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SSTEP Clinical Knowledge Exam (3 Month Follow-Up)

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SSTEP Clinical Knowledge Exam (3 Month Follow-Up)
Justin Wang
Quiz by Justin Wang, updated more than 1 year ago
Justin Wang
Created by Justin Wang about 9 years ago
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Resource summary

Question 1

Question
1. Which of the following statements regarding hand hygiene is NOT correct?
Answer
  • Health care workers (HCWs) should clean their hands with an antiseptic-containing agent before and after each contact with a patient
  • The use of soap and water for hand washing is required when hands are visibly soiled with blood or bodily fluids
  • Alcohol-based hand rubs are inferior to antimicrobial soaps for hand decontamination
  • Vancomycin-resistant enterococci are frequently isolated from the hands of HCWs

Question 2

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Question 3

Question
2. Out of the following four indicators, the best clinical sign of successful fluid resuscitation and end-organ perfusion in a patient with hemorrhagic shock is:
Answer
  • An increase in blood pressure
  • An increase in urine output
  • An increase in arterial oxygenation
  • A decrease in tachycardia

Question 4

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Question 5

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3. Technical errors during surgical procedures are MOST likely to occur:
Answer
  • During routine procedures in complex patients
  • In high-complexity operations
  • Due to surgical inexperience
  • Due to inadequate resident supervision

Question 6

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Question 7

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4. In the AD DAVID system for writing post-op orders, the “I” is an abbreviation for 3 things. Of the following, what does the “I” NOT stand for?
Answer
  • Investigations
  • IV
  • “Ins and outs” (intake and output)
  • Irrigation

Question 8

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Question 9

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5. The risk of developing a surgical site infection is dependent on all of the following factors, EXCEPT:
Answer
  • Hyperthermia
  • Immunosuppression
  • Diabetes mellitus
  • Length of operation

Question 10

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Question 11

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6. Of the following, what is NOT considered a phase of normal wound healing?
Answer
  • Proliferation
  • Remodeling
  • Exfoliation
  • Hemostasis and inflammation

Question 12

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Question 13

Question
7. Please choose the CORRECT statement regarding wound healing and closure.
Answer
  • Wound healing via secondary intention leads to improved scar formation and superior cosmetic outcome
  • A contaminated wound from an open fracture should be immediately closed via primary intention
  • Wound healing via primary intention requires manual approximation of wound edges and healing through the normal stages of wound healing
  • Wound healing via tertiary intention is reserved for simple, uncomplicated lacerations

Question 14

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Question 15

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8. With regards to the fundamental principles of antibiotic prophylaxis in surgery, which of the following are INCORRECT?
Answer
  • The antibiotic of choice should be active against organisms usually found at the site of surgery
  • During surgeries that go longer than expected, the antibiotic should be re-dosed to ensure adequate levels
  • The antibiotic should be given 30 minutes prior to the incision
  • The antibiotic should be continued for 7 days post surgery to prevent antibiotic resistance

Question 16

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Question 17

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9. What is NOT a benefit of laparoscopic surgery versus open surgery?
Answer
  • Decreased trauma to the abdominal wall and decreased post-operative scarring
  • Shorter recovery time
  • Decreased post-operative pain
  • Improved tactile sensation of tissues

Question 18

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Question 19

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10. Which of the following is NOT a physiological consequence of routine laparoscopic surgery?
Answer
  • Hypercarbia due to absorption of CO2 used to create a pneumoperitoneum
  • Decreased blood return from the lower body back to the heart
  • Decreased systemic blood pressure
  • Decreased lung volume and residual functional capacity

Question 20

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Question 21

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11. You are preparing to make an abdominal incision for a laparotomy as you suspect your patient has complex perforated appendectomy. What is the correct order of the layers you will cut through, starting with the most superficial layer?
Answer
  • Skin, superficial fascia (Camper’s and Scarpa’s), external oblique, internal oblique, transversus abdominis, transversalis fascia, extraperitoneal fascia, parietal peritoneum
  • Skin, extraperitoneal fascia, superficial fascia (Camper’s and Scarpa’s), external oblique, internal oblique, transversus abdominis, parietal peritoneum
  • Skin, superficial fascia (Camper’s and Scarpa’s), extraperitoneal fascia, external oblique, internal oblique, transversus abdominis, transversalis fascia, parietal peritoneum
  • Skin, extraperitoneal fascia, external oblique, internal oblique, transversus abdominis, transversalis fascia, superficial fascia (Camper’s and Scarpa’s), parietal peritoneum

Question 22

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Question 23

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12. Of the following, what is NOT an indication for chest tube insertion?
Answer
  • Pneumothorax
  • Pulmonary edema
  • Hemothorax
  • Postoperative cardiac surgery

Question 24

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Question 25

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13. Regarding chest tubes, which of the following answers is correct?
Answer
  • If a chest tube needs to be repositioned further into the chest cavity after insertion, simply advance it further as necessary
  • A chest X-ray should ALWAYS be taken to confirm the location of a chest tube
  • Routine chest tubes should be placed in the second intercostal space in the anterior axillary line
  • Prophylactic antibiotics (most commonly cefazolin) are indicated for chest tube insertions to prevent infection

Question 26

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Question 27

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14. A security guard sustains a left thoraco-abdominal stab wound. He is alert, talking, and hemodynamically stable. On examination, his abdomen is soft and non-tender. The most appropriate management would be:
Answer
  • Observation
  • Diagnostic peritoneal tap
  • CT thorax, abdomen, and pelvis
  • Laparotomy

Question 28

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Question 29

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15. A 30-year-old male pedestrian presents with a posterior left knee dislocation after being hit by a car. He has no distal pulses in his left leg. The most appropriate next step in his management would be to:
Answer
  • Take the patient to the operating room
  • Reduce dislocation in the ER
  • Obtain an angiogram
  • Start IV heparin

Question 30

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Question 31

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16. Comparing internal and external fixation, which of the following is true?
Answer
  • Internal fixation is generally preferable for open fractures
  • External fixation makes access for wound care more difficult
  • External fixation is useful in very comminuted fractures
  • Internal fixation is less invasive than external fixation

Question 32

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Question 33

Question
17. A patient is brought into the trauma bay after a high-speed motor vehicle collision.  He has decreased breath sounds on the right with a deviated trachea to the left, a laceration of his left radial artery with pulsatile bleeding, and an obvious deformity of his right thigh with bone protruding through a 7-cm wound.  Which of the following is the most important next step in his management?
Answer
  • Chest tube on the left (5th intercostal space, mid-axillary line)
  • Pressure dressing on the left forearm
  • Sterile dressing on the right thigh wound, antibiotics, tetanus booster
  • Needle thoracotomy on the right (2nd intercostal space, mid-clavicular line)

Question 34

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Question 35

Question
18. Which of the following is true?
Answer
  • Lag screws cause compression, stabilization, and healing mainly through secondary bone healing
  • External fixation causes compression and healing mainly through primary bone healing
  • Casting, splinting, and bracing result in callus formation leading to secondary bone healing
  • Bone plating induces absolutely stability and mainly leads to healing via secondary bone healing

Question 36

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Question 37

Question
19. A primipara is in labour and an episiotomy is about to be cut. Compared with a midline episiotomy, an advantage of mediolateral episiotomy is:
Answer
  • Ease of repair
  • Lower blood loss
  • Less dyspareunia
  • Less extension of the incision

Question 38

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Question 39

Question
20. A patient sustained a laceration of the perineum during delivery. It involved the muscles of perineal body but not the anal sphincter. Such a laceration would be classified as:
Answer
  • First degree
  • Second degree
  • Third degree
  • Fourth degree

Question 40

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Question 41

Question
21. Which of the following statements about episiotomy is FALSE?
Answer
  • Episiotomy incisions are repaired anatomically in layers
  • Mediolateral or lateral episiotomy may be associated with more blood loss than median one
  • Indications for episiotomy include avoiding an imminent perineal tear, the use of forceps, breech delivery, and the delivery of premature infants.
  • In general, the earlier the episiotomy is done during delivery, the more beneficial it will be in speeding up the delivery

Question 42

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Question 43

Question
22. Which is NOT an indication for urethral catheterization?
Answer
  • Chronic obstruction causing hydronephrosis
  • Acute urinary retention (BPH, blood clots, etc.)
  • Traumatic injury to the lower urinary tract causing painful urination
  • Intermittent decompression for neurogenic bladder

Question 44

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Question 45

Question
23. Urethral strictures also occur away from the ureterointestinal anastomosis. These are most commonly found in the _____ ureter.
Answer
  • Left
  • Right
  • Pelvic ureters
  • Infantile

Question 46

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Question 47

Question
24. With regard to acute traumatic subdural hematoma, which of the following is true?
Answer
  • Blood products collect between the inner surface of the calvarium and dura
  • Bleeding usually results from tearing of the bridging veins
  • Cerebral contusions are infrequently seen
  • Burr hole drainage is the surgical treatment of choice

Question 48

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Question 49

Question
25. The most common location for spontaneous intracerebral hemorrhage secondary to hypertension is the:
Answer
  • Cerebellum
  • Cerebral white matter
  • Basal ganglia
  • Brainstem

Question 50

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Question 51

Question
26. Indications for treatment of an unruptured intracerebral aneurysm include all of the following except:
Answer
  • Size >10 mm
  • Symptomatic lesion
  • Two 1st degree relatives with cerebral aneurysms
  • History of subarachnoid hemorrhage secondary to another treated aneurysm

Question 52

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Question 53

Question
27. For local excision, what is generally the best shape to use for ease of closure?
Answer
  • S-Shape
  • Ellipse
  • Rectangle
  • Square

Question 54

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Question 55

Question
28. To minimize scarring, in what orientation should incision lines be placed in reference to the lines of minimal tension?
Answer
  • Circumferential
  • Cross
  • Parallel
  • Perpendicular

Question 56

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Question 57

Question
29. An 8-year-old girl has a 2.5 cm breast mass that is enlarging just beneath her left nipple-areolar complex. Her mother first noticed this mass 2 months previously. Management may include all of the following, EXCEPT:
Answer
  • In-depth history for a review of systemic symptoms
  • Ultrasound imaging
  • Fine-needle aspiration
  • Excisional biopsy

Question 58

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Question 59

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30. A 62-year-old patient comes to clinic with a suspicious 2.0 cm lesion, which characteristic of the lesion would make you want to avoid investigating with a punch biopsy?
Answer
  • Ulcerated
  • Pigmented
  • Rapidly growing
  • Hard horn present

Question 60

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