CSFA EXAM

Which of the following statements is true concerning a hypophysectomy? 1. Replacement of adrenal steroid therapy is usually required 2. Diabetes may result 3. Growth will be increased 4. Cessation of menses and infertility may result

1 , 2, and 4 only

Surgeon's knot

Consists of two half-hitches in the same direction followed by the third half-hitch made in the opposite direction of the first two

Coumadin (warfarin)

Inhibits utilization of Vitamin K

A test in which iodine is applied to the cervix: normal cells will show the color; abnormal cells will not

Schiller's test

Lateral Flank muscles

Transverse abdominis, internal oblique, external oblique

Blood is supplied to the liver by the portal system and the hepatic artery. The junction of the superior mesenteric and splenic veins for the portal vein

True

The external carotid first branch is the superior thyroid artery

True

A process which the surgeon takes down the lateral perutoneal attachments of the duodenum to observe the pancreas, duodenum, and retroperitoneal structures a. kocher b. klatskin c. lichtenstein d. littre's

a. kocher

The knot preferred in surgery is a square knot....

also called a reef knot

Spinal anesthesia: the local anesthetic is injected into the

subarachnoid space

A hickman catheter is a very specialized central line placed directly into the right subclavian vein

true

1 or 2 percent lidocaine has a duration of

1.5 - 2 hours

PT (prothrombin time)

11-12.5 seconds

Sodium (Na) Serum Electrolyte Levels

135-145 mEq/L

The normal sodium range for an adult

136-145 mEq/L

The normal potassium range for an adult

3.5 - 5.0 mEq/L

Tetrology of Fallot includes which of the following defects? a. ventricular septal defect b. aortic stenosis c. pulmonary valve stenosis d. right ventricular hypertrophy

A , C, D Ventricular septal defect (VSD), pulmonary valve stenosis, and right ventricular hypertrophy

An active collagen available in powder form. It is applied directly to a bleeding surface, followed by placing firm pressure using a dry sponge

Avitene

The normal hemoglobin range for a male and female adult

Male: 14- 18 g/dL Female: 12- 16 g/dL

The normal hemoglobin range in an adult male and female

Male: 14-18 g/dL Female: 12-16 g/dL

Ethilon (nylon)

Non absorbable, monofilament, synthetic, black/undyed 20%-25% of tensile strength remaining at 1 year loses tensile strength over time

Blood supply to the perineal structures comes from the pudenal artery, a branch of the internal iliac artery

True

Local anesthetics are dived into amide and ester classes. Amide includes the commonly used lidocaine and bupivicaine (marcaine)

True

Red blood cells have and iron protein called hemoglobin that carries oxygen and gives blood its color. These cells are produced by bone marrow and circulate for about 120 days and are eventually removed by the spleen

True

The fourth ventricle connects with the subarachnoid space by two lateral foramina of Luschka (into there cisterns lateralis) and foramina of Magendie (into the ciserna magna) - CSF flows around the cerebrum, cerebellum, and down the spiral subarachnoid space

True

The right bronchus is straighter and wider than the left, and foreign bodies tend to lodge in the right bronchus.

True

Infections due to streptococci or clostridia may become severe with in ______ hours a. 24 b. 72 c. 12 d. 48

a. 24

Most wound infections do not become evident clinically for _____ days or longer after operation a. 5 b. 7 c. 3 d. 10

a. 5

Fracture of distal radius with dorsal carpal displacement a. Colles' fracture b. Smith's fracture c. Monteggia's fracture d. Galeazzi fracture

a. Colles' fracture

___________ is a condition characterized by swelling in the tendon sheath surrounding the tendons of the abductor pollicis longs (APL) and extensor pollicis breves (EPB) a. De Quervain syndrome b. Depuytren's contracture c. carpal tunnel syndrome d. trigger finger

a. De Quervain's syndrome

The lesser tuberosity is the attachment for the a. Subscapularis tendon b. supraspinatus tendon c. infraspinatus tendon d.teres minor tendon

a. Subscapularis tendon

The duct of ___________ is the main pancreatic duct a. Wirsung b. Santorini c. Ucinate

a. Wirsung

Which of the following is the BEST indication for endovascular abdominal aortic aneurysm repair? (EVAAAR) a. a proximal infrarenal neck remnant of 1-2 cm b. appropriate jugular vein access c. an aneurysm with aortic and bilateral common iliac vessel movement d. a patient who is unable to tolerate general anesthesia

a. a proximal infrarenal neck remnant of 1-2 cm

During coagulation, thrombin unites with fibrinogen, a blood protein, to form a. fibrin b. ADP c. thromboplastin d. prothrombin

a. fibrin Thrombin + fibrinogen = fibrin

Both the gallbladder neck and cystic duct contain mucosal folds called the valves of a. Heister b. Luschka c. Oddi d. Vater

a. heister

This solution is a combination intravenous fluid containing fixed amounts of dextrose, sodium, potassium, calcium, chloride, and lactate. a. lactated Ringers b. dextrose c. crystalloid d. normal saline

a. lactated Ringer's

When opening the aneurysmal sac during resection of an abdominal aortic aneurysm, which of the following arteries is ligated? a. lumbar b. supine mesenteric c. renal d. common hepatic

a. lumbar

The elbow articulation consists of three bones: the humerus, radius, and ulna. Elbow x-rays consist of two veins (AP & lateral). On the AP: laterally the humeral capitulum articulates with the a. radial head b. ulna c. femoral

a. radial head

Which of the following arteries may be detached and reanastomosed to the graft during an abdominal aortic aneurysm resection? a. renal b. inferior mesenteric c. celiac d. left gastric

a. renal

The extraperiotneal space located between the bladder and pubic symphysis a. retizius b. wilms c. nephron d. hypospadias

a. retzius

During First intention healing, the wound heals ______ across the incision line a. side to side b. end to end c. bottom to top d. top to bottom

a. side to side

This particular opportunistic pathogen is responsible for about 90% of all cases of pharyngitis a. streptococcus pyogenes b. pseudomonas c. S. epidermis d. staphylococcus arureus

a. streptococcus pyogenes

Cardiogenic shock can arise from an arrhythmia, ischemia-induced myocardial failure, valvular or septal defects, systemic or pulmonary hypertension, myocarditis, or cardiomyopathies. The diagnosis is usually made on the basis of a known history of cardiovascular disease in junction with an abnormal ECG in a patient in shock with distended neck veins. a. true b. false

a. true

The primary portal for shoulder arthroscopy is the posterior portal located between the infraspinatus and trees minor muscle (soft spot). It provides a viewing plane for the majority of the joint and aids in the placement of additional portals. Nerves at risk during placement of the posterior portal are the axillary and Subscapularis. a. true b. false

a. true

The signs of hypovolemic shock are postural hypotension, cutaneous vasoconstriction, sweat gland stimulation collapse of the neck veins, concentration of urine, oliguria, and decreasing hematocrit with administration of fluids. a. true b. false

a. true

The T wave is indicated of a. ventricular repolarization b. ventricular depolarization c. atrial depolarization

a. ventricular repolarization

Whole blood consists primarily of plasma (the liquid portion of blood), which is 90% water. Plasma has several functions, including helping maintain blood volume and pressure, supplying proteins for immunity and clotting, and providing a medium for the exchange of minerals required for cell function. Suspended within the plasma are:

alubumin Clotting proteins fibrinogen globulins platelets RBC's WBC's

Cryoprecipitate

an insoluble concentrate of certain coagulation factors obtained from fresh frozen plasma administered to patients with bleeding due to fibrinogen deficiency

Whereas a typical wound infection is first seen with low-grade fever, wound erythema, and tenderness 72 hours or later after surgery, the multi,icrobial soft-tissue infection (necrotizing fasciitis) manifests itself within _____ postoperative hours with a high temperature (103°F), confusion, agitation, and a watery foul-smelling discharge from a discolored, often necrotic wound. Blebs and crepitus could be present if anaerobic bacteria are involved. Typically, a Gram stain of the fluid exhibits a Gram-positive or polymicrobial involvment. a. 72 hours b. 48 hours c. 94 hours d. 24 hours

b. 48 hours

This syndrome is caused by the overproduction of cortisol and hydrocortisone a. Eisenmenger's b. Cushing's c. Marfan

b. Cushing

A technique used in GI surgeries. It can ve applied as either an interrupted or continuous suture that repairs the collagenous submucosal layer without disturbing the lumen a. Connell b. Lembert

b. Lembert

Technique used in pericardiocentesis procedures where a catheter is placed directly into the pericardial cavity and effusion is drained; more than 50mL of fluid withdrawn indicates perdicardial effusion a. Sibson's b. Seldinger's c. Pericardiocentesis d. Batista

b. Seldinger's

Clostridium are gram-positive, spore-forming rods that are a. aerobic b. anaerobic

b. anaerobic

_________ shoulder dislocation is often caused by a fall on an outstretched hand, causing abduction, extension and external rotation of the shoulder, or a significant posterior force on the shoulder. It accounts for 95-97% of all shoulder dislocations. a. posterior b. anterior c. inferior d. superior

b. anterior

Which of the following lasers is used in retinal surgery? a. excimer b. argon c. Nd: YAG d. carbon dioxide

b. argon

Surgical patient fluid and electrolyte abnormalities; the type of fluid replaces will depend in most cases on the serum electrolyte profile. If electrolytes are relatively normal in the face of obvious volume depletion, losses can be assumed to be isosmotic with plasma and should be replaced with a a. isotonic saline b.balanced salt solution, such as Ringer's lactate c. 5% dextrose in water d. hypertonic saline

b. balanced salt solution, such as Ringer's lactate

In patients who develop fever, abdominal pain, and profuse diarrhea, the most frequently seen antibiotic-associated enterocolitis is due to which of the following organisms? a. pseudomonas aeruginosa b. clostridium difficile c. enterobacter cloacae d. enterococcus faecalis

b. clostridium difficile

An adult male is injured in an automobile accident at 2am, an exploratory laparotomy for possible perforated bowel is initiated at 5 am, which of the following is the BEST wound classification in this scenario a. dirty or infected b. contaminated c. clean d. clean-contaminated

b. contaminated

A wound that is known to be infected at the time of surgery and is left open to be closed at a later date is categorized as a. granulation b. delayed primary closure c. second intention d. first intention

b. delayed primary closure

The lateral ventricles are located within the cerebral hemispheres. The lateral ventricles connect with the third ventricle through this structure a. Fissure of Sylvius b.Foramen of Monro c. Aqueduct of Sylvius d. Foramina of megendie

b. foramen of monro

The distal portion of the Javid shunt used during carotid endarterectomies is inserted into which of the following arteries? a. external carotid b. internal carotid c. common carotid d. middle cerebral

b. internal carotid proximal is inserted into common carotid artery

The _____ is the largest, thickest, and most powerful chamber of the heart. a. right ventricle b. left ventricle. c. right atrium d. left atrium

b. left ventricle

Which of the following structures is innervated by a branch/branches of the cervical plexus? a. trapezius b. omohyoid muscle c. coracobrachialis muscle d. pectoralis minor muscle

b. omohyoid muscle

The drainage system associated with increased infection rate in clean wounds a. pleuravac b. penrose c. Jackson-pratt

b. penrose

__________ are used in cases where bleeding is due to thrombocytopenia or platelet-function abnormalities. For adults pooled platelets or single-donor aphaeresis platelets are usually ordered. a. fibrinogen b. platelets c. albumin

b. platelets

The infection of lidocaine into the common carotid body prior to performing there arrteriotomy is done to prevent. a. sinus tachycardia b. sinus bradycardia

b. prevent sinus bradycardia

An excessive formation of mass of granulation tissue a. purulent b. proud flesh c. cicatrix d. keloid

b. proud flesh

The following symptoms would represent a _____________ burn classification: Can be red or white in appearance, but will appear dry, involves destruction of the entire epidermis and most of the dermis, sensation may be present, but diminished, blanching is sluggish or absent. a. first degree b. second degree c. third degree d. fourth degree

b. second degree

During a coronary artery bypass graft (CABG), the internal mammary artery (IMA) is also commonly used as a graft due to its durability. The internal mammary artery, also referred to as the internal thoracic artery, is located in the inside of the chest cavity running along both sides of the sternum and arises from the ________________ artery. a. left common carotid b. subclavian c.brachiocephalic d. left pulmonary

b. subclavian

The cecum, ascending colon, hepatic flexure, and proximal portion of the transverse colon blood supply is from the __________ artery a. inferior mesenteric b. superior mesenteric c. left colic d. iliac

b. superior mesentery artery

prostate-specific antigen (PSA)

blood test that measures the level of prostate-specific antigen in the blood 0.0-2.5 ng/mL

Branches of the aortic arch

brachiocephalic trunk, left common carotid artery, left subclavian artery

If the tension on the wound is extreme (as in the case of tendon or abdominal fascia), the wounds must be protected from stress for about 6 weeks, at which time wound strength is ________ of normal a. 3% b. 10% c. 35%-50% d. 10%-35%

c. 35%-50%

_________________ involves transferring the coracoid process, along with the short head of the biceps and coracobrachialis, through the Subscapularis and attaching it to the scapular neck with a screw. This procedure is for severe recurrent dislocations. a. Bankart b. Magnuson-Stack c. Bristow d. Putti-Platt

c. Bristow

during a carotid endarterectomy which two cranial nerves course through the operative field and must be preserved? a. X and XII b. IX and VII c. VII and X d. IV and VII

c. VII and X

The _____________ and the ___________ arteries interconnect at the Circle of Willis located at the base of the brain a. posterior cerebral arteries, anterior communicating artery b. external and internal carotid artery c. vertebral artery and internal carotid d. basilar and vertebral

c. Vertebral and internal carotid

A weak area in the muscular structure of the esophagus is Killian's triangle, which is between the oblique muscle fibers of the inferior constrictor muscles and the transverse fibers of the crocopharyngeus muscles. This area is the most common site for a. esophageal hiatal hernia b. Heller procedure c. Zenkers diverticulum d. nissen fundoplication

c. Zenker's diverticulum

The greater saphenous vein may be located distally at which of the following locations? a. anterior to the lateral malleolus b. posterior to the lateral malleolus c. anterior to the medial malleolus d. posterior to the medial malleolus

c. anterior to the medial malleolus

P waves display a. ventricular depolarization b. ventricular repolarization c. atrial depolarization

c. atrial depolarization

The uterus is connected to the lateral walls of the true pelvis by a double layer of peritoneum referred to as the a. uterosacral b. cardinal c. broad d. round

c. broad ligament

In an ankle injury, the widening of the medial portion of the mortise joint due to a rupture of at least a part of the ____________ ligament a. long plantar b. medial talocalcaneal c. deltoid d. navicular

c. deltoid

A depression left by the foramen oval, which is an embryonic interartrial opening that closes after birth a. crista terminalis b. sulcus terminalis c. fossa ovalis d. coronary sinus

c. fossa ovalis

Which of the following is an example of a high-level disinfecting agent? a. iodophor solution b. isopropyl alcohol c. glutaraldehyde d. quaternary ammonium

c. glutaraldehyde

Which of the following is commonly used for inhalation induction a. entlurane b. desflurane c. halothane d. isoflurane

c. halothane

A hernia that occurs lateral to the inferior epigastric vessels; it is congenital or acquired and goes through the deep ring and often into the scrotum. a. incarcerated b. epigastric c. indirect hernia d. direct hernia

c. indirect hernia

The left adrenal vein drains into the left renal vein. The right adrenal vein drains directly into the __________ a. right renal vein b. left renal vein c. inferior vena cava d. superior vena cava

c. inferior vena cava

A hypertrophic abnormal raised, thicken scar that extends beyond the normal borders/margins of the normal scar due to excessive dense collagen formation. a. hypertrophic scar b. cicatrix c. keloid d. eschar

c. keloid

Which of the following muscles may be retracted during a thyroidectomy? a. deltoid b. gastrocnemius c. sternocleidomastoid d. temporalis

c. sternocleidomastoid

________ begins with the physical stimulus to an electrical signal by free nerves endings in the tissues "damaged tissue releases chemical substances locally that stimulate these nerves endings" a. conduction b. nociception c. transduction d. synaptic transmission

c. transduction

Carotid Sheath

common carotid artery (medially) , internal jugular vein (laterally), vagus nerve (between the artery and vein posteriorly)

Square Knot

composed of two half-hitches, made in the opposite direction of each other

Hypercalcemia is defined as ionized calcium concentrate that exceeds a. 5.5 mEq/L b. 3.5 mEq/L c. 140 mEq/L d. 150 mEq/L

d. 150 mEq/L

Which of the following lasers are used in GYN surgery? a. ruby and CO2 b. Nd: YAG and argon c. argon and ruby d. CO2 and Nd: YAG

d. CO2 and Nd:YAG

The _______ is the most commonly fractured of all the carpals. a. Lunate b. Trapezium c. Hamate d. Scaphoid

d. Scaphoid

Term used to determine how much blood the heart is pumping per beat a. afterload b. preload c. stoke volume d. ejection fraction

d. ejection fraction

Cryoprecipitate is a product derived from plasma that has been frozen and the thawed. It is rich in clotting factors such as factor VIII and fibrinogen. Cryoprecipitate is administered to patients with bleeding due to _____________ deficiencies a. plasma b. albumin c. platelet d. fibrinogen

d. fibrinogen

This hemostatic agent is made from the raw material collagen (processed bovine tendon) and promotes platelet aggregation. This agent and the instruments and gloves used to apply it must be dry because it adheres extremely well to anything moist. a. avitene b. surgical c. gelfoam d. helistat

d. helistat

All of the following are opioids except a. demerol b.fentanyl c. alfenta d. ketamine

d. ketamine

Celiac artery comes off the front of the aorta and further divides into the a. inferior mesenteric artery b. superior mesenteric artery c. left gastric, hepatic d. left gastric, hepatic, and splenic arteries

d. left gastric, hepatic, and splenic arteries

The transmission of the pain stimulus from the periphery to the brain a. conduction b. transduction c. nociception s. synaptic transmission

d. nociception

The short gastric arteries are direct branches of which of the following: a. left gastric artery b. right left gastric artery c. right gastroepiploic artery d. splenic artery

d. splenic artery

The greater curvature of the stomach's arterial blood supply is from all of the following except a. left artery b. short gastric arteries (branches of the splenic artery) c. right gastroepiploic artery (branch of the gastroduodenal artery) d. superior mesenteric artery

d. superior mesenteric artery

_________ is the area within the brain that coordinates emotional response to a particular sensory impulse. a. hypothalamus b. cerebrum c. cerebellum d. thalamus

d. thalamus

The surgeon asks you to first gently supinate, then gently pronate the operative wrist of a 14 year-old patient in supine position. The operative extremity is positioned at 80 degrees to the torso. Which of the following most accurately describes the movement of the operative thumb? a. thumb lateral, then back to medial b. thumb medial, then back to lateral c. thumb superior, then back inferior d. thumb inferior, then back superior

d. thumb inferior, the back superior

A congenital complex malformation in which only one artery arises from the heart to form the aorta and pulmonary artery a. Ebstein's anomaly b. tetralogy of Fallot c. patent ductus arteriosus d. truncus arteriosus

d. trunks arteriosus

The recurrent laryngeal nerve is a branch of the a. phrenic b. facial c. brachial d. vagus

d. vagus

Located with the left lobe are the caudate lobe and majority of the quadrate lobe. The left lobe is anatomically divided from the caudate and quadrate by the fissures of the round ligament and ligamentum venosum. The round ligament is the remnant of the umbilical vein. The ligament venosum is the remnant of the

fetal ductus venosum

branches of superior mesenteric artery

inferior pancreaticoduodenal, middle colic, R colic, ileocolic

Foot Drop results from?

insufficiency of the extensor muscles in the foot and may be caused by lumbar disc herniation or compression of the perineal nerve as it courses superficial to the fibular head

parathyroid hormone

is an antagonist to calcitonin, They both work together to maintain calcium stasis

The normal RBC range for a male and female adult

male: 4.7 - 6.1 female: 4.2 - 5.4

Polyglycolic acid (Dexon)

mutifilament absorbable uses: tissue that requires long term tensile strength but absorbable suture desired for the stomach and vascular procedures. loses around 45% of tensile strength by 2 weeks; majority absorbed by the body by one month

The internal carotid artery divides into the:

ophthalmic artery, anterior cerebral artery, and middle cerebral artery

Hesselbach's triangle borders

rectus abdominus, inguinal ligament, inferior epigastric vessels direct hernia through triangle

hyperalkemia

serum potasium > 5.0 mEq/ Skeletal muscles weak or paralyzed ventricular fibrillation or cardiac standstill cardiac depolarization is impaired repolarization occurs more quickly abdominal cramping or diarrhea

Keloid is a raised dense accumulation of fibrous tissue from traumatic wounds or surgical scars

true

Squamous cell carcinoma originates middle of the epidermis and usually develops on sun-exposed skin

true

The brain is supplied by four major arteries. The internal carotid and vertebral arteries

true

The eyelid contains sebaceous (meibomian) glands which produce an oily secretion that lubricates the eyelid and the eye, These glands can become blocked and swollen creating a cyst called a chalazion

true

The hypoglossal nerve runs lateral to the carotid arteries

true

The hypothalamus produces two hormones - oxytocin and vasopressin- that are stored and released by the posterior pituitary gland

true

The pituitary gland is actually two distinct structures packaged together into one anatomical region. The anterior half of the pituitary gland, the adenohypophysis, is made of glandular epithelium and produces seven hormones: Follicle stimulating hormone (FSH) Luteinizing hormone(LH) Melanocyte-stimulated hormone (MSH) Adrenocorticotrophic hormone (ACTH) Thyroid stimulating hormone (TSH) Prolactin (PRL) Human growth hormone (hGH)

true

The right lymphatic duct empties into the left subclavian vein, and the thoracic duct empties into the inferior vena cava

true

The structures of the spermatic cord include the vas deferent, sympathetic nerves, testicular artery, testicular veins, testicular lymph vessels, cremaster artery, the remains of the processus vaginalis, and the genital branch of the femoral nerve

true

The vagus nerves sends sympathetic fibers to the heart and stomach

true

the ophthalmic maxillary and mandibular nerve arises from the trigeminal ganglion

true

The left ovarian vein drains into the left renal vein and the right ovarian vein drains into the inferior vena cava

true just as the right adrenal glad vein drains into the IVC

the eye is the only organ in the body in which both voluntary and involuntary muscles are found

true dat

Epidural hemorrhage

usually caused by injury to the middle meningeal artery

Structures located in the broad ligament

uterine tube, ovarian artery, round ligament, uterine artery, ovary, ovarian ligament

Hemoglobin (Hgb)

• Females 12-16 g/dL • Males 14-18 g/dL