Surgery Final (Part 2) Flashcards
1
Q
The treatment of choice in malignant lymphoma is/are:
A
B. Radiotherapy and/or chemotherapy
2
Q
The earliest sign of carcinoma of the larynx is
A
C. Hoarseness
3
Q
The most common histologic type of carcinoma in the head and neck area is
A
C. Squamous cell carcinoma
4
Q
The most commonly benign salivary gland tumor in children:
A
B. Hemangioma
5
Q
Knowledge of the lymphatic drainage is important because it will:
A
B. Give an idea where the primary lesion is
6
Q
A neoplasm that occurs primarily in the parotid gland, more commonly seen in males in the older age group and is also known as papillary cystadenoma lymphomatosum
A
C. Warthin’s tumor
7
Q
Sudden facial paralysis associated with vesicles in the external audiotory canal and pinna:
A
C. Ramsay hunt syndrome
8
Q
The opening of the parotid duct is at level:
A
C. 2nd upper molar
9
Q
In which of the following conditions is the cornea most opacified? MPL = 0.25
A
b. Leukoma
10
Q
A condition that gives painless blurring of vision is: MPL = 1.0
A
a. Central retinal vein occlusion
11
Q
The most important factor for developing diabetic retinopathy is: MPL = 0.25
A
a. Duration of the diabetes
12
Q
In hyperopia, the axial length is: MPL = 1.0
A
a. Too short
13
Q
The leading cause of avoidable and reversible blindness worldwide is/are … MPL = 0.5
A
a. …Cataracts.
14
Q
The most useful chart attractive to preschool illiterate children: MPL = 0.5
A
c. Allen Chart
15
Q
One advantage of Direct Ophthalmoscopy over Indirect Ophthalmoscopy is: MPL = 1.0
A
b. Magnification
16
Q
Flouresecin dye when viewed using a cobalt blue light will appear as: MPL = 0.5
A
d. Luminous green
17
Q
Blind spot on a normal visual field is also known as: MPL = 1.0
A
a. Scotoma
18
Q
Most accidental eye injuries can be prevented by… MPL = 0.5
A
a. …a good pair of protective goggles
19
Q
The most important consideration in Testing Near Acuity: MPL = 0.25
A
a. Age
20
Q
Determination of Visual Field Extent is best demonstrated by: MPL = 0.25
A
a. Octopus Perimetry
21
Q
In performing Direct Ophthalmoscopy, the first element that must be observed: MPL = 0.5
A
b. Red reflex
22
Q
In the three-part step-wise sequence in external eye examination, one procedure that is not usually included: MPL = 1.0
A
d. Percussion
23
Q
The patient was not able to see hand movement. What is the next step to check his visual acuity?MPL= 0.5
A
a. Check light perception*
24
Q
A patient is only able to read the first line of the Jaeger chart. His near visual acuity is recorded as…MPL=0.3
A
b. J16 -2 lines*
25
In assessing facial sensation, the three branches of the cranial nerve V that is being tested are…MPL=0.3
d. Ophthalmic n., maxillary n., mandibular n.*
26
Which of the following is/are true of the corneal blink reflex? MPL=0.3
b. The afferent arm of the reflex is the trigeminal nerve*
27
Which of the following is a term used to describe normal binocular eye movement in the same direction? MPL=0.5
b. Versions*
28
Giant papillary reaction is common in… MPL = 1.0
a. Contact lens overuse
29
Ophthalmia Neonatorum is usually a bacterial cause of conjunctivitis: MPL =0.3
a. True
30
The spread of epidemic viral conjunctivitis is best curtailed by: MPL =0.25
d. Frequent hand washing
31
Which is not an anatomic locale description of the conjunctiva? MPL =0.5
c. Limbal
32
Adenoviral conjunctivitis may cause: MPL =0.3
a. a true membrane on the tarsal conjunctiva
33
Which of the following statements regarding the use of steroid eye drops for red eyes is correct? MPL =0.3
c. The possible complications of steroid use include Glaucoma AND Cataract formation
34
The medication specifically used against adenovirus conjunctivitis currently is: MPL =0.3
d. There is no specific medication against adenovirus
35
The definitive management of gonococcal conjunctivitis is: MPL =0.3
b. Ceftriaxone 1gram intramuscular injection once only.
36
Which of the following conjunctivitides is almost always bilateral? MPL =0.5
d. Allergic
37
Fusion of the bulbar and tarsal conjunctiva as a result of prolonged inflammation and scarring is termed: MPL =0.3
b. Symblepharon
38
Painful blurring of vision can be due to: MPL = 1.0
b. Acute angle closure glaucoma
39
Glaucoma is characterized by: MPL = 0.25
d. Damage to optic nerve head
40
Secondary glaucoma may occur in: MPL = 0.25
a. Hyphema
41
The hallmark of Grade IV hypertensive retinopathy associated with malignant hypertension is: MPL = 0.25
c. optic disc edema
42
The systemic condition that presents with the most complications in the posterior pole of the eye: MPL = 0.25
b. Diabetes Mellitus
43
In testing for strabismus, the corneal light reflex did not fall at the same relative position on each eye instead it was located at the temporal borders of the pupils, the patient has: MPL = 0.5
b. Esotropia
44
In cover testing, the uncovered eye moves inward to fixate, the patient has: MPL = 0.5
c. Exotropia
45
A 5 year old child was brought to an ophthalmologist because his family had noticed a strange, white reflection that appeared in one of his eyes in photographs while the rest have red eyes due to the flash. Further examination disclosed Retinoblastoma.
b. leucocoria
46
Computed Tomogram of the above child showed a unilateral tumor filling the left eye. Nasal third of the tumor is calcified. Impression of Retinoblastoma is confirmed with the following histologic features: MPL=0.5
a. Islands of blue cells in a sea of pink necrosis / b. Cuboidal cells circled around a central luman: Flexner-Wintersteiner rosettes/ c. Flower like grouping of tumor cells which look like photoreceptors: Fleurettes/ d. All of the above
47
A 23/M consulted the OPD because anterior eyelid crusting of 3 days duration. The resident requested for a gram-stain which revealed Gram-positive cocci in clusters. Which statement is consistent with the impression of Staphylococcal blepharitis? MPL =
a. Coagulase production specifies etiologic agent to be Staphylococcus aureus
48
Which of the following viruses is transmissible even after medical instrumentation is cleaned with alcohol? MPL = 0.5
b. Adenovirus
49
A newborn was admitted to the NICU because of mucopurulent eye discharge at birth. The mother had a documented chlamydial genito-urinary tract infection. What bacterial features are consistent with the neonatal ocular finding? MPL = 0.5
c. The outer cell wall resembles the cell-wall of gram-negative bacteria
50
A 50/M farmer consulted the OPD because of right corneal opacity of 3 weeks duration. He claimed his right eye was hit by a palay strand while harvesting. Clinical history alone leads to a strong suspicion of fungal keratitis. Which of the following st
b. The cell wall polysaccharides are uniquely stained by periodic acid-Schiff (PAS)
51
A 43/F consulted because of a sessile mass at the limbus. The excision biopsy revealed squamous papilloma. Which of the following is true about the association of the Human Papilloma Virus (HPV) with squamous papilloma? MPL = 0.5
c. HPV DNA induces cellular proliferation and can lead to malignancy
52
A 30/M consulted the OPD because of foreign body sensation with mucopurulent discharge of 6 days duration. A detailed slit-lamp biomicroscopic examination demonstrated clinical features of trachoma. Which are features of an adult trachoma compared to a ne
d. Follicular response is greater
53
Condition in which there is discoloration of the eyelashes MPL = 0.5
d. Poliosis
54
The condition in which an extra row of lashes exists is MPL =0.5
b. Distichiasis
55
A white pupillary reflex is called: MPL = 1.0
c. leukocoria
56
An infant born less than 31 weeks, weighing less than 1500g (3 lb 5 oz) plus exposure to supplemental oxygen, one should screen the eyes for: MPL = 1.0
d. Retinopathy of Prematurity (ROP)
57
This is the second most common mode of presentation in Retinoblastoma which account for about 20 % of cases: MPL =0.5
d. strabismus
58
The following are treatment options for Retinoblastoma except MPL = 1.0
d. Evisceration
59
The following are correct in visual acuity testing in a child EXCEPT MPL=0.5
c. At 8 years old, test with an Amsler grid chart
60
Leukocoria caused by the presence of red cells in the vitreous secondary to birth trauma MPL=0.5
c. Vitreous Hemorrhage
61
A biconves, avascular, colorless structure that focuses light rays to the retina, an opacity of which will cause leukocoria MPL=0.5
a. Lens
62
Ophthalmological examination that would identify presence of an intraocular mass MPL=0.5
b. Indirect Ophthalmoscopy
63
The most common presenting sign of retinoblastoma is MPL=1.0
c. White pupil
64
Due to the inheritance pattern of retinoblastoma, a vital part of treatment would incude: MPL=0.5
b. Genetic counseling
65
A surgical procedure involving removal of intraocular contents: MPL=0.5
b. evisceration
66
Management of CRAO includes MPL =0.5
a. “Brown bagging” / b. Alternate compression and decompression of the globe/ d. A and B only
67
Characteristic findings in Central Retinal Artery Occlusion MPL = 0.25
b. Cherry red spot in the macula
68
The TRUE statement regarding chemical burns MPL = 1.0
d. In copious irrigation of the eye, the fluid used need not be sterile, provided the chemical is diluted properly
69
EOM movement of one eye is called MPL =0.5
a. Ductions
70
Absence of venous pulsations on funduscopy MPL =0.3
a. May indicate increase intracranial pressure/ b. May be normal / d. A and b
71
To examine the optic nerve binocularly, use MPL = 0.3
a. Indirect ophthalmoscope/ b. Non contact fundus lens / d. A and B
72
What ancillary procedures should you do if suspecting optic nerve toxicity? MPL = 0.25
a. Visual field exam / b. Visual evoked potential / c. Color test / d. All of the above
73
One of the most common reasons for Neuroophtha referral … MPL = 1.0
a. …unexplained vision loss
74
Which of the following is true regarding viewing the fundus… MPL = 1.0
c. Direct ophthalmoscopy provides greater detail of the fundus
75
What is the most important adverse effect of local anesthetic overdosage? MPL = 0.25
c. convulsion
76
Cortocosteroid stops the inflammatory process by inhibiting prostaglandin synthesis through the following mechanism: MPL = 1.0
b. blockage of the enzyme phospholipase A
77
Which of the following statements regarding papilledema is not true? MPL =0.3
a. Loss of venous pulsation is always present
78
Most common visual field finding in papilledema MPL = 0.3
d. Enlargement of the blind spot
79
Typically the onset of visual loss in demyelinating optic neuritis is noted MPL = 0.25
a. Upon arising in the morning
80
One of the following findings is not a characteristic of true disc edema MPL = 0.25
b. abnormal branching of vessels around the disc
81
Most common cause of optic disc swelling in children MPL = 0.3
a. Infectious optic neuritis
82
One of the following is not a characteristic finding of optic neuritis in children MPL = 0.25
d. Always resistant to steroids
83
Most common condition associated with nonarteritic anterior ischemic optic neuropathy MPL = 0.5
d. Hypertension
84
Which of the following is the most common optic neuropathy in patients over the age of 50? MPL = 0.3
d. Nonarteritic anterior ischemic optic neuropathy
85
10. An obese 26 year old woman presents with headaches and transient visual obscurations. Bilateral papilledema is documented. The next step should be which of the following MPL = 0.3
d. Do CT or MRI of the brain
86
Exophthalmos is a term used specifically in which of the following conditions? MPL = 1.0
a. Thyroid disease
87
The most commonly observed Cumulative Trauma disorder is
C. Carpal tunnel syndrome
88
The ff. is an indirect cost of injury among workers
C. Training replacements
89
The ff. is an indication for surgical release of CTS
A. Severe causalgia
90
The ff. is a feature of Impingement Syndrome
C. Limited active abduction of the shoulder
91
In Reflex sympathetic dystrophy the ff. is true
B. Autonomic changes
92
The most common lump on the hand is
B. Ganglion cyst
93
The Following can lead to Frozen Shoulder EXCEPT
D. Trigger finger
94
Avascular necrosis of the Lunate
B. Keinbocks
95
A worker comes with a lump on the dorsal elbow, it is movable, soft with tenderness. He has a habit on putting his weight at the elbow , he has
D. Student’s elbow
96
The best thing to do in acute tendenitis is
B. To rest it in a splint
97
The grip strength of a dominant hand is usually stronger than the non dominant hand by
A. 10 lb.
98
A functional non organic sensation deficit is evident if there is
B. sensory deficit in the whole leg
99
To prevent overvaluation and subjection to potential risk of tests. The following will suggest a non organic findings in back pain
B. light pinch tenderness of skin on vast area of the back
100
The most common type of muscular dystrophy is
A. Limb Girdle
101
Cramps is the usual complain of
B. Myotonic
102
Spinal dysraphism can be detected in utero after 18 weeks by taking the
B. Amniotic Alpha feto protein
103
A positive Gowers sign is
B. Present in pelvic and proximal leg weakness
104
Ischemic Compression Test is for
D. McArdle’s Disease
105
A dive bomber sound on EMG is seen in
B. Myotonia
106
Fasciculation’s of the tongue and limb muscles is frequently seen in
D. SMA
107
Most of children with this condition cannot reach adulthood except
B. Fascioscapulohumeral dystrophy
108
The most common cause of death of children with myopathies is
C. Pulmonary problem
109
This reflex is integrated in the spinal cord
C. Flexor withdrawal
110
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
111
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
112
Patient with Spina bifida should be examined for
C. Presence of hip dislocation
113
This instrument is used to measure range of motion of joints:
B. goniometer
114
Which of the following is considered as a deep heating modality:
C. ultrasound
115
On stimulation the baby extend and abduct the limbs followed by flexion and adduction
A. If this is a normal baby he is less than four months
116
Stroke rehabilitation may be started:
A. as soon as the patient’s neurological and medical condition stabilizes
117
This reflex is integrated in the spinal cord
C. Flexor withdrawal
118
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
119
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
120
At four months of age the child is expected to
D. Rolls over from supine
121
A child of 3 years is expected to
C. Walks up stairs alternating feet
122
A dyskenitic Cerebral palsy is frequently associated with
A. Bilirubin encephalopathy
123
True of a geriatric individual
· They prefer to be independent
124
Some of the changes in the elderly is
A. Decline in the number of motor units
125
Crystallized intelligence is preserved in elderly this is
C. comprehension
126
Elderly has tendency to fall. One reason is a sudden drop of blood pressure which can be due to
B. Sudden change in position or abrupt standing
127
Exercise prescription for an osteoporotic patient is
C. Walking
128
Osteoporosis has an earlier onset in women . And this is usually evident during
C. 5 to 7 years after menopause
129
Elderly patient is prone to bed sore because of
A. Loss of subcutaneous fat
130
Cardiorespiratory changes in elderly
A. Lower maximal heart rate
131
To prevent hypotension in elderly it is best to observe
C. Standing slowly while holding to a bar
132
A spinal cord injury with weaker upper extremities than lower extremities is
C. A bilateral brachial plexus injury
133
An SCI patient states that he has intact sensation up to the umbilicus, without movement over his legs. This means
A. His sensory level is T10
134
The most common site of heterotrophic ossification among burn patient is at the
C. Elbow
135
A bedridden quadriplegic has painful inflamed thigh . The working diagnosis is DVT , it is best to differentiate this with
B. Heterotopic ossification
136
The most common tumor of the bone
C. Metastatic
137
The most common cause of Traumatic brain injury is
A. Vehicular accident
138
A C-curve scoliosis is common in
D. Paralytic scoliosis
139
Physical finding in scoliosis on convexity side
D. Prominent scapula
140
Physical finding in scoliosis on concavity side
B. Prominent front chest
141
This syndrome of massive sympathetic discharge associated with the SCI patients with lesions at T6 level, characterized by headache, hypertension, diaphoresis and reflex bradycardia is known as:
C. autonomic dysreflexia
142
This is the most important aspect to consider in the management of decubitus ulcer:
A. relief of pressure
143
What is the key muscle for testing C7 myotome, according to the American Spinal Injury Association?
A. triceps
144
This level is generally the highest level of injury at which spontaneous ventilation can be sustained. Injuries above this level generally require mechanical ventilation:
A. C4
145
This is referred to as an ectopic bone formation occurring within 6 months after spinal cord injury:
A. heterotopic ossification
146
This is generally considered the drug of choice for spasticity in SCI:
B. Baclofen
147
The most commonly observed Cumulative Trauma disorder is
C. Carpal tunnel syndrome
148
The ff. is an indirect cost of injury among workers
C. Training replacements
149
The ff. is an indication for surgical release of CTS
A. Severe causalgia
150
The ff. is a feature of Impingement Syndrome
C. Limited active abduction of the shoulder
151
In Reflex sympathetic dystrophy the ff. is true
B. Autonomic changes
152
The most common lump on the hand is
B. Ganglion cyst
153
The Following can lead to Frozen Shoulder EXCEPT
D. Trigger finger
154
Avascular necrosis of the Lunate
B. Keinbocks
155
A worker comes with a lump on the dorsal elbow, it is movable, soft with tenderness. He has a habit on putting his weight at the elbow , he has
D. Student’s elbow
156
The best thing to do in acute tendenitis is
B. To rest it in a splint
157
The grip strength of a dominant hand is usually stronger than the non dominant hand by
A. 10 lb.
158
A functional non organic sensation deficit is evident if there is
B. sensory deficit in the whole leg
159
To prevent overvaluation and subjection to potential risk of tests. The following will suggest a non organic findings in back pain
B. light pinch tenderness of skin on vast area of the back
160
The most common type of muscular dystrophy is
A. Limb Girdle
161
Cramps is the usual complain of
B. Myotonic
162
Spinal dysraphism can be detected in utero after 18 weeks by taking the
B. Amniotic Alpha feto protein
163
A positive Gowers sign is
B. Present in pelvic and proximal leg weakness
164
Ischemic Compression Test is for
D. McArdle’s Disease
165
A dive bomber sound on EMG is seen in
B. Myotonia
166
Fasciculation’s of the tongue and limb muscles is frequently seen in
D. SMA
167
Most of children with this condition cannot reach adulthood except
B. Fascioscapulohumeral dystrophy
168
The most common cause of death of children with myopathies is
B. C. Pulmonary problem
169
This reflex is integrated in the spinal cord
C. Flexor withdrawal
170
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
171
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
172
Patient with Spina bifida should be examined for
C. Presence of hip dislocation
173
This instrument is used to measure range of motion of joints:
B. goniometer
174
Which of the following is considered as a deep heating modality:
C. ultrasound
175
On stimulation the baby extend and abduct the limbs followed by flexion and adduction
A. If this is a normal baby he is less than four months
176
Stroke rehabilitation may be started:
A. as soon as the patient’s neurological and medical condition stabilizes
177
This reflex is integrated in the spinal cord
C. Flexor withdrawal
178
This reflex develops mouth opening, helps find the breast and develops various tongue position
B. Rooting reflex
179
Asymmetric Tonic Neck reflex
B. Coordinates with tonic labyrinthine reflex for turning the body
180
At four months of age the child is expected to
D. Rolls over from supine
181
A child of 3 years is expected to
C. Walks up stairs alternating feet
182
A dyskenitic Cerebral palsy is frequently associated with
A. Bilirubin encephalopathy
183
True of a geriatric individual
C. They prefer to be independent
184
Some of the changes in the elderly is
A. Decline in the number of motor units
185
Crystallized intelligence is preserved in elderly this is
C. comprehension
186
Elderly has tendency to fall. One reason is a sudden drop of blood pressure which can be due to
B. Sudden change in position or abrupt standing
187
Exercise prescription for an osteoporotic patient is
C. Walking
188
Osteoporosis has an earlier onset in women . And this is usually evident during
C. 5 to 7 years after menopause
189
Elderly patient is prone to bed sore because of
A. Loss of subcutaneous fat
190
Cardiorespiratory changes in elderly
A. Lower maximal heart rate
191
To prevent hypotension in elderly it is best to observe
C. Standing slowly while holding to a bar
192
A spinal cord injury with weaker upper extremities than lower extremities is
A. A posterior cord syndrome B. Central cord syndrome C. A bilateral brachial plexus injury D. A hemi section of the spinal cord
193
An SCI patient states that he has intact sensation up to the umbilicus, without movement over his legs. This means
A. His sensory level is T10
194
The most common site of heterotrophic ossification among burn patient is at the
C. Elbow
195
A bedridden quadriplegic has painful inflamed thigh . The working diagnosis is DVT , it is best to differentiate this with
B. Heterotopic ossification
196
The most common tumor of the bone
C. Metastatic
197
The most common cause of Traumatic brain injury is
A. Vehicular accident
198
A C-curve scoliosis is common in
D. Paralytic scoliosis
199
Physical finding in scoliosis on convexity side
D. Prominent scapula
200
Physical finding in scoliosis on concavity side
B. Prominent front chest
201
This syndrome of massive sympathetic discharge associated with the SCI patients with lesions at T6 level, characterized by headache, hypertension, diaphoresis and reflex bradycardia is known as:
C. autonomic dysreflexia
202
This is the most important aspect to consider in the management of decubitus ulcer:
A. relief of pressure
203
What is the key muscle for testing C7 myotome, according to the American Spinal Injury Association?
A. triceps
204
This level is generally the highest level of injury at which spontaneous ventilation can be sustained. Injuries above this level generally require mechanical ventilation:
A. C4
205
This is referred to as an ectopic bone formation occurring within 6 months after spinal cord injury:
A. heterotopic ossification
206
This is generally considered the drug of choice for spasticity in SCI:
B. Baclofen
207
A female cancer patient is in constant pain which is severe, radiating, shooting and electric like in character. Most likely cause of her pain is:
B. Compression of a nerve by the enlarged mass
208
Gate’s Control Theory of pain is the basis for all the following non pharmacologic pain management EXCEPT:
D. Biofeedback
209
A peripheral type of pain:
A. Myofascial pain syndrome
210
Management of pain due to excision of mass in the anterior abdominal wall:
A. Non-steroidal anti inflammatory agents (NSAIDs)
211
Chronic use or prolonged intermittent administration of this opioids. Results in neurotoxicity due to its metabolite.
A. Meperidine
212
Major toxicity of short term use of NSAIDs:
B. C. Gastro duodenal irritation
213
Effective in neuropathic pains:
D. D. Anticonvulsants
214
Acupuncture based on traditional Chinese medicine.
B. Solid needles inserted along meridians
215
A focussed concentration used as a guide to patients to focuss away from their pain.
B. Hypnosis
216
Which of the following NSAIDs act on the central cyclooxygenase?
B. Paracetamol
217
The gold standard to which all of the other opioids are being compared to.
B. Morphine
218
Which of the following opioids is an agonist-antagonist.
C. Nalbuphine
219
Mechanism of action of ketamine.
C. Prevents the removal of magnesium from the NMDA receptor in the post-synaptic nerve
220
Opioids receptor responsible for the respiratory depressant effect of opioids
B. Mu 2 receptor
221
The following local anesthesic exhibit vasoconstricting effect at low and high doses.
D. Cocaine
222
One of the following is on objective sign of CNS toxicity:
A.Convulsion
223
Local anesthetic that belongs to amide group.
B. Lidocaine
224
Local anesthetic that is converted to O-toluidine in the liver:
C. Prilocaine
225
Local anesthetic with arrtiarrhythmic effect
C. Lidocaine
226
Addition of vasoconstrictors to local anesthetics will:
B. Prolong the duration of action of local anesthetic
227
Local anesthetic that causes unidirectional block and re-entry type of cardiac arrhythmia.
A. Bupivacaine
228
The median nerve originates from the:
A. Lateral cord / B. Medial cord/ C. Both A & B
229
The Dorsalis Pedis Artery is used as landmark to block the:
B. C. Deep Peroneal nerve
230
The nerve blocked, when local anesthetic is injected between the palmaris longus and tendon longus and flexor carpi radialis at the wrist.
B. Median nerve
231
Caudal anesthesia is a form of:
D. Epidural block
232
Boundaries of the anatomic Snuff Box EXCEPT:
D. Abductor Pollicis Brevis
233
The nerve blocked posterior to the lateral malleolus.
A. Sural nerve
234
Complication of pudendal nerve block during vaginal delivery:
B. C. Puncture of fetal head
235
Delayed complication of spinal anesthesia
B. Urinary retention
236
The nerve found at the anatomic snuff box nerve
C. Radial nerve
237
Nerve blocked in Retrobulbar nerve block
B. Ciliary Ganglion
238
Branch of intercostals nerve often spared when injection of local anesthetic is done at the anterior axillary line:
D. D. Lateral cutaneous branch
239
Landmark in doing superficial cervical plexus block.
C. Sternocleidonastoid muscle
240
Approach in doing brachial plexus block that anesthetize the entire plexus:
C. Infraclavicular Approach
241
Post spinal headache as a delayed complication of spinal anesthesia is due to:
C. CSF leakage
242
T6 level of sensory blockade is at the level of :
D. Xiphoid process
243
The line joining the highest points of iliac crest (ASIS) crosses:
C. L4 interspace
244
In adult the spinal cord ends at the level of:
C. L1
245
Drug administration that allows patient to titrate analgesics according to their needs:
A. Patient controlled analgesia (PCA)
246
A patient can be discharged from the Postoperative care unit if he is:
D. Pulse oximeter reading is 97% at room air.
247
CASE: LA, 35 years old female is schedule for appendectomy: BP=130/80 PR=88/min anesthesia given is subarachnoid block: What is the ideal level of the block?
B. Midspinal
248
Upon doing the pinprick test, the sensory block is at the level of the nipple (T4). Give the level of motor block:
A. T6
249
Five minutes after assuming the supine position; the BP because 90/60 PR=50/min. Give the reason for hypotension:
B. C. Sympathetic block
250
What is the immediate management? Of hypotension
C. Increase IV fluid infusion
251
What is the immediate management of the bradycardia?
C. Atropine sulfate
252
Intake of an agent by the body and the uptake of the agent by the tissues is termed.
C. Absorption
253
Distribution of general anesthetic drugs is influenced by:
C. Regional blood flow
254
Discovered oxygen and nitrous oxide:
B. Joseph Priestly
255
Muscle relaxation is the result of :
C. Motor block
256
True of nondepolarizing muscle relaxant:
A. Competetive inhibition with acetylcholine
257
Last CNS structure depressed by general anesthesia is:
C. Medullary center
258
A 16 year old healthy patient with incarcerated inguinal hernia, for inguinal herviorhaphy the American Society of Anesthesiologists risks classification under:
A. Class I
259
Cardiovascular intolerance to changes in position after anesthesia is a sign of:
B. C. Excessive depth of anesthesia
260
Heat and cold sensations are transmitted through this type of nerve fibers:
B. C. A beta fibers
261
Sharp cut on the skin are transmitted mostly through this type of nerve fibers:
A. C-fibers
262
Referred pain occurs due to convergence of nerve fibers in this neurons:
C. Wide dynamic range neurons
263
Which of the following is an excitatory nerve transmitter for the pain pathway:
A. Glutamate
264
In the dorsal horn of the spinal cord, the opioid receptor are found in:
B. Lamina II
265
First order neuron are found in:
D. D. Dorsal root ganglion
266
Primary afferent fibers with fastest conduction velocity:
C. A beta fibers
267
Known as carrier gas:
B. Oxygen
268
True of ketamine HCL effect:
B. C. Increase intraocular pressure
269
Which of the following is a belladona alkaloid?
C. Atropine sulfate
270
An inherited abnormality resulting from exposure of patient to certain anesthesic:
C. Malignant hyperthermia
271
One of the following is a weak anesthetic but a potent analgesic.
A. Nitrous oxide
272
Local anesthetic with vasoconstriction effect:
D. Cocaine
273
Systemic toxicity to local anesthesia is manisfested by:
A. Convulsions
274
Causes methemoglobinemia because it is degraded in the liver to otoluidine w/c causes oxidation of hemoglobine.
C. Prilocaine
275
Factors that affect absorption of local anesthetic.
C. pKA
276
Duration of action of local anesthetic correlates with :
B. Protein buiding
277
Potency of a local anesthetics correlates with.
A. Lipid solubility
278
Onset of action of a local anesthetic correlates with.
C. pKA
279
When asked about the pain he categorically says it is minimal. Numerical score is.
A. 1 to 3
280
Tramadol and Meperidine should not be given in patients receiving.
D. D. Monoamineoxydase inhibitor
281
Mechanism of action of tramadol.
A. A weak mu receptor agonist / B. Inhibits nor adrenalin receptor/ C. Inhibits serotonin receptor/ D. All of the above
282
Mechanism of action of NSAIDs
A. Inhibition of lipooxygenase/ B. Inhibition of cyclioxygenase inhibitor/ C. Inhibition of phospholipase /D. All of the above
283
Common complication of retrobulbar block in extremely myopic eye.
A. Globe perforation
284
The landmark for doing deep peroneal nerve block.
C. Dorsalis pedis artery
285
Most common complication of intercostals nerve block.
A. Pneumothorax
286
Local anesthetic technique which uses lidocaine spray 10%.
D. Topical
287
Needle puncture during spinal anesthesia can be made safely at the interspace.
C. L4 – L5
288
Mechanism of chronic pain which is often referred to as “nociceptive pain”.
A. Peripheral
289
Management for central type pf pain:
B. Opioids
290
Nerve missed in doing the axillary approach in brachial plexus block
D. Musculo cutaneous nerve
291
Nerve blocked posterior to the medial malleolus.
B. Tibial nerve
292
The anesthetic potency of volatile liquid anesthetic is measured by:
B. Minimum alveolar concentration
293
The most common cause of airway obstruction is general anesthesia is:
C. Falling back of the tongue
294
Green is the standard color code for :
C. Oxygen
295
Elimination of general inhalation anesthetics is mainly thru:
D. Lungs
296
Part of the anesthesia machine that releases gas to the atmosphere.
B. C. Pop-off value
297
A patient with severe systemic disease that is a constant threat to life, will have a physical status classification.
D. ASA IV
298
Lowest intensity at which a given stimulus is perceived as painful.
B. Pain threshold
299
One of the following is an example of acute pain.
D. Post-operative pain
300
This gas is known as a “Laughing Gas”
C. Nitrous oxide
301
Type of ventilation used for apneic patient.
B. Controlled ventilation
302
Transduction occurs in the :
A. Peripheral terminals of primary afferent neurons
303
Characteristics of acute pain:
A. Generate reflexes
304
The nerve fiber is freely permeable to:
C. Na + ions
305
Which of the following layers of the retina does not terminate at the optic disc margin:
B. Nerve fiber layer
306
The adult orbital measurement is attained at this age:
C. 9th year
307
The orbital space formed by the recti muscles and their intermuscular membrane with the Tenon’s capsule:
A. Central surgical space
308
The condensation of fibrous tissues that thickens to form a sling (hammock) upon 39 which the globe rests:
C. Ligament of Lockwood
309
Which of the following does not pass thru the Superior orbital fissure:
D. Optic nerve
310
The extrinsic muscle that is not inserted in front of the equator:
B. Superior rectus
311
The adult size of the cornea is attained at:
A. 6th year of life
312
Which of the following is not TRUE of the Meibomian gland:
C. Modified sweat gland
313
True of the Optic nerve, except:
B. Emerges from the posterior aspect of the globe.
314
True of Conjunctival injection:
B. Vessels constrict with a drop of 1:1,000 epinephrine
315
Marked enlargement of the optic disk is rarely seen, but its occurrence suggests:
A. Myopia/ B. posterior staphyloma/ C. Both
316
Any opacity in the lens is called:
A. Cataract
317
The optic nerve is actually a collection of axons of the:
D. ganglion cells
318
As it courses through the orbit, the optic nerve derives its blood supply from the:
D. d. central retinal artery
319
The center of the visual field corresponds to visual perception from the following anatomic structure:
B. the fovea
320
Mass lesions of the pituitary gland classically produce the following field pattern:
C. bitemporal hemianopsia
321
To enable stereoscopic vision, the visual fibers are so arranged that fibers over the nasal retina decussate while temporal fibers continue ipsilaterally to their corresponding lateral geniculate body. The crossover of fibers occur at the:
A. optic chiasm
322
Despite the seemingly horrendous appearance of the optic disc in acute papilledema, vision remains fairly good and the only deficit in the visual field is a:
B. enlarged blind spot
323
The following is true of optic nerve meningiomas:
B. symptoms are different from that of sphenoid wing meningiomas
324
Ischemic optic neuritis presents with this classical field defect:
B. cecocentral scotoma
325
True of pinguecula:
A. benign degenerative tissue
326
True of symblepharon:
A. chief cause is chemical burn/ B. keratitis occurs because of exposure / C. obliterate conjunctival cul-de-sac/ D. all of the above
327
Middle coat of the eye is composed of the following, except:
C. Retina
328
Structure that regulates the amount of light reaching the visual receptors of the eye:
D. Iris
329
The embryologic tertiary vitreous is known as what structure in the adult eye:
B. Vitreous body
330
Portion of the Tenon capsule that forma a sling upon which the globe rests:
A. ligament of lackwood
331
The type of conjunctivitis characterized by a localized whitish nodule with a necrotic excavated center surrounded by conjunctival injection:
c. phlyctenular conjunctivitis (Espiritu etal, p. 54)
332
The virus that can cause congenital cataract:
c. rubella (Newell, p. 377)
333
Carbonic anhydrase inhibitors are given as a treatment for glaucoma. Its mechanism of action is:
b. to decrease aqueous humor production (Espiritu, p. 101)
334
While cutting grass in his garden, a 50-year old male felt a small piece enter his left eye. He experienced foreign body sensation and eye redness. No consult was done and no medications were instilled. A few days later, he noted a fluffy, grayish white e
c. corticosteroids (Newell, p. 249)
335
Softening of the cornea associated with malnourishment:
b. keratomalacia (Espiritu etal, p. 60)
336
An ophthalmic emergency characterized by sudden blurring or complete loss of vision with a characteristic cherry-red spot on funduscopy:
d. central retinal artery occlusion (Espiritu, p. 88)
337
A 45-year old female suddenly experienced blurring of vision, with a sensation of a curtain in a part of the field of vision. The primary consideration in this patient is:
b. retinal detachment (Espiritu, p. 92)
338
A 2-year-old boy was brought in for consultation because the mother noted a “white pupil”. Which of the following is NOT a differential diagnosis for this case?
a. congenital glaucoma (Newell, p. 326)
339
Which of the following is responsible for scotopic vision or dim illumination:
a. rods only (Espiritu, p. 86)
340
The ocular lesion in congenital toxoplasmosis is characterized as:
c. single choroidoretinal scar prominently in the posterior fundus (Espiritu, p.126)
341
A 45-year-old male presents with a painless mass on the upper outer portion of his upper eyelid. There was moderate proptosis. Which is true of his condition?
c. It contains mesenchymal elements and double-layered tubular epithelial units (Newell, p. 263)
342
A chronic inflammatory lipogranuloma of a meibomian gland, characterized by a gradual painless swelling of the gland without other external signs of inflammation:
b. chalazion (Newell, p. 204)
343
The palpebral fissure among Filipinos measures:
d. 8-10 mm in height and 26-29 mm in length ( Espiritu, p. 9)
344
Passive swelling of the optic nerve occurring secondary to increased pressure in the subarachnoid space of the meningeal coverings of the brain and optic nerves:
a. papilledema (Newell, p. 357)
