SURGERY

All are class II Shock manifestation except?

1st Unit Exam Surgery a) 500 to 1000cc
Topics: b) Increase PR
Trauma c) Mild anxiety
Hemostasis, Surgical Bleeding and Transfusion d) 20 to 30 RR

The following are related to primary survey except. Four major events in hemostasis except.
Answer: Event Answer: Vascular dilation

BP 80/60mmHg. RR: 120 Respiratory distress. Absence Hemophilia C.

of sound in right lung. Answer: Factor XI
Answer: Tension Pneumothorax
Vitamin K dependent factors.
Initial management of case above? Answer: 2, 7, 9 & 10
Answer: Secure airway
Allows restoration of blood flow during healing process
How will you manage the abdomen in Case 2? and begins at the same time with clot formation?
Answer: FAST a) Sequestration
b) Platelet lysis
The following are life-threatening injuries except? c) Fibrinolysis
a) Cervical Spine Injury d) Revascularization
b) Massive hemothorax
c) Massive hemoperitoneum 36. The presence of fibrin degradation product in the
d) All of the above circulation may serve as marker of thrombosis or other
e) None of the above conditions in which a significant activation of the
fibrinolytic system is present.
BP: 100/70mmHg. HR: 96. RR 22.4 unya ICAA churva. Answer: D-dimer
Answer: Open Pneumothorax
Patient with hemophilia A with plasma factor of 4%.
Initial management for Case No. 9? a) Mild
a) Pressure then refer to the hospital b) Moderately severe
b) Apply 3-sided plaster c) Severe
c) Apply plaster with gel d) Extremely severe
d) Apply paster and observe
e) Suture then discharge In number 41, patient will?
Answer: Less spontaneous bleeding but are likely to
Possible complication of case above (Case 9) if left bleed severely after trauma or surgery
untreated?
Answer: Tension Pneumothorax Which of the following is the best choice to prepare a
patient with type 1 von williebrand's disease for
In relation to Case No. 9. surgery?
Answer: Suture the wound and insertt CTT Answer: Desmopressin

What is Flail Chest? If there is prolonged APTT and deep vein thrombosis
Answer: Occurs when 3 or more contiguous ribs are vein, what condition is associated with this?
fractured at least two locations Answer:

Initial treatment for flail chest?

Answer: Intubation and mechanical ventilation Chronic warfarin user patient with appendicitis. INR of
1.4
Carotid Pulse. a) Stop warfarin proceed with surgery
Answer: 60mmHg b) Stop warfarin, resume after 24-36 hours
c) Stop warfarin administer packed blood
Radial Pulse.
Answer: 80mmHg Anti-fibrinolytic drug, inhibit plasminogen and plasmin
activity.
45 year old male arrived at the center 5 hours post Answer:
injury, abused by a vehicular accident. He can open his
eyes with pain stimulus, confused and localized pain. Deficiency of this factor does not produce bleeding
Chest and abdominal pain were unremarkable. GCS tendencies and replacement is not required when?
score. a) Stuart prower
Ans: b) Hageman
 c) Christmas Circumferential injury .... leathery, surface is painless,
d) Proconvertin translucent or waxy white.
A. First degree
B. Second degree
3rd Unit Exam Surgery C. Third degree ***
Topics: D. Fourth degree
• Fluids and Electrolytes
• Burns Compartment syndrome.
A. Poilkilothermia
Hypercalcemia. B. Pain
Answer: Malignancy C. Paralysis
D. AOTA
An elderly patient with adult onset diabetes mellitus was
admitted to the hospital with severe True of the following.
pneumonia, the patient would not likely to develop? A. First degree includes epidermis and dermis
A. Hypokalemia B. Superficial thickness burn is associated with
B. Hyperkalemia hypotropic scarring and ...
C. Non ketotic hyperosmotic coma C. Third degree epidermis, dermis and subcutaneous
D. Hypophosphatemia D. Fourth degree is treated with skin grafting ...

Serum Ca 13.5mg/dL. What medication to avoid? Fluid of choice for management of burns?
A. Biphosphonates A. Plain saline
B. Thiazide diuretics B. Plain lactate ringers
C. Mithramycin C. 5% dextrose in lactate ringers
D. Calcitonin D. AOTA
E. Corticosteroids
Moist heat.
Hypovolemia in post operative patient. Answer: Scalding burn
True for K.
A. K daily intake is 150 - 200mEq Painfully hypersensitive, moist.
B. K in the body is in the ECF Answer: Second degree burn
C. With renal function is normal, hypercalcemia is not
usually encountered Associated with deep muscle necrosis, vessel
D. Administration of sodium bicarbonate can shift K from thrombosis, nerve injury.
ICF to ECF Answer: Electrical burn

Which of the following ECG finding for hyperkalemia? 4th Unit Exam Surgery Topics:
A. Inverted T wave • Surgical Infections
B. Short PR interval • Surgical Complications
C. Peak P wave **
D. Narrowing QRS Minimum pressure to diagnose ACS
A. 10
Patient with GCS 4. B. 25
Answer: Indicated for early intubation C. 35
D. 45
Incomprehensible words, no eye opening even vigorous
stimulation and no motor response. What is the GCS? Patient has a metal object on his medial plantar. No
Answer: 4 significant purulence. Cannot recall when last injected
tetanus shot.
Not part of the 4 crucial essential management of burn A. Fix wound
patients. B. Fix wound + IV antibiotic
A. Suction and removal of foreign bodies C. Fix wound + IV antibiotic + Tetanus toxoid
B. ? D. Fix wound + IV antibiotic + Tetanus toxoid + Tetanus
C. ? Immunoglobulin
D. Dressing with silver shit E. Do nothing

Corrosive injury ..., except? Not a classical manifestation of group A Streptococcus

A. Duration infection.
B. Concentration A. Necrotizing soft tissue infection
C. Volume B. Rheumatic Fever
D. Temperature*** C. Toxic Shock Syndrome
D. Pharyngitis
Which of the following is true regarding spontaneous
bacterial peritonitis in a cirrhotic patient?
A. Infection is always polymicrobial B. Ascitis fluid is
always positive
C. ?
D. 21 days antimicrobial is adequate
E. Incidence .... decline mortality rate to less than 10%
Who will benefit from the Systemic Antibiotic
Prophylaxis?
A. Ascitic protein fluid more than 1
B. Ascitic protein fluid less than 1
C. Previously cured from SBP
Confused and anxious. PR = 126 RR = 32 BP = 80/70.
a) 750
b) 750 - 1, 500
c) 1, 500 - 2, 000
d) >2, 000
How will you manage the abdomen (Case 1)?
Answer: FAST
Initial management in district hospital without surgeon
for case above (Open pneumothorax).
Answer: Apply 3-sided dressing, refer to tertiary
hospital for further management

. The most common complication of Tracheostomy A. Agrrevation of open pneuomothorax.

Injury to the Jugular veins and Carotid artery Answer: Tension pneumothorax
B. Wound infection
C. Injury to the Posterior Tracheal Wall
D. Injury to the Cupola Patient no eye opening, no verbal response, no
movement. What GCS score?
This is due to the ablation of the pylorus with resultant Answer: GCS: 3
loss of regulation of food osmolarity?
A. Frey Syndrome Severity of head injury?
B. Roux Syndrome A. Mild head injury
C. Dumping Syndrome B. Moderate head injury
D. Post Vagotomy Diarrhea C. Severe head injury �

Which of the following test best assess eradication of H. Temporal head injury diagnostic test.
pylori Infection after treatment? A. Cat scan
A. Urea breath Test B. Dog scan
B. CLO test C. Head X-ray
C. Biopsy and Culture D. Cranial CT Scan
D. ELISA E. Stool Antibody Test
Indication for doing ED thoracostomy in trauma.
Vascular control of intraoperative bleeding during A. Trauma to the torso >15min
hepatic surgery. B. Blunt trauma >10min
Answer: Pringles Maneuver C. Penetrating neck or extremities >5min
D. All of the above
Complication of failure to close wound E. None of the above
A. Fistula
B. Abscess JB had gunshoot on medial side of the proximal femur.
C. Dehiscence Normal iyang vital signs.
D. Obstruction A. Femoral fracture
B. Tangential muscle injury
C. Vascular injury
1st Bimonthly Exam Surgery
Topics: Class 4 except?
Trauma Answer: Anxious
Hemostasis, Surgical Bleeding and Transfusion
Shock Gunshot wound patient. At ER hypotensive. What is
damage control resuscitation strategy?
Conscious, coherent in respiratory distress, vital sign A. Initial resuscitation is maintaning SBO at 100 -
of ... absence of lung sound on right lung field with 120mmHg
subcutaneous emphysema. B. Control of hemorrhage in the OR
Answer: Tension pneumothorax C. Strategy begins in the OR and continues in the
ICU
Patient underwent excision mass, after operation, nurse D. Large bolus of IVF given to increase
inform you that the blood loss was 800cc. Patient weight intravascular volume
is 140kg.
Tachycardia Persistent hypoperfusion results in hemodynamic
Hypotension derangements and cardiovascular collapse.
Normal vital sign A. Compensated phase of shock
Change in sensorium B. Decompensation phase of shock
 C. Irreversible phase of shock B. Stimulare vasodilation of coronary artery
D. Vicious cycle of shock C. Vasodilation of splanchnic artery

Confused and Lethargic. 53-year old patient with gunshot wound in the left flank.
Answer: >2000 You suspect splenic injury with continuous bleeding. He
is taking Coumarin (Coumadin), what should be
Case. Abdominal pain. HR: 105 Temp: 39C BP: 87/60 RR: administered to patient?
30. A. IV Vitamin K
A. Activation of C7a and C4a B. Packed RBC transfusion
B. Increase permeability of vascular constriction C. FFP transfusion
of smooth muscle D. P ______ infusion
C. Lymphocyte 1st muadto sa site of injury?
D. Conversion of pyruvate to lactate by lactate Factors affected by the admission of coumarin to the
dehydrogenase in oxidative phosphorylation patient.
A. Factors 8 and 12
Patient is confused and lethargic, RR= 40 Hypotensive. B. Factors 12 and 13
Preganancy test is positive. C. Factors 2, 7, 9, and 11
A. Imcrease cardiac index D. Vitamin K-dependent factors
B. Decreased peripheral resistance
C. Increased cardiac output Deficiency of this factor does not produce bleeding
D. Decrease central venous pressure tendencies and replacement is not required when
patient is low with this factor only.
What is the first thing to do with the shock in the case? A. Stuart prower
A. Antibiotics B. Hageman
B. Target and biotics C. Christmas
C. Epinephrine and phenylephrine D. Prothrombin

What will happen in response to hypovolemic shock? 93. Best treatment (?) for type 1 von willebrand's prior
A. Alpha-1 adrenergic receptor - vasodilation surgery.
B. RAS activation - increase renal artery perfusion A. Pure XIII
C. Normal circulating blood volume maintain B. Von willebrand factor
within normal limits, kidney ability to maintain C. Factor VIII
salt and water balance D. Desmopressin
D. Neurogenic response to maintain perfusion in
the heart and lungs 94. 1 unit of platelets should raise the platelet count to?
A. 10, 000
30-year old male, hit by a car, neck pain, motion and B. 20, 000
sensory loss below the neck area. No other injuries. BP C. 30, 000
80/60. D. 40, 000
A. Hemorrhagic shock
B. Septic shock 95. Patient with prolonged APTT and deep venous
C. Traumatic shock thrombus should be evaluated by what conditions?
D. Neurogenic shock A. Protein C deficiency
E. Cardiogenic shock B. TTP
C. Antiphospholipid syndrome
25-year old unrestrained male vehicular accident. D. ITP
Confused, anxious, gives you his name. 70-kg. RR = 28
Pulse = 126 BP = 90/70. How much blood was lost?
A. Up to 750 3RD BIMONTHLY
B. 750 - 1, 500 SURGERY Unit Exam
C. 1, 500 - 2, 000 Surgical Oncology Physiologic Monitoring
D. >2, 000
E. None of the above Part of the cell cycle where protein synthesis and
chromosomal duplication occurs
Initial blood loss are compensated by? A. G1
Answer: Compensation phase B. G2
C. M phase
Anti-inflammatory except? D. S phase
Answer: Interleukin-1
What is the term for transformation of one tissue with
another?
Chemoreceptor of carotid artery. A. Hyperplasia
A. Stimulated by Oxygen and Hydrogen ion only B. Metaplasia
C. Dysplasia D. Seed and soil theory
D. Mutation
External mechanism of cell death
What tumor marker is associated with A. TNF
choriocarcinooma/ testicular cancer B. Mitochondrial cytochrome
A. HCG C. P53
B. CEA
C. CA 125 Angeline Jolie’s risk of developing breast cancer by the
D. CA 19-9 4. age of 70, who is known to have a BRCA 1 mutation is
approximately:
What cancer are aflatoxins associated with? A. 10%
A. HCC B. 20%
B. Cholangiocarcinoma C. 30%
C. Urinary bladder cancer D. 40%
D. Angiosarcoma
.A 45 year old female went to the OPD and ask about
Major source of cancer cells BRCA2 risk, BRCA2 mutations are associated with all of
A. Carbohydrates the following except:
B. Tryptophan A. Lung cancer
C. Glutamine B. Gastric cancer
D. Triglycerides C. Prostate cancer
D. Ovarian cancer
Assocated with breast cancer
ANs: BRC1-2 Revised Amsterdam Criteria II, except:
>STUDY BELOW<
Not a hallmark of cancer > or equal to 3 relatives with colorectal cancer or with
A. Invade and metastasize an HNPCC associated cancer
B. Evade apoptosis Endometrial carcinoma
C. Evade autophagy Small bowel
D. Evade immune destruction Adenocarcinoma
Ureter or renal pelvis cancer
Which of the following is not included in the 6 hallmarks  > or equal to 2 successive generations should be
of cancer affected
A. Self sufficiency of growth cells  > or equal to 1 tumor should be diagnosed before the
B. Predisposition to apoptosis age of 50 years FAP should be excluded
C. Angiogenesis  Tumors should be confirmed with histology
D. Invasiveness and metastasis
The ff are pathognomonic criteria for Cowden’s disease
Field effect is best described as except for
A. Effect of radiation on tumor A. Acral keratosis
B. Effect of loss of tumor suppressor function B. Facial trichilemommas
C. Effect of oncogene amplification C. Mucocutaneous lesions
D. Increased oncogene amplification D. Lipoma

Malignant cells are least likely to be in what stage of the A 65 year old man who previously work at a refrigerator
cell cycle? plant, came to OPD and was diagnosed with
A. S phase adenocarcinoma of the liver. What is the chemical
B. M phase carcinogen involved?
C. G0 phase A. Vinyl chloride
D. G1 phase B. Diethylstilbestrol
C. Benzene
What proto-oncogene promotes malignant growth by D. Coal tar
gene amplification:
A. HER2/neu A 60 year old man who had chronic exposure to coal tar
B. Ras is associated with which of the ff cancers:
C. BRCA1 A. Lung cancer
D. P53 B. Oral cancer
C. Scrotal cancer
Certain breast cancer subtype preferably metastasis in D. Bladder cancer
certain organ. Example of
A. In situ carcinoma
B. Lymphatic metastasis
C. Tumor dormancy
A 20 year old male who is positive for Epstein barr virus. All of the ff are forms of hormonal therapy, except:
He is at risk of what carcinoma A. Oophorectomy
A. Nasopharyngeal CA B. Vincristine
B. Kaposi sarcoma C. Tamoxifen
C. Non Hodgkin D. Aromatase inhibitor
D. Adult T cell lymphoma
Blood pressure is the measurement of blood exerted to
Highest risk for breast cancer using Gail model the systemic arterial system. It is determined by:
A. >2 first degree relatives with cancer A. Directly measuring the pressure through the arterial
B. Menarche at 14 years old lumen
C. Number of previous breast biopsy specimen and B. Indirectly measure the pressure through a cuff over
whether the biopsy specimen results revealed atypical an extremity
ductal hyperplasia C. Both A and B
D. … D. None of the above 3

All of the ff are involved in tumor staging except: In non-invasive measurement of arterial blood pressure,
A. Tumor stage korotkoff sound is defined as:
B. Tumor mutations A. Sound heard over the cardiac box
C. Nodal involvement B. Sound heard over the artery after it is inflated C.
D. Distant spread Sound heard over an artery distal to the cuff as the cuff
is deflated
All are correct except: D. Sound heard over a vein distal to the cuff as the cuff is
A. PSA – Prostate cancer deflated
B. 15-3 – Breast
C. CEA – Colon cancer In the auscultation of korotkoff sounds, systolic pressure
D. AFP – urinary bladder cancer is defined as:
A. The pressure in the cuff when audible sounds first
A 40 year old patient undergoing chemotherapy with the disappear
use of alkylating agent ANS: Cyclophosphamide B. The pressure in the cuff when audible sounds first
appear
A 40 year old patient is currently under treatment for C. The pressure in the cuff when audible sounds are
breast cancer. Work-up shows her to be HER2/neu +++. loudest
What molecular targeted therapy is needed for the D. The pressure in the cuff when audible sounds are
treatment of this patient? weakest
A. Cetuximab
B. Sunitinib Blood pressure using sphygmomanometer. Which is
C. Trastuzumab true:
D. Temsirolimus A. Width of the cuff should be 50% circumference B.
Diameter of the cuff is 40%
C-Kit (+) C. Width of the cuff should be 40%
A. Cetuximab D. Length of the cuff should be 4%
B. Imatinib C.
D. Trastuzumab What is the common site for intra-arterial pressure
monitoring?
A 24 year old female seen at the OPD with breast mass A. Brachial artery
on the right. Biopsy showed phyllo des tumor of the B. Radial artery
breast. All of the ff are true of surgical management of C. Femoral artery
the regional lymph node basin except: D. Carotid artery
ANS: Lymphadenectomy is performed in soft tissue
sarcoma Which of the ff is the complication of intra-arterial
catheterization
. A patient diagnosed with colon cancer is admitted at A. Pain
the ward. Upon metastatic work up a solitary node is B. Hypothermia
found in the liver. For select patients, all of the following C. Distal ischemia
parameters are necessary to perform metastasectomy D. Paresthesia
except:
A. Number of site of metastasis Intra-arterial catheterization increases incidence of
B. Type of primary cancer thrombosis through the following:
C. Rate of tumor growth A. Small gauge
D. Size of tumor B. Needle left too long
C. Removing catheter when feasible
D. Fever
Catheter acquired infection is relatively uncommon C. Size of cancer
occurring in ___ of cases D. Rate of growth of cancer
ANS: 0.4 – 0.7%
Which of the ff occurs abnormally proliferating,
Continuous ECG is useful in monitoring for acute transformed cells?
coronary syndrome and blunt myocardial infarction A. Anchorage-dependent growth
because: B. Immortalization
A. Dysarrythmias is the most common lethal C. Increase contact inhibition
complication D. Increased cell-cell adherence
B. Sepsis is the cause of death
C. …
D. Inadequate oxygen 4th Unit Exam Surgery
Topics:
Which of the following is not a determinant of cardiac • Surgical Infections
performance? • Surgical Complications
A. Preload
B. Afterload Minimum pressure to diagnose ACS
C. Contractility A. 10
D. Postload B. 25
C. 35
Afterload approximated by calculating systemic vascular D. 45
resistance
A. End diastolic pressure/ Cardiac output Patient has a metal object on his medial plantar. No
B. Cardiac output significant purulence. Cannot recall
C. Mean arterial pressure/ cardiac output when last injected tetanus shot.
D. Central venous pressure/ cardiac output A. Fix wound
E. Cardiac output/ MAP B. Fix wound + IV antibiotic
C. Fix wound + IV antibiotic + Tetanus toxoid
What is the main cause of VILI? D. Fix wound + IV antibiotic + Tetanus toxoid + Tetanus
A. Excessive airway pressure resulting to parenchymal Immunoglobulin
injury E. Do nothing
B. Ventilator acquired infection
C. Low airway pressure Not a classical manifestation of group A Streptococcus
D. Position of the patient infection.
A. Necrotizing soft tissue infection
Capnometry B. Rheumatic Fever
ANS: measurement of carbon dioxide in the airway C. Toxic Shock Syndrome
throughout the respiratory cycle D. Pharyngitis

Which is not a function of capnography Which of the following is true regarding spontaneous
A. Endotracheal intubation bacterial peritonitis in a cirrhotic
B. Integrity of the airway patient?
C. Cardiopulmonary function A. Infection is always polymicrobial
D. Lung protective ventilation B. Ascitis fluid is always positive
C. ?
A 25 year old female. Normal urine output D. 21 days antimicrobial is adequate
A. 100cc/hr E. Incidence .... decline mortality rate to less than 10%
B. 30cc/hr
C. 0.5ml/kg/hr Who will benefit from the Systemic Antibiotic
D. 2ml/kg/hr Prophylaxis?
A. Ascitic protein fluid more than 1
Triad of oliguria, increase abdominal pressyre, increase B. Ascitic protein fluid less than 1
___ pressure? C. Previously cured from SBP
A. Acute respiratory distress syndrome
B. Acute coronary syndrome The most common complication of Tracheostomy
C. Acute compartment syndrome A. Injury to the Jugular veins and Carotid artery
D. Acute Hypertension B. Wound infection
C. Injury to the Posterior Tracheal Wall
50. ANS: CPP = MAP – ICP D. Injury to the Cupola

All of the ff are parameters for metastatectomy except: This is due to the ablation of the pylorus with resultant
A. Number and site loss of regulation of food
B. Type of cancer osmolarity?
A. Frey Syndrome MOA of azathioprine.
B. Roux Syndrome Answer: Inhibits DNA synthesis
C. Dumping Syndrome
D. Post Vagotomy Diarrhea Lymphocele in renal transplant occurs in
A. Within 48 hours
Which of the following test best assess eradication of H. B. 1 week after surgery
pylori Infection after treatment? C. 2-3 weeks after surgery
A. Urea breath Test D. 3 months after surgery
B. CLO test
C. Biopsy and Culture Absolute Contraindication for Heart Transplantation,
D. ELISA Except?
E. Stool Antibody Test A. Carbon monoxide hemoglobin >20
B. Prolonged cardiac arrest
Vascular control of intraoperative bleeding during C. Prolonged high dopamine requirement
hepatic surgery. D. History of smoking
Answer: Pringles Maneuver
After completion of vascular anastomoses, drainage of a
Complication of failure to close wound transplanted pancreas is accomplished by anastomosis
A. Fistula to:
B. Abscess A. Right colon
C. Dehiscence B. Left colon
D. Obstruction C. Duodenum
D. Bladder or small bowel
Triad of oliguria, increase abdominal pressyre, increase
___ pressure? Immunologic rejection is mediated by patient's:
A. Acute respiratory distress syndrome A. Eosinophils
B. Acute coronary syndrome B. Lymphocytes
C. Acute compartment syndrome C. Neutrophils
D. Acute Hypertension D. Plasma cells

ANS: CPP = MAP – ICP **NO NUMBER** All of the ff Required test for transplantation, except.
are parameters for metastatectomy except: A. ABO
A. Number and site B. Cardiac catheter
B. Type of cancer C. CBC
C. Size of cancer D. APTT/PT
D. Rate of growth of cancer
Method use to monitor acute rejection after heart
Which of the ff occurs abnormally proliferating, transplant?
transformed cells? A. Dipyridamole thallium study
A. Anchorage-dependent growth B. ECG
B. Immortalization C. Endomyocardial biopsy
C. Increase contact inhibition D. Ultrasound of the heart
D. Increased cell-cell adherence
Absolute contraindications to renal transplant A. Hepa C
B. Age 60
7th Unit Exam Surgery Topics: C. Sickle cell
• MIS • Transplantation
Most common renal failure in US.
Cyclosporine adverse effect, except: A. Chronic glomerulonephritis
Answer: Pancreatitis B. Chronic pyelonephritis
C. Diabetes mellitus
5 year survival rate of patient having renal
transplantation? All of the potential donor are absolute contraindications
A. 30-45% in a kidney transplantation except.
B. 50-55% A. Age older than 70
C. 75-80% B. Chronic renal insufficiency
D. 90-95% C. Long standing hypertension
D. Hepatitis C
Hyper acute rejection is caused by.
A. Pre-formed Antibodies Currently, which of the following infectious diseases is
B. Related to atibodies too most likely to compromise after a renal transplantation?
C. T lymphocyte rejection A. Coli sepsis
B. Pneumococcal sepsis
 C. Candidiasis D. Laparoscopic assisted total colectomy
D. CMV sepsis
Cardiac transplant to be maintained below
All side effects of cyclosporineA except. A. 10mmHg
A. Hepatotoxicity B. 15mmHg
B. Hirsutism C. 20mmHg
C. Tremors D. 30mmHg
D. BM suppression
Pneumothorax is more likely to occur in patient
What is not an mis procedure? undergoing laparoscopy.
Answer: Breast biopsy A. Total gastrectomy
B. Total esophagectomy
Largest body buffer that help minimize respiratory C. Pancreaticoduodenectomy
acidosis and hypercarbia caused by CO2 insufflation of D. Hemicolectomy
peritoneal cavity.
A. Liver Effects of peritoneal insufflation on genitourinary
B. Bones system.
C. Lung A. Decreased urine output
B. Increased blood flow
Local physiologic effect caused by CO2 C. Increased GFR
pneumoperitoneum: D. Decreased bladder pressure
A. Decreased venous return
B. Increase in epinephrine Pneumoperitoneum increases free water absorption by
C. Respiratory acidosis increasing this substance.
D. Increase myocardial stroke work A. Erythropoietin
B. ADH
Maneuvers of the anaesthesiologist when CO2 retention C. ANP
is suspected. D. Renin
A. Decrease ventilation rate and vital capacity
B. Increase ventilatory rate and increase vital 65 y/o woman, laparoscopy for colon cancer, bp
capacity suddenly drops 60/40, tachycardic, hypotensive. No
C. Decrease ventilation rate or increase vital changes in ECG
capacity A. Occult
D. Decrease tidal volume only B. DVT
C. Vasovagal
Most common arrhythmia in laparoscopy. D. Gas embolism
A. Irregular sinus rhythm
B. Atrial fibrillation Extracavitary mis except?
C. Tachycardia Answer: Inguinal hernia repair
D. Bradycardia
Diagnosed by listening to esophageal stethoscope.
During insuflation of peritoneal cavity in laparoscopy in Answer: Mill wheel murmur
hypovolemic patient with reverse trendelenburg
position, what is the result? Answer: Decrease cardiac Gas emboli aspirate and
output and decrease venous return A. Reverse trendelenburg and left decubital
position *
65-year-old, male. Underwent laparoscopic B. Trendelenburg and left decubital
cholecystectomy due to Severe Cholecystitis. After C. Fowler's position and right decubital
insufflation and placing patient in reverse Trendelenberg D. Totally flat
position, his BP decreased and cardiac output
decreased . What is the next step? A. STAT Trop I
B. Refer to Cardiologist
C. Continue procedure but do it slower
D. Desufflation and lay the patient flat on bed

Reason why there is increased risk of DVT during upper

abdominal laparoscopic procedures. Answer:
Venoconstriction & decrease venous return

36. Would most benefit DVT prophylaxis. END

A. Breast cancer patient for stereotatic biopsy
B. Emergency laparascopic appendectomy
C. Elective robotic cholecystectomy