Surgical Disease CS

Bessisy Tamir M1248

1) SC Which of the following is characteristic for direct inguinal hernia:

a) [ ] Never descends to the scrotum
b) [ ] Is congenital
c) [ ] Is frequently unilateral
d) [ ] Strangulates frequently
e) [ ] Is an effort hernia
2) SC Strangulation of the Meckel's diverticulum is called hernia:
a) [ ] Rihter
b) [ ] Maydl
c) [ ] Littre
d) [ ] Hasselbach
e) [ ] Brok
3) SC The posterior wall of the inguinal canal is:
a) [ ] Fascia transversalis
b) [ ] Internal oblique muscle
c) [ ] Conjoint tendon
d) [ ] Crural arcade
e) [ ] External oblique muscle
4) SC The II most often strangulated hernia
is: a) [ ] Femoral
b) [ ] Umbilical
c) [ ] Direct inguinal
d) [ ] Indirect inguinal in male patients
e) [ ] Of the linea alba in children
5) SC Parietal antimesenteric strangulation is called hernia:
a) [ ] Brok
b) [ ] Hasselbach
c) [ ] Maydl
d) [ ] Rihter
e) [ ] Littre
6) SC Typical femoral hernia is found:
a) [ ] Anterior to the crural arcade
b) [ ] Medial to the femoral vessels
c) [ ] Lateral to the femoral vessels
d) [ ] Posterior to the femoral vessels
e) [ ] Medial to the Cooper ligament
9) SC The hernial sac is missing in:
a) [ ] Congenital inguinal hernia
b) [ ] Umbilical hernia
c) [ ] Sliding inguinal hernia
d) [ ] Perineal hernia
e) [ ] Posttraumatic diaphragmatic hernia
10) SC The main purpose in indirect inguinal hernia repair is enforcing the anterior wall of the
inguinal canal. The most frequent used method is:
a) [ ] Bassini
b) [ ] Girard-Spasokukotki with Kimbarovski suture
c) [ ] Postempski
d) [ ] Kukudjanov
e) [ ] Martynov

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Bessisy Tamir M1248

11) SC The most frequent used method for femoral hernia repair is:
a) [ ] Rudji
b) [ ] Zatepin
c) [ ] Rudji-Parlaveccio
d) [ ] Lexer
e) [ ] Bassini
12) SC The preferred surgical procedure for umbilical hernias with the ring 3 is:
a) [ ] Mayo
b) [ ] Bassini
c) [ ] Sapejko
d) [ ] None of listed answers is correct
e) [ ] Lexer
13) SC Orthopedic treatment of hernia is indicated in :
a) [ ] Irreducible hernia
b) [ ] Strangulated hernia
c) [ ] Umbilical hernia in new-born
d) [ ] Small femoral hernia
e) [ ] Umbilical hernia in adults
14) SC Clinical differentiation between inguinal and femoral hernia is made depending on the
location of the hernia lump in relation to:
a) [ ] Gimbernat ligament
b) [ x] Malgaigne line
c) [ ] Cooper ligament
d) [ ] Spermatic cord
e) [ ] Epigastric vessels
15) SC Brunner cells have a mucus rich secret with pH 8,2 -9,3 and are predominantly situated in:
a) [ ] Cardia
b) [ ] Duodenum (DI and DII)
c) [ ] Gastric fundus
d) [ ] Duodenum (DIII and DIV)
e) [ ] Gastric antrum
16) SC The determinant factor in gastric ulcer etiopathogenesis is:
a) [ ] Hyperacidity
b) [ ] Alimentary factor
c) [ ] Psychic factor
d) [ ] Defense factor
e) [ ] Hereditary factor
17) SC For which stage after ulcer perforation are the following signs characteristic: repeated
vomiting, tachycardia, superficial breathing, signs of hypovolemic shock, elevated body
temperature, distended tender abdomen, intestinal paresis:
a) [ ] False improvement
b) [ ] Shock
c) [ ] Diffuse peritonitis
d) [ ] Preperforation period
e) [ ] Onset of the disease
18) SC What surgical procedure should be done in a 40-60 years patient with a gastric ulcer
perforation within 6 hours from the onset?
a) [ ] Simple suture of the ulcer
b) [ ] Partial gastrectomy (gastric resection)
c) [ ] Biopsy and Oppel procedure

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d) [ ] Wedge resection of the stomach + vagotomy

e) [ ] Bilateral truncal vagotomy + simple suture
19) SC Gregersen-Adler test shows:
a) [ ] Pain decrease after the onset of bleeding
b) [ ] Occult bleeding
c) [ ] Presence of pancreatic gastrinoma
d) [ ] Rectal bleeding
e) [ ] Bleeding from esophageal varices
20) SC Bergman sign means:
a) [ ] Pain decrease after the onset of bleeding
b) [ ] Occult bleeding
c) [ ] Presence of pancreatic gastrinoma
d) [ ] Rectal bleeding
e) [ ] Bleeding from esophageal varices
21) SC Clinical features: epigastric distension, episodic vomiting with increasing volume
and amelioration after it, correspond to:
a) [ ] Subcompensated stenosis
b) [ ] Compensated stenosis c) [
] Decompensated stenosis
d) [ ] Penetration of gastric ulcer to the pancreas
e) [ ] Penetration of duodenal ulcer to the pancreas
22) SC Which ulcer exhibit malignancy more frequently:
a) [ ] In the distal third of the stomach
b) [ ] In the duodenum
c) [ ] In the cardia
d) [ ] In the gastric fundus
e) [ ] On the lesser curvature of the stomach
23) SC According to Johnson classification a mediogastric ulcer is:
a) [ ] Not matching this classification
b) [ ] Matching this classification in case of
malignancy c) [ ] Type I
d) [ ] Type II
e) [ ] Type III
24) SC Kussmaul sign is:
a) [ ] Phlebitis of the left lower limb in gastric cancer
b) [ ] Metabolic disturbances in decompensated pyloric stenosis
c) [ ] Muscle rigidity in duodenal ulcer perforation
d) [ ] Presence of peristaltic waves of the stomach in pyloric stenosis
e) [ ] Left supraclavicular lymphadenopathy
25) SC Which of the below listed surgical procedures for gastroduodenal ulcer has a lower rate of
postoperative diarheea?
a) [ ] Proximal vagotomy
b) [ ] Truncal vagotomy
c) [ ] Partial gastrectomy with Balfour anastomosis
d) [ ] Partial gastrectomy with Billroth-I anastomosis
e) [ ] Truncal vagotomy with Heineke-Miculicz operation
26) SC What surgical procedure includes omental patching of the ulcer perforation?
a) [ ] Oppel
b) [ ] Judd
c) [ ] Braun

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d) [ ] Heineke-Miculitz
e) [ ] Holle
27) SC Ulcerogen adenoma produces large amounts of:
a) [ ] Histamine
b) [ ] Trypsin
c) [ ] Kallicrein
d) [ ] Gastrin
e) [ ] Kinins
28) SC Truncal vagotomy in emergency surgery of the peptic ulcer is associated most frequently
with which gastric drainage procedure:
a) [ ] Judd pyloroplasty
b) [ ] Finney pyloroplasty
c) [ ] Jaboulay gastroduodenostomy
d) [ ] Gastrojejunostomy
e) [ ] Heineke-Miculicz pyloroplasty
29) SC Duodenal ulcer can have the following complications,
except: a) [ ] Malignancy
b) [ ] Stenosis c)
[ ] Bleeding d)
[ ] Penetration e)
[ ] Perforation
30) SC The most characteristic laboratory parameter for perforated ulcer is:
a) [ ] Leucopenia with shift to the left
b) [ ]
c) [ ] Moderate anemia
d) [ ] Moderate leucocytosis (12.000 -14.000), increasing gradually
e) [ ] Increased hematocrit
31) SC The pain in duodenal ulcer is:
a) [ ] Permanent
b) [ ] Colicky
c) [ ] Depends on food intake
d) [ ] Decreases after gastric lavage
e) [ ] Decreases during the night
32) SC What is the earliest sign of the ulcer
malignancy: a) [ ] Fetid vomiting
b) [ ] Hematemesis
c) [ ] Disappearance of pain periodicity and decrease of its intensity
d) [ ] Weight loss
e) [ ] Melena
33) SC The most accurate method to determine gastric secretion is:
a) [ ] Hollender test
b) [ ] pH-measuring
c) [ ] Kay test
d) [ ] X-ray
e) [ ] Upper GI endoscopy
34) SC Which of the below listed fits the Johnson I type gastric ulcer:
a) [ ] Prepyloric ulcers
b) [ ] Body ulcers on the greater curvature
c) [ ] Ulcers on lesser curvature and duodenal ulcer
d) [ ] Lesser curvature ulcers with normal antrum and pylorus and decreased acidity

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e) [ ] Lesser curvature ulcers with prepyloric ulcers and increased secretion

35) SC The most efficient method to find ulcer malignancy is:
a) [ ] Double contrast gastric X-ray
b) [ ] History and physical examination
c) [ ] Upper GI endoscopy
d) [ ] Gregersen-Adler test
e) [ ] Computed tomography
36) SC Which is the most indicated surgical procedure In a 45 years old patient with long history of
intractable duodenal ulcer with Kay test prevalence:
a) [ ] Highly selective vagotomy
b) [ ] Truncal vagotomy with ulcer excision and gastric drainage procedure
c) [ ] Selective vagotomy with Jaboulay gastroduodenostomy
d) [ ] Truncal vagotomy with gastrojejunostomy
e) [ ] 2/3 gastric resection
37) SC For which stage after ulcer perforation are the following signs characteristic: violent
epigastric pain, anxiety, mydriasis, cold sweat, superficial breathing, Eleker sign, forced position:
a) [ ] After 12 hours from perforation with bleeding
b) [ ] First 6 hours after retroperitoneal perforation of a duodenal ulcer
c) [ ] First (first 4-6 hours)
d) [ ] Second (next 4-6 hours)
e) [ ] Third (after 12 hours from onset)
38) SC Conservative treatment of the perforated ulcer (nasogastric aspiration, wide spectrum
antibiotiSC, correction of hydroelectrolytic imbalancies) is used when there are no conditions to
perform surgery or the patient is not agree with the surgery. This treatment method was proposed
by:
a) [ ] Billroth (1881)
b) [ ] Pierandozzi (1960)
c) [ ] Dragstedt (1960)
d) [ ] Taylor (1946)
e) [ ] Braun (1892)
39) SC Upper GI bleeding activity determines the surgical management and is assessed by:
a) [ ] Clinically
b) [ ] Laboratory values
c) [ ] X-ray
d) [ ] Endoscopy
e) [ ] Laparoscopy
40) SC Upper GI endoscopy reveals bleeding grade III esophageal varices (gastric mucosa normal).
What hemostatic method would you choose initially?
a) [ ] Endoscopic band ligation
b) [ ] Resection of the distal esophagus with esophagogastrostomy (Tanner procedure)
c) [ ] Blackmore probe+ pituitrin i/v
d) [ ] Azygoportal disconnection
e) [ ] Splenorenal anastomosis
41) SC What is Pean-Billroth-I anastomosis in gastric resection:
a) [ ] Gastroduodenal termino-terminal anastomosis with narrowing of the stomach from the lesser
curvature
b) [ ] Gastrojejunal termino-lateral anastomosis
c) [ ] Gastrojejunal "Y" anastomosis
d) [ ] Gastroduodenal latero-lateral anastomosis
e) [ ] Gastroduodenal termino-lateral anastomosis

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42) SC The most important sign of gastroduodenal anastomotic leak:

a) [ ] Intense epigastric pain
b) [ ] Nausea and vomiting
c) [ ] Fever with chills
d) [ ] Discharge of metilen blue through the drains after it was introduced to the stomach
e) [ ] Epigatsric muscle rigidity
43) Mod de punctare: A1Grad de dificultate: scazut
SC The most frequent cause of mechanical evacuation disturbances is:
a) [ ] Wrong position of the anastomotic loop
b) [ ] Transmesocolic hernia
c) [ ] Anastomotic healing
d) [ ] Anastomositis
e) [ ] Gastroplegia
44) SC Anastomisitis occurs usually in the early postoperative period after Billroth I gastric
resection and is caused by microbial factor, tissue trauma, reaction to sutures, allergy etc. Major
signs epigastric pain and abundant vomiting will appear on PO day:
a) [ ] 1-2 b)
[ ] 2-3 c) [ ]
4 - 5 d) [ ]
6 -7 e) [ ] 7
- 10
45) SC Disappearance of the liver dullness is present in the majority of perforated ulcers and may
be confused with what other sign:
a) [ ] Mandel-Razdolskii
b) [ ] Celoditi
c) [ ] Kulencampf
d) [ ] Vighiato
e) [ ] Iudin
46) SC The most informative diagnostic procedure for a perforated ulcer is:
a) [ ] Contrasted orthostatic gastrography
b) [ ] Pneumogastrography
c) [ ] Plain abdominal X-
ray d) [ ] Laparoscopy
e) [ ] Contrasted gastrography (patient lying on the side)
47) SC Surgical treatment is indicated for gastric ulcer:
a) [ ] Immediately upon revealing the ulcer
b) [ ] After the first bleeding
c) [ ] At first signs of malignancy
d) [ ] If medical treatment is ineffective for 1-2 months
e) [ ] Only in case of perforation
48) SC Hollender test (2 units of insulin/10 kg body weight i/m with sampling of 8 portions
of gastric juice at every 15 minutes) assesses the phase of secretion:
a) [ ] Nocturnal
b) [ ] Basal
c) [ ] Intestinal
d) [ ] Cephalic
e) [ ] Hormonal (gastric)

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49) SC Following signs: paresthesia, hallucinations, tetania, in blood metabolic alcalosis ,

hypochloremia, hyponatremia, hypopotassemia, extrarenal azotemia, in a cachectic patient with
rare, abundant vomiting, will speak for:
a) [ ] Late intestinal obstruction
b) [ ] Zollinger-Ellison syndrome
c) [ ] Hemorrhagic shock
d) [ ] Chronic renal failure
e) [ ] Decompensated pyloric stenosis
50) SC The most frequent complication after Billroth II gastric resection is:
a) [ ] Thrombophlebitis
b) [ ] Duodenal stump fistula
c) [ ] Sepsis
d) [ ] Retroanastomotic hernia
e) [ ] Bleeding
51) SC Kulencampf sign is characteristic for the II stage after ulcer perforation and means:
a) [ ] Acute pain on all abdominal area
b) [ ] Shiftable dullness in right iliac fossa
c) [ ] "Board-like abdomen"
d) [ ] Painful prolabation of the Douglas pouch
e) [ ] "knife sharp" pain
52) SC Loss of 1000-1500 ml of blood (30% of circulating blood volume) corresponds to:
a) [ ] Occult digestive bleeding
b) [ ] Minor upper GI bleeding
c) [ ] Moderate upper GI bleeding
d) [ ] Massive upper GI bleeding
e) [ ] Cataclysmic upper GI bleeding
53) SC Select the most frequent surgical procedure for peptic ulcer:
a) [ ] Partial gastrectomy Billroth II
b) [ ] Partial gastrectomy Billroth I
c) [ ] Excision-partial gastrectomy (Madlender)
d) [ ] Excision-partial gastrectomy (Finsterer, Wilmans, Plenk)
e) [ ] Fundusectomy
54) SC Select the most frequent cause of upper digestive bleeding:
a) [ ] Gastric ulcer
b) [ ] Duodenal ulcer
c) [ ] Erosive gastritis
d) [ ] Gastric cancer
e) [ ] Mallory-Weiss syndrome
55) SC The pain in strangulated intestinal obstruction is:
a) [ ] Continuous, intense, dramatic
b) [ ] Continuous and intermittent
c) [ ] Vague, diffuse pain
d) [ ] Intermittent, colicky
e) [ ] Violent pain at the onset followed by improvement
56) SC Schlange sign is:
a) [ ] Splash over the distended loop
b) [ ] Sound of the falling drop
c) [ ] Tympanic sound over the asymmetric site
d) [ ] Enlarged, empty rectal ampula
e) [ ] Loud hyperperistaltic sounds

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57) SC Diffuse distention of the bowel loops on X-ray will speak for:
a) [ ] Dynamic obstruction
b) [ ] Sigmoid colon volvulus
c) [ ] Strangulated inguinal hernia
d) [ ] Bouveret syndrome
e) [ ] Obstructive caecum cancer
58) SC X-ray signs of small bowel obstruction:
a) [ ] Haustra
b) [ ] Multipl
c) [ ] Peripheral hydro-aeric images
d) [ ] "Bycicle tyre"
e) [ ] Pneumoperitoneum
59) SC The major differentiation criterion between intracellular and extracellular dehydration is:
a) [ ] Arterial hypotension
b) [ ] Poignant thirst
c) [ ] Tachycardia
d) [ ] Meteorism
e) [ ] Oliguria
60) SC Sklearov sign is:
a) [ ] Tympanic sound over the asymmetric site
b) [ ] Elastic resistance of the abdominal wall
c) [ ] Asymmetric abdominal distention
d) [ ] Splash over the distended loop
e) [ ] Sound of the falling drop
61) SC Spasmodic abdominal pain, vomiting, periumbilical fusiform palpable mass and
bloody rectal discharge in a child will speak for:
a) [ ] Acute pelvic appendicitis
b) [ ] Acute enterocolitis
c) [ ] Dysenteria
d) [ ] Intestinal intussusception
e) [ ] Small bowel volvulus
62) SC The most frequent cause of intestinal obstruction in a patient with previous laparotomy is:
a) [ ] Intussusception
b) [ ] Gallstone ileus
c) [ ] Bands, adhesions
d) [ ] Postoperative foreign bodies
e) [ ] Postoperative intestinal stenosis
63) SC The most characteristic sign for mechanic obstruction of the ascending colon
is: a) [ ] Bayer sign
b) [ ] Abundant vomiting
c) [ ] Complete arrest of intestinal
transit d) [ ] Konig sign
e) [ ] Bouveret sign
64) SC Air fluid levels few, big, lateral and WBC count up to15.000 are more characteristic for:
a) [ ] Sigmo
b) [ ] Colon obstruction
c) [ ] Small bowel obstruction
d) [ ] Strangulated inguinal
hernia e) [ ] Mesenteric ischemia

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Bessisy Tamir M1248

65) SC The pain in simple mechanic intestinal is:

a) [ ] Vague
b) [ ] Continuous
c) [ ] Colicky (paroxysmal)
d) [ ] Transitory
e) [ ] Burning
66) SC In pleuritis, vertebral fractures, retroperitoneal hematoma the dynamic ileus
is: a) [ ] Toxic
b) [ ] Reflex c)
[ ] Metabolic
d) [ ] Neurogenic
e) [ ] Spastic
67) SC How much small bowel would you resect distally from the necrosis limit:
a) [ ] 30 - 40 MC
b) [ ] 10 - 15 MC
c) [ ] 15 - 20 MC
d) [ ] 5 -10 MC
e) [ ] 40 -50 MC
68) SC What type of obstruction is the gallstone
ileus: a) [ ] Intussusception
b) [ ] Volvulus
c) [ ] Due to compression
d) [ ] Due to intraluminal obstruction
e) [ ] Spasm of the bowel muscle
69) SC How much small bowel would you resect proximally from the necrosis limit:
a) [ ] 10 - 15 MC
b) [ ] 20 - 30 MC
c) [ ] 5 - 10 MC
d) [ ] 30 - 40 MC
e) [ ] 15 - 20 MC
70) SC Konig sign appears in the early stage of intestinal obstruction and means:
a) [ ] Sound of the falling drop
b) [ ] Asymmetric distention
c) [ ] Visible peristalsis
d) [ ] Distended caecum
e) [ ] Evident meteorism over the distended site
71) SC Air fluid levels small, central are characteristic for:
a) [ ] Bouveret syndrome
b) [ ] Obstructive sigmoid cancer
c) [ ] Small bowel obstruction
d) [ ] Acute pancreatitis
e) [ ] Pyloric stenosis
72) SC Increase of blood urea nitrogen in intestinal obstruction is due to:
a) [ ] Loss of extracellular protein
b) [ ] Loss of inracellular protein
c) [ ] Loss of extracellular fluid
d) [ ] Loss of potassium
e) [ ] Hypochloremia

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73) SC The most appropriate diagnostic method in colon obstruction

is: a) [ ] Schwartz procedure
b) [ ] Barium enema
c) [ ] Plain abdominal X-ray
d) [ ] Computed tomography
e) [ ] Laparoscopy
74) SC Bayer sign is:
a) [ ] Symmetric distention of the abdomen
b) [ ] Right side asymmetric distention
c) [ ] Peristaltic sounds on the right flank
d) [ ] Asymmetric distention from left iliac fossa to the right hypochondrium
e) [ ] Bloody rectal discharge
75) SC Bouveret syndrome is found in:
a) [ ] Mesenteric ischemia
b) [ ] Caecum cancer
c) [ ] Gallstone ileus
d) [ ] postoperative ileus
e) [ ] Strangulated hernia
76) SC Choose the normal value of intraintestinal pressure:
a) [ ] 2-4 MC H2O
b) [ ] 6-8 MC H2O c)
[ ] 10-12 MC H2O d)
[ ] 14-16 MC H2O e)
[ ] 18-20 H2O
77) SC What is the most frequent cause of intestinal obstruction in elderly:
a) [ ] Fecalyths
b) [ ] Left colon tumor
c) [ ] Intussusception
d) [ ] Right colon tumor
e) [ ] Small bowel volvulus
78) SC At what pressure the bowel wall becomes permeable for microbes and toxins:
a) [ ] 10-15 MC H2O
b) [ ] 20-25 MC H2O
c) [ ] 30-40 MC H2O
d) [ ] 50-60 MC H2O
e) [ ] 65-70 MC H2O
79) SC In some cases abdominal distention may be absent in intestinal obstruction. What is the level
of obstacle in this case:
a) [ ] Near Treitz ligament
b) [ ] At the transition point of the jejunum to ileum
c) [ ] At ileocecal level
d) [ ] At splenic colon flexure
e) [ ] At rectosigmoid level
80) SC What diagnostic method can determine not just the level of the obstruction, but also its
cause:
a) [ ] Plain abdominal X-ray
b) [ ] Schwartz procedure
c) [ ] Laparoscopy
d) [ ] Barium enema
e) [ ] Ultrasonography

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81) CS Spastic ileus can be induced by various factors,

except: a) [ ] Intestinal ascariasis
b) [ ] Lead intoxication
c) [ ] Compensated diabetes
d) [ ] Dorsal tabes
e) [ ] Hysteria
82) CS Dynamic ileus has the following features, except:
a) [ ] Abdominal distension
b) [ ] Absence of spastic pain
c) [ ] Arrest of intestinal passage
d) [ ] Splash sound on abdominal auscultation
e) [ ] Abdomen is flat
83) SC The most frequent cause of obstructive jaundice is:
a) [ ] Tumor of the pancreatic head
b) [ ] CBD stones
c) [ ] Biliary ducts stricture
d) [ ] Biliary ducts tumors
e) [ ] Stenotic papillitis
84) SC During liver scintigraphy a normal absorption of the isotopes was found, but the isotopes
were absent in the gallbladder, bile ducts and bowel. This speaks for:
a) [ ] Hepatic jaundice
b) [ ] Posthepatic jaundice
c) [ ] Hemolytic jaundice
d) [ ] Liver cirrhosis
e) [ ] None of the above listed
85) MC CBD gallstone found preoperatively can be removed by:
a) [ ] Supraduodenal CBD incision
b) [ ] Transduodenal intraoperative papillosphincterotomy
c) [ ] Postoperative endoscopic papillosphincterotomy
d) [ ] Preoperative endoscopic papillosphincterotomy
e) [ ] Is dissolved with drugs
86) SC Which of the below listed methods will provide the most complete information about
morphological type of cholecystitis, adjacent organs and perioneums changes:
a) [ ] Ultrasonography
b) [ ] Computed tomography
c) [ ] Transparietal cholecystocholangiography
d) [ ] Laparoscopy
e) [ ] ERCP
87) SC The optimal and less aggressive diagnostic method in a patient with obstructive jaundice
is: a) [ ] Oral cholecystography
b) [ ] Intravenous cholecystography
c) [ ] Ultrasonography
d) [ ] ERCP
e) [ ] Transparietohepatic cholangiography
88) SC Air in the bile ducts speak for:
a) [ ] CBD stones
b) [ ] Acute cholecystitis
c) [ ] Bilio-digestive fistula
d) [ ] Bilio-biliary fistula
e) [ ] Salmonella infection of the gallbladder

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89) SC The following signs: moderate pain in the right hypochondrium, moderate fever, marked
jaundice with reddish nuance, slight liver enlargement, moderate splenomegaly, without anemia
are specific for:
a) [ ] Acute cholecystitis
b) [ ] Cholangitis
c) [ ] CBD stones
d) [ ] Hepatic jaundice
e) [ ] Cancer of the pancreatic head
90) SC What kind of bile is formed in the hepatocytes and contains cholesterol, biliary acids and
phospholipids?
a) [ ] Primary bile
b) [ ] Secondary bile
c) [ ] Final bile
d) [ ] None of the listed
e) [ ] All three of them
91) SC In acute obstructive lithiasic cholecystitis the stone is
impacted: a) [ ] In intrahepatic bile ducts
b) [ ] In the body of the
gallbladder c) [ ] In the CBD
d) [ ] In the hepatic duct
e) [ ] In gallbladder infundibulum or cystic duct
92) SC Choose the gold standard diagnostic method in obstructive
jaundice: a) [ ] Oral cholecystography
b) [ ] Intravenous cholecystography
c) [ ] Ultrasonography
d) [ ] ERCP
e) [ ] Laparoscopy
93) SC The simple T shaped drain of the CBD is called:
a) [ ] Lane
b) [ ] Kehr
c) [ ] Cattele-Champeau
d) [ ] Voelker
e) [ ] Duval
94) SC The major differentiation sign of the stone in duced obstructive jaundice from malignant
jaundice is:
a) [ ] Marked jaundice accompanied by pain
b) [ ] Acholic stool and dark urine
c) [ ] Jaundice preceded by painful colic
d) [ ] Pruritus
e) [ ] Intermittent fever
95) SC The most informative noninvasive method of obstructive and hepatic jaundice
differentiation is:
a) [ ] ERCP
b) [ ] Scintigraphy
c) [ ] Oral cholecystography
d) [ ] Intravenous cholecystocholangiography
e) [ ] Transparietohepatic cholecystography
96) SC The third most frequent cause of obstructive jaundice is:
a) [ ] CBD stones
b) [ ] Bile ducts stricture

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c) [ ] Primary cancer of the bile ducts

d) [ ] Extrinsic compression of the bile ducts
e) [ ] Stenosis of the Vater papilla
97) SC Common bile duct drainage using a 2 mm tube introduced through the cystic duct towards
the duodenum is named:
a) [ ] Robson-Vishnevski
b) [ ] Lane
c) [ ] Halsted
d) [ ] Praderi-Smith
e) [ ] Kehr
98) SC Infected pancreatic necrosis is characteristic for the following phase of evolution of the
pathological process in the pancreas:
a) [ ] Edema
b) [ ] Fat necrosis
c) [ ] Hemorrhagic necrosis
d) [ ] Lysis and sequestration
e) [ ] Pancreatic pseudocyst
99) SC One of the mentioned substances in the evolution of the acute pancreatitis is formed in
the ischemic pancreas and induces pancreatic shock:
a) [ ] Kinine b)
[ ] Heparin c)
[ ] Serotonin d)
[ ] Kallikrein e)
[ ] Histamine
100) SC The most important in the management of acute pancreatitis in the early phase is:
a) [ ] Pain management, spasmolytics, circulation improvement
b) [ ] Shock and homeostasis management
c) [ ] Reducing pancreatic secretion and inactivation of the pancreatic enzymes
d) [ ] Reducing toxemia
e) [ ] Prevention of complications
101) SC The main aim in the management of acute hemorrhagic pancreatitis before surgery is:
a) [ ] Pain management
b) [ ] Detoxification
c) [ ] Spasmolytics and circulation improvement
d) [ ] Circulating plasma volume increase
e) [ ] Reducing pancreatic secretion
102) SC The most optimal surgical procedure for infected pancreatic necrosis is:
a) [ ] Peripancreatic infiltration with novocaine and antiferments
b) [ ] Lesser sack debridement
c) [ ] Pancreatic resection
d) [ ] Pancreas abdominisation
e) [ ] Pancreatic decapsulation and lesser sack drainage
103) SC The Courvoisier-Terrier sign is characteristic for:
a) [ ] CBD stones
b) [ ] Cancer of the body of the pancreas
c) [ ] Klatskin tumor
d) [ ] Cancer of the head of the pancreas
e) [ ] Gallbladder carcinoma

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104) SC Which of the following is a poor prognostic sign for acute pancreatitis:
a) [ ] Elevated blood amylase
b) [ ] Hypocalcemia
c) [ ] Elevated blood glucose
d) [ ] Elevated urine amylase
e) [ ] Elevated WBC
105) SC Korte sing in acute pancreatitis means:
a) [ ] Absence of pulsation on the abdominal aorta
b) [ ] Absence of intestinal peristalsis
c) [ ] Pain in the scapula-humerus area on the left
d) [ ] Tympanic sound located on the projection of the transvers colon
e) [ ] Muscular guarding and pain in the projection of the pancreas
106) SC The endocrine part of the pancreas is represented in form of islets located in:
a) [ ] Parenchymatous tissue
b) [ ] Interlobular spaces
c) [ ] Pancreatic fat tissue
d) [ ] Fibrous septa of the gland
e) [ ] Retroperitoneal at the level of the pancreatic tail
107) SC The most accepted theory for the onset of the acute pancreatitis is:
a) [ ] Common channel theory
b) [ ] Allergic theory
c) [ ] Fermentative theory
d) [ ] Vascular theory
e) [ ] Infectious theory
108) SC Gobiet sign in acute pancreatitis means:
a) [ ] Muscular guarding in the pancreas projection
b) [ ] Periumbilical cyanosis
c) [ ] Lack of abdominal aortic pulsation
d) [ ] Tympanic sound on the projection of the transverse colon
e) [ ] Pain upon percussion in the area of upper left abdominal quadrant
109) SC The most accurate diagnostic procedure for acute pancreatitis with fermentative
peritonitis is:
a) [ ] Contrasted abdominal x-ray
b) [ ] Abdominal ultrasonography
c) [ ] Scintigraphy
d) [ ] Laparoscopy
e) [ ] ERCP
110) SC The most efficient method for inactivation of the proteolytic ferments in case of
acute pancreatitis is:
a) [ ] Stimulated dieresis
b) [ ] Antienzymes in high doses
c) [ ] Laparoscopic lavage and drainage of the peritoneal cavity
d) [ ] Hemofiltration
e) [ ] Blood transfusion
111) SC In case that chronic pancreatitis is induced by stenosis of the big duodenal papilla, the most
indicated surgical procedure is:
a) [ ] Resection of the pancreatic head (Duval)
b) [ ] Pancreatojejunostomy (Puestow)
c) [ ] Pancreatojejunostomy (Duval)
d) [ ] Papillosphincterotomy and endoscopic wirsungotomy

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e) [ ] Papilectomy
112) SC The Grey-Turner sign for acute pancreatitis means:
a) [ ] Pale skin
b) [ ] Ecchymosis and cyanosis on the lateral edges of the abdomen
c) [ ] Pain in the point of junction of the ribs to the vertebrae on the left side
d) [ ] Sentinel intestinal loop on a plane abdominal x-ray
e) [ ] Pain upon palpation of the left upper abdominal quadrant
113) SC In order to reduce pancreatic secretion several treatment options are available, the least
indicated one due to adverse effects is:
a) [ ] Nasogastric intubation
b) [ ] Local extra and intragastric hypothermia
c) [ ] No enteral feeding
d) [ ] Atropine 0,1% -1,0 x 3 times a day
e) [ ] 5-Fluorouracil
114) SC The Cullen sign in acute pancreatitis means:
a) [ ] Pale skin
b) [ ] Ecchymosis and periombilical cyanosis
c) [ ] Pain in the point of junction of the ribs to the vertebrae on the left side
d) [ ] Sentinel intestinal loop on a plane abdominal x-ray
e) [ ] Pain upon palpation of the left upper abdominal quadrant
115) SC In the first phase (edema) of evolution of acute pancreatitis the optimal management is:
a) [ ] Medicamentous management and if necessary laparoscopy with drainage of the abdomen and lesser sack
b) [ ] Laparotomy with the drainage of the CBD
c) [ ] Laparatomy and pancreatic capsula removal
d) [ ] Laparatomy, peripancreatic blockage
e) [ ] Laparatomy, lesser sack debridement
116) SC The mean secretion volume of a healthy pancreas within 24 hours is (ml):
a) [ ] 1500 - 2500
b) [ ] 600 -700
c) [ ] 300 -400
d) [ ] 1000 -1500
e) [ ] 400 -500
117) SC In 85-90% of cases acute pancreatitis is:
a) [ ] Edematous
b) [ ] Necrotic
c) [ ] Hemorrhagic
d) [ ] Infiltrative necrotic
e) [ ] Infected pancreatic necrosis
118) SC In order to reduce pain, sphincter of Oddi and improvement of circulation the following
procedures are indicated except:
a) [ ] Epidural blockage in the T
7 -T8 segment using lidocaine 3%
b) [ ] Morphine 1% i/m every 4 hours
c) [ ] Novocaine 1% - 10 ml i/v
d) [ ] Baralgine 2,0 i/m every 6-8 hours
e) [ ] Rheopolyglucin + heparin + euphyllini i/v
119) SC A simple wound with a penetrating orifice and a exit one is called:
a) [ ] Penetrating wound
b) [ ] Penetrating but non-perforating wound
c) [ ] Perforating wound

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d) [ ] Through w
e) [ ] Blind wound
120) SC In case of multiple jejunal injuries within the first 6 hours after onset the optimal surgical
procedure is:
a) [ ] Simple suture
b) [ ] Resection with primary end-to-end anastomosis
c) [ ] Resection with primary end-to-side anastomosis
d) [ ] Jejunostomy
e) [ ] Primary anastomosis and protective stoma
121) SC The best majority (90%) of the abdominal traumas are multiple injuries, the main
etiology being:
a) [ ] Gunshot wounds
b) [ ] Knife wounds
c) [ ] Catatrauma (falls)
d) [ ] Traffic accidents
e) [ ] Sport trauma
122) SC The rate of isolated abdominal trauma is minimal (10%), because the main
etiological factor nowadays is:
a) [ ] Traffic accidents
b) [ ] Gunshot wounds
c) [ ] Knife wounds
d) [ ] Catatrauma (falls)
e) [ ] Sport trauma
123) MC The delayed diagnosis of retroperitoneal duodenal injuries is determined by the following factors:
a) [ ] Leakage of the duodenal content into the retroperitoneal space
b) [ ] Low aggressivity of the duodenal content c)
[ ] Initial onset of a retroperitoneal phlegmon
d) [ ] Lack of diffuse peritonitis within the first hours after onset
e) [ ] Reduced bacterial contamination of the duodenal content
124) SC A patient with a gunshot wound is diagnosed with liver, small bowel and mesentery
injuries. The correct determination of the trauma is:
a) [ ] Complex multiple injuries (multivisceral injuries)
b) [ ] Simple trauma
c) [ ] Through wall injury
d) [ ] Combined trauma
e) [ ] Penetrating but non-perforating wound
125) S A patient was diagnosed with the following injuries: pelvic fracture, urethral and splenic
injuries. The correct name for above mentioned trauma is:
a) [ ] Blunt non-penetrating
injury b) [ ] Polytrauma
c) [ ] Associated trauma
d) [ ] Simple trauma
e) [ ] Combined tra
126) SC The diagnosis of retroperitoneal injury of the duodenum is difficult. One of the most
important clinical signs is:
a) [ ] Blumberg
b) [ ] Mandel-Razdolski
c) [ ] Grassman-Kulenkampf
d) [ ] Bernstein
e) [ ] Vighiato

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127) SC The optimal surgical procedure in case of total pancreatic injury is:
a) [ ] Parenchyma suture with Wirsung duct suture
b) [ ] Distal pancreatic resection
c) [ ] Drainage of the both ends of the Wirsung duct as well as the lesser sack
d) [ ] Parenchyma suture with Wirsung duct drainage
e) [ ] Pancreatectomy
128) SC The Kehr sign in splenic injuries is:
a) [ ] Pain and rebound tenderness upon palpation of the left upper abdominal quadrant
b) [ ] Pain in the left upper abdominal quadrant irradiating into the left shoulder
c) [ ] Dull sound upon percussion of the left upper abdominal quadrant
d) [ ] Dull sound upon percussion of the abdominal flanks
e) [ ] Hypotension
129) SC In case of hollow organ injury the least invasive and the most informative is the following procedure:
a) [ ] USG
b) [ ] Laparoscopy
c) [ ] Plane abdominal X-ray
d) [ ] Diagnostic peritoneal lavage
e) [ ] CT scan
130) SC Pancreatic injuries are most frequently diagnosed in:
a) [ ] Isolated wounds
b) [ ] Associated wounds
c) [ ] Blunt trauma
d) [ ] Complex blunt multivisceral trauma
e) [ ] Combined
131) SC The frequency of hollow organ injury in blunt abdominal trauma is 20-30%, and the most
frequently affected (50-60%) is:
a) [ ] Duodenum
b) [ ] Small bowel
c) [ ] Colon
d) [ ] Bladder
e) [ ] Stomach
132) SC Hemobilia most frequently is caused by :
a) [ ] a. hepatica aneurism rupture
b) [ ] Liver injury
c) [ ] Gangrenous cholecystitis
d) [ ] Viral hepatitis
e) [ ] Hepatic hemangioma
133) SC Diaphragmatic injury has the following features, except:
a) [ ] Thoracic pain increased by breathe and coughing
b) [ ] Decreased respiratory sound
c) [ ] Dull and/or tympanic sound at percussion of the thorax on the injured
side d) [ ] Intestinal sounds on auscultation of the thorax on the injured side
e) [ ] Presence of the liver dullness
134) SC Blumberg sign in acute appendicitis is:
a) [ ] Pain during sudden decompression of right iliac fossa
b) [ ] Pain upon right iliac fossa palpation
c) [ ] Pain in the right iliac fossa upon chest extension
d) [ ] Pain upon right iliac fossa palpation irradiating in the epigastric area
e) [ ] Pain in the right iliac fossa during air insufflation intothe rectum

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135) SC A patient with clinical signs of acute appendicitis presents peritoneal signs in the right iliac
fossa and suprapubic area. What type of peritonitis is suspected?
a) [ ] Limited localized
b) [ ] Localized unlimited
c) [ ] Diffuse generalized
d) [ ] Total generalized
e) [ ] Douglas pouch abscess
136) SC Protein and fluid loss in case of acute peritonitis can reach 300 g and 9-10 l respectively.
The main factor for these losses is:
a) [ ] Circulatory disturbances
b) [ ] Intestinal paresis
c) [ ] Multiple vomiting
d) [ ] Alkalosis
e) [ ] Renal impairment
137) SC The optimal surgical approach in case of appendiceal abscess is:
a) [ ] Extraperitoneal, according to Pirogovs procedure
b) [ ] Through McBurney approach
c) [ ] Through middle inferior laparotomy
d) [ ] Through medial laparotomy
e) [ ] Through lumbar approach
138) SC Physical examination in case of the onset of a diffuse peritonitis reveals the following clinical
sign: a) [ ] Distended abdomen
b) [ ] Periombilical ecchymosis
c) [ ] Board-like abdomen
d) [ ] The abdomen is not participating to respiratory movements
e) [ ] Kussmauls sign
139) SC A patient with a perforated peptic ulcer is admitted after 10 hour after onset, presenting
the followingsigns: xerostomia, Ps - 96 b/min., BP -120/70 mmHg, dyspnea, severe abdominal pain,
board-like abdomen, WBC 16.000. Please tag the phase of the peritonitis:
a) [ ] Reactive phase
b) [ ] Toxic phase
c) [ ] Terminal phase
d) [ ] Infectious complications phase
e) [ ] Multiple organ failure phase
140) SC The most frequent cause of infection of the peritoneal cavity is:
a) [ ] Hollow organ perforation
b) [ ] Through the blood stream
c) [ ] Intraperitonealrupture of a hydronephrosis
d) [ ] Lymphatic way
e) [ ] None of the above
141) SC A patient with perforated peptic ulcer is admitted after 32 hours from onset presenting the
following signs: xerostomia, Ps - 120 b/min., BP -90/40 mm Hg, tachypnea 32 pe min., facies
hipocraticus, distended and painful abdomen, no intestinal peristalsis, WBC - 25.000. Indicate the
phase of peritonitis:
a) [ ] Reactive faze
b) [ ] Toxic faze
c) [ ] Terminal faze
d) [ ] Infectious complications faze
e) [ ] Multiple organ failure faze

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142) SC The management of acute generalized peritonitis follows several goals, the most important
is: a) [ ] Surgical debridement
b) [ ] Antibiotic treatment
c) [ ] I/V infusions
d) [ ] Restore intestinal function e)
[ ] Prophylaxis of complications
143) SC The most important for diagnosis of peritonitis is:
a) [ ] Plain X-ray
b) [ ] Local physical examination
c) [ ] Laboratory tests
d) [ ] Paraclinical examinations e)
[ ] Diagnostic peritoneal lavage
144) SC The most frequent cause of subphrenic abscess is:
a) [ ] Perforated appendicitis
b) [ ] Gangrenous acute cholecystitis
c) [ ] Perforated gastroduodenal ulcer
d) [ ] Necrotic acute pancreatitis
e) [ ] Hepatic abscess
145) SC Wirchows triad in the pathogenesis of acute thrombophlebitis means:
a) [ ] Hypercoagulability, hemodynamic changes (stasis, turbulence), endothelial injury/dysfunction
b) [ ] Injury to the valves, venous hypertension, varicous veins
c) [ ] Collagen synthesis deficiency, coagulopathy, venous stasis
d) [ ] Saphenous varices, hypoproteinemia and venous stasis
e) [ ] Venous stasis, coagulopathy, blood reflux through the perforating veins
146) SC The Delbe-Pertes test reveals:
a) [ ] The function of the main valve of the saphenous
vein b) [ ] The function of the valves of the deep veins
c) [ ] Permeability of the deep veins
d) [ ] Severity of the vertices of the superficial veins
e) [ ] Function of the perforating veins
147) SC Three main factor are important in the pathogenesis of various veins:
a) [ ] Cardiac insufficiency, venous dilatation and elevated venous pressure
b) [ ] Obesity, cardiac insufficiency and venous dilatation
c) [ ] Venous valve insufficiency, venous dilatation and elevated venous pressure
d) [ ] Elevated blood pressure, venous valve insufficiency and elevated venous pressure e) [
] Lymphatic stasis, venous valve insufficiency and elevated venous pressure
148) SC Pylephlebitis means:
a) [ ] Inflammation of the inferior mesenteric artery
b) [ ] Thrombophlebitis of the splenic vein
c) [ ] Thrombosis of the appendicular artery
d) [ ] Thrombophlebitis of the hepatic veins
e) [ ] Thrombophlebitis of the portal vein
149) SC Anticoagulant therapy in thrombophlebitis is aimed to:
a) [ ] Fibrin lysis
b) [ ] Prevent thrombus progression
c) [ ] Thrombus lysis
d) [ ] Stimulates healing of the intima
e) [ ] Reduces deoxyribonuclease activity

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150) SC The most frequent complication for the superficial venous thrombosis is:
a) [ ] Pylephlebitis
b) [ ] Myocardial infarction
c) [ ] Mesenteric ischemia
d) [ ] Deep vein thrombosis (DVT)
e) [ ] Pulmonary artery thrombosis
151) SC The most important signt in the diagnosis of acute appendicitis is:
a) [ ] Dieulafoy triade
b) [ ] Kocher sign
c) [ ] Bartomie-Mihelson
sign d) [ ] Sitcowschi sign
e) [ ] Blumberg sign
152) SC Blumberg sign in acute appendicitis means:
a) [ ] Pain during decompression of the right iliac fossa
b) [ ] Pain during palpation of the right iliac fossa
c) [ ] Pain lower limb lifting in the right iliac fossa
d) [ ] Pain referral to the epigastric region during right iliac fossa
palpation e) [ ] Pain in the right iliac fossa during rectal air insufflation
153) SC Pain in the paraumbilical area and the symptoms of Kummel, Krasnobaev are
characteristic for the following location of an inflamed appendix:
a) [ ] Subhepatic
b) [ ] In elderly
c) [ ] Retrocecal
d) [ ] Me
e) [ ] Pelvic
154) SC The most efficient method to secure an appendiceal stump is:
a) [ ] Simple ligation
b) [ ] Purse-string suture using non-absorbable stitches
c) [ ] Purse-string suture without ligation
d) [ ] Purse-string suture using absorbable
stitches e) [ ] Simple ligation and separate sutures
155) SC The management of appendicial infiltrate in the first phase of evolution is:
a) [ ] Non-operative management (local hypothermia, antibiotics)
b) [ ] Surgery is indicated in young patients
c) [ ] Surgery is indicated in elderly
d) [ ] Surgery is indicated in case of pelvic localization
e) [ ] Surgery is indicated in case of suspected cecal carcinoma
156) SC The major and constant sign of acute appendicitis
is: a) [ ] Anorexia
b) [ ] Vomiting
c) [ ] Fever
d) [ ] Diarrhea
e) [ ] Pain in the right iliac fossa
157) SC Differential diagnosis of acute appendicitis in children must be performed with:
a) [ ] Perforated peptic ulcer
b) [ ] Acute cholecystitis
c) [ ] Intoxication
d) [ ] Renal colic
e) [ ] Acute pancreatitis

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158) SC The most frequent position of the appendix is:

a) [ ] Lateral
b) [ ] Descending
c) [ ] Retrocecal
d) [ ] Ascending
e) [ ] Medial
159) SC What is most appropriate surgical approach in case of suspected acute appendicitis?
a) [ ] Lenander
b) [ ] McBurney
c) [ ] Sprengel
d) [ ] Midline laparotomy
e) [ ] Inferior midline laparotomy
160) SC The management of acute appendicitis in elderly is:
a) [ ] Non-operative
b) [ ] Emergency surgery
c) [ ] Colonic examination in order to rule out colon carcinoma
d) [ ] Initial management of concomitant diseases
e) [ ] Antibiotics
161) SC The optimal drainage in case of gangrenous appendicitis with localized peritonitis is:
a) [ ] Drainage of the Douglas pouch through a separate incision
b) [ ] Drainage of the Douglas pouch through McBurney incision
c) [ ] Drainage through the left iliac fossa
d) [ ] Drainage of the iliac fossa on the both
sides e) [ ] Drainageis not indicated
162) SC Dieulafoys tiad in acute appendicitis includes:
a) [ ] Epigastric pain shiftin within 4-6 hours to the right iliac fossa hypersensitivity of the skin,
tenderness and muscular contraction at McBurneys point
b) [ ] Hypersensitivity of the skin, tenderness and muscular contraction at McBurneys point
c) [ ] Anorexia, hypersensitivity of the skin, tenderness and muscular contraction at McBurneys point
d) [ ] Tenderness and muscular contraction at McBurneys point, hypersensitivity of the skin, fever
e) [ ] Tenderness and muscular contraction at McBurneys point, Hypersensitivity of the skin, pain
radiating into the right testicle
163) SC The optimal management of the appendiceal infiltrate in the phase of abscess formation is:
a) [ ] Non-operative management
b) [ ] Extraperitoneal drainage (Pirogov)
c) [ ] USG-guided abscess drainage
d) [ ] Laparotomy and abscess drainage
e) [ ] Abscess drainage through McBurney apporach
164) SC The most accepted etiological theory of acute appendicitis is:
a) [ ] Infectious
b) [ ] Polyethiologic
c) [ ] Mechanical
d) [ ] Cortico-visceral
e) [ ] Chemical
165) S In case of acute appendicitis, pain on abdominal palpation is localized
in: a) [ ] Sonnenburg point
b) [ ] Wenglovschi triangle
c) [ ] McBurneys point
d) [ ] Iacubovici triangle
e) [ ] Lanz point

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166) SC The most frequent histological form of acute appendicitis

is: a) [ ] Catarrhal
b) [ ] Appendiceal colic
c) [ ] Gangrenous
d) [ ] Perforating e)
[ ] Phlegmonous
167) SC Which layer of the appendix has an important number of follicles, due to which the
appendix is named abdominal amygdala:
a) [ ] Mucosa
b) [ ] Submucosa
c) [ ] Muscula
d) [ ] Serosal
e) [ ] All are correct
168) SC Choose the correct statement about appendiceal infiltrate treatment:
a) [ ] Conservative
b) [ ] Surgical
c) [ ] Medical-surgical
d) [ ] Physiotherapeutic
e) [ ] All are correct
169) CS Flail chest is:
a) [ ] Multiple rib fractures
b) [ ] When multiple adjacent ribs are broken in multiple places, separating a segment, so a part of the
chest wall moves independently
c) [ ] Formation of a flap intimately adhered to the rib cage
d) [ ] Chest trauma complicated by acute respiratory failure
e) [ ] Is a severe form of pneumothorax
170) CS What is the cause of paradoxical respiration?
a) [ ] Inhibition of the superior respiratory centers
b) [ ] Respiratory muscles' paralysis
c) [ ] Flail chest
d) [ ] Dilution of atmospheric air
e) [ ] Decrease of cardiac contractions
171) CS Emergency measures in case of an open pneumothorax are:
a) [ ] Urgent transportation of the patient to the hospital
b) [ ] Tamponade of the wound and occlusive bandage application
c) [ ] Oxygen therapy
d) [ ] Assisted respiration
e) [ ] Aspiration from pleural cavity
172) CS Choose the appropriate management for thoracic wounds with suspicion for peritoneal
cavity organs' injury :
a) [ ] Clinical monitoring
b) [ ] Analgesics, opioid and nonopioid
c) [ ] Diagnostic laparotomy
d) [ ] Aspiration of gastric content
e) [ ] Paracentesis, laparoscopy
173) CS Which of the below listed features does not fit pneumothorax:
a) [ ] Dyspnea
b) [ ] Cyanosis
c) [ ] Tympanic sound on percussion
d) [ ] Dull sound on percussion

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e) [ ] Absence of respiratory sounds

174) CS Management of non-complicated ribs fractures includes:
a) [ ] Thoracic bandage
b) [ ] Analgesics and intercostals blockage
c) [ ] Thoracotomy
d) [ ] Ribs suture using metallic stitches
e) [ ] External fixation for the fractured ribs
175) CS Emergency aid for a tension pneumothorax
is: a) [ ] Orotracheal intubation
b) [ ] Puncture of the pleural cavity using a large diameter needle in the II intercostal space on the
mediocalavicular line
c) [ ] Pleurostomy in the V intercostals space on the medial axillary line
d) [ ] Pleurostomy in the V intercostals space on the posterior axillary line
e) [ ] Pulsoximetry for determining blood oxygenation
176) CS The following is not characteristic for penetrating thoracic
wound? a) [ ] Pneumoperitoneum
b) [ ] Hemothorax
c) [ ] Hemopericardium
d) [ ] Open pneumothorax
e) [ ]Tension pneumothorax
177) CS What is characteristic for open
pneumothorax? a) [ ] Collapsed lung on the affected side
b) [ ] Collapsed lung on the opposite
side c) [ ] Mediastinum movement
d) [ ] Mediastinum shift to the healthy side
e) [ ] Mediastinum shift to the injured side
178) CS Emergency aid for open pneumothorax is:
a) [ ] Thoracic drainage
b) [ ] Occlusive bandage
c) [ ] Chest cast fixation
d) [ ] Thoracic aspiration in the III intercostals
space e) [ ] Pleurostomy

23