SURGICAL FIRST ASSIST COMPREHENSIVE EXAM UPDATED
QUESTIONS AND ANSWERS GRADED A+
✔✔The cell component that is the outer surface of the cell and regulates the material
going in and out of the cell is the
A) Smooth Endoplasmic
B) Rough Endoplasmic
C) Mitochondria
D) Plasma Membrane - ✔✔D) Plasma Membrane
✔✔Three terms—hypotonic, isotonic, and hypertonic—are used to compare the
osmolarity of a cell to the osmolarity of the extracellular fluid around it.
Note: When we use these terms, we are considering only solutes that cannot cross the
membrane.
· If the extracellular fluid has lower osmolarity than the fluid inside the cell, it's said to be
hypotonic—hypo means less than—to the cell, and the net flow of water will be into the
cell.
· In the reverse case, if the extracellular fluid has a higher osmolarity than the cell's
cytoplasm, it's said to be hypertonic—hyper means greater than—to the cell, and water
will move out of the cell to the region of higher solute concentration.
· In an isotonic solution—iso means the same—the extracellular fluid has the same
osmolarity as the cell, and there will be no net movement of water into or out of the cell.
Hypotonic, hypertonic, and isotonic are relative terms. That is, they des - ✔✔A) True
✔✔The greater curvature of the stomach's arterial blood supply is the right
gastroepiploic artery and short gastric arteries (branches of the splenic artery), and the
right gastroepiploic artery (branch of the gastroduodenal artery). The lesser curvature of
the stomach's arterial supply comes from the right splenic artery (celiac artery) and the
right gastric artery (branch of the hepatic or gastroduodenal). The gastric veins
correspond to the arteries in both direction and location. The left and right gastric veins
into the portal vein. The short gastric and left gastro-omental drain into the splenic, and
the right gastro-omental drains into the superior mesenteric vein (SMV). The prepyloric
vein is often used as landmark, as it passes over the pylorus and drains into the right
gastric. The gastric lymph vessels follow the arteries along the greater and lesser
curvatures.
A) True
B) False - ✔✔B) False
Response Feedback:
The greater curvature of the stomach's arterial blood supply is from the left
gastroepiploic artery and short gastric arteries (branches of the splenic artery), and the
right gastroepiploic artery (branch of the gastroduodenal artery).The lesser curvature of
the stomach's arterial supply comes from the left gastric artery (celiac trunk) and the
right gastric artery (branch of the hepatic or gastroduodenal). The gastric veins
,correspond to the arteries in both direction and location. The left and right gastric veins
drain into the portal vein. The short gastric and left gastro-omental drain into the splenic,
and the right gastro-omental drains into the superior mesenteric vein (SMV). The
prepyloric vein is often used as a landmark, as it passes over the pylorus and drains
into the right gastric. The gastric lymph vessels follow the arteries along the greater and
lesser curvatures.
✔✔The active process by which the sodium moves out of the cell and potassium moves
into the cell is called:
A) Filtration
B) Osmosis
C) Diffusion
D) Active Transport - ✔✔D) Active Transport
✔✔During a Nissen fundoplication, care should be taken when placing medial tractions
on the stomach to prevent avulsion of the
A) Splenic artery
B) Gastric arteries
C) Common duct
D) Pancreatic duct - ✔✔B) Gastric arteries
✔✔The process of cell division that occurs after fertilization is called
A) Blastula ion
B) Embryogenesis
C) Cleavage
D) Implantation - ✔✔C) Cleavage
✔✔Detoxifies drugs and produces membrane acting as a rehab center component of
the cell is the
A) Smooth Endoplasmic Reticulum
B) Cilia
C) Rough Endoplasmic Reticulum
D) Cytoplasm - ✔✔A) Rough Endoplasmic Reticulum
✔✔A double layer of lipid, containing some proteins, that surrounds biological cells and
some of their internal structures
A) Basement membrane
B) Plasma membrane
C) Membranes
D) Membrane - ✔✔D) Membrane
✔✔If dextrose is not needed, often an intravenous solution of sodium and water will be
administered. Sodium is an important electrolyte in both intracellular and extracellular
fluids in the body. The intravenous solution contains sodium and water in proportions
,which parallel those in tissue fluids. The concentration is known as a physiologic salt
solution and normal saline. Normal Saline (NS) actually equals 0.9% solution of sodium
chloride and water. Sometimes an I.V solution of held normal saline is ordered, this is
written as 0.45& rather than 0.5%
Normal saline (NS) 0.9% NaCl
Half Normal Saline 0.45% NaCl
A) True
B) False - ✔✔A) True
✔✔Multiple nucleus is called ______ and _____ is the extension of the plasma
membrane that allows things in and out ____ is the source that moves only in humans.
A) Cilia, Nuclei, Flagellum
B) Nuclei, Cilia, Flagellum
C) Nuclei, Cytosol, Flagellum
D) Nuclei, Cilia, Flagellums - ✔✔B) Nuclei, Cilia, Flagellum
✔✔A selective or partial cell vagotomy is the most common procedure preferred for
peptic ulcer disease. It involves cutting the nerves of Latariet from the lesser curvature
of the stomach. Surgeons prefer to save some of the terminal branches of the nerves of
Latariet called the crows foot that run to the antrum and pylorus. A branch of the
posterior trunk often missed during selective vagotomy is Grassis' nerves (criminal
nerve). If left intact, it predisposes the patient to returning ulcers. Patients who have
gastric operations experience some degree of dumping syndrome. Gastric
adenocarcinoma accounts for 95% of all gastric malignancies. H. Pylori is a gram-
negative organism associated with gastric ulcers.
A) True
B) False - ✔✔A) True
✔✔The suspensory ligament (muscle) of Treitz is a band of tissue extending from the
duodenojejunal angle and ascending section of duodenum to the diaphragm. It is a key
structure in determining orientation of the small bowel
A) True
B) False - ✔✔A) True
✔✔Marks the end of the duodenum and the start of the jejunum
A) Ligament of Treitz
B) Descending Colon
C) Splenic Flexure
D) Ligament of Tarkenton - ✔✔A) Ligament of Treitz
✔✔The small bowel wall consists of four layers: serosa, muscularis propria,
submucosa, and mucosa. The main role of the small intestine is the digestion and
absorption of nutrients, water, electrolytes, and minerals. It is the largest endocrine
organ in the body.
, A) True
B) False - ✔✔A) True
✔✔Which vessel provides blood supply to the appendix?
A) Superior pancreaticoduodenal artery
B) Superior mesenteric artery
C) Appendiceal artery
D) Inferior mesenteric artery - ✔✔C) Appendiceal artery
✔✔Diverticular disease of the small intestine is either true or false diverticula. True
diverticula contain all layers of the intestinal wall and are most often congenital. False
diverticula consist only of the mucosa and submucosa protruding through a defect in the
muscle court and are most often an acquired defect. Meckel's diverticula are the most
common false diverticula.
A) True
B) False - ✔✔B) False
Response Feedback:
Diverticular disease of the small intestine is either a true or false diverticulum. True
diverticula contain all layers of the intestinal wall and are most often congenital. False
diverticula consist only of the mucosa and submucosa protruding through a defect in the
muscle coat and are most often an acquired defect. Meckel's diverticulum is the most
common true diverticula.
✔✔Which of the following is an extra intestinal manifestation of inflammatory bowel
disease?
A) Hepatosteatosis
B) Primary Sclerosing Cholangitis
C) Peri cholangitis
D) All the above - ✔✔B) Primary Sclerosing Cholangitis
Response Feedback:
The liver is a common site of extracolonic disease in inflammatory bowel disease. Fatty
infiltration of the liver is present in 40 to 50% of patients and cirrhosis is found in 2 to
5%. Fatty infiltration may be reversed by medical or surgical treatment of colonic
disease, but cirrhosis is irreversible. Primary sclerosing cholangitis is a progressive
disease characterized by intra and extrahepatic bile duct strictures. Forty to 60% of
patients with primary sclerosing cholangitis have ulcerative colitis. Colectomy will not
reverse this disease, and the only effective therapy is liver transplantation. Peri
cholangitis also is associated with inflammatory bowel disease and may be diagnosed
with a liver biopsy. Bile duct carcinoma is a rare complication of long-standing
inflammatory bowel disease
✔✔Which of the following is the most common indication for surgery in a patient with
Chohn's disease?
A) Intestinal obstruction
B) Intestinal perforation
QUESTIONS AND ANSWERS GRADED A+
✔✔The cell component that is the outer surface of the cell and regulates the material
going in and out of the cell is the
A) Smooth Endoplasmic
B) Rough Endoplasmic
C) Mitochondria
D) Plasma Membrane - ✔✔D) Plasma Membrane
✔✔Three terms—hypotonic, isotonic, and hypertonic—are used to compare the
osmolarity of a cell to the osmolarity of the extracellular fluid around it.
Note: When we use these terms, we are considering only solutes that cannot cross the
membrane.
· If the extracellular fluid has lower osmolarity than the fluid inside the cell, it's said to be
hypotonic—hypo means less than—to the cell, and the net flow of water will be into the
cell.
· In the reverse case, if the extracellular fluid has a higher osmolarity than the cell's
cytoplasm, it's said to be hypertonic—hyper means greater than—to the cell, and water
will move out of the cell to the region of higher solute concentration.
· In an isotonic solution—iso means the same—the extracellular fluid has the same
osmolarity as the cell, and there will be no net movement of water into or out of the cell.
Hypotonic, hypertonic, and isotonic are relative terms. That is, they des - ✔✔A) True
✔✔The greater curvature of the stomach's arterial blood supply is the right
gastroepiploic artery and short gastric arteries (branches of the splenic artery), and the
right gastroepiploic artery (branch of the gastroduodenal artery). The lesser curvature of
the stomach's arterial supply comes from the right splenic artery (celiac artery) and the
right gastric artery (branch of the hepatic or gastroduodenal). The gastric veins
correspond to the arteries in both direction and location. The left and right gastric veins
into the portal vein. The short gastric and left gastro-omental drain into the splenic, and
the right gastro-omental drains into the superior mesenteric vein (SMV). The prepyloric
vein is often used as landmark, as it passes over the pylorus and drains into the right
gastric. The gastric lymph vessels follow the arteries along the greater and lesser
curvatures.
A) True
B) False - ✔✔B) False
Response Feedback:
The greater curvature of the stomach's arterial blood supply is from the left
gastroepiploic artery and short gastric arteries (branches of the splenic artery), and the
right gastroepiploic artery (branch of the gastroduodenal artery).The lesser curvature of
the stomach's arterial supply comes from the left gastric artery (celiac trunk) and the
right gastric artery (branch of the hepatic or gastroduodenal). The gastric veins
,correspond to the arteries in both direction and location. The left and right gastric veins
drain into the portal vein. The short gastric and left gastro-omental drain into the splenic,
and the right gastro-omental drains into the superior mesenteric vein (SMV). The
prepyloric vein is often used as a landmark, as it passes over the pylorus and drains
into the right gastric. The gastric lymph vessels follow the arteries along the greater and
lesser curvatures.
✔✔The active process by which the sodium moves out of the cell and potassium moves
into the cell is called:
A) Filtration
B) Osmosis
C) Diffusion
D) Active Transport - ✔✔D) Active Transport
✔✔During a Nissen fundoplication, care should be taken when placing medial tractions
on the stomach to prevent avulsion of the
A) Splenic artery
B) Gastric arteries
C) Common duct
D) Pancreatic duct - ✔✔B) Gastric arteries
✔✔The process of cell division that occurs after fertilization is called
A) Blastula ion
B) Embryogenesis
C) Cleavage
D) Implantation - ✔✔C) Cleavage
✔✔Detoxifies drugs and produces membrane acting as a rehab center component of
the cell is the
A) Smooth Endoplasmic Reticulum
B) Cilia
C) Rough Endoplasmic Reticulum
D) Cytoplasm - ✔✔A) Rough Endoplasmic Reticulum
✔✔A double layer of lipid, containing some proteins, that surrounds biological cells and
some of their internal structures
A) Basement membrane
B) Plasma membrane
C) Membranes
D) Membrane - ✔✔D) Membrane
✔✔If dextrose is not needed, often an intravenous solution of sodium and water will be
administered. Sodium is an important electrolyte in both intracellular and extracellular
fluids in the body. The intravenous solution contains sodium and water in proportions
,which parallel those in tissue fluids. The concentration is known as a physiologic salt
solution and normal saline. Normal Saline (NS) actually equals 0.9% solution of sodium
chloride and water. Sometimes an I.V solution of held normal saline is ordered, this is
written as 0.45& rather than 0.5%
Normal saline (NS) 0.9% NaCl
Half Normal Saline 0.45% NaCl
A) True
B) False - ✔✔A) True
✔✔Multiple nucleus is called ______ and _____ is the extension of the plasma
membrane that allows things in and out ____ is the source that moves only in humans.
A) Cilia, Nuclei, Flagellum
B) Nuclei, Cilia, Flagellum
C) Nuclei, Cytosol, Flagellum
D) Nuclei, Cilia, Flagellums - ✔✔B) Nuclei, Cilia, Flagellum
✔✔A selective or partial cell vagotomy is the most common procedure preferred for
peptic ulcer disease. It involves cutting the nerves of Latariet from the lesser curvature
of the stomach. Surgeons prefer to save some of the terminal branches of the nerves of
Latariet called the crows foot that run to the antrum and pylorus. A branch of the
posterior trunk often missed during selective vagotomy is Grassis' nerves (criminal
nerve). If left intact, it predisposes the patient to returning ulcers. Patients who have
gastric operations experience some degree of dumping syndrome. Gastric
adenocarcinoma accounts for 95% of all gastric malignancies. H. Pylori is a gram-
negative organism associated with gastric ulcers.
A) True
B) False - ✔✔A) True
✔✔The suspensory ligament (muscle) of Treitz is a band of tissue extending from the
duodenojejunal angle and ascending section of duodenum to the diaphragm. It is a key
structure in determining orientation of the small bowel
A) True
B) False - ✔✔A) True
✔✔Marks the end of the duodenum and the start of the jejunum
A) Ligament of Treitz
B) Descending Colon
C) Splenic Flexure
D) Ligament of Tarkenton - ✔✔A) Ligament of Treitz
✔✔The small bowel wall consists of four layers: serosa, muscularis propria,
submucosa, and mucosa. The main role of the small intestine is the digestion and
absorption of nutrients, water, electrolytes, and minerals. It is the largest endocrine
organ in the body.
, A) True
B) False - ✔✔A) True
✔✔Which vessel provides blood supply to the appendix?
A) Superior pancreaticoduodenal artery
B) Superior mesenteric artery
C) Appendiceal artery
D) Inferior mesenteric artery - ✔✔C) Appendiceal artery
✔✔Diverticular disease of the small intestine is either true or false diverticula. True
diverticula contain all layers of the intestinal wall and are most often congenital. False
diverticula consist only of the mucosa and submucosa protruding through a defect in the
muscle court and are most often an acquired defect. Meckel's diverticula are the most
common false diverticula.
A) True
B) False - ✔✔B) False
Response Feedback:
Diverticular disease of the small intestine is either a true or false diverticulum. True
diverticula contain all layers of the intestinal wall and are most often congenital. False
diverticula consist only of the mucosa and submucosa protruding through a defect in the
muscle coat and are most often an acquired defect. Meckel's diverticulum is the most
common true diverticula.
✔✔Which of the following is an extra intestinal manifestation of inflammatory bowel
disease?
A) Hepatosteatosis
B) Primary Sclerosing Cholangitis
C) Peri cholangitis
D) All the above - ✔✔B) Primary Sclerosing Cholangitis
Response Feedback:
The liver is a common site of extracolonic disease in inflammatory bowel disease. Fatty
infiltration of the liver is present in 40 to 50% of patients and cirrhosis is found in 2 to
5%. Fatty infiltration may be reversed by medical or surgical treatment of colonic
disease, but cirrhosis is irreversible. Primary sclerosing cholangitis is a progressive
disease characterized by intra and extrahepatic bile duct strictures. Forty to 60% of
patients with primary sclerosing cholangitis have ulcerative colitis. Colectomy will not
reverse this disease, and the only effective therapy is liver transplantation. Peri
cholangitis also is associated with inflammatory bowel disease and may be diagnosed
with a liver biopsy. Bile duct carcinoma is a rare complication of long-standing
inflammatory bowel disease
✔✔Which of the following is the most common indication for surgery in a patient with
Chohn's disease?
A) Intestinal obstruction
B) Intestinal perforation
