Beruflich Dokumente
Kultur Dokumente
Sobhi I Skaik,MS,MD,CABS,FRCSEd
Consuntant Surgeon,
Ass. Professor of Sirgary
B)
C)
D)
E)
B) CLINICAL SUGERY
B)
C)
D)
E)
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)
J) thyroid stimulating hormone (TSH)
19) Which of the following statements about fungal infection is NOT true ?:
A) Prior or synchronous culture positive for Candida at another site occurs in few
patients with candidimia
B) For critically ill patients nonhaematogenous sites of candida are appropriately
treated with systemic antifungal therapy
C) Mortality rates are similar regardlss of whether C. albicans fungmia is treated
with amphotericin B or fluconazole
D) Intravenous catheters and the gastrointestinal tract are common portals for
Candida to gain blood stream access
E) Septic emboli are more common with fungal endocarditis than with bacterial
endocarditis
20) The maximum safe dose of local anaesthetic administered subcutaneously in a 70-kg
man is:
A) 10 to 20 ml of 1% lidocaine
B) 40 to 50ml oh 2% lidocaine with epinephrine
C) 40 to 50 ml of 1% lidcaine with epinephrine
D) 40 to 50 ml of 1% bupivacaine (marcaine)
E) 40 to 50 ml of 1%lidocaine without epinephrine
21) Two days after right hemicolectomy for a Dukes B caecal carcinoma , the
Patient complains of sharp right-sided chest pain and dyspnea. HisPaO2
Is 64mmHg ,his PaCo2 is 32mmHg. CVP is 26 cm water, and the blood pressure is
102/78mmHg. A pulmonary embolus is suspected,
The next step in management should be:
A) A ventilation- perfusion lung scan
B) A pulmonary arteriogram
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
C) The chief manifestations are reflected in central venous pressure , ventilatory
function, and oliguria
D) Decopression of the abdomen is required to resverse the syndrome
E) Aggressive hemodynamic monitoring and management is required when the
abdomen is opened
27) The most appropriate treatment for histologically malignant cystadenoma
phylloides is :
A) total mastectomy without axillary node dissection
B) total mastectomy with axillary node dissection
C) wide margin (3) cm excision of the lesion
D) post operative hormonal manipulation
E) postoperative adjuvant chemotherapy
28) Deep venous thrombosis resulting from upper extremity central venous lines:
A) should be treated with catheter removal, heparin therapy, and long term
anticoagulants
B) is best with urokinase through the catheter
C) is innocuous and self limiting, and best treated with catheter removal only
D) is best treated with low-dose warfarin (coumadin, 1 mg / day) , without catheter
removal
E) is best managed by single systemic dose of low molecular weight heparin daily
and continued catheter use
29) Emergency surgery is indicated for all of the following complications of ulcerative
colitis EXCEPT:
A) colonic dilatation greater than 12 cm (toxic mega colon )
B) free perforation
C) complete intestinal obstruction
D) intractable haemorrhage
E) abscess formation
30) All the following statements concerning carcinoma of the oesophagus are true
EXCEPT that:
A) it has a higher incidence in males than females
B) alcohol has been implicated as a precipitating factor
C) adenocarcinoma is the most common type at the cardio esophageal junction
D) it occurs more commonly in patients with corrosive oesophagitis
E) surgical excision is the only effective treatment
d) Liver transplantation
e) Cryosurgical ablation
37- Oesophageal atresia all true except:
a) Is often associated with a distal trachea-oesophageal fistula
b) Polyhydramnios is often present late in pregnancy
c) 50% have other associated congenital abnormalities
d) Contrast X-ray studies are necessary to confirm the diagnosis
e) Post-operatively over 30% develop oesophageal strictures
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.
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
18192021222324252627282930-
E
A
C
D
D
B
D
A
A
C
A
E
E
48- B
49- C
50- C
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)
c) Cephalohaematoma.
d) Subgaleal hematoma.
e) Subperiostial haematoma.
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
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.
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)
e) A and B only.
51. Injuries to the urethra (all are correct except one)
a) Are more common in male.
b) Are often caused by road traffic accidents.
c) Are easily diagnosed on intra venous pyelography.
d) Require urgent surgical treatment.
e) Diagnosed by retrograde urethragraphy.
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