Surgery Week Quiz Series - Part 8 [GRADED A+]

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Surgery week 8 quiz Q # 1 of 45 - 1 Points USMLE Step 2 CK Board Preparation | 1. A 50-year-old woman presents with right-sided pleural effusion. Thoracentesis shows the presence of exudative sero ... sanguineous pleural fluid and positive cytology. For what condition is this finding most typical? A. Metastatic infiltrating ductal carcinoma B. Cor pulmonale C. Systemic lupus erythematosus D. Staphylococcus aureus septicemia E. Pulmonary infarction 2. A 24-year-old man came to the ER presenting with sudden shortness of breath while riding his bicycle. He has never had this before. He is athletic, works as a teacher, walks 10 miles every day, and gave no history of fever or palpitation. He is a smoker, smoking 10 cigarettes per day for the last 5 years. On examination, his heart rate was 120/min, regular rhythm, and no murmurs; breath sounds are heard all over the chest except at the upper left lung where it is hardly heard, and there is a hyperresonant note on percussion. What is the most likely diagnosis? A. Pulmonary embolism B. Panic attack C. COPD exacerbation D. Spontaneous pneumothorax E. Bronchial asthma 3. A 60-year-old Caucasian man with chronic obstructive pulmonary disease (COPD) and severe pneumonia has been intubated and mechanically ventilated for 5 days. Suddenly, he became agitated and diaphoretic; he has a blood pressure of 75/55 mm Hg, a heart rate of 120/min, and a respiratory rate of 42/min. Body temperature is 38.5 C. Physical examination revealed distended neck veins, decreased breath sounds on the left, and the trachea is deviated to the right. What should your next maneuver be? A. Chest X-ray B. Pericardiocentesis C. 14-gauge catheter-over-needle device in the left chest D. IV fluids E. Pull back the endotracheal tube and recheck breath sounds? 4. A 44-year-old man came to the ER after a motor vehicle accident. He has multiple and extensive internal and bone injuries. Exploratory laparotomy was done 2 hours later and splenectomy was performed. The patient also undergoes bone reduction and internal fixation of both femurs. The patient’s condition is stabilized after a week. The patient then suddenly complains of shortness of breath and dies. What is the most likely diagnosis? A. Myocardial infarction B. Pneumothorax C. Fat embolism D. Pneumonia E. Heart failure 5. A 26-year-old man is brought to the ER following a motor car accident 5 minutes ago. He is polytraumatized and is bleeding from his mouth. Both his legs seem to be disfigured and mostly broken. He has multiple cut wounds all over his body, and his breathing rate is 9/minute. What is the most critical first step in management of this patient upon or even before arrival to the ER? A. Blood transfusion B. Secure airway C. CPR D. Immediate surgery E. X-ray survey 6. An 18-year-old woman presents to the Emergency Department with shortness of breath, cough, malaise, and dyspnea on exertion. Her symptoms began abruptly approximately 2 hours ago. She has no history of illness or disease and has been very healthy up until this point. Physical exam revealed a thin, ill-appearing young woman in obvious respiratory distress. Her oxygen saturation was 82%, and she had decreased breath sounds bilaterally. Vital signs are as follows: blood pressure 128/88 mm Hg; pulse 124/min; respiratory rate 26 per minute; temp 97.8 degrees Fahrenheit. What concerning the patient’s probable diagnosis is true? A. Women are affected more often than men. B. Peak incidence is between 40 and 50 years. C. They are usually the result of trauma. D. Smoking can increase the chance of developing this condition. E. The trapped air is fixed and will not shift to the highest point when the patient is moved.? [Show More]

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