2017 1st part

Q. lactating pt has painfull lump on u\s hypodence irregular

edges
A)Galatocele
B)Fibroadenoma
C)Fibrocystic Change

1. Pt with melanoma palpable lymph node largest one 3x1 cm,

dissection of which level of lymph nod

A) level I
B) level 1&2
C) level 1&2&3
D) excision of affected lymph node

2. 3 cm sessile gastric polyps Found on UpperGI endoscopy

next step :
A)wedge resection

. B) Total gastric

. C) partial gastric.

. D) Endoscopic resection Piece-meal

3. Old Pt with breast ca scheduled for mastectomy her son told
you not to tell her what to do?

. A) Check her mental capacity

. B) Ask for her opinion

C)envolve some one from the family

D)

4. Young boy scheduled for appendectomy his father agreed

initially then changed his mind.what to do?

. A) Ask for ethical committee and medico legal team

. B) admit for observation and try to change the father's opinion

C) DAMA
D)
5. During lap chole. You injured the CBD and told the pt post
op what does this mean?

A)Disclosing an apparent complication

B)Disclosing complication
C)Disclosing error
D)Disclosing an apparent error

6. Pt on waiting list for cadaveric kidney. You discussed with

him a living donor option. He refused for ethical reasons. You
are explaining and trying to convince him using ...?

. A) non. Of donor

. B) malbenefice of recipient
C) malbenfinet for donor

7. Calculate relative risk for two group

/
(INCIDINCE OF EXPOSED INCIDINCE OF UNEXPOSED)
A) 12.9
B) 3.9

. A) 3.3

. B) 9

. C) 16.8

. D) 50.4

8. A diagram of surgical resident and non<surgical resident

followed for 4 years outcome studied: depression. Type of
study?

. A) cohart

. B) series case

. C) control study

D)

9. Colon ca pt and non<colon ca and eating habits. what type

of study?

. A) cohart

. B) control study RETROSPECTIVE

. C) section study

D)
10.Patient presented with gastric mass invading mucosa,
submucoa till extend to serosa ,, no distant mets . With positive
2 large lymph nodes ( largest one ) 3 cm. What is the stage:

A) T1<N2<Mo
B) T2<N2<M0
C) T3<N1<Mo
D) T4<N2<Mo

11. 25YEAR Patient presented to ER with anal

pain and itching. Examination showed anal warts. What is
your management?

A) excision B) phylosillin ointment C) podophyllin D)

12.pt with +ANCA and PANCA

A) UC (+PANCA AND –ANCA)
B) Crohn's disease
C)

D)

13. pt. Present to ER Post inguinlal hernia reapair 10 days

back c/o testecular swelling, testical atrophied on exam cause?

A) testicular artery thrombosis

B) pampiform venous plexis thrombosis
C) internal ring narrowing
D) external ring narrowing

14. patient post LAR , most appropriate IVF maintenance :

A) LR (Bx for Resus.)
B) NS
C) D5 1/2 NS

D)

15. case scenario PH 7.2, OverHydration with which of the

Fluid is most likely to cause his metabolic state

A) 25% albumin
B) NS HYPERCHOLRIMIC METABOLIC ACIDOSIS
C) RL
D) D5 1/2 normale saline

16. Maintenance fluid equation, 67 kg , should be calculated by

1ST 10 KG = 100 = 10*100=1000cc

2ND 10 KG = 50 10*50= 500cc

EACH KG = 20 = 47*20= 940 cc

TOTAL = 1000+500+940 = 2440 cc \24hrs = 101cc\hrs.

17. patient post fempop bypass. Had infection that exposed his
graft. What is the most likely cause:

A) B hemolytic streptococcus.
B) staph aureus.
C) staph epidermis
D) pseudomonas.

18. post scratching skin infection

A) B hemolytic streptococcus.
B) staph aureus.
C) staph epidermis
D) pseudomonas.

19. Pt with acute cholecystitis what it the most common

organism:

A) E coli
B)
C)
D)

20. Renal stone with bone ache

A) intact PTH

B)
C)
D)

21.Most sensitive test for pulmonary complication?

A) PFT
B)
C)
22. Most sensitive test for diagnosis acid base imbalance?
A) ABG
B)

23. 67 year old male pt c/o RUQ pain , Jaundice , clay stool
with high fever what's is the initial test?

A) Urine culture
B) blood culture
C) tumor marker
D) lactate

24. Most indicator for organic perfusion : urine output

25. A diagram of surgical resident and non-surgical resident

followed for 4 years outcome studied: depression. Type of
study?

A) cohort study
B) case series
C)
D)

26. Dry , scaly acrodermatitis

A) Essentialfattyacid

B) Zinc
27.Both result in hair loss and poor wound healing VitA

30. Unstable patient , known to have crhon's with distended?

A) total colectomy
B)

32. 19 yrs old male pt. victim of RTA sustained blunt chest
trauma. Physical examination revealed absent breathing sound
on the right side with hyper resonant percussion note. BP:
80/40 HR: 130 RR: 28 Temp: 36.7 which of the following
physiological effect is excepted ?

A) Increased venous return

B) Increased cardiac output
C) Increased intrathoracic pressure
D) Increased ventilation

33. Von will brand disease :

A)cryocieptate
B) FFP
C)
34. Most common complication with subclavian line :

A) obstruction
B) thrombosis
C) infection
D) sepsis

35. a trauma patient with facial injury in respiratory distress

and hematemesis. Vitals unstable.

What is your next step.

A) cricothyrodotomy
B) tracheostomy.
C) two other options that I don't remember.

36. MVA, ribs fracture, bilateral chest tenderness, x_ray

showed bilateral lung infilteration.... cause of desating ?

A) Lung contusion 

B) Atelactasis

C) lung infiltration
D)ARDS

37. male pt. c/o central abdominal pain with vomiting Medial
thigh swelling, pain relieve with leg flexion Hx of gastric
bypass 10 years back cause ?
A) internal hernia

B) Obturator hernia

38. Strangulated hernia symptoms and signs :

A) urgent OR
39. Biliary pancreatitis, labs normalized after 3 days ?

A) early lap cholecystectomy

B)

40. Symptomatic gall bladder with very small gall stones

(+ 8 mm polyp) :

A) Lap chole
B) observation
C)

41. Cause of pain in multiple gallstone without cholecystitis ?

A) contraction of bladder
B) CCK release
C) Cystic stone
D) CBD stone

42. thyroid, bethesda system 4 & 3 


43. post trauma pt. Studies showed transected pancreatic duct
at the neck of the pancreas, unstable pt what is the
management?

A) whipple
B) put drain. DAMAGE CONTROLLE
C) distal pancreatectomy

44. Pneumobilia question ?

A)INTRALUMINAL OBSTRUCTION
45. Post lap chole with cystic duct leak :

A) Lap correction

B) Endoscopic stenting

C) Open correction

46. Jaundiced , esophageal varecis UNCONTROLLED:

TIPS
STENG.STAKEAN TUBE

47. Old Pt with breast ca scheduled for mastectomy her son

told you not to tell her what to do? 

A) Check her mental capacity 
B)Ask for her opinion regarding son
request

C)
48. Young boy scheduled for appendectomy his father agreed
initially then changed his mind.what to do? 

A) Ask for ethical committee and medico legal team 

B) admit for observation and try to change the father's opinion

52. increase CO and CI, decrease SVR?

A) septic shock B) Cariogenic shock C) Hemorrhagic shock D)

53. jugular vein distention (delaying procedure) :

54. Post MI 3 month , safest anesthesia?

A) local B) epidural C) spinal

D) general

55. Patient c/o of abdominal pain and distention relived by

chest extension CT SHOWED COMPRESSION OF 3RD PART
OF DUE ??

A) SMA syndrome Cast syndrom

56. Pt with upper GI bleeding and after resuscitation , blood

and NGT ... bleeding stop , most likely the 
diagnosis is ?

A) Watermelon gastric B) Dieulafoy's lesion C) phytobezores D)

Mallory Weiss syndrome (self limiting )
57. Pediatric 13 years old , post MVA ,, vitally stable ,, spleen
laceration . CT showed peri splenic fluid with extravasation of
blue dye, Your management: 
A) Splenectomy 
B) Partial
splenectomy 
C) Non operative management

58. Patient k/c of gastric or duodenal ulcer, presented with

rectal bleeding with (clots) by sigmoidoscopy, Your initial next
step:
A) Colonoscopy 
B) NGT insertion

59. Succinylcholine Q : A) depolarizing

B) cause of malignant hyperthermia C)

D)

60. Patient head trauma with head injury Rt moderate

crescent shape on CT? 

A) Epidural with right mid line shift 

B) Subdural with no mid line shift “FRONTAL”
C) Subdural with shift midline
D) Epidural with no mid line shift

61. Post cholecystitis skin rash, echemosis , Hypotensive

80/40, Ptt high, Low fiprongen, Which the 
first thing in
management?? a. FFP 
b. Blood transfuse
C.AMINOTROPIC ACID
62. Angle of mouth drop, which facial nerve branch ? A)
Buccal B) Marginal C) Zygomatic

D) cervical

63. Transplant kidney preserved , with devitlization , The

cause :

A) Cold preserving more than 6 hours B) Warming heat more than

25 minutes

64. Patient with gunshot to the right chest , on examination

revealed absent Breath sound (low harsh sound in 
inspiration),
Your management?

A) Chest tube 
B) RT thoracotomy C) sterile dressing

65. Rectal bleeding saw Sigmoid angiodysplasia, What you will

do

A) Angio-embolization
B) Inject epinephrine endoscopicly
C) Resect segment
D)
66. about corrected sodium , Glucose 520 Na 118
1.6*4.2=6.72+118=124.72(kats formula)

2.4*4.2=10.08+118=128.08 (katz-hiller coversion e.g RBS above 400

a. 124.6 Bx ANSEWR
b. 124.4
c. 126.4

69. Pancreatitis: ESR, CRP, TNF alpha , lactate

70. 60 y\o c\o abdominal pain ct showed Sigmoid volvulus PT
STABLE next step :
A) SIGMODOSCOPY
B) OR “if unstable”

71. Pt present with neck swelling U/S neck showed Solitary

FNA showed Follicular thyroid nodule 1cm BIRAD IV What's
your plan :

A)follow up
B)lobectomy
C)Thyroidectomy
C) Repeat FNA
72. Case scenario of old burn in the thigh 12 y ago with
development of ulcer not healed now days next step :

A) Biopsy from ulcer edge

B) Excision

73 compartment syndrome Closed fracture tibia and fibula:

A) Physical examination “think pain “

74. Post lab chole c/o LoweLimb redness and tenderness:

elevate leg?

A)anticoagulation
B) elevation leg
C) antibiotics

75. signds pressistant hypocalcemia Chovestek sign

Ca Normal
Mg Sulfate

76. Post inguinal hernia 10 days back c/o swelling and redness?
A) serum B) hematoma best answer is localized hematoma
no answer that includes local infection
78. Extraperitonel Urinary bladder injury?

A) foly’s catheter. B) laparoscopic repair C) Supra-pubic repair

79. most common extraperitoneal cancer?

A)liposarcoma
B)
C)
D)

80. pt. post blood transfusion 10 units. What is most likely to

be present ?

. A) low potassium

. B) high calcium

C) high platelet
D) thrombombocytopenia

81. Plan for renal transplant with adenocarcinoma polyp in

rectum T(insitu) POST EXSION : precede to or
82. Small bowel obstruction with analgesia ( bowel distension)?

Nitrus oxide
83. Hepatitis c virus with liver mass afp high liver lesion:

HCC

84. Pt with RUQ pain CT done and it showed homogenous

with central scar what is the DX:

A) FHN
B) Hemangioma C) HCC

85. Post intubation end tidal CO2= 0 cause

A) esophagus intubation
B) High intrathoraci pressure

86. Isolated Gastric varices Sx :

splenectomy

87. ICU Post admission c/o RUQ pain US showed dilated GB,
thick wall, no stone UNSTABLE:
A) Percutanoeus Cholecystostomy
B) LAP CHOLE

C) OPEN CHOLE
D)

88. Refractory hypocalcemia: mg

89.Old man, know to haveAF, presented with severe central
abd pain what is the most likely dx:

A) Mesenteric occlusion B) Perforated viscous C) Acute

pancreatitis

90. Post sleeve c/o DIHRREA RELATED TO MEAL :

dumping syndrome
91. Post lap chole c/o abdominal pain:
US

93. LAR procedure c/o abdominal pain US showed 8*8 com

collection:
a) drainage

94. old patient STABLE , had abdominal pain with nausea and
vomiting. Upon exploration, found to have 3 cm Perforated 1st
duedenal ulcer. What is the management.

A) omental patch. IF UNSTABLE

B) omental patch with vagotomy.

C) gastrodeudostomy ( not sure ).

D) PPI.
97. female patient known to have PUD. On upper endoscopy
there was ulcer in the stomach 3*4 non healing. Biopsy showed
( chronic non specific inflammation ) what is the management:

A) H2 Pylori eradication.
B) PPI
C) repeat endoscopy biopsy
D) partial Gasterectomy

98. pt. Admitted as case of Biliary pancreatitis after few days

resolved?
lap cholecystectomy

99. Pt booked for elective inguinal hernia repair, what ABX

should be given POST OP

. A) No need

. B) 1 dose cefazloin “PREOP. 60 MIN BEFOR INCISION”

C) 3 dose ..
100. While you are trying to reduce bowel with inguinal hernia
there is minimal perforation with minimal with minimal
spillage what will use for irrigation of the wound :

-Normal saline
-NS with 0.01%metro

-NS with 0.01%drug

101. Air embolism:

left lateral decubitus

102. 17 yrs old girl, she has contaminated deep laceration

wound, last tetanus dose was taken 12 yrs back, what is next:

A) NothingB) Tetanus onlyC) Toxoid onlyD) tetanus and ABx

103. RTA DISCHARGED AFTER 2 DAYS CAME BACK

Abdominal PAIN ( stable ) NEXT STEP
A) CT THINK DUEDENAL HEMATOMA

104. Pt for total thyroidectomy and intraoperative cutting Rt

RLN:
A) stop procedure
B)REPAIR THEN STOP
C)REPAIR THEN CONTINUE
105. PE POSTS SLEEV DAY 2 :
spiral CT

106. Patient with liver mass upon aspiration the content was
like "anchovy sauce "

Whats the Tx:

A) Metronidazole “AMEOBIC LIVER ABSCESS”

107. 10years hx of DVT , pt booked for abdominal surgery ,

what pre op to be given:

A) LMWH+IPCD

B)

108. Trauma case follow up by:

A) lactate

109. While performing a laparoscopic inguinal hernia repair

the surgeon finds and artery in the extrpertonial connective
tissue. Running vertically just medial to the bowel as the bowel
passes through the abdominal wall. Which artery is this?

A) Inferior epigastric arteryB) Deep circumflex iliac artery C)

Superior epigastric artery D) Femoral artery
110 pt with neck mass in lat side biopsy show squamouscell ca.
No Hx of malignancy. best tool to looking for primary:a. CTb.
MRI

c. PETscand. Panendoscopy

111. Post knee replacement develope abd pain + nausea +

vomiting Glucose lowHyponatremiaHyperkalemia Normal
urine output Vital stable:-
A) Septic shock
C) PE.

b) Intra abd bleeding

d) adrenal insuffency

112. Pt epileptic came with hematemesis spont. stoped:

A) Dieufloys lesion

B) menitrier lesion
C) phytobezores

D) Mallory Weiss syndrome

115. study on drugs,drug (A) is causing more decrease in ca
level than drug (b) concluded of author :
A) patient based evidence
B) disease based evidence

C) evidence based medicine

116. Patient diabetic on oral hypoglycemic going for OR

A) Continues oral hypoglycemic

B) start him on short acting insulin
C) start him on long acting insulin

117. 45 Y\O FEMALE PT POST COLECTOMY FOR

adenocarcinoma , 2 FAMILY MEMBERS POSTIVE FOR
THE SAME CONDITION , BEST surrvilence:

A) PET
B) transvaginal
C) Brain MRI
118. Pt whith right thigh high grade sarcoma what's is
definitive ttt ( 1mm positive margin ):
A) Sparing excision with 1 cm margin

B) Wide local excision with radiotherapy

C)chemotheraby

119. Most resistance :

A) S phase B) M phase C) G1 phase D) G2 phase

120. ECG Q

1ST PEAK T WAVE Hyperkalemia

2ND HYPOCALCEMIA prolonged QT segament

31 years old involved in electrical burn 30% Admitted to ICU his urine

become brown despite Increase fluids and he had also high ICP on manitol

What to do:

1- give him 2000 crystalloids

2- increase dose of mannitol