1. Which is the shortest phase of the normal cell cycle?

A. G1 phase
B. S phase
C. G2 phase
D. M phase
E. All phases approximately equal in length
2. A 67 year-old women with rectal cancer is admitted to gereral surgical floor which of the following
laboratory studies should be included in the surgeons initial nutritional assessment :
A. Transferrin
B. Prealbumin
C. Albumin
D. Glutamine
E. All of above
3. In which of the following conditions is the entral route appropriate for nutrition :
A. Upper gastrointestinal obstruction
B. Complete small bowel obstruction
C. Acute flare-up of Crohns disease
D. Low out put colonic fistula
E. Non of the above

4. Which is the most commonly cultured hospital acquired organism in critical care with aspiration
pneumonia:
A. Staphylococcus aureus
B. Streptococcus pneumonia
C. Anaerobic species
D. Pseudomonas aeroginosa
E. Haemophlus influenzae

5. Which is the most appropriate single agent for empiric coverage of the above patient :
A. Metranidazole
B. Clindamycin
C. Pipracillin_tazobactam
D. Vancomycin
E. First generation penicillin

6. All of the following are true about neurogenic shock except:

A. There is a decrease in systemic vascular resistance and an increase in venous capacitance.
B. Tachycardia or bradycardia may be observed, along with hypotension.
C. The use of an alpha agonist such as phenylephrine is the mainstay of treatment.
D. Severe head injury, spinal cord injury, and high spinal anesthesia may all cause neurogenic shock.
E. A and B

7. Which of the following statements about head injury and concomitant hyponatremia are true?
A. There are no primary alterations in cardiovascular signs.
B. Signs of increased intracranial pressure may be masked by the hyponatremia.
C. Oliguric renal failure is an unlikely complication.
D. Rapid correction of the hyponatremia may prevent central pontine injury.
E. This patient is best treated by restriction of water intake
8. Regarding Cushing's Syndrome
A. 20% of cases are due to pituitary adenomas (Cushing's Disease)
B. Most ACTH secreting pituitary adenomas are more than 2 cm in diameter
C. Is characterised by loss of the diurnal rhythm of cortisol secretion
D. Cortisol production is suppressed by low-dose dexamethasone
E. Adrenal carcinomas are more common than adrenal adenomas
9. Which of the following statements about extracellular fluid are true?
A. The total extracellular fluid volume represents 40% of the body weight.
B. The plasma volume constitutes one fourth of the total extracellular fluid volume.
C. Potassium is the principal cation in extracellular fluid.
D. The protein content of the plasma produces a lower concentration of cations than in the interstitial fluid.
E. The interstitial fluid equilibrates slowly with the other body compartments.

10. In patients receiving massive blood transfusion for acute blood loss, which of the following is/are
correct?
A. Packed red blood cells and crystalloid solution should be infused to restore oxygen-carrying capacity and
intravascular volume.
B. Two units of FFP should be given with every 5 units of packed red blood cells in most cases.
C. A six pack of platelets should be administered with every 10 units of packed red blood cells in most
cases.
D. One to two ampules of sodium bicarbonate should be administered with every 5 units of packed red blood
cells to avoid acidosis.
E. One ampule of calcium chloride should be administered with every 5 units of packed red blood cells to
avoid hypocalcemia.

11. Which of the following statements about the presence of gallstones in diabetes patients is/are correct?
A. Gallstones occur with the same frequency in diabetes patients as in the healthy population.
B. The presence of gallstones, regardless of the presence of symptoms, is an indication for cholecystectomy
in a diabetes patient.
C. Diabetes patients with gallstones and chronic biliary pain should be managed nonoperatively with
chemical dissolution and/or lithotripsy because of severe complicating medical conditions and a high operative
risk.
D. The presence of diabetes and gallstones places the patient at high risk for pancreatic cancer.
E. Diabetes patients with symptomatic gallstones should have prompt elective cholecystectomy, to avoid the
complications of acute cholecystitis and gallbladder necrosis.

12. concerning Tetanus all true except:

A. Is due to an infection with a gram-negative spore forming rod
B. The organism produces a powerful exdotoxin
C. The toxin prevents the release of inhibitory neurotransmitter
D. Clostridium tetani is sensitive to penicillin
E. Risus sardonicus is the typical facial spasm
13. when should parentral antibiotics be given perioperatively?
A. The night before
B. 6 hr prior to surgery
C. 30 minutes prior to incision .
D. at the time of incision
E. 30 minutes after incision
14. Which of the following statements about esophageal anatomy is correct?
A. The esophagus has a poor blood supply, which is segmental in distribution and accounts for the high
incidence of anastomotic leakage.
B. The esophageal serosa consists of a thin layer of fibroareolar tissue.
C. The esophagus has two distinct muscle layers, an outer, longitudinal one and an inner, circular one, which
are striated in the upper third and smooth in the distal two thirds.
D. Injury to the recurrent laryngeal nerve results in vocal cord dysfunction but does not affect swallowing.
E. The lymphatic drainage of the esophagus is relatively sparse, localized primarily to adjacent
paraesophageal lymph nodes.
15. Wich of the following medication should be given in preparation of a pation with pheochromocytoma?
A. Phnoxybenzamine
B. Nifedipine
C. Linsinopril
D. Hydrochlorothiazide
E. Propranolol
16. Which of the following statement(s) is true concerning excessive scarring processes?
A. Keloids occur randomly regardless of gender or race
B. Hypertrophic scars and keloid are histologically different
C. Keloids tend to develop early and hypertrophic scars late after the surgical injury
D. Simple reexcision and closure of a hypertrophic scar can be useful in certain situations such as a wound
closed by secondary intention
E. Non of the above

17. A 22-year-old man sustains a single stab wound to the left chest and presents to the emergency room
with hypotension. Which of the following statement(s) is true concerning his diagnosis and management?
A. The patient likely is suffering from hypovolemic shock and should respond quickly to fluid resuscitation
B. Becks triad will likely be an obvious indication of compressive cardiogenic shock due to pericardial
tamponade
C. Echocardiography is the most sensitive noninvasive approach for diagnosis of pericardial tamponade
D. The placement of bilateral chest tubes will likely resolve the problem

18. Which of the following statement(s) is/are true concerning septic shock?
A. The clinical picture of gram negative septic shock is specifically different than shock associated with other
infectious agents
B. The circulatory derangements of septic shock precede the development of metabolic abnormalities
C. Splanchnic vascular resistance falls in similar fashion to overall systemic vascular resistance
D. Despite normal mechanisms of intrinsic expansion of the circulating blood volume, exogenous volume
resuscitation is necessary
19. During surgery on the submandibular gland
A. An incision on the lower border of the mandible is safe
B. The submandibular gland is seen to wrap around the posterior border of mylohyoid
C. The facial artery and vein are divided as they course through the deep part of the gland
D. The hypoglossal nerve is seen to loop under the submandibular duct
E. Damage to the lingual nerve will cause loss of sensation to the posterior third of the tongue
20. Regarding benign breast disease
A. Cyclical mastalgia is the commonest reason for referral to the breast clinic
B. Fibroadenomas are derived from the breast lobule
C. Lactational breast abscesses are usually due to Staph aureus
D. Duct ectasia is more common in smokers
E. Atypical lobular hyperplasia is associated with an decreased risk of breast cancer
21. Which of the following statements regarding unusual hernias is incorrect?
A. An obturator hernia may produce nerve compression diagnosed by a positive Howship-Romberg sign.
B. Grynfeltt's hernia appears through the superior lumbar triangle, whereas Petit's hernia occurs through the
inferior lumbar triangle.
C. Sciatic hernias usually present with a painful groin mass below the inguinal ligament.
D. Littre's hernia is defined by a Meckel's diverticulum presenting as the sole component of the hernia sac.
E. Richter's hernia involves the antimesenteric surface of the intestine within the hernia sac and may present
with partial intestinal obstruction

22. Staples may safely be placed during laparoscopic hernia repair in each of the following structures
except:
A. Cooper's ligament.
B. Tissues superior to the lateral iliopubic tract.
C. The transversus abdominis aponeurotic arch.
D. Tissues inferior to the lateral iliopubic tract.
E. The iliopubic tract at its insertion onto Cooper's ligament.

23. The following statements about the repair of inguinal hernias are true except:
A. The conjoined tendon is sutured to Cooper's ligament in the Bassini hernia repair.
B. The McVay repair is a suitable option for the repair of femoral hernias.
C. The Shouldice repair involves a multilayer, imbricated repair of the floor of the inguinal canal.
D. The Lichtenstein repair is accomplished by prosthetic mesh repair of the inguinal canal floor in a tensionfree manner.
E. The laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal approach (TEPA)
repairs are based on the preperitoneal repairs of Cheattle, Henry, Nyhus, and Stoppa.
4

24. A number of special circumstances exist in the repair of inguinal hernias. The following statement(s) is
correct.
A. Simultaneous repair of bilateral direct inguinal hernias can be performed with no significant increased risk
of recurrence
B. The preperitoneal approach may be appropriate for repair of a multiple recurrent hernia
C. A femoral hernia repair can best be accomplished using a Bassini or Shouldice repair
D. Management of an incarcerated inguinal hernia with obstruction is best approached via laparotomy
incision
E. All are correct.

25. Which of the following statement(s) is true about benign lesions of the liver?
A. Adenomas are true neoplasms with a predisposition for complications and should usually be resected.
B. Focal nodular hyperplasia (FNH) is a neoplasm related to birth control pills (BCPs) and usually requires
resection.
C. Hemangiomas are the most common benign lesions of the liver that come to the surgeon's attention.
D. Nodular regenerative hyperplasia does not usually accompany cirrhosis
26. Ligation of all of the following arteries usually causes significant hepatic enzyme abnormalities except:
A. Ligation of the right hepatic artery.
B. Ligation of the left hepatic artery.
C. Ligation of the hepatic artery distal to the gastro-duodenal branch.
D. Ligation of the hepatic artery proximal to the gastroduodenal artery.
27. Which of the following is the most effective definitive therapy for both prevention of recurrent variceal
hemorrhage and control of ascites?
A. Endoscopic sclerotherapy.
B. Distal splenorenal shunt.
C. Esophagogastric devascularization (Sugiura procedure).
D. Side-to-side portacaval shunt.
E. End-to-side portacaval shunt.
28. which of the following is associated with best prognosis for patient with breast cancer?
A. Male sex
B. Estrogen receptor positive
C. Patient age <35 years
D. Pregnant patient
E. Tumor with overexpression of HER/ner.
29. A 49-year-old women has a palpable breast mass in the upper outer quadrant. The size of the mass has
increased over the last month . exicisional biopsy reveals cystic carcinoma with invasion .appropriate
management now would be :
A. Re-excision with wide margins
B. Axillary node dissection and hormonal therapy
C. Simple mastectomy
D. Modified radical mastectomy
E. Bilateral mastectomies

30. A contraindication to stereotactic core biopsy of the breast is the mammographic presence of:
A. Microcacification
B. A radial scar
C. A nonpalpable mass lesion
D. Lesions<8 mm in diameter
E. Mutifocal lesions.

31. Which of the following statements about epiphrenic diverticula of the esophagus is/are correct?
A. They are traction diverticula that arise close to the tracheobronchial tree.
B. They characteristically arise proximal to an esophageal reflux stricture.
C. The degree of dysphagia correlates with the size of the pouch.
D. They are best approached surgically through a right thoracotomy.
E. The operation of choice is a stapled diverticulectomy, long esophagomyotomy, and partial fundoplication.

32. Which of the following statements about Schatzki's ring is correct?

A. The ring represents a panmural fibrotic stricture resulting from gastroesophageal reflux.
B. Dysphagia occurs when the ring diameter is 13 mm. or less.
C. The ring occurs within 1 to 2 cm. of the squamocolumnar epithelial junction.
D. Schatzki's ring indicates reflux esophagitis.
E. Schatzki's ring signifies the need for an antireflux operation.

33. Which of the following statements about pathology encountered at esophagoscopy is/are correct?
A. Reflux esophagitis should be graded as mild, moderate, or severe, to promote consistency among different
observers.
B. An esophageal reflux stricture with a 2-mm. lumen is not dilatable and is best treated with resection.
C. A newly diagnosed radiographic distal esophageal stricture warrants dilation and antireflux medical
therapy.
D. In patients with Barrett's mucosa, the squamocolumnar epithelial junction occurs 3 cm. or more proximal
to the anatomic esophagogastric junction.
E. After fasting at least 12 hours, a patient with megaesophagus of achalasia can safely undergo flexible
fiberoptic esophagoscopy.

34. Infantile hypertrophic pyloric stenosis

A. Occurs with a female : male ratio of 4:1.
B. Sons of affected mothers have a 20% risk of developing the lesion
C. Invariably presents between six and eights months of age
D. Typically presents with bile stained projectile vomiting
E. Surgical treatment is by Heller's Cardiomyotomy

35. Which of the following statements regarding the pathology of esophageal carcinoma is/are correct?
A. Worldwide, adenocarcinoma is the most common esophageal malignancy.
B. Squamous cell carcinoma is most common in the distal esophagus, whereas adenocarcinoma predominates
in the middle third.
C. Patients with Barrett's metaplasia are 40 times more likely than the general population to develop
adenocarcinoma.
D. Metastases from esophageal carcinoma are characteristically localized to regional mediastinal lymph
nodes adjacent to the tumor.
E. Achalasia, radiation esophagitis, caustic esophageal stricture, Barrett's mucosa, and Plummer-Vinson
syndrome are all premalignant esophageal lesions that predispose to the development of squamous cell
carcinoma.

36. 45-year-old with isolated 6-cm colorectal metastasis in the liver 2 years after colectomy, otherwise
healthy pest treatment would be:
A. Radiofrequency ablation
B. Systemic chemotherapy
C. Hepatic lobectomy
D. Liver transplantation
E. Cryosurgical ablation

37. Oesophageal atresia all true except:

A. Is often associated with a distal trachea-oesophageal fistula
B. Polyhydramnios is often present late in pregnancy
C. 50% have other associated congenital abnormalities
D. Contrast X-ray studies are necessary to confirm the diagnosis
E. Post-operatively over 30% develop oesophageal strictures

38. All are true about the dumping syndrome except:

A. Symptoms can be controlled with a somatostatin analog.
B. Diarrhea is always part of the dumping syndrome.
C. Flushing and tachycardia are common features of the syndrome.
D. Separating solids and liquids in the patient's oral intake alleviates some of the symptoms of the syndrome.
E. Early postoperative dumping after vagotomy often resolves spontaneously.

39. Which of the following statements about gastric polyps is/are true?
A. Like their colonic counterparts, gastric epithelial polyps are common tumors.
B. They are analogous to colorectal polyps in natural history.
C. Endoscopy can uniformly predict the histology of a polyp based on location and appearance.
D. In a given patient, multiple polyps are generally of a multiple histologic type.
E. Gastric adenomatous polyps greater than 2 cm. in diameter should be excised because of the risk of
malignant transformation.

40. All of the following statements about surgical management of gastric lymphomas are true except:
A. Stage I gastric lymphomas (small lesions confined to the stomach wall) can be cured completely with
surgical therapy alone.
B. Extensive gastric lymphomas that initially are treated with radiation and/or chemotherapy occasionally
perforate during treatment and require secondary resection.
C. Patients explored with a presumptive diagnosis of gastric lymphoma should undergo an attempt at curative
resection when this is safe and feasible.
D. Without a preoperative diagnosis resection for gastric mass should not be attempted unless lymphoma can
be excluded.
E. Appropriate staging for primary gastric lymphoma includes bone marrow biopsy.
41. the most accurate test to confirm diagnosis of infected necrotizing pancreases is:
A. Abdominal ultrasound study
B. Indium-labeled leeukocte scan
C. Cimputed tomographic scan
D. Elevated serum level of interleukain 6 and 8
E. Percutaneous needle aspiration
42. Which of the following variables best predicts prognosis for patients with a recent diagnosis of
cutaneous melanoma and no clinical evidence of metastatic disease?
A. Breslow thickness.
B. Clark's level.
C. Ulceration.
D. Gender.
E. Celtic complexion.
43. the following are true about intracranial tumors except:
A. The most common location of brain tumors of childhood is the posterior cranial fossa.
B. With few exceptions, examination of the CSF is of no value in the diagnosis of an intracranial tumor.
C. Even the most malignant of primary brain tumors seldom spread outside the confines of the central
nervous system (CNS).
D. The majority of astrocytomas can be cured surgically.
E. Primary neoplasms of astrocytic, oligodendroglial, or ependymal origin represent gradations of a spectrum
from slowly growing to rapidly growing neoplasms.
44. A right-sided disc herniation at the L5S1 level typically may cause:
A. Low back pain and left sciatica.
B. Weakness of dorsiflexion of the right foot.
C. A diminished or absent right ankle jerk.
D. Diminution of sensation over the medial aspect of the right foot, including the great toe.
E. Weakness of dorsiflexion of the left foot.
45. The preferred operation for initial management of a thyroid nodule that is considered suspicious for
malignancy by FNAB is:
A. Excision.
B. Partial lobectomy.
C. Total lobectomy and isthmusectomy.
D. Total thyroidectomy.
E. All methods are correct
8

46. the most common presentation of Meckel,s diverticulum in an adult is:

A. GIT bleeding
B. GIT obstruction
C. Intussuception
D. Litter,s hernia
E. Diverticulitis
47. Optimal front-line treatment of squamous cell carcinoma of the rectum includes:
A. Abdominal perineal resection.
B. Low anterior resection when technically feasible.
C. Radiation therapy.
D. Chemotherapy.
E. Combined radiation and chemotherapy.
48. 65-year-old man presents with complaints of mucous discharge and perianal discomfort. Physical
examination reveals a fistulous opening lateral to the anus. Anoscopic examination permits passage of a
probe through the fistula tract. The fistula traverses the internal anal sphincter, the intersphincteric plane,
and a portion of the external anal sphincter. The fistula is categorized as which type?
A. Intersphincteric
B. Transsphincteric
C. Suprasphincteric
D. Extrasphincteric
E. Non of the above
49. Warthin's tumor:
A. Is a pleomorphic adenoma of salivary gland
B. Should be treated by total paritidectomy
C. Is considered a benign salivary gland neoplasia
D. Respond well to preoperative radiotherapy
E. Often present with facial nerve compression

50. A 38 year old woman presents with right upper quadrant pain and bouts of vomiting. She is known to
have gallstones and has had similar episodes in the past. Which of the following might support a diagnosis
of acute cholecystitis rather than biliary colic
A. duration of symptoms
B. Severity of vomiting
C. Presence of Murphy's sign
D. Presence of gas under right hemidiaphragm on erect CXR.

51. Adequate urine out put for adult postoperative surgical patient is greater than:
A. 35 ml per hour regardless of body size
B. 50 ml per hour regardless of body size
C. 0.5 ml per kg. per hour
D. 1 ml per kg. per hour
E. 1.5 ml per kg. per hour

52. the MOST important finding in the diagnosis of acute appendicitis is:
A. vomiting
B. Fever
C. leukocytosis
D. right lower quadrant tenderness
E. referred rebound tenderness[ Rovsing sign ]
53. the most common site for intestinal obstruction due to cholecystoenteric fistula is the
A. pylorus
B. duodenum
C. jejunum
D. ileum
E. sigmoid colon.
54. Common characteristics of small bowel obstruction include all of the following EXCEPT:
A. ascites
B. frequent progression to strangulation
C. failure to pass flatus
D. distention
E. vomiting
55. Gastroesophageal reflux is BEST diagnosed with:
A. radiography
B. 24-hour pH monitoring of lower esophagus
C. esophagoscopy
D. documentation of a decrease in esophageal pH after HCI is placed in the stomach .
E. acid-clearing swallowing test .
56. The risk of esophageal cancer increases with all of the following EXCEPT:
A. alcohol ingestion.
B. smoking .
C. chronic ingestion of hot beverages.
D. aflatoxin.>>(HCC)
E. poor oral hygiene.
57. Achalasia is associated with all of the following EXCEPT:
A. chagas disease in South America
B. dysphasia.
C. weight loss.
D. relaxation of the lower esophageal sphincter with swallowing .
E. aspiration pneumonia, which may cause lung abscesses.
58. Nonsurgical causes of abdominal pain include all of the following EXCEPT:
A. pneumonia.
B. diabetic ketoacidosis.
C. acute salpingitis.
D. head trauma.
E. myocardial infarction.
10

59. Gastric acid secretion is stimulated by all of the following EXCEPT:

A. sight of food.
B. presence of food in the stomach.
C. fat in the duodenum.
D. gastrin.
E. histamine.
60. All the following statementare true of anal fissure EXCEPT:
A. is often associated with constipation
B. pain during and after defication is typical
C. the fissure is usually anterior
D. the lesion is commonly seen with crohns disease
E. division of the lower half of the internal sphincter is usually curative
61. Factors that are associated with the development of acute pancreatitis include all of the following
EXCEPT:
A. alcohol.
B. gallstones.
C. celiac sprue.
D. hyperlipidemia.
E. pancreatic divisum.
62. Complications of untreated pancreatic pseudocysts include all of the following EXCEPT:
A. gastrointestinal obstruction.
B. pancreatic necrosis.
C. free rupture.
D. abscess.
E. intracystic hemorrhage.
63. Common presenting conditions in patients with pancreatic carcinoma include all of the following
EXCEPT:
A. esophageal varices.
B. jaundice.
C. weight loss.
D. palpable gallbladder.
E. abdominal pain.

64. All of the following are associated with an increased risk of breast cancer EXCEPT:
A. dietary consumption of fat.
B. history of breast cancer in first-degree maternal relatives
C. age over 35.
D. early first pregnancy.
E. infertility

11

65. The MOST frequent histologic type of breast carcinoma is:

A. infiltrating papillary carcinoma.
B. infiltrating ductal carcinoma.
C. infiltrating lobular infiltrating.
D. colloid infiltrating.
E. medullary infiltrating.
66. The MOST frequent variety of Thyroid cancer is:
A. follicular carcinoma.
B. papillary carcinoma.
C. anaplastic carcinoma.
D. hashimotos associated lymphoma.
67. Acute mastitis MOST commonly occurs at or during:
A. birth.
B. puberty.
C. pregnancy.
D. lactation.
E. blunt trauma to the breast.
68. All of the following statements concerning nipple discharges are true EXCEPT:
A. they may be caused by multiple lesions.
B. when bloody , the discharge is due to a malignancy 70% of the time.
C. a milky discharge may be due to a pituitary adenoma .
D. benign duct papillomas are the most common cause of bloody discharges.
E. excision of involved duct may be necessary to determine the etiology
69. The MOST frequent site for breast cancer to develop is the :
A. upper inner quadrant.
B. lower inner quadrant.
C. lower outer quadrant.
D. upper outer quadrant.
E. subareolar zone.
70. The risk of bilateral breast cancer is HIGHEST if the first breast shows:
A. inflammatory carcinoma.
B. lobular carcinoma.
C. medullary carcinoma.
D. infiltrating ductal carcinoma.
E. pagets disease.
71. All of the following are true statements concerning pagets disease of the nipple EXCEPT.
A. it is very uncommon, accounting for only 2% of all breast cancers.
B. it is an in situ squamous cell malignancy of the nipple.
C. it is an eczematoid lesion.
D. it has a better prognosis than the majority of other breast cancers.
E. it can be confused with malignant melanoma histologically.
12

72. Initial fluid resuscitation of a patient with multiple fractures and hypovolemic shock should be :
A. blood transfusion
B. hypertonic saline
C. fresh frozen plasma
D. ringer s lactate
E. albumin
73. Which of the following findings suggests that shock in an injured patient may have a cause other than
hypovolemia:
A. hypotension/
B. distended neck veins.
C. decreased skin temperature.
D. diminished pulse pressure.
E. falling central venous pressure.
74. All of the following are physical signs of both massive hemothorax and tension pneumothorax
EXCEPT:
A. tracheal shift.
B. decreased breath sounds.
C. tachycardia.
D. hypotension.
E. distended neck veins.
75. What is the MOST common infecting organism in overwhelming postsplenectomy infection:
A. Escherichia coli.
B. meningococcus.
C. streptococcus.
D. pneumococcus.
E. staphlococcus.

76. Decreased Paco2 levels should be attained in a patient at serious risk for cerebral edema secondary to
a head injury in order to :A. prevent neurogenic pulmonary edema
B. allow reciprocally high levels of PaO2 in the brain
C. prevent increased capillary permeability
D. prevent cerebral vasodilation
E. prevent metabolic acidosis
77. Brain injury alone
A. frequently causes shock
B. causes shock that is reversed by very simple measures
C. causes shock only if the skull is intact
D. rarely causes shock
E. causes shock if hypoxia is superimposed

13

78. The level of consciousness for a head injury patient is BEST evaluated by :
A. Glasgow coma scale
B. response to pain
C. CT scan
D. papillary responses
E. visual evoked potentials
79. All of the following are signs of acute vascular compromise of an extremity EXCEPT:
A. diminished sensation
B. pallor
C. absent pulses
D. gangrene
E. pain
80. Which of the following should NOT be used to control the pain caused by fractured ribs:
A. morphine IV.
B. Demerol IM.
C. intercostals nerve blocks.
D. rib belts.
E. muscle relaxants.
81. Postthrombotic varicose veins are due to:
A. incompetent communicating veins
B. destruction of deep veins.
C. destruction of superficial veins.
D. iliofemoral incompetence.
E. block of the long saphenous vein.
82. Deep venous thrombosis prophylaxis is appropriate for all of the following patients EXCEPT:
A. 67-year-old male undergoing a colectomy.
B. 21-year-old male undergoing an outpatient open inguinal hernia repair.
C. 21-year-old male in the ICU, comatose, with a closed head injury.
D. 60-year-old female undergoing open reduction and internal fixation (ORIF) of a hip fracture.
C. 60-year-old female undergoing reduction of a lung carcinoma.
83. Causes of delayed union of fractures includes all the following EXCPET:
A. Compound fracture
B. Infection
C. Adequate immobilization
D. Poor blood supply
84. Indication for skull X-Ray in head injury are:
A. Loss of consciousness
B. Focal neurological symptoms
C. Difficulty in assessing the patient
D. A& B only
E. All the above
14

85. In Head injury C.T. scan is indicated in the following

A. Aphasia after the injury
B. Deterioration of level of consciousness
C. Skull fracture with persistent headache
D. A&B only
E. All the above
86. Most important steps in management of head injury include:
A. Prevent hypoxia
B. Prevent Dehydration
C. Assure Brain Metabolism
D. Prevent secondary brain injury
E. All the above
87. Most common cause of solitary thyroid nodule is:
A. Malignancy
B. Toxic goiter
C. Thyroid Adenoma
D. Thyroiditis
E. Hashimotos disease
88. Follicular carcinoma of thyroid gland:
A. Is the commonest tumor
B. Can be diagnosed by F.N.A.B
C. Usually multifocal
D. Commonest tumor of young age
E. Prognosis is worse than papillary carcinoma
89. Abnormal nipple discharge could be due to:
A. Duct papilloma
B. Duct ectasia
C. Retention cyst of montgomery gland
D. A&B only
E. All the above
90. Retracted nipple can be caused by the following EXCPET:
A. Carcinoma of Breast
B. Duct ectasia
C. Chronic periductal mastitis
D. A&B only
E. All the above
91. The commonest type of the breast cyst is:
A. Solitary mamary cyst
B. Galactocele
C. Lymphatic cyst
D. Simple multiple cysts.
15

92. Carcinoma of breast:

A. Is the third common malignant tumor of women
B. common in Ages between 45-55 years.
C. 10% of case are males.
D. usually tender rapidly enlarging
E. medullay carcinoma is the comment type .
93. Carcinoma of the breast
A. may be familial
B. infiltrating duct carcinoma is the commonest
C. treated by lumpectomy and axillary clearance
D. A&B only
E. None of the above
94. Fracture of the sternum
A. Is the comments fracture of thoracic cage.
B. Usually painful.
C. cannt be associated with myocardial damage
D. usually treaded by internal fixation .
E. B&C only.
95. In massive haemothorax.
A. about 500ml of blood in pleural cavity
B. cause dyspnea & Neck veins distension
C. treated by thoracotomy tube only
D. All of the above
E. None of the above
96. Tension pneumothorax
A. is the commonest type of chest injuries
B. Needs urgent X-Ray chest
C. Is a clinical Diagnosis
D. Causes flat neek viens
E. Treated by thoracotomy tube after chest X-ray.
97. Varicose view.
A. Primary type usually affect one limb , below the knee
B. Short saphenous system is more affected
C. May be caused by D.VT.
D. A&B only
E. None of the above.
98. Anal Fissure:
A. Usually anterior
B. May be caused by previous anal surgery
C. Can cause dark bleeding PR.
D. Sometimes is painful
E. Treated by steroids
16

99. The comments type of Anorectal abscess is:

A. Ischio rectal
B. Perianal
C. Submucons
D. Pelvirectal
100. Varicose ulcer is:
A. Usually very painful & shallow
B. Deep with much necrotic tissue
C. More common with primary varicose vein
D. A & C only
E. None of the above

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

D
C
D
D
C
C
A
C
B
A
E
A
C
C
A
B
C
D
B
E

21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40

C
D
A
B
A
D
D
B
C
B
E
B
D
B
C
C
B
B
E
D

E
A
E
C
C
A
E
B
C
C
C
D
D
A
B
D
D
D
C
C

41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
17

61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80

C
B
A
D
B
B
D
B
D
B
B
D
B
E
D
D
D
A
D
D

81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100

A
B
C
E
E
E
C
E
D
E
D
B
D
B
E
C
C
B
B
E