Sbas 2016 Annual Scientific Meeting MOC Questions

1. When is the 68 gallium Dotatate PET CT scan most helpful as part of patient work up?

In patients with carcinoid symptoms and negative conventional imaging

In all patients who present with flushing

Only in patients who are biochemically negative with flushing

In all patients with known history of cancer

2. How is E-Learning being effectively utilized to train medical students and residents in orthopedic surgery?

As a substitute for surgical training

As a replacement for anatomy laboratory sessions

As a tool used in didactic lecture teaching

As a substitute orthopedic pathology training

3. Which of the following is NOT a benefit of a service line approach to care delivery?

Improved patient experience

Shared savings

Integrated care

Duplicate ordering of medical diagnostic tests

4. Urinary Catheterization is infrequently performed by staff and resident physicians. What is one way that physician could safely practice diagnosis and treatment of complex urinary scenarios that would allow development and maintenance of technical and decision making skills?

Simulation designed to mimic complex urinary catheterization scenarios

Patients who require catheter placement prior to commencement of an operation

Patients with known complex urinary anatomy

Boot camp sessions with Urologists

5. A 40 yo liver transplant recipient uses a mobile phone application to remind him about taking his transplant medications. Adherence to his medication schedule can be determined by the measurement of what lab value?

Creatinine

Amylase

Tacrolimus

Bilirubin

6. Prolonged exposure to BMP2 protein leads to increased expression of which of the following?

Alkaline Phosphatase

Actin

Collagen Type 2

Myosin

7. What is the main reason that increasing diversity in the medical profession is expected to improve health equity for all patients?

White physicians are more likely to care for underserved populations

Minority physicians are more likely to care for under-served populations

Minority physicians are more likely to pursue subspecialty care than primary care

Minority physicians are less concerned about student loan debt than majority physicians

8. Physiologically based, predictive modeling using the sepsis predictive probability index improved the sensitivity early sepsis prediction by which of the following levels?

No difference

Twofold

Threefold

Fourfold

9. Lactobacilli strains are thought to be involved in the protection of which intestinal illness?

Necrotizing enterocolitis of the newborn

Gastroenteritis

Gastroesophageal reflux disease

Colon Cancer

10. Based on the results in the abstract, in what way is it clear that cystourethroscopy with bladder washout is effective at reducing the incidence of recurrent UTI in kidney transplant recipients?

Kidney transplant recipients with recurrent UTI never have a UTI after BW within 6 months

Kidney transplant recipients with recurrent UTI are always cured by BW

The Wilcoxon signed rank test indicated a complete reduction to 0 UTIs post-BW, for all participants in the study

11. When looking at various risk factors such as smoking, illicit drug use, alcohol use, and oral contraceptive use, which contributes significantly to mortality?

Smoking

Illicit drug use

Alcohol use

Oral contraceptive use

12. A 45 year old African American patient is about to undergo a renal transplant. Which of the following is more likely in African American kidney transplant recipients?

Delayed graft function

Living donor

Zero antigen HLA mismatch

Low panel reactive antibody level

13. Routine postoperative esophagram:

Accurately diagnoses a stricture that later requires dilation

Is often the first sign of a leak that requires an intervention

Is not necessary in the evaluation of all postoperative EA repairs

Can determine need for follow up imaging later in life

Always requires an intervention if an anastomotic leak or narrowing is found

14. What percentage of students completing the Reach One Each One, 10 week hospital-based, multidisciplinary youth mentoring and medical exposure program enrolled in college as Pre-Med majors?

Less than 10%

20%

40%

Over 60%

15. In accordance with the scale of this study, while BerbereX is demonstrated to be an effective anecdote to improve healing efficiency of chronic foot and ankle insults, a finding relating to the use of BerbereX in diabetic study participants most closely corresponds to which of the following statements?

The use of BerbereX prolongs chronic foot and ankle insults in non-diabetic patients.

The use of BerbereX causes the healing of chronic foot and ankle insults in diabetic patients to be prolonged.

16. A 45 year-old African American male has end-stage liver disease and has been recommended for a transplant. Which of the following statements is true as it relates to African American patients and liver transplantation?

African Americans have decreased access to the liver transplant waiting list

Current 1 year patient survival for liver transplantation is 75%

There are no geographic differences in organ allocation to patients on the liver transplant waiting list

The short term patient and graft (Liver) survival of African Americans and Caucasians is equivalent

17. A 4 day old boy presents to the emergency department with bilious vomiting, a swollen, firm abdomen and lethargy. Imaging shows midgut intestinal obstruction. What is the most likely diagnosis?

Intussusception

Pyloric Stenosis

Malrotation

Hirschsprung Disease

18. A 21 year old patient presents to the emergency department with a displaced fracture. A team of residents will reduce the fracture. Which of the following statements is true?

Less experienced residents have a higher satisfactory reduction rate (SRR)

More experienced residents have a higher satisfactory reduction rate (SRR)

Only attending orthopedic surgeons should reduce fractures

First year residents on pediatric rotation have a higher satisfactory reduction rate (SRR)

19. What region of the 5th metatarsal does a Jones Fracture occur in?

Base

Tuberosity

Metaphyseal-diaphyseal

Diaphyseal

20. In the study, "Post-Operative Outcomes Among Obese and Non-Obese Children Undergoing Cholecystectomy", what was a major difference in surgical outcomes among obese and non-obese pediatric patients?

Obese children have longer operative time than non-obese children

Obese children do not experience longer operative time than non-obese children

Obese children had twice the operative time as their non- obese counterparts

There was no statistically significant difference in operative times between obese and non-obese children

21. Orthopedic summer internship (OSI) for underrepresented minorities resulted in:

Poor success rate for OSI graduates to match in orthopedic residency

Mostly female graduates to match in orthopedic residency

Mostly African-American graduates to match in orthopedic residency

Mostly Latino graduates to match in orthopedic residency

22. What were the main risk factors associated with a higher rate of SCD (Sequential Compression Devices) noncompliance on an orthopedic unit?

Admittance to an orthopedic service

Weekends, afternoons and evenings, elective surgeries, and admittance to a non-orthopedic service

Length of hospital stay

Patients admitted for foot and ankle, upper extremity, and spine operations

23. A 10 year old girl presents to the ED with right lower quadrant pain that is diagnosed as ovarian torsion. Which factor will determine the use of a CT scan during her workup of ovarian torsion?

Age greater than 14

BMI over 35

Public insurance status

Visit to adult emergency room

24. How does E. coli 07: K1 effect the incidence of NEC found in neonatal rat pups?

Increases the incidence of NEC

Has no effect on the incidence of NEC

Decreases the incidence of NEC

E. coli 07:K1 has no correlation with NEC in neonatal rat pups

25. Several racial disparities have been identified with respect to outcomes and access to care in patients undergoing joint arthroplasty and spine surgery. Which of the following is true with regards to patients presenting for elective sports medicine procedures?

African American patients have lower pain scores and higher patient reported outcomes when compared to Caucasian patients

Female patients have higher pain scores and decreased patient reported outcomes when compared to male patients

Half of all patients presenting for hip arthroscopy are African American

26. How can resident assessment of surgical performance be improved?

It cannot

It can incorporate error analysis

Using resident interviews

Surveying resident perceptions

27. Which of the following states best describes cervical neuroblastic tumors?

Cervical neuroblastic tumors are generally unfavorable lesions compared to abdominal tumors

A minimally aggressive approach is recommended in treating patients with cervical neuroblastic tumors

Gross total resection of cervical neuroblastic tumors results in an exceedingly low rate of complication

Cervical neuroblastic tumor outcomes are similar to those of abdominal neuroblastic tumors

28. With the increased use of minimally invasive distal pancreatectomy (MIDP), what is the association between MIDP and usage of adjuvant chemotherapy?

The use of adjuvant chemotherapy has increased

The use of adjuvant chemotherapy has decreased

The use of adjuvant chemotherapy has remained the same

There is no statistically significant association between the two

29. In our study, "Cigarette Smoke Induces Microrna-145 Dysregulation During Esophageal Carcinogenesis" exposure of EACs to cigarette smoke led to which of the following microRNA alterations?

Increase in endogenous levels of miR-145

Decrease in endogenous levels of miR-145

Increase in endogenous levels of miR-487b

Decrease in endogenous levels of miR-372

30. A 55 year old was the unrestrained driver in a motor vehicle accident. What is the most likely cause of death associated with blunt trauma?

Aortic rupture

Chest trauma

Intra-abdominal hemorrhage

Traumatic Brain Injury

31. What variables are associated with decreased fall related mortality?

Elevated BAL

Previous admission to trauma center

Black race

Male sex

32. What hospital characteristic is associated with higher DCD rates (>10%)?

Teaching hospital

Non-profit hospital

Level I/II Trauma Center

Level III/IV/V Trauma Center

Stroke Center

33. Racial/Ethnic differences in longer-term outcomes among adult and older adult emergency general surgery (EGS) patients were found:

Concentrated in high-volume centers and those managing the highest percentages of minority patients

Among adult but not older adult EGS general population patients

Concentrated in low volume centers and those managing the lowest percentages of minority patients

34. The most significant predictor of readmission in thyroid and parathyroid patients is:

Black race

Thyroid Cancer

Self-Pay Insurance status

Secondary Hyperparathyroidism

35. What are the effects of NFkb signaling on bone?

Decreased Bone Loss

Increased Bone Loss

Bone Neoplasia

Increased Cartilage Growth

36. What are the targets for Vorinostat in HCC?

Vorinostat inhibits histone deacetylase activity

Vorinostat targets signaling pathways

Vorinostat is an anticarcinogen

Vorinostat is an acetylase inhibitor

37. The most common significant adverse effect of Liposomal Bupivacaine is:

Somnolence

Tinnitus

Blurred vision

Nausea

Incision site edema

38. A patient presents to your clinic with T1a thyroid cancer. Which of the following factors has a statistically significant association with RAI use?

Increasing patient age

Lower income

Lack of health insurance

Negative surgical margins

39. A 67 year old African American male presents with stage II melanoma. Based upon his race what is his Hazard Ratio for death?

0.8

1.4

2.5

4.0

40. What is the most common free flap utilized for head and neck reconstruction?

Anterior Lateral Thigh (ALT) flap

Radial Forearm Free flap

Rectus free flap

Gracilis free flap

41. After bone marrow transplant, immune system recovery occurs within six months to a year. What is the median time from bone marrow transplant to surgical consultation?

Thirty days

Three months

Ten months

One year

42. A 2 year old girl presents to the ED for a non-accidental trauma work-up. On skeletal survey, which structure has the lowest likelihood of being injured?

Skull

Cervical Spine

Ribs

Pelvis

Femur

43. A patient with a history of hepatocellular carcinoma who underwent a liver transplant is readmitted into the hospital. Which of the following statements concerning mortality is true?

The patient will have Increased 90 day mortality

The patient will have Reduced 30 day mortality

The patient will have Reduced overall survival

The admission is Not associated with mortality

44. Our pilot study demonstrated an increase in ICU Palliative Medicine referrals by:

Consulting Palliative Medicine for all ICU patients

Having Palliative Medicine round daily with the ICU multidisciplinary team

Utilizing a nurse-initiated screening tool based on specific "triggers"

Waiting for the patient to ask for a referral

45. The abstract states that repeated assessments and modification of scenario difficulty affected perceptions of skills decay and difficulty. Which of the following choices correctly reflects the differences between returning and first time participants in regards to the participants' confidence levels after urinary catheterization procedure?

First time participants were more confident than returning participants

First time participants and returning participants had similar confidence levels

First time participants were less confident than returning participants

Both first time participants and returning participants had decrease level of confidence

46. When adjusting for type II diabetes mellitus, hypertension, obesity, and hypercholesterolemia, blacks had a higher in-hospital and operative mortality compared to whites for:

CABG Procedures

Valve Procedures

CABG and Valve Procedures

ECMO Cannulation

There was no difference appreciated

47. The knockdown of IMP3 protein had what effect on tumor characteristics when knockdown renal cancer cells were injected into the tibia of nude mice and allowed to grow as tumors?

Increased vascularity compared to wild-type tumor cells

Decreased vascularity compared to wild-type tumor cells

Increased tumor growth

Decreased tumor growth

48. Palliative care consultations are more common in :

African- Americans

Caucasians

Asians

Latinos

Patients with complications of care

49. What was the rate of reduction in re-excision procedures associated with the transition from full cavity shavings to directed shavings guided by MarginProbe device?

6.0%

57%

No reduction

32%

50. Following blunt traumatic hemorrhagic shock, compared to females, male patients have a higher:

Length of hospital stay

Mortality

Incidence of myocardial infarction

Incidence of abdominal compartment syndrome

51. The following hospital characteristics are associated with patients being readmitted at non-index hospitals except:

Bed size less than 200

Non-trauma center

Absence of ICU facilities

Location in rural areas

52. As it relates to disparities in the application of therapies for cardiovascular care which of the following statements is false?

African Americans are more likely to receive AICD implantation when indicated than whites

African Americans are less likely to undergo emergent coronary reperfusion in acute STEMI than whites

African Americans are less likely to receive complex lower extremity revascularisation procedures than whites

53. Compared to counties with dissimilarity indices less than 40, counties with dissimilarity indices of 60 and above were associated with:

Lower transplant rates among White and Black residents

Higher transplant rates among White but not Black among residents

Higher transplant rates among Black but not among White residents

Higher transplant rates among White and Black residents

54. What is the proposed mechanism of action by which Trx1 may work to protect heart function?

By 3-nitrotyrosine signaling

By HO1 activation and downregulation of TXNIP

By inhibiting various inflammatory mediators such as IL-1B and TNF-a

There was no mechanism provided for Trx-1

55. Which racial/ethnic group is associated with higher odds of undergoing a laparoscopic as opposed to open elective surgery to treat diverticulitis?

White

Black

Hispanic

Asian

56. A 65 year old underwent an anatomic pulmonary valve replacement. In comparison to pulmonary valve replacement with a trans-annular patch which of the following post-operative outcomes is not expected to improve?

Prosthetic Valve Regurgitation

Ease of cardiac reoperation

Risk of ventricular arrhythmias

Right ventricular function

57. Decentralized cardiovascular care in Rwanda appears to yield or optimize:

Social and economic benefit among patients who have undergone cardiac surgery

Psychological and spiritual well- being among patients who have undergone cardiac surgery

Medication compliance among patients who have undergone cardiac surgery

Higher educational value among patients who have undergone open cardiac surgery

58. A 78 year old African American male with history of COPD and Diabetes mellitus is brought to the emergency room with severe burns to his face and upper body after lighting a cigarette while on oxygen. The family is at the bedside and wants to know his prognosis. Based on history, which statement is correct?

The presence of preexisting comorbidities has a positive effect on mortality

The presence of preexisting comorbidities has a negative effect on mortality regardless of age

The presence of preexisting comorbidities increases mortality

59. An African American male patient presents with early stage lung cancer. Based upon his race what is his rate for surgery?

20%

12.7%

76.5%

50%

60. Patient X is a 48 year old African American woman who underwent mastectomy. Which of the following statements are false as it relates to immediate breast reconstruction?

Women >45 have IBR at lower rates

Non-Caucasian women have IBR at lower rates

Obese women had a lower risk of surgical complications

She will have a greater risk of Surgical site wound infection than a Caucasian woman of the same age

61. Which group of patients, based on their income bracket, would be expected to have the greatest resolution of diabetes and hypertension post weight loss surgery?

$38,515-62,434

$62,435-101,577

>$101,578

Equal for each group

62. A 40 yo male presents for bariatric surgery. He reports to his surgeon that he is HIV+. Which of the following statements are true?

HIV (+) patients undergoing bariatric operations have a higher mortality rate, compared to HIV (-) patients

Percent excess weight loss is similar between HIV (+) and HIV (-)patients following bariatric surgery

Measures of HIV disease progression does not worsen with weight loss following bariatric surgery

Following bariatric surgery, HIV (+) patients experience similar rates of improvement in obesity-related comorbid conditions as HIV (-) patients