SOAL UJIAN BEDAH DIGESTIF

Dr. Errawan R. Wiradisuria. SpBD

RS. Persahabatan
1. The liver is divided into anatomical segments based on.. A. bile duct drainage B. hepatic arterial supply C. hepatic venous drainage D. portal vein distribution E. umbilical fissure 2. A 1 !year!old boy is admitted to the hospital after an automobile accident. E"cept for a #uiet abdomen. $e as no locali%ing physical findings. After receiving 2&&& m' of lactated ringer(s solution intravenously) his pulse rate is *& beats per minute and blood pressure 11&+ & mm$g Abdominal CT scan reveals a laceration of the left lobe of the liver e"tending from the dome more than half,ay trough the parenchyma. Appropriate management at this time ,ould be A. bed rest and observation B. abdominal e"ploration and ligature of intrahepatic blood vessels C. Abdominal E"ploration and pac-ing of the hepatic ,ound D. Abdominal e"ploration and left hepatic artery ligation E. abdominal e"ploration and left hepatectomy .. A /0!year!old ,oman is seen because of the abrupt onset of steady severe right upper #uadrant paint after ingestionof a heafy meal. 1n e"amination) there is a palpable) tender right upper #uadrant mass. The appropriate diagnostic step is A. Abdominal first ultrasonography B. 23C4 C. Computed Tomography 5CT6 D. Endoscopic retrograde cholangiopancreatography 5E3C46 E. 1ral Cholecystography 54TC6 /. The most common cause of acute cholecystitis is. A. Cystic duct obstruction B. Escherichia coli infection C. 7lebsiella infection D. multiple gallstones E. salmonella infection

0. A large retained stone impacted in the distal common bile duct is noted ,hen T! tube cholangiography is performed after choledochostomy. The best management of the stone is . A. dissolution ,ith sodium cholate B. dissolution ,ith heparin C. Catheter E"traction via the tract of of the T!tube D. 1perative removal E. transduodenal papillotomy ,ith endoscopic stone e"traction 8. The best initial procedure in defining the cause of obstructive 9aundice in a 0!year!old man is A. Endoscopoc retrograde cholangiopancretography 5E3C46 B. 4ercutaneous transhepatic cholangopgraphy 54TC6 C. :ltrasonography D. CT ;canning E. 3adionuclide scanning . Abdominal ultrasonography is carried out during evaluation for a possible abdominal aortic aneurysm. The presence of stones in the gallbladder is identified on this study. The patient( s only abdominal symptom is a sense of fullness after eating. The appropriate first step in managing the gallstones is. A. 1bservation B. 'aparascopic cholecystectomy C. 1pen cholecystectomy D. :rsodeo"ycholic acid therapy E. Electroshoc- ,ave lithotripsy 5E;<'6 =. <hich of the follo,ing is absorbed from the colon. A. De"trose B. >atty acid C. >iber D. 'actulose E. 4rotein *. A 8&!year!old ,oman undergoes a sigmoid resection for stage ??? cancer of the colon. The best therapy for this patient consist of operation.. A.Alone B. And radiation therapy C. And Tretment ,it 0!>: D. And Tretment ,ith levamisole E. And Tretment ,ith 0!>: plus >alinic acid

1&. An =&!year!old ,om,n is seen ,ith abdominal pain and obstipation. 1n e"amination. ;he is afebrile ,ith slight tachycardia. $er abdomen is distended and tympanitic) but there ar e no peritoneal signs. Abdominal @!rays sugest the presence of sigmoid volvulus. The first step in her management should be A. administration of la"satives and cleansing enemes B. Barium enema C. 3igid ;igmoidoscopy D. ;igmoid resection E. tranverse colostomy

JAWABAN SOAL UJIAN BEDAH DIGERTIF

Dr. Erawan R. Wiradisuria. SpBD.

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