True / false MCQs

1.Pulmonary atelectatsis

a. Include administration of 40-60 mEq of K+ in the 1st 24 hours
b. Account for insensible losses of up to 1000mls in afebrile patients
c. Include packed red cells if the hct falls below 40%
d. Provide at least 1000 kcal in the first post op day
e. Be increased if the UOP falls below 0.5 ml/kg/hr


3.A 25 year old weighing 70kgs is seen shortly after a RTA. She has abdo pain, but conscious, rational & well oriented. Examination reveals pallor, HR of 100/min, SBP of 120 mmHg. & a RR of 22/min. he has intraperitoneal blood & a ruptured spleen on imaging.


a. His vital organs are adequately perfused
b. He needs supplementary oxygen
c. He could have bled up to 1.5 l of blood
d. An arterial blood gas will show a lowered pCO2
e. Laparotomy can be delayed in view of the normal systolic pressure


4. In the early assessment & resuscitation following major trauma

a. Application of a thigh tourniquet is the initial step in the control of obvious bleeding from a leg wound
b. If the airway is patent ventilation is sufficient
c. Urinary catheterization is recommended even if the bladder is not distended
d. A soft cervical collar gives full protection in the case of cervical spine instability
e. Tension pneumothorax alone is a cause of hypotension


5. In extradural haemorrhage

a. Blood collects outside the dura mater
b. A lucid interval indicates bad prognosis
c. CT scanning of the brain is the mainstay of diagnosis
d. Bradycardia indicates raised ICP
e. Wide bore needle aspiration is effective in the majority


6.Surgical wound infection rates are greater with

a. A longer postoperative hospital stay compared with admission to hospital on the day of surgery
b. Well controlled DM compared with non-diabetic
c. Mesh repair of inguinal herniae compared with suture repair
d. Delayed 1ry closure compared with 1ry closure of contaminated wounds
e. Haemoglobin of 8g/dl compared with >10g/dl


7.The following is an ABG report in a diabetic patient on 3rd day following laparotomy for perforated bowel. This patient is febrile, confused and is breathing room air. pH 7.2 (7.35-7.45), pCO2 32mmHg (35-45), pO2 80mmHg (80-100) HCO3 20mmol/l (23-30), Base excess -4 (+/- 3). This patient,


a. Is acidotic
b. Needs supplementary oxygen
c. Requires ventilation immediately
d. Has an increased rate of breathing
e. Needs IV NaHCO3


8. Cellulitis

a. Is a spreading rather than a localized soft tissue infection
b. Is commonly polymicrobial
c. Is more common in the presence of lipodermatosclerosis
d. When recurrent, results in chronic lymphoedema
e. Is usually treated with broad spectrum antibiotics


9. The following statements are T/F

a. Short Anteroposterior diameter of the eye is a cause of myopia(short sightedness)
b. Astigmatism is corrected with spherical lenses
c. Ultrasound is used in phakoemulsification cataract surgery
d. Bitemporal hemianopia in the visual field is seen in chronic simple (open angle) glaucoma
e. High doses of broad spectrum systemic antibiotics are recommended in bacterial corneal infections


10.Regarding acute tonsillitis

a. Earache is a symptom
b. The commonest bacterial cause is haemolytic Streptococcus
c. Enlargement of the jugulodigastric lymph node is a feature
d. Due to IMN, a reduction in the absolute lymphocytic count is a feature
e. Tonsillectomy is indicated in a severe infection