Surgery exam- 4th year

1. The most common hernia in females is:

Choose one answer.
a. Femoral hernia.
b. Direct inguinal hernia
c. Indirect inguinal hernia
d. Obturator hernia
e. Umbilical hernia

2. compartment syndrome in the upper limb includes:

Choose one answer.
a. Painful on hand stretching
b. Altered sensation
c. All of the above

3. The inguinal canal:

Choose one answer.
a. The ilioinguinal nerve travels in the canal
b. Anterior wall is made laterally by the external oblique
c. Deep inguinal ring lies below the midline of the inguinal ligament
d. The external inguinal ring overlies the pubic tubercle
4. Treatment for type 1 choledochal cyst.
a. Cyst excision

5. In obstructive jaundice : Choose one answer.

a. most common cause is carcinoma of the head of the pancrease
b. stool is normal in color
c. Urinary urobilinogen is negative
d. only a and c

6. regarding tumor markers, all true except:

a. AFP is elevated in breast cancer
b. CEA: colon cancer
c. Ca19-9: pancreatic cancer

7. About liver Hemangiomas, all the following are true except:

Choose one answer.

a. They are usually asymptomatic.

b.
c.
 d. they may cause heart failure in children
e. only a and d

8. Concerning Papillary carcinoma of the thyroid which of the following is true:

Choose one answer.
a. The most common thyroid cancer
b. Familial types are rare
c. Previous exposure to radiation is protective
d. Only a and b
9. Which of the following is not a risk factor for gastric carcinoma:

a. Blood group O
b. Partial gastrectomy
c. Pernicious anemia
10. Concerning gastric ulcer, most common location is
a. Insisura
b. Antrum
11. PUD:
a. H.pylori
12. “beard’s beak” on barium swallow:
a. Achalasia
13. Cause of middle esophageal stricture:
a. Radiation
b. Corrosive
c. Mediastinal metastasis
d. Barret’s esophagus
e. All of the above

14. Leriche syndrome is:

a. Impotence, claudication of the buttocks, leg muscle atrophy due to PVD
15. About gastric lymphoma, which is wrong
a. MALT is the most common type
b. The stomach is the most affected of the GI
c. Age incidence is in the 5th and 6th decade
d.
16. Cells of chronic infection
a. PMNs
b. B cells
c. Macrophages
d. Eosinophils
17. Anaphylaxis, all true except:
a. Is mediated by IgA Abs
18. Indication for intubation in a trauma patient:
a. Cervical hematoma
b. Fascial injury
c. Inhalation injury
d. Altered mental status
19. All are complications of major burns except:
a. Inhalation injury
b. Acute liver failure
c. Acute renal failure
d. Infection
20. Sever sepsis is different from sepsis by:
a. It is associated with acute organ failure
21. The most common cause of fever with the 1 st 48 hours post op.:
a. Atelectasis
22. Patient had a fever in the fifth day post op., most common cause:
a. DVT
b. Wound infection
c. UTI
d. Atelectasis
e. Drug side effect
23. All cause dumping syndrome except:
a. Bradykinin
b. Serotonin
c. Secretin
d. Neuro……???
24. All are likely complication of gastrectomy, except:
a. Weight loss
b. Osteoporosis
c. Hypokalemia
d. Anemia
25. All result from terminal ileum resection except:
a. Gallstones
b. B12 deficiency
c. PA
d. ??
26. UC:
a. Almost always involves the rectum
27. UC:
a. Involves the mucosa and submucosa
28. CD:
a. Skip lesions
b. Most commonly affects the terminal ileum and cecum
 c. ?
d. Only a and c
29. Most common clinical presentation of CD:
a. Left sided BD pain
b. Resembles appendicitis
c. Colicky abd pain that increase with eating
d. Bleeding per rectum
30. Concerning massive blood transfusion:
a. Giving the patient at least equal his blood
b. Causes acid and base disturbances
c. DIC and bleeding is a common complication
31. FFP:
a. Is given for patient with acute bleeding due to warfarin
32. Most common cause of upper limbs ischemia:
a. Oblitrans arteritis
b. Vaso spastic disease
c. Internal injury of SA
d. trauma
33. Meckel’s diverticulum presentation in adults
a. GI bleeding
b. Intusseption
34. Most common cause of small bowel obstruction:
a. Adhesions
35. Cause for giving pain killers:
a. Early ambulation
b. Breathing normal
c. All of the above
36. A patient with MNG who is asympotomatic and doesn’t complain of pressure sx:
a. Observationn and follow up
37. All are types of marginal anal cancer exept:
a. BCC
b. Bowen’s disease
c. Paget’s disease
d. Epidermoid
38. Regarding the etiology of hemorrhoids
a. Diet
b. Straining
c. Rectal ca
d. Pregnancy
e. Portal HTN
39. Regarding the etiology of inguinal hernia:
 a. Strenuous activity
b. Previous abdominal surgery
c. Chronic cough
d. Colon ca
e. BPH
40. Complications of inguinal hernia include all except:
a. Impotence
b. Testicular atrophy
c. Hematoma
d. Infection
e. neuralgia
41. Pt c/o melena w/o hematemesis, UGI showed no bleeding lesion, and colonoscopy was
done and anal canal, the sigmoid and the ascending colon were all normal, but could’nt
pass the splenic flexure, the patient is discharged to do colonoscopy after 3 months but
she is still complaining of lower abdominal pain, what to do next:
a. Repeat colonoscopy
b. Do barium enema
c. Blood studies and tumor markers
42. Post splenectomy overwhelming sepsis
43. About spleen (red pulp, BS, embryology)
44. Hepatic adenoma + OCPs:
45. Partotid gland tumors:
a. Pleomorphic is the most common type
46. Thyroglossal duct cyst Mx:
a. ABT
b. Inscion and drainage
c. Excisional biopsy
d. FNA
47. in a patient with fibroadenosis of the breast ;
48. staging for a colon CA patient
49. staging for a breast CA patient
50. neo adjuvant treatment in breast CA:
a. down grade the tumor
b. avoid post mastectomy chemo
51. most common sites for breast Camets:
a. lung and bone
b. liver and lung
c. lung and brain
52. hiatal esophageal hernia
53. indication for colostomy exept:
a. desmoid,
b. prolapse !!!
54. superficial burns:
55. acute mesenteric ischemia
56. event that initiates appendicitis:
a. obstruction,
b. viral infection,
57. hyperkalemia on ECG:
58. small bowel fistula, all true except:
a. anastomosis leak,
b. wound dehiscence,
c. radiation,
59. not of ranson criteria:
a. age < 55,
b. LDH >700
60. about pancreatic cancer:
a. head cancer has a worse prognosis than tail
b. 5 year survival rate is ??
c. Wipple mortality is 5%
d. 80% arise from the head
61. not in addison: hypernatremia
62. trauma patient, stable, on fast there is fluid between kidney and liver, the next step:
a. explorative laparotomy
b. abdominal CT
63. affects the extent and the >> of the scar, except
a. DM
b. Age
c. Direction of the scar
d. Position of the scar
e. Ethnic group
64. Affects collagen, except:
a. long term ABT
b. steroids
65. Shock is defined as
66. Patient with biliary colic, study of choice: US
67. Doesn’t cause hypocalcemia:
a. Sarcoidosis
b. renal failure
c. Vit D deficiency.
68. The daily requirement of K for a 70 kg man:
a. 140 mmol/d
b. 70 mmol/d
c. 0.7 mmol/d
69. Epidural hematoma:
 a. Due to injury to the middle meningeal artery
b. The patient has contralateral dilated fixed pupils
c. Must go to the OR immediately.
d. Only a and b
70. All are true about ZES except:
a. Secondary mets to the liver
b. Intractable duodenal ulcers
71. Abdominal abscess:
a. Gram –ve bacilli
b. Gram +ve bacilli
c. Gram –vecocci
d. Gram +vecocci
72. Patient complain of RIF pain and hematuria, on PE he had a right sided abdominal mass,
diagnostic study?
a. Cystoscopy
b. Abdominal CT
c. Urogram
d. MRI
73. the canal of Nuck: hydrocele of the round ligament
74. are complications of fracture:
a. Infection
b. Compartment syndrome
75. Interval appendectomy:
a. Elective after course of ABTs
b. None of the above
76. Diverticular disease can present in all of the following except:
a. Colon cancer
b. Perforation
c. Hemorrhage
d. Diverticulitis
77. Amebic abscess:
a. Causes pyrexia and liver enlargement
b. Filled with golden yellow material
c. Treatment by drainage
d. Mostly in the post. Of the left lobe
78. A premalignant polyp:
a. adenomatous
79. Not indication for increasing the frequency of colonoscopicscreaning:
a. Hyperplastic polyp??
80. Causes for colon ca recurrence: all of the above
81. Hyperamylasemia except:
a. Perforated viscus
 b. Pancreatitis
c. Ruptured ectopic pregnancy
82. Signs of acute pancreatitis:
a. Grey-turner
b. cullen’s sign
c. Jackson knife posture to relieve pain
d. All of the above

Good luck

Aseel Bzour