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This page intentionally left blank Introduction this book has been designed to help you review Questions are stratified into three levels of surgery for both examination and patient manage difficulty: (a) rote memory questions; (b) memory ment. Here in one package is a comprehensive questions that require more understanding of the review with over 1000 multiple-choice questions question; and (c) questions that require understanding with paragraph-length discussions of each answer. This type of question presents a problem or asks a this introduction provides information on question and is followed by five or more choices, question types, question-taking strategies, various only one of which is entirely correct. In some cases (in both types of (A) Polycystic ovary disease questions), a group of two or three questions may (B) An ovarian tumor be related to a situational theme. Some illustrations, however, are included (E) Familial hirsutism mainly for their instructive value in clinical surgical practice. Familial hirsutism is not associated with the (B) Chloramphenicol menstrual irregularities mentioned. If a choice is partially correct, tentatively consider it to be abdominal pain and vaginal discharge due to incorrect. At this point, you may want to quickly scan the Table 2 lists strategies for answering one-best stem to be sure you understand the question and your answer. Your score is based on the number of correct answers, so do not skip any questions. In each of the sections of Lange Q&A: Surgery, Fifth Edition, the question sections are followed by a section containing the answers and explanations for the ques tions. This section: (a) tells you the answer to each question; and (b) gives you an explanation and review of why the answer is correct, background information on the subject matter, and/or why the other answers Introduction xv are incorrect. We encourage you to use this section as more realistic to take the Practice Test after you have a basis for further study and understanding. This If you choose the correct answer to a question, will probably give you a more realistic type of test you can then read the explanation: (a) for reinforce ing situation, because very few of us sit down to a ment; and (b) to add to your knowledge about the test without study. If you choose the wrong answer to a some reviewing (from superficial to in-depth), and question, you can read the explanation for an your Practice Test will reflect this study time. This will be a good indicator of your ini son must be either officially enrolled in or a gradu tial knowledge of the subject and will help to iden ate of a U. If you still have a major weakness, it should essary to complete any particular year of medical be apparent in time for you to take remedial action.
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Besides, it was quite healthful up there, and when in the warmer seasons of the year the side windows all around the dome of the theater were thrown open and sun and fresh air came pouring irresistibly into the dusky vault, it was even beautiful. Otherwise nothing disturbed his seclusion; Page 494 occasionally, perhaps, some theater hand straying through the empty theater of an afternoon gazed thoughtfully up into the great height of the roof, almost beyond eyeshot, where the trapeze artist, unaware that he was being observed, practiced his art or rested. The trapeze artist could have gone on living peacefully like that, had it not been for the inevitable journeys from place to place, which he found extremely trying. Despite so many journeys having been successfully arranged by the manager, each new one embarrassed him again, for the journeys, apart from everything else, got on the nerves of the artist a great deal. Once when they were again traveling together, the trapeze artist lying on the luggage rack dreaming, the manager leaning back in the opposite window seat reading a book, the trapeze artist addressed his companion in a low voice. The trapeze artist, biting his lips, said that he must always in future have two trapezes for his performance instead of only one, two trapezes opposite each other. The manager, watchfully feeling his way, once more emphasized his entire agreement, two trapezes were better than one, besides it would be an advantage to have a second bar, more variety could be introduced into the performance. Yet it took much questioning and soothing endearment until the trapeze artist sobbed: "Only the one bar in my hands how can I go on living! And so he succeeded in reassuring the trapeze artist, little by little, and was able to go back to his corner. But he himself was far from reassured, with deep uneasiness he kept glancing secretly at the trapeze artist over the top of his book. In the distance I heard the sound of a trumpet, and I asked the servant what it meant. What reminded me of a law court more than all the details was a droning noise which could be heard incessantly in the distance; one could not tell from which direction it came, it filled every room to such an extent that one had to assume it came from everywhere, or, what seemed more likely, that just the place where one happened to be standing was the very place where the droning originated, but this was probably an illusion, for it came from a distance. These corridors, narrow and austerely vaulted, turning in gradual curves with high, sparsely decorated doors, seemed to have been created specially for profound silence; they were the corridors of a museum or a library. Because I was searching for an advocate everywhere; he is needed everywhere, if anything less in court than elsewhere, for a court, one assumes, passes judgment according to the law. If one were to assume that this was being done unfairly or frivolously, then life would not be possible; one must have confidence that the court allows the majesty of the law its full scope, for this is its sole duty. Within the law all is accusation, advocacy, and verdict; any interference by an individual here would be a crime. It is different, however, in the case of the verdict itself; this is based on inquiries being made here and there, from relatives and strangers, from friends and enemies, in the family and public life, in town and village in short, everywhere. Here it is most necessary to have advocates, advocates galore, the best possible advocates, one next to the other, a living wall, for advocates are by nature hard to set in motion; the plaintiffs, however, those sly foxes, those slinking weasels, those little mice, they slip through the tiniest gaps, scuttle through the legs of the advocates. But I have not found any as yet, only those old women keep on coming and going; if I were not on my search it would put me to sleep. I ought to be in a place where all kinds of people meet, from various parts of the country, from every class, every profession, of all ages; I ought to have an opportunity of choosing carefully out of a crowd those who are kind, those who are able, and those who have an eye for me. Perhaps the most suitable place for this would be a huge fairground; instead of which I am hanging about in these corridors where only these old women are to be seen, and not even many of them, and always the same ones, and even those few will not let themselves be cornered, despite their slowness; they slip away from me, float about like rain clouds, and are completely absorbed by unknown activities.
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Opposite us on the other side of the avenue stood two bushes and down below these bushes was the town. Young healthy people sat in the garden at tables with beer and talked of hunting and adventures. Then he took off his hat and I saw his hair which, scented and beautifully combed, set off the round head on a fleshy neck in a sharp curving line, as was the fashion that winter. As though our sorrow had darkened everything, we sat high up on the mountain as in a small room, although a little earlier we had already noticed the light and the wind of the morning. I pulled out the knife, cut up the sleeve of his overcoat and jacket, tore his shirt sleeve open. Then I ran a little way up and down the road to see if there was anyone who could help. I ran up the steps leading to the upper lawn on the left side of the house, quickly examined the windows and doors, rang the bell furiously, and stamped my feet, although I knew all the time that the house was uninhabited. Oh yes, believe me, I beg you, and the sun will show you off to everyone at your best. On the pavement straight in front of him there were many people walking in various rhythms. The one held his hands palm-upward, raising and lowering them in regular motion, as though he were balancing a load. Then one caught sight of a lady whose hat was heavily laden with ribbons, buckles, and flowers. And hurrying past was a young man with a thin walking stick, his left hand, as though paralyzed, flat Page 74 on his chest. Now and then there came men who were smoking, bearing small upright elongated clouds along ahead of them. Three gentlemen two holding lightweight overcoats on their crooked forearms several times walked forward from the front of the buildings to the edge of the pavement, surveyed what was going on there, and then withdrew again, talking. Through the gaps between the passers-by one could see the regularly laid stones of the carriageway. There carriages on delicate high wheels were drawn along by horses with arched necks. The people who sat at ease on the upholstered seats gazed silently at the pedestrians, the shops, the balconies, and the sky. The animals tugged at the shafts, the carriage bowled along, swaying as it gathered speed, until the swerve around the carriage ahead was completed and the horses moved apart again, only their narrow quiet heads inclined toward each other.
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