WorksheetsBailey's Basic Science GM
Total questions: 107
Worksheet time: 54mins
All of the following are examples of absorbable suture, except which of the following?
Polyglactin
Poliglecaprone 25
Polypropylene
Polydioxanone
The most commonly indicated venous thromboembolic prophylaxis in otolaryngology
includes which of these treatments?
Early mobilization
Pneumatic compression devices
Pharmacologic prophylaxis in high-risk patients
Calf massage
none
Which of the following is true regarding perioperative smoking cessation therapy?
The optimal timing for smoking cessation is 2 weeks before surgery.
Smokers are twice as likely to have perioperative complications as nonsmokers.
In smokers, lower levels of circulating oxygen are matched by a decreased rate of
consumption.
Nicotine replacement therapy does not lead to impaired wound healing.
Coblation tonsillectomy is best described by which of the following statements?
Produces local temperatures much lower than those produced by electrocautery
Is now used more commonly than electrocautery tonsillectomy
May reduce postoperative pain and speed the return to a normal diet
Both A and C
All of the following are immediate treatments for malignant hyperthermia developing
after the induction of general anesthesia with halothane and succinylcholine except:
Immediately stop halothane and succinylcholine
Intravenous injection of dantrolene sodium
Intravenous injection of meperidine for shivering
Give 1 00% oxygen
All of the following are immediate treatments for malignant hyperthermia developing
after the induction of general anesthesia with halothane and succinylcholine except:
Immediately stop halothane and succinylcholine
Intravenous injection of dantrolene sodium
Intravenous injection of meperidine for shivering
Give 1 00% oxygen
n a diagnostic workup of headache, further radiologic evaluation with MRI or cr scan
is indicated in which of the following circumstances?
Pulsatile headaches
Headache awakening one from sleep
Onset of headache in childhood
Unilateral headache
Which drug is most likely to be effective for the treatment of migraine-associated
vertigo?
Sumatriptan
Meclizine
Nortriptyline
Diazepam
Hair removal prior to surgery should be completed by which of these methods?
Shaving
Hair clippers
Chemical remover
Should not be done
Which of the following is the least likely to cause tachyarrhythmias?
Dopamine
Epinephrine
Dobutamine
Norepinephrine
The Comprehensive Geriatric Assessment is:
A prerequisite test required of all Medicare patients prior to scheduling of elective
surgical procedures
A rapid test that must be performed on all Medicare patients prior to all surgical procedures
in order to assure appropriate reimbursement
A highly formalized assessment protocol that has little effective utility for preoperative
surgical assessment
The only evidence-based assessment available that can reliably evaluate frailty
The increasing number of adults over 65 in the United States and other highly developed
countries is largely due to which of these factors?
Increased life expectancy due to medical and public health advances
Decreasing birth rate leading to reduced total population numbers and a secondary increase in the relative percentage of older adults
Earlier retirement with resultant reductions in work-related disease and death
Marked improvements in data collection, particularly the recent increase in counting individuals in nursing homes and other long-term care facilities
Which of the following are appropriate instructions for preoperative fasting for a case
scheduled for 2 p.m. the next day?
No liquids after midnight
Toast and milk allowed until 7 a.m
Light meal allowed until l O a.m.
No solids after midnight
Surgical Care Improvement Guidelines require that preoperative antibiotics be given
when?
At the time of incision
2 hours before incision
Within 1 hour of incision
Any time during the procedure
A Marcus Gunn pupil is elicited with the swinging flashlight test. If positive, it is an
indication of which of the following?
Syphilis
Amblyopia
Optic nerve injury
Diabetes
Which of the following complementary and alternative medical treatments has shown
the most promise in preventing, but not treating, otitis media?
Cod liver oil
Osteopathic manipulation
Xylitol
Zinc
Which of the following is true of clinical outcomes research?
The only outcomes measured are quality of life or functional status.
Severity staging is more important than comorbidity in predicting outcome.
Observational methodology is required for clinical outcomes research.
Validated instruments must be used for outcomes assessment.
Mendelian genetics describe all of the following forms of inheritance except:
Autosomal dominant inheritance
Mitochondrial inheritance
X-linked inheritance
Autosomal recessive inheritance
Due to its high sensitivity and overall diagnostic performance (as compared to the
gold standard of polymerase chain reaction), which of the following is the preferred
method for identifying a human papillomavirus (HPV)-related carcinoma?
In situ hybridization for HPV DNA
Western blot analysis for the E7 protein
Serum titers of anti-HPV IgG
Immunohistochemical staining for p 1 6 protein
Palliative care is best described by which of these statements?
It is the same as hospice care and only appropriate for dying patients.
It is interdisciplinary care addressing all sources of suffering for seriously ill patients
and their families.
It cannot be combined with disease-directed treatment, as this would interfere with
the patient's need to accept that he or she is dying.
t is not appropriate for patients with head and neck cancer who still want aggressive
cancer treatments
Peri operatively, surgeons should advise their patients to stop taking supplements such
as fish oil, garlic, Ginkgo biloba, ginseng, and vitamin E because these may alter:
The immune system
Hemostasis
Wound healing
Fluid and electrolyte balanc
The propagation of headache through the stimulation of the trigeminal ganglion
includes all of the following except:
Calcitonin gene-related peptide
5-Hydroxytryptamine
Activation of the trigeminal nucleus caudalis
timulation of the superior salivatory nucleus
Each line on the Snellen eye chart is meant to be read by a person with normal vision
at which of the following distances?
10 feet
20 feet
30 feet
40 feet
Which of the following statements about the prevalence of tobacco smoking is true?
Smoking is more common in women.
An increase in prevalence is correlated with higher education.
Prevalence increases with age.
Over the last 40 years, smoking has decreased in prevalence.
Retinal detachment is most common in the presence of which of the following visual
conditions?
Hyperopia
Amblyopia
Optic neuritis
. Myopia
The four phases of wound healing include which of the following?
Hemostasis, complement activation, proliferation, scar formation
Hemostasis and coagulation, inflammation, proliferation, remodeling
Complement activation, inflammation, proliferation, scar formation
Complement activation, hemostasis, inflammation, proliferatio
What is the approximate prevalence of CAM (complementary and alternative medicine)
use among adults in the United States?
. 1 5 %
25%
40%
70%
If a penetrating injury to the eye is suspected, which of the following is the safest
course of action?
Remove the foreign body in the emergency center.
Suture the eyelids closed.
Protect the eye with a metal cone.
Begin topical antibiotic ointment.
During a radical neck dissection with your patient in the sitting position, the anesthesiologist
is acutely concerned because of a sudden decrease in the patient's end-tidal
C02 reading. Which of the following is your most appropriate immediate step?
Flood the field with saline and place the patient in the Trendelenburg position.
Tell the anesthesiologist to reduce the rate of ventilation as severe hypocarbia reduces
cerebral blood flow
Ask the anesthesiologist to increase the percentage of nitrous oxide to allow a lessvolatile
agent to be used
Tell the anesthesiologist to replace the machine's leaking inspiratory valve.
Place a pulmonary artery catheter and aspirate air from the pulmonary artery.
A 28-year-old woman presents with a long history of unilateral, pulsatile headaches
that are triggered by weather changes. Her symptoms improve with over-the-counter
analgesics and lying down in a quiet and dark room. What other aspects in her medical
history would suggest a diagnosis of migraine headache?
Unilateral headache lasting 3 0 minutes to 2 hours
Improvement with physical activity
Fully reversible loss of vision
Family history of depression
Which of the following descriptions is characteristic of carcinoma in situ?
Pushing borders with mild atypia along the basal layer
Mild atypia, but with violation of the underlying basement membrane
Full-thickness cellular atypia with an intact basement membrane
Full-thickness cellular atypia with an intact basement membrane
Which of these is the predominant collagen type present in the initial stages of
proliferation?
Type I
Type III
Type IV
Type VII
All the following are true when comparing enteral nutrition to total parenteral nutrition
(TPN) except:
Enteral nutrition provides more nutrients.
Enteral nutrition can buffer gastric acid.
Enteral nutrition is less expensive.
Enteral nutrition is more likely to cause hyperglycemia.
A 40-year-old man with a 20 pack-year smoking history complains of severe short
lasting attacks of unilateral periorbital pain, nasal congestion, rhinorrhea, and eyelid
edema. A Cf scan and MRI of the brain reveal no abnormalities. What is the recommended
initial therapy for this condition?
Intranasal fluticasone
Verapamil, 240 mg daily
1 00% oxygen via nonrebreather
Subcutaneous glucocorticoids
Which statement below best describes the benefits of survival analysis when interpreting
a cohort study on squamous cell carcinoma of the oropharynx?
Survival analysis reduces bias by excluding patients with limited follow-up.
Survival analysis increases precision by excluding censored observations.
Kaplan-Meier survival curves are most meaningful at the far right end (long-term
results) .
Kaplan-Meier survival curves increase precision by allowing full use of censored data.
Progression-free survival is preferred over disease-specific survival for outcome reporti
Which of the following are true concerning levels of individual studies?
Case-control study is higher than cohort study.
Randomized controlled trial is higher than case-control study.
Case series is the same level as cohort study.
Case series is higher than outcomes research.
Which of the following statements is true regarding thyroid function?
Myxedema coma has a high mortality rate and often occurs in those with a concurrent
illness.
In a thyroid storm, propylthiouracil (PlU) or methimazole can be used to suppress
thyroid hormone synthesis. Methimazole has the additional advantage of suppressing
the conversion ofT4 to T3.
Potassium iodide can be used to control hyperthyroidism chronically.
Glucocorticoids such as hydrocortisone are often not necessary in myxedema coma
because patients have normal adrenal function.
All of the following are nucleotide components of DNA except:
Adenine
Guanine
Cytosine
Uracil
Which of the following antibiotics inhibits synthesis of the 50S ribosomal subunit?
Neomycin
Aztreonam
Gentamicin
Clindamycin
Which of the following is true of evidence-based medicine (EBM)?
Only randomized controlled trials can be included in EBM.
EBM requires the input of the clinician's experience and expertise.
Evidence must include results from basic research and animal studies.
The overall evidence is given a grade based on study methodology.
Subarachnoid hemorrhage (SAH) is most commonly caused by:
Aneurysm
Trauma
Tumor
Seizure
Which of these are the most common pathogens found in acute otitis media?
Streptococcus pyogenes and Moraxella catarrhalis
Streptococcus viridans and Group A Streptococcus
Haemophilus infiuenzae and Streptococcus pneumoniae
taphylococcus aureus and Pseudomonas aeruginosa
Which of the following is the best approach to a patient presenting for resection of a
large mass at the base of the tongue?
Mask induction with desflurane, while maintaining spontaneous ventilation
Rapid sequence induction with etomidate and succinylcholine
Awake fiberoptic intubation
Refuse to operate unless the patient agrees to an awake tracheotomy
Attempt the resection with moderate sedation
Robotic surgery benefits from:
360° wristed motion
Scaled motion with tremor suppression
Binocular magnification
Both B and C
All of the above
Which of the following is most consistent with prerenal oliguria?
Urine Na = 3 0
Urine osmolality = 3 5 0
Fractional excretion of sodium (FENa) = 0. 1 %
Blood urea nitrogen (BUN)/creatinine ratio= 1 0
ccording to national surveys, the two most commonly used complementary and alternative
medical products in the United States are:
Xylitol and echinacea.
Glucosamine and chondroitin.
Echinacea and Ginkgo biloba.
Fish oilfomega-3 and glucosamine
Parathyroid cells increase in number in response to which chronic situation?
Hypocalcemia
Low level of 1 ,25(0HhD3Hypophosphatemia
D. Uremia
All of the above
You are asked to review a research article that compares the Epley maneuver to a sham
procedure for benign, paroxysmal, positional vertigo, in which the authors present
the beneficial effect of the therapy, reported as an absolute rate difference of 40%
(P < .001) and a 95% confidence interval (CI) of 25% to 55%. Which statement below
properly interprets these results?
The effect is likely biased because low statistical power may be present.
the 95% CI is too broad to conclude the effect is clinically important.
The chance of a type 1 statistical error is significant.
If 20 of 1 00 patients in the sham group improved, we would expect 28 of 1 00 to
improve after the Epley maneuver.
The 95% CI shows the zone of compatible results to be 25% to 5 5%.
Which of the following conditions is most likely to present with hearing loss?
Migraine
Vertebrobasilar insufficiency
Anterior inferior cerebellar artery (AICA) occlusion
Cerebellar infarction
What medical system is the most popular form of complementary and alternative
medical (CAM) therapy in Europe?
Homeopathy
Chiropractic
Osteopathy
Naturopathic medicine
Which of the following is a disease that affects the outcome being measured?
A comorbid condition
An example of bias
A dependent variable
A contributor to severity
Which of these is the most common cause of sinus headache in a 40-year-old woman
with complaints of pressure in the distribution of the sinuses, rhinorrhea, and ocular
tearing?
Obstruction of sinus ostia
Acute rhinosinusitis
A primary headache disorder
Mucosal contact headache
Which of the following is most acceptable for an 83-year-old patient with poorly controlled
hypertension presenting for middle ear surgery?
Maintenance of anesthesia with isoflurane and nitrous oxide until the patient is
extubated
Maintenance of anesthesia with isoflurane and remifentanil
Prevention of any patient movement with deep muscle relaxation from rocuronium
Antihypertensives to produce deliberate hypotension (systolic blood pressure approximately
1 00 mm Hg) to reduce blood loss and improve operating conditions
A pulmonary artery catheter to maximize the patient's intraoperative hemodynamic
status
54. Genetic mutations in the 22q 11.2 region of chromosome 22 are responsible for certain forms of the following syndromes except:
A. CHARGE syndrome
B. Velocardiofacial syndrome
C. Pallister-Hall syndrome
D. DiGeorge syndrome
55. Which of these is the most common inherited form of sensorineural hearing loss?
A. Autosomal dominant syndromic sensorineural hearing loss
B. Autosomal recessive syndromic sensorineural hearing loss
C. Autosomal dominant nonsyndromic sensorineural hearing loss
D. Autosomal recessive nonsyndromic sensorineural hearing loss
56. Which of the following does not have an active metabolite?
A. Morphine
B. Meperidine
C. Fentanyl
D. Hydromorphone
57. Outcomes in delirium are improved by identifying risk early, avoiding deliriogenic events
and medications, correcting triggering pathology, and ... (which of the following?)
A. using physical restraints
B. avoiding restraints
C. administering high-dose benzodiazepines
D. using music therapy
E. requiring nurses to wear white uniforms and caps
58. Antineoplastic strategies in head and neck cancer are best described by which statement?
A. Are associated with prolonged improved survival in patients with incurable, recurrent disease
B. Can result in temporary improvement in symptoms such as pain, swelling, and dysphagia in patients with otherwise incurable disease
C. Do not include palliative surgery in patients with incurable disease
D. Play no role in the palliative setting
59. A 62-year-old man was treated for T3N2b carcinoma of the supraglottic larynx with
chemoradiotherapy with planned posttreatment neck dissection. Combined with clinical examination, the study with the highest negative predictive value for residual disease at 10 to 12 weeks following the completion of treatment is:
A. Contrast-enhanced neck CT
B. MRI of neck with and without contrast
C. ct angiography of neck
D. Fludeoxyglucose F 18 C8F-FDG) PET/diagnostic neck CT
60. Specimen shrinkage is best described by which of these statements?
A. Is most marked in the immediate postresection period
B. May be prevented by in situ fixation of the tissues
C. Is primarily a result of formalin fixation
D. Typically results in a 1% to 5% disparity between gross and histologic margins
61. Which is the best description of how the evidence is graded, in the practice of
evidence-based medicine?
A. The overall grade is a compilation of the level of the best studies.
B. The overall grade is based on the highest level of study available.
C. The overall grade is determined by the level of the largest number of studies.
D. The overall grade is determined by the level of the poorest individual study.
62. Which of the following smoking cessation regimens would have the highest rate of
success?
A. Varenicline combined with a nicotine replacement patch
B. Varenicline and bupropion SR
C. Long-acting nicotine patch and short-acting nicotine gum
D. Selective serotonin reuptake inhibitor and clonidine
63. Which of the following is true of granulomatosis with polyangiitis?
A. This disease has its highest incidence in young African American women.
B. c-ANCA is helpful in diagnosis, but the utility of the test is limited by poor specificity.
C. This disease is self-limiting; most cases resolve without treatment.
D. Laryngeal involvement should alert the physician that the patient is unlikely to have granulomatosis with polyangiitis, and another rheumatologic disease diagnosis
should be pursued.
E. The disease is characterized by the triad of respiratory granulomas, vasculitis, and
glomerulonephritis.
64. Which of the following fungi reveals 45 o branching septate hyphae when grown on
Sabouraud agar?
A. Aspergillus
B. Rhizopus
C. Mucormycosis
D. Absidia
65. A 46-year-old woman presents with a mucosal lesion in the left hard palate. She has
numbness in the left V2 distribution concerning for perineural spread of tumor. What
would be the best imaging study to order?
A. Maxillofacial Cf without contrast
B. Maxillofacial and skull base MRI without and with IV contrast
C. Neck Ct without contrast
D. ct angiography of the neck
66. Which of the following is true concerning rheumatoid arthritis of the head and neck?
.
A. Hoarseness is always due to cricoarytenoid joint involvement.
B. Histologic examination of the cricoarytenoid joint rarely demonstrates pathology.
C. Rheumatoid arthritis is a common cause of conductive hearing loss.
D. Patients with rheumatoid arthritis and neck pain should have imaging of the cervical
spine prior to direct laryngoscopy.
E. The temporomandibular joint is nearly always spared in rheumatoid arthritis
67. In a journal club, you are asked to assign a level of evidence to a study about treatment effects. In making your assignment which of the following considerations would be helpful?
A. A systematic review of randomized trials could rank higher than a single randomized trial.
B. A systematic review of randomized trials is preferable to a clinical practice guideline.
C. Randomized trials, by nature of their study design, always have high methodological
quality.
D. Observational studies cannot provide a strength of evidence above level 3.
E. Levels of evidence, in general, are not appropriate for studies of treatment effects.
68. Aminoglycoside-induced ototoxicity is caused by damage to which of the following?
A. Inner hair cells
B. Outer hair cells
c. Stria vascularis
D. Scala tympani
69. Angiogenesis is a feature of the proliferative phase of wound healing and is largely
dependent upon which group of growth factors?
A. VEGF, IL-l, EDGF
B. VEGF, FGF, TGF-a, -
C. VEGF, EDGF, KGF
D. FGF, ILGF, KGF
70. Which of these statements best describes frailty?
A. It is an assessment of declining functional reserve.
B. It is seen only in the "old-old."
C. It has been linked to a specific mutation mapped to a locus adjacent to the Rb tumor suppressor gene.
D. It is a standardized test.
71. A 35-year-old woman has an MRI of the brain for headaches. The appearance of the
brain is normal. A well-marginated 3-cm prestyloid parapharyngeal T2-hyperintense
solid mass is incidentally seen on the study. The mass is most likely to be:
A. Salivary gland neoplasm
B. Paraganglioma
C. Hemangioma
D. Schwannoma
72. Which of the following statement regarding the adrenal glands is false?
A. Adrenal insufficiency can be diagnosed with a cosyntropin stimulation test.
B. For patients with a recent history of adrenalectomy for Cushing disease, stress-dose steroids are necessary if patients are undergoing surgery.
C. The best screening test for primary aldosteronism is aldosterone/renin ratio.
D. Primary adrenalectomy is demonstrated by hyperkalemia and hypertension.
73. General guidelines for pharmacologic treatment of chronic pain in patients with head and neck cancer include which of these statements?
A. Tricyclic antidepressants are the preferred medication for neuropathic pain in patients with cardiac disease.
B. Neuropathic pain rarely responds to pharmacologic therapy.
C. Chronic opioid therapy is necessary for most patients with moderate to severe pain.
D. If an opioid is tolerated but ineffective at a given dose, rather than increasing the dose, a different medication should be tried.
74. Slurred speech and tongue fasciculation are common early manifestations of:
A. Amyotrophic lateral sclerosis
B. Migraine
C. Guillain-Barre syndrome
D. Anterior inferior cerebellar artery stroke
75. Rapamycin may improve the wound healing process by which of the following
mechanisms?
A. Phagocytosing of infiltrating bacteria
B. Triggering apoptosis of fibroblasts
C. Inhibiting mammalian target of rapamycin (mTOR)
D. Promoting granulation tissue formation
76. Patients with diabetes suffer from impairment of wound healing secondary to all of
the following except which of the following?
A. Reduction in the elaboration of calcitonin gene-related peptide
B. Dysfunctional fibroblast activity
C. Increased levels of multiple medical problems
D. Increased leukocyte infiltration of the wound
77. Which of the following is true of Sjogren syndrome?
A. The primary form is associated with an increased risk of lymphoma.
B. The secondary form is rarely associated with systemic lupus erythematosus.
C. Primary Sjogren syndrome is a disease limited to the lacrimal and salivary glands.
D. The diagnosis of Sjogren syndrome is made based on noncaseating granulomas on
salivary biopsy.
E. Serologic testing for RojSS-A and La/SS-B is highly sensitive and specific for the diagnosis of Sjogren syndrome.
78. Which of these are dermal skin substitutes?
A. Can be divided into cellular and acellular products
B. Remain histologically evident on a permanent basis
C. Are rarely used
D. Both A and B
E. All of the above
79. A common side effect associated with phenylephrine includes:
A. Reflex bradycardia
B. Tachycardia
c. Hypertension
D. Hypotension
80. A group of investigators report superior patient satisfaction and outcomes after
robotic-assisted surgery, compared with conventional surgery {P < .0001). The trial
was randomized, but the nature of the interventions did not allow for blinding of the
patients, surgeons, or outcome assessors to patient allocation. The differences between
groups are unlikely to be caused by which of the following?
A. Halo effect
B. Allocation (susceptibility) bias
C. Inadequate sample size
D. Ascertainment (detection) bias
E. Lack of intention-to-treat analysis
81. The recent increased emphasis on the study and management of geriatrics can be
tied to:
A. Scientific advances in the assessment and management of diseases of older adults
B. Increased emphasis on effectiveness of medical and surgical interventions
C. Changing demographics of the U.S. population
D. Changing expectations of older individuals
E. All of the above
82. A 48-year-old woman with a history of papillary thyroid carcinoma status post-total
thyroidectomy and radioactive iodine (1311) ablation has a rising thyroglobulin level.
Neck ultrasound and CT show no locoregional disease recurrence, and 131I whole body
scintigraphy is negative for iodine avid disease. What is the next best imaging study to
evaluate for occult papillary thyroid carcinoma?
A. Neck ultrasound
B. cr angiography of the neck
C. Whole body fludeoxyglucose F 18 PET/Cf
D. Technetium Tc 99m sestamibi single-photon emission computed tomography
83. All of the following are true of a patient who has bleeding during surgery except:
A. The most likely cause of intraoperative bleeding is an unsecured vessel.
B. In a bleeding patient who has a normal prothrombin time and normal activated partial thromboplastin time, the most likely deficit is impaired platelet activity.
C. The clotting abnormality caused by heparin can be corrected with fresh frozen plasma (FFP) transfusion.
D. The clotting abnormality caused by warfarin can be corrected with FFP transfusion.
84. Universal precautions include all of the following except:
A. Gloves
B. Barrier gowns
c. Eye protection
D. Shoe covers
85. Which of the following statements is true?
A. Both T3 and T4 are produced by the thyroid gland, with more T3 being released into the circulation.
B. T3 is the most active thyroid hormone as it has high binding affinity to thyroid hormone nuclear receptors.
C. Most T3 and T4 in the circulation are free hormones.
D. During illness, surgery, and trauma, there is decreased reverse T3 production.
86. Which of the following is true concerning cat-scratch disease?
A. The name is deceiving; cats do not appear to serve as a reservoir as this bacterium is rarely recovered from these animals.
B. Inoculation can occur through the conjunctiva (Parinaud oculoglandular syndrome) .
C. If untreated, this disease often leads to a fulminant systemic infection.
D. Diagnosis relies on culturing the Bartonella henselae organism.
E. Multiple cervical nodes are usually found on presentation.
87. Concerning tuberculosis, which of the following is true?
A. The worldwide incidence is falling rapidly and soon this disease will not represent a
significant global health problem.
B. Transmission occurs most efficaciously through encounters with fomites.
C. Infectivity is especially high in the laryngeal form of the disease.
D. Patients with positive purified protein derivative (PPD) and without a history of treatment are universally highly contagious.
E. Treatment should not be initiated until sensitivity testing is done in culture to determine the minimal inhibitory concentration against various antituberculous drugs topick the drug that will be most efficacious
87. Concerning tuberculosis, which of the following is true?
A. The worldwide incidence is falling rapidly and soon this disease will not represent a
significant global health problem.
B. Transmission occurs most efficaciously through encounters with fomites.
C. Infectivity is especially high in the laryngeal form of the disease.
D. Patients with positive purified protein derivative (PPD) and without a history of treatment are universally highly contagious.
88. Eyelid notching after repair of a vertical marginal laceration is usually due to which of the following?
A. Failure to close tarsal plate well
B. Leaving sutures in too long
C. Using absorbable sutures
D. Not performing lateral canthotomy
89. Which of the following statements describe oxidized cellulose topical hemostatic
agents?
A. They provide scaffolding for clot formation.
B. They do not have bactericidal properties.
C. They have been shown to be less-effective hemostatic agents than microfibrillar
collagen.
D. Both A and C.
E. All of the above.
90. Which of the following definitions of inheritance is incorrect?
A. Penetrance describes whether individuals carrying a particular gene mutation also
express an associated trait or phenotype.
B. Expressivity describes the variation in phenotype among individuals carrying a particular genotype.
C. Genetic imprinting describes a genetic process by which certain genes are expressed in
a parent-of-origin-specific manner via upregulation of expression of specific alleles.
D. Digenic inheritance or diallelic inheritance refers to coinheritance of mutation at two
distinct genes or genetic loci which produce the phenotype of disease.
91. Which of the following modifications has been shown to improve accuracy and
adequacy of fine-needle aspiration (FNA) cytology specimens to the greatest extent?
A. Immediate assessment of adequacy by a cytopathologistjcytotechnologist
B. Avoidance of suction during aspiration
C. Preparation of a cell block
D. Using a "two hand" technique of palpation with simultaneous aspiration
92. Which of the following is the best intravenous treatment of cardiac arrest following
injection of bupivacaine?
A. Lidocaine
B. 20% lipids
c. Calcium chloride
D. Midazolam
E. Naloxone
93. The mecA gene, which is associated with methicillin resistance among Staphylococcus
aureus, encodes for which of the following resistance mechanisms?
A. Enhanced penicillinase production
B. Altered penicillin-binding protein (PBP)
C. -Lactamase production
D. Decreases drug permeability by efflux pumps
94. Which of these is the most likely cause of postoperative hypotension?
A. Inadequate pain control
B. Hypovolemia due to inadequate fluid replacement or hemorrhage
C. Pulmonary emboli
D. Residual effects of intraoperative anesthetics
95. A 57-year-old woman presents with clinical signs and symptoms of primary
hyperparathyroidism. Currently, the most commonly used combined imaging
approach for initial preoperative localization of abnormal parathyroid tissue is:
A. Neck CT with IV contrast and 131 I scintigraphy
B. Somatostatin scintigraphy and MRI of the neck
C. Neck ultrasound and technetium Tc 99m sestamibi single-photon emission computed tomography
D. Somatostatin scintigraphy and neck CT with IV contrast
96. Which of the following alterations in technique will reduce the degree of artifact seen
on histopathologic sectioning when the col laser is used for excision?
A. Defocusing of the beam
B. Using a fiber-coupled system rather than a micromanipulator
C. Switching to the pulse-wave mode
D. Increasing the power above 6 W
97. Patients with a Chiari type I malformation would commonly present to an otolaryngologist for the below symptoms except for:
A. Headache
B. Dizziness
C. Hoarseness
D. Unilateral hearing loss
98. Which of these statements can best describe ultrasonic shears?
A. Present no risk to adjacent nerves
B. Utilize ultrasonic blade vibrations at 5 5,000 Hz
C. Result in electrical energy transfer to affected tissues
D. Both A and B
E. All of the above
99. In a thyrotoxic storm, all the following medications are used except which one of the
following?
A. Aspirin to control hyperthermia
B. Propylthiouracil to block thyroid hormone production
C. Iodine to prevent thyroid hormone release
D. Propranolol to control tachycardia and tremor
100. Reading only the abstract of an original research article in an otolaryngology journal may provide an incomplete, or biased, view of study results because the abstract offers which of the following?
A. Usually does not provide the sample size
B. Frequently does not convey the study design
C. Infrequently describes adverse events
D. Provides too much information
E. Often confuses dropouts with loss to follow-up
101. When light is shined into one eye, causing pupillary constriction, and the opposite
pupil also constricts, this is known as:
A. Consensual light reflex
B. Direct light reflex
C. Vergence
D. Argyll Robertson pupil
102. For patients who have advanced head and neck cancer and are recognized to be dying,
and their families, which of these statements is best?
A. Palliative care or hospice involvement in their care has been shown to decrease the
suffering and distress associated with the dying process.
B. Resuscitation status is entirely a matter of their personal values, and no recommendation should be made by the physician.
C. It is rare that patients have significant or distressing symptoms.
D. Tube feedings should not ordinarily be discontinued in imminently dying patients
who have a feeding tube.
103. Which of the following is not a manifestation of hypercalcemia?
A. Confusion
B. Polyuria
c. Nephrolithiasis
D. Tetany
E. Constipation
104. Which of the following is an effect of secondhand smoke exposure?
A. Premature death in nonsmokers
B. Increased incidence of oral cavity cancer
C. Development of allergies in children
D. Hypertension
105 . Which of the following is an effect of nicotine?
A. Increased anxiety
B. Slight cognitive enhancement
C. Decreased oxygen demand
D. Vasodilation
106. Propofol properties are best described as:
A. Slow onset with decreased postoperative nausea
B. Slow onset with hypotensive side effects
C. Rapid onset with amnestic properties
D. Rapid onset with analgesic properties
