General Review Flashcards
A patient presents with a history of fatigue and dyspnea. He is found to have hepatomegaly, ascites, and an elevated jugular venous pulse. Heart sounds are normal, no murmurs are present, and the heart is of normal size. The pulse pressure is decreased by palpation. ECG is normal except for low voltage. The most likely diagnosis is:
A) Right Atrial Myxoma
B) Valvular Disease
C) Constrictive Pericarditis
D) Primary Pulmonary Artery Hypertension
C) Constrictive Pericarditis
Classic PE findings of Constrictive Pericarditis include JV distention with Kussmaul sign, diminished cardiac apical impulses, peripheral edema ascites, pulsatile liver, a pericardial knock, and, in advanced disease, signs of liver dysfunction such as jaundice and cachexia.
You are assisting a surgeon in an important procedure. The procedure is going well until you hear the anesthesiologist refer that the patient has an arrhythmia. What is the most common arrhythmia seen during laparoscopy.
A) Atrial Fibrillation
B) Sinus Tachycardia
C) PVCs
D) Sinus Bradycardia
D) Sinus Bradycardia
A rapid stretch of the peritoneal membrane often causes a vagovagal response with bradycardia and occasionally hypotension. The appropriate management is desuflation of the abdomen, administration of vagolytic agents (atropine), and adequate volume replacement.
While reviewing the pathology of a recent laparoscopic appendectomy, you note that in addition to acute appendicitis, the patient had a 1.5 cm carcinoid tumor located at the base of the appendix. The patient is otherwise healthy and recovering well from surgery. What would you recommend?
A) No additional therapy
B) Right Hemicolectomy
C) Right Hemicolectomy + Ileoectomy (removal of ileus)
D) Adjuvant chemotherapy
B) Right Hemicolectomy
Appendiceal carcinoid is one the most common neoplasms identified in the appendectomy specimen. Lesions that are <1 cm generally do not require additional therapy. Lesions larger than 1 or 2 cm, involving the appendiceal base or with lymph node metastasis of mesenteric invasion warrant right hemicolectomy. Adjuvant chemotherapy is only recommended after definitive surgical care
A 67 year old male was diagnosed with nasopharyngeal carcinoma. Which cervical lymph node level is his cancer most likely to spread to?
A) Level I, II, III
B) Level II, III, IV
C) Level I
D) Level V
D) Level V
Nasopharyngeal carcinoma - level V
Oral cavity - level I, II, III (Buccal mucosa - level I)
Oropharyngeal - Level II, III, IV
Hypopharynx - level III, IV
Accompanying desmoplastic response and fibrosis of tumor enlargement and invasion entrap and shorten which structure resulting to peau d’ orange?
A) Suspensory ligament of Belle
B) Cooper’s ligament
C) Murray’s ligament
D) Dermal ligament
B) Cooper’s ligament
Rationale: The suspensory ligaments of Cooper play an important role in the change in appearance of the breast that often accompanies the development of inflammatory carcinoma of the breast in which blockage of the local lymphatic ducts causes swelling of the breast.
Because the skin remains tethered by the suspensory ligaments of Cooper, it takes on a dimpled appearance reminiscent of the peel of an orange (peau d’orange). Carcinomas can also decrease the length of Cooper’s ligaments leading to a dimpling.
A 25 year old, 28 weeks AOG primigravid, came for consult because of anterior neck mass that she wished to be removed. What in the history will make the surgeon remove the anterior neck mass?
A) Family history of goiter
B) Patient is complaining of tachycardia
C) Patient has dyspnea and dysphagia
D) Recent history of very low TSH
C) Patient has dyspnea and dysphagia
Rationale: Indication for surgical treatment (sub-total thyroidectomy within the second trimester of gestation, soon after the euthyroid state following short medication is reached) - an elective approach:
1) allergy to antithyroid drugs
2) large compressive goiter
3) suspicion of thyroid cancer
4) patients who require large doses of antithyroid drugs to reach and sustain euthyroid state
5) poor patient compliance
6) extremely rare resistance to antithyroid drugs.
After an ordinary surgery, an infection in the operative wound is still considered secondary to the initial surgery when it falls within:
A) 2-3 days
B) 7-8 days
C) 30-31 days
D) 1 year
C) 30-31 days
What is the best imaging modality to request for a patient suspected to have multiple facial fractures from a motor vehicular accident?
A) Plain radiographs
B) Ultrasound
C) CT Scan
D) MRI
C) CT Scan
Rationale: Computer tomography (CT) is the imaging modality of choice when assessing a traumatic mandibular injury and can demonstrate a 100% sensitivity in detecting a fracture.
Which of the following is well-defined freely movable dominant mass on the left breast of an 18-year old girl?
A) Fibroadenoma
B) Papilloma
C) Fibrocystic disease
D) “Blue Dome” cyst
A) Fibroadenoma
The following is true regarding polyarteritis nodosa (PAN) EXCEPT
A) Is predominantly treated with steroid and cytotoxic agent therapy.
B) Predominantly affects women over men by a 2:1 ratio.
C) Presenting symptoms include low-grade fever, malaise, and myalgias.
D) May be sufficiently diagnosed by skin biopsy.
B) Predominantly affects women over men by a 2:1 ratio
What is the largest organ in the body? * A. Skin B. Brain C. Bone D. Liver E. Gluteus maximus
A. Skin
How many bones are in the adult body? * A. 270 B. 246 C. 214 D. 216 E. 198
D. 216
What is medical term for vomiting? * A. emesis B. halitosis C. flatus D. tenesmus E. Intussusception
A. emesis
This organ is triangular in shape and is connected to the thymus inferiorly and the crux of the diaphragm superiorly? * A. Lungs B. Heart C. Trachea D. Stomach E. Liver
B. Heart
What is the most common cause of ectopic hypercortisolism? * A. Renal cell carcinoma B. Cushing's disease C. Pheochromocytoma D. Neuroblastoma E. Small Cell Lung Carcinoma
E. Small Cell Lung Carcinoma
