h neon Aisin? hey Choose the best answer For questions | - 10; A 40 year-old, 70 kg. male was sovolvang hs amserior trunk and the whole genital arca. He also has full thickness burns invotving his left sper ‘extrem and the antenoe porbon of hs pre elper pearesmsrcage ies spelen + ‘Upon further inspection superficial burns were sees ‘L. Being the Surgical resident when the a se on duty patient arrived at the ER, your initial evaluation / manages brought to the ER who suffered parual thickness barns. A) Airway management 8) Estumate burn sane C) diagnosis of CO poisoning D) AaB E) ABandic 2. tt was chserved that the paticnt has stride: What will be the next appropriate stop in management? A) Prompt clocuve imtubaison B) Evaluate oral cavity and pharyux for mocosal injory ©) Chest X-ray D) AaB E) ABaiC 3. Using the “Ruske of 9's", the approximate *STBSA (Total Body Surface Area) burn is A) 8B) 2% C) 32.5% D) 3% E) 4% 4 sung te Parktand Formal the amount of fais needed 0 resuciae the patio fr the 1° 24 heen computed 25. A) 46 B) sa C) 6m D) 9iL BH) BL s Vem de Partin Forma, te amount fide be gives fort 1*8 hours i computed A) 287.5 coe B) 42schr C) Ss@ccrer D) 568. 7Sccthr E) wos te 6 nice as Pucond Poxmndn he cto is ob gven fr 16 hears afer he 8 hou pag- 8 - A) M2oofhs B) 1%6cc/er C) 28ccm D) 284cc/w E) Wicte 7. “The following parameters means adequacy of fic resuacitason A) Blood pressuse of 90/50 munHg, B) Urine ouput of 30° mnt Ae C) Pulse mate of 110 beaks per mnie, D) Aad BONLY E) All.of the Above a Cites therapeu ha ca wed rig ths pte! bur emeaciaton ice B= periormang. A) Analgesic 8) High dose vitamin C C) Fetamns D) AandB EB) Alt ofde Aboyp © Ab of te shove pu “True simomens/s im the initial evaluanon of Burn patients inclade/s: “A> Paments wit acute bara ijares should not roeive prophylactic ©) Bur poncnes should be firs considered trauma patients > Eeaten tell tod pa A ic. " E) All ofthe Above (L 13. Thus diagram gives a more accurate accounting v A) Pale of 9's B) Lund and Browder chart C) Pariland Bum Chart, D) AaiC E) None of the above 4 {4 Trac sumicment/s regarding electrical burn ‘A) A baseline ECG ts recommended all patients with electrical injury E) #* degree bums is usually scen in electrical bum C) Compartment syndrome usually managed with fascitomy D) AmiB E) Allof the Above 15. Burn Suid resuscitation is warremted in the following ‘of the true bum size in children less than 3 years old 5) £Z 18. Troe statements for the Zone of stasis inctude/s: o A) “This zone is in the oulermost area of the wound B) Appropriate resuscitation and wound care may wound ©) Arca of « bum wound which will heal with minimal oF no Sean D) Aan f E) All of the Above & 19. Rule of 9s in estimating bum size assigned 18% TBSA A) In the Anterior Trunk B) im both Upper Extremity ©) Incach Lower Extremity . D) Aand ERTE) All of the Above (y 20, Abdominal compartment syndrome is managed by doing A 2.1. Isotonic crystalloid forsnulas includes A). Parkland Formuta B) Warden formula C) Slater Formula D) Aandc E) Banc y 22. Afflicted patients may have unexpected nowralegic symiplonne A) Hydrogen Cyanide Toxicity B) Carbon Monoxide Poisor C) Treatment consists of administering 100% oxygen minor others D) Band C £) Aanac 23. Continuation of 1V Fluids adeninistration depend/s on A) Mean Arterial Pressure B) Urine Output C) Time since Injury D) AandB £) Allof the Above k 24, This full thickness burn wound management 1s b produces 0 tourniquet effect compromising the vascular supply. Initial i) 25, Painful burn wounds with blister formation A) 3" degree burns £) AandC only 26. Common site to harvest split thickness skin graft t31 Acute abdomen is defined as sudden abdominal disorder heralded by abdominal pais wef clinical manifestations Achitcually, which of Yas liteg tes eet ease cae ae A) immediate surgical intervention is usually necessary B) Frequently associated with a protracted underlying abdominal pathology C) Delay in treatment does not have any effect to outcome D) The cause may be traumatic or non-traumatic E) None of the above 32. Which among the following are Gi tract disorders that may manifest with acute abdomen? A A) Acute cholecystitis B) Acute cholangitis C) Acute pyelonephritis D) Acute myocardial infarction BS E) None of the above Which of the following are hepatobiliary disorders that may manifest with acule abdomen? A) Small bowel obstruction B) Ruptured aortic aneurysm C) Acute cholecystitis D) Perforated peptic ulcer E) None of the above ‘Cre 34. Tuberculous peritonitis is an example of acute abdomen due to disorder in which of the following? A) Peritoneal disorder A B) Gt tact disorder ) Retroperitoneal disorder 1D) Pancreatic disorder E) None of the above ‘Visceral abdominal pain are usually perceived in the central abdominal area, present as, A) Dull and vague A B) Sharper C) Well-localized D) More acute onset E) None of the above 36, Which of the following causes of abdominal pain? ‘A) Acute pancreatitis @ B) Perforated peptic ulcer C) Acute cholecystitis ‘D) Ureteral colic 37. Physical examination findings ofa tensed, seaphotd and rigid abdomen is seen in which of the following conditions? 35. ‘acute abdomen may manifest with a shifting or spreading pattern of A) Paralytic ileus |) _B) Bowel obstruction 5 C) Gastrointestinal bleeding D) Perforated viscus : 38. poe abdomen, minimal bowel sounds without Jocalized tendemess is characteristic of this abdominal condition ‘A) Bowel strangulation B) Paralytic ileus & C) Perforated viscus D) Peritonitis 3 oc 39. ey arrest due to pain upon palpation of the right upper quadrant of the abdomen, indicat ‘cholecystitis is also known as ‘A) Rovsing’s sign B B) Murphy's sign C) Obturator sign Date yhatever cause. 40. veapaibeal darkening of the skin duc to blood as @ esul! of hemopentoneum of wi A). Blumberg sign B) Cullen's sign C) Grey Tumer's sign sa a cnet a abominal pa, which ofthe following conditions may manifest with an explossys * qoute abxlomen? A) Strangulated bowel (0B) Perforated hollow viscus C} Mesenteric ischemia 1D) Acute appendicitis42. Gradual onset of acute abdominal pain is the manifestation in which of the following? A) Ruptured abdominal aortic aneurysm B) Acute cholecystitis C) Mesenteric ischemia D) Appendicitis 43. Steady mild pain becomin ‘ is ae {allowing ane ‘ancl centered in a well-defined area in | ~ 2 hours is characterized in which ‘A) Acute appendicitis CZ B) Incarcerated hernia, C) Acute pancreatitis D) Uncomplicated peptic ulcer disease 44, Pain referred to the MeBurney’s point upon direct pressure over the area ofthe left colon. A) Itiopsoas sign Cc B) Obturator sign, C) Rovsing’s sign D) Ten Horn sign 45. As to the clinical character of abdominal pain, which of the following conditions would manifest with an abeupt and excruciating pain? K A) Ureteral colic B) Acute cholceystitis C) Acute diverticulitis D) Acute appendicitis 46. Rapid onset of severe constant abdominal pain is the character of pain in which of the following? A) Acute appendicitis % B) Acule pancreatitis ©) Biliary colic D) Acute diverticulitis 47. Lisa Seana pain-free ittervals would be the characteristic abslominal pain in which of the following? A) Acute cholecystitis b B) Small bowel obstruction C)_ Acute pancreatitis D) Ectopic pregnancy 48, Physical examination maneuver that elicits abdominal pain on internal and external rotation of a flexed thigh is also known as: A) Miopsoas sign Cc B) Rovsing’s sign C) Obturator's Sign D) Murphy's sign 49. Which among the following is an example of referred abstominal pain? 'A) The pain elicited by the Murphy's sign in acute cholecystitis B) Direct and rebound tenderness in the right lower quadrant in acute appendicitis » C) The costovertebral punch tendemess in acute pyelonephritis 1D) Cutaneous pain in the right subscapular area in acuic cholecystitis 50. In coming up with a slinical diagnosis for acute abdomen, one of the following statements is true: ‘A)_ Vascular pathology of abdominal pain is common in young adults % B) Mesenteric adenitis mimics acute appendicitis in young children C)_ Lower abdominal pain in females is always gynecologic in origin D) ‘Abdominal pain persisting more than 6 hours may be observed without hospital admission Multiple Correct Response: Answer A D if choices 1, 2 and 3 are correct B if choices | and 3 are correct ee ifcchoioes 2 and 4 are correct > ifnty choice 4 is correct Bec mie ifall choices are correct 51. The following oluatary muscle guarding oi A 2. Tense or progressive abdominal distention 44. Persistent abxlominal pain without distention ane tenderness é 52. quivocal PE findings ofthe abdomen together with which athe following may indicat gent sage) im see ae sirton ig conserve management “The presence of desire 10 eat Suspected ischemia (fever, tachycardia, acidosis) ‘Normoactive bowel sounds % 1 2 3 453. Vague visceral abdominal pain perceived itt the mid im which of the following organs? se eee ' 1 Stomach 0 2. Urinary bladder 3. Pancreas 4. Sigmoid colon 5A. The following statement/s is/are correct reparding shifting or spreading sbxkonsital ai i ‘The progression of pain parallels the progression of underlying intra-alslominal pathology A 2. Example is the lower abslominal pain perceived by patient with perforated peptic weer The site of paim at onset is usuatly remote from thé site of pain at initial presentation of syaiptoins 4 Example is the back pain perceived in ruptured aortic aneurysin following are radiologic findings that may indicate urgent surpery in acute abxtomen |. Free extravasation of contrast materials 2. Pheumoperitoneum 3, Gross or progressive bowel distention 4. The presence of angiographic demonstration of vascular occlusion 56. Pain at McBumey’s point when compressing the Hifi lower abdomen A) Grey turner sign T B) Chandelier sign g C) Danforth sign D) Rovsing sign 57. Palpable gallbladder in presence of jaundice A) Courvoisier A B) Cruveihier C) Claybrook ) D) Camet 58. In the requesting plain radiographs for patients with pneuroperitomenm, thi view ca detect 1 iil of sir into the: peritoneal cavity é A) Lateral decubitus B) Supine C) Upright D) Apico-lordotic 59. Abdominal ultrasound findings indicative of Acute cholecystitis A) Presence of posterior sonic shadowing, iC B) Thin gallbladder wall C) Presence of pericholecystic fluid 60. True os ea bs use of CT scan in pationts with abdominal pain EXCEPT Widely available and less likely to be hindered by abdorwinal pan i scutes eee B) A well performed CT using oral, rectal and IV contrast is highly accurale for evaluating oD oO ara ificult diagnostic ditemumas,ictoding ate intial isin nel towel injury following bunt abdominal trauma, can often be Wdealied by (Ws meviot D) Not excellent for differentiating mechanical small bowel obstruction from para i rally Ln venation coi of EXCEPT 61. Preparation of a patient with surgical abdomen for emergency operation ‘A)_ IV access should be obtained ee aed B) Correction of fluid and electrolyte abt capped Oey ca tne nn peo att wall peri 62. Cee iia ei vecacbagn LSA ‘are usually decresed in ncuto inflammatory 55. The 2 i i th acute appendicitis c) Pyuria is common in patients wit met o 63. _D) meters porns pen pareve x ern or dane Ds = i a Site of an injury's origin” = A) ‘Visceral pain65. A rectus sheath hematoma will usually present with this sign A) Fothergill sign B) lliopsoas sign k C) Blumberg sign D) Aaron sign 66. Which of the following is true regarding carcinoma in situ? A) Involves the muscularis propia and outer layers & B) Exclusive to epithelial tumors C) Commonly has distant metastasis D) Should be treated by extensive surgery to improve survival 67. Which of the following is commonly associated with benign skin tumors and commonly develops cancer by 40 years old and is associated with mutation of the APC gene at chromosome 5q” % ‘A) Hereditary breast cancer-ovarian syndrome B) Familial adenomatous polyposis C) Hereditary non-polyposis colonic cancer D) Band 68. The most common genetic neurologic disorder caused by a single gene 1s A) Neurofibroma kK B) Hereditary non-polyposis colonic cancer C) Breast cancer D) Retinoblastoma 69. The greatest preventable cause of cancer A) Vimises B) Chemicals wD C) Obesity and dietary factors D) Tobacco 70. Which of the following cancers is not ‘associated with tobacco use? (A) Thyroid cancer h B) Transitional cell cancers of the ureter, urinary bladder and renal pelvis C) Esophagus, gastric and pancreatic cancer D) Cervical cancer 71. Which of the following causative agents can cause cancer A) Alcoliol and eventually becomes genetic? td B) Asbestos C)_ Chronic non-healing wounds more than 3 years duration D) Allof the above 72. Marjolin’s ulcer 'A) Avery virulent type of sarcoma Cy Treated by topical antibiotics and daily dressing only €)_ Commonly from third degree burs that were not covered by skin graft and healing external wounds D) Usually hereditary 73, What should be the next step in the diagnosis of solid tumors that area 'A) Mammogram ifthe mass is palpated in the breast B} Any form of biopsy €)_ CT scan-guided needle localization )_Imunediate removal of the mass especially its more dan 3 cin 74, What form of biopsy is preferred fr 1 cm skin tumor in ths abdominal wall which = mos, likely sqvamous cell carcinoma? ‘A)_ Incision biopsy 5) Wide exeision biopsy C) Fine needle aspiration biopsy D) Core needle biopsy red for intimeranial tumors? ‘of biopay is prefer e oe mda biopsy and follow up after L week (o see tf further surgery 15 indicated | BY Excision boner | () Wide excision D) Core needle biopsy | ee ‘osteomyelitis with non yecessible and palpable?76, Positson emission tomography is an imaging technique used to search for distant metastasis. local extent of tumor or residual tumor after surgery, What is the agent used in PET scan to see the lesion being sought? A) Technitium 99m i B) Iodine 131 \— _C) Fluorodeoxyglucose 18 D) Magnets 77. A 44 years old female came to your clinic with a strong family history of breast and ovarian cancer, Which of the following should NOT be included in your advice? é A) Testing for BRCA1, BRCA2 and Ki67 B) Mammogram C) Ultrasound-guided needle localization biopsy D) Genetic testing and counselling for the family members 78. If BRCA\ and BRCA2 are both positive in the previous case, what would you advise them to do? A) Have propylactic mastectomy and oophorectomy A B) Wait until breast cancer arises before the breast is removed C) ‘The chance of malignancy is very small, less than 5% hence may only require anual breast PI D} Repeat BRCA1 and BRCA2 after | year 79, Although the previous patient does not have a palpable breast mass, a cluster of microcalcifications wits soeh ( mammography. What would you advise your patient to do? A) Core needle biopsy under ultrasound guidance »D B) Wide excision biopsy ‘; C) Incision biopsy D) Mammogram-guided needle localization biopsy 80. Surgery is the only treatment needed for which of the Following cancers? A) Basal cell carcinoma k B) Lymphoma C} Rectal adenocarcinoma Sem with lymphatic involvement 1D) Esophageal cancer Bi, Most thyroid cancers are treated solcly by which of the following? A) Chemotherapy B) Radiotherapy C) Thyroidectomy 1D) Combination of any two of the above 82, Gastrointestinal cancer except esophagus and A) Radiotherapy B) Surgery ©) Chemotherapy D) Band Conly 83. Sarcomas are waually treated by which of the following? 'A) Surgery and radiotherapy Koi DB cere C) Both A and B D) None of the above 84. apes ofthe following is tue regarding chemotherapy inthe ealment of cancers? 'A)_ Utilized for lovo-regional control Py B) Utilized for systemic como! of te cancer —_}_ Utilized to control bone metastases Very wsefl inthe treatment of nasopharyngeal carcinoma 18S, Which of thiethesc cancer/s isare hormone sensitive? (A) Genito-wrinary tract cancers ip) Gastroiritestinal tract cancers 1 Srorne tryroid and Breas Caner te, thyroid an oe era rapeding oom, rons ml mate masons "A) The role of surgery in these cases is for diagsoris 8) Teepe ect eer first ) Radiation therapy does not have a:rote in the tsostment D) All of the above rectus treatment usually involves which of the following? omy andthe teatime of thst comacne111 Th ver Some sete wits alice mated neck and imgpeinal Ipmphadicacpathy, fever, night sweats, meas ions ‘Thee en hep mm the memagemecee of thas patens shombd be: ¢ A) Inemernane chemetheragy within bogey “) —() inctahe heryey oh the rage wate ©) Che ity sh rtd proto errratee (PPD) sin tet to rake oot mbencahoss 1D) Cnmerve with mcnathiy Solicrw ge: 1b) yeas oh wale ears with nese (ecling A madecuate cracaation of Sexes), toad streaked stools ai Gesriatt: se tenance A feces, Kertal examination shows 2 hard, frabhe, theeding mass with 3 caniifiermes tthe commen abena Lise ‘rome the aad verge. Wht thend be the next sep in the management of Gs cave hes ay Gag Coney which showed sbesocarcinoee, rectum if mectattic work wp i ) Reemive A) Nemes warwery Chen atin aed treatment B) Nomdpevana cheney snd rateoterapy 0 indicated prot to surgery C) Menatpevant chomotherapy and radiotherapy is indecated ater surgery D) Hormonal therapy 9. h cohen carcex patient 1 schertaed fox right hemicolectomy. Work up showed a small, solitary liver nodule on the left lateral lobe of the: Inver. otherwise the complete meusiztic work up is negative. What would be the best treatment plan fox thos passer? y A) Fuge hemcelecsomny only and subject solitary nodale to radiotherapy postop B) Pighe herecchecionmy ony then deeregard inver metastans once thes will aot improve her survival C) Right hemeclecomy then chemotherapy to treat the metastasis D) Highs bemacchecomy then left lateral hepatectomry to remove the metastatic lesion followed later by permet Aas ekderhy panera presems uth masarve abdomunal dastennon and ngsd abdomen with direct and rebound lendernesa all over (pomtive pertomes) A few days ago be was doagnoscd with 2 completely obstracting rectal L cance tant GA not comacet yet for surgery and went toca. This is most likely bowel perforation. Where is the ment Vikcely site of perforation im this case” A) Ceowmn B) Rectom ©) Stomach D) Appendix ; : 91. Mora cancers present with occult bleeding and rarely camse massive bioding. In this patient, an ints-sbsomsnet muligrency was diagnosed mothe age but was not wrested Where is the most likely locaton of the said cances? A) Colom and rectuin adenocancmoms CB) Esophageal seuamans cell corcenoma ©) Hepatoceliatas catcineena D) Gane adenocarcinoma 92. Which of the following is trae regarding palliative care |A) The maim objective is the protongation of tke B) “The main cbjective is improving the quality of remaining life ©) Bath nae colonic cancer. All of them sre positive for mation of family was disgnosed with heredaary nom-polyposis - tema, ait MSHE and PMI and 2 genes. What would be the best adrice for dhe faenily basin 2 ina saicsnoicealiati is ‘Anmual colonoscopy only afer 40 years old $4 Who he tllnting ire ale # tk or ae ad ation CARE? A) HBOCS C sB) HNpcc ©) Both BEA: x risk and COX? inhibitors im the tamoxifen to prevent breast cancer in indvidesls = ic Mi ton canes vccneen se ace SS EE A) Hepatitis B andl C-ensociatod hepatomas96. The gene mutation associated with Neurofibromatosis A) NF1 and NF2 A B) APC ©) MSH6 D) RBI 97. Which of the following is a feature of a familial cancer? A) Unusually early onset ) B) Having 2 cancers in the same organ C) Having cancers in both paired organs D) All of the above 98. The thyroid cancer associated with MEN 2 A) Papillary carcinoma % B) Medullary carcinoma a C) Follicular carcinoma 1D) Hurthie cell carcinoma : 99, Which of these cancers usually require surgery as the initial treatment lowed by chemo- adr msheeneray” A) Breast cancer B) Cervical cancer D C) Most GI cancers D) All of the above : 100. ‘The name of your lecturer in Principles of Surgical Oncology A) Dr. Roberto B. Acuita A.B) Dr. Wilfredo Potido C) Dr. Wilfredo Tayag D) Dr, Miles Dela Rosa END COMPILED BY: AMANO, LVL MED2E