1

The metabolic effects of the thyroid hormones are due to:

\\\ T3-T4 bound to albumin;
\\\ T3-T4 bound to thyroxine binding globuline (TBG);
\\\ T3-T4 bound to thyroxine binding prealbumine (TBPA);
\\ unbound free T3-T4;
\\\ all answers are correct.
2
Clinical types of thyrotoxicosis are all, except
\\\ diffuse toxic goitre (Grave`s disease);
\\\ toxic nodular goitre;
\\ endemic goitre;
\\\ toxic nodule;
\\\ hyperthyroidism due to rare causes.
3
If a thyrotoxic patient has been inadequately prepared for thyroidectomy, it occures:
\\\ haemorrhage;
\\\ recurrent laryngeal nerve paralysis;
\\\ parathyroid insufficiency;
\\ thyrotoxic crisis;
\\\ wound infection.
4
Benign breast disorders are all, except
\\\ cyclical nodularity and mastalgia;
\\\ fibroadenoma;
\\\ galactocelle;
\\ Pagets disease;
\\\ Tietzes disease.
5
Which form of the breast cancer presents as a painful, swollen breast, which is warm with
cutaneous oedema:
\\\ ductal carcinoma;
\\\ lobular carcinoma;
\\\ colloid carcinoma;
\\\ medullary carcinoma;
\\ inflammatory carcinoma.
6
The second stage of breast cancer T2N1M0 means:
\\ tumor size 2-5 cm, mobile axillary metastases, no known distant metastases;
\\\ tumor size 2-5 cm, no nodal metastases, no known distant metastases;
\\\ tumor size <2cm, no nodal metastases, no known distant metastases;

\\\ tumor size >5cm, mobile axillary metastases, no known distant metastases;
\\\ tumor size >5cm, fixed axillary metastases, distant metastases;.
7
The commonest symptom of the gastro-oesophageal reflux disease (GORD) are:
\\ heartburn and epigastric pain;
\\\ odynophagia;
\\\ dysphagia;
\\\ angina-like chest pain;
\\\ aphonia.
8
Gastro-oesophageal reflux following oesophagogastric resection may be limited or
avoided by:
\\\ subtotal oesophagectomy and gastric transposition high in the chest;
\\\ resection of a generous portion of proximal stomach if an anastomosis is made to the
lower oesophagus;
\\\ Roux-en-Y reconstruction with a long ascending jejunal limb (50-60cm);
\\\ interposition of jejunum or colon;
\\ all answers are correct.
9
What is the gold standard to investigate and image the stomach and duodenum?
\\\ contrast radiology;
\\ flexible endoscopy;
\\\ ultrasonography;
\\\ CT and MRI
\\\ laparoscopy.
10
Medical treatment of uncomplicated peptic ulcer aimed to reduce gastric acid secretion,
using:
\\\ NSAIDs,
\\ H2-receptor antagonists;
\\\ prednisolone;
\\\ histamine;
\\\ all answers are incorrect.
11
Most common place of localization of the upper gastrointestinal tract cancer, is:
\\\ mid-oesophagus,
\\ lower oesophagus and cardia,
\\\ body of the stomach;
\\\ antrum;
\\\ pylorus.

12
Early gastric cancer is defined as cancer:
\\ limited to the mucosa and submucosa with or without limph node involvement (T1, any
N);
\\\ invades muscularis or subserosa with or without limph node involvement(T2, any N);
\\\ invades mucosa, muscularis and serosa with or without limph node involvement (T3,
any N);
\\\ invades adjacent organs with or without limph node involvement (T4, any N);
\\\ all answers are incorrect.
13
The common site for primary gastrinoma (Zollinger-Ellison syndrome) is:
\\\ cardia;
\\\ body of the stomach;
\\\ antrum;
\\\ pylorus.
\\ duodenum.
14
What is this late dumping?
\\ reactive hypoglycemia;
\\\ reactive hyperglycemia;
\\\ sequestration of fluid from circulation into the gastrointestinal tract;
\\\ hypernatremia;
\\\ hypokalemia.
15
Routinely tests of liver functions are all, except
\\\ alkaline phosphatase (ALP);
\\\ aspartate transaminase (AST);
\\\ gamma-glutamyl transpeptidase (GGT);
\\\ albumin;
\\ glucose.
16
The current gold standard for liver imaging is:
\\\ ultrasound;
\\ triple-phase spiral computerised tomography (CT);
\\\ magnetic resonance imaging (MRI);
\\\ endoscopic retrograde cholangiopancreatography (ERCP);
\\\ angiography.
17
Budd-Chiari syndrome is a:
\\ thrombosis or obstruction of hepatic veins;
\\\ thrombosis or obstruction of portal vein;

\\\ thrombosis or obstruction of lienal vein;

\\\ thrombosis or obstruction upper mesenteric vein;
\\\ all this pathological conditions causes Budd-Chiari syndrome.
18
The congenital dilatation of the intrahepatic biliary tree which is often complicated by the
presence of intrahepatic stone formation is:
\\\ primary sclerosing cholangitis (PSC);
\\\ primary biliary cirrhosis (PBC);
\\ Carolis disease;
\\\ simple cystic disease;
\\\ polycystic liver disease.
19
.Amoebic liver abscess is cause by:
\\\ Streptococcus;
\\\ Escherichia coli;
\\\ Proteus vulgaris;
\\ Entamoeba histolytica;
\\\ Klebsiella.
20
.Haematological investigations using during the haemolitic anaemias are all, except
\\\ the fragility test;
\\\ the reticulocyte count;
\\\ faecal urobilinogen;
\\ fecal stercobilin.
\\\ use of radioactive chromium.
21
Acquired autoimmune haemolytic anemia may be due to:
\\\ portal hypertension;
\\\ Thalassemia;
\\\ hereditary spherocytosis;
\\\ sickle cell disease;
\\ a drug reaction.
22
Usually, cystic artery is a branch of
\\\ common hepatic artery;
\\\ left hepatic artery;
\\ right hepatic artery;
\\\ left gastric artery;
\\\ gastroduodenal artery.

23
Causal factor of gallstone formation is:
\\\ metabolic;
\\\ infective;
\\\ bile stasis;
\\ all answers is correct;
\\\ all answers is incorrect.
24
Indication for choledochotomy is:
\\\ palpable gall stones;
\\\ there is a jaundice or history of jaundice;
\\\ the common bile duct is dilaited;
\\\ the liver function tests are abnormal;
\\ all answers are correct.
25
Which of the pancreas imaging investigations is less informative?
\\\ ultrasonography;
\\\ CT;
\\\ MRI;
\\ flexible endoscopy;
\\\ ERCP.
26
Which type of the pancreas carcinoma is frequently occurs:
\\ duct cell carcinoma;
\\\ giant cell carcinoma;
\\\ adenosquamous carcinoma;
\\\ mucinous carcinoma;
\\\ microadenocarcinoma.
27
Correct diagnosis of Hirschsprungs disease depends on several investigations, except
\\\ colonoscopy;
\\\ rectal biopsy;
\\\ anorectal manometry;
\\ angiography;
\\\ radiography using water-soluble enema.
28
One stage operations performing for Hirschsprungs disease treatment are all, except
\\ sigmoidostomy;
\\\ coloanal anastomosis;
\\\ Duhamel operation;
\\\ Swensons procedure;

\\\ restorative proctocolectomy.

29
Usually Meckels diverticulitis clinical features are same as:
\\\ acute cholecystitis;
\\ acute appendicitis;
\\\ acute pancreatitis;
\\\ acute dysentery;
\\\ acute gastritis.
30
Which is the commonest extraintesrinal manifestation of ulcerative colitis:
\\\ arthritis;
\\\ erythema nodosum;
\\\ eye problems;
\\ sclerosing cholangitis;
\\\ bile duct cancer.
31
Which is the palliative operation when the carcinoma of the large intestine occurs:
\\\ right hemicolectomy;
\\\ excision of the transverse colon;
\\\ left hemicolectomy;
\\ colostomy;
\\\ excision of the sigmoid colon.
32
Carcinoma of the left side of the colon usually present with:
\\\ anemia;
\\\ the presence of a mass in the ileocaecal fossa;
\\\ sometimes discovered unexpectedly at operation for acute appendicitis;
\\ increasing intestinal obstruction;
\\\ all answers are incorrect.
33
The superior rectal artery is the direct continuation of the:
\\\ superior mesenteric artery;
\\ inferior mesenteric artery;
\\\ internal iliac artery;
\\\ external iliac artery;
\\\ internal pudendal artery.
34
Early symptoms of rectal cancer are all, except
\\\ bleeding per rectum;
\\\ tenesmus;

\\ pain,
\\\ early morning diarrhea;
\\\ sense of incomplete defecation.
35
Indications for haemorrhoidectomy are all, except
\\ first-degree haemorrhoids;
\\\ failure of nonoperative treatment of second-degree haemorrhoids;
\\\ third-degree haemorrhoids;
\\\ fibrosed haemorrhoids;
\\\ interoexternal haemorrhoids, when the external haemorrhoids is well defined.
36
The contents of external hernias can not be:
\\\ omenthum;
\\ pancreas;
\\\ small intestine;
\\\ large intestine;
\\\ ovary with or without the corresponding fallopian tube.
37
The Littres hernia is the content of the sac:
\\\ appendix;
\\\ a portion of the circumflexus of the intestine;
\\\ a portion of the bladder;
\\ a Meckels divertikulum;
\\\ fluids as part of ascitis.
38
The tension-free hernioplasty of inguinal hernia is the method of
\\\ Shouldice;
\\ Lichtenstein;
\\\ Lockwood;
\\\ McEvedy;
\\\ Lothessen.
39
When the conservative treatment of umbilical hernia is indicated:
\\ under the age of 2 years;
\\\ at 2 years and old;
\\\ in old patients;
\\\ in females during the first trimester of gravidity.
\\\ in all this cases.

40
Which from this techniques is now the method of choice for all postoperative hernias, but
smallest defects:
\\\ simple apposition;
\\\ complex apposition by Mayo;
\\\ complex apposition by Keel;
\\\ complex apposition by da Silva;
\\ plastic fiber mesh or net closures.
41
For the majority of lung cancers account:
\\ squamous cell carcinoma;
\\\ adenocarcinoma;
\\\ small cell carcinoma;
\\\ alveolar cell carcinoma;
\\\ all answers are incorrect.
42
.Pulmonary biopsy is hazardous under the following condition:
\\\ old patients with dyspnoea;
\\ patients with pulmonary hypertension;
\\\ patients with hamoptosis;
\\\ patients with invasion of the mediastinum;
\\\ in all cases pulmonary biopsy is hazardous;
43
Condition that still probably the most common predispose to pleural empyema formation
is:
\\ unresolved pneumonia;
\\\ bronchoectasis;
\\\ tuberculosis;
\\\ fungal infection;
\\\ lung abscess.
44
Sexual impotence (Leriche) presence when the site of obstruction located in:
\\ aortoiliac part;
\\\ iliac artery;
\\\ femoral artery;
\\\ popliteal artery;
\\\ in all sites of obstruction.
45
Investigation of venous disease is more informative to tested the patency and competence
of all lower limb veins:
\\\ pletismography;

\\\ doppler ultrasound;

\\ duplex ultrasound imaging;
\\\ photopletismography;
\\\ tourniquet tests.
46
The treatment of varicose vein includes all, except
\\\ compression stockings;
\\\ injection sclerotherapy;
\\ transluminal angioplasty and stenting;
\\\ phlebectomy;
\\\ saphenofemoral junction ligation.
47
Factor, that lead to venous thrombosis described by Virchow is:
\\\ high venous presuare;
\\\ decreased cuagulability of the blood;
\\ increased cuagulability of the blood;
\\\ venous valves failure;
\\\ all answers are correct.