General Surgery Exam 6th

General Surgery Exam 6th year General: I. Patient bled 20% of his blood volume, what will u not find 0 of activity against expected . . m1croorgamsms. C. Antibiotic prophylaxis is a cause of severe antibiotic resistance. A. Oliguria*** B. Tachycardia more than 120 C. 6. All affect the temp of the patient in operating room except : 2. Fluid requirements in a 35 child ?=10*100+10*50+15*20=1800 A. 1800 ml ***B. a-muscle relaxant b-humidified air c- I.Y fluid 3. Which one of the following is not a response to trauma0 A. Hypoglycemia*** B. 4. Which one of the following patients will not benefit from fresh frozen plasma? A. Bleeding time more than 15 seconds*** B. REST OF THE CHOICES WHERE ABOUT SECONDARY HEMOSTATIC DEFECTS (I.E. IN RELATION TO CLOTTING FACTOR DEFECIENCY. NOTE THAT BLEEDING TIME IS RELATED ONLY TO PLATELET FUNCTION/NUMBER PROBLEMS) 5. Regarding perioperative infection control. one is TRUE: A. Prophylactic antibiotics should be given within one hour of abdominal surgery.*** B. Prophylactic antibiotics should be appropriated to include a wide spectrum d-02 saturation (the answer i guess) 7. What is the major source of protein for catabolism in a trauma patient? A. Serum proteins. B. KidneyC. Liver D. Skeletal muscles.*** 8. All are true regarding femoral hernia except: A. Femoral hernias are relatively rarely strangulated*** B. 9.AII of the following are true regarding anatomy of abdominal wall except: A. Floor or posterior wall of the inguinal canal are formed by transversus abdominis aponeurosis and fascia. B. Iliohypogastric nerve runs anterior to internal oblique muscle. C. Femoral General Surgery Exam 6th year 2012 hernia might present sometimes above the inguinal ligament. 10. Which one of the following is the best indicator for malnutrition? A. Clinical examination. *** B. CBC 15 .A. Colloid is advised. B. Dopamine 16. Regarding neurogenic shock, all are true except : A. Tachycardia or bradycardia with hypotension***bradycardia only B. It might be caused by transection of the spinal cord. C. Albumin and transferrin levels. D. C. It's usually treated by giving an alpha agonist like phenylephrine. D. II. Regarding GERD which one of the following is false 0 A. It's associated with dysphagia to fluids. ***B. 17. Multiorgan failure syndrome, all are true except: A. Cardiac output should be measured invasively all the time.*** 18. Multiorgan failure syndrome 12. Which one of the lollowing is a specific complication of left internal jugular vein cannulation rather than the right 0 A. Sepsis sepsis is associated with lower mortality bcz it can be identified and treated by Abs*** B. A. Thoracic duct injury.***B. 19. What is wrong? A. Bone density is increased in bed ridden patients. 13.all affect healing except :(plastic Qs) A. Fatty acids low*** B. 20. Which of the following is true? 14.:all increase risk of operative infection except: A. Old people and females have more water content in their bodies. B. Water content is more in babies.**** A.Hypercholestrolemia. * ** C. Water content in the body is normally variable ( aw eshi zy haik) General Surgery Exam 6th year 2012 ENDOCRINE: A. It tends to have multicentric involvement*** B. It tends to metastasize via blood stream. I. What is the most common initial presentation B. Psychological 5. Which one of the following is not an indication for surgical intervention in the A. Autonomously functioning thyroid nodule*** 2. What is the most common pancreatic endocrine 6. All of the following drugs decrease synthesis of thyroid hormones except: A. Nonfunctioning *** (according to uptodate) A. Methemazole. A. Hypoglycemia*** B. Propranolol*** B. lnsulinoma. C. Propylthiouracil C. Gastrinoma. D. Carbimazole. E. Iodine. D. Glucagonoma. E. VIPoma. 3. r false : A. most common cause of hypoparathyroidism is postviral** 7. :all arc treatment options of hashimoto except: a- thyroxine b- Iodine c-surgery True: d- antithyroid drugs a-Superior parathyroid glands come from the third pharyngeal pouch. b-Superior parathyroid glands has constant location*** e- antiintlamatory drugs .,MY point of view that all can be used bcz of the different clinical stages of this disease except the anti inflamatory 4. All are true regarding follicular carcinoma of the thyroid except: S.all are indication of surgery in graves ds except : A. Led retraction. General Surgery Exam 6th year 2012 9. A. Atrial fibrillation in an old man. I 0. What is the most common presentation of a branchial A. Infection** B. Respiratory obstruction 15. A patient presented with galactorrhea. What of these will indicate the correct A. Bitemporal hemianopia***B. Gonadal atrophy. PEDIATRIC SURGERY: 1. Which one of the following is an ABSOLUTE indication for surgery in necrotizing enterocloitis? ( NOTE THAT ALL OF THE CHOICES WHERE INDICATIONS !) A. Evidence of gas in the portal vein. II. Which one of the following tests is not used to diagnose insulinoma? A. Secretin stimulation test *** 12. the most common risk factor of development of neck lymph nodes (2shi zay haik) B. Abdominal wall edema and erythema. C. Pneumoperitoneum*** (according to Medscape ). D. 2. All of the following are used in INITIAL investigations in a child with febrile UTI except: A. Old age? B. A. IVP B. DMSA.***** 13.Which one of the following is wrong regarding parotid gland C. eshi in boys. D. eshi in girls. A. Deep lobe constitutes I 0-15 %of the gland. 3. Pyloric stenosis, B. Parotid secretion is mixed serous and mucinous. * ** A. Child will be hungry immediately after feeding. B. Presents with nonbilious projectile 14.A. Hypercalcemia is caused by PTII from a tumor.*** Yomiting. General Surgery Exam 6th year 2012 4. was all regarding intussusception \vhafs \\·Tong : A. you will see dougnut sign on U/S(this sign is for pyloric stenosis)*** this is what was wrritten exactly in the slidespyloric stenosis : daughnut signintussusception : kidney and target D. Doing ultrasound or Doppler studies is a must in all cases (this is what's done in JUH) E. You should do BILATERAL orchidopexy stgn ONCOLOGY: B. lntussusiption is the most common cause of intestinal obstruction in children 3-5 years of age. 5. Wilms? all are true except : I. Medullary breast cancer: A. associated in over 90% of acses with positive estrogen receptors. B. Presents with fixed axial lymph nodes and still. has good prognosis. A. Lymph nodes involvement is associated with poor prognosis. PLASTIC SURGERY: 6. All of the following can be present in a child with esophageal atresia, except? A. Low birth weight. I. A patient presented with a 50 % bum with inhalational injury w make! hawa ... all are correct therapeutic interventions except: B. Oligohydramnios*** C. A. Giving prophylactic antibiotics.*** B. 7. Regarding testicular torsion, all are true except: A. surgical delay more than 6 hours carries a very poor prognosis. 2. Which one of the following cases will cause the most increase in basal metabolic needs: B. most in infant and peri pubertal boys A. 50% bum patient*** C. can be present with nausea and lower abdominal pain without testicular symptoms*** (of course there always will be something wrong with the testes ! !) B. Major trauma patient. C .narcotizing pancreatitis General Surgery Exam 6th year 2012 3. All are true except: A. A patient presenting with a burn due to an alkaline substance should be treated by topical weak acids*** B. 4. Which one of the following is Well a eshi taniry A. Nevus sebaceous. 8.Which one of the following is NOT a constituent of ringer lactatery A. Magnesium 5 mg *** 9. Management of fluids in a burn patient. USE PARKLAND FORMULA. DO NOT ADD I ST DEGREE BURNS TO THE FORMULA ' A. 3600 ml in the first 6 hours. B. 5.all are true regarding skin tumors except A. Morphea type basal cell carcinoma low recurrence ry b.nodular basal cell carcinoma is the most common c. lentigo maligna is found on head and neck d. nodular melanoma is the most aggrestve one 10. Which of the following is wrong regarding pressure sores ry A. Using a wound swap for culture *** II. A patient presented to the ER with human bite in the ear 5 em in length. Minimal tissue loss. \\'hat's the best management ry A. Delayed closure with a graft. B. Immediate grafting. C. primary closure. 6.\Vhich one of the following is not a contraindication to enteral feeding? D. Delayed primary closure*** E. Secondary. A. Severe diarrhea resistant to medical therapy. B. 180 em 12. Which one of the following is \Hong regarding felon (paronychia) : A. It's treated by antibiotics*** 7. What's the meaning of half strength formulary A. 50% formula with 50% water*** CARDIOTHORACIC AND VASCULAR General Surgery Exam 6th year 2012 5. what is the most common lung CAin nonsmoker" I. Atrial septal defect that is associated with partial anomalous pulmonary venous return is due to defect in : A. Osteum primum. 0 B. Osteum secondum.° C. Sinus Venosus*** (according to uptodate there are two types: septum primum defect and sinus venosus defect). A. Squamous cell carcinoma. B. Adenocarcinoma.*** C. Bronchogenic carcinoma. 6. Which one of the following is NOT present in cardiac tamponade? A. Muffled heart sounds. B. Kausmaul sign *** 2.A patient presents with symptoms typical of venous insutliciency in the lower limb ( rising leg to get better. Waking from sleep with pain .... _) What is the most likely cause 0 A. Deep venous insut1iciency *** 7. Popliteal aneurysm. which one of the following is true 0 A. Most common peripheral aneurysm B. B. Perforating veins insufficiency. C. Complicated varicose veins. D. 8. Which one of the follmving is false regarding fomeral aneurysm? 3. A motor vehicle accident patient presents with signs and symptoms of respiratory distress w ashya2 o5ra. What's the most likely cause" A. Involves all three layers of the vessel*** A. Traumatic diaphragmatic rupture. B. C.eshe 2n type I fomeral aneurysm 4. All of the following are true except: 9. Which one of the following scenarios regarding congenital anomalies is associated with the worse outcome? A. Diaphragmatic hernia is more common on the right.*** B. B. bilateral in I 0% A. Left coronary artery coming out of the pulmonary artery. General Surgery Exam 6th year 2012 B. Right coronary artey coming out of the pulmonary artery. C. 13. Obstructive sleep apnea7 7?!all except: A. Left sided heart failure. 10. Which one of the following is associated with mild hcmoptysis 7 14. \Vhich one of the following best describes the function of the aortic valve 7 A. Chronic bronchitis*** B. Lung cancer. A. Aortic valve prevents backflow of blood from aorta to left ventricle during diastole*** B. C. Tuberculosis. D. II. Regarding lntraaortic balloon pump counterpulsation IS. Which one of the following is not an indication for CABG? A. paraplegia. 71 7 17 A. two vessel disease with patent left coronary lumen. B. Stroke. (rare according to uptodate) B. C. C. aortic thrombosis. D. Limb ischemia*** (occurs in 6-25 GI surgery: % of cases. Uptodate) E. Femoral artery aneurysm. I-AII are associated vvith malignant transfonnation in small intestine except 12. Which one of the following is most diagnostic of thoracic aortic aneurysm rupture? a- Sclroderma*** b- Crohn · s disease A. Wide mediastinum on X-ray. c- FAP B. CT scan*** d- Puets j eghers syndrome C. Aortogram ( is the best when we want to detect branch vessel pathology according to uptodate ). Answer is 2-lntraaortic balloon pump counterpulsation is associated with : General Surgery Exam 6th year 2012 A- Stroke C- Nodular arthritis B- Arrhythmia D- Erythema nodosum ( l think ) C- Limb ischemia Answer is C 3-0ne of the following is a true diverticulum 8-0ne is false about appendicitis with elderly : A- Duodenal A- WBC is normal B- Jejunal diverticulum B- Fever is not always present C- Zenker"s C- 50% are ruptured at presentation D- Cecal 9-0ne is right about esophagous anatomy: 4-0ne of the following is true about hydatid cyst A- lHA-scrology is the most specific 5-0ne of the following doesn't cause cancer A- Scleroderma A- It deviates anterior and to the left at diaphragm. I 0-0ne is false about abdominal wall mets: A- Associated with hematogenus spread of malignancy BSeeding at site of laparoscopic entry. CPresent as painful peritoneal mass 6-0ne is false about ulcerative colitis A- Associated with cobble stoning BRarely involve rectum !!-something about testicular cancer non-semmoma A- A! fa fetoprotein . 7-0ne is not associated \\ith crohn's disease A- Sacroilitis B- Ankylosing spondylitis 12- \\ hich genetic defect associated with hereditary non polyposis syndrome: General Surgery Exam 6th year 2012 A- FPC B- K-ras b. can be associate with cancer in the long run c.megacolon and rupture is rare C- MLH 1/MS!-12 D- P53 17- opss-pneumococcus Answer is C 18-G IS T all true excpet 13- one of the following is not secreted by stomach: A- Lipase B- Glucagon C- Gastrin a-mets to the lymph nodes is common 19-child C 20- gastric cancer ,all true except a. PET is a good diagnostic tool Ana bagool glucagon. b.endoscopic ultrasound can be used in determining T and N 14-all of the following dcncrcase reflux to esophegous except : A- Fundus distention 21-papillothyroid 22-pancreas 15-needle stick injury by 1-IBV contaminated needle ... chances you get it IS : A- = = obesity head and tail 23- Which one of the following is a paraneoplastic syndrome associated with hepatocellular carcinoma? 3/10 A. Hypercalcemia B- 3/100 C- 3/1000 D- 3/10000 B.l-lypoglycemia ( Both happen according to uptodate) **Crohn ·s most E- 3/100000 16- one is false about crohn's A- Mostly at 4th and 5th decades all are affect healing except :fatty acid low