What is the absolute indication for surgery in spinal cord stenosis?
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Progressive neurological loss due to herniated disc.
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What is the absolute indication for surgery in spinal cord stenosis?
Progressive neurological loss due to herniated disc.
What is the most frequent bone malignant tumor?
Osteosarcoma.
What veins form the portal vein?
Inferior mesenteric vein with splenic vein and superior mesenteric vein with splenic vein.
What is a Boxer fracture?
Fracture of the 5th metacarpal bone.
What is the age range of pregnant women with the highest risk of fetal death due to trauma?
15 and 19 years.
What is the most common liver malignancy?
Hepatocellular carcinoma.
What is the surgical indication for a femoral diaphyseal fracture in an adult?
Internal fixation with plate and screws.
What are some causes of erythema nodosum?
Infections, collagen vascular diseases, inflammatory bowel disease, drugs, and positive family history.
In which extremity is compartment syndrome more commonly associated with crush injuries?
Forearm.
What is the main origin of liver metastases?
Gastrointestinal tumors.
What factors predict a negative prognosis for the progression of rheumatoid arthritis?
Asymmetric joint damage to small joints, positivity for both rheumatoid factors and ACPA, male sex.
What is the most frequent site of acute hematogenous osteomyelitis?
Metaphysis of long bones.
What is a clinical characteristic of pemphigus vulgaris?
Painful, fragile blisters on the skin and mucosa.
What defines massive hemothorax?
Loss of at least 1500 ml of blood in the pleural space.
What are some types of incomplete spinal cord injuries?
Paraplegia, Tetraplegia, Brown-Sequard syndrome, Anterior medullary syndrome, Central medullary syndrome.
What are the risk factors for the formation of urinary stones?
a) tubular acidosis, b) hyperparathyroidism, c) dehydration.
Which statement about acquired autoimmune hemolytic anemia is false?
They are not caused by infectious agents, inflammatory processes or neoplasm.
Which extraarticular complication can cause spinal cord compression in rheumatoid arthritis?
Atlantoaxial subluxation.
Which test is specific to spondyloarthritis?
Positive HLA-B27 test.
What sign is positive in pemphigus vulgaris?
Positive Nikolsky sign.
What are severe chest injuries in chest trauma?
Pneumothorax in tension, Cardiac tamponade, Massive hemothorax, Multiple rib fractures, The costal flap.
What is a characteristic of massive hemothorax?
Requires emergency thoracic drainage.
What is the standard treatment for a hemodynamically unstable patient with spleen laceration?
Emergency splenectomy.
What components make up a rigid cystoscope?
a) telescope, b) forceps of foreign bodies, c) an intermediate piece, d) a sheath containing inlet and outlet channels for irrigation.
What is the main method of assessing male infertility?
Sperm analysis.
What is the blood loss range for Class II hemorrhage in a 70 kg person?
1500-2000 ml.
What is false regarding investigations in ankylosing spondylitis?
HLA-B27 testing is sufficient for the diagnosis.
What is a common manifestation of spondyloarthritis?
Sacroiliitis.
What is a false statement about hepatic hemangioma?
It always requires surgical treatment.
For a 70 kg polytraumatized person with a pulse over 120 beats/min, what class of hemorrhagic shock is caused by a blood loss of 1 liter?
Class II.
Which treatment options are available for pemphigus vulgaris?
Corticosteroids, low-dose chloroquine or hydroxychloroquine, azathioprine, and cyclophosphamide.
What is a characteristic of the costal flap?
It may be associated with contusion of the underlying lung parenchyma.
What causes over 80% of all UTIs?
E. coli.
What are the clinical manifestations of erythema multiforme?
Macules, plaques or vesicles on extremities; target lesions; myalgias; pruritus; malaise.
What is true about bladder carcinoma?
a) It is the fifth most common cancer in the American population, b) the prevalence among smokers is 5 times higher, c) transitional cell carcinoma represents 85-90% of all bladder tumors.
What is the heart rate characteristic of Class II hemorrhage?
Over 100 beats per minute.
What is true about peripheral joint involvement in ankylosing spondylitis?
It is polyarticular.
Which extraarticular manifestation is associated with spondyloarthritis?
Uveitis.
What is true about most patients with hepatic hemangioma?
Most patients are asymptomatic.
What do high levels of rheumatoid factors indicate in rheumatoid arthritis?
Active persistent synovitis.
What is a key characteristic of megaloblastic anemia regarding deoxyuridine monophosphate?
There is no methylation of deoxyuridine monophosphate to deoxythimidine monophosphate.
What is a common feature of pemphigus vulgaris blisters?
Erosions are common.
What clinical signs are associated with the costal flap?
Kussmaul sign and paradoxical pulse.
Which part of the urinary tract is most commonly affected by congenital obstructions?
The junction between proximal ureter and renal pelvis.
What is the composition of the penis?
a) Two corpora cavernosa and one corpus spongiosum.
What laboratory findings are associated with toxic epidermal necrolysis?
Decreased WBC, decreased hemoglobin, decreased hematocrit, increased alanine aminotransferase (ALT), decreased aspartate aminotransferase (AST).
What is true about nervous system involvement in lupus?
Lesions can be caused by non-inflammatory microvasculopathy, thrombosis, vasculitis.
What percentage of blood loss is associated with Class II hemorrhage?
15-30%.
What is a criterion for the diagnosis of ankylosing spondylitis related to age?
Age of onset <45 years.
What are the classifications of fractures based on?
Healing prognosis, type, localization, displacement, and angulation.
How is hepatic hemangioma usually discovered?
It is usually discovered by chance.
What type of synovitis is associated with seropositive rheumatoid arthritis?
Limited type of synovitis.
Is the costal flap always associated with pneumothorax?
No, it is not always associated with pneumothorax.
What defines priapism?
e) It is a pathology defined by the presence of a prolonged erection.
What is the maximum value of urinary flow in men?
20-25 mL / sec.
What is observed in the cytoplasm of erythroblasts in megaloblastic anemia?
Delayed maturation.
What test is clinically used to reveal a knee collateral ligament tear?
Anterior drawer test.
What are acquired hemolytic anemias?
Anemias that may occur due to acquired membrane defects.
What are the cutaneous manifestations of seborrheic dermatitis?
Pruritus; erythematous plaques with yellow, greasy scales.
What is true about the etiopathogenesis of rheumatoid arthritis?
The pathogenesis is multifactorial and involves genetic and environmental factors.
Which aspect of axial spondyloarthritis is true?
It is an inflammatory pathology of the sacroiliac joints detectable by MRI.
What are the blood pressure characteristics of neurogenic shock?
Hypotension and hypertension.
When is external fixation of a fracture indicated?
In open, unstable fractures; infected fractures; stable pelvic ring fractures; severely comminuted or unstable fractures when internal fixation is not possible; and fractures with bone loss requiring preservation.
What is a false statement regarding hepatic vascularity?
1/4 of the hepatic blood flow is through the hepatic artery.
What is the specificity and sensitivity of rheumatoid factors for diagnosis?
They have the highest specificity and sensitivity.
How is urinary incontinence defined?
Involuntary loss of urine.
When does a costal flap occur?
When 2 or more adjacent ribs are fractured in several places.
In which conditions may megaloblastic changes occur?
In RNA synthesis defects and myelodysplasia due to dyserythropoiesis.
What are therapeutic choices in atopic dermatitis?
Moisturizing creams; topical corticosteroids; oral corticosteroids in severe cases; antihistamines.
What is a common characteristic of cold AIHA?
Antibodies are usually IgG.
What characterizes Peyronie’s disease?
b) It represents the presence of a scar of the tunica albuginea of the corpora cavernosa.
What indicates medio-lateral instability of the knee?
Knee collateral ligament tear.
What is the definition of gangrene?
Tissue necrosis because of poor vascular supply or severe infection.
What treatment option can improve symptoms of ankylosing spondylitis?
Nonsteroidal anti-inflammatory drugs (NSAIDs).
What heart rate condition is commonly seen in neurogenic shock?
Bradycardia.
What is the primary source of hepatic blood flow?
The liver has a double vascularization through the hepatic artery and portal vein.
What does 'varus' mean in orthopaedics?
Displacement of the distal part towards the median line of the body.
Can the absence of rheumatoid factors exclude rheumatoid arthritis?
Yes, it can exclude the disease.
What hematological finding is associated with megaloblastic anemia?
Hypersegmented polymorphonuclear neutrophils.
What clinical features are observed in psoriasis?
Sharply demarcated erythematous plaques with silvery scales; lesions affect the extensor surfaces; positive Auspitz sign; pitted nails; absence of pruritus.
What characterizes a sensory neurological bladder?
Decrease or lack of urination sensation, without detrusor hyperreflexia.
What is characterized by generalized, rigor mortis-like rigidity in antipsychotic treatment complications?
Neuroleptic malignant syndrome.
What percentage of AIHAs are idiopathic?
90%.
What displacement is associated with a medial collateral ligament tear?
Valgus displacement.
What is a clinical highlight of the costal flap?
Paradoxical movement of the chest wall with the respiratory rhythm.
What is a limitation of scintigraphy in spleen imaging?
It fails to identify possible accessory spleens.
Which clinical form of psoriatic arthropathy is characterized by joint deformity?
Arthritis mutilans.
What are the skin characteristics associated with hemorrhagic shock?
Cyanotic skin.
Where is erythema nodosum most commonly located?
Anterior tibias.
What does the ultrasound reveal in the 60-year-old male patient?
A solid mass in the right hepatic lobe.
What clinical signs indicate a herniated cervical disc affecting the C7 spinal nerve?
Hypesthesia of the medial part of the arm and 5th finger, weak finger extension, weak triceps extension, weak wrist flexion, and decreased tricipital reflex.
What causes joint injuries in rheumatoid arthritis?
Persistently high levels of rheumatoid factors.
What does a low serum folate level indicate?
Folate deficiency.
What syndrome is characterized by normal muscular tonus or relaxation and rarely myoclonus?
Serotonergic syndrome.
What treatments are available for psoriasis?
Emollients; topical corticosteroids; phototherapy; methotrexate, cyclosporine in severe cases.
How long can administration of iron supplements take?
Up to 6 months.
What displacement is associated with a lateral collateral ligament tear?
Varus displacement.
What does splenosis result in regarding radioisotope capture?
Hypocapture of the radioisotope in ectopic positions.
What conditions most frequently lead to a fistula between the intestine and the bladder?
a) Sigmoid diverticulitis, b) Cancers, c) Crohn's disease, d) Penetrating abdominal trauma, e) Benign prostatic hypertrophy.
What is a clinical form of psoriatic arthropathy?
Oligoarthritis.
At which spinal cord levels can motor paralysis of the quadriceps occur?
L2, L3, L4.
How does basal cell carcinoma clinically appear?
Pearly papule with fine vascular markings.
What is a possible diagnosis for the patient with jaundice and a solid mass?
The patient has a liver metastasis.
What is the typical condition in rheumatoid arthritis?
Progressive symmetrical peripheral polyarthritis.
What are the suspected diagnostic signs of a giant cell tumor?
Pain over the articular line, eccentrical epiphyseal radiological image with metaphyseal extension, pain near the joint, pain along the diaphysis, and localization in the epiphysis forming the knee joint.
What is the role of erythroferrone in iron absorption?
It regulates iron absorption in the stomach.
Which agents trigger characteristic syndromes in antipsychotic treatment complications?
Antinicotinic and antimuscarinic agents.
What is a common method for repairing the anterior cruciate ligament?
Autologous patellar tendon graft.
What is the recommended dosage of oral iron for iron deficiency anemia?
200 mg three times a day.
Which imaging method is best for quickly assessing trauma patients for blood in the peritoneal cavity?
Abdominal ultrasound.
What are complications of cellulitis?
a) Abscess, b) Compartment syndrome, c) Sepsis, d) Permanent scars, e) Necrotizing fasciitis.
What is a characteristic sign of urethral lesions?
Hematuria.
What is the most common site for metastasis of clear cell renal cell carcinoma (CRCC)?
Lung, bone, and brain.
What is the most frequent type of melanoma?
Superficial spreading.
What curative treatment options are available for hepatocellular carcinoma?
Liver transplantation and liver resection.
What joint damage is characteristic of rheumatoid arthritis?
All the above statements (swan neck, ulnar deviation, buttonhole, mallet finger).
Which bone areas are predisposed to necrosis after a fracture due to extended cartilage coverage?
Head of the humerus, head of the femur, head of peroneum, talus, and calcaneum.
What may influence the viability of an affected limb in open fractures?
Open fractures of extremities.
What therapy may be used for posttraumatic stress disorder?
Cognitive-behavioral therapy, alone or in combination with a SSRI or SNRI.
What was vitamin B12 first crystallized as?
Cyanocobalamin.
What form of folate is present in food?
Polyglutamates in reduced dihydrofolate or tetrahydrofolate forms.
What is an alternative graft option for anterior cruciate ligament repair?
Autologous semitendinosus and gracilis muscle graft.
What is the characteristic rigidity in serotonergic syndrome?
Plastic, lead bar-like rigidity.
What is the most useful radiologic investigation for determining spleen dimensions and injuries?
CT scan with contrast performed intravenously and orally.
What is koilonychia and when is it observed?
A nail condition observed only in cases with very long-term iron deficiency.
What are the clinical aspects of impetigo?
a) Yellow crusted lesions, b) Erythematous vesicles or blisters, c) Facial pruritus, d) Papules, pustules or erythematous nodules, e) Scars.
What is the treatment for localized clear cell renal cell carcinoma (CRCC)?
Radical or partial nephrectomy.
What are the classifications of shock based on root cause?
Hemorrhagic/hypovolemic, cardiogenic, neurogenic, obstructive.
What are the required surgical excision margins for a melanoma < 2mm thick?
1 cm.
What risk may occur in liver adenomas under clinical observation?
Increase in size.
What does the 2010 ACR/EULAR classification criteria for rheumatoid arthritis include?
10 joints and at least one small joint, low level positive RF and ACPA, symptoms lasting more than six weeks.
What is a common issue associated with open fractures?
Bacterial contamination.
What test is used as a routine measure for vitamin B12 deficiency?
Measurement of methylmalonic acid.
What are common symptoms of posttraumatic stress disorder?
Intrusive thoughts of the traumatic event and avoidance of related situations.
What is false about folic acid?
Folic acid is not present in nature in the form of polyglutamate, but appears as monoglutamate.
What surgical procedure can be performed for osteoarthritis treatment?
Arthroplasty.
How is angiography helpful in spleen evaluation?
It is helpful in the evaluation of spleen tumors.
What is the status of serum ferritin in iron deficiency anemia?
Serum ferritin is low.
Is there adjuvant pharmacological treatment for antipsychotic complications?
Yes, there is adjuvant pharmacological treatment.
What are therapeutic options for acne?
a) Topical retinoids, b) Antibiotics (oral or topical), c) Cryotherapy or topical salicylic acid, d) Topical benzoyl peroxide, e) Oral isotretinoin in severe cases.
What are the three divisions of the male urethra?
Posterior, middle, and anterior urethra.
What is the most common clinical sign of clear cell renal cell carcinoma (CRCC)?
Hematuria.
What is a potential complication of liver adenomas?
Rupture and hemorrhage.
Which statement about drug therapy in rheumatoid arthritis is false?
Adalimumab represents an extracellular fragment of the human p75 TNF receptor linked to the Fc portion of IgG1.
What complications can arise from open fractures?
Infections of the wounds and osteomyelitis.
In which condition is splenectomy usually not useful?
Hydrocytosis.
Where is vitamin B12 absorbed?
In the stomach.
What is a misconception about posttraumatic stress disorder?
It is characterized by ideas of grandeur and elevated self-esteem.
What is another surgical option for osteoarthritis besides arthroplasty?
Realignment osteotomy.
What are examples of persistent alterations in cognition and mood in posttraumatic stress disorder?
Arousal state, self-blame, social withdrawal, and amnesia.
What is true about the antibodies involved in warm AIHA?
They are predominantly IgG, and the Coombs test is positive for IgG, IgM, and complement.
What is one segment of the male urethra?
Membranous urethra.
What is the clinical appearance of cellulitis?
a) Erythema, swelling, and warmth in the involved area, b) Myalgias, c) Ulcers and bullae, d) Fever, chills, e) Extensive necrosis of the soft tissue.
What percentage of clear cell renal cell carcinoma (CRCC) cases may be bilateral?
50%.
What is a potential consequence of open fractures?
Shock.
What is a true statement about conversion disorder?
First-line treatment includes cognitive-behavioral therapy, and SSRIs or SNRIs may be useful.
What can lead to a falsely increased hemoglobin level?
An increased plasma volume.
What non-surgical treatment can be used for osteoarthritis?
Steroid or viscosupplementation agents intraarticular injections.
What is another segment of the male urethra?
Bulbar urethra.
What are the classic features of thrombocytopenic purpura (TTP)?
Haemolytic anaemia, fever, purpura, liver damage, neurological manifestations.
What is deoxyadenosylcobalamin a coenzyme for?
The conversion of succinyl CoA to cobalamin.
What does the compulsive eating disorder NOT include?
Uncontrolled episodes of compulsive eating without inadequate compensatory behaviors.
What are the complications of herpes simplex virus infection?
a) Encephalitis, b) Pneumonitis, c) Hepatitis, d) Transmission from infected mother to newborn can cause disseminated disease with severe neurologic involvement, e) Frequent recurrences.
Which medications are 5 α-reductase inhibitors used in the treatment of symptomatic BPH?
a) Finasteride, b) Dutasteride.
What type of disorder is schizophrenia classified as?
A severe psychosis.
How do open fractures generally compare to closed fractures in terms of outcome?
They have a better outcome than closed fractures in general.
What symptoms may be present in conversion disorder?
Dysphagia, paresthesia, hearing impairments, tremor, dysphonia/dysarthria, and seeing impairments.
What is one of the causes of microcytic hypochromic anemia?
Defect in globin production (sideroblastic anemia).
What structural feature does vitamin B12 have?
A central corrin ring and a nucleotide set at right angles.
When is splenectomy indicated in hypersplenism?
When platelet count is < 50,000 and there is hemorrhage.
What is the segment of the male urethra that is spongy?
Spongious urethra.
Which statement about personality disorders is FALSE?
The schizotypal personality disorder is characterized by grandiosity, fantasies of success, manipulation of others.
What is the most common risk factor for emphysematous pyelonephritis?
Uncontrolled diabetes.
What are the clinical features of verruca vulgaris?
a) Well-defined lesions of thickened epithelium, b) Shiny papules with central umbilication, c) May appear flat or raised, d) Painful, small vesicles, e) Occasional tenderness to palpation.
What are potential risk factors for developing schizophrenia?
Illnesses during pregnancy, maternal malnutrition, or family history.
In which conditions can pathological bone fractures occur?
Osteoporosis, submaximal stress on the same bone, malignant and benign bone tumors, and bone metastasis.
What type of genetic condition is polycystic liver disease?
It is an autosomal dominant condition.
What is another name for conversion disorder?
Disorder with functional neurological symptoms.
Can neurological changes occur in patients with pernicious anemia who are not clinically anemic?
Yes, occasionally.
What type of epithelium lines the male urethra?
Transitional cell epithelium.
What is a benefit of splenectomy in major thalassemia?
It reduces the need for transfusion and physical discomfort due to massive splenomegaly.
What are symptoms of amphetamine intoxication, except?
Somnolence.
How is the diagnosis of emphysematous pyelonephritis frequently established?
By CT.
What is required for a positive diagnosis of schizophrenia?
Presence of two or more characteristic symptoms for less than a month in an interval of 3 months and alteration of social functioning for at least 3 months.
Which types of fractures are considered comminuted?
Spiral fracture, oblique fracture, butterfly fragment fracture, fracture with more than two fragments, and segmentary fracture.
What percentage of patients experience polycystic liver disease?
It occurs in 10% of patients.
What is a true statement about anorexia nervosa?
Inpatient treatment is often necessary to help with weight gain.
What symptoms do patients with pernicious anemia present?
Asymmetrical paraesthesiae in the fingers and toes.
In hypospadias, where can the urethral meatus be located?
In the dorsal face of the penis.
What are the first-line treatments for schizophrenia?
SSRIs or SNRIs.
What risk do patients undergoing splenectomy for thalassemia face?
They are at risk of developing OPSI (overwhelming post-splenectomy infection).
What are contraindications to circumcision?
a) Myelodysplasia, b) Hypospadias, c) HIV.
What characterizes a 'greenstick' fracture?
It occurs in children, affects only one side of the cortex, and is an incomplete fracture.
How do the cysts in polycystic liver disease differ microscopically from simple cysts?
Multiple cysts are not similar to simple cysts.
What are the most frequent complications of anorexia nervosa?
Electrolytic imbalances.
What is a possible location for the urethral meatus in hypospadias?
Perineal.
What are typical neurological changes in pernicious anemia?
Polyneuropathy that progressively involves peripheral nerves and spinal cord columns.
Which symptoms must be present for the diagnosis of schizophrenia?
Negative symptoms, anhedonia, delusions, insomnia, disorganized thought or speech.
What types of personality disorders are included in group B?
a) Obsessive-compulsive, b) Schizoid, c) Avoidant, d) Schizotypal, e) Dependent.
What penile lesions are considered premalignant?
a) Leukoplakia, b) Bowen's disease, c) Queyraterythroplasia.
