PLE 2019 SAMPLEX- SURGERY| 100 QUESTIONS| WITH COMPLETE SOLUTIONS

1. Calculating the appropriate caloric needsof the burn patient can be challenging. Which of the ff is true regarding nutritional needs of burn patients? A.Early enteral feeding is safe when burns are less than 20% TBSA, otherwise enteral feeding should await return of bowel function to avoid feeding a patient with gastric ileus. B.For patients with greater than 40% TBSA, caloric needs are estimated to be 25kcal/kg/day plus 40% kcal/%TBSA/day. C.Oxandrolone, an anabolic steroid, can improve lean body mass but can be associated with hyperglycemia and clinically significant rise in hepatic transaminitis. D.The hypermetabolic response to burn wounds typically raises the basic metabolic rate by 120%. C. Oxandrolone, an anabolic steroid, can improve lean body mass but can be associated with hyperglycemia and clinically significant rise in hepatic transaminitis. 2. Patients with acute hypercalcemia usually have either acute hyperparathyroidism or metastatic breast carcinoma with no metastases. These patients develop severe headache, bone pain, thirst, emesis and polyuria. What is the FIRST step in the management of acute hypercalcemia? A.Induction of mithramycin B. Correct deficit of extracellular fluid volume C. Administration of furosemide D.Subject patient to hemodialysis B. Correct deficit of extracellular fluid volume 3. A patient with necrotizing pancreatitis undergoes computed tomography-guided aspiration which results in growth of Escherichia coli on culture. Which is the MOST appropriate treatment for this? A.Endoscopic retrograde cholangiopancreatography B.Culture-appropriate antibiotic therapy C.CT-guided placement of drain D.Exploratory laparotomy B. Culture-appropriate antibiotic therapy 4. Tumor necrosis factor-alpha is one of the earliest cytokines to be described. Which of the following is TRUE about TNF-A? A.Induces pre-coagulant activity and peripheral vasoconstriction B.Can be released as a response to bacteria or endotoxin C.Increased more in trauma than septic patients D.Contributes to anemia of chronic illness A.Induces pre-coagulant activity and peripheral vasoconstriction 5. Frozen plasma prepared from freshly donated blood is necessary when a patient requires which of the following? A.Christmas factor B.Antihemophilic factor C.Prothrombin D.Fibrinogen B. Antihemophilic factor 6. A patient with penetrating injury to the chest should undergo thoracotomy if there is A.more than 200 mL/h of blood for 3 hours from the chest tube. B.documented lung injury on CT scan. C.more than 500 mL of blood which drains from the chest t