Which statement is TRUE about PAST MEDICAL HISTORY?

Past medical history of patient and his family members @

Including the symptoms of current episode of illness

Not harness information about the habits of eating, living, allergies...

Not necessary to look at previous treatment plan

Which statement is FALSE about Clinical examination?

Including all the symptoms the patient reported to the doctor@

Includes general examination and organ system examination

Organ examination must be detailed and complete

Abdominal examination must include 4 steps of inspection, palpation percussion and auscultation

Which statement is TRUE about MEDICAL RECORD SUMMARY?

Only summarize the symptoms reported by the patient to the doctor

Not necessary to include patient's past medical condition

Age, gender and chief complaint must be clearly stated@

Summarize as short as possible

Which is NOT a category of paraclinical investigation?

Definitive diagnostic test and routine diagnostic test

Blood test

Biochemistry test

Psychological test@

Which statement is TRUE about diagnosis in surgical medical record?

After history taking and clinical examination, it is necessary to order paraclinical tests to establish a
initial diagnosis.

A differential diagnosis is not necessary when a clinical diagnosis is established

Paraclinical tests assist in making a definitive diagnosis@

Accurate diagnosis only requires information that patient reports

Which statement is TRUE about the history of STERILIZATION IN SURGERY?

The first article on surgical sterilization was written by Louis Pasteur

Halsted proposed using latex gloves in clinical examination and treatment@

Semmelweis recommended disinfecting hands with alcohol before clinical examination

Steam sterilization method was first described by Lister

Which statement is TRUE about the purposes of surgical sterilization?

Ensure the cleanliness of the surgeon

Ensure the surgical environment is completely free of pathogenic microorganisms @

Reduce surgery time

Help increase the quality of surgical instruments

Which statement is TRUE about surgical hand washing?

Not necessary for examining the patient and performing procedures because sterile gloves are
available

Long nails must be scrubbed carefully

Most important measure for medical personnels to disinfect their hands @

Cleaning the palms of hands is sufficient

Which of the following statements is TRUE regarding Spaulding's classification?

All medical instruments must be considered "Critical" for sterilization

Instruments that contact with mucous membranes or wounds must be sterilized in compliance with
"Semicritical" level. @

Dental chairs, stretchers are "Semicritical" tools.

Surgical instruments require only low level disinfection

Which of the following statements is FALSE regarding sterilization:

Ideal condition for surgery

Surgical instruments must be processed properly in order to achieve sterilization

Helps reduce infection rate

A state free of bacteria and viruses but fungi@

Name two sterilization methods:

Physical measures

Chemical measures

Microbiological measures

Both A and B@
Which form of heat is USUALLY used for sterilization?

Dry heat

Steam@

Ethylen Oxide

Radiation

The use of ultraviolet rays (UV rays) in sterilization

To disinfect the skin before surgery

To sterilize used medical instruments

To disinfect the air in operating room or hospital room.@

To disinfect eyes in the treatment of cataracts

Advantages of steam sterilization method

Not safe for the environment and medical staff

Short sterilization time@

Requires complex ventilation systems to remove heat

Not causing damage to heat and moisture sensitive parts

Which of the following statements is TRUE regarding commonly used disinfectant solutions

Iodine solution is a weak disinfectant and does not cause allergies

70 degrees alcohol is preferred to 90 degrees alcohol in medical use@

The advantage of hydrogen peroxide is its long-lasting effect

Betadine is a very inexpensive disinfectant

Which of the following statements is TRUE regarding acute abdominal pain?

Only presents in about 50% of abdominal emergencies

Relieves with nausea or vomiting

May be relieved or aggravated by a number of influencing factors. @

Constipation is the most common cause of acute abdominal pain

Which information is NOT necessary for medical history of abdominal pain?

How the patient responds to pain@

How the pain started

Severity
Characteristic of pain

Common causes of peritonitis, EXCEPT

Peptic ulcer perforation

Ruptured purulent necrotic appendicitis

Small intestine or colon perforation

Liver abscess@

Which sign or symptom is NOT common in mechanical bowel obstruction?

Colicky abdominal pain

Abdominal distention

Decrease bowel sounds @

Visible bowel peristalsis on abdominal wall

Which are the tests often used in the diagnosis of acute abdominal pain?

Lipid blood test

Electrocardiogram

Chest X ray

Abdominal ultrasound@

Which of the following is TRUE regarding first aid for patients with acute abdominal pain?

Detailed history taking and meticulous examination is required to accurately diagnose the disease

Immediately start treatment with pain relievers

Recognize surgical acute abdomen from common abdominal pains@

Not allowed to examine or ask the patients. Wait for the arrival of specialist

Which of the following statements is TRUE about acute appendicitis?

It is the most common surgical abdominal condition in the emergency department. @

Progression of the disease is very slow, not life-threatening

Early diagnosis does not change treatment outcome

Only seen in the elderly

Which of the following statements is FALSE about symptoms of acute appendicitis?

Abdominal pain usually begins in the epigastric region and then moves to the right iliac fossa region

Fever is never presented@

There may be loose stools or constipation

Nausea is sometimes presented

Which of the following statements is TRUE regarding signs of acute appendicitis?

Deep tenderness when pressing McBurney's point @

In the late stage, there's usually only pain at periumbilical region during palpation

In case of ruptured appendix causing peritonitis, there is usually guarding at the hypogastrium

Temperature is often less then 37 degrees Celcius

Which of the following statements is FALSE regarding clinical stages of acute appendicitis?

Asymptomatic appendicitis@

Suppurative appendicitis

Ruptured purulent necrotic appendicitis

Peritonitis due to ruptured appendicitis

Which of the following tests is used to diagnose appendicitis?

Complete blood count @

Chest X ray

Gastroendoscopy

Abdominal X ray

Which of the following statements is TRUE about treatment of appendicitis?

Surgery timing does not affect the patient's recovery outcome

Open laparotomy to remove appendix is the most popular method

Early stage of appendicitis can be treated with antibiotics without surgery

Appendectomy is the main treatment. @

Which of the following statements is FALSE about complications of appendicitis

Peritonitis due to ruptured appendicitis

Appendiceal abscess

Self-recovery appendicitis @

Phlegmonous appendicitis

Causes of upper gastrointestinal bleeding, EXCEPT

Gastric ulcer
Duodenal ulcer

Esophageal varices ruptured

Esophageal spasms @

Causes of lower gastrointestinal bleeding, EXCEPT

Hemorrhoids

Colorectal cancer

Anal stricture @

Ulcerative colitis

Choose the TRUE statement regarding the Glasgow Scale (GCS)

For the purpose of assessing the degree of bleeding in brain

Applied to both adults and children

Not applicable to coma cases

The maximum score is 15@

Which of the following statements is TRUE regarding vital signs examination of patients with
traumatic brain injury?

Tachycardia, low blood pressure are signs of increased intracranial pressure

It is easy to cause hemorrhagic shock in adults

Patients often have fever due to infected wounds

Sudden apnea is a sign of brainstem compression.@

Diagnosis tests of traumatic brain injury

Ultrasound is the most commonly used method

Cranial X-ray is not helpful in diagnosis

Head CT scan must be ordered in traumatic brain injury@

Only order test when the patient is awake

What is the caution when giving first aid to patients with suspected traumatic brain injury

Move the patient to the medical facility as soon as possible

Remove all skull fragments if the skull is severely broken

CPR are not required in case of cardiac arrest to prevent spinal cord injury

Check for combined lesions in other parts of the body@

Which of the following statements is TRUE regarding vascular wound?

Including arterial, venous, and lymphatic system injury

Vascular injury usually occurs on the neck

Bruising is a common sign

Vascular systems of the lower extremities are the least vulnerable to injury

Causes of vascular injury, EXCEPT

Weapons: bullets, bombs, mines

Bone fractures, dislocations

Stabbed by sharp object

Massage, reflexology@

Examining a vascular injury case

It's sufficient just to palpate the pulse at the site of lesion

A murmur may be heard in the area of the injured blood vessel.@

The skin color of the affected area is not related to the vascular wound

It's not necessary to measure blood pressure

Choose the TRUE statement regarding symptoms and signs of blood vessel damage

Anemia is the most typical and common sign

External bleeding is rare

Increased pulse rate at the site of injury

Loss of pulse near the site of injury is a serious sign.

Choose the TRUE statement regarding factors affecting bone fracture

Age and gender is related to bone structure@

Diet

Physical exercises

Means of transportation used

How does anatomical location affect bone fractures?

Related to bone pathology

Fractures at the head of bone are different from fractures at the body of bone.@

Compact bone breaks more easily than spongy bone

Lower limb fractures are harder to heal than upper limb fractures

Which of the following statements is TRUE regarding the effects of bone fracture on the body

Causes severe pain due to nerve damage and irritation at the site of injury@

Increases risk of malignancy (cancer) at the site of broken bone

Affects only the bone and soft tissue at the site of injury but the whole body

Rarely causes damage to surrounding soft tissue

Complications bone of fracture, EXCEPT

Traumatic shock

Fat embolism

Circulatory and respiratory failure @

Nerve and blood vessel damage

Which factor is NOT directly related to bone fracture history?

Age

Gender

Cause and mechanism of injury

Patient's occupation @

Definite signs of bone fractures, EXCEPT

Pain at fracture location @

Limb deformation

Abnormal movements

Crackled sound

Which of the following statements is FALSE regarding the steps to diagnose bone fractures?

Take history of bone fractures

Clinical examination for signs of bone fractures

X-ray of the area of broken bones

Investigate the accident scene to find the mechanism of injury @

Definitive signs of intra-abdominal bleeding:

Lightheadedness, dizziness, fainting

Withdraw unclotted blood on abdominal paracentesis @

Pale skin and mucus membranes

Abdominal ultrasound shows peritoneal fluid

Which of the following statements is TRUE regarding initial management of intra-abdominal

bleeding?

Transfer the patient immediately to the hospital, no further action needed

Monitor the patient for 24 hours more and transfer if the patient's condition deteriorates

Assess patient's conciousness and vital signs immediately @

Order immediate blood transfusion before hospital transfer

Causes of extrahepatic obstructive jaundice, EXCEPT:

Hepatitis B, C@

Pancreatic head tumor

Choledocholithiasis

Choledochal Cysts

Choose the TRUE statement regarding the diagnosis of obstructive jaundice:

Progressive darkening jaudice with right upper quadrant pain and loss of appetite suggests common
bile duct stones

Clinical course of fluctuating jaundice with weight loss suggests biliary obstruction due to
malignancy

Dark urine with pale stools and itching suggests obstructive jaundice@

An enlarged, painful gallbladder is a definitive sign of extrahepatic obstructive jaundice

What is the diagnostic modality that helps diagnose extrahepatic biliary obstruction?

Complete blood count, liver enzymes AST, ALT

Abdominal and pelvic CT scan with contrast @

Total, direct and indirect bilirubin

Gastroduodenal endoscopy

Which of the following malignancies causes extrahepatic obstructive jaundice?

Transverse colon cancer

Periampullary tumors (tumor within 2 cm of the ampulla of Vater) @

Tumors of the body and tail of the pancreas

Hepatocellular Carcinoma
Which is the CORRECT statement regarding chest trauma?

It is the most common injury caused by traffic accidents

Very low mortality rate

Treatment is mainly monitoring and medication

Flail chest is a very dangerous complication @

Injuries that can present in chest trauma, EXCEPT:

Broken ribs

Pneumothorax

Hemothorax

Myocardial infarction due to embolism@

Which lesions chest X-ray can NOT diagnose?

Hemothorax

Pneumothorax

Acute heart failure due to cardiac tamponade @

Broken ribs

Mr. K, 20 years old, had just eaten a full meal, fell from one-story-height at a construction site and
hit his belly against a barrel. Mr. K was admitted to the hospital after 2 hours. Examination
revealed that Mr. K had "peritonitis syndrome". Which organ was possibly damaged?

Liver

Spleen

Stomach @

Kidney

The MOST COMMON cause of burns:

Chemical burns (acids, bases, etc.)

Burns due to work accidents

Burns due to accidents in daily life @

Friction burns in traffic accidents

Choose the CORRECT statement regarding methods of calculating burn area:

The head, face and neck make up 8% of the body surface area
The back accounts for 18% of the body surface area @

The area of the hands is equivalent to 2% of the body surface area

Each arm and leg occupies 9% of the body surface area

Choose the CORRECT statement regarding the depth of the burn:

Second degree burn damages to the dermis@

Third degree burn only damages the epidermis and dermis

First degree burn only reddens the skin without leaving physical damage

Fourth degree burn is third degree burn with an area > 9%.

Acute consequences of burns causing to the body :

Hyperthermia

Volume overload due to permeation of fluid into blood vessels

Retracted scars resulting in deformity and limitation of limbs movements @

Increased serum albumin and blood protein concentration due to tissue lysis

Choose the FALSE statement regarding clinical examination of burns:

Check the site of burn

Assess the width and depth of the burn

Calculate the burn area using ruler @

Check for swelling, blisters, signs of infection

Choose the TRUE statement regarding principles of first aid for burns :

Dip the burned hands and feet in warm water after being burned for 30 minutes

Victims of electric burns must be resuscitated before being isolated from the power source

Give the victim electrolyte solution, sugar water, milk immediately before first aid

Give pain relievers@

Mr. A has acute abdominal pain and is suspected appendicitis. On abdominal examination when
pressing on the left iliac fossa, Mr. A reported pain in the right iliac fossa. What is the name of this
sign?

Blumberg

Rovsing @

Hyperesthesia of skin
Aaron