4 (Oct 12-30) Block 3_Surg Exam 2

1

Which of the following is NOT a common place for impaction of a kidney stone? a Uretal pelvic junction b Pelvic brim c Ureteral vesical junction d Vesicourethral junction

2

Urinary incontinence in women is initiated by: a Internal sphincter b Middle circular layer of the bladder neck c External sphincter d Lower bladder pressure

3

Prostate cancer occurs most commonly in which zone: a Central zone b Urethral zone c Transitional zone d Peripheral zone

4

The function of Leydig cells is: a Testosterone production b Support of sperm maturation c Establishment of the blodd-testis barrier d Production of sperm growth factors

5

The tunica vaginalis corresponds to which layer of the abdominal wall: a External oblique b Internal oblique c Transversalis fascia d Peritoneum 6. which of the ff is not part of the blood supply of testicles? a. gonadal artery b. vasal artery c. cremasteric artery d. superior epigastric artery 7. what will you advise a patient with a single episode of microscopic hematuria? a. reassurance and serial urinalysis to confirm resolution b. urine culture and IVP alone c. cystoscopy d. imaging of upper tract and cystoscopy 8. kidney function in a pre-operative patient is best measured by a.serum BUN and Crea b.creatinine clearance c.renal UTZ

d.CT stonogram 9.which of the following studies is not useful in evaluating a patient with bladder symptoms a.international prostate symptom score questionnaire b.cystoscopy c.pre-void utz d.pressure flow study 10. which of the following is not a medication used for BPH? a.terazosin b.captopril c.doxazosin d.tamsulosin 16. Most common presenting symptom of patients with ascending thoracic aneurysm a. anterior chest pain b. posterior chest pain c. atrioventricular valve sufficiency d. sudden death 17. Treatment of acute embolic mesenteric ischemia a. Observation b. Anticoagulant c. Thrombolysis d. Operative embolectomy 18. Bypass graft for children with renovascular HPN a. Saphenous vein graft b. Hypogastric artery c. Prosthetic d. Dacron 19. ‘Off pump’ coronary artery bypass means: a. Doing coronary artery bypass with the help of heart-lung machine b. Doing coronary artery with the use of arterial conduits c. Doing coronary artery bypass while the heart is beating (w/o cardiopulmonary bypass) d. Doing coronary artery bypass using a small incision, inserting probes with a camera and vascular staplers 20. The strongest risk factors for male patients in their mid-age to develop peripheral arterial occlusion disease (PAOD) a. Chronic alcoholic beverage intake b. High fat diet c. Heavy smoking d. Sedentary mode of living 26. Mostcommon tumor at Anterior mediastinum

Answer d. thymoma 27. In the management of Arterial occlusive disease, which parameter is monitored when starting with anticoagulants?

a. CBC b. Platelet count c. PT and PTT d. Protein S 28. Symptoms od PAOD except: answer: decrease in gross hearing 29. Simonart's Band: answer : incomplete cleft lip 30. Velopharyngeal closure is movement of palate against posterior pharyngeal wall. Direction? answer: superior and posterior 31. The most important muscle for achieving velophrayngeal closure is: a. levator veli palatine b. superior pharyngeal constrictor muscles c. palatopharyngeus muscle d. uvulus muscle 32. characteristic speech of velophryngeal incompetence is: a. hyponasal speech b. hypernasal speech c. stuttering speech d. slurred speech 33. A cleft extending posteriorly from the incisive foramen to the uvula is: a. incomplete cleft lip b. incomplete cleft palate c. complete cleft lip d. submucous cleft 34. True statements regarding cryptorchidism in children: a. Orchidopexy must be performed before 12 years old. b. Hormonal treatment is highly successful. c. Endocrine workup is recommended for bilateral conditions. d. AOTA 35. A 1 month old baby boy has a 2x1 cm capillary hemangioma of the cheek. The best mode of management: a. excision b. observation

c. sclerosant injection d. laser therapy 46.

In cases of biliary atresia, which is NOT a diagnostic finding? A. Intrahepatic ducts are never dilated B. Screening test for infectious and metabolic causes are negative C. Percutaneous needle biopsy of the liver usually establish the diagnosis D. Excretion of radionuclide into intestinal tract during technetium 99m IDA

Scan 47.

Definitive diagnosis of Hirschsprung disease is established by: A. Rectal mucosa biopsy B. Barium enema C. Invertogram D. Pelvic CT scan with triple contrast

48.

In the surgical management of Hirschsprung disease, pull-through procedure is usually accomplished when the child weighs: A. 5kg B. 10kg C. 15kg D. Adult weight

49.

In surgical management of Hirschsprung disease, the following methods of pull-through operation can be done, EXCEPT: A. Swenson B. Duhamel C. Soave D. Catles

50.

Meckel’s diverticulum is caused by a persistent portion of the omphalomesenteric duct. It occurs at around: A. 2-3 ft from ileocecal valve B. 2-3 ft from anal verge C. 2-3 ft from ligament of Treitz D. 2-3 ft from pylorus

61. Fetal circulation is described as, except: a. elevated vascular resistance b. little pulmonary blood flow c. no shunting of blood from right to left at the atrial level d. with expansion of lungs, there is decreased pulmonary resistance 62. True in the anatomy of the lung except: a. right lung has 3 lobes while the left has only 2 lobes b. right lung has 10 segments while the left has 9 segments

c. there are two lymphatic drainage- pulmonary and mediastinal nodes d. lymphatic drainage of the right lung is to the contralateral nodes whereas the left lung frequently drains to the contralateral as well as to the ipsilateral nodes 63. most common congenital deformity of the chest wall and is attributed to overgrowth of lower costal cartilages and ribs. The defect is more common in males and has a familial tendency a. sterna fissures b. pectus excavatum c. pectus carinatum d. bone cysts 64. patient in the ER with stage 4 pulmonary empyema, underwent lateral thoracotomy. all changes in the lung functions except: a. vital capacity decreased by 25-30% b. increased closing volume predisposing to increased atelectasis c. coughing is inhibited d. alveolar macrophage function is increased 65. condition requiring urgent thoracotomy except: a. massive air leak b. pericardial tamponade c. esophageal perforation d. flail chest

66. The hallmark finding in PDA a. continuous machinery murmur b. snowman sign on chest xray c. decreased pulmonary blood flow d. no increase in risk of endocarditis

67. Surgical procedures that can be employed in cyanotic heart disease except a. Blalock- Taussig b. Bidirectional Glenn shunt c. Hemi-fontan

d. Rocky davis procedure

68. True of Tetralogy of Fallot except a. is composed of VSD, overriding of the aorta, R. ventricular outflow obstruction, RVH b. squatting usually relieves respiratory distress c. brain abscess is a fatal complication d. egg on a string on chest xray

69. In surgical treatment of CAD, the artery most commonly anastomosed to the main trunk of left descending artery is a. left internal mammary artery b. intercostal arteries c. Left epigastric artery d. great saphenous

70. It is recommended that patient with abdominal aortic aneurysm with size greater than this undergo surgical repair (Schwartz) a. < 3 cm b. 3-4 cm c. 4.5-5 cm d. 2 cm 91. All are types of random flaps, EXCEPT: a. Z-plasty b. Advancement c. Deduction d. Transposition

92. On skin grafting, all are true EXCEPT: a. Split-thickness skin grafts include epidermis and a portion of the dermis, while full-thickness skin grafts include the epidermis and entire dermis b. Skin grafts will “take” on paratenon, periostium, bare tendon, and bone. c. Skin grafts may be stored for up to 21 days soaked in sterile saline at 4C. d. Meshing of the skin graft allows an increased area to be covered, however grafts to face and hands should not be meshed. 93. Not properly matched: a. Blepharoplasty – eyelid b. Rhinoplasty – nose c. Rhytidectomy – face d. Rhytidectomy – lips 94. In management of cleft lip and palate, the “rule of 10” is usually used as guideline. This includes the following EXCEPT: a. At least 10 weeks of age b. At least 10 lbs in weight c. Hemoglobin of 10 d. Albumin level of 10 95. The following etiologies were attributed to the incidence of CLAP EXCEPT: a. Phenytoin b. Maternal diabetes c. Amniotic band syndrome d. None of the above