2017 Flashcards by Fajer e

What procedure removes bacteria spores, fungi, and viruses from an object? 2017, 2016
a. Sterilization
b. Pasteurization
c. Boiling
d. Antisepsis
e. Disinfection

a. Sterilization

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A patient is a known case of DM, HT and is on clopidogrel. He is scheduled for an elective hernia repair. When should he discontinue clopidogrel preoperatively? 2017
a. 6 hours
b. 1 day
c. 3 days
d. 7 days
e. 10 days

d. 7 days

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How is anterior instability of the knee assessed? 2017
a. Plain X-ray
b. Posterior drawer test
c. Anterior drawer test
d. McMurry
e. Vagus stress test

c. Anterior drawer test

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During a routine screening mammogram, a 62 year old teacher was informed that she has changes on mammogram and she should consult her physician. Which of the following indicates benign finding? 2017, 2016
a. Clearly defined mass with irregular borders
b. Coarse calcifications
c. Discrete non-palpable mass that has increased in size compared to a previous mammogram
d. Linear branching calcifications
e. Solid, clearly defined mass with irregular edges

b. Coarse calcifications

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A gentleman involved in a car accident sustained an open fracture and was bleeding profusely. What measure would you do while waiting to be transferred to the hospital?
2017
a. Apply pressure on wound and elevate limb
b. Elevate limb
c. Apply a tourniquet
d. Apply pressure over the femoral artery
e. Clamp bleeding vessel

a. Apply pressure on wound and elevate limb

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Hep C has a risk of what

HCC risk

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What is an absolute contraindication of BC vaccination? 2017
a. Previous BCG treatment
b. Previous TB
C. Immunosuppression

C. Immunosuppression

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Which radiological finding indicates pelvic instability? 2017, 2016, 2011
a. Symphysis diastasis 5 mm
b. Sacroiliac impaction
c. Sacroiliac diastasis 1cm
d. Fracture of superior pubic rami
e. Fracture of inferior pubic ram

c. Sacroiliac diastasis 1cm

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What diagnostic test best differentiates testicular torsion from epididymo-orchitis? 2017
a. Absent cremasteric reflex
b. Testes in horizontal lie
c. US color doppler with no blood flow
d. High riding testis
e. Surgical exploration

c. US color doppler with no blood flow
(They want to rule in testicular torsion)

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A 9-year-old boy came with abdominal distension and discharge from the umbilicus. He also had tenderness on his lower abdomen. What is the diagnosis? 2017
a. Patent urachus
b. Umbilicus sinus

b. Umbilicus sinus

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Smoker patient had abdominoplasty and got hypoxia and fever 2 days later. What is the next step? 2017
a. Systemic anticoagulant
b. Pulmonary thrombolysis
c. Physiotherapy
d. Bronchoscopy and lavage

c. Physiotherapy

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Which nerve supplies pectoralis minor muscle? 2017, 2016, 2013
a. Medial pectoral nerve
b. Lateral pectoral nerve
c. Long thoracic
d. Thoracodorsal nerve

a. Medial pectoral nerve

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A 10-year-old boy presented with left testicular pain associated with tenderness over the upper pole of the testes and blue discoloration. There was no history of trauma and no fever, what will you find on scrotal exploration? 2017
a. Normal
b. Testicular torsion
c. Testicular appendix torsion
d. Bell clapper deformity

c. Testicular appendix torsion

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What is the best thing to reverse heparin in an emergency surgery? 2017, 2015
a. Dantrolene
b. Halothane
c. Naloxone
d. N-acetylcysteine
e. Protamine

e. Protamine

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Post radical prostatectomy, when do you measure PSA level? 2017
a. 14 days
b. 21 days
c. 28 days
d. 48 days

d. 48 days

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A 63-year-old male present with painless jaundice and pruritus. He reports to drink alcohol daily. Examination of his abdomen revealed a palpable non-tender gallbladder. What is the likely diagnosis? 2017, 2013
a. Alcoholic hepatitis
b. Gallstones
c. PBC
d. Pancreatic cancer

d. Pancreatic cancer
Chronic alcoholism causes chronic pancreatitis which is a risk factor for pancreatic cancer.
Courvoisier law supports the diagnosis.

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A 30-year-old patient underwent small bowel resection for closed loop obstruction. He is having persistent hypokalemia despite K+ replacement. What could be the cause? 2017
a. Hypocalcemia
b. Hypomagnesemia
c. Hypophosphatemia
d. Hyponatremia
e. Hypochloremia

b. Hypomagnesemia

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A 30 year old male patient came after a motorcycle accident with a GCS score of 15, heart rate was 120 beats per minute, blood pressure was 80/50 mHg. C-collar was placed. Chest exam was normal. FAST was negative. Pelvic exam revealed pelvic instability. What should be done next? 2017, 2016
a. Pelvic wrapping
b. Pelvic packing
c. External fixation
d. Internal fixation
e. Angioembolization

a. Pelvic wrapping

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What’s the main source of nutrients for enterocytes?

Glutamine

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What surgical specialties are required for management of an open fracture (GA grade 3b)?
2017
a. Orthopedic trauma surgeons only
b. Orthopedic & vascular surgeon
c. Orthopedic & plastic surgeon
d. Orthopedic & infection control specialist

c. Orthopedic & plastic surgeon

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An 8 cm homogeneously dense mass was found within the abdominal wall. What is it? 2017
a. Desmoid tumor
b. Lipoma
c. Hernia

a. Desmoid tumor

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What is the earliest sign of Volkmann’s ischemia (compartment syndrome)? 2017
a. Pain
b. Pallor and poor capillary filling
c. Paresthesia of median nerve area
d. Contracture of fingers
e. Gangrene of tips of finger

a. Pain

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A 60-year-old male with esophageal carcinoma and malnutrition and requires TPN. What would be his daily caloric intake? 2017
a. 1 kcal/kg body weight/day
b. 5 kcal/kg body weight/day
c. 30 kcal/kg body weight/day
d. 50 kcal/kg body weight/day
e. 100 kcal/kg body weight/day

c. 30 kcal/kg body weight/day

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A patient was recently diagnosed with peptic ulcer disease. H. pylori was successfully eradicated. How to check H. pylori eradication? 2017
a. Culture and sensitivity
b. Serology
c. Stool polymerase chain
d. Urea breath test

d. Urea breath test

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Which of the following is associated with the highest risk of transmission with needle stick injury? 2017, 2016, 2013, 2010 a. Epstien-Barr virus b. Hepatitis A virus C. Hepatitis B virus d. Hepatitis C virus e. HIV

C. Hepatitis B virus CDC data from most common to least: HBV (6-30%), HCV (1-2%), HIV (0.3%)

Following laparoscopic hernia repair for indirect right inguinal hernia, a 60-year-old male patient presents with pain and burning sensation that radiates to the lateral aspect of the ipsilateral thigh. The likely cause is injury to which of the following? 2017, 2016 a. loinguinal nerve b. Iliohypogastric nerve c. Femoral nerve d. Genitofemoral nerve e. Lateral Cutaneous nerve

e. Lateral Cutaneous nerve

A 22 year old male presented with anemia, endoscopy showed a gastric, small bowel and colon polyps in addition to dark pigmentation around his mouth. What is the diagnosis? 2017, 2013 a. Cronkhite-Canada syndrome b. Familial adenomatous polyposis c. Non-polyposis colonic cancer d. Juvenile polyposis e. Peutz-Jegher syndrome

e. Peutz-Jegher syndrome

A patient had a total thyroidectomy for a large goiter. On the third day, he complained of numbness and his hands contracted in response to increase cuff pressure. The ECG showed prolonged QT. What is the most likely abnormality? 2017, 2015 a. Hypokalemia b. Hyperkalemia c. Hypocalcemia d. Hypercalcemia

c. Hypocalcemia A positive Trousseau's sign is defined by flexion of the wrist, the thumb, and the joints located between the palm of the hand and the fingers, along with the extension of the fingers.

A 52-year-old man noticed prolapse in the anal area during defecation that he couldn't reduce manually. The patient had a colonoscopy 1 year ago for internal hemorrhoids. What's the diagnosis? 2017 a. Grade I hemorrhoids b. Grade Il hemorrhoids c. Grade Ill hemorrhoids d. Grade IV hemorrhoids e. Low rectal cancer

d. Grade IV hemorrhoids

Patient with obstructive jaundice (dilated CBD). Which of the following is absent in the patient's urine?

Urobilinogen

What nutritional deficiency is associated with floating stool? 2017 a. Vitamin A b. Vitamin B6 c. Vitamin C d. Vitamin E

a. Vitamin A

What forms the superior border of the ischiorectal fossa? 2017, 2013 a. Gluteus major b. Obturator Internus c. Levator Ani Complex

c. Levator Ani Complex

A 27-year-old female in her late first trimester was diagnosed with acute bacterial cystitis on routine U/A (urinalysis).What is the most appropriate treatment? 2017, 2012 a. Nitrofurantoin for 3 days b. Trimethoprim for 5 days c. Cephalosporin for 7 days d. Cefazolin for 7 days e. Ciprofloxacin for 7 days f. Levofloxacin for 7 days

a. Nitrofurantoin for 3 days

Flu-like illness and a painful neck. Tests show high T4, ESR, and a low TSH. What is the diagnosis?

Subacute thyroiditis

During a surgery, something went wrong and required anastomosis. What is the correct step to do?

a. Tell the patient and write it down

What forms the portal vein? 2017, 2011, 2010 a. Splenic vein and Inferior Mesenteric vein b. Superior Mesenteric vein and Splenic vein c. Superior Mesenteric vein and Inferior Mesenteric vein

b. Superior Mesenteric vein and Splenic vein

A 57-year-old patient underwent ERCP for choledocholithiasis. Five days later she presented with tachycardia and hypotension. Physical examination revealed a distended abdomen. Erect chest X-ray showed black shadow below the diaphragm. What’s the management?

Exploratory laparotomy

A patient presented with nonspecific abdominal pain found to have incidental adrenal mass 2.5 cm in size. What is your next step? 2017 a. Biochemical profile b. CT every 6 months c. CT every year d. FNA e. Laparoscopic adrenalectomy

a. Biochemical profile This is a case of adrenal incidentaloma. The goal is to know if it is functional and if it is malignant. * Malignancy: can be diagnosed by CT findings based on size (90% of malignant masses are > 4 cm), density and borders. * FNA biopsy CANNOT distinguish between benign mass and carcinoma. * PET scan is useful for someone with a history of malignancy. * Functionality by lab tests even if patient is asymptomatic. A is the best answer

Clinical evidence of cholecystitis and leukocytosis, but imaging is inconclusive. What's the management?

Diagnostic laparotomy

A patient with a history of breast cancer 8 years ago presented with back pain. What is the next step? 2017 a. Bone Scan b. CT c. Bone Density d. Calcium Vit D

b. CT

A 28-year-old male patient had fine needle aspiration of his left thyroid nodule. The result of his biopsy classified the lesion as Bethesda category 2. Which of the following does this best signify? 2017 a. Benign b. Follicular lesion of underdetermined significance c. Malignant d. Non-diagnostic e. Suspicious follicular carcinoma

a. Benign

A 57-year-old female with cirrhosis was admitted with esophageal varices. The bleeding was controlled with endoscopic banding, and the patient was admitted to the ICU for observation. 72 hours later the patient presented with confusion and combative behavior. What would you do? 2017 a. Physically restrain and give fluoroquinolone b. Physically restrain and give third generation cephalosporin c. Physically restrain and start over thiamine d. Physically restrain and start lactulose e. Start Ativan

d. Physically restrain and start lactulose

A trauma patient arrived at the ER unconscious and required immediate surgical intervention. From whom should the consent be taken? 2017, 2016, 2015 a. Patient b. Partner c. Ethics Office d. Judge e. Surgeon

e. Surgeon

What are the left and right lobes of the liver defined by? 2017, 2012 a. Calot's triangle b. Cantle line c. Hepatic artery d. Portal vein

b. Cantle line

A 50-year-old male scheduled for a surgery was put on TPN through a single port central vein IV. On the morning of the surgery, the TP was removed, and he was given Ringer's lactate. One hour later, he is tachycardic, sweating, and anxious. What is the cause of his presentation? 2017 a. Hypoglycemia b. Hypokalemia c. Hyponatremia d. Hypophosphatemia e. Hypovolemia

a. Hypoglycemia

1. What is the most common cause of failure of internal fixation? 2017 a. Infection b. Corrosion

a. Infection

Guy with asterixis

Esophageal varices

A young girl got an abrasion, and crepitations were found during her lower limb exam. What type of biopsy is needed to confirm diagnosis of necrotizing fasciitis? 2017 a. Fascia b. Skin c. Bone d. Blood

a. Fascia

A patient with periumbilical pain shifting to right iliac fossa, also he has rebound tenderness, leukocytosis, and high lactate. Abdominal ultrasound and CT were inconclusive. What is the next step? 2017 a. Admit for observation and serial abdominal examinations b. Magnetic resonance enterography c. Upper and lower Gl endoscopy d. Small bowel follow-through e. Diagnostic laparoscopy

e. Diagnostic laparoscopy

Which of the following is associated with increased risk of testicular germ cell cancer? 2017 a. Varicocele b. Down syndrome c. Radiation therapy

b. Down syndrome

Which of the following is a cofactor in the hydroxylation of proline?

Vitamin C

Barium showed stomach above diaphragm

Hiatal hernia

A 71-year-old woman presents with abdominal pain and vomiting. Plain radiograph of the abdomen shows dilated bowel loops, calcification in the right lower quadrant and air in the biliary tract. What is the likely diagnosis? 2017, 2011 a. Acute appendicitis b. Gallstone ileus

b. Gallstone ileus

A 27-year-old lady presented with right flank pain for 2 weeks duration. She underwent Roux-en-Y gastric bypass for her obesity 4 years ago. Upon examination, her renal ultrasound showed moderate hydro-uretero-nephrosis proximal to a 12 mm stone in the upper ureter. What is the most likely stone composition? 2017, 2016 a. Calcium oxalate b. Uric acid c. Cystine d. Magnesium ammonium phosphate

a. Calcium oxalate Explanation: in this case there is decreased absorption of fat, so calcium binds to fat and the absorption of oxalate is increased leading to hyperoxaluria, which facilitates calcium oxalate stones formation. same reason of increased calcium oxalate stone formation in inflammatory bowel disease)

A 28-year-old female pregnant in her third trimester presents with left flank pain and severe nausea. Her RFTs and other laboratory tests were insignificant. What is the best modality to diagnose her? 2017 a. MRI with contrast b. CT with contrast c. Fluoroscopy

a. MRI with contrast

Which of the following nerves is commonly injured with posterolateral knee dislocation? 2017, 2014 a. Common peroneal nerve b. Superficial peroneal nerve c. Anterior division of sciatic nerve d. Tibial nerve e. Femoral nerve

a. Common peroneal nerve

A 34-year-old female in a motorcycle accident, laparotomy and splenectomy was done. What should be given to her before discharge? 2017, 2016, 2014, 2012 a. Meningococcal, H. influenza, pneumococcal b. Pneumococcal and tetanus c. Varicella zoster, meningococcal and tetanus d. Meningococcal and hepatitis B e. Tetanus only

a. Meningococcal, H. influenza, pneumococcal

A 72-year-old man after hip replacement surgery presented with abdominal pain, bloating, nausea and vomiting. He was diagnosed with Ogilvie's syndrome (Acute Colonic Pseudo-Obstruction ACPO). Which of the following drugs is used for treatment?

Neostigmine

A 2-year-old girl presented with dysplasia of the hip shown on x-ray, what is the best management? 2017 a. Closed reduction, hip arthrogram, and spica cast b. Open reduction and spica cast c. Open reduction and pelvic osteotomy

b. Open reduction and spica cast

A 5-year-old boy presented with bone pain. Examination showed skin infiltrations. Further investigations revealed neutropenia and lymphocytosis with lymphocyte predominance on blood testing. What condition might he have? 2017 a. Acute lymphocytic leukemia b. Osteomyelitis

a. Acute lymphocytic leukemia

What type of wound is a robotic hemicolectomy?

a. Clean contaminated

A 60-year-old patient male presented with excruciating chest pain. This follows an episode of severe vomiting. On examination, the patient had subcutaneous emphysema. Chest x-ray shows air in the mediastinum and neck, and left air fluid level. What is the diagnosis? 2017 a. Inferior MI b. Mallory Weiss tear c. Spontaneous Esophageal Rupture

c. Spontaneous Esophageal Rupture

A 32-year-old male had a motorcycle accident and arrived by ambulance. He complains of abdominal pain. On a clinical exam, there was large left and right hemipelvic ecchymosis. The patient also had tachycardia. What would be the best initial management? 2017 a. 2 units of PRBC b. Normal saline infusion c. Lactate Ringer infusion

b. Normal saline infusion

What is the definition of nocturia? 2017, 2012 a. waking up at night to void where each micturition is preceded and followed by sleep b. the total volume of urine passed between the time the individual goes to bed with the intention of sleeping and the time of waking with the intention of rising.

a. waking up at night to void where each micturition is preceded and followed by sleep

A patient with left testicular cancer with positive lymph nodes. Which of the following lymph nodes are particularly affected? 2017, 2016, 2015 a. Para-aortic b. Paracaval c. Pelvic d. Inguinal

a. Para-aortic

A 36-year-old man was brought to the casualty after a traumatic accident. In the emergency room, the patient's blood started to ooze profusely from his wounds and sites of IV cannulation. What is the likely diagnosis? 2017, 2011 a. Catheter-related infection b. Disseminated intravascular coagulation c. Transfusion reaction

b. Disseminated intravascular coagulation

A 57-year-old patient with a previous history of infravesical obstruction due to BPH on tamsulosin presented to the ER with acute urinary retention. A 16 french catheter was inserted, and 600 ml of urine came out. What is the most appropriate measure to prevent future similar episodes? 2017 a. Add finasteride b. Switch tamsulosin to silodosin c. TURP

c. TURP

What is found on ECG in hypercalcemia? 2017 a. Short QT interval b. Tented t-waves c. Flattened t-waves d. Prolonged PR interval

a. Short QT interval

A 24-year-old female, who is nil per mouth, was given 1L normal saline. How much sodium does this bag contain? 2017, 2016 a. 77 mEq/L b. 130 mEq/L c. 140 mEg/L d. 154 mEq/L

d. 154 mEq/L

What is found in both the inguinal canal and femoral canal?

Inguinal ligament

What nutritional parameter has a lifespan of about 2 days? 2017 a. Albumin b. Prealbumin c. Creatinine d. Transferrin

b. Prealbumin

What are the boundaries of Calot's triangle? 2017, 2016, 2015, 2013 a. Cystic duct, common hepatic duct, inferior liver edge b. Left hepatic duct, inferior liver edge and CBD c. Right hepatic artery, cystic duct, and CBD

a. Cystic duct, common hepatic duct, inferior liver edge

What is the name of Meckel's diverticulum hernia? 2017 a. Amyand b. Littre's c. Perineal d. Spigelian

b. Littre's

Regarding follicular and papillary thyroid cancer, how does their staging system differ from other types of cancer? 2017, 2014 a. Age b. Sex

a. Age

Management of T3N1MO?

Neo adjuvant chemo or Abdominal hernia resection

3. How does diabetes cause delayed wound healing? 2017 a. Glycation of collagen in the wound bed b. High bacterial load due to hyperglycemia c. Local hypoxia due to impaired angiogenesis and vascular injury

c. Local hypoxia due to impaired angiogenesis and vascular injury

A 30-year-old female presented to the emergency department with a 3-month history of intermittent RLQ pain and low-grade fever. On physical examination, a mass was noted. An abdominal x-ray showed a mass with calcification in the RLQ, and a chest x-ray showed bilateral upper pulmonary infiltrates. What's the diagnosis? 2017 a. Ileocecal TB b. Cecal cancer c. Cecal diverticulitis d. Ovarian tumor e. Appendicular carcinoid

a. Ileocecal TB

A 27-year-old female presented with dysphagia to solids and to a lesser extent to liquids. Upper gastrointestinal endoscopy was normal. Manometry showed absence of peristalsis and failure of lower esophageal sphincter to relax. What is the diagnosis? 2017 a. Achalasia b. Diffuse esophageal spasm c. Esophageal stricture d. GERD e. Hiatal hernia

a. Achalasia

A 24-year-old female diagnosed with breast cancer; her genetic testing revealed BRCA1 mutation. What other type of cancer is it commonly associated with? 2017, 2012 a. Ovarian b. Parathyroid c. Prostate

a. Ovarian

What is the best time to screen for developmental dysplasia of the hip? 2017 a. At birth b. 3 months

b. 3 months

What is the advantage of synthetic mesh in the repair of inguinal hernia? 2017, 2014, 2012 a. Reduces Infection b. Reduces Recurrence c. Reduces operative time d. Reduces risk of scrotal hematoma

b. Reduces Recurrence

A 75-year-old male with hip osteoarthritis. He had subcapital femoral fracture, what is the management? 2017 a. ORIF b. Total arthroplasty c. Hemiarthroplasty

c. Hemiarthroplasty

What is the management of thyroglossal cyst in a 20-year-old patient? 2017, 2014 a. Observation b. Incision and drainage c. Excision d. Excision of entire tract and a part of hyoid bone e. Total thyroidectomy

d. Excision of entire tract and a part of hyoid bone

Female singer underwent a total thyroidectomy for thyroid malignancy, now her voice is low pitched, and she cannot reach high notes; her vocal cords were normal. What nerve could have been possibly injured? 2017, 2016 a. Internal laryngeal nerve b. Recurrent laryngeal nerve c. Superior laryngeal nerve d. Vocal cords

c. Superior laryngeal nerve

What is the most common complication of transrectal prostate biopsy? 2017 a. Sepsis b. Bleeding c. Fistula

b. Bleeding

What type of collagen is present in the proliferative phase of wound healing? 2017 a. Type 1 b. Type 2 c. Type 3 d. Type 4 e. Type 5

c. Type 3

What is the treatment for chronic anal fissure? 2017 a. Glyceryl Trinitrate (GTN) b. Sphincterotomy

Chronic anal fissures should be initially treated with topical pharmacologic agents, e.g., calcium channel blockers or nitrates. Patients who fail to respond to conservative or medical therapy can be referred to surgery.

Which tumor is not associated with Li Fraumeni syndrome? 2017 a. Breast Ca. b. Gastric Ca. c. Leukemia d. Sarcoma

b. Gastric Ca.

What is the embryological origin of the falciform ligament? 2017, 2013, 2012, 2011 a. Ductus venous b. Umbilical artery c. Umbilical vein d. Urachus

c. Umbilical vein

A 36 year old female came in with bloody nipple discharge. What is the diagnosis? 2017, 2010 a. Abscess b. Cyst c. Intraductal papilloma d. Prolactinoma

c. Intraductal papilloma

A 36-year-old female presented with visual disturbances and tremor and weight loss. A bruit can be heard over her neck. What is the diagnosis?

Graves

What forms the wall of pancreatic pseudocyst? 2017, 2011 a. Columnar b. Epithelial tissue c. Granulation tissue d. Squamous cell

c. Granulation tissue

3. What does the intercostobrachial nerve innervate? 2017 a. Skin of the upper posteromedial part of the arm b. Skin overlying the deltoids c. Skin of the posterior part of the forearm d. Skin overlying the medial half of the breast e. Skin overlying the lateral half of the breast

a. Skin of the upper posteromedial part of the arm

A fistula was left open and packed till it closed. What type of healing is this? 2017 a. Primary delayed b. Secondary delayed c. Primary intention d. Secondary intention e. Tertiary intention

d. Secondary intention

2017 Flashcards

(94 cards)