General Surgery End exam MCQ ( 1-50 )

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1- Which of the following is the best for diagnosis of acute appendicitis:
a.
b.
c.
d.
e.

Lab.Tests
US
Barium meal follow through
Barium enema.
Clinical Examination

2- BPH can present with the following symptoms except:

a.
b.
c.
d.
e.

heamaturia.
hesitency
frequency
poor stream
pain in perineum

3- Regarding liver abscesses, the incorrect statements is:

a.
b.
c.
d.
e.

acute appendicitis is a risk factor

entamoeba histolytica may be responsible.
percutaneous needle aspiration is an acceptable TTT option.
fever is usually absent
DM is a risk factor.

4- All of the following are common complication of diverticulitis except:

a. perforation
b. malignancy
c. stricture formation

d. fistula
e. abscess

5- How much of the circumference of the oesophagus must be involved by a

malignant growth before develops dyspahia:
a.
b.
c.
d.
e.

minimal involvement
About one forth
About one third
About one half
About two thirds

6. The commonest presenting features of ANDI include:

a.
b.
c.
d.
e.

Mastalgia
Lymphedema of arm
Breast atrophy
Peauo d orange
Amazia

7. In clean wounds, all the following is correct except one:

a.
b.
c.
d.
e.

Occur in areas away from known contamination.

Contain no gross dirt or devitalized tissue.
Have not been subjected to manipulation.
Tendons, vessels and nerves should not be repaired.
Healing occurs by first (primary) intension.

8. The contents of the sac of an oblique inguinal hernia in the adult can be one of
the following except one:
a.
b.
c.
d.
e.

Omentum
Portion of the circumference of the intestine
Diverticulum of the urinary bladder
Portion of the liver
Ascitic fluid

9. Anaphylactic shock is characterized by the following clinical finding except:

a.
b.
c.
d.
e.

Stridor
Cold extremities
Edema in tongue and lip
Skin wheals
Bronchospasm

10. A 32 years old female reported with history of bleeding per rectum and is
diagnosed as having adenocarcinoma of the rectum 6cms from anal verge. There
is no metastasis. The treatment is:

a.
b.
c.
d.
e.

Abdominoperineal resection with total mesorectal excision

Abdominoperineal resection with partial mesorectal excision
Low anterior resection with total mesorectal excision
Low anterior resection with partial mesorectal excision
Abdominoperineal resection with absolutely no mesorectal excision

11-The most important risk factor for buerger disease:

Hypercholestremia
Type 2 DM
Alcohoism
RA
Smoking

12- All of the following could be complication of appendectomy EXCEPT:

a. Interloop abcess Not sure b. Pelvic abcess
c. Subphenic abcess
d. Subcutaneous abcess
e. Psoas abcess

13- 63 years old male was incidentally found to have an AAA 4,1 cm in
diameter being evaluated for bronchial asthma , The TTT would be :a.
b.
c.
d.

Surveillance and regular follow up

Open Excision with repair and graft
Endovascular repair with graft
Endovascular graft without repair

14- Serum potassium level is :

a.
b.
c.
d.
e.

2 4 mmol/l
3,5 5.5 mmol/l
4,5 6,5 mmol/l
5 8 mmol/l
Non of the above

15. The following one is incorrect regading Nephroblstoma (Wilms tumor ):

a.
b.
c.
d.
e.

Usually present in The first 5 years of life .

Presented early with haematurea .
Typically present with an abdominal mass
May cause HTN , abdominal pain and fever
Metastasize to lung .

16- The most probable cause for massive blood loss per anus in a child:
a-

Peptic ulcer situated in a Meckl's diverticulum.

b- Erosion of a peridiverticular artery.

c-

Rectal polyps.

d- Familial polyposis.
e-

Intussusceptions.

17- Blood for transfusion should be stored at:

a-

-20 C.

b- -4 C to 0 C.
c-

+2 C to +7 C.

d- -10 C.
e-

+10 C to +14 C.

18- All of the following are common signs of strangulated hernia except:
a-

Fever.

b- Constant pain.
c-

Erythema of overlying skin.

d- Diarrhea.
e-

High WBC count.

19- Following are true about acute anal fissure except:

a-

Ischemic ulcer in the midline of anal canal.

b- Pain on defecation.
c-

Bright red bleeding.

d- Loose motion.
e-

Mucus discharge.

20- The following are indications for sigmoid colon resection as an elective surgery
in diverticular disease except:
a-

2 previous hospitalized attacks.

b- Abscess formation.
c-

Obstruction.

d- Fistula.
e-

Change of bowel habits.

21- Regarding Carcinoma of breast, all of the following are true except:
1- It is usually very aggressive in younger patients
2- The incidence of the cancer decreases with increasing age (correct answer)
3- The invasive ductal carcinom is the most common variety.
4- The incidence is much lower in males
5- Breast feeding is a protective factor.

22- Regarding staging of ca breast T > 2.5 but < .5 cm, N1 & M0 means:
1- stage 2 (correct)
2- stage 3
3- stage 1
4- stage 4

5 - surgically incurable Ca breast.

23- Regarding femoral ring, one is incorrect:

1- lies medial to the femoral vein
2- Has the inguinal ligament as its anterior border.
3- Has the lacunar border as its lateral border. (correct answer)
4- Has the pectineal ligament as its posterior border.
5- Is wider in females.

24- The axillary Lymph glands are categorized into different level in relation to:
1- The pectoralis major muscle
2- The subscapularis muscle
3- The serratus anterior muscle
4- The latissmus dorsi muscle
5- The pectoralis minor muscle (correct)

25- As regard extradural hemorrhage, one is not correct:

1- Tear of the anterior branch of the middle meningeal artery is the commonest cause
(correct)
2- Concussion is followed by lucid interval
3- Drowsiness, deepens into coma
4- In the face of the compression, tachycardia with lowering of blood pressure occurs
5- operation must be performed as soon as possible

26- Charcot's biliary triad includes only one of the followigs:

a- Itching of the skin.
b- Bradycardia
c- intermittent fever.
d- Distended Gall bladder.
e- Pale stool.

27- Regarding lobular carcinoma all of the following are false except:
a- it's the commonest variety of breast carcinoma
b- It's form sharply demarcated micro calcification on mammography.
c- It's arise from ductal epithelium
d- Has a high likelihood of being unilateral
e- it's often multi-centric.

28- regarding acute cholecystitis, one is incorrect:

a- Mostly presence in present of gall stones.
b- If it' occur in absence of gall stones, this signifies an underlying major illness.

c- perforation is usually localized in most cases:

d- Gangrene is never occur
e- cholecystectomy is the ideal TTT.

29- A 6 months old child has been diagnosed as having indirect inguinal
hernia. there're no features of obstruction, the management is:
a- observation and hernia repair at the age of 2 years
b-Elective hernia repair, with use non absorbable mesh.
c- Herniotomy scheduled electively as the earliest
d- Herniotomy on Emergency basis, the patient shouldn't be send back home with
unrepaired hernia.
E- Elective hernial surgery with use of absorbable mesh.

30- The TTT of choice of hydatid cyst of liver is:

a- Medical.
b- Surgical excision
c- needle aspiration
d- Chemotherapy
e- Radiation.

31- The following is useful sign in acute appendicitis except:

a- Tachycardia
b- low grade fever
c- Roving's sign
d- Boas's sign
e- obturator sign.

32- The most common peripheral artery aneurysm affect:

a- Radial A
b- Splenic A
c- Popliteal A
d- Brachial A
e- Carotid A

33- Bleeding Ulcer on posterior wall of duodenum involves:

a- Right gastro-epiploic A
b- Gastro-duodenal A
c- Common hepatic A
d- Superior mesenteric A
e- Middle colic A

34- Regarding the Parotid gland the incorrect statements are:

a- it' the largest of salivary glands
b- it's duct is the stenson's duct.
c- it's secretion is mainly serous.
d- it's the commonest site foe salivary gland stones.
e- facial nerve branches pass through it.

35- following one is not the complication of hemorrhidectomy:

a- Reactionary hemorrhage.
b- 2ry hemorrhage.
c- Anal stricture
d- Anal fissure
e- Rectal diverticulosis

36- Which of the following statements about hirschsprung's disease is not true?
a) There are no ganglion cells seen in auerbach's plexus
b) There is increased incidence of sown syndrome
c) It is more common in girls
d) It may be associated with enterocolitis
e) It may involve the small intestine

37- As general fasting period before operation is :

A)For clear fluids is 2 hours, while for solid food is 6-8 hours
B)For clear fluids is 4 hours, while for solid food is 6-8 hours
C)For clear fluids is 2 hours, while for solid food is 8-10 hours
D)For clear fluids is 4 hours, while for solid food is 8-10 hours
E) For clear fluids is 6 hours, while for solid food is 10-12 hours

38- regarding Ano-rectal abscess ,All true except:

a) Usually produce painful, throbbing swelling in the anal region
b) Antibiotics are treatment of choice
c)Subdivided according to the anatomical site
d)Underlying conditions include fistula in ano, crohn's disease, DM
e)Always look for potential underlying problem

39- Regarding incisional hernia, all of the following are true except:
a) Account 15-20 % of all abdominal wall hernias
b) The most common cause is wound infection
c) Can enlarge over the time
d)May cause pain & bowel obstruction
e)They are easy to repair

40- Appendicectomy is done by the following incision except:

a) Gridiron incision
b) Rutherford Morrison incision
c) Low right paramedian incision
d) Kocher incision

e) Lanz incision

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46- 35 yrs premenaposual woman has recently developed 1.5 cm sized pigmented
lesion on the back,which of the following would you recommend for her?
not answered.

47-process of healing affected by all of the following except:

a- Extension of the damage
b- adequate Blood supply
c- Sex of pateint
d- Intact skin and mucus membrane
e- Proper nutrition

48- Local anesthesia act on:

a- Na channle
b- K channle
c- GAPA
d- Mu receptor
e- Non of above

49- Regarding paget's disease of breast all are true except:

a- It's malignant condition often resembling eczema.
d- it's indicated the presence of an underlying carcinoma of breast.
c- the most common diagnostic test is biopsy of nipple.
d- prognosis it's much better in lymph nodes negative tumor.
e-Its common form of breast cancer

50- Which of the following has highest incidence among the skin malignancy:
a- SCC
b- BCC
c- Melanoma
d- Merkel cell tumor
e- Kaposi sarcoma