1.

2.

3.

4.
is

Which of the following is true regarding femoral hernia?

a. Commonly seen in children.
b. It is the commonest hernia seen in females
c. usually presents with inguinal swelling
d. it is liable for complications
e. usually treated conservatively
D
Regarding the scrotal swellings:
a.
Haemetoecle is very common
b.
Hydrocele could be inguinoscrotal
c.
Solid epididymal swelling is usually tumour
d.
Transluminant testicular mass is a tumor
e.
usually examined with the patient lying down
A cystic swelling Anterior to the testis is usually
a. vaginal hydrocele
b. Epidydisual cyst
c. Inguinal hernia
d. Encysted Hydrocele of the cord
e. Lipoma of the testis

The most common cause of an enlarged lymph node in the femoral triangle
a.
b.
c.
d.
e.

Tuberculosis lymphadenitis
Brucella
Neoplastic
Nonspecific lymphdenitis
Sarcoidosis

5.

The first symptoms of strangulated Inguinal Hernia is:

a. Vomiting
b. Fever
c. Septic shock
d. Constipation
e. Pain
E

6.

The most common cause of a pulsatile swelling in the femoral triangle is:
a.
saphena varix
b.
Acute lymphadenitis
c.
Femoral hernia
d.
Aneurysm
e.
Infected lipoma
D

7. Adult polycystic disease of the kidney:

a. Is an acquired degenerative disease
b. Is a risk factor in the development of Transitional Cell Carcinoma of the
renal pelvis.
c. Is a risk factor in the development of renal cell carcinoma of the kidney
d. Is always bilateral
e. Is an autosomal recessive disease
D

8. Renal cell carcinoma

a. is the commonest renal tumour in children
b.
is best diagnosed by urine cytology
c. is best treated, in absence of dissemination, by radical nephrectomy
d. is best treated in absence of dissemination by radiotherapy
e. it spreads by cell implantation to the ureter and bladder
C
9. Nephroblastoma:
a. is the commonest renal tumour in adults
b. is a benign tumours of the kidney
c. is a locally malignant tumour of the kidney
d. is best treated by a combination of surgery and chemotherapy
e. it never occurs in children
D
10. for the management of an adult male patient living in Riyadh for the last 10
years who presented with terminal hematuria and past history of urinary
bilharziasi during his childhood in Yemen:
a. no investigations are needed. Empirically give a course of antibilharzial
treatment .
b. do a urine analysis. If bilharzias ova are detected give antibilharzial
treatment .
c. treat as urinary tract infection complicating old bilharziasis .
d. arrange urgent full urinary investigations
e. follow up the patient and do the investigations if hematuria recurs
D
11. The following symptoms are common in anal problems, except:
a. Perianal discharge
b. Perianal itching and irritation
c. Pain
d. Nausea and vomiting
e. Anal bleeding
D
12.

The following statement regarding Haemorrhoids are true, except:

a. They are dilatation of the inferior haemorrhoidal vein only
b. They can present with fresh bleeding per rectum.
c. May be caused by chronic constipation
d. May develop secondary to pregnency
e. May be caused by carcinoma of the rectum
A
13. The following statement regarding Anal Fissure are true, except:
a.
longitudinal tear in the mucosa and skin of the anal canal
b.
commonly situated at the lateral side of the anal canal
c.
lateral fissures suggested specific lesions such as Ulcerative
colitis or Maligancy
d.
The chronic anal fissure can form A sentinel pile
e.
lateral internal sphincterotomy one option of surgical treatment
B

14.

The following are adverse prognostic factors in head injury except: (E)
a.
Hypertension.
b.
Poor Glasgow Coma Score on admission.
c.
Hypotension.
d.
Age > 65 years.
e.
Non of the above

15.

The Glasgow coma scale (GCS) is dependant upon the following except:
(C)
a. response to speech.
b. response to pain.
c. response of the pupils
d. best response
e. response of the patient.

16.

Severe head injury is defined as Glasgow Coma Score (GCS) of:

(B)
a.
3
b.
3-9
c.
10
d.
11-12
e.
13-15

17.

The outcome of head injuries:

(D)
a. depends upon the severity of head injury.
b. most of minor head injured are able to return to work.
c. only about a third of severe head injured make good recovery.
d. All the above
e. Non of the above.

18.

The adverse prognostic factors for the development of acute subdural

haematoma include the following except:
(B)
a. old age.
b. young age.
c. chronic alcoholism.
d. skull fracture.
e. anticoagulation therapy.

19.

The source of bleeding in the subdural space are all except:

a. bridging veins into the superior sagittal sinus.
b. bridging vein of Labbe.
c. cerebral contusion.
d. sinus bleeding.
e. fracture haematoma.

(E)

20.

Extradural haematoma, (the following are correct except):

a.
is more common than acute subdural haematoma.
b.
is more often associated with vault skull fracture.
c.
is caused by rupture of bridging veins.
d.
is more likely to expand.
e.
is more likely to be arterial in origin.

(C)

21.
The source of bleeding in extradural space could be any of the following
except: (B)
a. diploic vessels of the skull vault.
b. the cerebral veins.
c. the middle meningeal vessels.
d. the dural sinuses.
e. the dural arterioles.
22.

Mortality from trauma occurs mostly:

a. Immediately at the scene
b. During the first hour from the accident
c. After admission to the hospital
d. In the intensive care unit (ICU)
e. Just before discharge from the hospital

23.

Which one of the following is a life threatening injury?

a. Pneumothorax
b. Hemothorax
c. Head injury
d. Fractured ribs
e. Compound fracture of the leg
C

24.

Paradoxical breathing is associated with:

a. Bilateral ribs fracture
b. Massive hemothorax
c. Tension pneumothorax
d. Hypoxemia
e. Pulmonary contusion

25.

A polytraumatized patient who arrives to the emergency department a live

but unconscious is best managed by:
a. Adrenalin infusion
b. Blood transfusion
c. Cardiopulmonary compressions
d. Endotracheal intubation
e. Intravenous fluids resuscitation
D

26.
In hemodynamically stable trauma patient, intraabdominal injury is best
assessed by :
a. Clinical abdominal examination
b. CT scan
c. Diagnostic peritoneal lavage (DPL)
d. Four quadrants peritoneal tapping
e. Ultrasound
B
27.

The best method to stop continuous bleeding from pelvic fracture is by:
a. Applying mass trousers
b. Insertion of external fixators
c. Internal fixation
d. Internal pelvic packing
e. Radiological angio-embolization
B

28. Regarding ischemic leg ulcer, all are true EXCEPT:

a. Are small multiple painful ulcers.
b. Occur at tips of toes.
c. ABI is < 0.5
d. Occur above medial maleolus.
(D)
29. The initial step in the management of acute limb ischemia is:
a. Thrombolysis using tissue plasminogen activator.
b. Operative embolectomy.
c. Thrombolysis using urokinase.
d. Heparin infusion.
(D)
30. Specific sign for irreversible leg ischemia is:
a. Paralysis of foot short muscles.
b. Absence of sensation.
c. Pallor and coldness.
d. Fixed motling discouration.
(D)
31. Lower limb claudication:
a. Occur only in calf muscles.
b. Precipitated in long standing.
c. Usually occur in the same affected group of muscles.
d. Relieved by leg elevation

32. A 40-year-old lady in her 3rd day post op cholecystectomy developed swollen
left lower limb, which investigation is needed for diagnosis
32. ECG
b. U/S abdomen
c. Arteriogram
d. Echocardiogram
e. Duplex scan
(E)

33. In acute ischemia secondary to an embolus:

a. Thrombolysis is the best option of treatment.
b. Arteriogram is mandatory before intervention.
c. The usual site of embolus is middle third of superficial femoral artery.
d. Embolectomy without angiogram is the proper management
e. TED stocking is recommended
(D)
34. All the following can explain lower limb oedema EXCEPT:
a. Congestive heart failure.
b. Hepatic failure
c. Deep venous thrombosis
d. Severe acute limb ischemia
e. Nephrotic syndrome
35. The recommended test for diagnosis of acute DVT is:
a. Isotope scan
b. Venography
c. Doppler
d. Duplex
e. Plethysmography
D
36. Regards venous ulcer:
a.
Occur on the dorsum of foot.
b.
Treated by heparin infusion.
c.
Hydrostatic venous pressure of the leg on standing is above
90mmHg.
d.
ABI is usually < 0.5
e.
Signs of previous DVT is always absent
C
37. Guidelines in management of chronic limb ischemia:
a. Angiography is indicated in management of all claudicant patients.
b. Exercise training program is recommended in patient presented with rest
pain.
c. Estimation of claudication distance by treadmill is important guide for
choosing option of treatment ( Conservative or intervention ).
d. Decision for bypass surgery is made upon the results of ABI
C
38. Acute ischemia secondary to embolism is suspected on the following
conditions EXCEPT:
a. Previous myocardial infarction.
b. Absent peripheral pulses in contralateral limb
c. History of previous valve replacement
d. Presence of atrial fibrillation.
e. Rheumatic heart disease.
B
39. DVT is expected in following conditions EXCEPT:
a. Prolonged bedridden.
b. Pelvic tumours.
c. Hyproproteinemia.
d. Malignancy

40. In the presence of rest pain:

a. Pain came in calf muscles
b. Pain relieved by leg elevation
c. Such pain present for more than 2 weeks.
d. ABI is > 0.5

41.
Character of venous ulcer edge:
a. Sloping
b. Undermined
c. Beaded
d. Everted
e. Inverted
(A)
42. The following are complications of angiogram EXCEPT:
a. Haematoma
b. Renal failure
c. Infection
d. Pseudoaneurysm
e. Acute limb ischemia

43. The pressure of choice used to maintain pneumoperitomium during

laparoscopy in adult patient is :
a. 8 mm Hg.
b. 10 mm Hg.
c. 14 mm Hg.
d. 20 mm Hg
44. The best time for laparoscopic cholecytectomy in pregnant women is :
a. first trimester.
b. Second trimester.
c. Third trimester.
d. After delivery.
(D)
45.
Which of the following is used for pneumoperitonium?
a. Oxygen.
b. Carbon Dioxid.
c. Helium.
d. METhan.
(B)
46.
Absolute contritraindication for laparoscopic choleycystectomy is:
a. Cirrhosis.
b. Cholangitis.
c. Pregnancy .
d. Portal hypertension.
(B)

47.

48.

49.

50.

Successful reduction of an Intussusception is reflected by:

a.
Relief of abdominal pain.
b.
Reflux of Barium in small intestine.
c.
Complete filing of colon.
d.
Reduction in intussusception to the ileocaecal valve.
e.
None of the above.
(B)
In Pyloric stenosis, the laboratory data reflect:
a. Normal.
b. Respiratory acidosis.
c. Hyperkalaemia.
d. Metabolic alkalosis.
e. Respiratory alkalosis. (D)

Hirschspung's Disease
a.
It is only limited to rectum and sigmoid colon.
b.
Barium enema is always diagnostic.
c.
Delayed passage of meconium is the early presentation in full term
newborn.
d.
It is not due to the absence of ganglionic cell.
e.
Enterocolitis is not a complication of Hirschprung's Disease.

Inguinal Hernia:
a. Is more common in girls.
b. Hernioraphy is the treatment of choice.
c. Ultrasound is required to diagnose it.
d. Hernia sac may contain ovary, appendix, or omentum.
e. Direct inguinal hernia is more common than indirect..
(D)

51. Testicular Torsion:

a. Can not occur in neonates.
b. Radioactive isotope scan is essential to diagnose testicular torsion.
c. Treatment is observation.
d. Testicular or scrotal pain is the primary symptom.
e. The peak age of incidence is 10-15 years.
(D)
52. Undescended Testis
a. Is more common in left side.
b. Ectopic testis is not a type of undescended testis.
c. Treatment is orchidopexy at the age of 6 month.
d. It is not associated with hernial sac.
e. Laparoscopy is the investigation of choice for impalpable testis.. (E)

53.

54.

55.

56.

Acute Appendicitis
a. Is more common in children less than 3 years.
b. Treatment is conservative with antibiotic.
c. Wound infection, Pelvic abscess are the complications of perforated
appendix.
d. X-ray abdomen is needed to diagnose appendicitis.
e. Most of the patients have high fever at presentation.

Anorectal Malformation ( ARM)

a. Imperforate anus without fistula is the commonest defect.
b. The treatment of high type includes colostomy at birth followed by
posterior saggital anorectplasty (PSARP) in 3-6 months time.
c. Sacral deformities are always associated with ARM.
d. Invertogram must be done within first 6 hours of life.
e. Imperforate anus with recto-urethral fistula is the commonest form of low
type in male.
(B)
The most common cause of neonatal intestinal obstruction is :
a. Meckel's diverticulum.
b. Volvulus.
c. Intestinal atresia.
d. Intussusception
e. Adhesive bands.
(C)
Abdominal x- ray of a newborn infant demonstrate a " double-bubble" sign
and a small amount of scattered gas in the mid-abdomen. Which of the
following should be performed next?
a.
Upper GI barium study.
b.
upper GI gastrograffin study.
c.
lower GI barium enema
d.
lower GI gastrograffin eneme.
e.
Laparotomy.
(E)

57. A 28- days old male newborn presents with nonbilious vomiting. One week
ago, he weighed 4 kg; his current weight is 3.6 kg. On examination his anterior
fontanelle is flattened and his mucous membranes are dry. Between episodes
of crying an olive-sized epigastric mass is palpable. Laboratory data include
Na 133. K 3.6 CI 93, CO2 28, and capillary pH 7.51. The most likely diagnosis is :
a. Meningitis.
b. Hypertrophic pyloric stenosis.
c. Antral web.
d. Intestinal atresia.
e. Hiatal hernia.
(B)

58.

In children under 2 years of age, with acute appendicitis, the incidence of

appendiceal perforation noted at appendicectomy is:
a. Greater than 80%.
b. 50%.
c. 30%.
d. 30%
e. less than 20%.
A

59.

Congenital hydrocele
a. Tran-illumination is a reliable method to differentiate hernia from
hydrocele.
b. Clinically presents as tender scrotal swelling.
c. Communicating hydrocele is treated by needle aspiration .
d. Associated with many complications.
e. in 90% of cases spontaneous resolution is expected before two years of
age.
(E)

60.

The most common cause of duodenal obstruction in the neonate is:

a. Duodenal atresia.
b. Doudenal web.
c. Malrotation.
d. Annular pancreas.
e. Duodenal tumor.
A

61.

Which of the following is an absolute indication for operation in an infant

with necrotizing enterocolitis:
a. Pneumatosis interstinalis.
b. Portal vein gas.
c. Pneumoperitoneum.
d. Erythema amd edema of the abdominal wall.
e. Progressive thrombocytopenia.

62. Intussusception
a. Colic abdominal pain, vomiting, palpable abdominal mass are the
common clinical features.
b. Secondary intussusception is more common than primary intussusception
.
c. Ba enema is only used as diagnostic tool.
d. Colo-colic is the commonest type.
e. Laparotomy is required in all cases.
(A)

63.

The most common cause of rectal bleeding in infant is:

a. Ulcerative colitis.
b. Fissure in ano.
c. Rectal polyps.
d. Meckel's diverticulum
e. Intussusception.
(B)

64.

Basal cell Carcinoma:

a.
Metastasis is usually to Lymph nodes before systemic Metastasis.
b.
Metastasis is usually systemic before lymph nodes Metastasis.
c.
Metastasis is usually to both lymph nodes and systemic Metastasis at
the same time.
d.
Metastasis is usually to skin as " Satellite " Lisions.
e.
Does not develop Metastasis.
Answer (e)

65.

Patients with Gorlin Syndrome are known to develop:

a.
Basal Cell Carcinoma.
b.
Melanoma.
c.
Squanous Cell Carcinoma.
d.
Bowen's disease lesions.
e.
Dysplastic nervi.
Answer (a)

66.

Squanous Cell Carcinoma of the skin:

a.
Is Radio Sensitive.
b.
Is best treated by Chemotherapy.
c.
Surgery is done with 5cm skin margin.
d.
Usually seen in children.
e.
Its Metastasis is usually systemic before lymph node metastasis.
Answer (a).

67.

Melanoma.
a.
Nodular melanoma has a better prognosis than all other types.
b.
Acrol Melanoma is known to have the best prognosis .
c.
Is Radio sensitive.
d.
Usually develops metastasis to lymph nodes before systemic
metastasis.
e.
Is more common is black populations.
Answer (d).

68.

A melanoma with Clark level "2"

a. Reaches the epidermis.
b. Reaches the Basal layer.
c. Reaches the Reticular Dermis.
d. Reaches Junction of Reticular and papillary dermis.
e. Reaches the papillary Dermis.
Answer is (e)

69.

Majolin ulcer:
a.
is a type of basal cell carcinoma.
b.
Is a type of squamous cell carcinoma.
c.
Is a type of Melonama.
d.
Is a type of ulcer is a blue nervus.
e.
Is a type of an ulcer in a dysplastic nervus.
Answer is (b)

70.

The junctional nervus

a.
is flat in appearance.
b.
Is nodular in appearance.
c.
Has a flat centre and elevated edges.
d.
Has and elevated center and flat surrounding.
e.
Is also known as the dysplastic nervus.
Answer (a).

71.

Neurofibromatosis
a.
type I is Autosemal receive
b.
type II has a defect in chromosome 22.
c.
"caf au lait " spots are only seen in type I and not type II.
d.
skin neurofibromas are only seen in type II and not type I.
e.
a caustic neuromas are only seen in type I and not type II.
Answer (b).

72.

In Cavernous Vascular Malformations, the abnormal is :

a.
in the cappillaricy.
b.
In the arterioles.
c.
In the veins.
d.
In the arteries.
e.
In the lymphatics.
Answer

73.

The following are important steps in the management of strangulated

hernia except:
a.
Nasogastric tube
b.
Antibiotics
c.
Conservative treatment till obstruction is relieved
d.
Intravenous fluids
e.
Consent for possible bowel resection

74.

The above figure shows :

a. Double lumen tube
b. Armoured endotracheal tube
c. RAE tube
d. Combi-tube
e. Laryngeal mask airway

75. The most sensitive tissue for ischemia is:

a. Muscle
b. Nerve
c. Skin
d. Fat
e. Bone

76. The prefered treatment of a patient with painful thrombosed haemorrhoids is:
a. Excision of the haemorrhoid
b. Incision and evacuation of the blood clot
c. Use of stool softener and sitz bath
d. Injection with sclerosing agent
e. Rubbber band ligation of the haemorrhoid
A
77. The proper treatment of a patient with a peri-anal abscess is;
a. Incision and drainage as soon as fluctuation develops
b. Incision and drainage with excision of the internal opening
c. Prompt incision and drainage
d. Use of antibiotics and sitz bath
e. None of the above
C

78. The differential diagnosis of an inguinal swelling could include all of the
followings except:
a. Lipoma of the cord
b. Indirect inguinal hernia
c. Encysted hydrocele
d. Undescended testis
e. Varicocele
E

79.

Immediate life-saving attention is required for a trauma victim who suffers

any of the following conditions except:
a.
Airway obstruction
b.
Fracture of the femoral shaft
c.
Massive flail chest
d.
Open pneumothorax
e.
Tension pneumothorax
B

80.

The most common chest injury is:

a. Pneumothorax
b. Hemothorax
c. Sternal fracture
d. Rib fracture
e. Pulmonary contusion
D

81. In laparoscopic procedures:

a. CO is used for insufflation
b. The umbilical trocar is commonly used for the camera
c. Bowel perforation occurs more commonly with the open method for trocar
insertion
d. Diathermy is not used because of risk of explosion
e. The pressure in the abdomen can be raised safely up to 35mmHg B
82.

The third postoperative day following thyroidectomy, a patient c/o tingling

of her finger tips and is found to have serum calcium of 1mmol/l.
The next step in the treatment should be
.a Careful observation until the calcium level increases
.b Administration of vit. D
.c Administration of dihydrotachysterol
.d Administration of 1, 25(OH) 2D (calcitrol)
.e Administration of calcium gluconate by slow intravenous drip
E

.83 A 24 years old man brought to the ER after a fall from a height. His breathing
was laboured and he was cyanotic. No breath sounds can be heard in the
right lung field, which was resonant to percussion. The first step in the
management will be
a. Cricothyroidotomy
b. Obtaining stat chest x-ray
c. Passing an oral endotracheal tube
d. Starting oxygen by mask
e. Tube thoracostomy
E
84.
Medullary thyroid carcinoma:
a. Is a tumor of the Para follicular C cells
b. Produce thyroxin as the principle hormone
c. Are TSH dependant
d. Can be treated by radio-iodine ablation
e. T3 act as a tumor marker.
A

85. The following necessitate admission to the intensive care unit except:
a. 3% burned patient
b. Head injury victim
c. Bilateral multiple fracture ribs
d. Post-operative respiratory failure
e. Near drowning patient
A
86. Sungstakin tube:
a. Has two lumens
b. Possess a single balloon
c. Used to treat bleeding esophageal varices
d. Is 20cm long
e. Should stay in the patient for at least 5 days

87. Which of the following is correct?

a. Foleys catheter is typically triluminal
b. The artery forceps is used as a hemostat
c. The subclavian catheter is inserted through the subclavian artery
d. Silk suture is used in vascular anastamosis
e. Vicryl is non absorbable
B
88. Parents of an infant with a unilateral undescended tesis should be adviced
that:
a. Correction of the problem should be carried out immediately
b. Spontaneous descend may occur after the age of 5 years
c. Orchidopexy should be performed to prevent malignancy
d. Orchidopexy may prevent infertility
e. Orchidopexy should be done if the patientpresents at the age of 10 years or
more
D
89.

A patient with enlarged cervical lymph node, which of the following is

unlikely to be the primary site:
a. Bronchus
b. Stomach
c. Colon
d. Mouth
e. Laryngopharynx
C

90.

Which of the following is true concerning traumatic pneumothorax?

a.
b.
c.
d.
e.

Needle aspiration is the treatment of choice

The commonest type of chest injury
Definitive treatment by intercostals tube drainage
The main factor causing respiratory distress in flail chest
Present with stridor
D

91. L4-5 disc prolapse the patient will have:

a. pain in front of the thigh and groin.
b. weakness of the dorsiflexors of the foot.
c. absent knee jerk.
d. hypothesia around knee.
e. muscle fasciculation in the calf muscle.

answer b

92. The best radiological investigation in a case of spastic paraplegia with

sensory level at T10.
a. Myelogram
b. CT myelogram
c. Spinal angiogram
d. CT Scan of the dorsal spine
e. Magnetic Resonance Image Scan
Answer e
93. All of the followings are external hernias except:
a. Obturator hernia
b. Hiatal hernia
c. Femoral hernia
d. Lumbar hernia
B
94. Two hours post Rt subclavian central venous catheter insertion, patient
started to complain of Rt sided chest pain, shortness of breath, taccypnea,
and he is tacchycardic. There is decrease air entry to the Rt side. The most
likely diagnosis is:
a. Hemothorax
b. air embolism
c. line was inserted in the artery
d. pneumothorax
A
95. The proper management of the previous patient is:
a. Chest tube
b. Removal of the line
c. Intubation
d. Aspiration of the gas from the line
A

The end

1)WithregardtoMeckelsdiverOculum,whichistrue:

a.

Theyarepresentin50%ofthepopulaOon

b. TheyaretruediverOcula.
c.

AllcanbevisualizedbyMeckelsscan.

d. MostcomplicaOonsoccurintheelderly.
e.

DiverOculiOsisthemostcommoncomplicaOon.

2)Adeniteincreasedriskofcoloncancerisassociatedwith:

f.

Diethighinber.

g. Dietlowinanimalfatandprotein.
h. Dietlowinber.
i.

UlceraOvecoliOs

j.

Priorcholecystectomy.

3)Withregardtocolorectalpolyps,whichofthefollowingisconsideredprecancerous:

k. HyperplasOcpolyps.
l.

Hamartomatouspolyps

m. Adenomatouspolyps
n. Lymphoidpolyps
o. Inammatorypolyps.


4)Whichofthefollowingisthemainchemicalcomponentofpigmentgallstones:

p. Cholesterol.
q. Calciumbilirubinate.
r.

Calciumcarbonate.

s.

Calciumpalmitate.

t.

Calciumoxalate

======

1. IntheevaluaPonofthepaPentswithuretericcolic.Whichofthe
followingstatementsistrue:

a.Absenceofgrossormicroscopichematuriadoesnotruleouturinarystones
b.PlainKUBcanidenOfythestonein70%ofpaOents.
c.UltrasoundistheinvesOgaOonofchoiceforpaOentswithuretericstones.
d.EmergencyIVPshouldalwaysbecarriedout.
e.DTPArenogramhasnoroleinevaluaOngpregnantwomenwithuretericcolic.

2. FactorsthatshouldbeconsideredwhenevaluaPngthetreatment
opPonsforpaPentswithuretericstonesinclude:

a.Sizeofthestone
b.Siteofthestone
c.SexofthepaOent
d.A&B
e.A&c

Best answer:
Thiopentone induces mainly:
Sedation
Hypnosis
Delerium
Hangover
Hypotension
B
(2) Spinal analgesia is commonly used for:
Upper abdominal surgery
Labor
Chronic pain relief
Anal surgery
Thoracic surgery
D
Blood transfusions may cause all of the following except:
Microcirculation thrombosis
Transmission of malaria
Allergic reaction
Bronchospasm
Increase platelets count
E
The most common chest injury is:
Pneumothorax
Hemothorax
Sternal fracture
Rib fracture
Pulmonary contusion

Successful reduction of an intussusception is reflected by:

Reduction of intussusception to the ileocecal valve
Relief of colicky pain
Relux of barium into the small intestine
Complete filling of the colon
None of the above
C
Regarding varicose veins all are true except:
Primary type include healthy deep system
Primary type include diseased superficial system
Secondary type include healthy superficial system
Secondary type include diseased superficial system
Secondary type include diseased deep system
C

A patient known to have rheumatoid arthritis on steroid therapy and he is

going to have elective surgery, which of the following is true regarding his
preparation for the surgery?
Keep the patient on the same dose of the steroids
Increase the dose of the steroids preoperatively and give it intravenously
Stop steroid therapy before surgery
Shift steroid to aspirin and other NSAID
Cancel the surgery.
B
Preoperative antibiotics should be given to the following patients except
A patient who is going to have thyroidectomy
A patient who is going to appendicectomy
A patient who is known to have mitral stenosis
An obese patient undergoing cholecystectomy
A patient who going to have right hemicolectomy
A
Strawberry hemangioma in a newborn in the cheek
Best treated by surgical excision
Best treated by steroid injection
Best managed by observation for 4-5 years
None of the above
All of the above
C
All of the following are used to assess the nutritional status of the patient
except:
Platelet count
Lymphocyte count
Body weight
Serum albumin
Triceps skin fold
A
In laparoscopic procedures:
CO is used for insufflation
The umbilical trocar is commonly used for the camera
Bowel perforation occurs mosr commonly with the open method for trocar
insertion
Diathermy is not used because of risk of explosion
The pressure in the abdomen can be raised safely up to 35mmHg B
TPN is indicated in a patient
With severe diverticular disease of the sigmoid colon
For conservative treatment of appendicular mass
For treatment of perianal fistula
With enterocutaneous fistula having a daily discharge of over 600cc
With 25cm of small bowel resection
D

Which of the following types of intestinal obstruction does not need an

emergency surgery?
Mechanical obstruction in the early postoperative period
Colonic obstruction
Closed loop obstruction
Strangulation obstruction
Paralytic ileus
E
Commonest cause of antenatal hydronephros is
Vesicoureteric reflux
Posterior urethral valve
Ureterocele associated with reflux
Prime belly syndrome
Pelviureteric junction obstruction (PUJ)

Features of Dumping syndrome include all of the following except:

Tachycardia
Sweating
Palpitations
Constipation
Diarrhea
D
In a jaundiced patient
Vitamin C absorption is impaired
Albumin is always low
Coagulation defect is correctable with parentral vitamin C
More prone to infection
Kidneys will have pathological changes if hepatorenal syndrome
developes D
Which of the following conditions is an absolute indication for surgical
exploration in renal trauma?
Large perinephric hematoma
Presence of hematuria
Injury of renal vessels
Extravastion of urine
Injury of a solitary kidney
C

Regarding the treatment of duodenal ulcer:

Most duodenal ulcers are treated medically with no need for surgical
intervention
Arteriography in bleedind ulcers is a useful diagnostic modality but has
no place in therapy
Endoscopy in bleeding ulcers is a useful diagnostic modality but has no
place in therapy
When a vagotomy is performed only one vagus should be divided in order
to preserve the pyloric function
A Billroth 2 gastrectomy is more physiological and anatomical than highly
selective vagotomy
A
(19) A patient with enlarged cervical lymph node, which of the following is
unlikely to be the primary site:
Bronchus
Stomach
Colon
Mouth
Laryngopharynx
C
Patients with benign prostatic hypertrophy (BPH)
Patients would require surgical treatment
Most of them will respond to medical therapy
BPH is a precancerous condition
The usual age of presentation is between 35-45
Painless hematuria is a leading symptom
B



1427\1426

100 20 74
tutorials
-1 breast ca residents
-2 brain ca ) (
-3 laprascopy
-4

Best single response

1aBercurableresecPonofca.pancreastheexpected5yearsurvivals:
10%
30%

20%
2CholestaPcjaundicemeans:
ObstrucOonofthebileouNlow.

320y/omalewillhavelipsurgerybutyoundhisBP160/120yournextstepis:
consolethesurgery

4inobstrucPvejaundiceyouwillnd:
increaseinALP

5bestPmetodolaparoscopicCholycystectomyforpregnantwomen:
1sttrimester
2ndtrimester
3rdtrimester
ABerdelivery

6AbsolutecontraindicaPonfordoinglaparoscopiccholecystectomy:
cirrhosis
portalHTN
cholangiOs
pregnancy

7Ladypresentedwithlowerabdominalpain,onex.Shehas+vereboundbestTX.Is:
laparoscopy
Laparatomy
C.T

8commonsiteforstulabetweengallbladder&intesPneis:
duodenum
jejunum
illume
ascendingcolon

9commonorganismfoundinbrainabscessis:

Streptococcus

10Dxofperforatedviscous

11IntheevaluaPonofptnwithacutepancreaPPsduringthe1st48H,alltrueexcept:
amylase3500(NOTpartofRansoncriteria)
dropofHCTby10%
BUNincrease(>5)from6to11
AST2500(?)
O2saturaOon<60mmHg.

12ca.esophagus:

13Tx.Ofachalasiaisby:
balloondilaPonorheller

14ScenarioofabusinessmandiagnosedtohavelargepepPculcerbyendoscopy,medicalTXisstartedbyH2
blockersbutitdidn'tworksoyournextstepis:
givebismuth+claythromycin+tetracycline
truncalvagotomy+antractomy

truncalvagotomy+pyloroplasty

15TPNisindicatedinallptn.Except:
diverPculiPs
postgastricsurgery
highoutputcolocutaneousstula
shortbowelsyndrome
severnecroOzingpancreaOOs

16regardingCHO:
consPtute60%ofthedailyintake
1gofCHO=6.7kcal
CHOcanprovidethebodywithenergyfor1weekincaseofstarvaOon
Storedinthemuscles

17preOPanPbioPcsgivenforallexcept:
thyroidectomy

18whichdoesn'tcausenippledischarge:
Pagetdisease
eczema
psoriasis
cancer
ductectasia

19excellentwayfordoingspleenectomyisby:
open
laparascopic
embolizaOon

20ptn.whodevelopsca+2<2aBerthyroidectomygiveher:
ca+2gluconatebyslowinfusion
observeunOlspontaneousraiseoccure
infuseDOH2(dihydroxycholecalcefrol)

21IndicaPonsforTUBPinptn.WithBPH:
recurrentUTI
irritaOve&obstrucOvesymptomsinBPH

22CalciumoxalatestonescanbeTx.Byallexcept:
medicallytodissolvethestone
ESWL
PNL
alkalinizaPon

23inincompletekidneyobstrucPon,thekidneywillbedamagedaBer:
4weeks
2weeks
6weeks

24commoncauseofantenatalHydronephrosisis:
pelviurertricjuncPonobstrucPon
posteriorurethralvalves

25CommoncauseofHydronephrosisinfemaleneonateis:

Ureterocele

26bestgasusedforinsuaPonsinlaparoscopicsurgeryis:
co2
O2
Helium

27thepressureofthegasinsidetheabdomeninlaparoscopicsurgeryis:
20
10
14
35

28theconcentraPonofelectrolytesinRingerlactates:
Na:130K:cl:110lactate:28k:4ca:3
Na:135K:cl:only

29painduetoappendiciPsis:
relivedbyleaningforward

30amanwithHx.Ofprogressivedyspneaover3y&regurgitaPon,massontheRtside:
goiter
zenker'sdiverPculum
caroOdbodytuomer
branchialcyst

31hypertrophicscar:
growslocallyatthesideoftheoriginalinjury
vascularity..
regressspontaneouslyoverOme

32cushiningulcer(repeatedQfrompreviousexam).

Stressulcer(pepPculcer)causedbyincreasedintracranialpressurethatwillleadtoincreasedvagus
sPmulaPonandgastricacidsecrePons.

33K+level(repeatedQfrompreviousexam)

34osmolarityofblood(repeatedQfrompreviousexam)

35Themajormortalityintraumaptn.:
withinthescene
With24H
inICU
bygePngoutofthehospital

36inpapillaryca.ofthyroid:
TSHdependent
mulOfocal

37themostcommoncauseofurinarystonesindevelopedworld:
hypercalciuria
recurrentUTI

..PH

38medullaryca:
arisefromparafollicularcells(Calcitoninproducingcells)

39benigntumorsofthelargecolonincludeallexcept:
carcinoid
liomyoma
angioma
familialpolyposiscoli
villusadenomatouspolyps

40duodenalulcer:
mostofthecasesrespondtomedicalTx.

41.?
interinsicfactorissecretedinthestomach
cuQngoneofthebranchesofthevagusisgoodinprevenPon
antraumcontainsGcells
gastroenterostomywithoutvagotomyisass.Withhighrecurrencerateofulcers

42managementofbreastca.includesallofthegoalsexcept:
savingtheshape&funcPon
prevenOonofcomplicaOons

43inurinarybladdertrauma:
extraperitonialoccursincaseofpelvicfracture
cystoscopyintheERisenoughtodetectpathology

treatedbyprimarysuturing

44indicaPonsofIVPincludeallexcept:
Grosshaematuria
contusionsintheanks
microscopichaematuriawithsystolicBPof100

MicroscopichaematuriawithmulPorganfailure

45indicaPonsofexploraPoninrenaltrauma:
penetraPnginjury
laceraOon
signsofmulOorganinvolvement

46mildrenaltraumaincludesallexcept:
laceraOonofrenalcortex
laceraPonofcorPcomedullaryjuncPon

47complicaPonsofTPNthroughcentrallineallexcept:
subclavianinury
Hemothorax
pneumothorax
hydrothorax
airembolism

48thebestwayoffeedingptn.ForlongPmepostCVAwhoishavingdysphagia:
NGT
gastrostomy
TPN

49preopraPveprophylaxisanPbioPcsinvalvularheartD:
gentamycin+amoxicillin

50symptomsoftheceacalca.includeallexcept:
anemia
massinRTiliacfossa
occultblood
melena

51Themetabolicabnormalityinhypertrophicpyloricstenosis:
respiratoryacidosis
hyperkalemia
Respiratoryalkalosis
metabolicalkalosis

52thecauseofdysphagiainptn.WithGERD:
moOlitydisorder
stricture

53renalcolictypicalfeaturesincludeallofthefollowingsexcept:
painincostvertebralangel
frequency&dysuria
exionofthehipcausesreferredpain
radiaOontotesOs

54heparin:
ptn.WhoaregivenprophylacOcheparinshouldhavecoagulaOonproleeveryhour
monitoredbyparPalthromboplasPnPme
ptn.Whoaretotallyonheparinshouldbegiven2500IUeveryH

55inlaparoscopy:
cameratrochershouldbeputatumbilicus
pressureshouldbekeptat35
wideincisionforthetrocherisassociatedwithperforaOonofviscus

56
ptn.Whoarereceving3unitsofpackedRBCsshouldbegiven!unitofFFP

57complicaPonsofbloodtransfusion:
microcirculatorythrombi
allergy
bronchospasm

Increaseinplatelet

58intrcranialtumorscanpresentwith:
deterioraOoninthelevelofconsciousness
focalneurologicaldecit
alloftheabove

59cholycysPPswithoutstonesisbestinvesPgatedwith:
ERCP
PTC
HIDAscan
60glioma:
inchildrenoccursin.
metastasisinadultsisuncommon

61cleBpalate:
occurinthe16thweekofintrauterinelife
canbeuni\bilatral
canbeassociatedwithrecurrentoOOsmedia
canbeassociatedwithURTI
besttreatedby2yofagetoavoidnasalspeech

62pressuresores
changingtheposiPonevery2hoursshouldbeincludedintheTx.
treatmentbydebridment
theonlysoluOonistoreplaceitbyskinaporgra?
developsonbonyprominence

63caloricintakeperday:
3035gm/kg(maybe2530)

4045

64Meckel'sdiverPculum:
composedofcolonicmecosa
present2feetawayfromilioceacalvalve

65complicaPonsofdiverPculiPsincludeallofthefollowingsexcept:
bleeding
perforaOon
stulaformaOon
malignancytransformaPon

66LFTsinptn.WithobstrucPvejaundice:
elevatedSGOTast
elevatedSGPT
elevatedalkalinephosphatase
elevatedundirectbilirubin

67acutepancreaPPsalltrueexcepte:
themostcauseisobstrucOonbystones
causedbylymphoidhyperplasiainchildren

68XrayofthecervicalspineisperforatedpreOP"
rheumatoidarthriOs

69KUBwilldiagnoseurinarytractstonesin:
90%oftheptn.
10%

70theinvesPgaPonochoiseinaptn.WithperforatedpepPculceris:
uprightabdominalXraycccccccccccccxr

71trumaptn.Comeunconsciousbutiswhatisthenextthingyouwanttodo:
infusionwithadrenaline
endotrachealintubaPon
intravenoushydraOon

72Paradoxicalbreathingcauses:
lungcontusion
ailchest

73Onofthefollowingisanemergency:
pneumothorax

74Monitoringofuidinaptnwith..:
swanGanzcatheter

Best single response

1-

k+ in blood : 3.5 -5.5

infant born with strawberry nevus on his cheek :best tx:

observation for 4-5y
steroid injection
excision
layer

neurofibroma:
type I autosomal dominant
chrosome 22
caffe ola skin manifestation appears only in type I
acoustic neuroma happens only in type I

clark grading in malignant melanoma grade III means:

- involving papillary _ reticular junction

papillary layer

5- basal cell ca . metastasis :

- not metastasize
-metastasize to lymph nodes before the body
-To the body before the lymph node

to lymph nodes+ To organs in the same time

6- most common chest injury is:

- pneumothorax
- rib fracture
-Haemothorax

7- ptn. With pneumothorax tx. Is by:

chest tube

8- in flail chest the respiratory distress is caused by:

- lung contusion
- exuhation and pain only

Multiple segment fracture

9- Common site of metastasis in neck lymph node in the anterior 1\3 of sternomasroid muscle is
from:

lung

- nasopharynx

- breast

- GIT

10- branchial cyst:

- lined by squamous epithelial cells
- comes from 1st branchial clet

in the posterior border of srenomastoid M

11- investigation done for carotid body tumor except [un helfull]
-CT

- angiogram - FNA

12- cystic hygroma .all true except

- posterior triangle of the neck.
- could be bilateral
- compressible
- decrease in size when child cries

pulstie

13- tx . of bleeding esophageal varices.

- best treated by porto systemics shunt [TIPS]
- somatostatiens
- sclerotherapy
- B2- blokers only

14- massive lower GI bleeding is caused by

- carcinoma

- ulcerative colitis

- diverticulitis
- hemorrhoids

polyps

15- in GIT bleeding

- Angiogram is sensitive
- Angiogram can detect bleeding 0.1mh/min
- RBC scan is localize bleeding site

RBC scan is more sensitive in detecting bleeding while angiogram is more specific

16- in lower GIT bleeding investigations all can be used except.

- colonoscopy
- angiography
- RBC scaning

barium enema

17- question on sutures.

silk sutures are commonly used in vascular surgery

18- cat-gut sutures.

- made from cat-stomach
- absorbable

excellent for hernia repair

19- commonly used in surgical sterilization

- autoclave
- alcohol 20%
- ethylene oxide
- che .xidide

-phenol

20- microscopic haematuria which is found many times in 55y old man:
- not important unless ass. With pus cells
- always significant

not imp. Unless ass with +ve cytology

21- ptn . know to have bilhariziasis came from Yemen, complaining of terminal haematuria.
- treat with antibilharizal antibiotics
- assure the pth.
- it means ca. bladder

22- ca. bladder caused by bilharziasis is:

- squamous cell ca.
- adeocarcenoma
- transitional cell ca.
- renal cell ca.
23- commonest tumor in the kidney.
- renal cell ca.
-Transitional cell ca.
24- ptn. Treated by nephrouretrotomy is likely to have.
- transitional cell ca.[renal pelvis ca.]
- renal cell ca.
- squamous cell ca.
25- cushing ulcer.
- neurological
-In pth. With burn
26- sliding heria.
- more common in females
- contain retroperitoneal structures
- recurrence rate is high after Tx.
- anterior abdominal incision

27- Mcburn's point.

- point of maximum tenderness caused by pancreatitis
- lies on deep inguinal ring
- lies on the junction between ileum & cecum
- 1/3 between A.S iliac spine & umbilicus
28- cardinal sign of hernia.
- cough impulse
- painful swelling
29- inguino-scrotal swelling, all true except:

- vaginal hydroceal
- indirect inguinal hernia
- epidedmal cyst
- Torsion of the cord
30- Femoral hernia
- more common in males
- treated by surgical excision
- not prone to strangulation
- above & medial to pubic tubercle
31- Thiopentone.
- induces sedation
- induces hypnosis
32- MAOI are contraindicated to be given with.
- cocaine

- procain

- prilocainen

- pethidine

- morphrine

33- early sign of local anesthesia Toxicity:

- Tachycardia
- circumoral numbness

34- pain:
- transmitted through 4 order neurons
- NSAI are usefully
- can be acute or chronic
- can radiate to another site
35 - pulse oximetry measures:
- o2 saturation
- pulse
- b+c
- all of the above
36- malignant hyperthermia early sign

- tachycardia
- increase body temp.
- increase ET-co2
37- complication of endotracheal intubation:
- Tachycardia &hypertension
- Tachycardia &hypotension
- bradycardia &hypotension
- bradycardia &hypertension
- no complication to CVS
38- Functional residual capacity is
- tidal volume +aspiratory Reservoir
- tidal volume +exp . Reservoir
- tidal volume + exp. Reservoir +insp. Reservoir
- non f the above

39- in spinal analgesia the needle pass through

- Supra-spinous ligament
- Intra -spinous ligament
-CSF
- posterior longitudinal ligament
- ligmentum flavum
40- C.S.F is found in:
- between dura &arachnid
- between dura & pia
- between arachnoid & pia
41- folly's catheter
- typical type is tiuminar
42- in pth . with acute subdural haem. The prognosis is bad in all except.
- old age

- anticoagulation
- young age
- smoking
43- lower limb edema occur in all of the followings except.
- CHF
- hepatic failure
- nephritic syndrome
- DVT
- sever acute limb ischemia
44- ptn. Who develops venous ulcer.
- ABI <o.5
- venous pressure when standing >50
- occur in the dorsum of the foot

45- acute limb ischemia all true except

- ABI<o.5
- happens on medial malleuols
- multiple small ulcers on tip of the toes
- painfull ulcers
46- ptn . have disc prolaps in L4\L5 he will have
- lost knee jerk
- weak in the muscles that do dorsi flexion
47- factor which indicate irreversible leg ischemia:
- fixed mottling of the limb
- paralysis
- sensory loss
-Cold & pale
48- 10y old boy weaks from sleep at midnight complaining of lower abdominal pain what you will
examine:
- testis

-kidney
- rectum
- non of the above
49- last modality will be lost in lumbar spinal anesthesia:
- motor
-Proprioception
pain & touch
autonomic
50-The most killing in polytraumatic pth.is
- neurologic defict
- bleding
- respirarory failure

51- junctional nevus:

- also called dysplastic
- elevated edge & flat center
- elevated center &flat edge
- Flat
-nodular
52- 40y old female present wit spastic paraplegia & sensory level at TI0 best investigation:
- MRI
- CT
- myelography
- CT+ myelography
53- Diabetic ketoacidosis:
- only in insulin dependent diabetes
- give high doses of long- acting
- resuscitate intravascular compartment
- non of the above
54- PTN. With iliocecal intussusception treated with contrast enema ,sucssful treatment will show:
- colon filed with contrast

- colicky pain is relieved

- barium enema of small intestine
-non of the above
55- treatment of cerebral edema except:
- manitol
- dexamethason
- hyperventilation

56- complications of subclvian vein catheterization:

-air embolim
- pneumothorax
- haemothorax
57- Treatment of hyperkalemia all true except:
- B2 agonist
- ca+2 supplement
- insulin shift k+ into the cell
- haemodyalesis
58- pulmonary embolism investigation:
- VIQ scan [ventilation perfusion scan]
- angiogram
- ECG
- electrocardiogram
59- rest pain
- pain in calf M
- relived by elevation
- more than 2 weeks
- ABI<0.5
60-in perforated appendix common organism

- E. coli
- bacteriods
- E. coli+ bacteriods+ others
61- cardiac temponade:
- mediasetinal emphysema
- tachdycardia
- high JVP

62- case of haemothorax initial treatment:

- chest tube
- o2 mask
63- body response to lactic acidosis
- compensated by hyperventilation
- compensated by retention of Hco3 in the kidney
- metabolized in he liver
- given bicarbonate
64- pre-op preparation for ptn. Emboli:
- do embolectomy without angiogram
- angiogram is mandatory
65- O2 dissociation curve shift to the left:
- acidosis
- sickle cell anemia
- 2_3 DPGs
-storage of blood
- sepsis
66-increase O2 delivery to tissues by:
- anemia
- cardiac out put

- hypovolemia
67- in 5 leads ECG changes in lead II indicate
- anterior MI
- posterior MI
- latral MI
- anterolatral MI

68- commonest infection acquired in hospital:

- lower respiratory treat
- UTI
- orophoyngeal
- wound infection
69- angiogram complications all true except.
- haematoma
- renal failure
- psudoanyrusm
- infection
- sever acute limb ischemia
70- Treatment of sinus bradycardia:
- atropine
- lidocain
71- osmolalityof blood 280-290 mosm

2nd Written Exam of surgery 451 2007

( 2nd cycle females )
There were 100 questions , I only
remembered these , MOONTI6.
Primary fistulotomy can be done in which one :
Intersphincteric
Transsphincteric
Lateral suprasphinctric
Extra sphincteric from Chron's disease

Which patient will have the first priority in a triage for a bus car
accident :
Cervical spine injury
Airway compromise
Multiple fractures
Pelvic fracture??

Gallstones could be all types except :

Mixed
Cholesterol
Phospholipid stones
Black
Brown stones

Which one of these parameters do you have to have in order to

diagnose shock?
Hypotension
Decreased tissue perfusion
Tachycardia

All surgeries need prophylactic antibiotics except :

Thyroid surgery

What is Dercun disease

Multiple lipomas
Multiple nevie

What is the best way to assess for proper tracheal intubation?

Auscultation of the chest bilaterally and the epigastrium
Visualize the chest rising
Presence of fog or vapor on the endotracheal tube
End tidal CO2 monitoring

A woman who has aortic stenosis, came with lower GI bleeding

, the most likely cause is :
Ishcemic colitis
Diverteculitis

Rodent ulcer is

Basal cell carcinoma

All can be a scrotal swelling in a male infant except:

Sebasous cyst of the scrotum
Inguinal hernia

Barratt's eosophagus

Caused by Achalasia
Most commonly in the middle third
Highest risk of eosophageal cancer
Only if dysplasia not metaplasi
Early resection if metaplasia

Regarding TPN :
It should be

Calcium oxalate stones can be TX. By all except:

only ESWL
ESWL
PNL
Open surgery
alkalinization

Most common cause of urine retention in a male infant is :

Posterior urethral valves
Bilateral pelvic ureteric junction obstruction
uretrocele

Percentage of water in body of a male is

40%
50%
60%
75%

Mickel's diverticulum :
composed of colonic mecosa
present 2 feet away from ilioceacal valve

Regarding Men1 all are true except

AR pattern of inheritance
Affects both sexes equally
Affects 90% of parathyroid
40% of pancereas
Usually affects the pitutaty gland

Regarding Cushing's syndrome

Its a synonymous of cushing's disease

Pheochromocytoma
Always associated with weight gain
Only located in the adrenals

A 3 week old healthy baby girl , suddenly starts to vomit bilious

vomiting .The most likely cause is :
Pyloric stenosis
Malrotation and volvulous
Deudonal atresia

A patient with Rheumatoid Arthritis , going to surgery , the

following should be done regarding her steroids :
Stop the steroids
Increase the dose and give it IV
Stop then replace by aspirin or other NSAIDs

LR is used for:
Plasma expansion
Correcting metabolic abnormalities
Intracellular
extra cellular

intracranial tumors can present with:

deterioration in the level of consciousness
focal neurological deficit
seizures
all of the above

Which factor increases intracranial pressure?

Movement
Fever
Pain
Valsalva
All of the above

Synactyl is :
Complete cleft of primary palate is :
A 50yr old man with a history of right hemicolectomy,
presented with colicky abdominal pain which became constant,
N, V and abdominal distention. the most likely cause is :
Small bowel obstruction
Large bowel obstruction
Paralytic ileus
Closed loop obstruction.

what is the next step after an X-ray in a trauma patient

showing air under the diaphragm :
Laprotomy
Laproscopy
CT abdomen
US abdomen
DPL

Regarding acute peptic ulcer all are true EXCEPT:

Can be drug induced
Can occur anywhere in the stomach
Can occur anywhere in the duodenum
Cushing's ulcer can happen post-trauma

Definition of Coma is:

In a trauma patient what should u do before introduction of a
urethral catheter :
Examination of the rectum and perineum

Pattern of appendicitis history :

Regarding Flail chest:
Most common presentation of Renal cell carcinoma is :
Heamaturia
Pain
Incidental
Mass in the abdomen??

Regarding testicular carcinoma , All are true except:

Mostly are malignant
Requires scrotal insicion for biobsy

Which one of these measurements indicates malnutrition (or

gives the diagnosis of malnutrition ) :
Albumin <29 g/l
BMI = 22

Anal cancer treatment

Anal cancer is not associated with :
Smoking
HIV
HPV
Anal intercourse

Hirshsprung's disease
Parkland's formula :
half of the fluid is given in the first hour
the urine output is 10ml/min

Split thickness versus Full thickness graft???

One of these skin lesions is pre-cancerous to squamous cell
carcinoma :
Keratocanthosis
seborrehoic keratosis
actrickeratosis
skin tag
skin wart

According to Clark's classification invasion of papillary layer in

malignant melanoma is :
Clark 1
Clark 2
Clark 3
Clark 4
Clark 5

Regarding Diaphragmatic hernia:

rolling type is most common
both have GERD
herniation is through the central ligament of the diaphragm

Most common organism cultured from brain abscess is:

Strep milleri

Varicocele :
Is an exclusive condition of adult male
Abdominal ultrasaound should be done if they are bilateral or not reduced by
lying down

What is the best initial management in a patient with

neurogenic bladder and spina bifida?
Clear intermittent catheterization with anticholinergics
Pylostomy
Cystostomy
Uretrostomy

Best investigation of choysistis whithout a stone is

PTC
ERCP
HIDA scan
CT scan

Vertical banding gastroplasty has lost its famousness and not

used anymore because of :
Increased number of complications
Less maintenance of lost weight in the long term

Most important factor causing failure of the surgical reduction

of weight is :
Sweet eaters

Achalasia
Do the surgery of a boy having bilateral pelviureteric junction
for all except :
Because of recurrent pain

All are complications of thyroid surgery except:

A tracheo-eosophageal fistula or atresia or H type in a baby
wih
Tumors of the brain can present as
All of the above ( ICP , seizures , headaches ...)