Beruflich Dokumente
Kultur Dokumente
B) CLINICAL SUGERY
18) The best test to monitor the adequacy of levothyroxin therapy is:
F) radioactive iodine uptake
G) thyroglobulin
H) free thyroxine index (T4)
I) triiodothyronine resin uptake (T3)
22) The major cause of graft loss in heart and kidney allograft is:
A) acute rejection
B) hyperacute rejection
C) vascular thrombosis
D) chronic rejection
E) graft infection
23) All of the following are indicators of tumor aggressiveness and poor outcome for
papillary carcinoma of the thyroid gland EXCEPT:
A) age over 50 years
B) microscopic lymph node metstasis
C) tumor larger than 4 cm
D) poorly differentiated histological grade
E) invasion through capsule to adjacent tissues
24) A 40-year-old woman has extensive microcalcifications involving the
entire upper aspect of the right breast. Biopsy shows a commedo pattern of
intraductal carcinoma.
The most appropriate treatment is :
A) wide local excision
B) radiation therapy
C) wide local excision plus radiation therapy
D) right total mastectomy
E) right modified radical mastectomy
25) In the conventional ventilator management of acute adult respiratory distress
syndrome (ARDS) , arterial O2 saturation is maintained above 90% by all the
following EXCEPT :
F) increasing the ventilatory rate
G) the use of positive end-expiratory pressure (PEEP)
H) increasing mean airway pressure
I) increasing tidal volumes
J) increasing FiO2
26) Which of the following statements about patients with abdominal compartment
syndrome is NOT true ?
A) Abdominal pressure is usually measured indirectly through inferior vena cava
B) Multiple contributing factors are commonly responsible
a) They are traction diverticula that arise close to the tracheobronchial tree.
b) They characteristically arise proximal to an esophageal reflux stricture.
c) The degree of dysphagia correlates with the size of the pouch.
d) They are best approached surgically through a right thoracotomy.
e) The operation of choice is a stapled diverticulectomy, long esophagomyotomy,
and partial fundoplication.
32- Which of the following statements about Schatzki's ring is correct?
a) The ring represents a panmural fibrotic stricture resulting from gastroesophageal
reflux.
b) Dysphagia occurs when the ring diameter is 13 mm. or less.
c) The ring occurs within 1 to 2 cm. of the squamocolumnar epithelial junction.
d) Schatzki's ring indicates reflux esophagitis.
e) Schatzki's ring signifies the need for an antireflux operation.
33. Which of the following statements about pathology encountered at
esophagoscopy is/are correct?
a) Reflux esophagitis should be graded as mild, moderate, or severe, to promote
consistency among different observers.
b) An esophageal reflux stricture with a 2-mm. lumen is not dilatable and is best
treated with resection.
c) A newly diagnosed radiographic distal esophageal stricture warrants dilation and
antireflux medical therapy.
d) In patients with Barrett's mucosa, the squamocolumnar epithelial junction occurs
3 cm. or more proximal to the anatomic esophagogastric junction.
e) After fasting at least 12 hours, a patient with megaesophagus of achalasia can
safely undergo flexible fiberoptic esophagoscopy.
34. Infantile hypertrophic pyloric stenosis
a) Occurs with a female : male ratio of 4:1.
b)
c)
d)
e)
42- Which of the following variables best predicts prognosis for patients with a
recent diagnosis of cutaneous melanoma and no clinical evidence of metastatic
disease?
a) Breslow thickness.
b) Clark's level.
c) Ulceration.
d) Gender.
e) Celtic complexion.
43-the following are true about intracranial tumors except:
a) The most common location of brain tumors of childhood is the posterior cranial
fossa.
b) With few exceptions, examination of the CSF is of no value in the diagnosis of an
intracranial tumor.
c) Even the most malignant of primary brain tumors seldom spread outside the
confines of the central nervous system (CNS).
d) The majority of astrocytomas can be cured surgically.
e) Primary neoplasms of astrocytic, oligodendroglial, or ependymal origin represent
gradations of a spectrum from slowly growing to rapidly growing neoplasms.
e) Diverticulitis
47-Optimal front-line treatment of squamous cell carcinoma of the rectum
includes:
a) Abdominal perineal resection.
b) Low anterior resection when technically feasible.
c) Radiation therapy.
d) Chemotherapy.
e) Combined radiation and chemotherapy.
48 -65-year-old man presents with complaints of mucous discharge and perianal
discomfort. Physical examination reveals a fistulous opening lateral to the anus.
Anoscopic examination permits passage of a probe through the fistula tract. The
fistula traverses the internal anal sphincter, the intersphincteric plane, and a
portion of the external anal sphincter. The fistula is categorized as which type?
a) Intersphincteric
b) Transsphincteric
c) Suprasphincteric
d) Extrasphincteric
e) Non of the above
49-Warthin's tumor:
a) Is a pleomorphic adenoma of salivary gland
b) Should be treated by total paritidectomy
c) Is considered a benign salivary gland neoplasia
d) Respond well to preoperative radiotherapy
e) Often present with facial nerve compression
50-A 38 year old woman presents with right upper quadrant pain and
bouts of vomiting. She is known to have gallstones and has had similar
episodes in the past. Which of the following might support a diagnosis of
acute cholecystitis rather than biliary colic
a) duration of symptoms
b) Severity of vomiting
c) Presence of Murphy's sign
d) Presence of gas under right hemidiaphragm on erect CXR.
31- E
32- B
33- D
34- B
35- C
36- C
37- B
38- B
39- E
40- D
41- E
42- A
43- E
44-C
45- C
46- A
47- E
48- B
49- C
50- C
30- E
Surgical MCQ
1. The radial nerve.
a)
b)
c)
d)
e)
b)
c)
d)
e)
23 pairs +XX.
b)
21 pairs +XY.
c)
22 pairs +XY.
d)
22 pairs +XX.
e)
23 pairs +XY.
b)
c)
d)
In alkalotic states.
b)
c)
d)
Use of immunoglobulin.
e)
b)
c)
d)
e)
10. All the followings are Indications for central line insertion EXCPET:
a) Massive fluid replacement
b) Massive blood replacement
c) Measurement of central venous pressure
d) Prolonged Intervenes fluid therapy
11. Most common early complication of central venous line is:
a) Sepsis
b) Pneumothorax
c) Thoracic duct injury
d) Thrombosis
12. The following are Complications of shock:
a) Acute Respiratory failure
b) Acute myocardial infarction
c) Acute renal failure
d) A&C only
e) All the above
13. Causes of delayed union of fractures includes all the following
EXCPET:
a) Compound fracture
b) Infection
c) Adequate immobilization
d) Poor blood supply
14. In Head injury C.T. scan is indicated in the following
a) Aphasia after the injury
b) Deterioration of level of consciousness
c) Skull fracture with persistent headache
d) A&B only
e) All the above
15. Most important steps in management of head injury include:
a)
b)
c)
d)
e)
Prevent hypoxia
Prevent Dehydration
Assure Brain Metabolism
Prevent secondary brain injury
All the above
Parathyroid gland.
b)
c)
d)
Pituitary gland.
e)
Gonads.
18. Regarding tension pneumothorax, the first step in the management is:
a)
b)
Cricothyroidectomy.
c)
d)
e)
Weight gain.
b)
Palpitations.
c)
Proximal myopathy.
d)
e)
Pretibial myxoedema.
Miosis
b)
c)
d)
Exophthalmos.
e)
21. In role of nine extent of burn if entire trunk is burned it will be equal to:
a)
b)
c)
d)
e)
b)
c)
d)
e)
b)
c)
d)
e)
b)
c)
d)
e)
25. Regarding fluid losses in a major burn all are true except:
a)
b)
c)
d)
e)
b)
c)
d)
e)
b)
Analgesia.
c)
Neck immoblization.
d)
Cervical traction.
e)
29. The first aid of treatment in fracture of cervical spine should be:
a) Cervical spine x-ray.
b) Analgesia.
c) Neck immoblization.
d ) Cervical traction.
30. Regarding local anaesthesia:
a)
b)
c)
d)
e)
31. Small bowel obstruction often results in: (all correct except one)
a)
Hyperkalaemia.
b)
Metabolic alkalosis.
c)
Oliguria.
d)
Hypovolaemia.
e)
Severe dehydration.
Abdominal paracentesis.
b)
c)
d)
e)
b)
c)
Produces radiological evidence of free gas in the peritoneum in over 90 percent of the
patients.
d)
e)
Is accompanied by hypocalcaemia.
b)
c)
d)
e)
b)
Lasts 5 to 20 minutes.
c)
d)
e)
B&C only.
b)
If complicated by pulmonary embolism, it occures usually after the 7th post operative day.
c)
d)
e)
Anorexia.
b)
c)
d)
e)
Carcinoma.
b)
Diverticulosis
c)
Diverticulitis
d)
Polyp.
e)
Ulcerative colitis.
b)
c)
Ureteric stone.
d)
Pelvi-ureteric obstruction.
e)
Ureterocele.
b)
Transmission of infection.
c)
Hypercalcaemia.
d)
Hyperkalaemia.
e)
Transfusion reactions.
e) Psychological complication.
42. The recurrent laryngoeal nerve is branch of :
a) Facial nerve.
b) Glosso-pharyngeal nerve.
c) Cervical plexus.
d) Vagus nerve.
e) Brachial plexus.
43. The thyroid tumor which is may be associated with pheochromocytoma
is :
a)
Papillary carcinoma.
b)
Medullary carcinoma.
c)
Follicular carcinoma.
d)
Anaplastic carcinoma.
e)
Malignant lymphoma.
b)
c)
Pancreas pseudocyst.
d)
Pancreatic cystadenoma.
e)
b)
c)
Dentate line.
d)
Arcuate line
e)
Ano-rectal ring.
c) Submucons
d) Pelvirectal
Usually anterior
May be caused by previous anal surgery
Can cause dark bleeding PR.
Sometimes is painful
Treated by steroids
49. acute superior mesenteric artery occlusion: (all correct except one)
a)
b)
c)
d)
e)
Key Answers
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
E
A
C
D
B
E
D
C
D
B
B
E
C
E
E
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
C
B
E
A
A
C
D
E
A
A
A
E
C
C
E
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
A
E
A
D
C
D
E
B
A
C
C
D
B
C
E
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
B
B
A
D
E
C
B
A
A
A
B
B
E
E
B
61
62
B
C