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28 year old male juvenile diabetic suddenly developed intolerable pain at the perianal area aggravated by movement. He is
febrile with temp of 38.8 deg. Cent. Patient was then diagnosed to have perianal abscess. A graver sequel would develop in the
form of
a. Fistula in ano
b. Rectal prolapsed
c. Fourniers gangrene
d. Fissure in ano
Carcinoma of the distal anal canal is almost always
a. Epidermoid cancer
b. Adenocarcinoma
c. Melanoma
d. Basal cell cancer
True statement regarding hemorrhoids
a. They aid in the continence mechanism of the anorectal area
b. Hemorrhoidal cushions are primarily located in left anterior, right anterior, right posterior positions
c. These are submucosal tissues containing venules, arterioles, and smooth muscle fibers located in the rectum
d. Hemorrhoids are a normal part of anorectal anatomy, treated by excision when encountered in routine anorectal
examination
Treatment of uncomplicated acute sigmoid volvulus should begin with
a. Colonoscopy or proctogigmoidoscopy
b. Laparotomy and detorsion
c. Sigmoid colostomy
d. High pressure barium enema
A 78 y/o male patient recovered from uneventful acute attack of sigmoid diverticulitis and is now asymptomatic. This patient
should be treated this time with
a. High fiber diet
b. Regular 3 month colonoscopy
c. Elective anterior resection
d. Emergency total colectomy
Correct statement/s regarding patients with anal/ perianal symptoms
a. Careful and adequate history usually clinches a diagnosis
b. Digital rectal examination is imperative
c. Use of other diagnostic ancillaries sometimes necessary
d. A and B only
e. All are correct statements
For serum CEA determination to be useful in the management of colorectal cancer, you would suggest
a. Before any form of treatment is begun
b. Before surgery
c. Immediately after surgery
d. 3 months after surgery
On rectal examination of a 58 y/o male patient with a history of bleeding per rectum on defecation and a hard mass irregular
and friable 4cm from anal verge occupying of the circumference. The most likely diagnosis is
a. Rectal carcinoma
b. Rectal adenoma
c. Anal epidermoid carcinoma
d. Anal adenocarcinoma
In the same case as mentioned above, the best diagnostic procedure would be
a. Colonoscopy with biopsy
b. CEA determination
c. Anoscopy with biopsy
d. A and C only
e. All of the above
10. In the same case as mentioned above, the appropriate initial management would be
a. Low anterior resection
b. Abdominoperineal resection
c. Trans anal excision
d. Chemotherapy and radiation (nigro protocol)
e.
11. The most acceptable method of treatment for the first episode of uncomplicated acute colonic diverticulitis is:
a. Diverting transverse colonoscopy
c. NPO and Intravenous antibiotic
b. Primary resection and anastomosis
d. Colonoscopic decompression
d.
e.
Fecalysis
Barium enema
14. Most common indication for surgical intervention in recurrent diverticulitis of the colon is:
a. Intractability
b. Bleeding
c. Obstruction
d. Perforation e. Fistula formation
15. Fascia that separates the rectum from the prostate and seminal vesicles in men and from the vagina in women
a. DenonVillers fascia
c. Rectus sheat fascia
b. Presacral fascia
d. Retrosacral fascia
18. 65 year old male patient diagnosed with colon CA, with TNM class of TANT 3, month. The test for survival rate is:
a. 0 16%
b. 70 95%
c. 54 65%
d. 39 60%
e. 5%
c. cyst
d. lymph node
13. Diagnosis showing a smudged appearance is by:
a. ultrasound
b. x-ray
c. MRI
D. CT SCAN
14. Cysts are commonly caused by blocked:
a. veins
b. arteries
C. LYMPHATIC CHANNELS
d. apocrine glands
15.A cyst that can be diagnosed by x-ray is a ________ cyst:
A. DERMOID
b. sebaceous
c. lymphatics
d.
16. The most common solid tumor of the omentum:
a. dermoid
B. METASTATIC TUMOR
c. sarcoma
d. lymphoma
17. Most common site of volvulus:
A. SIGMOID
b. descending colon
c. cecum
d. ascending colon\
18. Layers of the colon, EXCEPT:
A. OUTER CIRCULAR
b. inner circular
c. mucosa
d. submucosa
19. Most common cause of life-threatening colonic bleeding:
a. polyps
B. DIVERTICULOSIS
c. cancer
d. Crohns disease
20. Serum marker for colonic CA:
a. AFP
B. CEA
c. CAL-90
d. CA 125
21. Most common histopath for colonic CA
a. Clear cell CA
b. Transitional CA
c. Squamous cell CA
D. ADENOSARCOMA
22. Most common site of colonic malignancy:
a. ascending colon
b. Codens disease
C. RECTOSIGMOID
d. splenic flexure
23. Non-polyposis inherited colon CA is also known as:
A. LYNCH SYNDROME
b. Codens disease
c. Gardners syndrome
d. Peutz-Jegher syndrome
24. Blood supply of the small intestines comes from:
a. celiac artery
B. SUPERIOR MESENTERIC ARTERY
c. inferior mesenteric artery
d. internal iliac artery
25. Neoplasm that mimic PUD is:
a. Villous adenoma
b. Leiomyoma
C. BRUNNERS GLAND
d. Adenoma
26. Blood supply to the colon include the following EXCEPT:
A. CELIAC ARTERY
b. superior mesenteric artery
c. inferior mesenteric artery
d. artery of Drummond
c. Open Biopsy
b. Rhabdomyosarcoma
d. Hemangiopericytoma
3. A 57 y/o male was admitted due to a deep 12 cm soft tissue tumor on his left deltoid. Open
biopsy revealed positive for poorly differentiated rhabdomyosarcoma. No other palpable
mass was noted on further examination. The present clinical staging is:
a. Stage IB
d. Stage III
b. Stage IIA
e. Stage IV
c. Stage IIB
4. The 5-year survival rate of this patient based on the tumor size (Q no. 3) is estimated to be:
a. 84%
c. 50%
b. 70%
d. 33%
c. Nodal metastasis
b. Tumor size
d. Distant metastasis
c. 50% to 60%
b. 25% to 30%
d. 70% to 80%
7. Histologic subtypes of soft tissue sarcoma with higher incidence of nodal involvement:
a. Rhabdomyosarcoma
d. A and C only
b. Epitheloid sarcoma
9. It is an alternative treatment using TNF and melphalan as limb sparing for patients with
locally advanced soft tissue sarcoma or as a palliative treatment to achieve local control for
patients with distant metastasis:
a. Radiation therapy
c. Brachytherapy
d. Systemic therapy
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Group of axillary lymph node that are immediately posterior to the pectoralis minor muscle:
a. Subscapular LN
B. CENTRAL AXILLARY LN
c. External mammary LN
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d. Apical group LN
Most common cause of bloody nipple discharge
a. Pagets disease of the nipple
b. Adenoma of the nipple
C. INTRADUCTAL PAPILLOMA
d. Invasive duvtal CA
Due to obstruction of a mammary duct results to distention of mmamry lobule with milk:
A. GALACTOCEOLE
b. Plasma cell mastitis
c. Comedomastitis
d. Fibrocystic disease
The most common cause of cold abscess of the breast is:
a. Fungi
B. M. TUBERCULOSIS
c. Adenocarcinoma
d. None
This structure serves as a border between carcinoma in situ from invasive CA of the breast
a. Lining epithelium
b. Lamina propia
C. BASEMENT MEMBRANE
d. None
Breast CA with desmoplastic response to invading CA cell is
A. SCIRROUS CA
b. Medullary CA
c. Colloid CA
d. Tubular CA
The primary therapy of inflammatory breast CA is:
a. Mastectomy
B. CHEMOTHERAPHY
c. Hormonal therapy
d. MRI
Adenocarcinoma of the breast
a. Papillary breast CA
b. Scirrous breast CA
c. Colloid breast CA
D. MEDULLARY BREAST CA
These are the axillary LN in zone 1 EXCEPT:
a. Subscapular LN
b. Anterior LN
C. CENTRAL LN
d. Lateral LN
Risk factors for breast CA EXCEPT
a. Lobular carcinoma in situ
b. Mammary duct anaplasia
C. TUBULAR CARCINOMA IN SITU
d. Mother and sister with breast CA
The most common histologic type of breast CA;
a. Epidermoid
B. ADENOCARCINOMA
c. Lymphoma
d. NOTA
Subtotal parathyroidectomy means
a. Removal of 2 of the 4 glands, contralateral
b. Removal of 3 of the 4 glands
c. Removal of 3.5 of 4 glands
d. Removal of 2 of 4 glands ipsilateral
e. Removal of all 4 glands
Called infraclavicular LN
a. Rottons LN
b. Central LN
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C. APICAL LN
d. Subscapular LN
Gives the cytologic impression of the specimen submitted
A. FNAB
b. Excision biopsy
c. Incision biopsy
d. Core biopsy
The most common cause of blood nipple discharge
a. Pagets disease of the breast
b. Adenoma of the nipple
C. INTRADUCTAL PAPILLOMA
d. Invasive ductal carcinoma
Most common cancer occurring in the breast
a. Intraductal papilloma
b. Squamous or epidermoud CA
c. Malignant cystosarcomaphyllodes
D. ADENOCARCINOMA
This has the worst prognosis
a. Lymphoma
b. Scirrous breast CA
c. Squamous cell CA
D. INFLAMMATORY BREAST CA
Accepted form of management of lobular carcinoma in situ
a. closed follow up
b. bilateral mastectomy
c. tamoxifen for 5 years
D. ALL OF THE ABOVE
indications for conservative breast surgery
a. breast CA >4 cm
B. ADEQUATE BREAST SIZE TO ALLOW UNIFORM DOSAGE OF IRRADIATION
c. axillary (+) LN for CA
d. AOTA
Chemotherapeutic drugs used for breast CA
a. Cyclophosphamide
b. Adriamycin
c. Vincristin
D. AOTA
The primary therapy for inflammatory breast CA;
a. Mastectomy
B. CHEMOTHERAPY
c. Hormonal treatment
d. MRM
These are breast CA in male EXCEPT:
a. Invasive lobula CA
b. Lymphoma of the breast
c. Epidermoid carcinoma of the breast
D. AOTA
If this LN is positive for malignant cell, the breast is stage III B
a. Rotters LN
b. Central LN
c. Apical LN
D. INTERNAL MAMMARY LN
Breast malignancy with several lymphatic follicles
a. Pagets disease of the breast
b. Colloid CA
C. MEDULLARY CA
d. Schiroous CA
The following structures are in classical radical mastectomy, EXCET:
a. Axillary lymphoarleolar tissues
B. SERRATUS ANTERIOR
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c. Pectoral major
d. Pectoralis minor
Predominant breast carcinoma that presents concurrently with fibroadenoma
a. Medullary CA
b. Schirrous CA
C. LOBULAR CARCINOMA INN SITU
d. Tubular carcinoma
The most common distant metastatsis of breast CA
a. Lungs
b. Liver
C. BONE
d. Brain
Considered as the most important diagnostic aid in evaluating breast lesions
a. Biopsy
B. MRI
C. CLINICAL HX AND PE
d. Ultrasound
Breast malignancy in male EXCET:
a. Invasive lobular CAR of the breast
b. Lymphoma of the breast
c. Epidermal CA of the breast
D. INVASIVE DUCTAL CA OF THE BREAST
Adenocarcinoma of the breast that has the highest axillary LN involvement is;
a. Papillary breast CA
B. SCHIRROUS BREAST CA
c. Colloid breast
d. Medullary breast CA
Management of male breast CA:
a. MRM
b. Orichectomy
c. Chemotherapy
D. AOTA
Breast CA can bypass the lungs and metastasize directly to the CNS due to:
a. Axillary vein
B. BATSONS PLEXUS
c. Internal mammary vein
d. Rotters node
The best screening procedure for breast lesion is:
A. MAMMOGRAPHY
b. MRI
c. CT scan
d. Ultrasonography
Interventional technique used in detecting the location of non-palpable intraductal papilloma
a. Ultrasound
b. MRI
C. DUCTORAPHY
d. CTscan
Malignant tumor of the breast that is made up of large round cells with abundant cytoplasm arranged in broad plexiform mass
surrounded by lymphocytes and lymphatic follicles
a. Mucimous CA
b. Fibrinocarcinoma
C. MEDUALLRY CA
d. Papillary Ca
Characteristic of chronic cystic mastitis
a. Unencapsulated
b. Most common breast tumor
c. Can co-exist with breast CA
D. AOTA
The most common erroneous preoperative diagnosis of acute appendicitis is:
a. UTI
b.
C.
d.
Acute gastroenteritis
ACUTE MESENTERIC ADENITIS
Ruptured graafian follicle
APPENDIX
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a. E. coli
B. B. FRAGILIS
c. Proteus sp.
d. P. aeriginosa
The ff. are symptoms of acute appendicitis in congestive stage, EXCEPT:
a. N/V
b. Anorexia
C. HIGH GRADE FEVER
d. Abdominal pain
Distinguishing character of intussusceptions from acute appendicitis:
a. Age of the patient
b. Sausage shape mass at RLQ
c. Bloody mucus stool
D. AOTA
Part of the wall of the large bowel used by surgeon to locate appendix;
a. Haustration
B. TAENIA COLI
c. Marginal artery of Drummond
d. Appendages epiplocae
True about appendix
a. Lined by simple columnar epithelium
B. INTRAPERITONEAL ORGAN
c. No mesentery
d. NOTA
Adenocarcinoma of the appendix is/are:
A. MANAGE WITH RIGHT HEMICOLECTOMY
b. Has good prognosis
c. Common malignant CA of GIT
d. AOTA
A complicated appendicitis
a. Suppurative appendicitis
B. GANGRENOUS APPENDICITIS
C. RUPTURED APPENDICITIS
d. B &C
Pseudomyxoma peritonitis is/are:
A. ASSOCIATED BY CYSTADENOMA CA OF THE OVARY OR APPENDIX
b. it is best managed with appendectomy if it rise in the appendix
c. is usually to pulmonary failiure
d. AOTA
Statement true about the anatomical and physiological features of the appendix:
a. The location of the tip of this organ is constant
b. Its lumen is lined by pseudocolumnar epithelium with goblet cells
c. E. coli is the most common bacteria isolated in its lumen
D. NOTA
True statements regarding blood supply to the head of the pancreas
a. Supplied by superior pancreaticoduodenal artery which is a branch of the superior mesenteric artery
B. SUPPLIED BY SUPERIOR PANCREATICODUODENAL ARTRY WHICH A BRANCH OF THE GASTRODUODENAL
ARTERY
c. Both are correct
d. Neither
This benign lesion can degenerate into a malignant lesion
a. Fibrocystic disease of the breast
b. Galactoceole
c. Fibroadenoma
D. NOTA
This/these can differentiate benign from malignant phyllodes tumor:
a. Size of the tumor
b. Consistency of the lesion
C. > 3 MITOTIC FIGURE/HPF
d. AOTA
35. Breast malignancy with several lymphatic follicles near cancer cells
a. Pagets disease of the breast
b. Colloid carcinoma
C. MEDULLARY CA IN THE BREAST
d. Schirrous Ca of the breast
36. The following structures are excised in classical radical mastectomy, EXCEPT:
a. Axillary lymphoalviolar tissues
B. SERRATUS ANTERIOR
c. Pectoralis major
d. Mectoralis minor
37. The most common distant metastases of breast carcinoma is:
a. Lungs
B. BONE
c. Brain
d. Liver
38. Considered as the most important diagnostic aid in evaluating a breast lesion is:
a. Biopsy
b. MRI
c. CT scan
D. CLINICAL HISTORY AND PE
e. Ultrasonography
APPENDIX
39. The most common erroneous preoperative diagnosis of acute appendicitis is:
e. UTI
f. Acute gastroenteritis
G. ACUTE MESENTERIC ADENITIS
h. Ruptured grafian follicle
40. Abdominal condition that is misdiagnosed for appendicitis, but needs surgical intervention is:
e. Torsion of the testis
F. MECKELS DIVERTICULITIS
g. Acute mesenteric adenitis
h. Pelvic inflammatory disease
41. The most common gynecological disorder that is misdiagnosed for appendicitis but needs surgical intervention is:
e. Ruptured graafian follicle
f. Twisted ovarian cyst
G. PID
h. Endometriosis
42. Part of the management of acute appendicitis:
e. We have to feel the patient orally to provide the necessary energy for surgery
f. Steroids
G. ANTIBIOTICS FOR GM (-), GM(+) AND ANAEROBES
h. AOTA
43. Statement/s true regarding appendicitis during preganancy:
e. Most frequent during 3rd tri
f. Abdominal wall sign are more prominent
G. APPENDICEAL PERFORATION IS A SIGN. FACTOR ASSOCIATED WITH FETAL AND MATERNAL DEATH
h. AOTA
44. This patient who had appendectomy could have a 15% mortality
e. Appendectomy for suppurative appendicitis in a 40 y/o female
f. Appendectomy for ruptured appendicitis in 15 y/o male
G. APPENDECTOMY IN 60 Y/O MALE WITH OPERATIVE FINDING OF A PHLEGMON
h. Appendectomy in a 8thmos pregnant
45. The most common cause of mortality in post-appendectomy is:
e. Cardiac/pulmo insufficiency
f. Pulmonary embolism
g. Aspiration
H. UNCONTROLLED SEPSIS
H. NOTA
70. True statements regarding blood supply to the head of the pancreas
e. Supplied by superior pancreaticoduodenal artery which is a branch of the superior mesenteric artery
F. SUPPLIED BY SUPERIOR PANCREATICODUODENAL ARTRY WHICH A BRANCH OF THE GASTRODUODENAL
ARTERY
g. Both are correct
h. Neither
71. This benign lesion can degenerate into a malignant lesion
e. Fibrocystic disease of the breast
f. Galactoceole
g. Fibroadenoma
H. NOTA
72. This/these can differentiate benign from malignant phyllodes tumor:
e. Size of the tumor
f. Consistency of the lesion
G. > 3 MITOTIC FIGURE/HPF
h. AOTA
73. Breast malignancy with several lymphatic follicles near cancer cells
e. Pagets disease of the breast
f. Colloid carcinoma
G. MEDULLARY CA IN THE BREAST
h. Schirrous Ca of the breast
74. The following structures are excised in classical radical mastectomy, EXCEPT:
e. Axillary lymphoalviolar tissues
F. SERRATUS ANTERIOR
g. Pectoralis major
h. Mectoralis minor
75. The most common distant metastases of breast carcinoma is:
e. Lungs
F. BONE
g. Brain
h. Liver
76. Considered as the most important diagnostic aid in evaluating a breast lesion is:
f. Biopsy
g. MRI
h. CT scan
I. CLINICAL HISTORY AND PE
j. Ultrasonography