic or rubber material
G. Spoils metal instruments
H. Does not destroy dry spores

16. Nosocomial infection could be all of the following EXCEPT:

A. Sexually transmitted infection
B. Catheter associated urinary infection
C. Ventilator associated pneumonia
D. Surgical site infection

17. All vegetative bacteria and most resistant dry spores are destroyed by the
following methods of sterilization EXCEPT:
A. Autoclaving
B. Dry heat
C. Boiling
D. Ethylene oxide gas

18. Delayed wound healing is expected in following patient group: (Preoperative care II)
F.E. Receiving
Protein large doses of corticosteroids
G. Epilepsy
H. Chemotherapy

19. Delayed wound healing is expected in all of the following groups EXCEPT:
A. Ascorbic acid deficiency
B. Receiving large doses of corticosteroids
C. Cut by sharp knife
D. Diabetes mellitus
20. Delayed wound healing is NOT associated with the following: (Preoperative care II)
A. Protein depletion
B. Receiving large doses of corticosteroids
C. Pneumothorax
D. Chemotherapy

21. General medical state ASA1 means: (Preoperative care I)

A. Mild diseases only without substantive functional limitations.
B. Healthy, non-smoking, no or minimal alcohol use
C. Constant threat to life
D. Not expected to survive without the operation

22. Joseph Lister, british surgeon was a pioneer of:

A. Antiseptics
B. Plastic surgery
C. Anesthesia
D. Anatomy

23. The sterilization device is: (Preoperative care II)

A. Cleaner
B. Boiler
D.
C. Steamer

24. Patients general health could be estimated as all of the following EXCEPT:
A. Stabile
B. Serious but stabile
C. Good
D. Critical

25. Which of the following studies is most helpful in evaluating a patient's risk for
a routine operative procedure:
A. Chest x-ray
B. Physical examination
C. Electrocardiogram
D. History

26. Melena or melana is the sign of:

A. Upper Gl bleeding
B. Lung injury
C. Anal bleeding
D. Goiter
 27. Compromised immune competence is expected in all of the following groups
EXCEPT:
E. Having joint dislocated
F. Receiving corticosteroids
G. Malnutrated patients
H. Organ transplant recipients

28. Postoperative thromboembolism can be prevented by:

A. Compression stockings
B. Diuretics
C. Oxygen therapy
D. Diet

29. Postoperative thromboembolism can be prevented by:

A. Low molecular weight heparin
B. Steroids
C. Avoid walking
D. Wearing loose clothes
OLD EXAMS
Questions Answer
Physical examination of the patient is the part of Objective examination
Nonopioid analgesics, NSAID( non steroid anti Can cause of gastric bleeding during COX
inflammatory drugs) (cyclooxygenase) inhibition
Compromised immune competence is expected in
Having joint dislocated
all of the following groups EXCEPT:
Which statements are correct about the General Unconscious(amnesia), analgesia, muscle
anesthesia’s so-called major triad relaxation
Malignant Hyperthermia(MH)is a hereditary, life-threatening, hypermetabo
Delayed wound healing is expected in all of the
Cut by sharp knife
following groups EXCEPT:
What describes the action of the body on the Pharmacokinetics
drug?
Delayed wound healing is expected in following Protein depletion
patient group:
What describes the action of a drug on the body? Pharmacodynamics
Delayed wound healing is expected in following Diabetes mellitus
patient group:
In the usual preparation for general surgery, the
NPO for 12 to 14 hours before
patient may be:
For most elective (nonemergency) cases the
correct sequence of patient management is:
which statement is true for the induction of The induction of general anesthesia is the
anesthesia
Which statement is true about Esters and Amides Most of Amides are metabolized in liver
Delayed wound healing is NOT associated with Pneumothorax
the following:
Markers of malnutrition during preoperative
Elevated free thyroxin
evaluation are EXCEPT:
Which of the following studies is most helpful in
evaluating a patient's risk for a routine operative History
procedure:
Which statement is true Regional anesthesia provides only two of th
Succinylcholine Can cause of elevation of plasma potassium
For Isoflurane which statements is true Has no effect on cardiac rate or rhythm
Spinal anesthesia: Possible complications are hypotension and
High risk of thromboembolism has a patient with
INR>2.5
all of the following condition EXCEPT:
Postoperative thromboembolism can be Low molecular weight heparin
prevented by:
Naloxone Is a pure antagonist of opioids
Joseph Lister, british surgeon was a pioneer of: Antiseptics
Disatvantages of dry heat sterilisation are all of
Does not destroy dry spores
the following EXCEPT:
Shaving of the operative field is recommended: Immediately before the operation
Disatvantage of ethylene exide sterilisation is: It is flammable and toxic
About the preoperative risk assessment which of The coexisting presence of liver disease may
further statements are true influence the selection of volatile anest
Which statements are true for Local anesthetic Manifests at first with liver insufficiency
toxicity
Lidocaine and bupivacaine are: Amides
Which way of airway management is wrong after
breath “mouth to mouth”
the induction of anesthesia
Dry heat sterilisation parameters are: 160°C 1hr
16 th of October in 1846 Dr. Morton gave the first
public demonstration of anesthesia, what was a Ether
medication
Which statements are wrong for the post Abnormal bleeding, hypertension, dysrhyth
anesthesia care
Autoclaving parameters are: 2 atm (121°C) 15 min
For the preoperative preparation end evaluation Concurrent medications must be fully
of patient next statements are true explored, and adverse interactions with age
All vegetative bacteria and most resistant dry
spores are destroyed by the following methods of Boiling
sterilization EXCEPT:
Propofol Is an irritant and can cause of pain during i
Postoperative thromboembolism can be Compression stockings
prevented by:
When does the healing ridge appear normally
1st week
postoperatively?
What describes the action of the body on the Pharmacokinetics
drug?
Malignant Hyperthermia(MH)is a hereditary, life-threatening, hypermetaboli
What is the minimal amount of hours required for
2
pressure ulcer development?
What describes the action of a drug on the body? Pharmacodynamics
Pressure in which of the following compartments
Right atrium
can be identified as a pulmonary wedge pressure?
Which of the following BMI index can be
>30
identified as obesity?
Which statements are correct about the General Unconscious(amnesia), analgesia, muscle
anesthesia’s so-called major triad: relaxation
Which of the following does NOT represent the
Fever
sign of embolism syndrome?
Which of the following is a cardinal sign of Reduced vital capacity
respiratory failure?
About the preoperative risk assessment which of The coexisting presence of liver disease may
further statements are true influence the selection of volatile anest
Which of the following factors has a least effect
Male Sex
on wound closure?
Which of the following triage codes corresponds
Red
to lifethreatening injury?
Lidocaine and bupivacaine are: Amides
Which of the following medications heavily affect
Steroids
normal wound healing?
Which of the following veins are most commonly
Subclavian
used for central vein catheterization?
16 th of October in 1846 Dr. Morton gave the first
public demonstration of anesthesia, what was a Ether
medication
which statement is true for the induction of The induction of general anesthesia is the
anesthesia
What describes the action of a drug on the body? Pharmacodynamics
Succinylcholine Can cause of elevation of plasma potassium
Which of the following medications are not used
Thyroxine
during thyroid storm?
For the preoperative preparation end evaluation Concurrent medications must be fully
of patient next statements are true explored, and adverse interactions with age
What describes the action of the body on the Pharmacokinetics
drug?
Which of the following descriptions best
A patient with severe systemic disease
evaluates the patient as a Class III by ASA?
Which of the following can describe a grade V
Death
surgical complication?
Which of the following conditions can complicate
Thyroid disease
establishing of an airway?
Which of the following agents are routinely used
Bupivacaine
for continuous epidural analgesia?
Spinal anesthesia: Possible complications are hypotension and
Which of the following does NOT represent the
Iodine soaking
common method of sterilization?
16 th of October in 1846 Dr. Morton gave the first
public demonstration of anesthesia, what was a Ether
medication
Barbiturates: Are anticonvulsants and protect the brain d
Which statements are true for Local anesthetic Is a result absorption into the bloodstream
toxicity
Lidocaine and bupivacaine are: Amides
Which statements are correct about the General Unconscious(amnesia), analgesia, muscle
anesthesia’s so-called major triad: relaxation
Which of the following events are most likely to
Trauma
cause retrograde amnesia?
Which of the following can describe a grade III
Requiring surgical treatment
surgical complication?
Which statement is true about Esters and Amides Most of Amides are metabolized in liver
What describes the action of a drug on the body? Pharmacodynamics
Which of the following patients condition can be Vital signs may be unstable and not within
descirbed as "Serious"? normal limits. Patient is seriously ill. Indicat
Which of the following patients condition can be Vital signs are stable and within normal
descirbed as "Fare"? limits. Patient is conscious, but may be unco
MIDTERM 2
During the hemostasis phase of wound healing
Platelets
main cell type found in the wound is:
Neurotmesis is: Complete transection of nerve
In the gastrointestinal surgery serosa-to-serosa Serosa releases fibrin which makes suture
approximation is important because: line watertight.
During the proliferation phase of wound healing
Fibroblasts
the main cell type found in the wound is:
Wound heals by secondary intention during
Wound is clean and sutured
following circumstances EXCEPT:
Failure of healing of the gastrointestinal wall
sutures could lead to the following complications Intestinal obstruction
EXCEPT:
Phases of bone healing are all of the following Epithelisation
EXCEPT:
All of the following principles are important
for successful healing of the bowel Depressed bowel motility
anastomosis
EXCEPT:
Acute is a wound which heals earlier then: 6 weeks
Neurapraxia is: Focal demyelination of nerve
Following factors affect wound healing EXCEPT: Antibiotics
Main components of the extracellular matrix are Myosin
all EXCEPT:
Wounds could be classified as following EXCEPT: Preoperative
The symptom of superficial wound infection is: Hyperemia
During the early inflammation phase of wound
Neutrophils
healing the main cell type found in the wound is:
The correct sequence of wound healing phases is:
Wounds could be classified as following EXCEPT: Congenital
Wound heals by secondary intention when: Wound edges are separated
Axonotmesis is: Interruption of axonal continuity but preser
Following factors affect wound healing EXCEPT: Wound irrigation
During the late inflammation phase of wound
Macrophages
healing the main cell type found in the wound is:
Excess healing after gastrointestinal surgery could
Stricture formation
lead to the following complications:
During remodeling phase of wound healing the Collagen type III is gradually replaced by
tensile strength of the scar tissue gradually stronger type I collagen
increases because of:
Wound reepithelisation occurs by: Covering the granulation tissue with epitheli
The main peculiarity of fetal wound healing is: Absence of scarring
Following factors affect wound healing EXCEPT: Vitamins
Laparotomy belongs to the following wound types Abrasion
EXCEPT:
Wounds could be classified as following EXCEPT: Partial
Major types of chronic wound are EXCEPT: Post appendectomy wound
Wound heals by primary intention when: There is a little gap between wound edges
Which of the following conditions is NOT a risk
Arterial hypertension
factor for the wound dehiscence:
Prevention of the postoperative parotitis consists
Administration of anticholinergic
of all of the following measures EXCEPT:
Hypertrophic scars are: Rise above the skin level but stay within the
Immediate postoperative complications could be
Incisional hernia
all of the following EXCEPT:
A chronic pain of an healed wound can be caused Nerve entrapment in suture
by:
A chronic pain of an healed wound can be caused Stitch abscess or granuloma
by:
For the postoperative acute urinary retention all
It is treated by diuretics.
of the following statements are true EXCEPT:
Chronic Granulomatous Disease is caused by: The congenital defect of phagocyte function
Treatment of early gastric dilation consists of the Nasogastric tube insertion
following:
Early postoperative complications are all of the
Keloid formation
following EXCEPT:
Treatment of superficial wound infection is: Opening the small segment of incision and
Marjolin ulcer is: Malignant transformation of chronic wound
A chronic pain of an healed wound can be caused Occult incisional hernia
by:
Gastric dilation if untreated leads to the following
Melena
condition EXCEPT:
The following test is used for the evaluation of
the patency of the ulnar artery before Allen test
establishing
the radial line:
Postoperative pneumonia can be caused by all of
Wound hematoma
the following factors EXCEPT:
Signs of postoperative wound hematoma are all
Vomitus
of the following EXCEPT:
The correct sequence of acute wound treatment
is:
Postoperative hematomas in neck region is
Airway obstruction
dangerous because of the following reason:
The following points are true for Split-thickness Needs vascular anastomosis for blood
skin graftEXCEPT: supply
Seroma is a collection of the following fluid in the Lymph
wound:
Following points are true for the necrotizing Treatment - Oral antibiotics
fasciitis EXCEPT:
The following factors facilitate postoperative
Ice pack application on the wound
hematoma formation EXCEPT:
Symptoms of the postoperative hematoma could
Hypothermia
be all the following EXCEPT:
Examples of deep wound infections are following Abscess under the axillary skin
EXCEPT:
Which method is NOT used for the treatment of
Diuretic administration
the postoperative seroma:
The neck hematoma can cause: Airway obstruction
Keloids are characterized by the following points Often regress over time
EXCEPT:
Symptoms of a superficial wound infection are Vomitus
EXCEPT:
Patient describes a popping sensation during
coughing in the postoperative wound and a
Wound dehiscence
discharge of serosanguineous fluid. Possible
diagnosis is:
What is the most common location for pressure
Sacrum
ulcer in ICU patient?
Which the following factors predisposes a patient
Dark skin color
to a keloid formation?
Parallel to which of the following nerves should
the incision be made during drainage of pus after VII
postoperative parotitis?
Which of the following descriptions of surgical Presence of tumor tissue during gross
margins applies to R2? examination at the resection margin
Which of the following factors promotes VEGF
angiogenesis?
Deficiency in which of the following Vitamins is
Vitamin C
also called a "Scurvy"?
Deficiency in which of the following elements can
cause decreased fibroblast proliferation and Zinc
collagen synthesis and delay epithelialization?
Which of the following is the most severe of
complications resulting from long term placement Ischemic necrosis of the digits
of arterial line?
Which of the following phases of wound healing
Inflammation
are affected the most with steroid use?
What is a Marjolin ulcer? Malignized ulcer
Which types of wound close produces a hairline Primary intention
scar?
Which of the following factors in TNM
Size of the tumor
classification is described as T?
Which stage of pressure ulcer can be described as
ulcer with partial-thickness skin loss involving Stage II
epidermis or dermis, or both?
Which of the following diseases results from
Osteogenesis imperfecta
mutations in Type I collagen?
Which of the following damages to the nerve can
be described as interruption of axonal continuity Axonotmesis
but preservation of Schwann cell?
What time does it take for a wound to complete a
6 weeks to 2 years
remodeling phase?
During which of the following types of ulcers is
Venous
compression therapy used?
What is the average infection rate for >30%
Contaminated wounds?
Elevated levels of cancer antigen 19-9 is most
likely to indicate a tumor in which of the following Pancreas
organs?
Which of the following conditions usually results
Chronic granulomatous disease
from mutation of NADPH oxidase in phagocytes?
FINAL
In the usual preparation for general surgery, the
NPO for 12 to 14 hours before
patient may be:
Treatment options of gastric dilation includes Decompression with a nasogastric tube
following:
Acute is a wound which heals earlier then: 6 weeks
In the gastrointestinal surgery serosa-to-serosa Serosa releases fibrin which makes suture
approximation is important because: line watertight.
Wound heals by secondary intention during
Wound is clean and sutured
following circumstances EXCEPT:
Wounds could be classified as all of the following Congenital
EXCEPT:
The management of small pleural effusion after
Leave undisturbed (observation)
upper abdominal operations includes:
Risk of postoperative myocardial infarction
Age under 30
includes All of the following EXCEPT:
Preventing measures for the postoperative lung
Swan-Ganz catheter
atelectasis are all of the following EXCEPT:
Following factors affect wound healing EXCEPT: Wound irrigation
Axonotmesis is: Interruption of axonal continuity but preser
The main peculiarity of fetal wound healing is: Absence of scarring
The correct sequence of wound heasling phases
is:
Bleeding from cut bone can be controlled by: Packing a wax
Laparotomy belongs to the following wound types Abrasion
EXCEPT:
Prevention of postoperative pneumonia includes : Encourage coughing
Disatvantages of dry heat sterilisation are all of
Does not destroy dry spores
the following EXCEPT:
Prevention of postoperative pneumonia includes : Maintaining the airway clear of secretions
The correct sequence of acute wound treatment
is:
During the late inflamation phase of wound
Macrophages
healing the main cell type found in the wound is:
During remodeling phase of wound healing the Collagen type III is gradually replaced by
tensile strength of the scar tissue gradually stronger type I collagen
increases because of:
Postoperative thromboembolism can be Low molecular weight heparin
prevented by:
A chronic pain of an healed wound can be caused Nerve entrapment in suture
by:
Compromised immune competence is expected in
Having joint dislocated
all of the following groups EXCEPT:
Delayed wound healing is expected in following Diabetes mellitus
patient group:
Marjolin ulcer is: Malignant transformation of chronic wound
After abdominal surgery the sequence of bowel
motility restoration is:
Delayed wound healing could be associated with
Pneumothorax
all of the following conditions EXCEPT:
The neck hematoma can cause: Airway obstruction
During the hemostasis phase of wound healing
Platelets
main cell type found in the wound is:
Neurotmesis is: Complete transection of nerve
All of the following points are true for the
Treatment - Oral antibiotics
necrotizing fasciitis EXCEPT:
Folowing factors affect wound healing EXCEPT: Vitamins
Risk factors for pulmonary aspiration of the
Lung atelectasis
gastric contents are EXCEPT:
The following points are tue for Split-thickness Needs vascular anastomosis for blood
skin graftEXCEPT: supply
Symptoms of Class III hypovolemia (loss of 30- Tachycardia, tachypnea, hypotension,
40% of blood volume) are: oliguria, and changes in mental status
Signs of postoperative wound hematoma are all
Vomitus
of the following EXCEPT:
Wound reepithelisation occurs by: Covering the granulation tissue with epitheli
All vegetative bacteria and most resistant dry
spores are destroyed by the following methods of Boiling
sterilization EXCEPT:
During the proliferation phase of wound healing
Fibroblasts
the main cell type found in the wound is:

General Surgery Midterm II

(02.06.2021)
1. The treatment of the coagulopathy caused by liver disease includes the
following: A. Vitamin K, FFP
B. Aspirin
C. Heparin
D. Warfarin
2. Warfarin dose is controlled by the following test:
A. Bleeding time
B. aPTT
C. Factor 8
D. INR/PT

3. Excess healing after gastrointestinal surgery could lead to the following complications:
A. Diarrhea
B. Stricture formation
C. Gastrointestinal bleeding
D. Fistula formation

4. All of the following principles are important for seccessful healing of the
bowel anastomosis EXCEPT:
A. Absence of tension
B. Adequate blood supply
C. Depressed bowel motility
D. Adequate nutrition

5. The symptom of superfitial wound infection is:

A. Hypothermia
B. Hyperemia
C. Muscle spasm
D. Cyanosis

6. Major types of chronic wound are EXCEPT:

A. Pressure ulcers
B. Arterial ulcers
C. Diabetic ulcers
D. Post appendectomy wound

7. Which medication is used as antidote in case of the heparin overdose:

A. Protamine sulphate
B. Platelet concentrate
C. FFP
D. Aspirin

8. The correct sequence of wound healing phases is:

 Hemostasis
 Inflammation
 Proliferation
 Remodeling/Maturation
9. During remodeling phase of wound healing the tensile strength of the scar
tissue gradually increases because of:
E. Collagen type Ill is gradually replaced by stronger type I collagen
F. Number of blood vessels in the scar is reduced
G. The fibroblasts start to disappear
H. Scar shrinkage

10. Marjolin ulcer is:

A. Chronic venous ulcer
C.B.Chronic arterial
Malignant ulcer
transformation of chronic
D. Chronic diabetic ulcer

11. Damage control resuscitation means all the following principles EXCEPT:
A. O-negative uncrosmathched RBC is used before typing results are available
B. Initial transfusion of red blood cells
C. In case of massive transfusion plasma, platelets and red blood cells are
transfused in a 1:1:1 ratio
D. Initial infusion of normal saline

12. Following factors affect wound healing EXCEPT:

E. Wound irrigation
F. Diabetes mellitus
G. Malnutrition
H. Vitamin deficiencies

13. Flowing factors affect wound healing EXCEPT:

E. Steroid use
F. Hypoperfusion of tissues
G. Advanced age
H. Antibiotics

14. Flowing factors affect wound healing EXCEPT:

E. Cancer
F. Cardiac failure
G. Vitamins
H. Chemotherapeutic antimetabolite drugs

15. Wounds could be classified as following EXCEPT:

A. Puncture
B. Preoperative
C. Chronic
D. Closed
16. Wounds could be classified as following EXCEPT:
A. Thermal
B. Congenital
C. Caused by radiation
D. Mechanical

17. Wounds could be classified as following EXCEPT:

A. Partial
B. Penetrating
C. Missile
D. Crushed

18. Tests necessary for RBC transfusion are the following EXCEPT:
A. Human leukocyte antigen (HLA) typing
B. Cross matching
C. Rh typing
D. ABO typing

19. Treatmet of superficial wound rection is:

A. Removal of drains
B. Oral steroids
C. Heparin ointment
D. Opening the small segment of incision and draining of purulent content

20. The extrinsic pathway of hemostasis is initiated

by: A. Tissue thromboplastin
B. Thrombin
C. Red blood cells
D. Plasmin

21. Keloids are characterised by the following points EXCEPT:

A. Excision alone of keloids is subject to a high recurrence rate, ranging from
45 to 100%
B. Is more common in darker-pigmented ethnicities, with individuals of
African, Spanish, and Asian ethnicities
C. Rise above the skin level as well, but extend beyond the border of
the original wound
D. Often regress over time

22. Wound reepithelisation occurs by:

A. Replacement of epithelium with connective tissue (scar)
B. Covering the granulation tissue with epithelial cells migrating from
wound edges
23. Examples of deep wound infections are following EXCEPT:
A. Abscess under diaphragm
C.B.Abscess
Abscessunder
underfascia
the axillary
D. Abscess in the Douglass pouch

24. Neurapraxia is:

A. Interruption of axonal continuity but preservation of Schwann cell basal
lamina B. Congenital absence of nerve
C. Focal demyelination of nerve
D. Complete transection of nerve

25. Main enzyme causing thrombosis is: (!!!)

A. Tissue thromboplastin
B. Heparin
C. Plasmin
D. Von Willebrand's factor

26. Phases of bone healing are all of the following EXCEPT:

A. Remodeling
B. Epithelisation
C. Soft callus formation
D. Hard callus formation

27. Laparotomy belongs to the following wound types EXCEPT:

A. Incision
B. Mechanical
C. Abrasion
D. Open

28. Axonotmesis is:

A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Complete transection of nerve
C. Focal demyelination of nerve
D. Congenital absence of nerve

29. Wound heals by primary intention when:

A. There is a little gap between wound edges
B. Wound is packed with sterile gauze
C. The wound is infected
D. After wound dehiscence
30. Wound heals by secondary intention during following circumstances EXCEPT:
A. The wound is infected
B. Wound is clean and sutured
C. Wound is packed with sterile gauze
D. Sutures are applied after granulation tissue formation

31. Wound heals by secondary intention when:

A. Wound edges are separated
B. The wound is sutured
C. Incised or cut wounds
D. There is no infection

32. Chronic Granulomatous Disease is caused by:

A. Malnutrition
B. Vitamin deficiency
C. Defective connective tissue
D. The congenital defect of phagocyte function.

33. Symptoms of a superficial wound infection are EXCEPT:

A. Wound swelling
B. Hyperemia
C. Vomitus
D. Hyperthermia

34. Failure of healing of the gastrointestinal wall sutures could lead to the
following complications EXCEPT:
A. Peritonitis
B. Fistula formation
C. Intestinal obstruction
D. Intraabdominal abscess

35. Neurotmesis is:

A. Interruption of axonal continuity but preservation of Schwann cell basal lamina
B. Complete transection of nerve
C. Congenital absence of nerve
D. Focal demyelination of nerve

36. The main pecularity of fetal wound healing is:

A. Absence of healing
B. Absence of scarring
C. Slow healing
D. Excess healing
37. During the hemostasis phase of wound healing main cell type found in the
wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils

38. During the late inflamation phase of wound healing the main cell type found in
the wound is:
A. Platelets
C.B.Fibroblasts
D. Neutrophils

39. During the early inflamation phase of wound healing the main cell type found
in the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D.
40. During the proliferation phase of wound healing the main cell type found in the wound is:
A. Platelets
B. Macrophages
C. Fibroblasts
D. Neutrophils

41. Following points are true for the necrotizing fasciitis EXCEPT:
A. Treatment - Oral antibiotics
B. Characterized by high mortality rate
C. Is caused by the septic thrombosis of the vessels
D. Treatment - Removal of all necrotized skin and fascia

42. Main components of the extracellular matrix are all EXCEPT:

A. Glycosaminoglycan
B. Proteoglycans
C. Collagen
D.

43. Symptoms of Class IIIhypovolemia (loss of 30-40% of blood volume) are:

A. Face hyperemia, bradycardia
B. Dry mouth, normal pulse pressure
C. Tachycardia and decreased pulse pressure but, normal BP (Class II)
D. Tachycardia, tachypnea, hypotension, oliguria, and changes in mental status
44. Acute is a wound which heals earlier then:
A. 6 weeks
B. 10 weeks
C. 3 months
D. 2 months

45. The following points are tue for Split-thickness skin graft EXCEPT:
A. May be "meshed" to cover larger area
B. Is harvested using dermatomes
C. Consists of epidermis and part of dermis
D. Needs vascular anastomosis for blood supply

46. Hypertrophic scars are:

A. Rise above the skin level as well, but extend beyond the border of
the original wound and rarely regress spontaneously
B. Rise above the skin level but stay within the confines of the original
wound and often regress over time

47. Methods of mechanical hemostases are the following EXCEPT:

A. Application of the tourniquet
B. Bipolar electrocautery
C. Direct digital pressure over a bleeding site
D. Vascular clamp Simple ligature (transfixion suture) Direct pressure
applied by packs

48. Bleeding from cut bone can be controlled by:

A. Ligature
B. Tourniquet
C. Packing a wax
D. Vascular clamp

49. The correct sequence of acute wound treatment is:

 Temporary hemostasis
 Anesthesia
 Wound toilet
 Debridement/Definite hemostasis
 Proper approximation of wound edges
 Wound dressing

50. In the gastrointestinal surgery serosa-to-serosa approximation is important because:

A. Serosal epithelium releases growth factors for faster
healing B. Serosal epithelium releases growth factors for faster
healing
C. Serosa releases fibrin which makes suture line watertight.
D. Serosa has the greatest tensile strength and suture-holding capacity
 Old Exams

Questions Answer
During the hemostasis phase of wound
healing main cell type found in the Platelets
wound
is:
Neurotmesis is: Complete transection of nerve
In the gastrointestinal surgery serosa-to- Serosa releases fibrin which makes suture
serosa approximation is important line watertight.
because:
During the proliferation phase of wound
healing the main cell type found in the Fibroblasts
wound is:
Wound heals by secondary intention
Wound is clean and sutured
during following circumstances EXCEPT:
Failure of healing of the
gastrointestinal wall sutures could lead Intestinal obstruction
to the following
complications EXCEPT:
Phases of bone healing are all of the Epithelisation
following EXCEPT:
All of the following principles are
important for successful healing of Depressed bowel motility
the
bowel anastomosis EXCEPT:
Acute is a wound which heals earlier 6 weeks
then:
Neurapraxia is: Focal demyelination of nerve
Following factors affect wound healing Antibiotics
EXCEPT:
Main components of the extracellular Myosin
matrix are all EXCEPT:
Wounds could be classified as following Preoperative
EXCEPT:
The symptom of superficial wound Hyperemia
infection is:
During the early inflammation phase of
wound healing the main cell type found in Neutrophils
the wound is:
The correct sequence of wound healing
phases is:
Wounds could be classified as following Congenital
EXCEPT:
Wound heals by secondary intention Wound edges are separated
when:
Axonotmesis is: Interruption of axonal continuity but
preser
Following factors affect wound healing Wound irrigation
EXCEPT:
During the late inflammation phase of
wound healing the main cell type found in Macrophages
the wound is:
Excess healing after gastrointestinal
surgery could lead to the following Stricture formation
complications:
During remodeling phase of wound Collagen type III is gradually replaced by
healing the tensile strength of the scar stronger type I collagen
tissue gradually increases because of:
Wound reepithelisation occurs by: Covering the granulation tissue with
epitheli
The main peculiarity of fetal wound Absence of scarring
healing is:
Following factors affect wound healing Vitamins
EXCEPT:
Laparotomy belongs to the following Abrasion
wound types EXCEPT:
Wounds could be classified as following Partial
EXCEPT:
Major types of chronic wound are Post appendectomy wound
EXCEPT:
Wound heals by primary intention when: There is a little gap between wound
edges
Which of the following conditions is NOT
Arterial hypertension
a risk factor for the wound dehiscence:
Prevention of the postoperative parotitis
consists of all of the following measures Administration of anticholinergic
EXCEPT:
Hypertrophic scars are: Rise above the skin level but stay within
the
Immediate postoperative complications
Incisional hernia
could be all of the following EXCEPT:
A chronic pain of an healed wound can be Nerve entrapment in suture
caused by:
A chronic pain of an healed wound can be Stitch abscess or granuloma
caused by:
For the postoperative acute urinary
retention all of the following statements It is treated by diuretics.
are true EXCEPT:
Chronic Granulomatous Disease is caused The congenital defect of phagocyte
by: function
Treatment of early gastric dilation Nasogastric tube insertion
consists of the following:
Early postoperative complications are all
Keloid formation
of the following EXCEPT:
Treatment of superficial wound infection Opening the small segment of incision
is: and
Marjolin ulcer is: Malignant transformation of chronic
wound
A chronic pain of an healed wound can be Occult incisional hernia
caused by:
Gastric dilation if untreated leads to the
Melena
following condition EXCEPT:
The following test is used for the
evaluation of the patency of the ulnar Allen test
artery before establishing the radial line:
Postoperative pneumonia can be caused
Wound hematoma
by all of the following factors EXCEPT:
Signs of postoperative wound hematoma
Vomitus
are all of the following EXCEPT:
The correct sequence of acute wound
treatment is:
Postoperative hematomas in neck region
is dangerous because of the following Airway obstruction
reason:
The following points are true for Split- Needs vascular anastomosis for blood
thickness skin graftEXCEPT: supply
Seroma is a collection of the following Lymph
fluid in the wound:
Following points are true for the Treatment - Oral antibiotics
necrotizing fasciitis EXCEPT:
The following factors facilitate
postoperative hematoma formation Ice pack application on the wound
EXCEPT:
Symptoms of the postoperative
hematoma could be all the Hypothermia
following
EXCEPT:
Examples of deep wound infections are Abscess under the axillary skin
following EXCEPT:
Which method is NOT used for the
Diuretic administration
treatment of the postoperative seroma:
The neck hematoma can cause: Airway obstruction
Keloids are characterized by the following Often regress over time
points EXCEPT:
Symptoms of a superficial wound Vomitus
infection are EXCEPT:
Patient describes a popping sensation
during coughing in the postoperative
wound and a discharge of Wound dehiscence
serosanguineous fluid. Possible diagnosis
is:
What is the most common location for
Sacrum
pressure ulcer in ICU patient?
Which the following factors predisposes a
Dark skin color
patient to a keloid formation?
Parallel to which of the following nerves
should the incision be made during
VII
drainage of pus after postoperative
parotitis?
Which of the following descriptions of Presence of tumor tissue during gross
surgical margins applies to R2? examination at the resection margin
Which of the following factors promotes VEGF
angiogenesis?
Deficiency in which of the following
Vitamin C
Vitamins is also called a "Scurvy"?
Deficiency in which of the following
elements can cause decreased fibroblast
Zinc
proliferation and collagen synthesis and
delay epithelialization?
Which of the following is the most severe
of complications resulting from long term Ischemic necrosis of the digits
placement of arterial line?
Which of the following phases of wound
healing are affected the most with steroid Inflammation
use?
What is a Marjolin ulcer? Malignized ulcer
Which types of wound close produces a Primary intention
hairline scar?
Which of the following factors in TNM
Size of the tumor
classification is described as T?
Which stage of pressure ulcer can be
described as ulcer with partial-thickness
Stage II
skin loss involving epidermis or dermis, or
both?
Which of the following diseases results
Osteogenesis imperfecta
from mutations in Type I collagen?
Which of the following damages to the
nerve can be described as interruption of
Axonotmesis
axonal continuity but preservation of
Schwann cell?
What time does it take for a wound to
6 weeks to 2 years
complete a remodeling phase?
During which of the following types of
Venous
ulcers is compression therapy used?
What is the average infection rate for >30%
Contaminated wounds?
Elevated levels of cancer antigen 19-9 is
most likely to indicate a tumor in which Pancreas
of
the following organs?
Which of the following conditions
usually results from mutation of NADPH Chronic granulomatous disease
oxidase
in phagocytes?