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POS 2003 Questions

By Daniel Morris,2014-06-26 21:06
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POS 2003 Questions ...

    POS 2003 Questions

    Most of these have answers which we believe to be correct…but we could be wrong…

    For the rest…YOYO. Best of luck!

    1. The principal difference between LMWHs and Heparin are that LMWHs have a

    lesser effect on

    a. Haugen factor

    b. Antithrombin III

    c. Thrombin

    d. Factor Xa

2. The most serious side-effect of Bleomycin is

    a. pulmonary fibrosis

    b. aplastic anemia

    c. liver failure

    d. rash

3. The principal organism in nosocomial infections is

    a. staph aureus

    b. staph pneumo

    c. pseudomonas

    d. enterococcus

4. All are necessary for declaration of brain death except

    a. Dolls eyes and vestibulooccular reflex

    b. Temperature >32 C

    c. SBP >90mmhg

    d. Lack of any response to painful stimuli (double negative!)

    5. 60 yo maile with history of colon cancer presents with a solitary frontal lobe

    tumour. Treatment is:

    a. excision

    b. nothing due to poor prognosis

    c. chemotherapy

    d. radiation therapy

    6. The most sensitive assessment of depth of a burn to the palm of the hand

    a. injection of indomethacin

    b. injection of fluoroscine

    c. clinical exam

    d. ultrasound

    7. 65 yo man with NIDDM presents in extremis. He is nonresponsive, tachycardic

    and hypotensive. All would be expacted in his labs except:

    a. ketosis

    b. uremia

    c. acidosis

    d. hyperglycemia

    e. leukocytosis

    8. 9 yo male with a four hour history of right testicular pain. It awoke him in the night. He has no history of trauma or injury. On exam he has a swelling of the right scrotum but you are unable to exam further due to extreme pain. Select the correct statement: (YOYO but my money’s on C)

    a. EUA and then decide on treatment.

    b. Observe. If still present after 12 hours investigate as no permanent

    damage will occur until then.

    c. He probably has the same anatomical defect on the other side.

    d. His father and brothers likely had a similar problem.

    e. If > 12 hrs no further treatment is necessary.

    9. 19yo male otherwise healthy involved in MVA and sustains a closed head injury. He is hypotensive 6 hrs after the accident. The most likely cause is:

    a. unrecognized spinal cord injury

    b. hypovolemia

    c. failure of cerebrail autoregulation

    d. unrecognized intraabdominal injury

    10. 75 yo woman on Warfarin for a mechanical valve is admitted with a hip fracture. In preparation for the OR:

    a. run heparin and allow INR to normalize

    b. allow INR to normalize

    c. draw a CBC, BUN, Creat

    11. All are seen with adrenal insufficiency except

    a. hypoglycemia

    b. hyponatremia

    c. hypotension

    d. hypokalemia

    12. An elderly person with a dislocated subcapital fracture is more likely to get which vs an elderly person with a dislocated intertrochanteric fracture

    a. Avascualar necrosis of the femoral head

    b. DVT

    c. Nonunion

    13. The hypermetabolic state induced by intraabdominal surgery can be inhibited by

    a. administration of growth hormone intraoperatively

    b. NSAID suppositories preop

    c. PCA

    d. Epidural

    e. Metabolic support perioperatively and postoperatively

14. Not in human bites

    a. pseudomonas

    b. clostridium

    c. eikenella

    d. staph aureus

    e. strep

15. Why does LMWH have a lower incidence of HIT?

16. The principal determinant of intra vs extravascular osmotic pressure is

    a. intravascular Na

    b. extravascular Na

    c. intravascular protein

    d. extravascular protein

    e. intravascular K

17. The most important regulator of extracellular calcium is

    a. PTH

    b. Vit D

    c. Calcitonin

18. What does NOT cause and increase in serum calcium

    a. prolonged bed rest

    b. multiple fractures

    c. Paget’s disease of bone

    d. Sarcoidosis

    19. Patient is hypotensive with a positive DPL and bilateral pubic rami fractures, The

    next step is:

    a. ICU for stabilization

    b. Laparotomy

    c. External fixation of pelvic fracture (these are stable fractures)

    20. Patient in MVA with gross hematuris. On CT there is extravasation from the

    inferior pole of the L kidney. Tx:

    a. renal artery embolization

    b. instertion of ureteric stent

    c. observation

    d. OR

21. Most common cause of death following transfusion

    a. acute transfusion reaction

    b. Hep A

    c. Hep B

    d. Hep C

    e. HIV

    22. The most commonly transmitted disease with blood transfusion is

    a. Hep A

    b. Hep B

    c. Hep C

    d. HIV

    e. Toxoplasmosis

    23. A patient is in recovery following bowel surgery. (You are given an EKG with

    only P waves and no QRS complexes) Your next course of action is:

    a. give epinephrine IV

    b. give lidocaine IV

    c. transvenous pacing

    d. transcutaneous pacing

    e. defibrillate

24. What antibiotic most reliably treats enterococcus

    a. ciprofloxacin

    b. ampicillin

    c. ceftriaxone

    d. gentamicin

     rdndst25. 3 generation cephalosporins vs 2 and 1

    a. increased gram positive activity

    b. increased entercacteraciae coverage

    c. increased anaerobic coverage

26. Azathioprine (Imuran) belongs to which class of drugs

    a. alkylating agent

    b. purine analog

27. Effects of ionizing effects of radiation on skin:

28. Alkylating agents act by

    a. crosslinking DNA

    29. The side effects of methotrexate can be decreased by administering

    a. folic acid

    30. Calculated the sodium deficit of a 70 kg man with a serum Na of 120

    a. 420

    b. 840

    c. 1400

    31. Which is most consistent with compartment syndrome of the deep posterior

    compartment of the R lower leg

    a. Compartment pressure of 25

    b. Pain with dorsiflexion of the great toe

    c. Pain with plantar flexion of the toe

    d. A cold pulseless foot.

32. The most sensitive finding of optic nerve injury after trauma is

    a. visual field deficits

    b. loss of papillary light reflex

    c. loss of visual acuity

    d. fundoscopic exam

    33. Which cranial nerve is most commonly injured after craniocerebral trauma

    a. I

    b. III

    c. IV

    d. VII

    34. Following a MVA a patient has otorrhea and Battle’s sign. The most appropriate

    tx is

    a. observe and give broad spectrum Abx

    b. Oberve and refer to appopriate specialty if persists

    c. Consult ENT for immediate repair of leak

    d. Consult neurosurgery for immediate intracranial repair of leak

    35. Female with a displaced mid-humeral shaft # would be unable to do what?

    a. Wrist extension

    b. Wrist flexion

    c. Finger abduction

    d. Elbow flexion

36. Patient has L4/5 disc protrusion. Phyical findings would include:

    a. Decreased knee jerk

    b. Decreased ankle jerk

    c. Decreased great toe flexion

    d. Decreased great toe extension

    e. Decreased sensation to upper lateral thigh

37. Patient has C5/6 disc protrusion. Affected is:

    a. Wrist flexion

    b. Wrist extension

    c. Finger abduction

    d. Shoulder abductors

    38. Female with a C7 level following trauma. BP 80/50 and HR110. Most likely

    explanation for shock is:

    a. Spinal shock

    b. Neurogenic shock

    c. Unrecognized intraabdominal injury

39. Young male with # femur. Best way to transport is:

    a. Above knee cast

    b. Above knee splint

    c. Fixed traction

    d. Balanced traction

    e. Velcro splint with metal stays

    40. Jehovah’s Witness 9 yo girl was in MVA and her father was killed in the accident.

    Her mother prohibits transfusion. A chest tube is inserted and drains massive

    amount of blood requiring an OR and transfusion. Your FIRST step would be:

    a. Call Children’s Aid Society

    b. Take to OR immediately and transfuse

    c. Get hospital to appoint temporary decision maker

    d. Try to avoid transfusion

41. 2.4 melanoma deep melanoma on R shoulder. Surgical treatment:

    a. 1 cm margin

    b. 2cm margin

    c. 3cm margin

    d. 3cm with therapeutic lymph node dissection

    e. 3cm with prophylactic lymph node dissection

42. Leading cause of cancer deaths in women is: (repeat question)

43. Contraindication for resecting a pulmonary met from known ca

    a. uncontrolled primary

    b. bilateral mets

    c. would not resect.

    44. Man with sudden onset of headache which is the worst of his life. Workup with

    a. CT of head

    b. MRI of head

    c. LP

    d. Skull xrays

45. which sedative also has an analgesic effect.

    a. Versed

    b. Thiopental

    c. Ketamine

    d. Chloral hydrate

    e. Propofol

    46. Safe to give to patient with history of malignant hyperthermia

    a. Thiopental

    b. Succ

    c. Adrenaline

    d. Halothane

47. All are relative CIs to laparoscopic surgery EXCEPT

    a. Umbilical wall infection

    b. Umbilical hernia

    c. CHF

    d. Coagulopathy

    48. Young male in bike accident with trauma to perineum. Has scrotal hematoma and

    you are unable to clearly palpate testicle.

    a. Isotope scan

    b. Observe

    c. Explore

    d. ?

    49. Distraction injury of arm. Horners injury is most likely to be secondary to injury

    to

    a. C5

    b. C6

    c. C7

    d. C8

    e. T1?

    50. Patient bleeds after dental extraction. Bleeding time and aPTT increased but INR

    is normal. Normal capillary frag. and clot retraction.

    a. VW

    b. Factor IX

    c. Glandsmans disease

    d. Factor VII

    51. Blood transfusion given in OR. Patient’s serum subsequently turns pink and they

    become hypotensive and tachycardic. Treatment

    a. Give more blood

    b. Administer fluids and mannitol

    52. Family with MENII (pheo and medullary thyroid ca). Best way to check children

    for disease

    a. Ultrasound

    b. Ret proto-oncogene

    c. PTH level

    d. CT scan

    53. Two days after embollectomy a patient is on heparin and develops hematuria

    a. Stop heparin

    b. Fluids and alkanalize urine

54. In disclosure all are true EXCEPT

    a. Provides benefits and risks of a treatment

    b. Provides explanation of option

    c. Provides explanation of risk of no treatment

    d. Provides opportunity for patient to ask questions (**disclosure does

    NOT = consent)

55. Mesothelioma is related to

    a. Thoracic trauma

    b. Exposure to asbestos

    c. Hypoglycemia

    d. Smoking

56. Muscle energy availability depedent on

    a. ATP

    b. Creatine phosphate

    c. Glucose

    d. Lactate

57. Kidney acid-base regulation

58. The most sensitive way to assess the depth of a burn to the hand is:

    a. injection of indomethacin

    b. injection of fluorescin

    c. clinical exam

    d. ultrasound

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