Please Read Carefully and Choose The Best Answer:: A. Trauma
Please Read Carefully and Choose The Best Answer:: A. Trauma
a) Tumor Grade
b) Number . of lymph nodes
c) Lateral Margin Involvement
d) Inexperienced surgeon
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e) All of the above
11. Treatment of cyclical pronounced mastalgia includes all the following except
a. supportive bra
b. reduce caffeine, red ,chocolate intake
c. simple analgesi
d. Vitamin A, Vitamin C
e. evening primrose oil
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14. Thyroid cyst
a. 50% due to degeneration in the colloid
b. 30-50% of cold nodules
c. Intra cystic malignancy is more in males
d. all the above
e. none of the above
15. Regarding occult papillary carcinoma of the thyroid all the following are
true except
a. the lesion is 1cm or less
b. usually not clinically obvious
c. rarely metastasis
d. Infiltrates the capsule
e. Surgery is not required in all cases
16. The most common cause of pyrexia in the 5th post operative day is
a. deep vein thrombosis
b. wound infection
c. respiratory tract infection
d. urinary tract infection
e. pulmonary embolism
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d. prolonged use causes hyponatremia
e. none of the above
22. Carbuncle
a. is a confluence of several boils
b. causes minimal tissue destruction,
c. usually pointing to the skin
d. less common in diabetic patients
e. treated by incision and drainage
24. All the following are indications of surgery in small bowel fistula except
a. associated peritonitis
b. failure to close in three weeks
c. malignant disease
d. distal obstruction
e. substantial bowel discontinuity
25. All the following are indications of total parenteral nutrition in the surgical
patient except
a. Short gut syndrome
b. Sever acute pancreatitis
c. Extensive Burns
d. Enterocutaneous fistula
e. Esophageal carcinoma
26. A 22-year-old male presents into the ER after sustaining stab wound to the left
chest. The injury is 2 cm left of the sternum at the level of his nipple. Initial vital
signs include a pulse rate 88 bpm, GCS 15, respiratory rate 12 breaths/mm, and
blood pressure 139/74 mmHg.
Initial management of this patient should be:
a. CXR
b. pericardiocentesis
c. left chest tube thoracostomy
d. esophagogram
e. echocardiogram
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27. Which of the following is true regarding pancreatic trauma and its
complications
a. Complications of pancreatic trauma include pancreatic pseudocyst, abscess,
hemorrhage, and fistula.
b. Asymptomatic pseudocysts may be managed conservatively, as approximately 80%
will spontaneously resolve .
c. Pseudocysts which do not spontaneously resolve can be
managed with percutaneous drainage, if ductal disruption is identified.
d. If a pancreatic fistula is secondary to a major ductal disruption it will not
respond to sphincterotomy and duct stenting via endoscopic retrograde
pancreatic cholangiopancreatography (ERCP)
e. Overall mortality from pancreatic injuries is approximately 45%.
30. The chromosome carrying the gene associated with MEN I is:
a. chromosome 14
b. chromosome 13
c. chromosome 12
d. chromosome 11
e. chromosome 10
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32. Nasopharyngeal carcinoma is associated most strongly with which virus?
a. CMV
b. varicella zoster
c.herpes simplex.
d.Epstein-Barr virus (EBV).
e. human papilloma virus.
33. Which of the following is false concerning the physiologic effects of volatile
anesthetics?
a. decreased tidal volume
b. decreased blood pressure
c. decreased respiratory rate
d. bronchodilation
e. decreased sensitivity to the ventilatory stimulant effects of carbon dioxide
36. A patient presents with a history of low back pain and sciatica. The pain
radiates to the little toe, the ankle reflex is absent and the patient has difficulty in
everting the foot. Which nerve root is likely to be trapped?
a. L3
b. L4
c. L5
d. S1
e. S2
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e. Embriologically may transmit urine but never bowel contents
38. Regarding intestinal obstruction, all of the following are true Except:
a. Its cardinal features are; abdominal pain, distension, vomiting and constipation
b. Small bowel obstruction is commonly of adhesive aetiology in adults
c. Erect plain abdominal X-Ray is usually requested to localize the site of
obstruction
d. Intussception is usually treated primarily with hydrostatic pressure
e. Superior mesenteric artery embolus the commonest cause of acute
mesenteric ischaemia
42. Deep venous thrombosis prophylaxis is appropriate for all of the following
patients EXCEPT:
a. a 67-year-old male undergoing a colectomy.
b. a 21-year-old male undergoing an outpatient open inguinal hernia repair.
c. a 21-year-old male in the ICU, comatose, with a closed head injury.
d. a 60-year-old female undergoing open reduction and internal fixation of a hip
fracture.
e. a 60-year-old female undergoing reduction of a lung carcinoma.
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44. Concerning the inguinal canal:
a. It transmits the ilio-inguinal nerve
b. The deep inguinal ring lies below the mid-point of inguinal ligament
c. The superficial inguinal ring overlies the pubic tubercle
d. Laterally , the anterior wall is made up of the external oblique aponeurosis
e. Laterally, the posterior wall is formed by the conjoint tendon
45. Clinical picture of the lung tumor include all the following Except:
a. Carcinoide syndrome
b. Superior venacava syndrome
c. Horner's syndrome
d. Superior laryngeal nerve paralysis
e. Dyspnoea
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a. due to middle meningeal artery tear
b. can be treated conservatively
c. classically there is contra lateral, dilated, fixed pupil
d. needs operation within 24 hours
e. a ad c only
c. Over 20% of patients present with more than one primary tumour
a. Both serum iron and total iron binding capacity are reduced
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b. Operative cholangiogram
d. Portography
Which of the following does not appear to cause early dumping .55
a) Serotonin
b) Bradykinin
c) Neurotensin
d) Secretin
a) Stomach is the most common organ in the gi system which is involved in
Lymphoma
b) Peak incidence of lymphomas is seen in 6th-7th decade
.c) Endoscopy usually reveals gastritis like picture or gastric ulcer
.d) MALT lymphoma is the commonest variety
Which is false for GIST (Gastro intestinal stromal tumor) of stomach .57
.a) It is the same as leiomyoma and leomyosarcoma as described previously
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b) origin is from mucosa from the interstitial cells of Cajal
c) Associated with C-Kit Mutation
.d) Imatinab is a new effective drug for adjuvant therapy
a) Intrahepatic liver
b) Hepatic duct bifurcation
c) Lower End of CBD (Common Bile Duct)
d) Lower 1/3rd of CBD (Commmon Bile duct)
Which of the following is not a criteria for diagnosing Sphincter of Oddi .60
Dysfunction
a) CBD diameter more than 12 mm on USG
b) Decrease in CBD pressure after infusion of Cholecystokinin
c) Ampullary pressure more than 40 mm Hg
d) Delayed emptying of contrast from CBD after ERCP
What is not included in the triad of zollinger ellison syndrome (ZES) .63
A) Hyperacidity
B) Intractable duodenal ulcer disease
C) Liver secondaries
D) Non beta islet cell tumor of pancreas
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b) Extrahepatic 15% in lungs 2% in brain
c) Adult worm infests herbivores
.d) Indirect Heamagglutination (IHA) is the most specific serological test
68. In a patient with positive occult blood in stool, the most likely diagnosis is:
a. hemorrhoids
b. duodenal ulcer
c. colon cancer
d. gastric ulcer
e. esophageal cancer
69. In a 50 year old patient with rectal bleeding and internal piles, the most
appropriate next step is:
a. Gastric ulcer
b. Colonic volvulus
c. Esophageal stricture
d. Esophageal achalasia
e. Hiatus hernia
71. 16th year old female patient, known to be Situs inversus totale came to our
hospital complaining of severe left lower abdominal pain, nausea and vomiting of 7
hours duration. On physical exam tenderness in the LIF, guarding was positive and
Blumberg sign was +. CBC showed increase in WBCs with shift to the left . The most
possible diagnosis is:
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a. Gastro enteritis
b. Meckel’s diverticulitis
c. Acute appendicitis
d. Imperforated hymen
e. UTI
72. S.E is a 68 year-old female patient underwent inner lower quadrantectomy with
clearance of the axilla because of mucinous carcinoma of the breast diagnosed by true
cut needle biopsy. The pathology result was : Tumor size was 1,2 X 2 X1.5 Cm. Two
out of 13 LNs were with Mets. Estrogen and progesterone receptors were negative
and her-2 was positive +3. Chest and abdominal CT were free, Bone scan was with no
evidence of mets.
For this patient what is the stage of her breast Ca:
a) Stage one
b) Stage ll
c) Stage lll
d) Stage lV
a. subtotal gastrectomy
b. radiotherapy
c. subtotal gastrectomy and radiotherapy
d. chemotherapy
e. wide local excision
75. Correct statements about the characterization and histologic features of Crohn's
disease include
a. A marked connective tissue reaction is present in the bowel wall and mesentery
b. Cicatrization and bowel stenosis are frequent problems
c. Exacerbations and remissions are characteristic of the disease
d. Patients are more likely to develop fistulas into bowel or bladder than to
experience free perforations
e. Patients with long-standing Crohn's disease have an increased incidence of small
bowel carcinoma
76. A small bowel fistula will not close during a course of bowl rest and
Total parenteral nutrition if there is
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a. active Crohn's disease
b. an undrained abscess
c. distal obstruction
d. epithelialization of the tract
e. radiation enteritis
78. A 33-year-old man presents with a complaint of a slow-growing mass over his
right pre auricular area. The lesion is fixed to the underlying structures and has
recently become painful.
Which of the following features strongly suggests that this patient's lesion is a
malignancy?
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81. A. M a 30-year old underwent total thyroidectomy before 2 years because of
papillary carcinoma of thyroid.
Which is the most reliable lab test for follow up to the patient R\O recurrence of
the disease
a. TSH
b. T3
c. Thyroglobuline
d. gamaglobuline
e. CEA
For this patient, which of the following findings would indicate that the tumor is
?unresectable
a. Invasion of the superior mesenteric artery
b. Peritoneal metastasis
c. Metastasis to celiac lymph nodes
d. All of the above
83. A 71 year-old man, on non steroidal anti-inflammatory treatment for his back
pain has had sudden onset severe epigastric pain while he was walking in his
garden. He was transferred to the E.R, Chest X-Ray done and showed the picture
in the Rt. What is the possible diagnosis
a. Miocardial infarction
b. Pulmonary embolism
c. Perforated viscus
d. Neumothorax
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which of the following is not a choice for immediate management of blunt .86
abdominal trauma patient with unstable vital signs
88. A 35- year old woman experiences acute onset of epigastric and right
upper quadrant pain several hours after a large dinner. She has had
similar episode in the past that resolved after a few hours. This episode
persists, and she has fever and nonbilious vomiting. What is the most
likely source of abdominal pain?
a. Perforated ulcer
b. Acute appendicitis
c. Perforation following bowel obstruction
d. Acute Cholecystitis
e. Diverticulitis
91. All of the following are associated with morbid obesity except?
a. Coronary artery disease
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b. Sleep apnea
c. Reduction in life expectancy
d. Asthma
e. None of the above
93. Regarding post burn sequelae, all of the following statements are
correct except?
a. All second-and third-degree burns produce permanent scarring
b. The incidence of hypertrophic scar formation is less after excision and
skin grafting than with wounds that heal spontaneously.
c. Hypertrophic scars are best treated by early excision and would
closure.
d. Burn scar hypopigmentation and irregularities can be signif-icantly
improved by demabrasion and thin split-thickness skin grafting
e. Squamous cell carcinoma is the most common carcinoma in an old burn
scar.
94. All of the following statements regarding diabetic foot infections are
true except?
a. Foot infection occurs more frequently in diabetic than in nondiabetic
patients
b. The saline injection-aspiration method is the preferred method for
obtaining reliable cultures
c. Diabetic foot infections are commonly polymicrobial
d. Osteomyelitis of the foot is frequently encountered in patients with a
long history of diabetes and neuropathic ulcers
e. None of the above
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97. The appropriate therapy for Paget’s disease of the nipple is:
a. Topical steroid cream
b. Topical antifungal medication
c. Intralesional steroid injection
d. Resection
Good luck
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