1.
A man is brought into the ER with multiple gunshot wounds to the upper torso. He is combative and has difficulty breathing. The trauma physician orders him to the OR for an ELAP. What is this?
Correct Answer
C. Exploratory laparotomy
Explanation
Exploratory laparotomy is a method of abdominal exploration, a diagnostic tool that allows physicians to examine the abdominal organs. The procedure may be recommended for a patient who has abdominal pain of unknown origin or who has sustained an injury to the abdomen. Injuries may occur as a result of blunt trauma (e.g., road traffic accident) or penetrating trauma (e.g., stab or gunshot wound). Because of the nature of the abdominal organs, there is a high risk of infection if organs rupture or are perforated. In addition, bleeding into the abdominal cavity is considered a medical emergency. Exploratory laparotomy is used to determine the source of pain or the extent of injury and perform repairs if needed.
2.
B12 therapy is given to patients diagnosed with:
Correct Answer
D. Pernicious anemia
Explanation
Pernicious anemia is a type of vitamin B12 anemia. The body needs vitamin B12 to make red blood cells. You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products.
3.
A change in the shape, color and texture of a nevus may indicate:
Correct Answer
C. Malignant melanoma
Explanation
Although a nevus and a melanoma are often treated as independent entities, there is evidence that a nevus can be a precursor for a melanoma demonstrated by physical changes on the nevus.
4.
Multiple myeloma is associated with elevated levels of:
Correct Answer
D. IgG
Explanation
In theory, multiple myeloma can produce all classes of immunoglobulin, but IgG paraproteins are most common, followed by IgA and IgM. IgD and IgE myeloma are very rare.
5.
Before transfusion, donor blood is mixed with the recipient's blood to test for compatibility, indicated by negative agglutination. This test is called:
Correct Answer
C. A crossmatch
Explanation
Cross-matching (or crossmatching) blood, in transfusion medicine, refers to the testing that is performed prior to a blood transfusion in order to determine if the donor's blood is compatible with the blood of an intended recipient, or to identify matches for organ transplants.
6.
Which laboratory test is used to determine the degree of histocompatibility between transplant recipients and donors?
Correct Answer
C. HLA typing
Explanation
A histocompatibility antigen blood test looks at proteins called human leukocyte antigens (HLAs), which are found on the surface of nearly every cell in the human body. HLAs are found in large amounts on the surface of white blood cells. They help the immune system tell the difference between body tissue and foreign substances.
7.
Which of the following is an intradermal injection test for TB?
Correct Answer
B. PPD
Explanation
The only test available for in vivo diagnosis of tuberculosis is the intradermal injection of tuberculin according to the Mantoux method (also named tuberculosis skin test or PPD skin test). The tuberculin skin test is based on a delayed-type hypersensitivity skin reaction However, this test needs to be performed by trained personnel, presents problem of reproducibility, and its interpretation is not well standardized (measure in millimeters of skin induration 48 to 72 hours after the PPD skin test).
8.
One possible sequela of mumps in males is:
Correct Answer
B. Orchitis
Explanation
Orchitis may be caused by an infection from many different types of bacteria and viruses.
The most common virus that causes orchitis is mumps. It most often occurs in boys after puberty. Orchitis usually develops 4 - 6 days after the mumps begins.
9.
Which of the following is an example of a BRIEF FORM?
Correct Answer
A. Cath
Explanation
Brief forms are shortened forms of legitimate words that can be documented in a reputable dictionary or have come into acceptance through usage (i.e. cath for catheterization.
10.
Which of the following is correctly pluralized?
Correct Answer
A. Serial K’s
Explanation
The correct answer is "Serial K's" because when pluralizing a word that ends in a consonant followed by a vowel and then a consonant, we add an apostrophe followed by an "s". In this case, "K" is the consonant, followed by a vowel "s" and then a consonant "s".
11.
Petechiae are:
Correct Answer
D. Small pinpoint hemorrhages
Explanation
Petechiae (pinpoint hemorrhages) represent bleeding from small vessels and are classically found when a coagulopathy is due to a low platelet count. They can also appear following sudden hypoxia.
12.
Surgical fusion of a joint is termed:
Correct Answer
C. Arthrodesis
Explanation
Bone or joint fusion surgery, called arthrodesis, is performed to relieve arthritis pain in the ankles, wrists, fingers, thumbs, or spine.
In arthrodesis, two bones on each end of a joint are fused, eliminating the joint itself.
13.
How would you transcribe "3 and 4 oh silk suture"?
Correct Answer
C. 3-0 and 4-0 silk suture
Explanation
As per BOS3:
10.3.12 Sutures, Catheters, Needles, and Wires
Sutures: The United States Pharmacopeia (USP) system sizes, among other things, steel sutures and sutures of other materials. The sizes range from 11-0 (smallest) to 7 (largest). Thus, a size 7 suture is different from and larger than a size 7-0 suture. Use 0 or 1-0 for single-aught sutures; use the "digit hyphen zero" style to express sizes 2-0 through 11-0. Express sizes 1 through 7 with whole numbers. Place the # symbol before the size if "number" is dictated.
14.
Marked wasting away of the body resulting from chronic disease is called:
Correct Answer
C. Cachexia
Explanation
Cachexia (/kəˈkɛksiə/; from Greek κακός kakos "bad" and ἕξις hexis "condition")[1] or wasting syndrome is loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite in someone who is not actively trying to lose weight. The formal definition of cachexia is the loss of body mass that cannot be reversed nutritionally: Even if the affected patient eats more calories, lean body mass will be lost, indicating a primary pathology is in place.
15.
A sudden and intense need to void, as commonly seen in the elderly, is called:
Correct Answer
C. Urge incontinence
Explanation
With urge incontinence, you leak urine because the bladder muscles contract at the wrong times. Often these contractions occur no matter how much urine is in the bladder.
Urge incontinence may result from:
Bladder cancer
Bladder inflammation
Bladder outlet obstruction
Bladder stones
Infection
Nervous system diseases (such as multiple sclerosis)
Nervous system injuries (such as spinal cord injury or stroke)
In men, urge incontinence also may be due to:
Bladder changes caused by benign prostatic hypertrophy (BPH)
Bladder outlet obstruction from an enlarged prostate
In most cases of urge incontinence, no cause can be found. Although urge incontinence may occur in anyone at any age, it is more common in women and the elderly.
16.
An accumulation of fluid in the abdominal cavity is termed:
Correct Answer
C. Ascites
Explanation
Ascites is an abnormal accumulation of fluid in the abdomen. Rapidly developing (acute) ascites can occur as a complication of trauma, perforated ulcer, appendicitis, or inflammation of the colon or other tube-shaped organ (diverticulitis). This condition can also develop when intestinal fluids, bile, pancreatic juices, or bacteria invade or inflame the smooth, transparent membrane that lines the inside of the abdomen (peritoneum). However, ascites is more often associated with liver disease and other long-lasting (chronic) conditions.
17.
A chronic inflammation of the ileum is called:
Correct Answer
D. Crohn disease
Explanation
Crohn's disease (also spelled Crohn disease) is a chronic inflammatory disease of the intestines. It primarily causes ulcerations (breaks in the lining) of the small and large intestines, but can affect the digestive system anywhere from the mouth to the anus. It is named after the physician who described the disease in 1932. It also is called granulomatous enteritis or colitis, regional enteritis, ileitis, or terminal ileitis.
18.
Intussusception, volvulus and ileus are all:
Correct Answer
D. Types of obstruction
Explanation
Intestinal obstruction refers to the partial or complete mechanical or nonmechanical blockage of the small or large intestine.
Mechanical obstructions occur because the bowel is physically blocked and its contents cannot get past the obstruction. Mechanical obstructions can occur for several reasons. Sometimes the bowel twists on itself (volvulus) or telescopes into itself (intussusception). Mechanical obstruction can also result from hernias, impacted feces, abnormal tissue growth, the presence of foreign bodies in the intestines (including gallstones), or inflammatory bowel disease (Crohn's disease). Nonmechanical obstruction, called ileus, occurs because the wavelike muscular contractions of the intestine (peristalsis) that ordinarily move food through the digestive tract stop.
19.
One common physical sign of Down syndrome is:
Correct Answer
D. Single transverse palmar crease
Explanation
Single transverse palmar crease of SPTC (“Simian crease” its outdated term): The skin of a normal palm has three large creases. The distal transverse palmar crease runs near the top of palm and begins close to the little finger. The thenar transverse crease is the lowest on the palm and appears to run almost vertically. The proximal transverse palmar crease lies between the other two creases.
In cases of SPTC, the distal and proximal creases are not present. Instead, they combine to form one transverse palmar crease. The thenar transverse crease remains the same.
STPC is a symptom of disorders such as Down syndrome.
20.
Which of the following represents the correct style for transcribing a vertebral disk?
Correct Answer
B. C1-2
Explanation
As per BOS3:
18.2.2 Vertebrae, Spinal Nerves, and Spinal Levels
Sharing a common nomenclature, these entities are derived from spinal anatomic regions:
region vertebrae spinal nerves
Portions of a vertebra may be referred to as follows, i.e., without the term vertebra:
EXAMPLE
C3 spinous process
L4 lamina
transverse process of T10
Use a hyphen to express the space between two vertebrae (the intervertebral space). It is not necessary to repeat
the same letter before the second vertebra, but it may be transcribed if dictated.
EXAMPLE
C1-2 or C1-C2
L5-S1
21.
Don and doff means:
Correct Answer
C. Put on and take off
Explanation
Don and doff are archaic words, contractions to be precise. Don meaning "do on" and doff meaning "do off." Both were popular during the 14th century, but eventually lost popularity. Doff fell into disuse sometime before the 1750's, while don didn't even make it beyond the 1650's.
22.
One outward manifestation of Cushing syndrome is:
Correct Answer
C. Purple striae
Explanation
Purple marks (1/2 inch or more wide), called striae, on the skin of the abdomen, thighs, and breasts are symptoms of Cushing syndrome.
23.
Which of the following describes patients with a grandiose sense of self-importance and fantasies of success and power?
Correct Answer
B. Narcissistic
Explanation
Narcissistic personality disorder is characterized by a grandiose sense of self-importance and fantasies of success and power. Individuals with this disorder have an excessive need for admiration and lack empathy for others. They often believe that they are special and unique, and may exploit others for their own gain. This behavior is different from histrionic personality disorder, which is characterized by attention-seeking and dramatic behavior, and exhibitionist personality disorder, which is not a recognized disorder. Antisocial personality disorder is characterized by a disregard for the rights of others and a lack of remorse for harmful actions.
24.
The pulmonologist might order an AFB if he/she suspects tuberculosis. What is an AFB?
Correct Answer
D. Acid-fast bacillus smear and culture
Explanation
Acid- Fast Bacilli (AFB) smear and culture are two separate tests always performed together for diagnosis of tuberculosis. AFB smear refers to the microscopic examination of a fluorochrome stain of a clinical specimen. The AFB culture is the inoculation of a clinical specimen onto culture media Becton-Dickinson Mycobacteria Growth Indicator Tube (B-D MGIT broth) and Lowenstein-Jensen (L-J) media slant, incubation at 37°C for up to six (6) weeks and detection of growth or no growth during this incubation period.
25.
An abnormal opening of the male urethra on the undersurface of the penis is called:
Correct Answer
D. Hypospadias
Explanation
Hypospadias /haɪpoʊˈspeɪdɪəs/[1][2] is a birth defect of the urethra in the male that involves an abnormally placed urinary meatus (the opening, or male external urethral orifice). Instead of opening at the tip of the glans of the penis, a hypospadic urethra opens anywhere along a line (the urethral groove) running from the tip along the underside (ventral aspect) of the shaft to the junction of the penis and scrotum or perineum. A distal hypospadias may be suspected in an uncircumcised boy from an abnormally formed foreskin and downward tilt of the glans.
26.
A scan which uses a radioactive tracer to examine heart function is a:
Correct Answer
D. MUGA scan
Explanation
A multigated acquisition (MUGA) scan creates video images of the ventricles (lower chambers of the heart that hold blood) to check whether they are pumping blood properly. It shows any abnormalities in the size of the ventricles and in the movement of the blood through the heart. Other names for this test include cardiac blood pooling imaging, nuclear heart scan, nuclear ventriculography, and radionuclide ventriculography.
27.
Which of the following contains a formatting error?
Correct Answer
C. Grade I/IV systolic ejection murmur
Explanation
Per BOS3:
14.1.2 Murmurs
Murmurs are graded from soft to loud and are written in Arabic numerals. Systolic murmurs are graded on a scale of 1 to 6, and diastolic murmurs are graded on a scale of 1 to 4.
28.
A mother brings her child into the ER and the PA dictates, "This is an 18-month-old child with FUO." The abbreviation FUO means:
Correct Answer
D. Fever of unknown origin
Explanation
The correct answer is "Fever of unknown origin." In medical terminology, FUO stands for Fever of Unknown Origin. This term is used to describe a persistent fever that cannot be explained by a specific diagnosis after a thorough medical evaluation. It is commonly used when a patient has a fever for more than three weeks with no clear cause.
29.
A benign pigmented lesion of the skin, commonly called a mole is a/an:
Correct Answer
C. Nevus
Explanation
Moles are common skin lesions. They are correctly called melanocytic naevi (American spelling ‘nevi’), as they are due to a proliferation of the pigment cells, melanocytes. If they are brown or black in colour, they may also be called pigmented naevi.
30.
Bell's palsy is a disease of which facial nerve:
Correct Answer
B. VII
Explanation
Bell's palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve) causing an inability to control facial muscles on the affected side. Several conditions can cause facial paralysis, e.g., brain tumor, stroke, myasthenia gravis, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell's palsy. Named after Scottish anatomist Charles Bell, who first described it, Bell's palsy is the most common acute mononeuropathy (disease involving only one nerve) and is the most common cause of acute facial nerve paralysis (>80%).