اسئلة الجراحة 2017 (1)
1 ) Regarding the preoperative management , all sentences are true except ?
A . A recent MI is the most important risk factor to preoperative MI .
B . Patients should stop taking their regular antihypertensive drugs on the day of surgery .
C . History and examination alone are usually sufficient in evaluating the risk of bleeding .
D . LMWH is used in venous thromboembolism prophylaxis .
E . Poorly controlled blood sugar in the preoperative period increases the risk for surgical site infection .
2 ) In infantile hypertrophic pyloric stenosis, one of the following is false ?
A . The infant usually presents with projectile non bilious vomiting .
B . The treatment is surgical by Ramstedt operation .
C . Symptoms commence at age of 3 _ 4 weeks .
D . A palpable olive shaped mass is usually felt in the epigastric region in the classical case .
E . Usually ultrasound is not sufficient for diagnosis .
3 ) A 62 years old male patient presented with nocturia ( 4 time / night ) , weak stream , intermittency and frequency , his DRE revealed induration of the right lobe of prostate gland , all of the following sentences are true except ?
A . Treat the obstructive symptoms .
B . Perform ultrasound for residual urine assessment .
C . Request blood sample for prostate specific antigen .
D . Unlikely this patient will need biopsy from prostate .
E . His past history and medications have to be checked
4 ) All sentences about wound healing are correct except ?
A . Presence of a foreign body delays the wound healing .
B . The final strength of a healed wound is greater than that of the surrounding skin .
C . The surgical wound of a thyroid operation is considered a clean wound .
D . Staphylococcus aureus is the most common cause of wound infection following surgery .
E . Hand wash and hygiene decrease community and hospital acquired wounds infections .
5 ) A 65 years old gentleman presented to you at the emergency room after road traffic accident complaining of left chest pain , his vital signs were blood pressure 110/50 , HR 100 , RR 20 , GCS 14/15 . One examination , he was found to have diminished breath sounds on the left side . CXR demonstrated opacification of the left hemithorax . What is the most likely diagnosis ?
A . Left hemothorax .
B . Left pneumothorax .
C . Cardiac tamponade .
D . Splenic injury .
E . Left tension pneumothorax .
6 ) All of the following can cause bilious vomiting in an infant or child except ?
A . Intestinal malrotation and volvulus .
B . Pyloric stenosis .
C . Duodenal atresia .
D . Small bowel obstruction .
E . Ulcerative colitis with colonic obstruction
7 ) A 5 year old boy is referred to you as an emergency with right groin and hip pain . All of the following are important differential diagnosis except ?
A . Inguinal hernia .
B . Acute appendicitis .
C . Testicular torsion .
D . Congenital hip abnormality .
E . Sigmoid diverticulitis .
8 ) Regarding breast cancer , all of the following are true except ?
A . Tumor speed to the skin means T4 on TNM classification .
B . Eczema around the nipple should always be investigated .
C . True cut biopsy is more accurate than fine needle aspiration .
D . Bloody nipple discharge is always due to cancer .
E . Metastasis usually involve lung , liver and / or bone .
9 ) The most common presenting symptom in patient with pancreatic cancer is ?
A . Midepigastric pain .
B . Nausea .
C . Malaise .
D . Anemia .
E . Anorexia .
10 ) All of the following are true regarding Hirschsprungs disease except ?
A . There is no ganglion cell's seen in Auerbach plexus .
B . There is increased Incidence of Down syndrome .
C . It is more common in boy's .
D . May be familial .
E . On X_Ray the affected bowel is narrowed proximally while the normal bowel is dilated distally .
11) All sentences about skin cancers are true except ?
A . BCC are faster growing than SCC .
B . Malignant melanoma are the most aggressive skin tumors .
C . SCC is often seen in areas exposed to sunlight such as a scalp and face .
D . Rodent ulcer is a BCC .
E . Marjolin ulcer is a SCC .
12 ) In a patient with hypovolemic shock , which cannula size would you ideally choose for infusion ?
A . 19 G .
B . 21 G .
C . 14 G .
D . 26 G .
E . 30 G .
13 ) Which is not a cause of pancreatitis ?
A . Hypercalcemia .
B . Hypokalemia .
C . Hypertriglyceridemia .
D . Obstruction of ampulla of vater .
E . Thiazides .
14 ) You were the night shift doctor , at the emergency room when a 50 year old gentleman presented to you after a trauma to his abdomen . His vital signs were blood pressure 110/60 , HR 90 , RR 17 , GCS 15/15 . Physical exam his abdomen is soft but tender on the right upper quadrant . What will be your best next step ?
A . DPL .
B . FAST .
C . ICU admission .
D . Call the surgeon for immediate Laparotomy .
E . CT scan of the abdomen .
15 ) All sentences about appendicitis are true except ?
A . Psoas sign is elicited by extension of the right hip .
B . Rovsing sign is elicited by pressing in the left iliac fossa causing pain in the right iliac fossa .
C . Pain is less after laparoscopic compared with open appendectomy .
D . Wound infection is less after laparoscopic compared open appendectomy .
E . In female patients , open approach is preferred over the laparoscopic appendectomy .
16 ) All sentences about trauma are true except ?
A . The term triage is generally used in acute trauma life support ( ATLS ) .
B . The rationale behind triage is for the benefit of the majority .
C . The role of the designated triage person is only to triage and not to treat .
D . The triage process must be constantly repeated .
E . Coma correspond to a GCS of more than 8.
17 ) When total number of death's due to measles is presented in relation to the total case's of measles , it is best labeled as ?
A . Cause specific death rate .
B . Incidence rate .
C . Prevalence rate .
D . Case fatality rate .
E . Proportional mortality .
18 ) Which is not contributory to GCS ?
A . Obey commands .
B . Localizes painful stimuli .
C . Open eyes to calling .
D . Incomprehensible sounds .
E . Pupils size .
19 ) A 30 year old female came to your clinic requesting your opinion about surgery as a treatment for her IBD . Which sentence will you tell her ?
A . Surgery is the primary treatment for Crohn disease .
B . Surgery for ulcerative colitis is curative .
C . Surgery is indicated as prophylaxis for colorectal cancer in Crohn disease .
D . Strictures are common indications for surgery in ulcerative colitis .
E . Recurrence is rare after surgery for Crohn disease
20 ) A 50 year old male felt a pain in his groin after lifting a heavy box . He was advised an operation . During the surgery a hernial sac with a small knuckle of intestine was found protruding just below the inguinal ligament . The hernia was diagnosed as ?
A . Direct inguinal hernia .
B . Indirect inguinal hernia .
C . Incisional hernia .
D . Femoral hernia .
E . Congenital inguinal hernia .
21 ) Imaging in surgery , all are true except ?
A . In abdominal X_Ray , the transverse colon can be seen in various locations in the centre of the abdomen because it is a totally intraperitoneal organ .
B . Gallstones are usually seen on X_Ray .
C . The presence of gas in the small bowel raise the suspicion of bowel obstruction .
D . Ultrasound is better than CT scan for gallstones detected .
E . Ultrasound can assess solid organs better than gas filled organs .
22 ) All of the following sentences about gallstones are true except ?
A . Obesity and bariatric surgery are risk factors for gallstones formation .
B . Cholecystectomy can be performed in pregnant women .
C . Every patient undergoing Cholecystectomy should be consented about bile leak .
D . Extracarporeal shock wave lithotripsy is not an effective treatment for gallstones .
E . Most gallstones are seen on X_Ray .
23 ) Which of the following statement regarding the differentiation of Keloid scar from hypertrophic scar is false ?
A . Keloid scars are most often seen in dark skin people .
B . Hypertrophic scars respond better to treatment than Keloid scars .
C . Keloid scars occur when scar cross joints at right angle .
D . Keloid scars outgrow the wound area .
E . Keloid scars have a familial predisposition
24 ) Spot diagnosis to differentiate Lipoma and sebaceous cysts is ?
A . Consistency .
B . Compressibility .
C . Fluctuation .
D . Attachment to deep muscle .
E . Slippery edge of the lipoma and the punctum of the sebaceous cyst .
25 ) All of the following sentences about hernia are true except ?
A . Inguinal hernia is the most common in both females and male's .
B . Incisional hernia is more common after open compared with laparoscopic operation .
C . Open is always better and safer than laparoscopic approach for hernia repair .
D . Divarication of rectus abdominis muscles in elderly does not necessitate surgical repair .
E . Morbidity is increased after emergency compared with elective repair of hernia .
26 ) A 63 years old male presented as emergency with crampy abdominal pain for 4 days and associated with vomiting and abdominal distension and constipation , patient denies weight loss . His past history was only significant for previous open appendectomy and open Cholecystectomy . All of the following sentences are true except ?
A . Abdominal X_Ray ( upright and supine ) can be postponed for few days .
B . It is essential to obtain an upright CXR .
C . Adhesions are possible cause for this condition .
D . Abdominal and groin examination should be carried out to rule out hernia .
E . He should be admitted for IV fluid hydration and electrolyte replacement .
27 ) A 35 years old female patient underwent incision and drainage of a perianal abscess 2 months ago . Now she presented to your clinic with an intermittent pain and smelly discharge from the site of previous surgery . What is the most common problem that would expect and you should check for ?
A . Perianal fistula .
B . Anal fissure .
C . Incontinence .
D . Complication of her hemorrhoids .
E . Necrotizing fasciitis .
28 ) Paget disease of the breast ?
A . Present any where on the breast skin .
B . Usually bilateral .
C . Uncommon breast carcinoma .
D . Bad prognosis .
E . It's diagnosed by mammogram .
29 ) Informed consent for a surgical procedure involves discussion all of the following except ?
A . The main treatment available .
B . The individual benefits and risks associated with each treatment option .
C . Wether the operation is entirely necessary and the effects of possibly not having the procedure at all .
D . It is acceptable not to mention some risks that may upset your patient or his family .
E . It's good idea to have such discussion in the presence of the close relative .
30 ) 10 cases of food poisoning had been reported in hospital . 2 out these developed mild GI symptoms . 4 out these developed moderate dehydration but recovered . The characteristic of the organism of food poisoning that produces the severest form of the disease ?
A . Infectivity .
B . Pathogenicity .
C . Resistibility .
D . Communicability .
E . Virulence .
31) All of the following increase suspicion of malignant thyroid nodule except ?
A . Age less than 20 years .
B . Age more than 60 years .
C . Pain and tenderness .
D . New Onest of hoarseness .
E . Male gender .
32) A 35 years old lady who's otherwise fit and healthy , was admitted via emergency complaining of upper abdominal pain associated with nausea and fever . Her initial blood test showed WBC 16 , HB 12 . What is the best imaging study in this situation ?
A . Abdominal ultrasound .
B . MRCP .
C . ERCP .
D . Endoscopic ultrasound .
E . Abdominal and pelvic computed tomography scan .
33 ) A 70 years old woman presented to the emergency department with 3 days history of worsening abdominal pain , vomiting , constipation . On examination you find that she has abdomen distended , generalized tenderness , high pitched bowel sounds . All of the following are important differential diagnosis except ?
A . Colorectal cancer .
B . Sigmoid diverticulitis .
C . Gastroenteritis .
D . Sigmoid volvulus .
E . Femoral hernia .
34 ) At what age is intussusception most frequent ?
A . Newborns .
B . Preschool .
C . School .
D . Adult .
E . Infants .
35 ) A 40 years old female previously healthy , presented as an emergency with abdominal pain aggravated by fatty meals , associated with yellowish discoloration of her sclera , vomiting , itching , clay color stool and dark urine . No history of weight loss . All are true except ?
A . The cause of dark urine is the increased conjugated bilirubin in urine .
B . The serum liver function tests will most likely shows increase alkaline phosphatase .
C . The serum will most likely show increased level of amylase with decrease level of lipase .
D . The most likely diagnosis in this patient is gallstones and stones in the common bile duct .
E . This patient need admission , painkillers , rehydration IV fluid , antibiotics and arrangement for ERCP .
36 ) A 28 years old lady complains of painful defecation associated with fresh per rectal blood . Possible diagnosis to consider is ?
A . Hidradenitis suppurativa .
B . Dermoid cyst .
C . Pilonidal sinus .
D . Anal fissure .
E . Pruritus ani .
37 ) One of the following is false concerning gastrointestinal stoma ?
A . Patient with colorectal abdominal perianal resection require a permanent stoma .
B . Ileostomy is usually fashioned with aspout to avoid skin irritation .
C . Colostomy is usually constructed in the right iliac fossa .
D . Stoma may be indicated in patients with bowel ischemia .
E . Patients with Ileostomy may be need water and electrolyte replacement by IV route .
38 ) A 25 years old thin and tall man suddenly develops left sided chest pain with cough and dyspnea . Provisional diagnosis is ?
A . Atelectasis .
B . Pulmonary embolism .
C . MI .
D . Bronchopneumonia .
E . Pneumothorax .
39 ) The earliest indication of hypocalcemia is usually ?
A . Tachycardia .
B . Positive Chvostek sign .
C . Carpopedal spasm .
D . Hyperthermia .
E . Tingling of face , nose , hands .
40 ) A 60 years old patient is diagnosed with colorectal cancer , all sentences are true except ?
A . Most cases are sporadic ( not related to inheritance ) .
B . Cure is possible if the disease is localized .
C . Chemotherapy could be given before or after surgery .
D . Bleeding per rectum usually indicates that the cancer in the Cecum .
E . CT scan for chest , abdomen , pelvis is the usual imaging test for staging .
41 ) In a 3 years old boy , painless ballotable mass in the right flank , can be all of the following except ?
A . Wilms tumor .
B . Neuroblastoma .
C . Urinary bladder tumor .
D . Mesoblastic nephroma .
E . Hyderonephrotic kidney
42 ) The following are principles of primary health care except ?
A . Equity .
B . Community participation .
C . Use of sophisticated technology .
D . Integrated comprehensive services .
E . Multi _ sectoral approach
43 ) Which of the following is true for BCC ?
A . Painful ulcer is the usual presentation .
B . Metastasis to lymph node is very rare .
C . UV light is not a cause .
D . The growth is rapid .
E . Treatment of choice is radiotherapy .
44) 40 years old male with ulcerative colitis , now the exacerbation of GI symptoms . You can assess severity with ?
A . Erythema nodosum .
B . Anemia .
C . Dose of Salazopyrin .
D . Ankylosing spondylitis .
E . Dysplasia on colonoscopy
45 ) In patient who develop a documented episode of DVT , the most significant long term sequelae is ?
A . Claudication .
B . Recurrent foot infection .
C . Development of stasis ulcer .
D . Pulmonary embolization .
E . Diminished arterial perfusion .
46 ) The commonest hernia type that can been strangulated is ?
A . Incisional
B . Inguinal
C . Paraumbilical
D . Femoral
E . Linea alba
47 ) Which of the following is the most likely diagnosis in head trauma patient who loses consciousness recovers to have a lucid interval and again loses consciousness ?
A . Epidural hematoma .
B . Subdural hematoma .
C . SAH .
D . Concussion .
E . Contusion .
48 ) All sentences about burn are correct except ?
A . Burn area's can be calculated by the rule of nines .
B . Fluid resuscitation is calculated based on burn area .
C . IV fluid resuscitation is necessary in child with 10% partial thickness burn .
D . Prophylactic intubation is rarely indication in inhalation burn .
E . Full thickness burns extends into deep reticular dermis , yellow white appearance , fairly dry texture , painful , needs 3 _ 8 weeks for healing .
49 ) All sentences about screening test are true except ?
A . Screening tests are available for all common cancers .
B . Most screening tests are not 100% sensitive .
C . No benefit has yet been shown for breast screening in women under age 40 years .
D . Prostate specific antigen estimation is currently the best screening tool for prostatic cancer .
E . It takes approximately 10 years for colorectal polyp to develop into a cancer .
50 ) All sentences about cancer surgery is true except ?
A . It is called preventive when it removes a potential source of malignancy .
B . It is called curative or primary when it is the definitive treatment for the present tumor .
C . It is called palliative when the aim is to relieve symptoms and improve the quality of the life rather than prolong survival .
D . It is called emergency when it deals with problem such as obstruction or perforation .
E . Neoadjuvant chemo or radiotherapy are always required before cancer therapy .
A . A recent MI is the most important risk factor to preoperative MI .
B . Patients should stop taking their regular antihypertensive drugs on the day of surgery .
C . History and examination alone are usually sufficient in evaluating the risk of bleeding .
D . LMWH is used in venous thromboembolism prophylaxis .
E . Poorly controlled blood sugar in the preoperative period increases the risk for surgical site infection .
2 ) In infantile hypertrophic pyloric stenosis, one of the following is false ?
A . The infant usually presents with projectile non bilious vomiting .
B . The treatment is surgical by Ramstedt operation .
C . Symptoms commence at age of 3 _ 4 weeks .
D . A palpable olive shaped mass is usually felt in the epigastric region in the classical case .
E . Usually ultrasound is not sufficient for diagnosis .
3 ) A 62 years old male patient presented with nocturia ( 4 time / night ) , weak stream , intermittency and frequency , his DRE revealed induration of the right lobe of prostate gland , all of the following sentences are true except ?
A . Treat the obstructive symptoms .
B . Perform ultrasound for residual urine assessment .
C . Request blood sample for prostate specific antigen .
D . Unlikely this patient will need biopsy from prostate .
E . His past history and medications have to be checked
4 ) All sentences about wound healing are correct except ?
A . Presence of a foreign body delays the wound healing .
B . The final strength of a healed wound is greater than that of the surrounding skin .
C . The surgical wound of a thyroid operation is considered a clean wound .
D . Staphylococcus aureus is the most common cause of wound infection following surgery .
E . Hand wash and hygiene decrease community and hospital acquired wounds infections .
5 ) A 65 years old gentleman presented to you at the emergency room after road traffic accident complaining of left chest pain , his vital signs were blood pressure 110/50 , HR 100 , RR 20 , GCS 14/15 . One examination , he was found to have diminished breath sounds on the left side . CXR demonstrated opacification of the left hemithorax . What is the most likely diagnosis ?
A . Left hemothorax .
B . Left pneumothorax .
C . Cardiac tamponade .
D . Splenic injury .
E . Left tension pneumothorax .
6 ) All of the following can cause bilious vomiting in an infant or child except ?
A . Intestinal malrotation and volvulus .
B . Pyloric stenosis .
C . Duodenal atresia .
D . Small bowel obstruction .
E . Ulcerative colitis with colonic obstruction
7 ) A 5 year old boy is referred to you as an emergency with right groin and hip pain . All of the following are important differential diagnosis except ?
A . Inguinal hernia .
B . Acute appendicitis .
C . Testicular torsion .
D . Congenital hip abnormality .
E . Sigmoid diverticulitis .
8 ) Regarding breast cancer , all of the following are true except ?
A . Tumor speed to the skin means T4 on TNM classification .
B . Eczema around the nipple should always be investigated .
C . True cut biopsy is more accurate than fine needle aspiration .
D . Bloody nipple discharge is always due to cancer .
E . Metastasis usually involve lung , liver and / or bone .
9 ) The most common presenting symptom in patient with pancreatic cancer is ?
A . Midepigastric pain .
B . Nausea .
C . Malaise .
D . Anemia .
E . Anorexia .
10 ) All of the following are true regarding Hirschsprungs disease except ?
A . There is no ganglion cell's seen in Auerbach plexus .
B . There is increased Incidence of Down syndrome .
C . It is more common in boy's .
D . May be familial .
E . On X_Ray the affected bowel is narrowed proximally while the normal bowel is dilated distally .
11) All sentences about skin cancers are true except ?
A . BCC are faster growing than SCC .
B . Malignant melanoma are the most aggressive skin tumors .
C . SCC is often seen in areas exposed to sunlight such as a scalp and face .
D . Rodent ulcer is a BCC .
E . Marjolin ulcer is a SCC .
12 ) In a patient with hypovolemic shock , which cannula size would you ideally choose for infusion ?
A . 19 G .
B . 21 G .
C . 14 G .
D . 26 G .
E . 30 G .
13 ) Which is not a cause of pancreatitis ?
A . Hypercalcemia .
B . Hypokalemia .
C . Hypertriglyceridemia .
D . Obstruction of ampulla of vater .
E . Thiazides .
14 ) You were the night shift doctor , at the emergency room when a 50 year old gentleman presented to you after a trauma to his abdomen . His vital signs were blood pressure 110/60 , HR 90 , RR 17 , GCS 15/15 . Physical exam his abdomen is soft but tender on the right upper quadrant . What will be your best next step ?
A . DPL .
B . FAST .
C . ICU admission .
D . Call the surgeon for immediate Laparotomy .
E . CT scan of the abdomen .
15 ) All sentences about appendicitis are true except ?
A . Psoas sign is elicited by extension of the right hip .
B . Rovsing sign is elicited by pressing in the left iliac fossa causing pain in the right iliac fossa .
C . Pain is less after laparoscopic compared with open appendectomy .
D . Wound infection is less after laparoscopic compared open appendectomy .
E . In female patients , open approach is preferred over the laparoscopic appendectomy .
16 ) All sentences about trauma are true except ?
A . The term triage is generally used in acute trauma life support ( ATLS ) .
B . The rationale behind triage is for the benefit of the majority .
C . The role of the designated triage person is only to triage and not to treat .
D . The triage process must be constantly repeated .
E . Coma correspond to a GCS of more than 8.
17 ) When total number of death's due to measles is presented in relation to the total case's of measles , it is best labeled as ?
A . Cause specific death rate .
B . Incidence rate .
C . Prevalence rate .
D . Case fatality rate .
E . Proportional mortality .
18 ) Which is not contributory to GCS ?
A . Obey commands .
B . Localizes painful stimuli .
C . Open eyes to calling .
D . Incomprehensible sounds .
E . Pupils size .
19 ) A 30 year old female came to your clinic requesting your opinion about surgery as a treatment for her IBD . Which sentence will you tell her ?
A . Surgery is the primary treatment for Crohn disease .
B . Surgery for ulcerative colitis is curative .
C . Surgery is indicated as prophylaxis for colorectal cancer in Crohn disease .
D . Strictures are common indications for surgery in ulcerative colitis .
E . Recurrence is rare after surgery for Crohn disease
20 ) A 50 year old male felt a pain in his groin after lifting a heavy box . He was advised an operation . During the surgery a hernial sac with a small knuckle of intestine was found protruding just below the inguinal ligament . The hernia was diagnosed as ?
A . Direct inguinal hernia .
B . Indirect inguinal hernia .
C . Incisional hernia .
D . Femoral hernia .
E . Congenital inguinal hernia .
21 ) Imaging in surgery , all are true except ?
A . In abdominal X_Ray , the transverse colon can be seen in various locations in the centre of the abdomen because it is a totally intraperitoneal organ .
B . Gallstones are usually seen on X_Ray .
C . The presence of gas in the small bowel raise the suspicion of bowel obstruction .
D . Ultrasound is better than CT scan for gallstones detected .
E . Ultrasound can assess solid organs better than gas filled organs .
22 ) All of the following sentences about gallstones are true except ?
A . Obesity and bariatric surgery are risk factors for gallstones formation .
B . Cholecystectomy can be performed in pregnant women .
C . Every patient undergoing Cholecystectomy should be consented about bile leak .
D . Extracarporeal shock wave lithotripsy is not an effective treatment for gallstones .
E . Most gallstones are seen on X_Ray .
23 ) Which of the following statement regarding the differentiation of Keloid scar from hypertrophic scar is false ?
A . Keloid scars are most often seen in dark skin people .
B . Hypertrophic scars respond better to treatment than Keloid scars .
C . Keloid scars occur when scar cross joints at right angle .
D . Keloid scars outgrow the wound area .
E . Keloid scars have a familial predisposition
24 ) Spot diagnosis to differentiate Lipoma and sebaceous cysts is ?
A . Consistency .
B . Compressibility .
C . Fluctuation .
D . Attachment to deep muscle .
E . Slippery edge of the lipoma and the punctum of the sebaceous cyst .
25 ) All of the following sentences about hernia are true except ?
A . Inguinal hernia is the most common in both females and male's .
B . Incisional hernia is more common after open compared with laparoscopic operation .
C . Open is always better and safer than laparoscopic approach for hernia repair .
D . Divarication of rectus abdominis muscles in elderly does not necessitate surgical repair .
E . Morbidity is increased after emergency compared with elective repair of hernia .
26 ) A 63 years old male presented as emergency with crampy abdominal pain for 4 days and associated with vomiting and abdominal distension and constipation , patient denies weight loss . His past history was only significant for previous open appendectomy and open Cholecystectomy . All of the following sentences are true except ?
A . Abdominal X_Ray ( upright and supine ) can be postponed for few days .
B . It is essential to obtain an upright CXR .
C . Adhesions are possible cause for this condition .
D . Abdominal and groin examination should be carried out to rule out hernia .
E . He should be admitted for IV fluid hydration and electrolyte replacement .
27 ) A 35 years old female patient underwent incision and drainage of a perianal abscess 2 months ago . Now she presented to your clinic with an intermittent pain and smelly discharge from the site of previous surgery . What is the most common problem that would expect and you should check for ?
A . Perianal fistula .
B . Anal fissure .
C . Incontinence .
D . Complication of her hemorrhoids .
E . Necrotizing fasciitis .
28 ) Paget disease of the breast ?
A . Present any where on the breast skin .
B . Usually bilateral .
C . Uncommon breast carcinoma .
D . Bad prognosis .
E . It's diagnosed by mammogram .
29 ) Informed consent for a surgical procedure involves discussion all of the following except ?
A . The main treatment available .
B . The individual benefits and risks associated with each treatment option .
C . Wether the operation is entirely necessary and the effects of possibly not having the procedure at all .
D . It is acceptable not to mention some risks that may upset your patient or his family .
E . It's good idea to have such discussion in the presence of the close relative .
30 ) 10 cases of food poisoning had been reported in hospital . 2 out these developed mild GI symptoms . 4 out these developed moderate dehydration but recovered . The characteristic of the organism of food poisoning that produces the severest form of the disease ?
A . Infectivity .
B . Pathogenicity .
C . Resistibility .
D . Communicability .
E . Virulence .
31) All of the following increase suspicion of malignant thyroid nodule except ?
A . Age less than 20 years .
B . Age more than 60 years .
C . Pain and tenderness .
D . New Onest of hoarseness .
E . Male gender .
32) A 35 years old lady who's otherwise fit and healthy , was admitted via emergency complaining of upper abdominal pain associated with nausea and fever . Her initial blood test showed WBC 16 , HB 12 . What is the best imaging study in this situation ?
A . Abdominal ultrasound .
B . MRCP .
C . ERCP .
D . Endoscopic ultrasound .
E . Abdominal and pelvic computed tomography scan .
33 ) A 70 years old woman presented to the emergency department with 3 days history of worsening abdominal pain , vomiting , constipation . On examination you find that she has abdomen distended , generalized tenderness , high pitched bowel sounds . All of the following are important differential diagnosis except ?
A . Colorectal cancer .
B . Sigmoid diverticulitis .
C . Gastroenteritis .
D . Sigmoid volvulus .
E . Femoral hernia .
34 ) At what age is intussusception most frequent ?
A . Newborns .
B . Preschool .
C . School .
D . Adult .
E . Infants .
35 ) A 40 years old female previously healthy , presented as an emergency with abdominal pain aggravated by fatty meals , associated with yellowish discoloration of her sclera , vomiting , itching , clay color stool and dark urine . No history of weight loss . All are true except ?
A . The cause of dark urine is the increased conjugated bilirubin in urine .
B . The serum liver function tests will most likely shows increase alkaline phosphatase .
C . The serum will most likely show increased level of amylase with decrease level of lipase .
D . The most likely diagnosis in this patient is gallstones and stones in the common bile duct .
E . This patient need admission , painkillers , rehydration IV fluid , antibiotics and arrangement for ERCP .
36 ) A 28 years old lady complains of painful defecation associated with fresh per rectal blood . Possible diagnosis to consider is ?
A . Hidradenitis suppurativa .
B . Dermoid cyst .
C . Pilonidal sinus .
D . Anal fissure .
E . Pruritus ani .
37 ) One of the following is false concerning gastrointestinal stoma ?
A . Patient with colorectal abdominal perianal resection require a permanent stoma .
B . Ileostomy is usually fashioned with aspout to avoid skin irritation .
C . Colostomy is usually constructed in the right iliac fossa .
D . Stoma may be indicated in patients with bowel ischemia .
E . Patients with Ileostomy may be need water and electrolyte replacement by IV route .
38 ) A 25 years old thin and tall man suddenly develops left sided chest pain with cough and dyspnea . Provisional diagnosis is ?
A . Atelectasis .
B . Pulmonary embolism .
C . MI .
D . Bronchopneumonia .
E . Pneumothorax .
39 ) The earliest indication of hypocalcemia is usually ?
A . Tachycardia .
B . Positive Chvostek sign .
C . Carpopedal spasm .
D . Hyperthermia .
E . Tingling of face , nose , hands .
40 ) A 60 years old patient is diagnosed with colorectal cancer , all sentences are true except ?
A . Most cases are sporadic ( not related to inheritance ) .
B . Cure is possible if the disease is localized .
C . Chemotherapy could be given before or after surgery .
D . Bleeding per rectum usually indicates that the cancer in the Cecum .
E . CT scan for chest , abdomen , pelvis is the usual imaging test for staging .
41 ) In a 3 years old boy , painless ballotable mass in the right flank , can be all of the following except ?
A . Wilms tumor .
B . Neuroblastoma .
C . Urinary bladder tumor .
D . Mesoblastic nephroma .
E . Hyderonephrotic kidney
42 ) The following are principles of primary health care except ?
A . Equity .
B . Community participation .
C . Use of sophisticated technology .
D . Integrated comprehensive services .
E . Multi _ sectoral approach
43 ) Which of the following is true for BCC ?
A . Painful ulcer is the usual presentation .
B . Metastasis to lymph node is very rare .
C . UV light is not a cause .
D . The growth is rapid .
E . Treatment of choice is radiotherapy .
44) 40 years old male with ulcerative colitis , now the exacerbation of GI symptoms . You can assess severity with ?
A . Erythema nodosum .
B . Anemia .
C . Dose of Salazopyrin .
D . Ankylosing spondylitis .
E . Dysplasia on colonoscopy
45 ) In patient who develop a documented episode of DVT , the most significant long term sequelae is ?
A . Claudication .
B . Recurrent foot infection .
C . Development of stasis ulcer .
D . Pulmonary embolization .
E . Diminished arterial perfusion .
46 ) The commonest hernia type that can been strangulated is ?
A . Incisional
B . Inguinal
C . Paraumbilical
D . Femoral
E . Linea alba
47 ) Which of the following is the most likely diagnosis in head trauma patient who loses consciousness recovers to have a lucid interval and again loses consciousness ?
A . Epidural hematoma .
B . Subdural hematoma .
C . SAH .
D . Concussion .
E . Contusion .
48 ) All sentences about burn are correct except ?
A . Burn area's can be calculated by the rule of nines .
B . Fluid resuscitation is calculated based on burn area .
C . IV fluid resuscitation is necessary in child with 10% partial thickness burn .
D . Prophylactic intubation is rarely indication in inhalation burn .
E . Full thickness burns extends into deep reticular dermis , yellow white appearance , fairly dry texture , painful , needs 3 _ 8 weeks for healing .
49 ) All sentences about screening test are true except ?
A . Screening tests are available for all common cancers .
B . Most screening tests are not 100% sensitive .
C . No benefit has yet been shown for breast screening in women under age 40 years .
D . Prostate specific antigen estimation is currently the best screening tool for prostatic cancer .
E . It takes approximately 10 years for colorectal polyp to develop into a cancer .
50 ) All sentences about cancer surgery is true except ?
A . It is called preventive when it removes a potential source of malignancy .
B . It is called curative or primary when it is the definitive treatment for the present tumor .
C . It is called palliative when the aim is to relieve symptoms and improve the quality of the life rather than prolong survival .
D . It is called emergency when it deals with problem such as obstruction or perforation .
E . Neoadjuvant chemo or radiotherapy are always required before cancer therapy .
Comments
Post a Comment