اسئلة الجراحة 2016 (1)
1) All of the following are true except ?
A . The best test for platelet function is bleeding time .
B . FFP is the most effective way to acutely correct INR .
C . Factor 8 is synthesized in the liver .
D . Calcium is required for normal coagulation .
2) All are true statement except ?
A . The most predominant cell at day 3_4 after a wound is macrophages .
B . The most predominant cell in the first 24 hours of the wound is PMN .
C . The order of cell arrival in wound is macrophages , platelets , PMNs , fibroblasts .
D . The most predominant cell type in a 7 day old wound is fibroblasts .
3) The principle cells involved in acute organ rejection is ?
A .B_cell .
B . T_cell .
C . Macrophages .
D . Platelets .
E . Monocyte .
4) The appendiceal artery is a branch of ?
A . Right colic artery .
B . Middle colic artery .
C . Left colic artery .
D . Ileocolic artery .
E . Hypogastric artery .
5) The most common presentation for Appendiceal adenocarcinoma is ?
A . Acute appendicitis .
B . Ascites .
C . Chronic anemia .
D . Palpable abdominal mass .
E . Incidental finding .
6) All of the following are considered risk factors for breast cancer except ?
A . Obesity .
B . Hx of ovarian cancer .
C . Hx of endometrial cancer .
D . Multiparity .
E . Late menopause .
7) Coarctation of the aorta most commonly occur in ?
A . Ascending thoracic aorta .
B . Transverse thoracic aorta .
C . Thoracic aorta just proximal to left Subclavian artery .
D . Thoracic aorta just distal to left Subclavian artery .
E . Descending thoracic aorta just above diaphragm .
8 ) Which of the following is not an indication for surgical intervention in a patient with aortic stenosis ?
A . Syncope .
B . Angina pectoris .
C . Poor ventricular function .
D . Valve area less than 0.5 cm2 .
E . Calcification of the stenotic valve .
9) A 65 year old female presents with a massive lower GIT bleeding . In ER BP 80/40 , HR 120 BPM . After fluid resuscitation the blood pressure 120/80 , HR 100 . A Nasogastric tube aspirate is negative for blood. The best next step is ?
A . Mesenteric Arteriography .
B . Upper GI endoscopy .
C . Exploratory Laparotomy .
D . Lower GI endoscopy .
E . Observation .
10) Which of the following is true regarding ulcerative colitis and colon cancer ?
A . The risk of cancer unrelated to the extent of inflammation .
B . The malignancy typically develops in a polyp .
C . The risk of cancer related to disease duration .
D . Random endoscopy and biopsies ineffective .
E . CEA level are useful Guid _ when to perform a colonoscopy .
11) A 65 year old man presents with a 2 day history of left quadrant abdominal pain , nausea , low grade fever . Temperature 39 , WBC 14000 , localized moderate left lower quadrant pain . The best next step in management ?
A . NG tube .
B . IV antibiotics .
C . Flexible sigmoidscopy .
D . Barium Enema
E . Gastrograffin enema
12) In female patients with a family history of HNPCC , which of the following is recommended beginning at age 25 . In addition to screening colonoscopy ?
A . Annual mammography
B . Annual CT abdomen
C . Annual endometrial biopsy
D . Annual ovarian ultrasound
E . Annual brain CT
13) A 63 year old man is restless and ataxic and has tonic spasms . Serum osmolality 330 mosm/kg . The most likely diagnosis ?
A . Hyponatremia
B . Hypercalcemia
C . Hyperkalemia
D . Hypernatremia
E . Hypermagnesemia
14) Which of the following statement about esophageal leiomyoma is false ?
A . It is the most common benign esophageal neoplasm .
B . Most common sites middle and lower third
C . They have risk of malignant degeneration
D . Preoperative endoscopic biopsy should be done .
E . Treatment of choice is endoscopic enucleation
15) Jaundice with absent urine urobilinogen is most likely consist with ?
A . Hepatitis
B . Cirrhosis
C . Hemolysis
D . Biliary obstruction
E . Sepsis
16) Management of nasopharyngeal carcinoma consist primarily by ?
A . Radiation
B . Chemotherapy
C . Surgical excision
D . Combined chemo_radio
E . Combined chemo_radio followed by surgery
17) Barrett esophagus ?
A . It is a congenital anomaly .
B . When diagnosed , should be treated by surgery .
C . Occurs in 5% of patient with Achalasia .
D . More common in females .
E . Presence of intestinal Goblet cells .
18) A 65 year old male presents with a persistent firm lateral neck mass that measures approximately 2.5 cm . The best next step in management is ?
A . Positron emission tomography .
B . CT scan of the head and neck .
C . Fine needle aspiration cytology .
D . Chest radiography .
E . Excision of the neck mass .
19) All are true about carcinoma of the lip except ?
A . 95% of lip carcinoma in the Lower lip .
B . Sun exposure and smoking are risk factors .
C . More common in elderly white men .
D . Radiation therapy is the treatment of choice .
E . The majority presents as ulcerative lesion .
20) Which of the following is true regarding Mallory Weiss syndrome ?
A . Spontaneous perforation of the esophagus .
B . Forceful vomiting followed by hematemesis .
C . It's usually associated with air in the mediastinum .
D . Endoscopy is contraindicated .
E . Prompt surgical management is the best .
21) All are true about salivary glands neoplasms except ?
A . Mostly arise in the Parotid gland .
B . Warthin tumors are the second most common benign salivary glands tumor and strongly related to smoking .
C . Mucoepidermoid carcinoma is the most common malignant salivary glands tumor .
D . Pleomorphic adenoma does not undergo malignant degeneration .
E . Minor salivary glands tumor are more likely to be malignant than submandibular gland tumors .
22) The first step in process of hemostasis after vessel injury is ?
A . Platelet adherence
B . Platelet aggregation
C . Vasoconstriction
D . Release of thromboxane
E . Thrombus activation
23) The most useful laboratory test to assess risk of bleeding and response to therapy in patient with Uremia is ?
A . Bleeding time
B . Platelet count
C . INR
D . PTT
E . Thrombin time
24) Which of the following is the best method to prevent a first bleed in a patient with known esophageal varices ?
A .B blockers
B . TIPS surgery
C . Sclerotherapy
D . Endoscopic ligation
E . Nitrate
25) A 45 year old female presents with intermittent vague right upper quadrant pain and jaundice . In addition she notes having floating fatty stool . Ultrasound : gallstone in gallbladder and mass in pancreatic head . The most likely diagnosis ?
A . Vipoma
B . Glucagonoma
C . Somatostatinoma
D . Gastrinoma
E . Insulinoma
26) Which of the following is true regarding esophageal atresia and TE fistula ?
A . The most common type is the H type .
B . It is suspected prenatally by Oligohydramnios .
C . In most cases gastrostomy is required before surgical repair .
D . 20 % of patient have cardiac anomalies .
E . This condition is more in females .
27) Neurogenic thoracic outlet syndrome most common affect which nerve ?
A . Radial
B . Ulnar
C . Median
D . Musclocutaneous
E . Axially
28) Management of pancreatic lymphoma is by ?
A . Pancreaticoduodenectomy
B . Chemotherapy
C . Radiotherapy
D . Pancreaticoduodenectomy followed by radio
E . Chemo_radio therapy
29) A 32 year old woman notes that her hands become cold and painful when exposed to cold temperature . Change in color ( pale _ blue _ red ) , vascular pulse is normal , the best next step in management ?
A . Upper limbs sympathectomy
B . Prostaglandins
C . Fluoxetine
D . Arteriography
E . Diltiazem
30) The initial step in management of SIADH ?
A . Furosemide
B . Hypertonic saline
C . Demeclocycline
D . Isotonic saline
E . Restriction of free water
31) The most common presentation of Pheochromocytoma ?
A . Excess sweating
B . Palpitations
C . Chest pain
D . Headache
E . HTN
32) The first biochemical abnormality detected in the majority of patient with MEN1 ?
A . Hypoglycemia
B . Hyperchloremia
C . Hypocalcemia
D . Hypercalcemia
E . Polycythemia
33) The organism most common associated with acute mesenteric Lymphadenitis is ?
A . Campylobacter jejuni
B . E coli.
C . Enterococcus
D Yersinia enterocolitica
E . Pinworms
34) All are true about Crohn disease except ?
A . It's more common in individual of low socio-economic status .
B . It's most common primary surgical disease of the small bowel .
C . It's more common in smokers .
D . Early sign is aphthous ulcer
E . Extensive mesenteric fat wrapping
35) Diagnosis of Carcinoid syndrome is best by ?
A . Serum Serotonin level
B . Serum substance P levels
C . 24 hour urinary 5_HIAA
D . Serum Neurotensin levels
E . Serum Neurokinin A levels .
A . Associated with Radiation , alcoholism , Fanconi anemia , Amyloidosis , HIV infection .
B . Complicated with sepsis with encapsulated bacteria .
C . Complicated by Thrombocytosis and Leucocytosis .
D . Howell Jolly bodies in RBCs are absent on blood film .
E . It can occur in the presence of enlarge spleen
37) The most sensitive and specific diagnostic test for Gastrinoma is ?
A . Octreotide scan
B . Fasting serum gastrin
C . Calcium stimulation test
D . Secretin stimulation test
E . Basal and stimulated gastric acid outputs
38) The treatment of choice for high grade primary gastric lymphoma ?
A . Total gastrectomy
B . Subtotal gastrectomy
C . Chemo_radio therapy
D . Total gastrectomy followed by chemotherapy
E . Radiation therapy
39) Cryoprecipitate contains high concentrations of all of the following except ?
A . Fibrinogen
B . Factor 8
C . VWF
D . Fibronectin
E . Factor 11
40) All are true about malignant tumors of the small bowel except ?
A . Adenocarcinoma most commonly in the duodenum .
B . Adenocarcinoma and Carcinoid are the most common types .
C . Gastrointestinal stromal tumors are associated with acquired immunodeficiency syndrome .
D . Lymphoma most commonly in the Ileum .
E . Majority of small bowel malignancy are treated surgically
41) The best test to confirm eradication of H pylori after treatment is ?
A . H pylori serology
B . Urea breath test
C . Histologic biopsy
D . Rapid urease test
E . Antral mucosal biopsy and culture
42) Which of the following antibiotics can cause Red man syndrome if given Rapid IV ?
A . Clindamycin
B . Gentamicin
C . Ciprofloxacin
D . Levofloxacin
E . Vancomycin
43) The body response to hypothermia includes all of the following except ?
A . Decreased platelet function
B . Decreased cardiac output
C . Tachycardia
D . Cardiac arrhythmia
E . Increased risk of wound infection
44) Abdominal compartment syndrome should be suspected when bladder pressure exceed ?
A . 10 cm H2o
B . 25 cm H2o
C . 35 cm H2o
D . 40 cm H2o
E . 50 cm H2o
45) After excision of multiple lipomas under anaesthesia . A 42 year old male seizes . The surgeon should be aware that the maximum safe dose of local anesthetic in 70 kg patient ?
A . 10_20 ml 1% lidocaine .
B . 40_50 ml 2% lidocaine with epinephrine .
C . 40_50 ml 1% lidocaine with epinephrine .
D . 40_50 ml 0.5% lidocaine
E . 40_50 ml 1% lidocaine without epinephrine
46) All are true about Peutz_Jeghers syndrome except ?
A . Typical small bowel lesion adenomatous polyps .
B . It's autosomal dominant .
C . Small bowel obstruction is the most common presentation .
D . There is increased risk of small bowel cancer .
E . There is increased risk of breast cancer .
47) After splenectomy for trauma the optimal timing for administration of the pneumococcal vaccine is postoperative day ?
A . 1
B. 4
C . 7
D . 10
E . 14
48) All of the following are true about TTP except ?
A . It does not lead to Hemolysis .
B . The Coombs test is negative .
C . Lower limbs petechiae are the most common presentation .
D . Seizures and coma are common complications .
E . The first line of treatment is plasma exchange .
49) Which of the following describes the association between Sister Mary Joseph nodule and stomach cancer ?
A . Metastatic left axiallary lymph nodes .
B . Metastatic left supraclavicular lymph node .
C . Ovarian mass .
D . Umbilical metastasis .
E . Anterior nodule palpable on rectal exam .
50) Peripheral neuropathy with prolonged use is most commonly associated with ?
A . Clindamycin
B . Metronidazole
C . Ciprofloxacin
D . Gentamicin
E . Vancomycin
51) Bacteremia from which of the following organism is associated with colon cancer ?
A . Streptococcus bovis
B . C difficile
C . MRSA
D . H pylori
E . Streptococcus viridans
52) Most common cause of SVC syndrome ?
A . Radiation therapy
B . Malignancy
C . Infections
D . Idiopathic
E . Post central line insertion
53) Small cell lung carcinoma is managed by ?
A . Chemotherapy followed by surgery .
B . Surgical resection .
C . Radiation therapy .
D . Combination chemo_radio therapy .
E . Radiotherapy followed by surgery .
54) All of the following are true regarding blood supply to the thyroid , parathyroid glands except ?
A . The parathyroid glands are usually supplied by the superior thyroid arteries .
B . The superior thyroid artery is the first branch of the external carotid artery .
C . The recurrent laryngeal nerves are at risk of injury during ligation of the inferior thyroid arteries .
D . The external branch of the superior laryngeal nerve is at risk of injury when the superior laryngeal arteries are ligated .
E . The thyroidea ima artery usually arises from the aorta .
55) A 60 year old male smoker presents with radicular right arm pain . A chest radiograph reveals a bulky mass in the posterior apex of the chest in the superior sulcus . All of the following are commonly associated with this mass except ?
A . Ptosis
B . Right eye miosis
C . Right facial anhidrosis
D . Right eye exophtalmus
E . Non small cell lung cancer
56) A patient presents with fatigue and bone pain . Serum calcium level is 11.1 mg/dl , PTH is elevated . The best next step is ?
A . Operative exploration
B . Neck CT scan
C . Technetium 99m sestamibi imaging
D . MRI
E . Ultrasound scan
57) Factors related to increased risk of thyroid cancer include all of the following except ?
A. Family history
B . Hx of radiation
C . Smoking
D . Female
E . Low iodine diet
58) All of the following are true regarding head injury except ?
A . Epidural hematoma are associated with lucid interval .
B . Subdural hematoma are due to laceration of bridging veins .
C . Epidural hematoma are usually associated with a skull fracture .
D . CT scan shows convex lens hematoma in epidural hematoma .
E . Epidural hematoma generally have a worse prognosis than Subdural hematoma .
59) Which of the following is the most common risk factor for spontaneous venous thromboembolism ?
A . Antithrombin 3 deficiency
B . Factor 5 Leiden
C . Protein C deficiency
D . Protein S deficiency
E . Antiphospholipid syndrome
60) All are true about Achalasia except ?
A . It can be congenital or acquired .
B . In young patient , myotomy is the best treatment .
C . CCB exacerbate this condition .
D . Caused by neurogenic degeneration .
E . Dysphagia , regurgitation , weight loss .
61) Which of the following is least likely associated with Hyperparathyroidism ?
A . Cholelithiasis and urolithiasis .
B . Acute pancreatitis .
C . Osteitis fibrosa cystica
D . Diarrhea
E . PUD
62) A 30 year old man is brought into the emergency room after 20 foot fall . He is noted to speak using inappropriate words . He with draws and open his eyes to pain only , Glasgow coma scale score is ?
A .10
B .9
C .8
D .7
E .6
63) Trauma patients are at highest risk of venous thromboembolism is ?
A .Head trauma
B .Femur fracture
C .Pelvic fracture
D .Splenectomy
E .Spinal cord injury
64) All are true about Bochdalek hernia except ?
A . It is type of congenital Diaphragmatic hernia .
B . Newborn presents with respiratory distress at birth .
C . It is more common in left side .
D . It is associated with intestinal Malrotaion and obstruction .
E . Can result in pulmonary hypoplasia of both lung .
65) The definitive management of Hyperkalemia is ?
A. Calcium chloride
B . Dextrose
C . Dialysis
D . Fluid hydration
E. Salbutamol
66) One of the following is most likely to be present in a patient with severe magnesium deficiency ?
A .Respiratory depression
B .Cardiac depression
C .Tetany
D .Hypotension
E .Loss of patellar reflex
67) Which of the following is an appropriate definition of shock ?
A . Low blood pressure
B . Low cardiac output
C . Low circulating volumes
D . Inadequate tissue perfusion .
E . Abnormal vascular resistance .
A . The best test for platelet function is bleeding time .
B . FFP is the most effective way to acutely correct INR .
C . Factor 8 is synthesized in the liver .
D . Calcium is required for normal coagulation .
2) All are true statement except ?
A . The most predominant cell at day 3_4 after a wound is macrophages .
B . The most predominant cell in the first 24 hours of the wound is PMN .
C . The order of cell arrival in wound is macrophages , platelets , PMNs , fibroblasts .
D . The most predominant cell type in a 7 day old wound is fibroblasts .
3) The principle cells involved in acute organ rejection is ?
A .B_cell .
B . T_cell .
C . Macrophages .
D . Platelets .
E . Monocyte .
4) The appendiceal artery is a branch of ?
A . Right colic artery .
B . Middle colic artery .
C . Left colic artery .
D . Ileocolic artery .
E . Hypogastric artery .
5) The most common presentation for Appendiceal adenocarcinoma is ?
A . Acute appendicitis .
B . Ascites .
C . Chronic anemia .
D . Palpable abdominal mass .
E . Incidental finding .
6) All of the following are considered risk factors for breast cancer except ?
A . Obesity .
B . Hx of ovarian cancer .
C . Hx of endometrial cancer .
D . Multiparity .
E . Late menopause .
7) Coarctation of the aorta most commonly occur in ?
A . Ascending thoracic aorta .
B . Transverse thoracic aorta .
C . Thoracic aorta just proximal to left Subclavian artery .
D . Thoracic aorta just distal to left Subclavian artery .
E . Descending thoracic aorta just above diaphragm .
8 ) Which of the following is not an indication for surgical intervention in a patient with aortic stenosis ?
A . Syncope .
B . Angina pectoris .
C . Poor ventricular function .
D . Valve area less than 0.5 cm2 .
E . Calcification of the stenotic valve .
9) A 65 year old female presents with a massive lower GIT bleeding . In ER BP 80/40 , HR 120 BPM . After fluid resuscitation the blood pressure 120/80 , HR 100 . A Nasogastric tube aspirate is negative for blood. The best next step is ?
A . Mesenteric Arteriography .
B . Upper GI endoscopy .
C . Exploratory Laparotomy .
D . Lower GI endoscopy .
E . Observation .
10) Which of the following is true regarding ulcerative colitis and colon cancer ?
A . The risk of cancer unrelated to the extent of inflammation .
B . The malignancy typically develops in a polyp .
C . The risk of cancer related to disease duration .
D . Random endoscopy and biopsies ineffective .
E . CEA level are useful Guid _ when to perform a colonoscopy .
11) A 65 year old man presents with a 2 day history of left quadrant abdominal pain , nausea , low grade fever . Temperature 39 , WBC 14000 , localized moderate left lower quadrant pain . The best next step in management ?
A . NG tube .
B . IV antibiotics .
C . Flexible sigmoidscopy .
D . Barium Enema
E . Gastrograffin enema
12) In female patients with a family history of HNPCC , which of the following is recommended beginning at age 25 . In addition to screening colonoscopy ?
A . Annual mammography
B . Annual CT abdomen
C . Annual endometrial biopsy
D . Annual ovarian ultrasound
E . Annual brain CT
13) A 63 year old man is restless and ataxic and has tonic spasms . Serum osmolality 330 mosm/kg . The most likely diagnosis ?
A . Hyponatremia
B . Hypercalcemia
C . Hyperkalemia
D . Hypernatremia
E . Hypermagnesemia
14) Which of the following statement about esophageal leiomyoma is false ?
A . It is the most common benign esophageal neoplasm .
B . Most common sites middle and lower third
C . They have risk of malignant degeneration
D . Preoperative endoscopic biopsy should be done .
E . Treatment of choice is endoscopic enucleation
15) Jaundice with absent urine urobilinogen is most likely consist with ?
A . Hepatitis
B . Cirrhosis
C . Hemolysis
D . Biliary obstruction
E . Sepsis
16) Management of nasopharyngeal carcinoma consist primarily by ?
A . Radiation
B . Chemotherapy
C . Surgical excision
D . Combined chemo_radio
E . Combined chemo_radio followed by surgery
17) Barrett esophagus ?
A . It is a congenital anomaly .
B . When diagnosed , should be treated by surgery .
C . Occurs in 5% of patient with Achalasia .
D . More common in females .
E . Presence of intestinal Goblet cells .
18) A 65 year old male presents with a persistent firm lateral neck mass that measures approximately 2.5 cm . The best next step in management is ?
A . Positron emission tomography .
B . CT scan of the head and neck .
C . Fine needle aspiration cytology .
D . Chest radiography .
E . Excision of the neck mass .
19) All are true about carcinoma of the lip except ?
A . 95% of lip carcinoma in the Lower lip .
B . Sun exposure and smoking are risk factors .
C . More common in elderly white men .
D . Radiation therapy is the treatment of choice .
E . The majority presents as ulcerative lesion .
20) Which of the following is true regarding Mallory Weiss syndrome ?
A . Spontaneous perforation of the esophagus .
B . Forceful vomiting followed by hematemesis .
C . It's usually associated with air in the mediastinum .
D . Endoscopy is contraindicated .
E . Prompt surgical management is the best .
21) All are true about salivary glands neoplasms except ?
A . Mostly arise in the Parotid gland .
B . Warthin tumors are the second most common benign salivary glands tumor and strongly related to smoking .
C . Mucoepidermoid carcinoma is the most common malignant salivary glands tumor .
D . Pleomorphic adenoma does not undergo malignant degeneration .
E . Minor salivary glands tumor are more likely to be malignant than submandibular gland tumors .
22) The first step in process of hemostasis after vessel injury is ?
A . Platelet adherence
B . Platelet aggregation
C . Vasoconstriction
D . Release of thromboxane
E . Thrombus activation
23) The most useful laboratory test to assess risk of bleeding and response to therapy in patient with Uremia is ?
A . Bleeding time
B . Platelet count
C . INR
D . PTT
E . Thrombin time
24) Which of the following is the best method to prevent a first bleed in a patient with known esophageal varices ?
A .B blockers
B . TIPS surgery
C . Sclerotherapy
D . Endoscopic ligation
E . Nitrate
25) A 45 year old female presents with intermittent vague right upper quadrant pain and jaundice . In addition she notes having floating fatty stool . Ultrasound : gallstone in gallbladder and mass in pancreatic head . The most likely diagnosis ?
A . Vipoma
B . Glucagonoma
C . Somatostatinoma
D . Gastrinoma
E . Insulinoma
26) Which of the following is true regarding esophageal atresia and TE fistula ?
A . The most common type is the H type .
B . It is suspected prenatally by Oligohydramnios .
C . In most cases gastrostomy is required before surgical repair .
D . 20 % of patient have cardiac anomalies .
E . This condition is more in females .
27) Neurogenic thoracic outlet syndrome most common affect which nerve ?
A . Radial
B . Ulnar
C . Median
D . Musclocutaneous
E . Axially
28) Management of pancreatic lymphoma is by ?
A . Pancreaticoduodenectomy
B . Chemotherapy
C . Radiotherapy
D . Pancreaticoduodenectomy followed by radio
E . Chemo_radio therapy
29) A 32 year old woman notes that her hands become cold and painful when exposed to cold temperature . Change in color ( pale _ blue _ red ) , vascular pulse is normal , the best next step in management ?
A . Upper limbs sympathectomy
B . Prostaglandins
C . Fluoxetine
D . Arteriography
E . Diltiazem
30) The initial step in management of SIADH ?
A . Furosemide
B . Hypertonic saline
C . Demeclocycline
D . Isotonic saline
E . Restriction of free water
31) The most common presentation of Pheochromocytoma ?
A . Excess sweating
B . Palpitations
C . Chest pain
D . Headache
E . HTN
32) The first biochemical abnormality detected in the majority of patient with MEN1 ?
A . Hypoglycemia
B . Hyperchloremia
C . Hypocalcemia
D . Hypercalcemia
E . Polycythemia
33) The organism most common associated with acute mesenteric Lymphadenitis is ?
A . Campylobacter jejuni
B . E coli.
C . Enterococcus
D Yersinia enterocolitica
E . Pinworms
34) All are true about Crohn disease except ?
A . It's more common in individual of low socio-economic status .
B . It's most common primary surgical disease of the small bowel .
C . It's more common in smokers .
D . Early sign is aphthous ulcer
E . Extensive mesenteric fat wrapping
35) Diagnosis of Carcinoid syndrome is best by ?
A . Serum Serotonin level
B . Serum substance P levels
C . 24 hour urinary 5_HIAA
D . Serum Neurotensin levels
E . Serum Neurokinin A levels .
A . Associated with Radiation , alcoholism , Fanconi anemia , Amyloidosis , HIV infection .
B . Complicated with sepsis with encapsulated bacteria .
C . Complicated by Thrombocytosis and Leucocytosis .
D . Howell Jolly bodies in RBCs are absent on blood film .
E . It can occur in the presence of enlarge spleen
37) The most sensitive and specific diagnostic test for Gastrinoma is ?
A . Octreotide scan
B . Fasting serum gastrin
C . Calcium stimulation test
D . Secretin stimulation test
E . Basal and stimulated gastric acid outputs
38) The treatment of choice for high grade primary gastric lymphoma ?
A . Total gastrectomy
B . Subtotal gastrectomy
C . Chemo_radio therapy
D . Total gastrectomy followed by chemotherapy
E . Radiation therapy
39) Cryoprecipitate contains high concentrations of all of the following except ?
A . Fibrinogen
B . Factor 8
C . VWF
D . Fibronectin
E . Factor 11
40) All are true about malignant tumors of the small bowel except ?
A . Adenocarcinoma most commonly in the duodenum .
B . Adenocarcinoma and Carcinoid are the most common types .
C . Gastrointestinal stromal tumors are associated with acquired immunodeficiency syndrome .
D . Lymphoma most commonly in the Ileum .
E . Majority of small bowel malignancy are treated surgically
41) The best test to confirm eradication of H pylori after treatment is ?
A . H pylori serology
B . Urea breath test
C . Histologic biopsy
D . Rapid urease test
E . Antral mucosal biopsy and culture
42) Which of the following antibiotics can cause Red man syndrome if given Rapid IV ?
A . Clindamycin
B . Gentamicin
C . Ciprofloxacin
D . Levofloxacin
E . Vancomycin
43) The body response to hypothermia includes all of the following except ?
A . Decreased platelet function
B . Decreased cardiac output
C . Tachycardia
D . Cardiac arrhythmia
E . Increased risk of wound infection
44) Abdominal compartment syndrome should be suspected when bladder pressure exceed ?
A . 10 cm H2o
B . 25 cm H2o
C . 35 cm H2o
D . 40 cm H2o
E . 50 cm H2o
45) After excision of multiple lipomas under anaesthesia . A 42 year old male seizes . The surgeon should be aware that the maximum safe dose of local anesthetic in 70 kg patient ?
A . 10_20 ml 1% lidocaine .
B . 40_50 ml 2% lidocaine with epinephrine .
C . 40_50 ml 1% lidocaine with epinephrine .
D . 40_50 ml 0.5% lidocaine
E . 40_50 ml 1% lidocaine without epinephrine
46) All are true about Peutz_Jeghers syndrome except ?
A . Typical small bowel lesion adenomatous polyps .
B . It's autosomal dominant .
C . Small bowel obstruction is the most common presentation .
D . There is increased risk of small bowel cancer .
E . There is increased risk of breast cancer .
47) After splenectomy for trauma the optimal timing for administration of the pneumococcal vaccine is postoperative day ?
A . 1
B. 4
C . 7
D . 10
E . 14
48) All of the following are true about TTP except ?
A . It does not lead to Hemolysis .
B . The Coombs test is negative .
C . Lower limbs petechiae are the most common presentation .
D . Seizures and coma are common complications .
E . The first line of treatment is plasma exchange .
49) Which of the following describes the association between Sister Mary Joseph nodule and stomach cancer ?
A . Metastatic left axiallary lymph nodes .
B . Metastatic left supraclavicular lymph node .
C . Ovarian mass .
D . Umbilical metastasis .
E . Anterior nodule palpable on rectal exam .
50) Peripheral neuropathy with prolonged use is most commonly associated with ?
A . Clindamycin
B . Metronidazole
C . Ciprofloxacin
D . Gentamicin
E . Vancomycin
51) Bacteremia from which of the following organism is associated with colon cancer ?
A . Streptococcus bovis
B . C difficile
C . MRSA
D . H pylori
E . Streptococcus viridans
52) Most common cause of SVC syndrome ?
A . Radiation therapy
B . Malignancy
C . Infections
D . Idiopathic
E . Post central line insertion
53) Small cell lung carcinoma is managed by ?
A . Chemotherapy followed by surgery .
B . Surgical resection .
C . Radiation therapy .
D . Combination chemo_radio therapy .
E . Radiotherapy followed by surgery .
54) All of the following are true regarding blood supply to the thyroid , parathyroid glands except ?
A . The parathyroid glands are usually supplied by the superior thyroid arteries .
B . The superior thyroid artery is the first branch of the external carotid artery .
C . The recurrent laryngeal nerves are at risk of injury during ligation of the inferior thyroid arteries .
D . The external branch of the superior laryngeal nerve is at risk of injury when the superior laryngeal arteries are ligated .
E . The thyroidea ima artery usually arises from the aorta .
55) A 60 year old male smoker presents with radicular right arm pain . A chest radiograph reveals a bulky mass in the posterior apex of the chest in the superior sulcus . All of the following are commonly associated with this mass except ?
A . Ptosis
B . Right eye miosis
C . Right facial anhidrosis
D . Right eye exophtalmus
E . Non small cell lung cancer
56) A patient presents with fatigue and bone pain . Serum calcium level is 11.1 mg/dl , PTH is elevated . The best next step is ?
A . Operative exploration
B . Neck CT scan
C . Technetium 99m sestamibi imaging
D . MRI
E . Ultrasound scan
57) Factors related to increased risk of thyroid cancer include all of the following except ?
A. Family history
B . Hx of radiation
C . Smoking
D . Female
E . Low iodine diet
58) All of the following are true regarding head injury except ?
A . Epidural hematoma are associated with lucid interval .
B . Subdural hematoma are due to laceration of bridging veins .
C . Epidural hematoma are usually associated with a skull fracture .
D . CT scan shows convex lens hematoma in epidural hematoma .
E . Epidural hematoma generally have a worse prognosis than Subdural hematoma .
59) Which of the following is the most common risk factor for spontaneous venous thromboembolism ?
A . Antithrombin 3 deficiency
B . Factor 5 Leiden
C . Protein C deficiency
D . Protein S deficiency
E . Antiphospholipid syndrome
60) All are true about Achalasia except ?
A . It can be congenital or acquired .
B . In young patient , myotomy is the best treatment .
C . CCB exacerbate this condition .
D . Caused by neurogenic degeneration .
E . Dysphagia , regurgitation , weight loss .
61) Which of the following is least likely associated with Hyperparathyroidism ?
A . Cholelithiasis and urolithiasis .
B . Acute pancreatitis .
C . Osteitis fibrosa cystica
D . Diarrhea
E . PUD
62) A 30 year old man is brought into the emergency room after 20 foot fall . He is noted to speak using inappropriate words . He with draws and open his eyes to pain only , Glasgow coma scale score is ?
A .10
B .9
C .8
D .7
E .6
63) Trauma patients are at highest risk of venous thromboembolism is ?
A .Head trauma
B .Femur fracture
C .Pelvic fracture
D .Splenectomy
E .Spinal cord injury
64) All are true about Bochdalek hernia except ?
A . It is type of congenital Diaphragmatic hernia .
B . Newborn presents with respiratory distress at birth .
C . It is more common in left side .
D . It is associated with intestinal Malrotaion and obstruction .
E . Can result in pulmonary hypoplasia of both lung .
65) The definitive management of Hyperkalemia is ?
A. Calcium chloride
B . Dextrose
C . Dialysis
D . Fluid hydration
E. Salbutamol
66) One of the following is most likely to be present in a patient with severe magnesium deficiency ?
A .Respiratory depression
B .Cardiac depression
C .Tetany
D .Hypotension
E .Loss of patellar reflex
67) Which of the following is an appropriate definition of shock ?
A . Low blood pressure
B . Low cardiac output
C . Low circulating volumes
D . Inadequate tissue perfusion .
E . Abnormal vascular resistance .
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