اسئلة الجراحة 2017 (5)
1 ) When total number of deaths due to measles is presented in relation to the total cases 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 .
2 ) a Which is not contributory to Glasgow Coma Scale?
A .obey commands .
B . Localizes painful stimuli .
C . Open eyes to calling .
D . Incomprehensible sounds .
E . pupils size .
3) A 30-year-old female came to your dinic requesting your opinion about surgery as a treatment for her inflammatory bowel disease. Which sentence will you tell her?
A . Surgery is the primary treatment for Crohn's disease.
B . Surgery for ulcerative colitis is curative .
C . Surgery is indicated as prophylaxis for colorectal cancer in Crohn's disease .
D . Strictures are common indications for surgery in ulcerative colitis .
E . Recurrence is rare after surgery for Crohn's disease
4 ) 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 smal knuckle of intestine was found protruding just below the inguinal lgament. The hernia was diagnosed as:
A . Congenital inguinal hernia .
B . Direct inguinal hernia .
C . Femoral hernia .
D . incisional hernia .
E . Indirect inguinal hernia .
5 ) Imaging in surgery, al are true ExCEPT:
A . in abdominal Xray, the transverse colon can be seen in various locations in the centre of the abdomen because it is a totally intra-peritoneal organ.
B . Gallstones are usually seen on Xray
C . The presence of gas in the small bowel raise the suspicion of bowel obstruction.
D . Ultrasound is better than CTscan for gallstones detection
E . Ultrasound can assess solid organs better than gas-filled organs
6 ) Al the folowing sentences about hernias are true EXCEPT:
A . Inguinal hernia is the most common hernia in both females and males.
B . incisional hernia more common after open compared with laparoscopic operation.
C . Open is always better and safer than laparoscopic approach for repair
D . Divarication of rectus abdominis muscles in elderly does not necessitate surgical repair .
E . Morbidity is increased after emergency compared with elective repa of hernia.
7 ) Spot diagnosis to differentiated lipoma and sebaceous cyst is:
A . Consistency .
B . attachment to deep muscle .
C . slippery edge of the lipoma and the punctum of the sebaceous cyst .
D .Compressibiltry.
E . Fluctuation .
8 ) Which of the folowing statements regarding the differentiation of Keloid scars from Hypertrophic Scars is False:
A . Keloid scars are most often seen in dark skinned 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 out grow the wound area .
E . Keloid scars have a familial predisposition .
8 ) Which of the folowing statements regarding the differentiation of Keloid scars from Hypertrophic Scars is False:
A . Keloid scars are most often seen in dark skinned 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 out grow the wound area .
E . Keloid scars have a familial predisposition .
9 ) AI the folowing sentences about gallstones are true EXCEPT:
A . Obesity and bariatric surgery are risk factors for gallstones formation .
B . Cholecystectomy can be performed in pregnant woman .
C . Every patient undergoing cholecystectomy should be consented a about bile leak .
D . Extracorporeal shock wave lithotripsy is not an effective treatment for gallstones .
E . Most gallstones are seen on X-ray .
10 ) In infantie hypertrophic pyloric stenosis, one of the folowing statements is FALSE:
A . The infant usually presents with projectile nonbilious vomiting .
B . The treatment is surgical by Ramstedt's operation .
C . symptoms commence at the age of 3-4 weeks .
D . olive shaped mass is usually felt in the epigastnc region in a the classical case .
E . Usually, ultrasound is not sufficient for diagnosis
11) Regarding the pre-operative management, al sentences are true Except:
A . A recent myocardial infarction is the most important risk factor for perioperative myocardial infarction .
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 . Low molecular weight heparin is used in venous thromboembolism prophylaxis .
E . Poorly controlled blood sugar in the pre-operative period increases the risk for surgical site infection .
12) AIl sentences about trauma are true ExCEPT:
A . The term Triage is generally used in Acute Trauma Life Support a (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 treat .
D . The triage process must be constantly repeated .
E . Coma correspond to a Glasgow Coma Scale (GCS) of more than 11 .
13 ) In a patient with hypovolaemic shock, which cannular size would you idealy choose for infusion?
A . 19G .
B . 21G .
C . 14G .
D . 26G .
E . 30G .
14 ) AIl sentences about skin cancers are true ExCEPT:
A . Basal cell carcinomas are faster growing han squamous carcinomas .
B . Malignant melanomas are the most aggressive skin tumors .
C . Squamous cell carcinoma is often seen in areas exposed to sunlight such as scalp and face .
D . Rodent ulcer is a basal cell carcinoma .
E . Marjolin's ulcer is a squamous cell carcinoma .
15 ) AI of the folowing are true regarding Hinschsprung's disease :
A . There is no ganglion cells seen in Auerbach's plexus .
B . There is an increased incidence of down syndrome .
C . It is more common in boys .
D . May be familial .
E . On x-ray the affected bowel is narrowed proximally while the normal bowel is dilated .
16 ) The most common presenting symptom in patients with pancreatic cancer is:
A . Midepigastric pain .
B . Anorexia .
C . Malaise .
D . Nausea .
E . Anemia .
17) Regarding breast cancer, All the folowing are true, except:
A . Tumor spread 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 (FNA) .
D . Bloody nipple discharge is always due to cancer .
E . Metastases usually involve lung, liver and /or bone .
18) A 5-year-old boy is referred to you as an emergency with right groin and hip pain. AI the folowings are important differential diagnoses ExCEPT:
A . Inguinal hernia .
B . Acute appendicitis .
C . Testicular torsion .
D . Congenital hip abnormality .
E . Sigmoid diverticulitis .
19) the folowing can cause bilous vomiting in an infant or chid except :
A . Intestinal malrotation and volvulus .
B . Pyloric stenosis .
C . Duodenal atresia .
D . Small bowel obstruction .
E . Ulcerative colitis with colonic obstruction .
20 ) A 65-year-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, Heart Rate 100, Respiratory Rate 20) Glasgow Coma Scale 14/15. On examination, he was found to have diminished breath sounds on the left side. Chest x-ray demonstrated opacification of the left hemi-thorax. What is the most likely diagnosis ?
A . Left hemothorax .
B . Left pneumothorax .
C . Cardiac tamponade .
D . splenic injury .
E . Right tension pneumothorax .
21) AI sentences about wound he are correct EXCEPT:
A . The final strength of a healed wound is greater than that of the surrounding skin .
B . Presence of a foreign body delays the wound healing .
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 .
22) A 62-year-old male patient presented with Nocturia (4time/night), weak stream, intermittency and frequency, his digital rectal examination revealed induration of the right lobe of prostate. All the following statements are appropriate 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 .
23) AIl sentences about appendictis 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 with open appendectomy .
E . in female patients, open approach is preferred over the appendectomy .
24 ) 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, Heart Rate 90, Respiratory Rate 17). Glasgow Coma Scale 15/15. His abdommen is soft but tender on the right upper quadrant, what w be your best next step?
A . Diagnostic peritoneal lavage .
B . Focused Assessment by sonography test (FAST) ultrasound if available .
C . ICU admission .
D . Call the surgeon for immediate laparotomy .
E . CT scan of the Abdomen .
25 ) Which is not a cause of pancreatitis?
A . Hypercalcemia .
B . Hyperkalemia .
C . Hyperlipidemia .
D . Obstruction ampulla of Vater .
E . Thiazides .
26 ) All the folowing increase the suspicion of malignant thyroid nodule except :
A . Age less than 20 .
B . Male gender .
C . Age more than 60 .
D . New onset of hoarseness .
E . Pain and tenderness .
27 ) Informed consent for a surgical procedure involves discussion al of the folowings except :
A . The main treatment options available .
B . The individual benefits and risks associated with each treatment option .
C . Whether 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 is a good idea to have such discussion in the presence of a close relative .
28 ) 10 cases of food poisoning had been reported in hospital, 2 out of these developed mid gastrointestinal symptoms, 4 developed moderate dehydration but recovered and 2 to the disease. The characteristic of the organism of food poisoning that produces the severest of the disease is :
A . Infectivity .
B . Pathogenicity .
C . Virulence .
D . Communicability .
E . Resistibility .
29) Al sentences about burn are correct ExCEPT :
A . Full thickness burns are not painful .
B . Burn areas can be calculated by the Rule of Nines .
C . Fluid resuscitation is calculated based on burn area .
D . Intravenous fluid resuscitation is necessary in a child with 10% partial thickness burn .
E . Prophylactic intubation is rarely indicated in inhalation burns .
30 ) The commonest hernia type that can be seen strangulated is :
A . incisional .
B . Inguinal .
C . Para-umbilical .
D . Fermoral .
E . Linea alba .
31) Paget's disease of the breast :
A . Present anywhere on breast skin .
B . usually bilateral .
C . Uncommon breast carcinoma .
D . Bad prognosis .
E . Is diagnosed by mammogram .
32 ) 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 life rather than prolong survival .
D . It is called emergency when it deals with problems such as obstruction or perforation .
E . Neoadjuvant chemo- or radio-therapy are always required before cancer surgery .
33 ) Which of the folowing is the most lkely diagnosis in a head trauma patient who loses consoousness, recovers to have a lucid interval, and again loses consciousness ?
A . Contusion .
B . Subdural hematoma .
C . Subarachnoid hemorrhage .
D . epidural hematoma .
E . Concussion .
34 ) A 35-y female patient underwent incision and drainage of a perianal abscess two months ago. Now she presented to your clinic with an intermittent pain and sme discharge from the site of previous surgery. What is the most common problem that you would expect and you should check for ?
A . Perianal fistula .
B . Anal fissure .
C . Incontinence .
D . Complication of her hemorrhoids .
E . Necrotizing fasciitis .
35 ) which of the folowing is true for basal cell carcinoma?
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 .
36 ) 40 year old male with ulcerative coltis now with exacerbation of GI symptoms. Assess severity with :
A . Erythema nodosum .
B . Anemia .
C . Dose of salazopyrine .
D . Ankylosing spondylitis .
E . Dysplasia on colonoscopy .
37 ) At what age is intussusception most frequent?
A . newborns .
B . Preschool .
C . School .
D . Adult .
E . Infants .
38 ) In patients who develop a documented episode of deep venous thrombosis (DVT) the most significant long-term sequel a is ?
A . Claudication .
B . Recurrent foot infections .
C . Development of stasis ulcer .
D . Pulmonary embolization .
E . Diminished arterial perfusion .
39 ) All sentences about screening tests are true EXCEPT:
A . Screening tests are available for all common cancers .
B . Most screening tests are not 100% sensitive and specific .
C . No benefit has yet been shown for breast screening in women under 40 years of age .
D . Prostatic Specific Antigen (PSA) estimation is currently the best screening tool for prostatic cancer .
E . It takes approximately 10 years for a colonic polyp to develop
40 ) A 60-year-old patient is diagnosed with a 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 and pelvis is the usual imaging test for Staging .
41 ) The folowing are principles of Primary Health Care (PHC) except :
A . Community participation .
B . Equity .
C . Use of sophisticated technology .
D . Integrated comprehensive services .
E . Multi-sectorial approach .
42 ) The earliest indication of hypocalcemia is usualy:
A . Tingling of face, nose and hands .
B . Positive Chvostek's sign .
C . Carpopedal spasm .
D . Hyperthermia .
E . Tachycardia .
43 ) One of the folowing is FALSE concerning gastrointestinal stoma ?
A . Patients with colorectal abdominoperineal resection require a permanent Stoma .
B . ileostomy is usually fashioned with a spout to avoid skin irritation .
C . Colostomy is usually constructed in the right iliac fossa .
D . Patients with ileostomy may need water and electrolytes replacement by intravenous route .
E . Stoma may be indicated in patients with bowel ischemia .
44 ) In a 3-year-old boy, a painless ballotable mass in the right flank can be all the folowings EXCEPT:
A . Wilm's tumor .
B . Neuroblastoma .
C . urinary bladder tumor .
D . Hydronephrotic kidney .
E . Mesoblastic nephroma .
45 ) A 63 year-old male presented as an emergency with crampy abdominal pain for 4 days and associated with vomiting, abdominal distension and constipation Patient denies weight loss. His past history was only significant for previous open appendectomy and open cholecystectomy. All the folowing sentences are true, EXCEPT:
A . He should be admitted for Intravenous fluid hydration and electrolyte replacement.
B . Abdominal and groin examination should be carried out to rule out hernias .
C . Adhesions are possible cause for his condition .
D . It is essential is to obtain an upright chest x-ray .
E . Abdominal x ray (upright supine) can be postponed for few days
46 ) A 28 year old lady complains of painful defecation associated with fresh per-rectableed. Possible diagnosis to consider is:
A . Hiradenitis suppurativa .
B . Dermoid cyst .
C . Pilonidal sinus .
D . Anal fissure .
E . Pruritis ani .
47 ) A 70-year-old woman presented to the emergency department with a 3 day history of worsening abdominal pain, vomiting and constipation. On examination, you find that she has a distended abdomen, generalized tenderness and high-pitched bowel sounds. All the folowings are important differential diagnoses EXCEPT:
A . Colorectal cancer .
B . Sigmoid diverticulitis .
C . Gastroenteritis .
D . Sigmoid volvulous .
E . Femoral hernia .
48 ) A 35-year-old lady, who is otherwise fit and healthy, was admitted via emergency complaining of upper abdominal pain associated with nausea and fever. Her initial blood tests showed WCC-16, Hba 12. What is the best initial imaging study in this situation?
A . Abdominal and pelvic computed tomography (CT) scan .
B . Endoscopic ultrasound (EUS) .
C . Magnetic resonance imaging with magnetic resonance a hy (MRCP) cholangiopancreatography .
D . Endoscopic retrograde cholangiopancreatography (ERCP) .
E . Abdominal ultrasound (US) .
49 ) A 25 year old thin and tal man suddenly develops left sided chest pain with cough and dysponoea, Provisional diagnosis is ?
A . atelectasis .
B . Pneumothorax .
C . Pulmonary embolism .
D . Myocardial infarction .
E . Bronchopneumonia .
50 ) A 40yr female, previously healthy, presented as an emergency with abdominal pain aggravated by fatty meals and associated with yelowish discoloration of her scera, vomiting, itching, day color stool and dark urine. No history of weight loss. Al are true, EXCEPT:
A . This patient needs admission, painkillers, rehydration (IV fluids) antibiotics .
B . The most likely diagnosis in this patient is gallstanes and stone(s) in the common bile duct .
C . The serum will most likely show increased level of amylase with a decreased level of lipase .
D . The cause of color urine is the increased conjugated bilirubin in urine .
E . The serum liver function tests will most likely show increased AIkaline Phosphatase .
A . Cause specific death rate .
B . Incidence rate .
C . Prevalence rate .
D . Case fatality rate .
E . Proportional mortality .
2 ) a Which is not contributory to Glasgow Coma Scale?
A .obey commands .
B . Localizes painful stimuli .
C . Open eyes to calling .
D . Incomprehensible sounds .
E . pupils size .
3) A 30-year-old female came to your dinic requesting your opinion about surgery as a treatment for her inflammatory bowel disease. Which sentence will you tell her?
A . Surgery is the primary treatment for Crohn's disease.
B . Surgery for ulcerative colitis is curative .
C . Surgery is indicated as prophylaxis for colorectal cancer in Crohn's disease .
D . Strictures are common indications for surgery in ulcerative colitis .
E . Recurrence is rare after surgery for Crohn's disease
4 ) 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 smal knuckle of intestine was found protruding just below the inguinal lgament. The hernia was diagnosed as:
A . Congenital inguinal hernia .
B . Direct inguinal hernia .
C . Femoral hernia .
D . incisional hernia .
E . Indirect inguinal hernia .
5 ) Imaging in surgery, al are true ExCEPT:
A . in abdominal Xray, the transverse colon can be seen in various locations in the centre of the abdomen because it is a totally intra-peritoneal organ.
B . Gallstones are usually seen on Xray
C . The presence of gas in the small bowel raise the suspicion of bowel obstruction.
D . Ultrasound is better than CTscan for gallstones detection
E . Ultrasound can assess solid organs better than gas-filled organs
6 ) Al the folowing sentences about hernias are true EXCEPT:
A . Inguinal hernia is the most common hernia in both females and males.
B . incisional hernia more common after open compared with laparoscopic operation.
C . Open is always better and safer than laparoscopic approach for repair
D . Divarication of rectus abdominis muscles in elderly does not necessitate surgical repair .
E . Morbidity is increased after emergency compared with elective repa of hernia.
7 ) Spot diagnosis to differentiated lipoma and sebaceous cyst is:
A . Consistency .
B . attachment to deep muscle .
C . slippery edge of the lipoma and the punctum of the sebaceous cyst .
D .Compressibiltry.
E . Fluctuation .
8 ) Which of the folowing statements regarding the differentiation of Keloid scars from Hypertrophic Scars is False:
A . Keloid scars are most often seen in dark skinned 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 out grow the wound area .
E . Keloid scars have a familial predisposition .
8 ) Which of the folowing statements regarding the differentiation of Keloid scars from Hypertrophic Scars is False:
A . Keloid scars are most often seen in dark skinned 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 out grow the wound area .
E . Keloid scars have a familial predisposition .
9 ) AI the folowing sentences about gallstones are true EXCEPT:
A . Obesity and bariatric surgery are risk factors for gallstones formation .
B . Cholecystectomy can be performed in pregnant woman .
C . Every patient undergoing cholecystectomy should be consented a about bile leak .
D . Extracorporeal shock wave lithotripsy is not an effective treatment for gallstones .
E . Most gallstones are seen on X-ray .
10 ) In infantie hypertrophic pyloric stenosis, one of the folowing statements is FALSE:
A . The infant usually presents with projectile nonbilious vomiting .
B . The treatment is surgical by Ramstedt's operation .
C . symptoms commence at the age of 3-4 weeks .
D . olive shaped mass is usually felt in the epigastnc region in a the classical case .
E . Usually, ultrasound is not sufficient for diagnosis
11) Regarding the pre-operative management, al sentences are true Except:
A . A recent myocardial infarction is the most important risk factor for perioperative myocardial infarction .
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 . Low molecular weight heparin is used in venous thromboembolism prophylaxis .
E . Poorly controlled blood sugar in the pre-operative period increases the risk for surgical site infection .
12) AIl sentences about trauma are true ExCEPT:
A . The term Triage is generally used in Acute Trauma Life Support a (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 treat .
D . The triage process must be constantly repeated .
E . Coma correspond to a Glasgow Coma Scale (GCS) of more than 11 .
13 ) In a patient with hypovolaemic shock, which cannular size would you idealy choose for infusion?
A . 19G .
B . 21G .
C . 14G .
D . 26G .
E . 30G .
14 ) AIl sentences about skin cancers are true ExCEPT:
A . Basal cell carcinomas are faster growing han squamous carcinomas .
B . Malignant melanomas are the most aggressive skin tumors .
C . Squamous cell carcinoma is often seen in areas exposed to sunlight such as scalp and face .
D . Rodent ulcer is a basal cell carcinoma .
E . Marjolin's ulcer is a squamous cell carcinoma .
15 ) AI of the folowing are true regarding Hinschsprung's disease :
A . There is no ganglion cells seen in Auerbach's plexus .
B . There is an increased incidence of down syndrome .
C . It is more common in boys .
D . May be familial .
E . On x-ray the affected bowel is narrowed proximally while the normal bowel is dilated .
16 ) The most common presenting symptom in patients with pancreatic cancer is:
A . Midepigastric pain .
B . Anorexia .
C . Malaise .
D . Nausea .
E . Anemia .
17) Regarding breast cancer, All the folowing are true, except:
A . Tumor spread 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 (FNA) .
D . Bloody nipple discharge is always due to cancer .
E . Metastases usually involve lung, liver and /or bone .
18) A 5-year-old boy is referred to you as an emergency with right groin and hip pain. AI the folowings are important differential diagnoses ExCEPT:
A . Inguinal hernia .
B . Acute appendicitis .
C . Testicular torsion .
D . Congenital hip abnormality .
E . Sigmoid diverticulitis .
19) the folowing can cause bilous vomiting in an infant or chid except :
A . Intestinal malrotation and volvulus .
B . Pyloric stenosis .
C . Duodenal atresia .
D . Small bowel obstruction .
E . Ulcerative colitis with colonic obstruction .
20 ) A 65-year-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, Heart Rate 100, Respiratory Rate 20) Glasgow Coma Scale 14/15. On examination, he was found to have diminished breath sounds on the left side. Chest x-ray demonstrated opacification of the left hemi-thorax. What is the most likely diagnosis ?
A . Left hemothorax .
B . Left pneumothorax .
C . Cardiac tamponade .
D . splenic injury .
E . Right tension pneumothorax .
21) AI sentences about wound he are correct EXCEPT:
A . The final strength of a healed wound is greater than that of the surrounding skin .
B . Presence of a foreign body delays the wound healing .
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 .
22) A 62-year-old male patient presented with Nocturia (4time/night), weak stream, intermittency and frequency, his digital rectal examination revealed induration of the right lobe of prostate. All the following statements are appropriate 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 .
23) AIl sentences about appendictis 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 with open appendectomy .
E . in female patients, open approach is preferred over the appendectomy .
24 ) 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, Heart Rate 90, Respiratory Rate 17). Glasgow Coma Scale 15/15. His abdommen is soft but tender on the right upper quadrant, what w be your best next step?
A . Diagnostic peritoneal lavage .
B . Focused Assessment by sonography test (FAST) ultrasound if available .
C . ICU admission .
D . Call the surgeon for immediate laparotomy .
E . CT scan of the Abdomen .
25 ) Which is not a cause of pancreatitis?
A . Hypercalcemia .
B . Hyperkalemia .
C . Hyperlipidemia .
D . Obstruction ampulla of Vater .
E . Thiazides .
26 ) All the folowing increase the suspicion of malignant thyroid nodule except :
A . Age less than 20 .
B . Male gender .
C . Age more than 60 .
D . New onset of hoarseness .
E . Pain and tenderness .
27 ) Informed consent for a surgical procedure involves discussion al of the folowings except :
A . The main treatment options available .
B . The individual benefits and risks associated with each treatment option .
C . Whether 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 is a good idea to have such discussion in the presence of a close relative .
28 ) 10 cases of food poisoning had been reported in hospital, 2 out of these developed mid gastrointestinal symptoms, 4 developed moderate dehydration but recovered and 2 to the disease. The characteristic of the organism of food poisoning that produces the severest of the disease is :
A . Infectivity .
B . Pathogenicity .
C . Virulence .
D . Communicability .
E . Resistibility .
29) Al sentences about burn are correct ExCEPT :
A . Full thickness burns are not painful .
B . Burn areas can be calculated by the Rule of Nines .
C . Fluid resuscitation is calculated based on burn area .
D . Intravenous fluid resuscitation is necessary in a child with 10% partial thickness burn .
E . Prophylactic intubation is rarely indicated in inhalation burns .
30 ) The commonest hernia type that can be seen strangulated is :
A . incisional .
B . Inguinal .
C . Para-umbilical .
D . Fermoral .
E . Linea alba .
31) Paget's disease of the breast :
A . Present anywhere on breast skin .
B . usually bilateral .
C . Uncommon breast carcinoma .
D . Bad prognosis .
E . Is diagnosed by mammogram .
32 ) 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 life rather than prolong survival .
D . It is called emergency when it deals with problems such as obstruction or perforation .
E . Neoadjuvant chemo- or radio-therapy are always required before cancer surgery .
33 ) Which of the folowing is the most lkely diagnosis in a head trauma patient who loses consoousness, recovers to have a lucid interval, and again loses consciousness ?
A . Contusion .
B . Subdural hematoma .
C . Subarachnoid hemorrhage .
D . epidural hematoma .
E . Concussion .
34 ) A 35-y female patient underwent incision and drainage of a perianal abscess two months ago. Now she presented to your clinic with an intermittent pain and sme discharge from the site of previous surgery. What is the most common problem that you would expect and you should check for ?
A . Perianal fistula .
B . Anal fissure .
C . Incontinence .
D . Complication of her hemorrhoids .
E . Necrotizing fasciitis .
35 ) which of the folowing is true for basal cell carcinoma?
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 .
36 ) 40 year old male with ulcerative coltis now with exacerbation of GI symptoms. Assess severity with :
A . Erythema nodosum .
B . Anemia .
C . Dose of salazopyrine .
D . Ankylosing spondylitis .
E . Dysplasia on colonoscopy .
37 ) At what age is intussusception most frequent?
A . newborns .
B . Preschool .
C . School .
D . Adult .
E . Infants .
38 ) In patients who develop a documented episode of deep venous thrombosis (DVT) the most significant long-term sequel a is ?
A . Claudication .
B . Recurrent foot infections .
C . Development of stasis ulcer .
D . Pulmonary embolization .
E . Diminished arterial perfusion .
39 ) All sentences about screening tests are true EXCEPT:
A . Screening tests are available for all common cancers .
B . Most screening tests are not 100% sensitive and specific .
C . No benefit has yet been shown for breast screening in women under 40 years of age .
D . Prostatic Specific Antigen (PSA) estimation is currently the best screening tool for prostatic cancer .
E . It takes approximately 10 years for a colonic polyp to develop
40 ) A 60-year-old patient is diagnosed with a 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 and pelvis is the usual imaging test for Staging .
41 ) The folowing are principles of Primary Health Care (PHC) except :
A . Community participation .
B . Equity .
C . Use of sophisticated technology .
D . Integrated comprehensive services .
E . Multi-sectorial approach .
42 ) The earliest indication of hypocalcemia is usualy:
A . Tingling of face, nose and hands .
B . Positive Chvostek's sign .
C . Carpopedal spasm .
D . Hyperthermia .
E . Tachycardia .
43 ) One of the folowing is FALSE concerning gastrointestinal stoma ?
A . Patients with colorectal abdominoperineal resection require a permanent Stoma .
B . ileostomy is usually fashioned with a spout to avoid skin irritation .
C . Colostomy is usually constructed in the right iliac fossa .
D . Patients with ileostomy may need water and electrolytes replacement by intravenous route .
E . Stoma may be indicated in patients with bowel ischemia .
44 ) In a 3-year-old boy, a painless ballotable mass in the right flank can be all the folowings EXCEPT:
A . Wilm's tumor .
B . Neuroblastoma .
C . urinary bladder tumor .
D . Hydronephrotic kidney .
E . Mesoblastic nephroma .
45 ) A 63 year-old male presented as an emergency with crampy abdominal pain for 4 days and associated with vomiting, abdominal distension and constipation Patient denies weight loss. His past history was only significant for previous open appendectomy and open cholecystectomy. All the folowing sentences are true, EXCEPT:
A . He should be admitted for Intravenous fluid hydration and electrolyte replacement.
B . Abdominal and groin examination should be carried out to rule out hernias .
C . Adhesions are possible cause for his condition .
D . It is essential is to obtain an upright chest x-ray .
E . Abdominal x ray (upright supine) can be postponed for few days
46 ) A 28 year old lady complains of painful defecation associated with fresh per-rectableed. Possible diagnosis to consider is:
A . Hiradenitis suppurativa .
B . Dermoid cyst .
C . Pilonidal sinus .
D . Anal fissure .
E . Pruritis ani .
47 ) A 70-year-old woman presented to the emergency department with a 3 day history of worsening abdominal pain, vomiting and constipation. On examination, you find that she has a distended abdomen, generalized tenderness and high-pitched bowel sounds. All the folowings are important differential diagnoses EXCEPT:
A . Colorectal cancer .
B . Sigmoid diverticulitis .
C . Gastroenteritis .
D . Sigmoid volvulous .
E . Femoral hernia .
48 ) A 35-year-old lady, who is otherwise fit and healthy, was admitted via emergency complaining of upper abdominal pain associated with nausea and fever. Her initial blood tests showed WCC-16, Hba 12. What is the best initial imaging study in this situation?
A . Abdominal and pelvic computed tomography (CT) scan .
B . Endoscopic ultrasound (EUS) .
C . Magnetic resonance imaging with magnetic resonance a hy (MRCP) cholangiopancreatography .
D . Endoscopic retrograde cholangiopancreatography (ERCP) .
E . Abdominal ultrasound (US) .
49 ) A 25 year old thin and tal man suddenly develops left sided chest pain with cough and dysponoea, Provisional diagnosis is ?
A . atelectasis .
B . Pneumothorax .
C . Pulmonary embolism .
D . Myocardial infarction .
E . Bronchopneumonia .
50 ) A 40yr female, previously healthy, presented as an emergency with abdominal pain aggravated by fatty meals and associated with yelowish discoloration of her scera, vomiting, itching, day color stool and dark urine. No history of weight loss. Al are true, EXCEPT:
A . This patient needs admission, painkillers, rehydration (IV fluids) antibiotics .
B . The most likely diagnosis in this patient is gallstanes and stone(s) in the common bile duct .
C . The serum will most likely show increased level of amylase with a decreased level of lipase .
D . The cause of color urine is the increased conjugated bilirubin in urine .
E . The serum liver function tests will most likely show increased AIkaline Phosphatase .
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