• Basic Surgical Techniques pl05- pl07.

1. Sutures and Suturing.

***) Twenty milliliters of 2% Lidocaine contains:

1. 20 mgs

2. 40 mgs

3. 200 mgs

4. 400 mgs

5. 800 mgs

Answer: D* 400mgs

• Wounds pl07- pl13.

1. Wounds.

???) Wound healing is enhanced by the administration of all the following, except:

1. High protein diet

2. Vitamin C

3. Cortisol

4. Oxygen

5. Zinc

Answer: C* Cortisol

???) The major cause of impaired wound healing is:

1. Anemia

2. Diabetes mellitus

3. Local tissue infection

4. Malnutrition

5. Steroid therapy

Answer: C* Local tissue infection

???) Wound healing is affected by all the following except:

Black skin

Oxygen

Blood supply

Nutrition

Vitamin c

Answer: 1* Black skin

???) The most common source of bacteria in wound infection after groin hernia repair is:

The patient's skin

The patient's nasopharynx

Operating room air

Surgical instruments

Operating room staff

Answer: 1* The patient's skin

???) Management of contaminated contused wound is best by:

Primary suturing

Dressing and antibiotics

Wound debridement, dressing daily, antibiotics and suturing later on

Primary excision and grafting

Tetanus toxoid and primary suturing

Answer: 3* Wound debridement, dressing daily, antibiotics and suturing later on

???) Regarding crushed (war) wounds all of the following should be done, except:

Good debridement

Washing the inside of the wound with normal saline

Giving good doses of broad spectrum antibiotics

Giving tetanus immunoglobulin

Primary wound closure

Answer: 5* Primary wound closure

???) The most dangerous type of wounds is the:

Incised

Lacerated

Penetrating

Crushed

Abrasion

Answer: 4* Crushed

???) The immediate treatment of a sucking wound in the chest should be:

Thoracoscopy

Tracheostomy

Under water seal drainage

Immediate closure of the wound by any maneuver irrespective of bacterial contamination

Give good dose of morphine and antibiotics

Answer: 4* Immediate closure of the wound by any maneuver irrespective of bacterial contamination

???) Factors which contribute to wound dehiscence include all except:

Vit C deficiency

Local radiation

Hypoproteinemia

Anemia

Malignancy

Answer: 4* Anemia

???) In wound dehiscence all are considered to be causes, except:

Anemia

Hypoalbuminemia

Ascites

Chronic pulmonary disease

Chronic cough

Answer: 5* Chronic cough

• Ulcers pl14- pl16.

1. Lower Limb Ulcers.

???) A chronic leg ulcer just above the medial malleolus and surrounded by brownish skin pigmentation is usually:

Ischemic ulcer

Venous ulcer

Tuberculous ulcer

Chronic non-specific ulcer

Malignant ulcer

Answer: 2* Venous ulcer

???) All of the following are causes of leg ulceration, except:

Venous insufficiency

Arterial insufficiency

Sickle cell disease

Erythema nodosum

Post-cellulitis

Answer: 4* Erythema nodosum

???) All of the following are causes of leg ulceration, except:

Beta-thalassemia trait

Ulcerative colitis

Syphilis

Polyarteritis nodosa

Diabetes mellitus

Answer: 2* Ulcerative colitis

???) Regarding diabetic foot all of the following are true, except:

Correction of an associated anemia or pulmonary disease improves the condition of the foot

Diabetes has to be controlled by insulin therapy

Amputation is required once bone is infected

Sympathectomy has a major role in the management

Antibiotics against aerobes and anaerobes are to be given

Answer: 3* Amputation is required once bone is infected

???) Patients with diabetic foot, all are causes for the condition, except:

Unnoticed trauma

High blood sugar

Altered immunity of the patient

Infection

Ischemia of the lower limb

Answer: 3* Altered immunity of the patient

???) As regard diabetic foot all of the following are correct, except:

Infection, neuropathy and angiopathy share in its development

Pockets of pus must be opened widely

Sympathectomy is of great benefit

Angiography may be needed

In infected type diabetes must be controlled by insulin

Answer: 3* Sympathectomy is of great benefit

???) In the management of infected diabetic foot all of the following are correct, except:

Diabetes is controlled by one of the hypoglycemic drugs

The limb has to be elevated on one or two pillows

Antibiotics against aerobes and anaerobes should be given

Any associated blood, chest or heart disease causing tissue hypoxia should be managed

If amputation is required conservative one is usually adopted

Answer: 1* Diabetes is controlled by one of the hypoglycemic drugs

???) The most important predisposing cause to diabetic foot is:

Hyperglycemia

Ischemia

Neuropathy

Infection

Unnoticed injury

Answer: 1* Hyperglycemia

???) The least important factor in developing diabetic foot ulcers is:

Atherosclerosis

Peripheral neuropathy

Microangiopathy

Obesity

Decreased immunity

Answer: 4* Obesity

???) Regarding diabetic foot ulcers all are true except:

It is the most common cause of amputation in adults

Diabetic foot with cellulites should be treated with IV antibiotics

Patients with severe infections and high serum glucose should be given oral hypoglycemic drugs

Prevention of diabetic foot ulcers is better than treatment

30% of patients with amputation will need another amputation in 5 years

Answer: 3* Patients with severe infections and high serum glucose should be given oral hypoglycemic drugs