TOPNOTCH MEDICAL BOARD PREP SURGERY PRACTICE TEST HANDOUT BY DR. BRADLEY ONG NOVEMBER 2022

• Total body weight and total body water is relatively constant for a person and is primarily a reflection of body fat. Meaning, lean tissues (e.g. muscle and solid organs) have higher water content than fat and bone. Adult males have 60% TBW, whereas adult females have 50% TBW. Females have higher amount of fat relative to men. Topnotch Surgery Main Handout Page 1 2. C. HYPERCALCEMIA • Hypokalemia is caused by inadequate K+ intake, excessive renal K+ excretion, K+ loss in pathologic GI secretions, or intracellular shifts from metabolic alkalosis or insulin therapy. Clinical manifestations are primarily related to failure of normal contractility of GI smooth muscle (ileus, constipation), skeletal muscle (decreased reflexes, weakness, paralysis), and cardiac muscle (arrest). Topnotch Surgery Main Handout Page 3 3. D. INTRAVENOUS LACTATED RINGER • This patient has likely developed pneumonia and has signs of septic shock, including fever, tachycardia, hypotension, and poor urine output. After securing an airway, if needed, the goals in managing septic shock include restoring adequate tissue perfusion and identifying the underlying infection and treating it appropriately. Crystalloid solution (eg, normal saline, lactated Ringer) is the fluid of choice to restore volume quickly as it is as effective as albumin in t