1. A 45-year old female has a 2-cm firm, movable breast mass. Encircle the true statement.

A. A biopsy procedure should be done to rule our breast cancer.

B. Mammography should be requested to further investigate the mass.
C. Breast ultrasound should be done to characterize the nature of the mass.
D. An MRI should be done to visualize not only the mass, but the entire breast.

2. Regarding complications associated with colonoscopy and colonoscopic polypectomy:

A. Perforation from diagnostic colonoscopy requires an immediate exploratory celiotomy.
B. Transmural burn after polypectomy requires an immediate explatory celiotomy.
C. Most delayed bleeding from colonoscopic polypectomy requires surgical intervention.
D. Immediate treatment of bleeding secondary to snaring of a pedunculated polyp should be electrocoagulation of
the stalk.

3. A 70-year old patient presents with jaundice of 2 weeks duration without a significant history of abdominal pain.
Ultrasound revealed markedly distended gall bladder. The most likely diagnosis is:
A. Acute cholecystitis
B. Choledocholithiasis
C. Periampullary tumor
D. Choledochal cyst

4. Ultrasonography reveals a single 1-cm gallstone in an asymptomatic 50 year old woman. Which of the following is the
recommended treatment?
A. Observation and follow-up
B. Laparoscopic cholecystectomy
C. Open cholecystectomy
D. Bile acid dissolution therapy

5. A 65-y.o. known alcoholic came in due to increase in sleeping time with associated left-sided weakness of two weeks
duration. A month ago, he suffered a fall. The most likely diagnosis is:
A. intraparenchymal tumor
B. hypertensive bleed
C. chronic subdural hematoma
D. ruptured aneurysm

6. While jogging along Manila Bay, a 24 year old intern tripped, landing on his groin straddling a pole. PE shows blood per
meatus, scrotal contents are intact, and the prostate is not floating. His bladder is distended and he cannot void. What is the
appropriate management?
A. Insert a foley catheter to relieve the bladder
B. Request for a retrograde urethrography
C. Perform a suprapubic tube cystostomy
D. Explore the scrotum for associated injuries.

7. Following Goodsall’s rule, a fistula in-ano with an external opening located 1.5 cm from the anal verge would have its
internal opening located:
A. in the anterior midline
B. in the posterior midline
C. radially, in the same quadrant
D radially, in a separate quadrant

8. In patients with rectal cancer, Computed Tomography scanning best evaluates:

A. The presence or absence of hepatic metastases.
B. The depth of rectal wall penetration.
C. The presence of lymph node metastases.
D. The configuration of the primary tumor

9. Ultrasonography revealed a single 1 cm gallstone in an asymptomatic 55 year old diabetic. Which of the following is the
recommended treatment?
A. Observation and follow-up
B. Laparoscopic cholecystectomy
C. Open cholecystectomy
D. Bile acid dissolution therapy

1
10. 70-90% of primary gastrinomas are located in the area defined by a triangle with points located at the junction of the cystic
duct and common bile duct, the second and third portion of the duodenum, and the neck and body of the pancreas. This
area is known as the Triangle of:
A. Calot C. Passaro
B. Hesselbach D. Bermuda

11. Histologic examination of a thyroid gland tumor reveals psammoma bodies. This finding indicates that the lesion is:
A. Follicular Carcinoma C. Papillary Carcinoma
B. Medullary Carcinoma D. Hurtle Cell Carcinoma

12. A 40 year old female was diagnosed with Papillary Thyroid Carcinoma. She presents with a hard thyroid mass, cervical
lymphadenopathies, and several coin lesions on chest x-ray. Clinical staging for this patient would be:
A. Stage I C. Stage III
B. Stage II D. Stage IV

13. A 45 year old woman has a mobile lump in the upper outer quadrant of her right breast. An open excisional biopsy reveals a
1.5 cm lobular carcinoma in situ with negative margins. With regards to further management, which of the following
statements is true?
A. Follow-up without further surgical intervention is sufficient at this time.
B Mirror image biopsy of the contralateral breast is warranted.
C. Total mastectomy, without axillary dissection, is indicated.
D. Lumpectomy with radiation therapy is the recommended treatment.

14. During the initial assessment of the multiply injured patient, the main goal and objective of the Primary Survey is to:
A. obtain a detailed history and complete physical examination
B. stabilize the patient and comfort the relatives
C. detect and treat immediately life-threatening injuries
D. detect and treat immediately limb-threatening injuries

15. In performing maneuvers to ensure airway patency, it is most critical to:

A. provide 100% oxygen C. stabilize the cervical spine
B. have intravenous lines running D. have intubation set ready

16. Respiratory distress in cases of congenital diaphragmatic hernia is a result of

A. inability of the ipsilateral lung to expand due to the herniated abdominal viscera
B. recurrent aspiration pneumonia due to concomitant gastroesophageal reflux
C. splinting of the contralateral diaphragm from distention of the intestinal tract
D. incomplete development of the lung resulting in inadequate area for gas exchange

17. Which of the following statements about Protein Metabolism after trauma is true?
A. Skeletal muscle breakdown is inhibited by interleukin-1.
B. Glutamine consumption by fibroblasts is increased.
C. Hepatic and renal glycogenesis is upregulated.
D. Adrenal synthesis of acute-phase reactants occurs

18. Which of the following situations would be a contraindication for performance of an Emergency Department Thoracotomy?
A. Rapidly deteriorating patient with cardiac tamponade
B. Agonal patient with penetrating abdominal injury
C. Witnessed arrest in a patient with penetrating chest trauma
D. Agonal patient with multiple organ system blunt trauma

19. What is the likely diagnosis in a 30/M presenting with nasal congestion, epistaxis and bilateral enlarged infraauricular
nodes?
A. Non-Hodgkin’s Lymphoma C. Tonsillar Carcinoma
B. Maxillary Carcinoma D. Nasopharyngeal Carcinoma

20. Which of the following conditions is not associated with familial adenomatous polyposis syndrome?
A. Periampullary cancer (ampulla of Vater).
B. Multiple Fibromas
C. Circumoral pigmentation.
D. Duodenal polyps

2
21. During an inguinal herniorrhaphy, the hernial sac was noted to contain a Meckel’s diverticulum. Academically, this is termed
a:

A. Spigelian hernia C. Maydl’s hernia

B. Littre’s hernia D. Sliding hernia

22. Which of the following is not a source of upper gastrointestinal bleeding?

A. Cushing’s ulcer C. Marjolin’s ulcer
B. Curling’s ulcer D. Bormann’s ulcer

23. A 24 year old street sweeper was brought to the ER for exhaustion. The patient claims to have a congenital heart disease. On
examination, a grade 3/6 diastolic murmur is heard at the 2 nd intercostal space, parasternal border. The murmur’s duration
does not vary with respiration. The patient most likely has:

A. Atrial Septal Defect C. Patent Ductus Arteriosus

B. Ventricular Septal Defect D. Tetralogy of Fallot

24. Superior vena cava syndrome occurs in about five percent of cases of lung cancer and is considered extensive disease and an
emergency. It is best treated with:
A. Chemotherapy C. Immunotherapy
B. Radiotherapy D. Surgical Debulking

25. A 60 kg male sustained partial thickness burns totaling 40% of his total body surface area. He was brought to the emergency
room 10 hrs post injury. Based on the Parkland formula, resuscitative fluids should be given at the rate of:
A. 300 ml per hour
B. 450 ml per hour
C. 600 ml per hour
D. 685 ml per hour

26. In electrical burns of the extermities, the physician must primarily watch out for
A. Dry and wet gangrene
B. Compartment Syndrome
C. Autoamputation of digits
D. Peripheral denervation

27. Which of the following statements is true regarding airway management in the early post burn period?
A. Carbon monoxide pulmonary toxicity is a frequent cause of death in burn patients
B. Upper airway obstruction may occur as late as 48 hours after the burn injury
C. Fiberoptic bronchoscopy has no role in the assessment of airway in the burn patient
D. In securing the airway, tracheostomy is preferred over intubation .

28. What is the most likely histology in a patient with a malignant thyroid nodule and a 5 cm hard shoulder mass?
A. Papillary C. Follicular
B. Medullary D. Parafollicular

29. A 26/F was admitted 3 hours after ingestion of muriatic acid of undetermined amount. Except for superficial burns of the
oral cavity, the rest of the physical examination was normal. Which of the following interventions is appropriate?
A. Insert a nasogastric tube
B. Request for immediate endoscopy
C. Start systemic antibiotics and steroids
D. Extract blood for CBC and electrolytes

30. In which of the following patients is mammography most indicated?

A. 30/F with a 3cm left breast mass, FNAB + for cancer
B. 35/F with breast pain; mother had breast cancer
C. 39/F asymtomatic, requests for breast cancer screening
D. 42/M with a 1 cm hard breast mass

31. A 45/M underwent a Radical Total Gastrectomy last month. Which of the following vitamins must be given as routine
supplement?
A. Vitamin B1 C. Vitamin B6
B. Vitamin B2 D. Vitamin B12

3
32. With regards to liver anatomy, which of the following statements is true?
A. The right lobe is twice the size of the left
B. The falciform ligament divides the liver into equal halves
C. The left lobe contains anterior and posterior segments
D. The caudate is part of the left lobe

33. In which condition is splenectomy a hundred percent curative?

A. Hereditary Spherocytosis
B. Sickle Cell Anemia
C. Idiopathic Thrombocytopenic Purpura
D. Hodgkin’s lymphoma

34. Destruction of the ganglia of the myenteric plexuses in acquired megacolon occurs in:
A. Intermittent Porphyria
B. Chaga’s Disease
C. Lead poisoning
D. Crohn’s Disease

35. Sexual dysfuntion or impotenence after proctectomy involves loss of:

A. Erection and ejaculation mediated by parasympathetics.
B. Erection and ejaculation mediated by sympathetics.
C. Erection mediated by parasympathetics and ejaculation mediated by sympathetics.
D. Erection mediated by sympathetics and ejaculation mediated by parasympathetics.

36. Copious anal bleeding occuring 2 hours after hemorrhoidectomy is best managed by:
A. Bed rest, pressure dressing, and sedatives.
B. Intraluminal rectal packing.
C. Suture ligation of bleeders.
D. Epinephrine injection.

37. Which of the following statements is true concerning carcinoembryonic antigen?

A. It is elevated in only 10 percent of patients with stages I-II colon carcinoma
B. It is elevated in approximately 65 percent of patients with colon carcinoma
C. It is more likely to be produced by poorly differentiated colon carcinoma.
D. Its level is expected to decrease after the tumor has been extirpated.

38. A 40 year old female with a 6 cm breast CA underwent modified radical mastectomy. 10
out of 15 nodes were positive for tumor. You would advise:
A adjuvant radiotherapy to the chest wall
B. adjuvant cytotoxic chemotherapy
C. adjuvant hormonal therapy
D. adjuvant chemotherapy and radiotherapy

39. The most important prognosticating factor in well-differentiated thyroid cancer is:
A. age of the patient
B. size of the mass
C. presence or absence of neck nodes
D. tumor grade and histology

40. What nerve when transected during mastectomy, will result in numbness of the upper medial aspect of the upper arm?
A. thoracoacromial nerve
B. thoracodorsal nerve
C. long thoracic nerve
D. intercostobrachial nerve

41. A 70-year-old male complaining of colicky abdominal pain, progressive constipation

with intermittent passage of watery, bloody and mucus-containing stools and associated
with an abdominal mass often have carcinoma in the:
A. Right colon
B. Cecum
C. Transverse colon

4
 D. Left colon

42. The most important route by which carcinoma of the colon metastasizes is through:
A. Lymphatics C. Direct extention
B. Hematogenous D. Peritoneal seeding

43. Courvoisier’s sign is associated with:

A. acute cholecystitis
B. acute pancreatitis
C. toxic cholangitis
D. pancreatic cancer

44. True about inguinal hernias in women:

A. femoral hernias are the most common variety
B. direct hernias are more common than indirect hernias
C. in women, direct hernias are more common than in men
D. in women, femoral hernias are more common than in men

45. A Pringle’s maneuver consists of occlusion of the portal triad (portal vein, hepatic artery,
common bile duct) by the placement of a vascular clamp across the:
A. Gastroduodenal ligament
B. Gastrosplenic ligament
C. Hepatoduodenal ligament
E. gastrohepatic ligament

46. The second most common primary malignant tumor of the liver is:
A. Hemangiosarcoma
B.Lymphoma
C. cholangiocarcinoma
D.hemangiosarcoma

47. The most sensitive test for determining the presence of intraabdominal injury secondary to
a stab wound in a patient with equivocal PE findings is:
A. plain abdominal x-rays
B. computed tomography scanning
C. diagnostic peritoneal lavage
D. wound exploration

48. A newborn infant was taken to the pediatric admitting section with the following findings on
examination: there was a thin membrane covering a big abdominal defect; the umbilical cord was at the apex of this
membrane; abdominal organs which can be seen through the thin membrane include the liver. What is the most likely
diagnosis?
A. ectopia cordis
B. omphalocoele
C. gastroschisis
D. umbilical hernia

49. The most common congenital cardiac lesion is:

A. ASD
B. VSD
C. TOF
D. PDA

50. In a patient with head trauma, the CT-scan plates revealed a lenticular hyperdensity at the R temporal area with slight
midline shift. There was cerebral edema. The radiographic findings are consistent with a:
A. acute subdural hematoma
B. subarachnoid hemorrhage
C. epidural hematoma
D. hemorrhagic contusion of the temporal lobe

51. The same patient also presented with otorrhagia. One should also suspect:
A. frontal bone fracture
B. nasal bone fracture

5
 C. occipital bone fracture
D. temporal bone fracture

52. The neurologic examination finding which heralds the completion of a spinal cord injury is:
A. hyperreflexia
B. bulbocavernosus reflex
C. clonus/babinski
D. motor strength improvement

53. The most important reason for requesting a KUB-IVP in a patient with a stab wound in the left flank and gross hematuria is
to assess the:
A. Degree of renal injury
B. Location of injury
C. Function of the right kidney
D. Function of the left kidney

54. An 80-kg male is brought to the Surgery ER 30 minutes after sustaining full thickness and partial thickness burns involving
40% and 20% of his total body surface area, respectively. Using the Parkland formula to guide initial fluid resuscitation, he
should receive Ringer’s lactate at :
A. 1,200 ml/hr for the next 12 hours
B. 800 ml/hr for the next 8 hours
C 1,800 ml/hr for the next 8 hours
D 1,200 ml/hr for the next 8 hours

55. A 34 year old male presents with a 3 x 2 cm hard mass at the right thyroid lobe with note of lymph nodes at the right lateral neck.
FNAB of the thyroid nodule would most likely reveal:
A. follicular carcinoma
B. papillary carcinoma
C. medullary carcinoma
D. Non-Hodgkin’s lymphoma

56. Most common complication of bilobar thyroid resection:

A. transient hypocalcemia
B. hematoma or bleeding
C. surgical site infection
D. recurrent laryngeal nerve injury

57. A 30-year old female presents with breast pain nad a non-tender, well-defined 3 cm movable mass on the left breast.
Aspiration yielded 10-cc of clear fluid with disappearance of the mass. You would advise:
A. sonomammography
B. excision biopsy to prevent recurrence
C. observation and follow-up
D. cytologic examination of aspirated fluid

58 A 34 year old female with a 1 cm invasive ductal carcinoma on the right breast decided to undergo lumpectomy and axillary
dissection. Histopath revealed that axillary nodes were negative for tumor. What is the appropriate adjuvant treatment?:
A. chemotherapy
B. radiotherapy
C. observation
D. immunotherapy

59. Regarding lower GI bleeding due to typhoid fever, which among the following statements is false?
A. Exploratory laparotomy is the preferred treatment after resuscitation
B. GI bleeding from typhoid ileitis usually occurs on the 2 nd week of illness
C. Nasogastric intubation is essential for proximal bowel decompression
D. Bleeding is secondary to ulceration of Peyer’s patches

6
60. Proctosigmoidoscopic findings in a 37 year old male include a necrotic, fungating 2 cm mass obstructing 20% of the lumen.
Mass is located 4 cm from the anal verge. Most appropriate surgical procedure for him is:
A. abdominoperineal excision
B. coloanal pullthrough
C. radiotherapy and chemotherapy
D. Harmann’s procedure

61. In all patients presenting with UGIB, which of the following takes precedence over all the rest?
A. complete history
B. physical examination
C. resuscitation
D. gastrointestinal endoscopy

62. The most common cause of bloody pleural effusion is:

A. tuberculosis
B. malignancy
C. bacterial
D. pulmonary infarction
E. trauma

63. A 25 year old male was wheeled into the ER with a knife impaled in his belly. The most appropriate intervention is to:
A. carefully and slowly pull out the knife
B. do wound exploration, then pull out the knife
C. do laparotomy, pull out knife under direct visualization
D. do triple contrast abdominal ct-scan, then decide from there

64. A patient with hypertrophic pyloric stenosis would most likely have which of the following acid-base problems
A. hyperchloremic, hypokalemic metabolic acidosis
B. hyperchloremic, hyperkalemic, metabolic acidosis
C. hypochloremic, hypokalemic metabolic alkalosis
D. hypochloremic, hyperkalemic metabolic alkalosis

65. The essential physiologic defect in varicose veins is

A. increased venous distensibility
B. venous valvular incompetence
C. increased blood flow through arteriovenous communications
D. incompetent perforating veins

66. In a patient with hematuria, the next diagnostic modality to request for if creatinine is elevated is:
A. KUB-Intravenous Pyelography
B. Computed Tomography scannning
C. Retrograde pyelography
D. Magnetic Resonance Imaging
67. A 55-year old female consulted you for a right preauricular mass of 19 years’ duration. Except for its bothersome
appearance, she is otherwise asymptomatic. The most likely diagnosis is:
A. lympadenopathy
B. adenoid cystic carcinoma
C. mucoepidermoid carcinoma
D. pleomorphic adenoma

68. Injury to this nerve during a thyroidectomy results to inability to produce high voice pitches:
A. either recurrent laryngeal nerve
B. external branch of the superior laryngeal nerve
C. internal branch of the superior laryngeal nerve
E. either superior thyroid nerve

69. Which of the following is not a component of Brodie’s triad?

A. Anal fissure
B. Fistula-in-ano
C. Sentinel pile
D. hypertrophic papillae

7
70. The single most helpful maneuver in the operative treatment of anal fissure:
A. External sphincterotomy
B. Internal sphincteroplasty
C. External sphincteroplasty
D. Internal sphincterotomy

71. Which of the following statements regarding the pathogoenesis of acute appendicitis is true?
A. Fecaliths are identified in most patients with acute uncomplicated appendicitis
B. The amount of lymphoid tissue in the appendix is directly related to the incidence of acute appendicitis
C. Luminal obstruction is the least important factor in the development of appendicitis
D. the secretory capacity of the appendiceal mucosa is increased in the elderly

72. The median survival rate of an unresectable cancer of the pancreas is

A. 1 month
B. 3 months
C. 6 months
D. 12 months

73. The most common site of obstruction in gallstone ileus is around the area of the:
A. terminal ileum
B. duodenum
C. ligament of treitz
D. pylorus

74. True of the liver anatomy:

A. The right lobe is twice the size of the left
B. The falciform ligament divides the liver into equal halves
C. The left lobe contains anterior and posterior segments
E. The caudate lobe is part of the left lobe

75. A vehicular crash patient is suspected of having a cervical trauma. A cross-table lateral x-ray study of the cervical spine is
taken. Six cervical vertebrae can be visualized well. In this case:
A. the study is adequate to clear the cervical spine
B. the x-ray study should be repeated
C. a swimmer’s view should be taken
D. a CT scan should be performed next

76. A 25-year old patient came to the ER for an icepick wound at the ICS 4, L parasternal border. He is dyspneic upon arrival.
Further examination revealed decreased BP, distended neck veins and muffled heart sounds. If you were the only medical
personnel at the ER, which immediate procedure should be done to best manage the situation?
A. Tube thoracostomy
B. Pericardiocentesis
C. Thoracentesis
D. ED Thoracotomy

77. What is correctly considered the best diagnostic test in a hemodynamically stable patient with blunt abdominal trauma?
A. Ultrasound
B. CT scan
C. DPL
D. MRI

78. During your frontline duty at the Pedia ER, a 6 month old patient was brought in for abdominal distention, vomiting and
passage of currant-jelly stools. On PE you noted a tender abdomen with sausage shaped mass at the RUQ. Your likely
diagnosis is
A. Misdirected, refer to surgery
B. Meckel’s diverticulm
C. Annular pancreas
D. Intussusception

79. Superior vena cava syndrome occurs in about five percent of cases of lung cancer and is considered extensive disease and an
emergency. It is best treated with
A. chemotherapy
B. radiotherapy

8
 C. surgery
D. immunotherapy

80. A previously non-hypertensive patient underwent modified radical mastectomy. One hour after the surgery, she was
referred for BP = 170/70. What is the most likely cause for the hypertensive spike?
A. Hypothermia
B. Inadequate analgesia
C. Fluid overload
D. Essential hypertension

81. A 60-year old male presents with a 10-cm firm mass of the left thigh area of 6 months duration. The most appropriate
method to establish the diagnosis is
A. fine needle biopsy
B. section biopsy
C. CT scan of the involved area
D. excision biopsy

82. The physical finding present in a parotid mass that connotes malignant behavior
A. hardness
B. tenderness
C. facial nerve palsy
D. sanguinous discharge

83. A 19-year old female medical student consulted because of dull, aching pain on both breasts associated with a feeling of
fullness, heaviness and tenderness usually accentuated before each menstrual period. PE revealed ill-defined nodularities in
both upper outer quadrants. In this patient
A. mirror breast biopsies must be done
B. tamoxifen therapy must be instituted
C. subcutaneous mastectomy is indicated
D. analgesics and reassurance are all that is needed

84. A 60 year old woman who underwent thyroidectomy under general anesthesia was referred to you for fever of 39 0C on her
first post-operative day. On examination BP=100/70; HR=88; RR=22, with fine crackles on basal lung field on deep
inspiration. The most likely cause is:
A. Dehydration
B. Atelectasis
C. Urinary tract infection
D. Superficial phlebitis

85. Direct inguinal hernia protrudes through what triangle:

A. Calot’s triangle
B. Kisselbach’s triangle
C. Hesselbach’s triangle
D. Passaro’s triangle

86. The most common cause of airway obstruction in the patient with multiple injuries is:
A. Tongue
B. Blood
C. Vomiting
E. Dentures

87. Barium enema can be both diagnostic and therapeutic in intestinal obstruction due to:
A. Ileocecal TB
B. Intussusception
C. Rectal prolapse
D. Diverticulitis

88. The classic triad of pain, mass and on and off jaundice is found in:
A. Neonatal hepatitis
B. Hepatoblastoma
C. Biliary atresia

9
 D. Choledochal cyst

89. Mammography is useful in which of the following instances?

A. As a substitute for biopsy, especially in deep seated lesions
B. As an annual screening procedure for women 35 years old and above
C. As a follow-up study on the contralateral breast following mastectomy for breast cancer
D. As a screening procedure for women in the child bearing age group

90. A 36-year old lactating mother consulted for a painful inflamed area in her right breast. The pain was noted since five days
prior to consultation. Two days PTC, she likewise began to have spikes of fever. Examination shows an inflamed, fluctuant
markedly tender area in the right breast. Which of the following regarding the case is true?
A. She needs only to stop breast feeding and the swelling will subside.
B .The etiologic agent of the infection is probably Lactobacilli sp.
C. The mainstay for treatment of this patient is proper use of antibiotics.
D. Incision and drainage, with deloculation, is the treatment of choice

91. A patient who just underwent modified radical mastectomy complains that her scapula protrudes out upon movement of
her ipsilateral arm. The surgery probably severed her:
A. Thoracodorsal nerve
B. Intercostobrachial nerve
C. Lateral thoracic nerve
D. Long thoracic nerve

92. Recurrent episodes of diverticulitis are best managed with:

A. increasing dietary fiber intake
B. elective subtotal colectomy
C. antibiotics and hydration
D. steroid enemas and cathartics

93. A 20-year old male consulted for recurrent perianal fistulae draining purulent material. On physical examination, there
were two external openings. One opening is located at the base of the scrotum . The other is located 4cm from the anal
verge at 5 o’clock in a jack knife position. The internal opening/s is/are probably located in the
A. Anterior midline:
B. Posterior midline .
C. anterior and posterior midline
D. Radially at two points

94. A hold-up victim was rushed to the E.R. with a gunshot wound in the left chest. He was shocky but was resuscitated with
crystalloid and blood infusions. Tube thoracostomy was done but during the next three hours, there was a total drainage of
a liter of blood. As the intern-on-duty monitoring the patient, you would suggest:
A. Transfusing more blood
B. Putting in a second chest tube
C. an exploratory thoracotomy
D. Observing the patient further

95. A 4-year old child is noted to have fractures of ribs 10 to 11 on the left side with falling hematocrit following a fall from the
stairway. The organ most probably injured in this situation is the:
A. Kidney
B. Aorta
C. Spleen
D. Liver

96. The most frequently injured intraabdominal viscus following penetrating trauma is the:
A. Liver
B. Spleen
C. Small intestine
D. Stomach

97. Which of the following statements is true regarding urinary bladder cancer?
A. Adenocarcinoma is the common histologic type
B. Prognosis is not related to histologic grade of the tumor

10
 C. Painless hematuria is the most common presenting symptom.
D. Early pulmonary metastasis is characteristic.

98. In flail chest, the most important predictor of the patient's clinical course is:
A. number of fractured ribs
B. degree of paradoxical movement
C. degree of underlying pulmonary contusion
D. mechanism of injury

99. The ideal age for repair of cleft palate is around 1 to 2 years old because
A. the child is cooperative enough to follow simple instructions on feeding
B. the child is about to enter pre-school and might be ridiculed
C. the child is about to learn how to speak
D. the child can already ambulate right after surgery

100. An 18 year old psychiatric patients consults you for weakness of left hand.
On physical examination you note that there is linear scar on her wrist and a positive Froment’s sign. This would mean
injury to the
A. ulnar nerve
B. radial nerve
C. median nerve
D. B and C

11