اسئلة الجراحة 2017 (2)

 1) At which level , end of the spinal cord ?
A)Forth lumbar vertebrae
B)L3_L4 interspace
C ) Second lumbar vertebrae
D) T12_L1 interspace
E) S2_S3 interspace



2) 20 years old woman with a bloody single duct discharge and a palpable mass at the areola no malignant cells are isolated from discharge the likely diagnosis is ?
Ductal carcinoma
Duct ectasia
Intraductal papilloma
Prolactinoma
Periductal mastitis


 3) Which of the following statement about the anatomy of the esophagus is correct ?
A . The cervical esophagus passes behind and to the right of the trachea .
B . The esophagus deviates anteriorly and to the left as it enters the abdomen .
C. The thoracic esophagus enter the posterior mediastinum anteriorly to the aortic arch .
D . The thoracic esophagus passes behind the right mainstem bronchi and the pericardium .
E . The esophagus enters the Diaphragmatic hiatus at the level of T8


4) The most common type of intracranial hemorrhage ?
Extradural
Subdural
Subarachnoid
Intracerebral
Intraventricular

5) A 50 years old man is admitted to hospital with severe bleeding and bruising . He is on warfarin and INR is 10 , for rapid complete reversal the best is ?
Platelets
FFP and vitamin K
IV vitamin K
Whole blood and vitamin K
FFP and vitamin C


6) Most common hernia in females is ?
Femoral hernia
Umbilical hernia
Obturator hernia
Direct inguinal hernia
Indirect inguinal hernia


7) A 73 years old man known of IHD presented complaining of severe abdominal pain , ABGs shows PH = 7.3 , PCO2 = 25 mmHg , PO2 = 73 mmHg , HCO3 = 14 mmol / L , BE = _ 15.9 , the diagnosis is ?
A. Metabolic acidosis
B . Metabolic acidosis with respiratory compensation .
C . Respiratory acidosis .
D . Respiratory acidosis with metabolic compensation .
E . Metabolic and respiratory acidosis mixed

8) Allen's test is used to examine ?
Suppurative tenosynovitis
Thoracic outlet syndrome
Dislocated HIP
Nerve supply the upper limb
Blood supply of the hand

9) The preferred operation for initial management of a thyroid nodule that is considered suspicious of malignancy by FNAB is ?
Nodule excision
Partial lobectomy
Total thyroidectomy
Near total thyroidectomy
Total lobectomy and isthmusectomy

10) Acute appendicitis is most commonly associated with which of the following signs ?
A . Temperature above 40 Celsius .
B . Frequent loose stools .
C . Anorexia , abdominal pain , RLQ tenderness .
D . WBC count > 20.000 per cu ml .
E . None of above .


11) Which of the following statements is true about drug therapy for Crohn disease ?
A . Corticosteroids effective treat acute attack and to prolong remission .
B . Sulfasalazine for Acute attack involving small bowel .
C . Azathioprine and immunosuppressive drugs for remission .
D . Low dose Cyclosporine for patients with both low and high disease activity .
E . All of the above .

12) Hyperthyroidism can be caused by all except ?
Medullary thyroid cancer
Gravis disease
Plummer disease
Struma ovarii
Hashimoto disease

13) A major bleeding in the thigh is best controlled in emergency room by ?
A . Tourniquent
B . Direct compression by hand .
C . Exploration under local anesthesia and clamp
D . Exploration and ligation under local anesthesia .
E . Send to operating room for exploration under general anesthesia .
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14) Which of the following is associated with increased risk of development of breast cancer ?
Fibrocystic mastopathy
Atypical hyperplasia
Severe simple hyperplasia
Papillomatosis
Hypertrophy of glandular tissues


15) Post mastectomy and axially clearance for a patient with breast cancer , the patient was found to have a winged scapula , the most likely cause ?
A . Patient suffered a TIA .
B . Damage to thoracodorsal nerve during surgery .
C . Damage to long thoracic nerve during surgery .
D . Damage to serratus anterior muscle .
E . Dislocated scapula .
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16) One is false?
A . Femoral artery is lateral to femoral vein in the inguinal area .
B . Femoral nerve is present within the femoral sheath .
C . Femoral triangle is bounding by Sartorius muscle laterally .
D . Siatic nerve injury can be avoided by giving im injection on the upper lateral quadrant on the gluteal area .
E . Great saphenous vein drain to femoral vein below the inguinal ligament .

17) The principal blood supply to the parathyroid glands is by ?
A . Superior thyroid arteries
B . Inferior thyroid arteries
C . Thyroid ima arteries
D . Parathyroid arterial branches from external carotid arteries .
E . Highly variable


18) Most common cause of goitrous hypothyroidism in adults ?
Hashimoto disease
Gravis disease
Riedel thyroiditis
De quervain thyroiditis
Iodine deficiency

19) The first step in management hypercalcemia is ?
IV hydration normal saline 0.9%
Hydrocortisone
Dialysis
Administration of Furosemide
Administration of mithramycin

 20) All predispose to necrotizing fasciitis except ?
DM
Severe head injuries
Cortisone therapy
Advance malignancy
Renal failure


21) The most precise diagnostic screening procedure for differentiating benign thyroid nodules from malignant ones is ?
Thyroid ultrasonography
Thyroid scintision
Thyroid hormone suppression
FNAB
CT scan

22) All are risk factors for breast cancer except ?
Non smoker female
Artificial induced menopause
Unbalanced HRT
Nulliparity
Obesity

23) All are true about caludication pain except ?
Increased by night time
Not postural
ABI < 0.9
Increased with exertion


24) All are true about burns except ?
A . Blisters , hair follicles presents _ super facial partial thickness .
B . No pain , hard leathery eschar , black grey_ white color _ full thickness .
C . Best IV solution is normal saline .
D . Circumferential burns require emergency Escharotomy .
E . Prognosis best determined by burn size ( TBSA )

25) All are true about warthin tumor except ?
A . Benign cystic tumor of the salivary glands .
B . Malignant potential 20%
C . Smoking is a major risk factor
D . Slowly growing painless mass at the angel of the mandible
E . Old age 60_70 years male predominance

26) All are true about inflammatory bowel disease except ?
A . Crohn disease frequently presents with abdominal mass .
B . Ulcerative colitis rarely presents with obstruction, fistulizition of GIT .
C . Ulcerative colitis always affect the rectum .
D . ASCA antibodies are positive in Crohn disease .
E . Granulomas on biopsy are presents in ulcerative colitis

27) All are common of neonatal obstruction except ?
Volvulus
Intussusception
Meconium ileus
Annular pancreas
Strangulated inguinal hernia

28) The risk of gallbladder cancer is increased with all of the following except ?
Obesity
Porcelain gallbladder
Merrizi syndrome
Male
Large gallstone compared with small

 29) Which intestinal cells have been implicated in the formation of gastrointestinal stromal tumors ?
Goblet cells
APUD cells
Cajal cells
Paneth cells
G cells

 30) Which of the following is not an indication for surgical intervention in a patient with aortic stenosis ?
Syncope
Angina pectoris
Poor ventricular function
Valve area less than 0.5 cm
Calcification of the stenotic valve

31) Which of the following describes the association between sister Mary Joseph nodule and stomach cancer ?
A. Metastasis left axially lymph node .
B . Metastatic left supraclavicular lymph node
C . Ovarian mass
D . Umbilical metastasis
E . Anterior nodule palpable on rectal exam


32) Bacteremia from which of the following is associated with colon cancer ?
A . Streptococcus bovis
B . Difficile
C . MRSA
D . H pylori
E . Streptococcus viridans

33) Most common site of Volvulus

34) Most common cause of postoperative fever third day

35) Causes of Hypocalcemia

36) Urine output

 37) Dumping syndrome

38) Best diagnostic test of Carcinoid tumor

39) Risk factors for colon cancer

40) Components of Ringer lactate

 41) Glasgow coma scale

42) Wrist drop

43) Thyroid cancer spread by lymph

44) Most common benign tumor in small bowel

45) Most common type of gallstones

 46) BCG vaccine stored in

 47) Drug's causes Pseudomembranous colitis