Minor Surgery Exam 1

30 Questions | Total Attempts: 108

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Surgery Quizzes & Trivia

Questions and Answers
  • 1. 
    A 57 year-old man presents with pain and swelling of the lateral aspect of his right toe, surrounding the lateral edge of the toenail. His toenail is yellow and thickened at the lateral margin. The pain and swelling developed gradually over a period of about 10 days. He denies known trauma to the area, but he does work in construction, and wears heavy boots; during the work day, his feet usually feel sore and hot from standing in his boots for hours. No allergies, no medications. What is the proper location for the injection of anesthesia prior to the surgical procedure for this condition?
    • A. 

      Field block surrounding to the paronychia

    • B. 

      Nerve block proximal to the head of the first metatarsal

    • C. 

      Digital block just proximal to the interphalangeal joint

    • D. 

      Digital block just distal to the metatarsalphalangeal joint

  • 2. 
    A 57 year-old man presents with pain and swelling of the lateral aspect of his right toe, surrounding the lateral edge of the toenail. His toenail is yellow and thickened at the lateral margin. The pain and swelling developed gradually over a period of about 10 days. He denies known trauma to the area, but he does work in construction, and wears heavy boots; during the work day, his feet usually feel sore and hot from standing in his boots for hours. No allergies, no medications. After cutting the nail to the matrix, which instrument would you then use in order to loosen the nail for removal?
    • A. 

      Adson's foreceps

    • B. 

      Elevator

    • C. 

      Straight hemostat

    • D. 

      Curved hemostat

  • 3. 
    A 57 year-old man presents with pain and swelling of the lateral aspect of his right toe, surrounding the lateral edge of the toenail. His toenail is yellow and thickened at the lateral margin. The pain and swelling developed gradually over a period of about 10 days. He denies known trauma to the area, but he does work in construction, and wears heavy boots; during the work day, his feet usually feel sore and hot from standing in his boots for hours. No allergies, no medications. If you were using 1% lidocaine without epinephrine for this procedure, and the patient weights 170 lbs (77.3 kg), what would the appropriate max dose of this anesthetic be for this patient?
    • A. 

      0.35 ml

    • B. 

      3.5 ml

    • C. 

      35 ml

    • D. 

      350 ml

  • 4. 
    A 57 year-old man presents with pain and swelling of the lateral aspect of his right toe, surrounding the lateral edge of the toenail. His toenail is yellow and thickened at the lateral margin. The pain and swelling developed gradually over a period of about 10 days. He denies known trauma to the area, but he does work in construction, and wears heavy boots; during the work day, his feet usually feel sore and hot from standing in his boots for hours. No allergies, no medications. If this is a recurrent condition for him, and you want to perform a matrixectomy to prevent recurrence, what would the appropriate method be for this procedure?
    • A. 

      After removal of the nail, apply 80% phenol to the nail matrix for 1-3 minutes, followed by neutralization with alcohol. Repeat this process 3 times.

    • B. 

      After removal of the nail, apply 1% phenol to the nail matrix for 1-3 minutes, followed by neutralization with alcohol. Repeat this process 3 times.

    • C. 

      Before removal of the nail, apply 80% phenol to the nail matrix for 1-3 minutes, followed by neutralization with alcohol. Repeat this process 3 times.

    • D. 

      Before removal of the nail, apply 1% phenol to the nail matrix for 1-3 minutes, followed by neutralization with alcohol. Repeat this process for 3 times.

  • 5. 
    A 57 year-old man presents with pain and swelling of the lateral aspect of his right toe, surrounding the lateral edge of the toenail. His toenail is yellow and thickened at the lateral margin. The pain and swelling developed gradually over a period of about 10 days. He denies known trauma to the area, but he does work in construction, and wears heavy boots; during the work day, his feet usually feel sore and hot from standing in his boots for hours. No allergies, no medications. What post-operative instructions would you give him following paronychia removal?
    • A. 

      Rest and elevate the leg for 24 hours.

    • B. 

      Remove the bandage and gently wash the toe with soapy water 3-5 times per day

    • C. 

      Remove the bandage within 24 hours and do not reapply the bandage; it is essential to expose the toe to open air to prevent infection

    • D. 

      To prevent recurrence, cut the toenails at least 1cm proximal to the edge of the toe

  • 6. 
    What is the duration of the action of marcaine?
    • A. 

      5-10 minutes

    • B. 

      30-60 minutes

    • C. 

      3-8 hours

    • D. 

      16-22 hours

  • 7. 
    A 45-year-old man presents with concerns of a small, firm, round nodule on the dorsal aspect of his wrist. It is 1.5 cm in diameter, without erythema of the surrounding skin, pain on palpation, epithelial disruption, or discharge. The patient is afebrile and in no acute distress. He denies a history of trauma to the area, or any clear etiology. The most likely diagnosis is  XXXXXX, but you must also consider XXXXXXXXX in your differentials.
    • A. 

      Lipoma; dermatofibroma and sebaceous cyst

    • B. 

      Sebaceous cyst; lipoma and pilonidal cyst

    • C. 

      Ganglion cyst: lipoma and sebaceous cyst

    • D. 

      Pilonidal cyst; dermatofibroma and ganglion cyst

  • 8. 
    A 45-year-old man presents with concerns of a small, firm, round nodule on the dorsal aspect of his wrist. It is 1.5 cm in diameter, without erythema of the surrounding skin, pain on palpation, epithelial disruption, or discharge. The patient is afebrile and in no acute distress. He denies a history of trauma to the area, or any clear etiology. The most appropriate treatment for this lesion is:
    • A. 

      Incision and drainage

    • B. 

      Excisional biopsy

    • C. 

      Crush the lesion with a heavy book

    • D. 

      Refer the patient to a hand surgeon

  • 9. 
    A 45-year-old man presents with concerns of a small, firm, round nodule on the dorsal aspect of his wrist. It is 1.5 cm in diameter, without erythema of the surrounding skin, pain on palpation, epithelial disruption, or discharge. The patient is afebrile and in no acute distress. He denies a history of trauma to the area, or any clear etiology. These lesions are almost always:
    • A. 

      Very easily removed without complications

    • B. 

      Highly prone to infection and abscess formation

    • C. 

      Attached to underlying tendons and nerves

    • D. 

      Associated with malignancy

  • 10. 
    The suture size that is appropriate for suturing an incision on the face is:
    • A. 

      1-0

    • B. 

      4-0

    • C. 

      6-0

    • D. 

      12-0

  • 11. 
    After performing a biopsy, send the sample in XXXXXX to the cytologist.
    • A. 

      10% formalin

    • B. 

      50% sodium tetradecyl sulfate

    • C. 

      1% lidocaine

    • D. 

      2% marcaine

  • 12. 
    A 35-year-old woman presents with concerns of a small dark purple lump on her right lower leg. The lesion is firm, intradermal, reddish purple nodule, and is 6 mm in diameter. She denies pain on palpation. There is no surrounding erythema, epithelial disruption, or discharge. What is the most likely diagnosis?
    • A. 

      Basal cell carcinoma

    • B. 

      Malignant melonoma

    • C. 

      Dermatofibroma

    • D. 

      Lipoma

  • 13. 
    A 35-year-old woman presents with concerns of a small dark purple lump on her right lower leg. The lesion is firm, intradermal, reddish purple nodule, and is 6 mm in diameter. She denies pain on palpation. There is no surrounding erythema, epithelial disruption, or discharge. What is the appropriate treatment for this lesion?
    • A. 

      Removal by incision and drainage

    • B. 

      Removal by excisional biopsy

    • C. 

      Removal by punch biopsy

    • D. 

      It is best not to remove the lesion, because the scar is often worse than the lesion itself

  • 14. 
    A 35-year-old woman presents with concerns of a small dark purple lump on her right lower leg. The lesion is firm, intradermal, reddish purple nodule, and is 6 mm in diameter. She denies pain on palpation. There is no surrounding erythema, epithelial disruption, or discharge. What is the prognosis of this lesion?
    • A. 

      It is likely to metastasize rapidly

    • B. 

      It is unlikely to metastasize, but can potentially be fatal

    • C. 

      It is only potentially dangerous in young children and elderly populations

    • D. 

      It is benign

  • 15. 
    Procaine is often avoided as an anesthetic because of its side effect profile. A very common side effect of procaine is:
    • A. 

      Anaphylaxis

    • B. 

      Hypertension

    • C. 

      Lupus-like syndrome

    • D. 

      Esophageal reflux

  • 16. 
    After performing a skin biopsy, what type of bandage would you use to dress the wound?
    • A. 

      An occlusive bandage to prevent infection

    • B. 

      A non-occlusive bandage to allow air to reach the wound

    • C. 

      A non-occlusive bandage treated with formalin to prevent infection

    • D. 

      An occlusive bandage treated with lidocaine to prevent post-operative pain

  • 17. 
    A 33-year-old African-American woman presents with concerns of atopic dermatitis; she is interested in alternative treatments for her skin condition. She also has noticed two small, soft, pedunculated, skin-colored papules located below her right axilla. She is 10 weeks pregnant, and she reports that the pedunculated skin lesions have grown more since the pregnancy. What is an appropriate procedure for removal of the pedunculated skin lesions?
    • A. 

      Inject the lesion with 2.5% marcaine, and have the patient return daily for 1 week for repeated injections until the lesion falls off

    • B. 

      Inject the lesion with 3% hydrogen peroxide and have the patient return daily for 1 week for repeated injections until the lesion falls off

    • C. 

      Anesthetize the area, lift the papule with forceps, and remove it at the base of the lesion with a scalpel

    • D. 

      Anesthetize the area, lift the papule with forceps, and remove it by twisting the papule until it loosens from the skin

  • 18. 
    A 33-year-old African-American woman presents with concerns of atopic dermatitis; she is interested in alternative treatments for her skin condition. She also has noticed two small, soft, pedunculated, skin-colored papules located below her right axilla. She is 10 weeks pregnant, and she reports that the pedunculated skin lesions have grown more since the pregnancy. What is the rationale behind the pedunculated lesions worsening during pregnancy?
    • A. 

      Increased dietary protein during the pregnancy is the most likely reason

    • B. 

      It is most likely psychosomatic in etiology

    • C. 

      These lesions respond to increased estrogen levels

    • D. 

      The increased emotional stress of pregnancy causes these lesions to grow

  • 19. 
    To definitively diagnose the atopic dermatitis, you might choose to perform a punch biopsy. Which method is appropriate for this procedure?
    • A. 

      Pinch the underlying muscle tissue between your thumb and forefinger before performing the punch biopsy

    • B. 

      Press the underlying muscle tissue away from the lesion with your thumb and forefinger before performing the punch biopsy

    • C. 

      Traction the skin parallel to the skin tension lines before performing the punch biopsy

    • D. 

      Traction the skin perpendicular to the skin tension lines before performing the punch biopsy

  • 20. 
    If the punch biopsy sample were to become struck in the core, what method would be best for removal of the sample?
    • A. 

      Remove the sample with a thin needle

    • B. 

      Remove the sample with serrated forceps

    • C. 

      Remove the sample with medical adhesive

    • D. 

      Loosen the sample with silver nitrate solution

  • 21. 
    A 39-year-old woman presents with a very tender and swollen pustule with erythema of the surrounding skin. The lesion is located on the medial aspect of the anterior crease between her pelvis and her thigh. It began as a small pink papule, and over about 2 weeks, progressively enlarged and became increasingly painful and inflamed. She denies fever, chills, trauma to the area, or history of significant medical conditions. She has no known allergies to medications, and is not currently taking any prescriptions.  The most likely diagnosis is XXXXXX but you must also consider XXXXXX in your differentials.
    • A. 

      Fistula; felon and abscess

    • B. 

      Abscess; carbuncle and furuncle

    • C. 

      Sebaceous cyst; seborrheic keratosis and fistula

    • D. 

      Sebaceous cyst; abscess and carbuncle

  • 22. 
    A 39-year-old woman presents with a very tender and swollen pustule with erythema of the surrounding skin. The lesion is located on the medial aspect of the anterior crease between her pelvis and her thigh. It began as a small pink papule, and over about 2 weeks, progressively enlarged and became increasingly painful and inflamed. She denies fever, chills, trauma to the area, or history of significant medical conditions. She has no known allergies to medications, and is not currently taking any prescriptions.  The most appropriate treatment for this condition is...
    • A. 

      Incisional biopsy

    • B. 

      Excisional biopsy

    • C. 

      Incisional and drainage

    • D. 

      Dilation and curettage

  • 23. 
    A 39-year-old woman presents with a very tender and swollen pustule with erythema of the surrounding skin. The lesion is located on the medial aspect of the anterior crease between her pelvis and her thigh. It began as a small pink papule, and over about 2 weeks, progressively enlarged and became increasingly painful and inflamed. She denies fever, chills, trauma to the area, or history of significant medical conditions. She has no known allergies to medications, and is not currently taking any prescriptions.  You would perform this procedure in what surgical field?
    • A. 

      Clean field

    • B. 

      Sterile field

    • C. 

      Open field

    • D. 

      Closed field

  • 24. 
    A 39-year-old woman presents with a very tender and swollen pustule with erythema of the surrounding skin. The lesion is located on the medial aspect of the anterior crease between her pelvis and her thigh. It began as a small pink papule, and over about 2 weeks, progressively enlarged and became increasingly painful and inflamed. She denies fever, chills, trauma to the area, or history of significant medical conditions. She has no known allergies to medications, and is not currently taking any prescriptions.  For this procedure, you would use which type of scalpel blade?
    • A. 

      #10

    • B. 

      #11

    • C. 

      #15

    • D. 

      #16

  • 25. 
    A 39-year-old woman presents with a very tender and swollen pustule with erythema of the surrounding skin. The lesion is located on the medial aspect of the anterior crease between her pelvis and her thigh. It began as a small pink papule, and over about 2 weeks, progressively enlarged and became increasingly painful and inflamed. She denies fever, chills, trauma to the area, or history of significant medical conditions. She has no known allergies to medications, and is not currently taking any prescriptions.  In order to prevent worsening or spread of infection in this case, what medication would be most appropriate for this patient?
    • A. 

      Cephalexin

    • B. 

      Terbinafine

    • C. 

      Mupirocin

    • D. 

      Piperazine