FINALL WRITTEN EXAM _ GROUP_ 2011

Match: 1- has irregular hard fixed mass in the outer lateral quadrant of her breast (C). 2- has eczema like lesion without a mass (D). a) Fibroadenoma. b) Fibrocystic disease. c) Breast cancer. d) Pagets disease. e) Duct ectasia. 3- patient, known case of 1ry biliary cirrhosis, now she is presenting with jaundice (A) 4- Patient is presenting with weight loss, jaundice, itching, mass in the upper right quadrant of the abdomen and epigastrium (B). 5- Patient has fullness in the epigastrium, he had history of 10 days hospitalization because of sever epigastric pain that radiates to the back (C). 6- Patient has recurrent attacks of epigastric pain, on X-ray he has calcification all through the pancreas (E). a) Cholangiocarcinoma. b) Pancreatic cancer head of pancreas. c) Pancreatic pseudocyst. d) Empyma. e) Chronic pancreatitis. 7- Life threatening condition with shifted medistinum & decreased air entry to one side of the chest (C). 8- Fractured ribs after trauma, may need intubation (B). 9- Wide medistinum after trauma (A). 10- In a patient with emphysematous bollus (D). a) Ruptured aorta. b) Flail chest. c) Tension pneumothorax. d) Simple pneumothorax.

11- New born baby has mild abdominal distension, delayed passing of muconium and bilious vomiting, on X-ray has dilated bowels, multiple fluid levels and conical appearance of the sigmoid colon (B). 12- 1 week baby has clear greenish vomiting, severe abdominal pain and drawling his legs to his abdomen (A). 13- Baby is presenting with abdominal pain and failure to pass muconium in the 1 st 24 h of life, on X-ray there is soap bubble appearance in the terminal ileum (C). a) Intestinal volvulus. b) Hirchsprung disease. c) Muconium ileus. 14- patient developed swollen leg after surgery (B). 15- Patient has thrombosed varicose veins and cellulitis (A). a) Leg elevation+ NSAIDS+ antibiotics. b) IV heparin. c) Warferin. d) Embolectomy. 16- 68 years old patient is presenting with recent altered bowel habits, sense of incomplete evacuation and lower abdominal distension (B). 17- 30 years female has diarrhea, abdominal pain and mass in the right side of the abdomen (E). 18- 63 years old patient has constipation, fresh bleeding per rectum and abdominal distention for 6 years (A). a) Diverticular disease. b) Cancer rectum. c) Cancer sigmoid. d) Ulcerative colitis. e) Crohns disease. 19- Indications of chest tube insertion, except: a) Flail chest. b) Hemothorax. c) Pneumothorax. d) Hemopneumothorax. 20- About tension pnemothorax, one true statement: a) Central trachea.

b) Hyper-resonance on the affected side. c) 1st treatment is chest tube insertion. 21- All can be used in treatment of breast cancer, except: a) Cyclophosphamide. b) 5-flurouracil. c) Methotrexate. d) Citomycin C. e) LHRH agonists. 22- Indications of thoracotomy, except: a) >100 cc of blood/h is drained from the chest. b) 500 ml of blood once the chest tube is inserted. c) Pericardial effusion not relieved by thoracocentesis. 23- Patient has AF now presenting with cold, painful right leg, the management is: a) Embolectomy. b) Heparin. c) Thrombolytic therapy. d) Amputation. 24- Most common organism in UTI: a) E.coli. b) Strept. c) Staph. d) Proteus. e) Pseudomonas. 25- Management of intra-peritoneal bladder injury is: a) Foleys catheter. b) Laparatomy & repair. c) Observation. 26- Patient with history of laparatomy 6 years ago is presenting with abdominal pain, vomiting and distension, he is managed with IV fluids & NG suction, then he develops generalized tenderness and fever, the management is: a) Aggressive hydration. b) Add antibiotics. c) Exploration.

27- Patient in his post operative 3rd day developed spiking fever (39.4), he had a Folyes catheter, he received IV heparin before the operation and TED stocking, the most likely cause of his fever is: a) Atelectasis. b) UTI. c) Abscess. d) Wound infection. 28- Prostate cancer usually metastasize to: a) Bone. b) Lung. c) Lymph nodes. 29- Most common malignant tumor of the brain is: a) Astrocytoma. b) Meningioma. c) Oligodendroma. 30- All are associated with hyperparathyroidism, except: a) Pathological fractures. b) Renal stones. c) Diarrhea. 31- About brain metastases, most common 1ry site is: a) Colon. b) Braest. c) Lung. d) Liver. 32- Treatment of 1ry thyrotoxicosis include all except: a) Hemithyrodectomy. b) Carbimazole. c) Radio-iodine. d) Subtotal thyrodectomy. 33- Neat total thyrodectomy means: Unilateral lobectomy + isthmectomy + subtotal thyrodectomy of the other lobe. 34- About Burgers disease all true except: a) Intermittent claudication.

b) Affects large arteries & veins. c) In smokers. d) Young male. 35- About peptic ulcer, one false statement: a) Duodenal ulcer are produced by H.pylori that colonize the duodenal mucosa. b) Gastric ulcers are due normal or low PH. c) Duodenal ulcers are more common than gastric. 36- Bleeding peptic ulcer is from: a) Gastrodeudenal b) hepatic. c) Right gastroepiploic. d) Left gastric. 37- Patient with history of peptic ulcer and now he has generalized abdominal pain and tenderness. He is unstable. Management of perforated duodenal ulcer is: Closure with omental patch. 38- A patient had trauma and presented with abdominal tenderness. His vital signs are stable, next action is: a) CT. b) FAST. c) DPL. d) Exploration. 39- US can diagnose all except: a) Intestinal obstruction. b) Acute cholycystitis. c) Pancreatitis. 40- About FAST one true statement: a) Useful in penetrating injuries in unstable patients. b) In blunt injuries. 41- patient had breast lump and underwent lumpectomy with safety margins & axillary dissection. Removed mass reveals free margin, hormone ve and 9 lymph nodes are dissected , your next action is: a) Systemic chemotharpy + hormonal. b) Hormonal therapy.

c) Radiotherapy for the breast only. d) Modified radical mastectomy. 42- About esophageal cancer, all true except: a) Most common arise from the distal part. b) Radiotherapy has no role. c) Achalasia is precancerous. d) Squamous cancer is the most common. 43- Causes of bleeding during surgery, except: a) Aspirin. b) Thrombocytopenia. c) Excess protamine sulphate use. d) Fibrinolysis. 44- Patient has tumor Duke A located 3 cm from the anal verge. Treatment is: a) Abdomino-perineal resection. b) Anterior abdominal resection. c) Right hemicolectomy. d) Left hemicolectomy. 45- Which hernia follows the inguinal pathway: a) Indirect inguinal. b) Direct inguinal. c) Femoral. 46- Treatment of congenital inguinal hernia should be: a) Once seen by the doctor. b) After 1 year. c) After complications. d) Observation. 47- Patient underwent gastrectomy and then develops a fistula, feeding is by : a) Peripheral line feeding. b) NGT. c) Gastrostomy tube. d) Central line feeding. 48- Patient is presenting with jaundice, right upper quadrant pain, fever and rigors. The diagnosis is:

a) Acute cholangitis. b) Acute cholycystits. c) Pancreatitis. 49- Patient has basal cell carcinoma at the angle of his right eye, the best treatment is by: a) Surgical removal with 2-5 mm safety margins. b) Radiotherapy. 50- Appendicular mass is composed of all except: a) Small bowl. b) Cecum. c) Inflamed appendix. d) Omentum. e) Fallopian tube & ovary. 51- Masses of anterior triangle, except: a) Thyroid. b) Carotid body tumor. c) Pharyngeal pouch. d) Brachial cyst. e) Brachial fistula. 52- Injury in the neck deep to the platysma, management is: Exploration. 53- Female patient is found to have right side thyroid nodule. No other symptoms. Next investigation is: a) Thyroid scan. b) FNA. c) MRI. 54- FNA is diagnostic for all except: a) Papillary cancer. b) Papillary adenoma. c) Follicular carcinoma. d) Medullary carcinoma. 55- Treatment of pulp abscess is : a) Drainage. b) Cephalosporin.

c) Penicillin. d) Observation. 56- About sigmoid volvulus all true except: a) In old age. b) Predisposed by short sigmoid mesentry. c) Absolute constipation. d) Acute onset of pain. 57- About liver injury, all true except: Majority of cases need surgical repair. 58- Most common liver tumor in children is: a) Hepatoblastoma. b) Hemangioma. 59- Treatment of acute bleeding from esophageal varices is by, except: a) Sclerotherapy. b) IV vasopressin. c) Shunt operation. d) Balloon tamponade. 60- About pheochromocytoma all true except: a) 10% are unilateral. b) 10% are bilateral. c) 10% are malignant. d) 10% extra-adrenal. 61- patient with history of perineal pain and fever, now there is discharge coming out from beside the anus, the diagnosis is: a) Anal fistula. b) Pilonidal sinus. c) Perianal abscess. d) Anal fissure. 62- Complications of varicose veins are all except: a) Venous ulcer. b) Skin pigmentation. c) DVT d) Liposclerosis.

63- Count the GCS for a patient who opens his eyes on verbal, with flexion withdrawal and his speech is confused: a) 10. b) 11. c) 14. d) 15. 64- Most common position of the appendix is: a) Post-ileal. b) Pre-ileal. c) Subcecal. d) Retrocecal. e) Pelvic. 65- Which of the following is not a definitive airway: a) Cricothyrodotomy. b) Oropharyngeal airway. c) Endotracheal intubation. d) Tracheostomy. 66- patient is presented with brownish uni-ductal discharge, there is no mass, the treatment is: Microdoctomy. 67- 21 years patient has anal fissure, he had been treated conservatively but no improvement, the management is: a) Lateral internal sphincterotomy. b) Fissurectomy. c) Continue conservative treatment. 68- Early symptoms of cancer stomach is: a) Weight loss + vague abdominal symptoms. b) Vomiting. c) Abdominal pain. 69- Most constant sign of acute appendicitis is: a) Tenderness over McBurney point. b) Rebound tenderness. c) Obturator sign. d) Rovsing sign. e) Psoas sign.

70- One true statement about colon cancer: a) Right side cancers have better prognosis than left sided. b) Right side cancer usually have aneamia. 71- One true statement about cancer colon: a) Majority arise from premalignant polyps. b) Right side cancers present with altered bowel habits. 72- Courivisoir sign is: Palpable non-tender gall bladder in case of cancer head of pancreas. 73- All are causes of wound infection, except: a) Good blood supply. b) Steroid. 74- All post-operative respiratory complications, except: a) Early mobilization. b) Smoking. c) Upper respiratory tract infection. 75- Monitor of heparin therapy is by: a) a PTT. b) INR. c) PT. 76- Cushing ulcer is: a) Ulcers seen in patients with head injury. b) Ulcers seen in burn patients.

Typed by: Najla Collected by: Ghadi, Heba, Kholoud, Manar ,Sama.