‫اﻟﻠﻬﻢ اﺳﺘﻮدﻋﻚ ﻣﺎ ﻗﺮأت وﻣﺎ ﺣﻔﻈﺖ‬

‫اﺳﺌﻠﺔ وزارة اﻟﺼﺤﺔ ﻟﻼﻟﺘﺤﺎق‬ ‫وﺗﻌﻠﻤـﺖ ‪ ،‬ﻓـﺮده ﻟـﻲ ﻋﻨـﺪ ﺣﺎﺟﺘـﻲ اﻟﻴﻪ ‪,‬‬

‫ﺑﺒﺮﻧﺎﻣﺞ اﻻﻗﺎﻣﺔ واﻻﻣﺘﻴﺎز‬ ‫إﻧـــﻚ ﻋﻠﻰ ﻣﺎ ﺗﺸﺎء ﻗﺪﻳﺮ‬

‫) ‪( 2018 -2013‬‬
‫اﺧﻮﻛﻢ اﻟﺪﻛﺘﻮر ‪ :‬اﺳﺎﻣـﻪ اﻟﺨﺰاﻋﻠـﻪ‬
‫ﻗﻤﺖ ﺑﺎﻋﺎدة ﺟﻤﻊ وﺗﻨﺴﻴﻖ‬ ‫ﺑﻔﻀﻞ ا‬
‫‪0799430239‬‬
‫اﺳﺌﻠﺔ اﻟﺪورات اﻟﺴﺎﺑﻘﺔ‪ ,‬اﻟﺼﺎدرة ﻣﻦ‬ ‫ﻃـــﺐ ﻋـــﺎم وﺟﺮاﺣــﻪ‬
‫وزارة اﻟﺼﺤﺔ ﻻﻣﺘﺤﺎﻧـــﺎت اﻻﻗﺎﻣـــﺔ‬

‫) ‪-2013‬‬ ‫واﻻﻣﺘﻴــﺎز ﻟﻼﻋـــﻮام‬

‫‪ , ( 2018‬ﺑﻌﺪ ﺟﻬـــﺪ وﻋﻨــﺎء ‪ ,‬وﺣﻠﻬﺎ‬

‫ﺑﺎﻻﺳﺘﻌﺎﻧﺔ ﺑﺎﻟﻤﺮاﺟﻊ واﻟﻜﺘﺐ اﻟﻤﺨﺘﻠﻔﺔ‬

‫ﻟﺘﻮﺧﻲ اﻟﺪﻗﺔ ﻓﻲ ﻧﺸﺮ اﻟﻤﻌﻠﻮﻣﺔ‬

‫اﻟﺼﺤﻴﺤــﺔ ﻟﻠﺰﻣﻼء واﻟﺰﻣﻴﻼت ‪ ,‬ﻓﺈن )‬

‫‪ ,‬وان اﺳﺄت ﻓﻤﻦ‬ ‫اﺣﺴﻨﺖ ﻓﻤﻦ ا‬

‫ﻧﻔﺴﻲ ( ‪ ,‬واﻧﻲ اﻗـــﺪم ﻫﺬا اﻟﻌﻤﻞ ﺧﺎﻟﺼﺎ‬

‫ﺗﻌﺎﻟﻰ ‪ ,‬راﺟﻴﺎ اﻟﻤﻮﻟﻰ اﻟﻘﺒﻮل ‪,‬‬ ‫ﻟﻮﺟﻪ ا‬ ‫*****‬

‫وان ﻳﻨﺎل اﻋﺠﺎﺑﻜﻢ ‪.‬‬

‫‪SURGERY‬‬
 D . The floor is formed by the adductor longus
and pectineus muscle medially .
E . The floor is formed by the Iliopsoas muscle

*****
laterally .

* A 54 year old man on renal dialysis is found to

have raised serum calcium and PTH . This is
called ?
A . Primary hyperparathyroidism .
B . Secondary hyperparathyroidism .
C . Tertiary hyperparathyroidism .
D . Hypercalcemia of malignancy .

‫ﻧﺴﺨﺔ ﻣﺪﻗﻘﺔ‬
E . Hypoparathyroidism .

* Most common cause of non pitting edema ?

A . Iatrogenic
B . Filariasis
C . Lymph node resection surgery .
D . Leptospirosis
E . Chagas disease

* 65 year old male has an entero_cutaneous * A 19 year old man involved in RTA , found to
fistula originating from the jejunum , suffered have a femur fracture and crush injury to his
from inflammatory bowel disease , which of the foot . After fixation he becomes dyspneic and
following would be the most appropriate hypoxemic . The most likely etiology ?
replacement of his losses ? A . Aspiration
A . DW5% B . Atelectasis
B . N/S 3% C . Fat embolism
C . Ringer lactate D . Fluid overload
D . 0.9% sodium chloride E . Pneumonia
E . 6% sodium bicarbonate solution
* After exposure to suspected rabied animal ,
* A 84 year old man presents with a small ulcer which of the following should be given ?
on the bridge of his nose . It has been present for A . Rabies immunoglobulin and one dose of
a number of months . On examination it has vaccine as soon as possible .
pearly white rolled edges . The type of ulcer is ? B . Rabies immunoglobulin then several doses of
A . Curling ulcer vaccine .
B . Cushing ulcer C . Rabies immunoglobulin alone .
C . Marjolin ulcer D . Rabies immunoglobulin and antibiotic .
D . Rodent ulcer E . Vaccine and antibiotics .
E . Venous ulcer
* Which of the following supports the diagnosis
* Which of the following skin tumors is the most of Hypovolemia ?
common in whites ? A . Urine sodium 28 meq/L
A . SCC B . Urine chloride 15 meq/L
B . BCC C . Fe Na < 1
C . Malignant melanoma D . Urine / serum creatinine ratio of 20
D . Merkel cell tumor E . Urine Osmolarity of 350 mosm/ kg
E . Dermatofibrosarcoma
* Calcitonin sometimes elaborated by which one
* All of the following is true regarding the femoral of the following tumors ?
triangle except ? A . Medullary carcinoma of the breast .
A . The inguinal ligament forms the base . B . Medullary carcinoma of the thyroid .
B . The medial border is formed by the lateral C . Giant cell carcinoma of the pancreas .
border of the adductor longus . D . Carcinoid tumor of appendix .
C . The lateral border is formed by the medial E . Ganglioneuromas .
border of the Sartorius .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 2
* In the management of pyloric stenosis , which D . Obesity BMI > 30
of the following is true ? E . Surgery to excise scalp lipoma
A . Acidosis should be corrected first .
B . Chloride level is normal in spite alkalosis . * What is the first parameter to change in early
C . Hypokalemia should be corrected . hypovolemic shock ?
D . Usually there is compensatory hypocarbia . A . Systolic blood pressure
E . Paradoxical aciduria is not a feature . B . Pulse rate
C . Diastolic blood pressure
* Differential diagnosis of right iliac fossa pain D . Respiratory rate
includes all of the following except ? E . Level of consciousness
A . Tubo _ ovarian mass
B . Acute pyelonephritis * A 32 year old man presents with Hematuria . A
C . Crohn disease KUB X_Ray reveals a staghorn calculus in the
D . Empyema of the gallbladder right kidney and midstream urine , sample grows
E . Splenic vein thrombosis proteus . The most likely stone type is ?
A . Bile pigment stone
B . Calcium oxalate
C . Calcium phosphate
D . Cholesterol stone
E . Cystine stone

* The GCS for 25 year man involved in RTA in a * Most common site of volvulus in the colorectal
head on collision with a lorry . On examination he region ?
is unable to obey commands but localizes to A . Descending colon
pain and is able to speak , but appear confused . B . Sigmoid
He only opens his eyes to pain ? C . Transverse colon
A.4 D . Rectum
B.6 E . Ascending colon
C.7
D . 10 * 52 year old male patient was found to have
E . 13 Gastrinoma , which of the following is the most
likely location for Gastrinoma ?
* Which of the following is not associated with A . Fundus of stomach
compartment syndrome ? B . Antrum of stomach
A . Disproportionate level of pain . C . The triangle formed by the junction of the
B . Absent distal pulses . second and third portion of the duodenum , the
C . Paresthesia . junction of the neck and body of the pancreas and
D . Calor = Heat . the junction of the cystic and common bile duct .
E . Paralysis . D . The tail of pancreas
E . The triangle formed by the inferior edge of the
* 80 year old woman presents with liver , the cystic duct , and the common hepatic
hematemesis . She has had intermittent duct .
epigastric pain after food for the past 6 months .
She has lost weight about 4 kg . She was recently * An 18 year old female patient develops urticaria
started on Diclofenac . The most likely cause for and wheezing after injection of intravenous
her condition ? contrast for an abdominal CT scan . Her BP
A . Mallory Weiss tear 120/60 ,HR 155 / min , RR 30 / min , which of the
B . Esophagitis following is the most appropriate immediate
C . Gastric malignancy therapy ?
D . Aortoenteric fistula A . Intubation
E . Gastric ulcer B . Epinephrine
C . B _ blockers
* Which of the following is not an increased risk D . Iodine
for venous Thromboembolism ? E . Fluid challenge
A . Active cancer
B . Age greater than 60 * Which is gram negative organism ?
C . Thrombophilia A . Group A Streptococcus
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 3
B . MRSA D . Inferior thyroid artery
C . Pseudomonas aeruginosa E . Facial artery
D . Clostridium tetani
E . Listeria * On postoperative day 5 post hepatic resection a
healthy 55 year old patient is noted to have fever
* The most reliable indicator of the adequacy of 38.6 c . Which of the following is the most
burn resuscitation is ? ommon associated ?
A . CVP A . UTI
B . PCWP B . Wound infection
C . Urine output C . Pneumonia
D . Blood pressure D . Intra_abdominal abscess
E . Heart rate per minute E . Intravenous catheter related infection

* The most common site for SCC of the lips is ? * One of the following statement is incorrect ?
A . Upper lip midline A . Elevated CA125 is ass with ovar carcinoma .
B . Upper lip laterally B . Elevated CEA is associated with
C . Lower lip midline chondrosarcoma .
D . Lower lip laterally C . Elev CA 15_3 is ass with certain breast CA .
E . Oral commissure D . Elevated B_HCG is associated with certain
testicular cancer .
E . Elevated CA 19_9 is associated with
* A 39 year old man presents with severe pancreatic cancer .
epigastric pain and right upper quadrant pain . * The spleen filters all of the following particles
Radiating to the back associated with nausea cells except ?
and vomiting . Inspection of the abdomen shows A . Malformed erythrocytes
bruising below the inguinal ligament . This sign is B . T lymphocytes
called ? C . Malarial parasites
A . Cullen sign D . Streptococcus pneumonia
B . Boas sign E . Platelets
C . Fox sign
D . Grey turner sign * Which of the following is not a feature of Crohn
E . Murphy's sign disease ?
A . Involvement from mouth to anus .
* Pleomorphic adenomas of the salivary glands B . Risk of flare up is decreased with smoking
are characterized by one of the following ? C . Macroscopically demonstrates cobblestone .
A . They occur only in the parotid glands . D . Endoscopically demonstrates skip lesions .
B . They grow rapidly . E . Histologically demonstrates transmural
C . They rarely recur if simply enucleated . granulomatous inflammation .
D . They present as rock _ hard masses .
E . They are common benign salivary tumors . * A 45 year old female . Patient presented to E.R
complaining of right hypochondriac pain and
* A 20 year old man involved in RTA sustains nausea with repeated vomiting for the last few
bilateral fractured femurs . On assessment , he is hours . She recalls eating a cheese cake earlier
anxious and confused , with a pulse of 130 / min that day . Examination showed right
and BP of 70/50 mmhg . Urine output over 1 hour hypochondriac tenderness but otherwise soft
is 10 ml . This patient has hemorrhagic shock and lax . Her laboratory results were normal . The
type ? most appropriate next investigation ?
A . Class 1 A . Erect abdominal X_Ray
B . Class 2 B . Endoscopy
C . Class 3 C . CT abdomen
D . Class 4 D . Ultrasound of the abdomen
E . Class 5
* A 50 year old man presented to E.R
* All of the following are branches from the complaining of severe epigastric pain of 5 hours
external carotid artery except ? duration . The pain is radiating to his back
A . Superior thyroid artery associated with recurrent vomiting . His amylase
B . Ascending pharyngeal artery is 2017 u/ L . All of the following criteria are used
C . Lingual artery
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 4
to predict the severity of the case during E . Is ideally 50% saturated at a PO2 of 28 mmhg
admission except ?
A . Age over 55 years * One of the following passes through the aortic
B . Blood sugar more than 200 mg/dl . hiatus in the diaphragm ?
C . AST more than 250 u/ L A . Vagal trunks
D . WBC less than 5000 /UL B . Right phrenic nerve
E . LDH more than 350 u/ L C . Thoracic duct
D . Esophagus
* The highest potassium concentrate in ? E. Branches from left gastric artery
A . Saliva
B . Gastric juice * A 62 year old male patient presented
C . Bile complaining of bloody diarrhea and cramps , he
D . Ileal has recently been started on Clindamycin for
septic arthritis . As he is allergic to penicillin .
* Regarding abdominal trauma in pediatric age Which of the following is the most likely
group , which of the following is true ? diagnosis
A . Clinical examination , stabilization and A . Campylobacter jujeni diarrhea .
resuscitation are not of priority . B . Pseudomembranous colitis .
B . Ultrasound is the diagnostic tool of choice . C . Salmonella typhi diarrhea .
C . Blood transfusion should be started D . Rectal cancer .
immediately . E . Hemorrhoids .
D . Peritoneal lavage is contraindicated .
E . Splenectomy is not a routine management for
all types of Splenic injuries .
* Which of the following is true regarding the * One of the following is not a complication of
femoral pulse ? gallstones ?
A . It is usually felt at the midpoint of inguinal A . Intestinal obstruction
ligament . B . Mucocele .
B . The femoral nerve is medial to the femoral C . Acute cholycystitis .
pulse . D . Liver cirrhosis .
C . The femoral pulse is lateral to the deep E . Pancreatitis .
inguinal ring .
D . The femoral pulse is felt at the mid inguinal * Which of the following statements is true
point . concerning Meckels diverticulum ?
E . A Radio_femoral delay is usually felt in aortic A . It's found within 2 inches of the ileocecal
stenosis . valve .
B . It's a remnant of the embryonic vitelline duct .
* Which of the following is not true regarding C . Ectopic colonic epithelium is found in it .
sepsis ? D . Diagnosis is best made by CT_ scan .
A . Tachycardia and / or tachypnea may be a E . It's usually found on the mesentric border of
sign . the bowel .
B . Sepsis is defined as systemic inflammatory
response syndrome in the presence * A 34 years old male patient presented after
of infection . being in RTA with severe shortness of breath .
C . Leukocytosis or leukopenia may be a sign . Examination revealed a deviated trachea to the
D . Sepsis and hypotension is defined as septic left side . Absent breath sounds on the right side
shock . of the chest . The best initial management option
E . Temperature greater than 38 or less than 36 for this patient is ?
may be a sign . A . Intubate the patient .
B . Insert a chest tube on the right side .
* Regarding the oxygen dissociation curve , one C . Do a chest X_Ray then manage accordingly .
is true ? D . Insert a needle thoracostomy followed by a
A . Is shifted to the left by increase 2.3 _ DPG . chest tube in the right side of chest .
B . Is Sigmoid shape for both hemoglobin and E . Insert 2 large bore cannulas and give 1 liter of
myoglobin . ringer lactate .
C . Is shifted to the left when one ascends to high
altitude . * All of the following are true regarding colon
D . Is shifted to the right by an increase in the PH cancer except ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 5
A . It's the second most common cause of * What is the most likely diagnosis in a 45 year
cancer related death in Jordan . old male patient with HTN , development of facial
B . A ( T1 N1 M0 stage 3 ) tumor is equivalent to hair and 7cm suprarenal mass ?
Duke stage C tumor . A . Myelolipoma
C . A majority of colorectal cancers occur in the B . Cushing disease
descending colon . C . Adrenocortical adenoma
D . FAP and HNPCC are two inherited causes of D . Pheochromocytoma
colorectal cancer . E . Carcinoid tumor
E . Patients with primary sclerosing cholangitis
and ulcerative colitis have increased risk of * 60 kg woman involved with extensive burns .
developing colon cancer . On physical exam found to have pink to red skin
colour , slightly swelling and pain , dry skin on the
* One of the following is false regarding head . Her left arm and leg have dry white
crystalloid solutions ? painless burns and her anterior torso has
A . Osmolarity of RL solution 273 mosm L . Erythematous painful burns with blistering. How
B . Ringer lactate contain 154 meq/L sodium . much fluid she require ?
C . Readily pass through semi _ permeable A . 2500 ml
membrane , therefore they are considered B . 10800 ml
extravascular space expanders . C . 8640 ml
D . Have poor capillary perfusion and no allergic D . 12960 ml
reaction and short intravascular half life 20_30 m E . 17280 ml
E . Hartmann solution , 0.9% NaCl solution , 5%
Dextrose in water are isotonic crystalloid
solutions .
* How much calories per liter in D_Dextrose 5% ?
A . 150 * A patient has the following ABG , PH = 7.56 ,
B . 170 PCO2 = 50 mmhg , PO2 = 85 mmhg , HCO3 = 40
C . 180 meq/L . What is the acid base abnormality ?
D . 200 A . Uncompensated metabolic alkalosis .
E. 250 B . Respiratory acidosis with metabolic
compensation .
* A 66 years old woman falls fracturing the C . Combined metabolic and respiratory alkalosis
surgical neck of humerus . Sex months later she D . Metabolic alkalosis with respiratory
is unable to abduct her arm's above her hand . compensation .
Most likely nerve injury ? E . Mixed respiratory and metabolic alkalosis .
A . Median nerve
B . Radial nerve . * Most common thyroid tumor that spread via
C . Ulnar nerve lymphatics ?
D . Axillary nerve A . Follicular
E . Musclo_cutaneous nerve B . Anaplastic
C . Medullary
* A 45 years old female found to have wasting of D . Papillary
intrinsic muscle , of the hand , weakness and E . Lymphoma
pain in the wrist , most likely nerve injury ?
A . Ulnar nerve * All of the following are causes of blood stained
B . Radial nerve nipple discharge except ?
C . Median nerve A . Intraductal papilloma
D . Axillary nerve B . Carcinoma
E . Thenar and hypothenar nerves C . Ductectasia
D . Fibrocystic disease
* The following causes of Hypercalcemia except E . Fat necrosis of breast
A . Sarcoidosis
B . Primary hyperparathyroidism * Which of the following pathologies is thought to
C . Acute pancreatitis have no malignant potential ?
D . Metastasis bronchial carcinoma A . Ulcerative colitis
E . Milk Alkali syndrome B . Villous adenoma
C . FAP
D . Hyperplastic polyps
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 6
E . Crohn disease D . Evaluation for fracture of the other extremities
and visceral injury is
* Which of the following vaccines are live ? indicated .
A . H influenza type B E . Cardiac conduction abnormalities are unlikely
B . Diphtheria
C . OPV * 5_HIAA is tested in which of these disease ?
D . Hepatitis B A . Medullary carcinoma of the breast .
E . H influenza A B . Papillary thyroid carcinoma .
C . Giant cell carcinoma of the pancreas .
* One of the following is true regarding the D . Carcinoid tumor .
electrolyte concentration in Hartmann solution ? E . Ganglioneuromas .
A . Chloride 200 mmol/L
B . Lactate 70 mmol/L * Capillary refill time is elicited by ?
C . Sodium 131 mmol/L A . Pressing over the skin for 3 seconds ,
D . Potassium 40 mmol /L normally return perfusion by 2 seconds .
E . Calcium 15 mmol/L B . Pressing over the skin for 5 seconds , normally
return perfusion by 2 seconds .
* All are true regarding Heparin except ? C . Pressing over the skin for 5 seconds, normally
A . It's heterogeneous mixture of sulfated return perfusion by 5 seconds
polypeptides . D . Pressing over the skin 10 seconds , normally
B . Potentiates the actions of antithrombin 3 . return perfusion by 5 seconds .
C . Has a half life of a 90 minutes . E . Pressing over the skin for 2 seconds ,
D . Can be reversed by protamine sulphate . normally return perfusion by 5 seconds .
E . Can induce an idiosyncratic
thrombocytopenia .
* All of the following fistulas are unlikely to close * All of the following are true regarding neck
spontaneously except ? lumps except ?
A . Fistulas secondary to malignancy . A . Thyroglossal cysts move upwards on
B . Fistulas due to Crohn disease . protrusion of tongue .
C . Fistulas with epithelized track . B . Branchial cysts typically present in the first
D . Fistulas with long track . decade of life .
E . Fistulas with foreign bodies . C . Thyroid masses move upwards on swallowing
D . Cystic hygromas are lymphatic malformation .
* A palpable radial pulse indicate a systolic blood E . Parotid glands are not normally palpable .
pressure greater than ?
A . 40 mmhg * A 50 years old man is admitted to hospital with
B . 60 mmhg severe bleeding and bruising . He is on warfarin
C . 80 mmhg and his INR is 10 . For rapid complete reversal of
D . 100 mmhg his INR , which of the following mostly used ?
E . 120 mmhg A . Platelets .
B . FFP and vitamin K .
* The main reason of delay of eradication of C . IV vitamin K .
measles in Jordan is ? D . Whole blood and vitamin K .
A . Migration or refugee from neighbor Arab E . Fresh frozen and vitamin C .
countries ( Iraq , Syria ) due to unstable
conditions in their countries . * All are true about thyroid gland except ?
B . Immunization coverage rate is low in Jordan . A . It's composed of two lobes , weighs 25 grams
C . High cost of vaccine . in adult , each lobe 5 cm long , 3 cm wide , 2 cm
D . Cold chain of vaccine is not accurate . thick .
B . Epiglotic cartilage lie just above the gland .
* One is true regarding electric burns ? C . It extends from first tracheal ring up to sixth
A . Injuries are generally more superficial than tracheal ring .
those with thermal burns . D . Infrahyoid muscles lie in front , and
B . Intravenous fluid replacement is based on the sternocleidomastoid muscle to the side of the
percentage of body surface gland .
area burnt . E . It has follicles , follicular cells , and
C . Electric burns often result in transient parafollicular cells surgery
traumatic optic neuropathy .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 7
* The most common blood transfusion reaction * The most important prognostic factor for
is breast cancer devoid of systemic metastasis is ?
A . Clerical error A . Node status
B . ABO incompatibility B . Size of tumor
C . Delayed hemolysis C . Tumor grade
D . Febrile reaction D . Gender of patient
E . Transfusion related acute lung injury E . Comorbidities

* Sludging in the gallbladder and cholestatic * The most predominant cell type in a 7 day old
jaundice is characteristic for wound is ?
which of the following antibiotics ? A . PMNs
A . Quinolones B . Macrophages
B . Metronidazole C . Lymphocytes
C . Ceftriaxone D . Fibroblasts
D . Erythromycin E . Platelets
E . Ampicillin
* All are true about keloid scar except ?
* The composition of Ringer lactate is ? A . They are confined to the original scar area
A . Na 145 , Cl 109 , K 4 , Ca 2.7 , HCO3 28 . B . Can be treated with silicon , steroid or
B . Na 130 , Cl 103 , K 4 , Ca 2.7 , HCO3 28 . radiotherapy .
C . Na 154 , Cl 109 , K 4 , Ca 4 , HCO3 28 . C . Occur mainly on the ear lobe , shoulders ,
D . Na 130 , Cl 109 , K 4 , Ca 2.7 , HCO3 28 . sternal notch , rare across
joints .
D . More common in dark skin .
E . More common in females than males .

* Maintenance fluid rate to a 50 kg patient ? * A 22 years old man suffers a severe pelvic
A . 120 ml/hr fracture and has Hematuria . You get a
B . 90 ml/hr retrograde cystourethrogram and see an
C . 60 ml/hr extraperitoneal bladder rupture . The most
D . 30 ml/hr appropriate therapy ?
E . 150 ml/hr A . Foley drainage for 7 day .
B . Exploratory laparotomy
* Ileal resection can result in all of the following C . Cystectomy
except ? D . Observation
A . Decreased B12 and folate uptake . E . Cystoscopy and repair
B . Decreased bile salt uptake .
C . Decreased iron uptake . * A 26 years old woman is involved in a severe
D . Diarrhea , steatorrhea . MVA . She is BP 80/40 , HR 120 , and has
E . Gallstones formation . distended abdomen . You give her a 2 liter Ringer
lactate and then start blood transfusion ,
* Ototoxicity is characteristic of which of the however she remain hypotensive , the most
following chemotherapy ? appropriate next step is ?
A . Bleomycin A . Abdomen CT scan
B . Cisplatin B . Abdomen angiography
C . Cyclophosphamide C . Diagnostic peritoneal lavage or FAST .
D . Vincristine D . Exploratory laparotomy
E . Adriamycin E . Abdomen X_Ray

* The most common metastasis to the small * A 25 years old man involved in a vehicle
bowel is ? accident will open his eye's only to painful
A . Lung cancer stimuli , does not form word's but mumbles and
B . Colon cancer withdraw to pain . The GCS is ?
C . Prostatic cancer A . 10
D . Melanoma B.8
E . Brain cancer C.7
D.6
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 8
E.4 * While performing a MRM in the patient with
breast cancer , you cut the thoracodorsal nerve .
* A patient stops making urine after surgery . All Postoperative this patient is most likely to have ?
of the following values are consistent with A . Weak adduction
prerenal renal failure except ? B . Winged scapula
A . Urine Na 5 meq/L C . Weak abduction
B . BUN/cr ratio 35 D . Paralyzed diaphragm
C . Fe Na = 0.3% E . Facial drop
D . Urine osmolality = 200 mosm/ L .
E . Urine specific gravity = 1.050 * Which lung cancer is most likely to be
associated with a paraneoplastic syndrome ?
* The initial treatment of choice in a patient with A . Small cell lung cancer
Hyperkalemia and arrhythmia is ? B . Adenocarcinoma
A . Insulin and glucose C . SCC
B . Amiodarone D . Large cell cancer
C . Calcium resonium E . Mesothelioma
D . Calcium gluconate
E . Dialysis * The most common location for a Boerhaves
syndrome is ?
* A 50 years old man has a mass 1cm anterior to A . The left posterior lower esophagus .
the ear . The mass causes him pain and facial B . The left posterior middle esophagus .
drop . CT of the head shows mass in both the C . The left posterior upper esophagus .
deep and superficial part of the parotid glands . D . The right posterior middle esophagus .
The most likely diagnosis ? E . The right posterior upper esophagus .
A . Mucoepidermoid carcinoma .
B . Adenoid cystic carcinoma .
C . Pleomorphic adenoma .
D . Warthins tumor .
* A 20 years old man comes to your office and * The typical manometric finding in patient with
has a blood pressure 240/120 . He states that he Achalasia is ?
gets headaches sometimes and excessive A . Normal LES pressure and absent peristals .
sweating . Which of the following tests is best for B . Failure to LES to relax and absent peristals .
making the diagnosis ? C . Increased of LES pressure and normal
A . Urine cortisol peristals .
B . Urine aldosterone D . Increased of LES pressure and high peristals
C . Urine VMA And metanephrines E . Low of LES pressure and absent peristals .
D . Urine epinephrine
E . Urine norepinephrine * A 60 years old man develops TIAs and has a
carotid ultrasound that shows an 80% stenosis .
* A 30 years old woman recently diagnosed with The next appropriate next step is ?
MEN1 syndr.ome . Develops confusion A . Plavix
somnolence , and short QT interval on the ECG , B . ASA
the next appropriate next step is ? C . Warfarin
A . Alpha blockade D . Carotid endarterectomy
B . Beta blockade E . Observation
C . CCB
D . IV fluid and lasix * Intrinsic factor of the stomach binds to ?
E . Dialysis A . Fe
B . Cu
* Which of the following lab values is most C . Vitamin B12
effective at picking up recurrent Papillary or D . Folate
follicular thyroid cancer ? E. Vitamin K
A . TSH
B . Free T4 * Barrett esophagus refers to ?
C . Thyroglobulin A . The change in esophageal mucosa from
D . Transferrin columnar to squamous .
E . TRH B . The change in esophageal mucosa to
transitional epithelium .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 9
C . Keratinization of the esophageal mucosa .
D . Change in esophageal mucosa from squamous * A 50 years old woman with a pancreatic mass
to columnar epithelium . in the tail of the pancreas develops watery
E . Cancer of the esophagus . diarrhea and Hypokalemia . The most likely
diagnosis is ?
* A 50 years old man presents with epigastric A . Glucagonoma
pain unrelieved by PPI . You perform an upper B . Gastrinoma
endoscopy , mass in the mucosa only . You C . Somatostatinoma
biopsy it and it was lymphoproliferative tissue , D . Vipoma
the next appropriate therapy ? E . Insulinoma
A . Total gasterectomy
B . Partial gasterectomy * The right gastric artery is normally a branch of
C . Chemotherapy the ?
D . Radiotherapy A . Gastroduodenal artery
E . Triple therapy for H pylori B . Right gastro_epiploic artery
C . Pancreatoduodenal artery
* A 25 years old woman develops jaundice and D . Proper common hepatic artery
Ascites 2 week after childbirth , the most likely E . Right hepatic artery
related to ?
A . Retained placenta * All of the following are true about TTP except ?
B . Hepatic vein thrombosis A . Enlarged spleen .
C . HCC B . Loss of platelets inhibition .
D . Biliary cystadenocarcinoma C . Splenectomy is usually indicated .
E . Hepatitis D . The primary therapy is plasmapheresis .
E . Thrombosis .

* The primary surgery for patients with gallstones * A patient with a liver metastasis related to a
ileus is ? small bowel Carcinoid tumor , develops flushing
A . Open the ileum and removing obstruction and diarrhea . These symptoms are most likely
B . Whipple surgery . caused by ?
C . Cholecystectomy . A . Epinephrine
D . Hepatojejunostomy . B . Serotonin
E . ERCP . C . Bradykinin
D . ACTH
* A 60 years old woman with no past medical E . Gastrin
problems . Presents to the E.R with jaundice ,
RUQ pain and fever . Her BP 80/40 , HR 120 , the * If the anal fissure was located laterally , what
most appropriate next step ? disease should be ruled out ?
A . Emergent Cholecystectomy A . Crohn disease
B . Emergent ERCP . B . Ulcerative colitis
C . Emergent PTC placement . C . Gardner disease
D . Volume resuscitation and IV antibiotics . D . FAP
E . Emergency laparotomy . E . Anal cancer

* A 56 years old woman presents to the * The most common location of colon cancer is ?
emergency room with severe abdominal pain . A . Right colon
She occasionally drinks . You get routine labs , B . Left colon
amylase 24000 , lipase 7000 , WBC 17.000 , BP C . Transverse colon
90/40 , HR 120 , you examine her and she is fairly D . Descending colon
tender in the epigastric area . The most E . Sigmoid colon
appropriate next step ?
A . Start IV fluid and get a CT scan . * The most common injured nerve with inguinal
B . Start IV fluid and get a MRI . hernia repair ?
C . Start IV fluid and get an ultrasound . A . Ilioinguinal nerve
D . Start IV fluid and get to operation . B . Genitofemoral nerve
E . Start IV fluid and observation . C . Sciatic nerve
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 10
D . Lumbosacral nerve E . Type E
E . Femoral nerve
* The most common blood transfusion reaction ?
* A 65 years old woman presents with a tender A . ABO incompatibility reaction
medial thigh mass . The pain increases with B . Acute lung injury
internal rotation of the thigh . The most likely C . Delayed Hemolytic reaction
diagnosis ? D . Febrile non Hemolytic reaction
A . Inguinal hernia E . Hypocalcemia
B . Obturator hernia
C . Ventral hernia * The most common blood product containing
D . Femoral hernia bacterial contamination ?
E . Howship Romberg hernia A . Red blood cells
B . Platelets
* Anterior dislocation of the shoulder is most C . Cryoprecipitate
likely to injury the ? D . Fresh frozen plasma
A . Subclavian vein E . WBC
B . Subclavian artery
C . Axillary artery * Each of the following antibiotics is
D . Axillary nerve bacteriostatic except ?
E . Thoracic duct A . Sulfonamides
B . Tetracycline
C . Erythromycin
D . Gentamycin
E . Azithromycin

* A 2 year old is brought into your office for an

umbilical hernia . All of the following are true * A severe overdose of Diazepam is treated with
except ? A . Flumazenil
A . Patient should have surgery at about age 5 B . Nalxone
year if it fails to close . C . Neostigmine
B . Patient is at high risk for incarceration . E . Atropine
C . This hernia are increased in African patients .
D . This hernia are increased in premature * The true composition of normal saline ?
pediatric . A . Na 154 , CL 154 , K 4
E . Associated with congenital hypothyroidism B . NA 154 , CL 154
C . NA 130 , CL 109 , K 4 , Ca 2.7
* A newborn infant fails to pass meconium in the D . NA 130 , CL 130
first 48 hours of life and subsequently gets
progressive abdominal distension . Your order * A 3 month old child has persistent vomiting
plain films which show distended loops of small associated with Pyloric stenosis , the common
bowel , but no air _ fluid levels . The colon is metabolic change is ?
totally decompressed . The transition point in the A . Hypochloremic hypokalemic metabolic
RLQ . On exam , the has an anus located in the alkalosis .
proper position . The most appropriate next step B . Hypochloremic hyperkalemic metabolic
A . Upper GI endoscopy alkalosis .
B . Rectal biopsy C . Hyperchloremic hyperkalemic metabolic
C . Barium enema alkalosis .
D . Upper GI series D . Hypochloremic hypokalemic metabolic
E . Enteroclysis alkalosis

* The most common type of Tracheoesophageal * What should the maintenance fluid rate to 50
fistula is ? kg medically free boy ?
A . Type A A . 120 ml/hour
B . Type B B . 90 ml/hour
C . Type C C . 60 ml/hour
D . Type D D . 30 ml/hour
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 11
 B . Kidney
* Ileal resection can result in all except ? C . Lung
A . Decreased B12 uptake D . Bone
B . Megaloblastic anemia E . Colon
C . Increased bile salt uptake
D . Gallstones formation * All of the following values are consistent with
prerenal acute renal failure except ?
* Hemorrhagic cystitis is characteristic of one of A . Urine NA 10
the following chemotherapy ? B . BUN / creatinine ratio 30:1
A . Cisplatin C . Fe Na 0.5%
B . Bleomycin D . Urine osmolality 200
C . Cyclophosphamide E . Creatinine / creatinin plasma 50
D . Methotrexate
E . Tamoxifen * A 25 year old man involved in a MVA will open
his eyes only to pain , formes incomprehensible
* The most predominant cell type in the first 24 sounds , and withdraw to pain , this patient
hours of a wound ? Glasgow coma score ?
A . PMNs A . 10
B . Macrophages B.8
C . Lymphocytes C.6
D . Fibroblasts D.4
E.3
* The earliest cell type involved in wound healing
A . PMNs * The treatment of choice for severe burn with
B . Macrophages myoglobinuria ?
C . Platelets A . Broad spectrum antibiotic
D . Lymphocytes B . Inotropic support
E . Fibroblasts C . Fluid resuscitation and bicarb
* The vitamin that prevent the negative effects of D . Lasix
steroids on wound healing ? * The tumor most likely to involve bilateral
A . Vitamin B12 parotid glands at the time of presentation ?
B . Vitamin A A . Mucoepidermoid carcinoma
C . Vitamin D B . Adenoid cystic carcinoma
D . Vitamin C C . Pleomorphic adenoma
E . Vitamin E D . Warthin tumors

* A 26 year old female involved in RTA , she is * A 5 year old girl present with a midline anterior
hypotensive . Blood pressure 85/40 , heart rate neck mass painless mass that moves with
120 . Was intubated , she has distended tongue protrusion and swallowing . The most
abdomen , you give her 2 liter ringer lactate and common cause ?
start packed red blood cells . However she A . Thyroid tumor
remain hypotensive , the best next step ? B . Branchial cleft cyst
A . Abdomen CT scan C . Dermoid cyst
B . Angiogram D . Thyroglossal duct cyst
C . FAST scan
D . Exploratory laparotomy * A 28 year old male patient , suffers severe
second and third degree burns , he is intubated
* The initial treatment of choice in a patient with and started IV fluid resuscitation . Patient has a
Hyperkalemia and arrhythmia ? circumferential burn to his right arm with pale
A . DC shock cyanotic his right arm . The best next step ?
B . Insulin and glucose A . Fasciotomy
C . Calcium gluconate B . Arm elevation
D . Kaexylate C . Thrombectomy
E . Dialysis D . Streptokinase
E . Escharotomy
* The highest concentration of angiotensin
converting enzyme is in ? * The most common organism involved in burn
A . Liver wound sepsis ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 12
A . Staphylococcus aureus * Which lung cancer is most likely associated
B . Pseudomonas with Paraneoplastic syndrome ?
C . Streptococcus viridans A . Small cell cancer
D . Klebsiella B . Adenocarcinoma
C . SCC
* The best test for the diagnosis of adrenal D . Large cell cancer
medulla tumor ?
A . 24 hour urine metanephrine * The most common location for a Boerhaave
B . 24 hour urine cortisol syndrome ?
C . 24 hour urine Aldosterone A . Left posterior lower 3d of the esophagus .
D . 24 hour urine epinephrine and norepinephrine B . Left posterior middle third of the esophagus .
C . Left posterior upper third of the esophagus .
* The blood supply to the parathyroid glands ? D . The upper stomach .
A . Superior thyroid arteries for both glands .
B . Inferior thyroid arteries for both glands . * A 50 year old woman present with chief
C . Superior thyroid arteries for superior glands . complaint of dysphagia and odynophagia , the
D . Superior thyroid arteries for inferior glands . best first step to do ?
E Transverse cervical artery for both glands . A . EGDS
B . Chest CT scan
* A 30 years old female recently diagnosed with C . Abdomen CT scan
MEN1 syndrome , develops confusion , D . Barium swallow
Somnolence , constipation , short QT interval on E . Esophageal manometry
ECG , the best next step ?
A . Alpha B blockers * A 65 year old cachetic man smoker with an
B . B blockers apical lung cancer ( Pancoast tumor ) present
C . Calcium gluconate with Ptosis , Myosis and Anhydrosis . The most
D . IV fluid normal saline and Lasix likely cause ?
A . Paraneoplastic syndrome
B . Invasive CA to brachial plexus
* The first drug you must be prescribe for patient C . Invasive CA to SVC
with adrenal medulla tumor ? D . Invasive CA to sympathetic chain at T1
A . Propranolol * The most common nerve injured after MRM ?
B . Phenoxybenzamine A . Long thoracic nerve
C . Hydralazine B . Thoracodorsal nerve
D . Enalapril C . Phrenic nerve
E . Lowsartane D . Intercostal brachiocutaneous nerve

* Most common cause of Hypoparathyroidism ? * The most common nerve injured with carotid
A . Previous thyroid surgery endarterectomy ?
B . Radiation therapy A . Vagus
C . Chemotherapy B . Hypoglossal
D . Malignancy C . Lingual
D . Glossopharyngeal
* The best initial treatment of thyroid storm ?
A . Dantrolene * Most common artery ligated in AAA repair ?
B . Propranolol A . Right colic artery
C . Emergency thyroidectomy B . Inferior mesenteric artery
D . Steroids C . Superior mesenteric artery
D . Middle colic artery
* While performing a modified radical E . Inferior rectal artery
mastectomy , the surgeon cut the long thoracic
nerve , the patient postoperatively mostly have ? * Parietal cells of the stomach secrete ?
A . Weak adduction A . HCL and I.F
B . Weak abduction B . Pepsinogen
C . Paralyzed diaphragm C . Secretin
D . Winged scapula D . Cholecystokinin

‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬

Page 13
* Most common problem following Vagotomy pressure 85/40 heart rate 125 , temperature 39 ,
and Pyloroplasty ? the best next step ?
A . Diarrhea A . Emergency Cholecystectomy
B . Dumping syndrome B . Emergency ERCP
C . Gallstones C . Emergency PTC placement
E . Reflux gastritis D . IV fluid and IV antibiotics

* The LES pressure at rest and during a swallow * All are true about ITP except ?
in normal person ? A . Splenomegaly
A . 70 mmHg and 15 mmHg B . In children less than 10 years usually resolves
B . 15 mmHg and 70 mmHg spontaneously .
C . 15 mmHg and 0 mmHg C . The primary treatment is steroids .
D . 0 mmHg and 15 mmHg D . Splenectomy is indicated if medical therapy
fails or chronic ITP .
* Barrett esophagus refers to ? E . Anti platelets antibodies .
A . The change in esophageal mucosa from
columnar to squamous epithelium . * Most common congenital abnormality requiring
B . The change in esophageal mucosa to splenectomy ?
transitional epithelium . A . Hereditary spherocytosis
C . Keratinization of the esophageal mucosa . B . Hereditary elliptocytosis
D . Change in esophageal mucosa from squamous C . Protein kinase deficiency
to columnar epithelium . D . B Thalassemia minor

* The best first step in treatment of gastric * The right gastric artery is normally a branch of
mucosa associated with lymphoproliferative the ?
tissue tumor ( MALTOMA) ? A . Gastro_doudenal artery
A . Total gasterectomy B . Right gastro_epiploic artery
B . Partial gasterectomy C . Pancreato_duodenal artery
C . Chemo_radio therapy D . Proper hepatic artery
D . Triple therapy for H pylori infection

* A 40 year old female present with chief * A 50 years old woman with a pancreatic mass ,
complaint of RUQ abdominal pain , abdomen CT develops watery diarrhea , Hypokalemia , the
scan shows a calcified cyst in the liver , she has most likely diagnosis ?
a positive Casoni test , the best next step ? A . Glucagonoma
A . Percutaneous aspiration B . Gastrinoma
B . Albendazole C . Somatostatinoma
C . Albendazole followed by liver resection D . Vipoma
D . Metronidazole E . Insulinoma

* The most appropriate therapy for Barrett * An Amoebic abscess is best treated with ?
esophagus ? A . Percutaneous drainage and antibiotics
A . Photodynamic therapy B . Levofloxacin
B . Chemotherapy C . Praziquantel
C . PPI D . Metronidazole
D . Esophagectomy
E . Radiotherapy * One of the following is a cause of lateral
located anal fissure ?
* The primary surgery for with gallstones ileus ? A . Crohn disease
A . Whipple operation . B . Ulcerative colitis
B . Cholecystectomy . C . Gardner syndrome
C . Open Ileum and removing the obstruction D . FAP
D . Hepato_jejunostomy .
* A 25 year old man underwent appendectomy
* 60 year old female present to emergency room and found to have 2.5 cm tumor at the tip of the
with chief complaint of RUQ pain , and fever , on appendix . Pathology _ the tumor is carcinoid ,
physical found to have jaundice . Her vital blood the best next step ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 14
A . Chemotherapy D . Needs to be in 3 primary relatives , over 2
B . Radiotherapy generation , with one person
C . Right Hemicolectomy being less than 50 years old at the time of
D . Chemo_radio therapy diagnosis

* All are true about TTP except ? * The most common nerve injured in inguinal
A . Loss of platelet inhibition and thrombosis hernia repair ?
formation . A . Genitofemoral nerve
B . Splenomegaly . B . Ileoinguinal nerve
C . Splenectomy is rarely indicated . C . Sciatic nerve
D . The primary therapy is steroids . D . Lumbosacral nerve
E . Associated with HUS .
* A 1 year old baby found to have umbilical
* A 50 year old woman develops DM and severe hernia all are true except ?
migratory Erythematous skin rash , on abdomen A . Check thyroid function is important .
CT scan found to have pancreatic mass, the B . More common in premature baby .
most likely C . More common in African babies .
diagnosis ? D . Surgery treatment at about 5 year old if hernia
A . Glucagonoma fails to close .
B . Gastrinoma E . High risk for incarceration .
C . Vipoma
D . Insulinoma * A 15 year old develops sudden , severe scrotal
E . Somatostatinoma pain, and high riding right
testicle , the best next step ?
* Posterior dislocation of the Hip is most A . Bilateral exploration of testicles through
common to injure the ? inguinal incision .
A . Femoral artery B . Unilateral exploration of testicles through
B . Femoral vein inguinal incision .
C . Femoral nerve C . Bilateral exploration of testicles through
D . Sciatic nerve scrotal incision .
D . Unilateral exploration of testicles through
scrotal incision .

* All are true about urinary bladder cancer except

A . The most common is TCC . * Anterior dislocation of the shoulder is most
B . Schistosomiasis infection is risk factor for commonly to injure the ?
SCC . A . Subclavian vein
C . TCC limited to Submucosal , can be treated B . Subclavian artery
with intra_vesical BCG or TURT . C . Axillary nerve
D . TCC with invasive to muscle (T* is best treated D . Thoracic duct
with wedge resection .
* Treatment of choice of Mucoepidermoid
* A 65 year old woman present with a tender carcinoma of salivary glands ?
mass just below the inguinal ligament , the most A . Superficial paratidectomy
likely diagnosis ? B . Total paratidectomy
A . Inguinal hernia C . Chemotherapy
B . Femoral hernia D . Radiotherapy
C . Obturator hernia
D . Ventral hernia * Most common benign salivary glands tumor ?
E . Richter hernia A . Warthin tumors
B . Pleomorphic adenoma
* All of the following are true about HNPCC C . Mucoepidermoid adenoma
except ? D . Adenoid cystic adenoma
A . Colon cancer are right sided .
B . Associated with ovarian, breast , stomach * Most common cancer that give metastasis to
cancer . the small bowel ?
C . Patient have thousands of polyps . A . Lung cancer
B . Colon cancer
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 15
C . Prostatic cancer C . Hypothyroidism .
D . Melanoma D . Dehydration .
E . Breast cancer E . DM .

* Erythema multiforme is most commonly with * Life threatening causes of abdominal pain . All
which of the following antibiotics ? are true except ?
A . Quinolones A . Perforation .
B . Bactrim( CO_ trimoxazole ) B . Gastroduodenitis .
C . Erythromycin C . Acute pancreatitis .
D . Ceftriaxone D . Ruptured ectopic pregnancy .
E . Vancomycin E . Referred pain ( MI , aortic dissection ) .

* The mechanism of action for Fluoroquinolones * Which of the following signs does not suggest
A . Inhibition of RNA polymerase a tension pneumothorax ?
B . Inhibition of DNA gyrase A . Hypotension
C . Inhibition of ribosomes B . Tachycardia
D . Production of oxygen radicals C . Dyspnea
D . Tracheal deviation
* The most common malignancy following organ E . Subcutaneous emphysema
transplantation ?
A . Lung cancer * In bowel obstruction , which one of the
B . Prostatic cancer following features is suggestive of
C . Skin cancer strangulation ?
D . Breast cancer A . Intermittent pain .
E . Colon cancer B . Acidosis .
C . Alkalosis .
* Diaphragm injuries ? D . Heavy watery diarrhea .
A . More common in the right . E . Reducible hernia .
B . More common in the left .
C . Most common cause is penetrating trauma . * Worrying features of acute abdominal pain . All
D . Easy to find with CT scan . are true except ?
A . Tachycardia
B . Hypotension
C . Anorexia
* A 22 years old male patient suffers a severe D . Persistent vomiting
pelvic fracture and has Hematuria , on retrograde E . Massive rectal bleeding
cysto_urethrogram found to have extraperitoneal * All of the following are true about thyroid gland
bladder rupture . The most appropriate therapy ? except ?
A . Foley catheter for 7 days . A . Thyroid gland is one of the largest endocrine
B . Exploratory laparotomy and surgical repair . glands .
C . Cystoectomy . B . Thyroid gland consists of 2 lobes ( right ,
D . Nothing to do and observation . left ) , isthmus and pyramidal lobe in 50% of
surgery 7,2018 population .
C . Hormones secreted by the thyroid are not
* The first systemic complication after a major affected by the pituitary gland .
burn injury ? D . Thyroid gland has 2 arteries and 3 veins .
A . Hemodynamic instability . E . The thyroid gland develops at 4 week of
B . Metabolic acidosis . gestation
C . Renal failure .
D . Hyperkalemia . * In graves disease all are true except ?
E . Sepsis . A . It is the most common cause of
Thyrotoxicosis .
* A 56 years old man presents with constipation , B . More common in women .
abdominal pain , kidney stones and suffers with C . Treatment includes medical , iodine ablation
depression . Which of the following is the most and surgery .
possible ? D . In graves disease TSH increased while T4
A . Hypercalcemia . markedly decreased .
B . Hypokalemia .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 16
E . Diarrhea , palpitation and heat intolerance can B . Superior mesentric artery .
be found in graves disease . C . Superior epigastric artery .
D . Celiac trunk .
* Helicobacter pylori may cause the following E . Abdominal aorta .
conditions in the stomach and duodenum except
A . Gastric ulcer . * All are indications for surgery in benign
B . Duodenal ulcer . prostatic hyperplasia except ?
C . Gastric lymphoma . A . Large prostate 100 grams .
D . Gastrointestinal stromal in the stomach . B . Refractory urinary retention .
E . Gastric adenocarcinoma . C . Renal impairment .
D . Recurrent UTI .
* A child with abdominal pain is suspected of E . Recurrent gross Hematuria.
having an intussusception One is true ?
A . The condition occurs in 3 months old in 70% * A 41 years old male smoker is diagnosed with
of case's . low grade gastric lymphoma . After a successful
B . Ileocolic intussusception is most common treatment , he underwent surveillance upper
C . Vomiting occur early in the presentation . endoscopy that showed a complete cure . What
D . Fever excludes intussusception as the is the type of treatment he received ?
diagnosis . A . Medical treatment .
E . Plain abdominal X_Ray is diagnostic . B . Surgical treatment .
C . Chemotherapy .
* All of the following are risk factors for breast D . Observation .
cancer except ? E . Surgical and chemotherapy
A .Obesity .
B . Low bone mineral density . * At what age is surgical orichidopexy
C . High breast density . recommended for a child with unilateral
D . Smoking . undescended testes ?
E . First full term pregnancy at age of 35 years . A . 4 _ 5 years .
B . 5 _ 6 years .
* All of the following are complication of colonic C . Any time prior puberty .
diverticulosis except ? D . 1 year .
A . Diverticulitis . E . Promptly upon discovery , regardless of age .
B . Hemorrhage .
C . Fistulae .
D . Cancer .
E . Abscesses .
* Which of the following most reliably
* Adenocarcinoma of the small intestine is most distinguished erysipelas from other causes of
commonly associated with ? skin infection ?
A . Familial adenomatous polyposis . A . Associated abscess .
B . Tuberculosis of the small bowel . B . Increased margin of infection .
C . Lymphoma . C . Patients non toxic appearance .
D . Prolonged use of cytotoxic chemotherapy for D . Usually caused by group B Streptococcus .
breast cancer . E . Usually seem on chest .
E . Ulcerative colitis .
* The most sensitive image for urinary tract
* Femoral hernia is differentiated from all the stones is ?
following diseases except ? A . MRI .
A . Bartholin gland cyst . B . Ultrasound .
B . Lipoma . C . Intravenous pyelogram .
C . Cold abscess . D . Enhanced urinary tract CT .
D . Varicose node . E . Unenhanced urinary tract CT
E . Inguinal hernia .
* All of the following are known complication of
* Asthenic man with chronic symptoms of gallbladder stones except ?
proximal bowel obstruction , which vessel is the A . Obstructive jaundice .
most suggestive cause of obstruction ? B . Cholangitis .
A . Inferior vena cava . C . Acute pancreatitis .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 17
D . Liver cirrhosis . E . PUD .
E . Cholecystoduodenal fistula .
* All of the following are branches of External
* Tetanus , all are true except ? carotid artery except ?
A . Tetanus is a serious toxin mediated disease . A . Posterior auricular artery .
B . Tetanus is with a mortality of up to 50% . B . Ascending pharyngeal artery .
C . Gram positive anaerobic organism . C . Mandibular artery .
D . Culture is essential for diagnosis . D . Maxillary artery .
E . Causes diffuse muscle rigidity . E . Superior thyroid artery .

* Which artery is considered to be differentiate * Circle of willis is composed of all of the

between site of origin in inguinal hernia ? following arteries except ? ‫ﻛﻞ اﻻﺟﺎﺑﺎت ﺻﺤﻴﺤﻪ‬
A . Cremasteric artery .
A . Anterior communicating artery .
B . Superior epigastric artery .
B . Posterior communicating artery .
C . Inferior epigastric artery .
C . Internal carotid artery .
D . From artery .
D . Middle cerebral artery .
E . Superficial circumflex iliac artery .
E . Anterior cerebral artery
* Which of the following is true regarding breast
* A alcoholic patient was admitted to hospital 30
cancer ?
min after the fight , he was excited , there were
A . The majority of case's with breast cancer are
ecchymosis and abrasion on left temporal
familial in origin .
region . 6 hours later consciousness was 8 point
B . The most important risk factor for developing
by GCS , weakness of the right limbs , left
breast cancer is age .
mydriasis . What is the most likely cause ?
C . Breast density has no correlation with the risk
A . SAH .
of breast cancer .
B . Subdural hematoma .
D . Up to 10% of breast cancer is hereditary .
C . Intraventricular hemorrhage .
E . BRCA1 mutation is associated with significant
D . Focal edema of the brain .
increase in breast and endometrial cancer risk
E . Alcoholic coma .
* Which of the following is the greatest risk
* All are true about base of skull fracture except ?
factor for developing anaortic aneurysm ?
A . Base of skull fracture are often missed on
A . Age
plain skull X_Ray .
B . History of smoking
B . Base of skull fractures are often diagnosed on
C . History of HTN
head CT scan .
D . Metabolic disturbances
C . Cerebrospinal fluid otorrhea and rhinorrhea
E . Male factor
are signs of BSF .
* Most common causative microorganism of
D . Postauricular ecchymosis and periorbital
Acute Osteomyelitis is ?
ecchymosis and finding on
A . Streptococcus pyogenes .
examination .
B . Staphylococcus aureus .
E . Nasogastric tube is contraindicated .
C . Salmonella .
D . E coli .
* All of the following statements are true about
E . Hemophilus influenzae .
inguinal canal except ?
A . Anterior wall is external oblique , internal
* Most common benign tumor of the hand ?
oblique muscles , and
A . Hemangioma .
superficial inguinal ring .
B . Lipoma .
B . Posterior wall is Transversalis fascia ,
C . Ganglion cyst .
conjoint tendon , and deep inguinal
D . Giant cell tumor of tendon sheath .
ring .
E . Epidermoid inclusions cyst .
C . Inguinal canal transmit the genitofemoral
nerve .
* Most common cause of gastric outlet
D . Superior wall is lacunar ligament and external
obstruction is ?
oblique muscle .
A . HPS .
E . Inferior wall is inguinal ligament .
B. Pancreatic cancer .
C . Crohn disease .
* All of the following are risk factors for volvulus
D . Erosive gastritis .
except ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 18
A . Low fiber diet . C . IV hydration and hypertonic gastrografin
B . Constipation . enema .
C . Pregnancy . D . Sweat chloride test and pancreatic enzyme
D . Laxative abuse . therapy .
E . Old age . E . Lower GI endoscopy .

* All of the following are risk factors for * Branchial cleft remnants most often present
Hepatocellular carcinoma except ? with which of the following clinical problems ?
A . Hepatitis B virus . A . Airway obstruction .
B . Wilson disease . B . Hemorrhage .
C . Alcohol . C . Malignancy .
D . OCPs . D . Pain .
E . Alpha one antitrypsin deficiency . E . Infection .

* All of the following are risk factors for * All are true matching about thyroid gland
Cholesterol gallbladder stones except ? cancer except ?
A . Obesity . A . Papillary carcinoma _ best prognosis .
B . Crohn disease . B . Follicular carcinoma _ blood spread .
C . Multiparity . C . Anaplastic carcinoma _ Multiple endocrine
D . Cirrhosis liver . neoplasia .
E . Starvation . D . Lymphoma _ treatment chemoradiotherapy .
E . Medullary carcinoma _ secrete calcitonin .
* One is true about Hashimoto thyroiditis ?
A . Most common cause of hyperthyroidism * A 3 kg neonate with excessive salivation
worldwide . develops respiratory distress . Attempts to pass
B . Women to men ratio 1:20 . and orogastric tube failure . A chest film shows
C . Autoimmune disease . right upper lobe atelectasis and a gasless
D . Local enlargement of thyroid gland . abdomen , the most likely diagnosis ?
E . Strongly associated with HLA_DR4 and A . Proximal esophageal atresia with distal
HLA_B4 . Tracheosesophageal fistula .
B . H type Tracheosesophageal fistula .
* Which of the following bad prognostic factor C . Congenital esophageal stricture .
for acute pancreatitis ? D . Proximal esophageal atresia without a fistula .
A . Very high amylase serum level . E . Esophageal atresia with both proximal and
B . Very high lipase serum level . distal Tracheosesophageal
C . Low PaO2 less than 60 mmhg . fistula .
D . Pseudocyst .
E . Very high LDH serum level .
* Treatment of choice of papillary thyroid cancer?
A . Radiotherapy . * Signs of metastatic gastric carcinoma include
B . Chemoradiotherapy . all of the following except ?
C . Chemotherapy . A . Virchow node .
D . Observation . B . Blumer shelf .
E . Total thyroidectomy and neck dissection . C . IDA .
D . Sister mary Joseph node .
* One of the following infections spread mainly E . Irish node .
by airborne route ?
A . Warts * All are true about femoral hernia except ?
B . Impetigo A . Most common groin hernia in women .
C . Tuberculosis B . It goes into femoral canal .
D . Malaria C . It goes below inguinal ligament .
E . Chickenpox D . It lies medial to femoral vein .
E . It is high risk for strangulation .
* The treatment of choice for neonates with
uncomplicated meconium ileus is ? * Most common presentation of left colon
A . Observation . adenocarcinoma ?
B . Emergency laparotomy . A . Weight loss .
B . IDA .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 19
C . Bowel obstruction . A . Epidemia .
D . Abdominal pain . B . Pandemia .
E . Rectal bleeding . C . Endemia .
D . Outbreak .
* All of the following are clean or clean _ E . Virulence .
contaminated surgery except ?
A . Hernia repair . * At which level , end of the spinal cord :
B . Thyroidectomy . A) 4th lumbar vertebrae
C . Laparoscopic cholecystectomy . B) L3_L4 inter space
D . Bowel obstruction . C) Second lumbar vertebrae
E . Radical mastectomy . D) T12_L1 inter space
E) S2_S3 inter space
* Most common site of needle thoracostomy in
management of tension pneumothorax is ? * A 20 years old with a bloody single duct
A . First intercostal space mid clavicular line . discharge and a palpable mass at the areola , no
B . 2d intercostal space mid axillary line . malignant cells and isolated from discharge . The
C . 2d intercostal space mid clavicular line . likely diagnosis is :
D . Fifth intercostal space mid clavicular line . A) Ductal carcinoma
E . Fifth intercostal space anterior axillary line B) Duct ectasia
C) Intraductal papilloma
* Which of the following is true regarding breast D) Prolactinoma
cancer ? E) Periductal mastitis
A . The majority of case's with breast cancer are
familial in origin . * A 50 years old man , presented to E.R with
B . The most important risk factor for developing severe Epigastric pain of 5 hours duration . The
breast cancer is age . pain radiating to back , associated with recurrent
C . Breast density has no correlation with the risk vomiting , Amylase level is high , all of the
of breast cancer . following criteria are used to peridict mortality
D . Up to 10% of breast cancer is hereditary . and morbidity during admission except :
E . BRCA1 mutation is associated with significant A) Age over 55 years
increase in breast and B) Blood sugar more than 200 mg / dl
endometrial cancer risk . C) AST more than 250 u/ L
D) WBC less than 5000/mm3
* The goal of primary prevention is ? E) LDH more than 350 u/ L
A . Early detection of disease .
B . Minimize the complication of disease . * All are true about Crohn disease except :
C . Prevent disease Onest . A) Stenosis more seen in ulcerative colitis
D . Rehabilitation of disease . B) Macroscopically cobblestoning
E . Prevent progression of disease C) Endoscopically skip lesions
* Ideal criteria for screening test in all of the D) Histologically transmural Granulomas
following except ? * Which of the following statement about the
A . High specificity . anatomy of the esophagus is correct :
B . Low sensitivity . A) The cervical esophagus passes behind and to
C . Safe , rapid and easy . the right of the trachea
D . Cost effective . B) The esophagus deviates anteriorly and to the
E . For significant suffering disease . left as it enters the abdomen
C) The thoracic esophagus enters the posterior
* Mortality from all causes of death per 1000 in mediastinum anteriorly to the
population is called ? aortic arch
A . Life expectancy . D) The thoracic esophagus passes behind the
B . Infant mortality rate . right mainstem bronchi and the
C . Crude death rate . pericardium
D . Crude death ratio . E) The esophagus enters the diaphragmatic
E . Total death rate . hiatus at the level of T8

* An outbreak or excessive rate of disease that * A 35 years old man with known ulcerative
rapidly spread over a wide area , crossing colitis , which of the following is an indication for
international boundaries is called ? total proctocolectomy :
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 20
A) Occasional attack of colic and diarrhea * All are features of tumor lysis syndrome except
B) Sclerosing Cholangitis A) Hyperkalemia
C) Arthritides B) Hyperphosphatemia
D) Toxic megacolon C) Hypercalcemia
E) IDA D) Hyperurecemia
E) High BUN
* The most common type of intracranial
hemorrhage : * The preferred operation for initial management
A) Extradural of a thyroid nodule that is considered suspicious
B) Subdural of malignancy by FNAB is :
C) Subarachnoid A) Nodule excision
D) Intracerebral B) Partial lobectomy
E) Intraventricular C) Total lobectomy and isthmusectomy
D) Total thyroidectomy
* One is true regarding the electrolyte E) Near total thyroidectomy
concentration in Hartmann solution :
A) chloride 200 mmol / L * A 50 years old man is admitted to hospital with
B) Lactate 70 mmol /L severe bleeding and bruising . He is on warfarin
C) Na 131 mmol/L and INR is 10 , For rapid complete reversal . The
D) K 40 mmol/L best is :
E) Calcium 15 mmol/L A) Platelets
B) FFP and vitamin K
* Most common hernia in females : C) IV vitamin K
A) Femoral hernia D) Whole blood and vitamin K
B) Umbilical hernia E) FFP and vitamin C
C) Obturator hernia
D) Direct inguinal hernia * A 36 years old woman , 20 weeks pregnant ,
E) Indirect inguinal hernia was in investigating a 1.5 cm right thyroid
nodule , fine needle aspiration is consistent with
* A 73 years old man, known of IHD , presented Papillary neoplasm , which of the following
complaining of severe abdominal pain . In ABG methods of treatment is contraindicated :
shows PH = 7.31 , PCO2 = 25 mmhg , PO2= 73 A) Right thyroid lobectomy
mmhg , HCO3 = 14 mmol /L , BE = 15.9 . The B) Subtotal thyroidectomy
diagnosis is : C) Total thyroidectomy
A ) Metabolic acidosis D) Total thyroidectomy with lymph node
B) Metabolic acidosis with respiratory alkalosis dissection
compensation E) Radioactive iodine ablation of thyroid gland
C) Respiratory acidosis
D) Respiratory acidosis with metabolic
compensation
E) Metabolic and respiratory acidosis mixed
* All are true about colorectal except : * One of the following suggest portal
A) More than half of the cancers in the hypertension :
recto_sigmoid A) Low platelet
B) More common in older people B) High ALP
C) More common in economically and C) Normal INR
underdeveloped world D) Low globulin
D) Risk of synchronous tumor , diagnosis in 5% E) High GGT
E) Patients with family history of CRC have
increased risk * Acute appendicitis is most commonly
associated with which of the following signs :
* Allen test is used to examine : A) Temperature above 40 C
A) Suppurative tenosynovitis B) Frequent loose stools
B) Thoracic outlet syndrome C) Anorexia , abdominal pain , RLQ tenderness
C) Dislocated hip D) WBC count > 20.000
D) Nerve supply of the upper limb E) None of above
E) Blood supply of the hand

‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬

Page 21
* Which of the following is not true regarding E) Hypertrophy of glandular tissue
sepsis :
A) Tachycardia and / or tachypnea may be a sign * Post mastectomy and axially clearance for a
B) Sepsis is defined as systematic inflammatory patient with breast cancer , the patient was found
response in the presence of infection to have a winging scapula , the most likely cause
C) Leucocytosis or Leukopenia may be a sign A) Patient suffered a TIA
D) Sepsis and hypotension despite IV fluid is B) Damage to thoracodorsal nerve during surgery
defined as septic shock C) Damage to long thoracic nerve during surgery
E) Temperature greater than 38 or less than 36 D) Damage to serratus anterior muscle
may be a sign E) Dislocated scapula

* Which of the following statement is true about * Regarding abdominal trauma in pediatric
drug therapy for Crohn disease : group , one is true :
A) Corticosteroids effective treat acute attack A) Splenectomy is not a routine for all types of
and to prolong remission splenic injuries
B) Sulfasalazine for acute attack involving small B) Peritoneal lavage is contraindicated
bowel C) Blood transfusion must be started
C) Azathioprine and immunosuppressive drugs immediately
for remission D) Ultrasound is the diagnostic tool of choice
D) Low dose cyclosporine for patients with both E) Clinical exam , stabilisation , resuscitation are
low and high disease activity not of priority
E) All of the above
* All of the following is true regarding the femoral
* The spleen filters all of the following particles triangle except :
cells except : A) The inguinal ligament forms the base
A) Malformed RBCs B) The medial border _ lateral border of adductor
B) T lymphocytes longus muscle
C) Malarial parasites C) The lateral border _medial border of sartorius
D) Streptococcus pneumonia D) The floor _ adductor longus and oblique
E) Platelets muscle medially
E) The floor _ iliopsoas muscle laterally
* Hyperthyroidism can be caused by all of the
following except : * Capillary refill time is elicited by :
A) MTC A) Pressing over the skin for 3 seconds , normally
B) Graves disease return of perfusion by 2 seconds
C) Plummer disease B) Pressing over the skin for 5 seconds , normally
D) Struma ovarii return of perfusion by 2 seconds
E) Hashimoto disease C) Pressing over the skin for 5 seconds , normally
return of perfusion by 5 seconds
D) Pressing over the skin for 10 seconds ,
normally return of perfusion by 5 seconds

* A major bleed in the thigh is best controlled in

emergency room by : * One is false :
A) Tourniquet A) femoral artery is lateral to femoral vein in the
B) Direct compression by hand inguinal area
C) Exploration under local anesthesia and clamp B) Femoral nerve is present within the femoral
D) Exploration and ligation under local sheath
anesthesia C) Femoral triangle is bounded by sartorius
E) Send to operating room for exploration under muscle laterally
General anesthesia D) Siatic nerve injury can be avoided by giving im
injection on the upper lateral quadrant on the
* Which of the following is associated with gluteal area
increased risk of development of breast cancer : E) Great saphenous vein drain to femoral vein
A) Fibrocystic mastopathy below the inguinal ligament
B) Atypical hyperplasia
C) Severe simple hyperplasia * The principal blood supply to the parathyroid
D) Papillomatosis glands is by :
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 22
A) Superior thyroid arteries E) Colovesical fistula
B) Inferior thyroid arteries
C) Thyroidea ima arteries * All of the following are true regarding nick
D) Parathyroid arterial branches from external lumps except :
carotid arteries A) Thyroglossal cyst moves upward on
E) Highly varible protrusion of tongue
B) Branchial cysts typically present in the first
* Most common cause of Goitrous decade of life
hypothyroidism in adults is : C) Thyroid masses move upwards on swallowing
A) Hashimoto disease D) Cystic hygromas are lymphatic malformation
B) Graves disease E) Parotid glands are not normally palpable
C) Riedels thyroiditis
D) De Quervain thyroiditis * Assessment of a breast lump include all ,
E) Iodine deficiency except :
A) Clinical examination
* A 25 years old . Underwent an antrectomy. and B) Mammography
vagotomy , he is complaining of nausea, C) Core biopsy
vomiting , diarrhea , dizziness , fatigue , bloating . D) FNA
Within 15_30 min from meal ingestion , and low E) Mastectomy
blood sugar within 2 hours from meal . The most
likely diagnosis : * Influenza is one of the greatest pandemic
A) Anemia disease because of :
B) Jejunogastric intussusception A) Mutation of the virus
C) Dumping syndrome B) Spread by water
D) Afferent loop syndrome C) Long incubation period
E) Alkaline reflex gastritis D) High fatality rate
E) Lack of specific vaccines
* A 32 years old man present with Hematuria. A
KUB X_Ray reveals a staghorn calculus in the * The most important indicator of a population
right kidney and mid stream urine sample grows health :
proteus . The most likely stone type is : A) Crude birth rate
A) Bile pigment stone B) Crude mortality rate
B) Calcium oxalate C) Infant mortality rate
C) Calcium phosphate D) Maternal mortality rate
D) Cholesterol stone E) Total fertility rate
E) Cysteine stone
* Which of the following is not associated with
* The first step in management hypercalcemia compartment syndrome :
is : A) Disproportionate level of pain
A) IV hydration normal saline 0.9% B) Absent distal pulse
B) Hydrocortisone C) Paresthesia
C) Dialysis D) Heat
D) Administration of Furosemide E) Paralysis
E) Administration of mithramycin
* A 54 years old man on renal dialysis is have to
raised serum calcium and PTH this is called : * Colon pseudo_obstruction is caused by all ,
A) Primary Hyperparathyroidism except :
B) Secondary Hyperparathyroidism A) Systemic illness
C) Tertiary Hyperparathyroidism B) Electrolyte imbalance
D) Hypercalcemia on malignancy C) Fecal impaction
E) Hypoparathyroidism D) Opioids
E) Hypothyroidism
* One of the following is an indication for
nasogastric tube insertion : * All predispose to necrotizing fascitis except :
A) Recent esophageal surgery A) Diabetes
B) Suspected esophageal perforation B) Severe head injuries
C) PE C) Cortisone therapy
D) Perforated stomach D) Advance malignancy
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 23
E) Renal failure D) CBD stone
E) Sepsis
* A 59 years old patient presented with left upper
abdominal discomfort . His physical exam * Which of the following is true regarding
reveals left upper quadrant tenderness . A CT gallstones type's :
scan of abdomen _ spleen infarction . Most A) Pure cholesterol stone are the commonest
common cause of of his splenic infarction : B) Brown stones usually from Hemolysis
A) Aplastic anemia C) Black stones usually with bacterial infection
B) ITP D) Pigment stones are dark because of presence
C) Gilbert disease of calcium bicarbonate
D) Atrial fibrillation E) Most cholesterol stones are radiopaque
E) Idiopathic pulmonary fibrosis
* A strong correlation exists between
* A 62 years old female was recently diagnosed Nasopharyngeal carcinoma and :
with an adenocarcinoma of the Sigmoid colon . A) White race
You are concerned about the possibility of B) EBV
metastasis. Which of the following is most C) Betel nut chewing
suggestive of metastatic disease : D) Alcohol
A) Multiple hepatic hypoechoic lesions on E) Plummer Vinson syndrome
abdominal ultrasound
B) Mild elevation of carcinoembryonic antigen * All of the following are true regarding
C) Abdominal pain Clopidogrel except :
D) Severe constipation A) It inhibits activation of glycoprotein 2B/3A
E) Abundant blood per rectum complex
B) The risk of bleeding is increased if it is used
* Carpal tunnel syndrome is due to compression with aspirin
A) Median nerve C) When discontinued , bleeding time normalizes
B) Ulnar nerve in approximately 2_3 days
C) Radial nerve D) It inhibits platelet aggregation within 2 hours
D) Radial artery of oral administration
E) Ulnar artery
* Management of Ascites due to liver cirrhosis
* The most precise diagnostic screening includes all except :
procedure for differentiating benign thyroid A) TIPS
nodules from malignant ones is : B) Paracentesis
A) Thyroid ultrasonography C) Spironolactone
B) Thyroid scintiscan D) Furosemide
C) Thyroid hormone suppression E) Sodium restriction
D) FNAB
E) CT scan * All of the following are part of the child pugh
scoring system for portal HTN except :
A) Hemoglobin level
B) Ascites
C) Encephalopathy
D) Serum bilirubin
* The risk of gallbladder cancer is increased with * Most common functional pancreatic endocrine
all of the following except : neoplasm is :
A) Obesity A) Vipoma
B) Porcelain gallbladder B) Glucagonoma
C) Mirrizzi syndrome C) Somatostatinoma
D) Male D) Gastrinoma
E) Large gallstones compared with small E) Insulinoma

* Jaundice with absent urinary urobilinogen is * A 30 kg child has an estimated daily fluid
most consistent with : requirement :
A) Hepatitis A) 40 ml/hour
B) Liver cirrhosis B) 50 ml/hour
C) Hemolysis C) 60 ml/hour
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 24
D) 70 ml/hour C) Increase in arterial oxygenation
E) 80 ml/hour D) Decrease in thirst
E) Decrease in tachycardia
* The test with highest sensitivity for
Pheochromocytoma is : * Which of the following is the most common
A) Plasma catecholamine neoplasm of the appendix :
B) Plasma metanephrine A) Mucinous adenocarcinoma
C) Urinary catecholamine B) Carcinoid tumor
D) Urinary metanephrine C) Malignant mucocele
E) Urinary VMA D) Lymphoma
E) Lymphosarcoma
* Which intestinal cells have been implicated in
the formation of GIST : * Which of the following is the most reliable in
A) Goblet cells confirming the diagnosis of acute appendicitis :
B) APUD cells A) Classic history of initial periumbilical pain
C) Cajal cells shifting to the right lower quadrant
D) Paneth cells B) Rebound tenderness
E) G cells C) Localized tenderness at Mcburneys point
D) Psaos sign presence
* Which of the following is the best first line E) Rovsing sign presence
option for an acute exacerbation of Crohn
disease : * The primary adverse reaction to Trastuzumab :
A) Sulfasalazine A) Liver toxicity
B) Mesalamine B) Renal toxicity
C) Natalizumab C) Thromboembolic events
D) Prednisone D) Cardiac toxicity
E) Infliximab E) Aplastic anemia

* A hernia sac containing a Meckels diverticulum * After a modified radical mastectomy , A 45

is called : years old woman reports weakness in her arm .
A) Petit hernia On exam she has mild weakness . When she
B) Littre hernia internally rotates and adducts her arm . The most
C) Spiglian hernia likely injured nerve is :
D) Richter hernia A) Intercosto_brachial
E) Grynfeltt hernia B) Long thoracic
C) Supraclavicular
* The most common organism associated with D) Medial pectoral
overwhelming post splenectomy sepsis : E) Thoracodorsal
A) Group A Streptococcus
B) Haemophilus influenzae
C) Streptococcus pneumonia
D) Meningococcus
E) Babesia microti

* Which of the following is the most effective * First degree burns involving the both hands ,
treatment for intractable Dumping syndrome : second degree burns involving the entire head
A) Low fat , lactose free diet and neck , third degree involving the entire back
B) Serotonin antagonists and half of the chest , would be considered :
C) Low carbs , high fat diet A) 12% TBSA
D) Octreotide B) 27% TBSA
E) Omeprazole C) 36% TBSA
D) 40% TBSA
* In the management of hemorrhagic shock , the E) 45% TBSA
best clinical sign of successful fluid resuscitation
is : * Which of the following are true regarding FAP :
A) Increase in blood pressure A) It is autosomal recessive
B) Increase in urine output B) The polyps are hamartomas
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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C) The risk of colon cancer is 100% by age 50 E . His past history and medications have to be
D) Once a polyp is detected total checked
proctocolectomy is recommended
E) There is no association with upper GIT * All sentences about wound healing are correct
malignancy except ?
A . Presence of a foreign body delays the wound
* According to Parkland formula , the amount of healing .
crystalloid fluids , that should be administered to B . The final strength of a healed wound is greater
the first 8 hours to a 70 kg man with a 15% TBSA than that of the surrounding skin .
first degree burns , 50 % TBSA second degree C . The surgical wound of a thyroid operation is
burn , 20% TBSA third degree burn : considered a clean wound .
A) 5000 ml D . Staphylococcus aureus is the most common
B) 6500 ml cause of wound infection following surgery .
C) 7350 ml E . Hand wash and hygiene decrease community
D) 9800 ml and hospital acquired wounds infections .
E) 11900 ml
* A 65 years old gentleman presented to you at
* Regarding the preoperative management , all the emergency room after road traffic accident
sentences are true except ? complaining of left chest pain , his vital signs
A . A recent MI is the most important risk factor were blood pressure 110/50 , HR 100 , RR 20 ,
to preoperative MI . GCS 14/15 . One examination , he was found to
B . Patients should stop taking their regular have diminished breath sounds on the left side .
antihypertensive drugs on the day of surgery CXR demonstrated opacification of the left
C . History and examination alone are usually hemithorax . What is the most likely diagnosis ?
sufficient in evaluating the risk of bleeding . A . Left hemothorax .
D . LMWH is used in venous thromboembolism B . Left pneumothorax .
prophylaxis . C . Cardiac tamponade .
E . Poorly controlled blood sugar in the D . Splenic injury .
preoperative period increases the risk for E . Left tension pneumothorax .
surgical site infection .
* All of the following can cause bilious vomiting
* In infantile hypertrophic pyloric stenosis, one of in an infant or child except ?
the following is false ? A . Intestinal malrotation and volvulus .
A . The infant usually presents with projectile non B . Pyloric stenosis .
bilious vomiting . C . Duodenal atresia .
B . The treatment is surgical by Ramstedt D . Small bowel obstruction .
operation . E . Ulcerative colitis with colonic obstruction
C . Symptoms commence at age of 3 _ 4 weeks .
D . A palpable olive shaped mass is usually felt in * A 5 year old boy is referred to you as an
the epigastric region in the classical case . emergency with right groin and hip pain . All of
E . Usually ultrasound is not sufficient for the following are important differential diagnosis
diagnosis . except ?
A . Inguinal hernia .
B . Acute appendicitis .
C . Testicular torsion .
* A 62 years old male patient presented with D . Congenital hip abnormality .
nocturia ( 4 time / night ) , weak stream , E . Sigmoid diverticulitis .
intermittency and frequency , his DRE revealed * Regarding breast cancer , all of the following
induration of the right lobe of prostate gland , all are true except ?
of the following sentences are true except ? A . Tumor speed to the skin means T4 on TNM
A . Treat the obstructive symptoms . classification .
B . Perform ultrasound for residual urine B . Eczema around the nipple should always be
assessment . investigated .
C . Request blood sample for prostate specific C . True cut biopsy is more accurate than fine
antigen . needle aspiration .
D . Unlikely this patient will need biopsy from D . Bloody nipple discharge is always due to
prostate . cancer .

‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬

Page 26
E . Metastasis usually involve lung , liver and / or D . Call the surgeon for immediate Laparotomy .
bone . E . CT scan of the abdomen .

* The most common presenting symptom in * All sentences about appendicitis are true
patient with pancreatic cancer is ? except
A . Midepigastric pain . A . Psoas sign is elicited by extension of the right
B . Nausea . hip .
C . Malaise . B . Rovsing sign is elicited by pressing in the left
D . Anemia . iliac fossa causing pain in the right iliac fossa .
E . Anorexia . C . Pain is less after laparoscopic compared with
open appendectomy .
* All of the following are true regarding D . Wound infection is less after laparoscopic
Hirschsprungs disease except ? compared open appendectomy .
A . There is no ganglion cell's seen in Auerbach E . In female patients , open approach is preferred
plexus . over the laparoscopic appendectomy .
B . There is increased Incidence of Down
syndrome . * All sentences about trauma are true except ?
C . It is more common in boy's . A . The term triage is generally used in acute
D . May be familial . trauma life support ( ATLS ) .
E . On X_Ray the affected bowel is narrowed B . The rationale behind triage is for the benefit
proximally while the normal bowel is dilated of the majority .
distally . C . The role of the designated triage person is
only to triage and not to treat .
* All sentences about skin cancers are true D . The triage process must be constantly
except ? repeated .
A . BCC are faster growing than SCC . E . Coma correspond to a GCS of more than 8.
B . Malignant melanoma are the most aggressive
skin tumors . * When total number of death's due to measles is
C . SCC is often seen in areas exposed to presented in relation to the total case's of
sunlight such as a scalp and face . measles , it is best labeled as ?
D . Rodent ulcer is a BCC . A . Cause specific death rate .
E . Marjolin ulcer is a SCC . B . Incidence rate .
C . Prevalence rate .
* In a patient with hypovolemic shock , which D . Case fatality rate .
cannula size would you ideally choose for E . Proportional mortality .
infusion ?
A . 19 G . * Which is not contributory to GCS ?
B . 21 G . A . Obey commands .
C . 14 G . B . Localizes painful stimuli .
D . 26 G . C . Open eyes to calling .
E . 30 G . D . Incomprehensible sounds .
E . Pupils size .
* Which is not a cause of pancreatitis ?
A . Hypercalcemia .
B . Hypokalemia .
C . Hypertriglyceridemia .
D . Obstruction of ampulla of vater .
E . Thiazides .
* You were the night shift doctor , at the * A 30 year old female came to your clinic
emergency room when a 50 year old gentleman requesting your opinion about surgery as a
presented to you after a trauma to his abdomen . treatment for her IBD . Which sentence will you
His vital signs were blood pressure 110/60 , HR tell her ?
90 , RR 17 , GCS 15/15 . Physical exam his A . Surgery is the primary treatment for Crohn
abdomen is soft but tender on the right upper disease .
quadrant . What will be your best next step ? B . Surgery for ulcerative colitis is curative .
A . DPL . C . Surgery is indicated as prophylaxis for
B . FAST . colorectal cancer in Crohn disease .
C . ICU admission .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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D . Strictures are common indications for surgery D . Keloid scars outgrow the wound area .
in ulcerative colitis . E . Keloid scars have a familial predisposition
E . Recurrence is rare after surgery for Crohn
disease * Spot diagnosis to differentiate Lipoma and
sebaceous cysts is ?
* A 50 year old male felt a pain in his groin after A . Consistency .
lifting a heavy box . He was advised an B . Compressibility .
operation . During the surgery a hernial sac with a C . Fluctuation .
small knuckle of intestine was found protruding D . Attachment to deep muscle .
just below the inguinal ligament . The hernia was E . Slippery edge of the lipoma and the punctum
diagnosed as ? of the sebaceous cyst .
A . Direct inguinal hernia .
B . Indirect inguinal hernia . * All of the following sentences about hernia are
C . Incisional hernia . true except ?
D . Femoral hernia . A . Inguinal hernia is the most common in both
E . Congenital inguinal hernia . females and male's .
B . Incisional hernia is more common after open
* Imaging in surgery , all are true except ? compared with laparoscopic operation .
A . In abdominal X_Ray , the transverse colon can C . Open is always better and safer than
be seen in various locations in the centre of the laparoscopic approach for hernia repair .
abdomen because it is a totally intraperitoneal D . Divarication of rectus abdominis muscles in
organ . elderly does not necessitate surgical repair .
B . Gallstones are usually seen on X_Ray . E . Morbidity is increased after emergency
C . The presence of gas in the small bowel raise compared with elective repair of hernia .
the suspicion of bowel obstruction .
D . Ultrasound is better than CT scan for * A 63 years old male presented as emergency
gallstones detected . with crampy abdominal pain for 4 days and
E . Ultrasound can assess solid organs better associated with vomiting and abdominal
than gas filled organs . distension and constipation , patient denies
weight loss . His past history was only significant
* All of the following sentences about gallstones for previous open appendectomy and open
are true except ? Cholecystectomy . All of the following sentences
A . Obesity and bariatric surgery are risk factors are true except ?
for gallstones formation . A . Abdominal X_Ray ( upright and supine ) can be
B . Cholecystectomy can be performed in postponed for few days .
pregnant women . B . It is essential to obtain an upright CXR .
C . Every patient undergoing Cholecystectomy C . Adhesions are possible cause for this
should be consented about bile leak . condition .
D . Extracarporeal shock wave lithotripsy is not D . Abdominal and groin examination should be
an effective treatment for gallstones . carried out to rule out hernia .
E . Most gallstones are seen on X_Ray . E . He should be admitted for IV fluid hydration
and electrolyte replacement .

* A 35 years old female patient underwent

incision and drainage of a perianal abscess 2
months ago . Now she presented to your clinic
with an intermittent pain and smelly discharge
from the site of previous surgery . What is the
most common problem that would expect and
* Which of the following statement regarding the you should check for ?
differentiation of Keloid scar from hypertrophic A . Perianal fistula .
scar is false ? B . Anal fissure .
A . Keloid scars are most often seen in dark skin C . Incontinence .
people . D . Complication of her hemorrhoids .
B . Hypertrophic scars respond better to E . Necrotizing fasciitis .
treatment than Keloid scars .
C . Keloid scars occur when scar cross joints at * Paget disease of the breast ?
right angle . A . Present any where on the breast skin .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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B . Usually bilateral . A . Colorectal cancer .
C . Uncommon breast carcinoma . B . Sigmoid diverticulitis .
D . Bad prognosis . C . Gastroenteritis .
E . It's diagnosed by mammogram . D . Sigmoid volvulus .
E . Femoral hernia .
* Informed consent for a surgical procedure
involves discussion all of the following except ? * At what age is intussusception most frequent ?
A . The main treatment available . A . Newborns .
B . The individual benefits and risks associated B . Preschool .
with each treatment option . C . School .
C . Wether the operation is entirely necessary and D . Adult .
the effects of possibly not having the procedure E . Infants .
at all .
D . It is acceptable not to mention some risks * A 40 years old female previously healthy ,
that may upset your patient or his family . presented as an emergency with abdominal pain
E . It's good idea to have such discussion in the aggravated by fatty meals , associated with
presence of the close relative . yellowish discoloration of her sclera , vomiting ,
itching , clay color stool and dark urine . No
* 10 cases of food poisoning had been reported history of weight loss . All are true except ?
in hospital . 2 out these developed mild GI A . The cause of dark urine is the increased
symptoms . 4 out these developed moderate conjugated bilirubin in urine .
dehydration but recovered . The characteristic of B . The serum liver function tests will most likely
the organism of food poisoning that produces shows increase alkaline phosphatase .
the severest form of the disease ? C . The serum will most likely show increased
A . Infectivity . level of amylase with decrease level of lipase
B . Pathogenicity . D . The most likely diagnosis in this patient is
C . Resistibility . gallstones and stones in the common bile duct .
D . Communicability . E . This patient need admission , painkillers ,
E . Virulence . rehydration IV fluid , antibiotics and arrangement
for ERCP .
* All of the following increase suspicion of
malignant thyroid nodule except ? * A 28 years old lady complains of painful
A . Age less than 20 years . defecation associated with fresh per rectal
B . Age more than 60 years . blood . Possible diagnosis to consider is ?
C . Pain and tenderness . A . Hidradenitis suppurativa .
D . New Onest of hoarseness . B . Dermoid cyst .
E . Male gender . C . Pilonidal sinus .
D . Anal fissure .
* A 35 years old lady who's otherwise fit and E . Pruritus ani .
healthy , was admitted via emergency
complaining of upper abdominal pain associated * One of the following is false concerning
with nausea and fever . Her initial blood test gastrointestinal stoma ?
showed WBC 16 , HB 12 . What is the best A . Patient with colorectal abdominal perianal
imaging study in this situation ? resection require a permanent stoma .
A . Abdominal ultrasound . B . Ileostomy is usually fashioned with aspout to
B . MRCP . avoid skin irritation .
C . ERCP . C . Colostomy is usually constructed in the right
D . Endoscopic ultrasound . iliac fossa .
E . Abdominal and pelvic computed tomography D . Stoma may be indicated in patients with
scan . bowel ischemia .
* A 70 years old woman presented to the E . Patients with Ileostomy may be need water
emergency department with 3 days history of and electrolyte replacement by IV route .
worsening abdominal pain , vomiting , * A 25 years old thin and tall man suddenly
constipation . On examination you find that she develops left sided chest pain with cough and
has abdomen distended , generalized dyspnea . Provisional diagnosis is ?
tenderness , high pitched bowel sounds . All of A . Atelectasis .
the following are important differential diagnosis B . Pulmonary embolism .
except ? C . MI .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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D . Bronchopneumonia . E . Dysplasia on colonoscopy
E . Pneumothorax .
* In patient who develop a documented episode
* The earliest indication of hypocalcemia is of DVT , the most significant long term sequelae
usually ? is ?
A . Tachycardia . A . Claudication .
B . Positive Chvostek sign . B . Recurrent foot infection .
C . Carpopedal spasm . C . Development of stasis ulcer .
D . Hyperthermia . D . Pulmonary embolization .
E . Tingling of face , nose , hands . E . Diminished arterial perfusion .

* A 60 years old patient is diagnosed with * The commonest hernia type that can been
colorectal cancer , all sentences are true except strangulated is ?
A . Most cases are sporadic ( not related to A . Incisional
inheritance ) . B . Inguinal
B . Cure is possible if the disease is localized . C . Paraumbilical
C . Chemotherapy could be given before or after D . Femoral
surgery . E . Linea alba
D . Bleeding per rectum usually indicates that the
cancer in the Cecum . * Which of the following is the most likely
E . CT scan for chest , abdomen , pelvis is the diagnosis in head trauma patient who loses
usual imaging test for staging . consciousness recovers to have a lucid interval
and again loses consciousness ?
* In a 3 years old boy , painless ballotable mass A . Epidural hematoma .
in the right flank , can be all of the following B . Subdural hematoma .
except ? C . SAH .
A . Wilms tumor . D . Concussion .
B . Neuroblastoma . E . Contusion .
C . Urinary bladder tumor .
D . Mesoblastic nephroma . * All sentences about burn are correct except ?
E . Hyderonephrotic kidney A . Burn area's can be calculated by the rule of
nines .
The following are principles of primary health B . Fluid resuscitation is calculated based on
care except ? burn area .
A . Equity . C . IV fluid resuscitation is necessary in child with
B . Community participation . 10% partial thickness burn .
C . Use of sophisticated technology . D . Prophylactic intubation is rarely indication in
D . Integrated comprehensive services . inhalation burn .
E . Multi _ sectoral approach E . Full thickness burns extends into deep
reticular dermis , yellow white appearance , fairly
Which of the following is true for BCC ? dry texture , painful , needs 3 _ 8 weeks for
A . Painful ulcer is the usual presentation . healing .
B . Metastasis to lymph node is very rare .
C . UV light is not a cause . * All sentences about screening test are true
D . The growth is rapid . except ?
E . Treatment of choice is radiotherapy . A . Screening tests are available for all common
cancers .
B . Most screening tests are not 100% sensitive .
C . No benefit has yet been shown for breast
screening in women under age 40 years .
D . Prostate specific antigen estimation is
* 40 years old male with ulcerative colitis , now currently the best screening tool for prostatic
the exacerbation of GI symptoms . You can cancer .
assess severity with ? E . It takes approximately 10 years for colorectal
A . Erythema nodosum . polyp to develop into a cancer .
B . Anemia .
C . Dose of Salazopyrin . * All sentences about cancer surgery is true
D . Ankylosing spondylitis . except ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 30
A . It is called preventive when it removes a E . Hypoparathyroidism .
potential source of malignancy .
B . It is called curative or primary when it is the * Most common cause of non pitting edema ?
definitive treatment for the present tumor . A . Iatrogenic
C . It is called palliative when the aim is to relieve B . Filariasis
symptoms and improve the quality of the life C . Lymph node resection surgery .
rather than prolong survival . D . Leptospirosis
D . It is called emergency when it deals with E . Chagas disease
problem such as obstruction or perforation .
E . Neoadjuvant chemo or radiotherapy are always * A 19 year old man involved in RTA , found to
required before cancer therapy . have a femur fracture and crush injury to his
foot . After fixation he becomes dyspneic and
* 65 year old male has an entero_cutaneous hypoxemic . The most likely etiology ?
fistula originating from the jejunum , suffered A . Aspiration
from inflammatory bowel disease , which of the B . Atelectasis
following would be the most appropriate C . Fat embolism
replacement of his losses ? D . Fluid overload
A . DW5% E . Pneumonia
B . N/S 3%
C . Ringer lactate * After exposure to suspected rabied animal ,
D . 0.9% sodium chloride which of the following should be given ?
E . 6% sodium bicarbonate solution A . Rabies immunoglobulin and one dose of
vaccine as soon as possible .
* A 84 year old man presents with a small ulcer B . Rabies immunoglobulin then several doses of
on the bridge of his nose . It has been present for vaccine .
a number of months . On examination it has C . Rabies immunoglobulin alone .
pearly white rolled edges . The type of ulcer is ? D . Rabies immunoglobulin and antibiotic .
A . Curling ulcer E . Vaccine and antibiotics .
B . Cushing ulcer
C . Marjolin ulcer * Which of the following supports the diagnosis
D . Rodent ulcer of Hypovolemia ?
E . Venous ulcer A . Urine sodium 28 meq/L
B . Urine chloride 15 meq/L
* Which of the following skin tumors is the most C . Fe Na < 1
common in whites ? D . Urine / serum creatinine ratio of 20
A . SCC E . Urine Osmolarity of 350 mosm/ kg
B . BCC
C . Malignant melanoma * Calcitonin sometimes elaborated by which one
D . Merkel cell tumor of the following tumors ?
E . Dermatofibrosarcoma A . Medullary carcinoma of the breast .
B . Medullary carcinoma of the thyroid .
* All of the following is true regarding the femoral C . Giant cell carcinoma of the pancreas .
triangle except ? D . Carcinoid tumor of appendix .
A . The inguinal ligament forms the base . E . Ganglioneuromas .
B . The medial border is formed by the lateral
border of the adductor longus . * In the management of pyloric stenosis , which
C . The lateral border is formed by the medial of the following is true ?
border of the Sartorius . A . Acidosis should be corrected first .
D . The floor is formed by the adductor longus B . Chloride level is normal in spite alkalosis .
and pectineus muscle medially . C . Hypokalemia should be corrected .
D . Usually there is compensatory hypocarbia .
* A 54 year old man on renal dialysis is found to E . Paradoxical aciduria is not a feature .
have raised serum calcium and PTH . This is * Differential diagnosis of right iliac fossa pain
called ? includes all of the following except ?
A . Primary hyperparathyroidism . A . Tubo _ ovarian mass
B . Secondary hyperparathyroidism . B . Acute pyelonephritis
C . Tertiary hyperparathyroidism . C . Crohn disease
D . Hypercalcemia of malignancy . D . Empyema of the gallbladder
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 31
E . Splenic vein thrombosis C . Calcium phosphate
D . Cholesterol stone
* The GCS for 25 year man involved in RTA in a E . Cystine stone
head on collision with a lorry . On examination he
is unable to obey commands but localizes to * Most common site of volvulus in the colorectal
pain and is able to speak , but appear confused . region ?
He only opens his eyes to pain ? A . Descending colon
A.4 B . Sigmoid
B.6 C . Transverse colon
C.7 D . Rectum
D . 10 E . Ascending colon
E . 13
* 52 year old male patient was found to have
* Which of the following is not associated with Gastrinoma , which of the following is the most
compartment syndrome ? likely location for Gastrinoma ?
A . Disproportionate level of pain . A . Fundus of stomach
B . Absent distal pulses . B . Antrum of stomach
C . Paresthesia . C . The triangle formed by the junction of the
D . Calor = Heat . second and third portion of the duodenum , the
E . Paralysis . junction of the neck and body of the pancreas and
the junction of the cystic and common bile duct .
* 80 year old woman presents with D . The tail of pancreas
hematemesis . She has had intermittent E . The triangle formed by the inferior edge of the
epigastric pain after food for the past 6 months . liver , the cystic duct , and the common hepatic
She has lost weight about 4 kg . She was recently duct .
started on Diclofenac . The most likely cause for
her condition ? * An 18 year old female patient develops urticaria
A . Mallory Weiss tear and wheezing after injection of intravenous
B . Esophagitis contrast for an abdominal CT scan . Her BP
C . Gastric malignancy 120/60 ,HR 155 / min , RR 30 / min , which of the
D . Aortoenteric fistula following is the most appropriate immediate
E . Gastric ulcer therapy ?
A . Intubation
* Which of the following is not an increased risk B . Epinephrine
for venous Thromboembolism ? C . B _ blockers
A . Active cancer D . Iodine
B . Age greater than 60 E . Fluid challenge
C . Thrombophilia
D . Obesity BMI > 30 * Which is gram negative organism ?
E . Surgery to excise scalp lipoma A . Group A Streptococcus
B . MRSA
* What is the first parameter to change in early C . Pseudomonas aeruginosa
hypovolemic shock ? D . Clostridium tetani
A . Systolic blood pressure E . Listeria
B . Pulse rate
C . Diastolic blood pressure * The most reliable indicator of the adequacy of
D . Respiratory rate burn resuscitation is ?
E . Level of consciousness A . CVP
B . PCWP
C . Urine output
D . Blood pressure
E . Heart rate per minute
* A 32 year old man presents with Hematuria . A * The most common site for SCC of the lips is ?
KUB X_Ray reveals a staghorn calculus in the A . Upper lip midline
right kidney and midstream urine , sample grows B . Upper lip laterally
proteus . The most likely stone type is ? C . Lower lip midline
A . Bile pigment stone D . Lower lip laterally
B . Calcium oxalate E . Oral commissure
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 32
 C . Elevated CA 15_3 is associated with certain
* A 39 year old man presents with severe breast cancer .
epigastric pain and right upper quadrant pain . D . Elevated B_HCG is associated with certain
Radiating to the back associated with nausea testicular cancer .
and vomiting . Inspection of the abdomen shows E . Elevated CA 19_9 is associated with
bruising below the inguinal ligament . This sign pancreatic cancer .
is called ?
A . Cullen sign * The spleen filters all of the following particles
B . Boas sign cells except ?
C . Fox sign A . Malformed erythrocytes
D . Grey turner sign B . T lymphocytes
E . Murphy's sign C . Malarial parasites
D . Streptococcus pneumonia
* Pleomorphic adenomas of the salivary glands E . Platelets
are characterized by one of the following ?
A . They occur only in the parotid glands . * Which of the following is not a feature of Crohn
B . They grow rapidly . disease ?
C . They rarely recur if simply enucleated . A . Involvement from mouth to anus .
D . They present as rock _ hard masses . B . Risk of flare up is decreased with smoking
E . They are common benign salivary tumors . C . Macroscopically demonstrates cobblestone .
D . Endoscopically demonstrates skip lesions .
* A 20 year old man involved in RTA sustains E . Histologically demonstrates transmural
bilateral fractured femurs . On assessment , he is granulomatous inflammation .
anxious and confused , with a pulse of 130 / min
and BP of 70/50 mmhg . Urine output over 1 hour * A 45 year old female . Patient presented to E.R
is 10 ml . This patient has hemorrhagic shock complaining of right hypochondriac pain and
type ? nausea with repeated vomiting for the last few
A . Class 1 hours . She recalls eating a cheese cake earlier
B . Class 2 that day . Examination showed right
C . Class 3 hypochondriac tenderness but otherwise soft
D . Class 4 and lax . Her laboratory results were normal . The
E . Class 5 most appropriate next investigation ?
A . Erect abdominal X_Ray
* All of the following are branches from the B . Endoscopy
external carotid artery except ? C . CT abdomen
A . Superior thyroid artery D . Ultrasound of the abdomen
B . Ascending pharyngeal artery E . H1 breath test for H pylori
C . Lingual artery
D . Inferior thyroid artery * A 50 year old man presented to E.R
E . Facial artery complaining of severe epigastric pain of 5 hours
duration . The pain is radiating to his back
* On postoperative day 5 post hepatic resection a associated with recurrent vomiting . His amylase
healthy 55 year old patient is noted to have fever is 2017 u/ L . All of the following criteria are used
38.6 c . Which of the following is the most to predict the severity of the case during
common associated ? admission except ?
A . UTI A . Age over 55 years
B . Wound infection B . Blood sugar more than 200 mg/dl .
C . Pneumonia C . AST more than 250 u/ L
D . Intra_abdominal abscess D . WBC less than 5000 /UL
E . Intravenous catheter related infection E . LDH more than 350 u/ L

* One of the following statement is incorrect ?

A . Elevated CA125 is associated with ovarian * The highest potassium concentrate in ?
carcinoma . A . Saliva
B . Elevated CEA is associated with B . Gastric juice
chondrosarcoma . C . Bile
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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D . Ileal C . Thoracic duct
E . Duodenum D . Esophagus
E. Branches from left gastric artery
* Regarding abdominal trauma in pediatric age
group , which of the following is true ? * A 62 year old male patient presented
A . Clinical examination , stabilization and complaining of bloody diarrhea and cramps , he
resuscitation are not of priority . has recently been started on Clindamycin for
B . Ultrasound is the diagnostic tool of choice . septic arthritis . As he is allergic to penicillin .
C . Blood transfusion should be started Which of the following is the most likely
immediately . diagnosis
D . Peritoneal lavage is contraindicated . A . Campylobacter jujeni diarrhea .
E . Splenectomy is not a routine management for B . Pseudomembranous colitis .
all types of Splenic injuries . C . Salmonella typhi diarrhea .
D . Rectal cancer .
* Which of the following is true regarding the E . Hemorrhoids .
femoral pulse ?
A . It is usually felt at the midpoint of inguinal * One of the following is not a complication of
ligament . gallstones ?
B . The femoral nerve is medial to the femoral A . Intestinal obstruction
pulse . B . Mucocele .
C . The femoral pulse is lateral to the deep C . Acute cholycystitis .
inguinal ring . D . Liver cirrhosis .
D . The femoral pulse is felt at the mid inguinal E . Pancreatitis .
point .
E . A Radio_femoral delay is usually felt in aortic * Which of the following statements is true
stenosis . concerning Meckels diverticulum ?
A . It's found within 2 inches of the ileocecal
* Which of the following is not true regarding valve .
sepsis ? B . It's a remnant of the embryonic vitelline duct .
A . Tachycardia and / or tachypnea may be a C . Ectopic colonic epithelium is found in it .
sign . D . Diagnosis is best made by CT_ scan .
B . Sepsis is defined as systemic inflammatory E . It's usually found on the mesentric border of
response syndrome in the presence of infection . the bowel .
C . Leukocytosis or leukopenia may be a sign .
D . Sepsis and hypotension is defined as septic * A 34 years old male patient presented after
shock . being in RTA with severe shortness of breath .
E . Temperature greater than 38 or less than 36 Examination revealed a deviated trachea to the
may be a sign . left side . Absent breath sounds on the right side
of the chest . The best initial management option
* Regarding the oxygen dissociation curve , one for this patient is ?
is true ? A . Intubate the patient .
A . Is shifted to the left by increase 2.3 _ DPG . B . Insert a chest tube on the right side .
B . Is Sigmoid shape for both hemoglobin and C . Do a chest X_Ray then manage accordingly .
myoglobin . D . Insert a needle thoracostomy followed by a
C . Is shifted to the left when one ascends to high chest tube in the right side of chest .
altitude . E . Insert 2 large bore cannulas and give 1 liter of
D . Is shifted to the right by an increase in the PH ringer lactate .
E . Is ideally 50% saturated at a PO2 of 28 mmhg
* All of the following are true regarding colon
cancer except ?
A . It's the second most common cause of
cancer related death in Jordan .
B . A ( T1 N1 M0 stage 3 ) tumor is equivalent to
Duke stage C tumor .
* One of the following passes through the aortic C . A majority of colorectal cancers occur in the
hiatus in the diaphragm ? descending colon .
A . Vagal trunks D . FAP and HNPCC are two inherited causes of
B . Right phrenic nerve colorectal cancer .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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E . Patients with primary sclerosing cholangitis A . Myelolipoma
and ulcerative colitis have increased risk of B . Cushing disease
developing colon cancer . C . Adrenocortical adenoma
D . Pheochromocytoma
* One of the following is false regarding E . Carcinoid tumor
crystalloid solutions ?
A . Osmolarity of Ringer lactate solution 273 * 60 kg woman involved with extensive burns .
mosm L . On physical exam found to have pink to red skin
B . Ringer lactate contain 154 meq/L sodium . colour , slightly swelling and pain , dry skin on the
C . Readily pass through semi _ permeable head . Her left arm and leg have dry white
membrane , therefore they are considered painless burns and her anterior torso has
extravascular space expanders . Erythematous painful burns with blistering. How
D . Have poor capillary perfusion and no allergic much fluid she require ?
reaction and short intravascular half life 20_30 A . 2500 ml
minutes . B . 10800 ml
E . Hartmann solution , 0.9% NaCl solution , 5% C . 8640 ml
Dextrose in water are isotonic crystalloid D . 12960 ml
solutions . E . 17280 ml

* How much calories per liter in D_Dextrose 5% ? * A patient has the following ABG , PH = 7.56 ,
A . 150 PCO2 = 50 mmhg , PO2 = 85 mmhg , HCO3 = 40
B . 170 meq/L . What is the acid base abnormality ?
C . 180 A . Uncompensated metabolic alkalosis .
D . 200 B . Respiratory acidosis with metabolic
E. 250 compensation .
C . Combined metabolic and respiratory alkalosis
* A 66 years old woman falls fracturing the D . Metabolic alkalosis with respiratory
surgical neck of humerus . Sex months later she compensation .
is unable to abduct her arm's above her hand . E . Mixed respiratory and metabolic alkalosis .
Most likely nerve injury ?
A . Median nerve * Most common thyroid tumor that spread via
B . Radial nerve . lymphatics ?
C . Ulnar nerve A . Follicular
D . Axillary nerve B . Anaplastic
E . Musclo_cutaneous nerve C . Medullary
D . Papillary
* A 45 years old female found to have wasting of E . Lymphoma
intrinsic muscle , of the hand , weakness and
pain in the wrist , most likely nerve injury ? * All of the following are causes of blood stained
A . Ulnar nerve nipple discharge except ?
B . Radial nerve A . Intraductal papilloma
C . Median nerve B . Carcinoma
D . Axillary nerve C . Ductectasia
E . Thenar and hypothenar nerves D . Fibrocystic disease
E . Fat necrosis of breast
The following causes of Hypercalcemia except ?
A . Sarcoidosis * Which of the following pathologies is thought to
B . Primary hyperparathyroidism have no malignant potential ?
C . Acute pancreatitis A . Ulcerative colitis
D . Metastasis bronchial carcinoma B . Villous adenoma
E . Milk Alkali syndrome C . FAP
D . Hyperplastic polyps
E . Crohn disease

* What is the most likely diagnosis in a 45 year

old male patient with HTN development of * Which of the following vaccines are live ?
facial hair and 7cm suprarenal mass ? A . H influenza type B
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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B . Diphtheria A . Medullary carcinoma of the breast .
C . OPV B . Papillary thyroid carcinoma .
D . Hepatitis B C . Giant cell carcinoma of the pancreas .
E . H influenza A D . Carcinoid tumor .
E . Ganglioneuromas .
* One of the following is true regarding the
electrolyte concentration in Hartmann solution ? * Capillary refill time is elicited by ?
A . Chloride 200 mmol/L A . Pressing over the skin for 3 seconds ,
B . Lactate 70 mmol/L normally return perfusion by 2 seconds .
C . Sodium 131 mmol/L B . Pressing over the skin for 5 seconds , normally
D . Potassium 40 mmol /L return perfusion by 2 seconds .
E . Calcium 15 mmol/L C . Pressing over the skin for 5 seconds, normally
return perfusion by 5 seconds .
* All are true regarding Heparin except ? D . Pressing over the skin 10 seconds , normally
A . It's heterogeneous mixture of sulfated return perfusion by 5 seconds .
polypeptides . E . Pressing over the skin for 2 seconds ,
B . Potentiates the actions of antithrombin 3 . normally return perfusion by 5 seconds .
C . Has a half life of a 90 minutes .
D . Can be reversed by protamine sulphate . * All of the following are true regarding neck
E . Can induce an idiosyncratic lumps except ?
thrombocytopenia . A . Thyroglossal cysts move upwards on
protrusion of tongue .
* All of the following fistulas are unlikely to close B . Branchial cysts typically present in the first
spontaneously except ? decade of life .
A . Fistulas secondary to malignancy . C . Thyroid masses move upwards on swallowing
B . Fistulas due to Crohn disease . D . Cystic hygromas are lymphatic malformation .
C . Fistulas with epithelized track . E . Parotid glands are not normally palpable .
D . Fistulas with long track .
E . Fistulas with foreign bodies . * A 50 years old man is admitted to hospital with
severe bleeding and bruising . He is on warfarin
* A palpable radial pulse indicate a systolic blood and his INR is 10 . For rapid complete reversal of
pressure greater than ? his INR , which of the following mostly used ?
A . 40 mmhg A . Platelets .
B . 60 mmhg B . FFP and vitamin K .
C . 80 mmhg C . IV vitamin K .
D . 100 mmhg D . Whole blood and vitamin K .
E . 120 mmhg E . Fresh frozen and vitamin C .

* The main reason of delay of eradication of * All are true about thyroid gland except ?
measles in Jordan is ? A . It's composed of two lobes , weighs 25 grams
A . Migration or refugee from neighbor Arab in adult , each lobe 5 cm long , 3 cm wide , 2 cm
countries ( Iraq , Syria ) due to thick .
unstable conditions in their countries . B . Epiglotic cartilage lie just above the gland .
B . Immunization coverage rate is low in Jordan . C . It extends from first tracheal ring up to sixth
C . High cost of vaccine . tracheal ring .
D . Cold chain of vaccine is not accurate . D . Infrahyoid muscles lie in front , and
sternocleidomastoid muscle to the side of the
* One is true regarding electric burns ? gland .
A . Injuries are generally more superficial than E . It has follicles , follicular cells , and
those with thermal burns . parafollicular cells .
B . Intravenous fluid replacement is based on the
percentage of body surface area burnt . * The major risk factor for mastitis ?
C . Electric burns often result in transient A . DM .
traumatic optic neuropathy . B . Twins .
D . Evaluation for fracture of the other extremities C . Breast cancer .
and visceral injury is indicated . E . Cardiac D . Breast feeding
conduction abnormalities are unlikely . E . Bad hygiene .
* 5_HIAA is tested in which of these disease ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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* Most common symptom in rectal cancer ? E . Melanoma
A . Bleeding per rectum * Most sensitive laboratory test for thyroid
B . Weight loss . function ?
C . Pain per rectum . A . T3
D . Change bowel habits . B . T4
E . Constipation . C . TSH
D . TRH
* Most common cause of Acute pancreatitis in E . TBG
children ?
A . Alcohol . * Most common type of anal cancer ?
B . Congenital . A . Adenocarcinoma
C . Drugs . B . Melanoma
D . Blunt trauma C . SCC
E . Gallbladder stone D . BCC
E . Cloacogenic carcinoma
* Most significant initial complication of acute
pancreatitis is ? * Most common cause of anal stricture ?
A . DM . A . Post hemorrhoidectomy
B . Pseudocyst . B . Hemorrhoids
C . ARDS C . Anal fissure
D . Exocrine insufficiency . D . Perianal abscess
E. Hemorrhagic peritonitis E . Perianal hematoma

* Most important point in diagnosis acute * Shock is defined as ?

appendicitis ? A . Bradycardia .
A . Laboratory result . B . Hypothermia .
B . Pain in right lower quadrant . C . Hypoperfusion at the tissue level
C . Shifting of pain . D . Hypotension .
D . History and physical exam E . Loss of consciousness
E . Low grade fever and Leucocytosis .
* Most common cause of upper GI bleeding ?
* Most common site of ischemic colitis ? A . Chronic gastric ulcer .
A . Splenic flexure B . Mallory Weiss syndrome .
B . Hepatic flexure C . Chronic duodenal ulcer
C . Ascending colon D . Gastric cancer .
D . Transverse colon E . Varicose veins of esophagus
E . Iliocecal valve
* Most common cause of lower GI bleeding ?
* Most common site of Angiodysplasia ? A . Colorectal cancer .
A . Rectum B . Ischemic colitis .
B . Transverse colon C . Angiodysplasia .
C . Descending colon D . Diverticular disease
D . Ascending colon E . Hemorrhoids .
E . Cecum
* Lateral internal sphincterotomy is the treatment
* Most common site for distant metastasis for of choice for ?
breast cancer ? A . Hemorrhoids .
A . Bone B . Anal fissure
B . Lung . C . Perianal abscess .
C . Brain . D . Perianal hematoma .
D . Liver . E . Intrasphincteric abscess
E . Lymphatic nodes .
* First priority in multiple injured patient is ?
* Most common soft tissue tumor ? A . Ribs fracture .
A . Osteoma B . Cut wound .
B . Epithelioma C . Tension pneumothorax
C . Lipoma D . Femur fracture .
D . Rodent ulcer E . Subdural hematoma .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 37
* Most common cause of bleeding per nipple ? * One of the following is contraindication for
A . Fibrocystic disease of breast . surgical treatment of varicose veins ?
B . Intraductal papilloma A . DVT
C . Breast cancer . B . Old age
D . Paget disease . C . Pregnancy
E . Fibroadenoma . D . Bilaterally
E . Peripheral vascular disease
* Most common thyroid gland cancer ?
A . Anaplastic * Most common microorganism that cause
B . Papillary infection in diabetic foot ?
C . Follicular A . Staphylococcus aureus
D . Medullary B . Pseudomonas
E . Lymphoma C . Mixed
D . Listeria
* Treatment of choice of liver cancer mostly ? E . Clostridium perfringens
A . Palliative
B . Surgical resection * Most common salivary glands cancer ?
C . Radiation A . Warthin tumors
D . Chemotherapy B . Mucoepidermoid carcinoma
E . Symptomatic C . Adenoidcystic cancer
D . Adenocarcinoma
* First anatomical structure that compressed in E . Malignant mixed cancer
compartment syndrome ?
A . Fascia * Treatment of choice in Hypovolemic shock ?
B . Muscles A . 0.45% Normal saline
C . Arteries B . Albumin
D . Veins C . Blood products
E . Nerves D . 0.9% Normal saline
E . Ringer lactate
* The first Sign of compartment syndrome ?
A . Pallor and pulselessness * Most specific tool for spleen injury ?
B . Coldness A . CT scan
C . Tingling and Paresthesia B . Abdominal ultrasound
D . Pain C . Abdominal X_Ray
E . Paralysis D . DPL
E . Angiography
* One of the following a cause of increasing
intracranial pressure ? * Most common cause of Incisional hernia ?
A . Exercise A . Wound infection
B . Fever B . COPD
C . Stress C . Acute appendicitis
D . Pulmonary embolism D . Wound hematoma
E . Valsalva maneuver E . Ascites

* It is difficult to diagnose acute appendicitis in * First to do in multiple trauma patients ?

all of the following A . Immobilization
except ? B . Breathing
A . Old age C . Blood pressure
B . Athletes D . Pupil reaction
C . Children E . Airway obscure
D . Pregnancy
E . HIV patients * Most common cause of large bowel
obstruction
A . Polyps of the colon
B . Hirschsprung disease
C . Colon cancer
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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D . Ischemic colitis B . N2O
E . Ulcerative colitis C . N2
D . Co2
E . He
* All are risk factors for colorectal cancer except * Anesthetic drug that has analgesic and
A . Ulcerative colitis anesthetic effect ?
B . Juvenile polyposis A . Isoflurane
C . Crohn disease B . Sevoflurane
D . FAP C . Thiopental sodium
E . Gardner syndrome D . Suxamethonium
E . Ketamine
* Transformation of ulcerative colitis to
malignancy is related to ? * All of the following side effects of morphine
A . Activity of disease except ?
B . Race of the patients A . Nausea
C . Immunity of the patients B . Vomiting
D . Duration of disease C . Cough
E . Drugs administration D . Myosis
E . Respiratory depression
* All are causes of persistent Hypotension except
A . Heart failure stage 4 * The strongest relation between lung cancer and
B . Pneumothorax one of the following ?
C . Inadequate IV fluids in shock patients A . Tuberculosis
D . Persistent external bleeding B . Asbestosis
E . Hidden internal bleeding C . Byssinosis
D . Pneumoconiosis
* One of the following is contraindication for NG E . Silicosis
tube placement ?
A . Acute pancreatitis * All of the following operations need antibiotics
B . Intestinal obstruction prophylaxis except ?
C . Drug poisoning A . Thyroidectomy
D . Basal skull fracture B . Hemicolectomy
E . Laparoscopic surgery C . Appendectomy
D . Pulmonary lobectomy
* All are causes of Hypersplenism except ? E . Cholecystectomy
A . Liver cirrhosis
B . Portal HTN * Glasgow coma scale includes . All of the
C . Sarcoidosis following except ?
D . HCC A . Motor response
E . Papillary thyroid cancer B . Eye's movement
C . Verbal response
* Most common liver cancer ? D . Pain response
A . Hepatoblastoma E . Pupil reaction to night
B . Fibrolamellar carcinoma
C . Adenocarcinoma * One of the following is water borne disease ?
D . HCC A . Scabies
E . SCC B . Mycoplasma
C . Chlamydia
* Most important point in intravenous fluid of D . Typhoid fever
patient with burn ? E . Hepatitis C
A . Body surface area percentage
B . Grade of burns * All are specific complications of thyroid surgery
C . Site of burns except ?
D . Type of burns A . Dental caries
E . Clinical picture of the patient B . Airway obstruction
C . Convulsions
* Gas that used in laparoscopic operations ? D . Hypoparathyroidism
A . O2 E . Hypothyroidism
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 39
 E . Direct inguinal hernia is a congenital hernia .

* Percentage of liver tissue that should be * The true arrangement for gastrointestinal tract
maintain after liver resection recovery after any abdominal surgery ?
for donation porpoises ( if liver was completely A . Stomach then colon then small bowel .
healthy ) ? B . Colon then small bowel then stomach .
A . 0.8 C . Stomach then small bowel then colon .
B . 8% D . Small bowel then stomach then colon
C . 80% E . Small bowel then colon then stomach .
D . 20%
E . 0.2% *One of the following is false concerning
gastrointestinal stoma ?
* Newborn presented with hypersalivation , A. Patient with abdomenoperitoneal reaction
irritability , Cyanosis , coughing , choking , require a permanent stoma .
gagging , malpositioning of a NG tube . The most B. Iliostomy is usually fashioned with a spout to
likely diagnosis ? avoid skin irritation .
A . Duodenal atresia C. Colostomy is usually constructed in the Rt iliac
B . Pyloric stenosis Fossa .
C . Esophageal atresia D. Patient with Iliostomy may need water and
D . Diaphragmatic hernia electrolytes replacement by IV .
E . GERD E. Stoma may be indicated in patient with bowel
ischemia
* 7 years old child , presented with submental
swelling , hotness , redness , it was very painful , * all sentences About a colles fracture are true
the most likely diagnosis ? except ?
A . Cystic hygroma A. A fracture with mild angulation may require
B . Thyroglossal cyst closed reduction .
C . Lipoma B. Usually produced by fall on out stretched hand
D . Dental caries C. Defined as a fracture of the distal radius with
E . Submental abscess ventral displacement .
D. Occur more frequently in elderly persons as a
* 5 years old child presented with midline neck result of osteoporosis .
swelling , that protruded with swallowing or no E. Could be complicated by neuropathy and
protrusion of the tongue , the most likely volkman ischemic contracture .
diagnosis ?
A . Thyroglossal cyst * All the following are true about pulse oximetry
B . Cystic hygroma except ?
C . Thyroid lymphoma A. Presence of smoke inhalation injury and may
D . Cleft bronchial cyst lead to a falsely elevated pulse
E . Thyroiditis oximetry .
B. Nails Polish should be removed before any
* 35 years old male patient present with painless surgery because it affects reading
pulsatile femoral swelling in the inguinal area , on the pulse oximeter .
the most likely diagnosis ? C. Ear probes can detect changes on oxygen
A . Inguinal hernia saturation faster than finger probes .
B . Femoral hernia D. It depends on the fact that oxygenated and
C . Varicose veins deoxygenated Hb absorb red and
D . Lipoma infra red light differently .
E . Aneurysm E. It's reading are not affected by the
temperature of patient hand.
* One of the following is true about inguinal
hernia ?
A . Femoral hernia is more common than inguinal
B . Direct hernia is more common than indirect .
C . Treatment of choice is Herniorrhaphy
D . Most common seen in females .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 40
* You have been asked to consent a patient for * Severe electrical burn , one is true ?
insertion of a central line you counsed the patient A . Causes most of it's damage of the exit site .
* through the reason for the procedure, what is B . Is usually more sever it caused by direct
the most common immediate complications of current rather than alternating current .
central line insertion ? C . Frequently causes a muscle injury more like
A. Infection . crush injury .
B. Thrombus . D . Tends to resolve quickly in patients who
C. Hemorrhage . survive the initial injury .
D. Pneumothorax . E . Is usually treated according to the extent of
E. Air embolism . thermal and underlying subcutaneous tissue
damage .
* which of the following is true about testicular
tumors ? * All sentences about burn are correct except ?
A. The incidence of germ cell tumors has A . Circumferential superficial partial thickness
decreased over the past 20 years . burn causes compartment syndrome .
B. An elevated lactate dehydrogenase is indicator B . Deep partial thickness burn appears more
of good prognosis . pale and mottled to superficial degree .
C. Orchidectomy should be performed only after C. Blister can form in both superficial and deep
confirmation of diagnosis with partial thickness .
frozen section . D . Sun burn cause superficial partial thickness
D. Elevated alfa feto protein is found in 75% of burn .
patient with pure seminoma . E . Skin grafts are not required in managing
E. Orchidectomy and nodal radiotherapy result in partial thickness .
a cure rate of 98% in stage 1 seminoma .
* To allow kidney donation from a young patient
* Regarding simple appendicitis , all are true intubated in the ICU , a brain death need to
except ? confirmed first , all of the following examination
A . Periumbilical pain is visceral in nature and finding are consistent with brain death except ?
occurs early . A . Dilated non reactive pupils .
B . Right iliac fossa pain is somatic in nature and B . Absent oculocephalic reflex .
occurs later . C . Extensor posturing .
C . Positive rebound tenderness means D . Absent gag reflex .
peritoneal irritation . E . Absent corneal reflex .
D . CT scan is the preferred imaging test for
appendicitis in females and children . * A 56 years old woman presented with sever
E . Meckel diverticulum may mimic the clinical upper abdominal pain related to her back and
picture of appendicitis . associated with nausea and vomiting , her serum
lipase level was 6300 u/ L . The patient was
* 57 years old patient presented with nocturia ( 3 given intravenous analgesia . What is the best
time / night ) , weak stream intermittency and and most important next step in management ?
frequency , his digital rectal examination revealed A . Begin intravenous fluid resuscitation and
induration of the right lobe of prostate . All of the oxygen supplement .
following statements are appropriate except ? B . Begin prophylactic antibiotics to minimize the
A . Treat the obstructive symptoms . risk of pancreatic infection .
B . Perform ultrasound for residual urine C . Change her diet to clear liquids by mouth only
assessment . D . Obtain a contrast enhanced CT scan of the
C . Blood sample for prostate specific antigen is abdomen .
not usually required . E . Obtain a right upper quadrant ultrasound .
D . This patient most likely needs prostate biopsy
E . His past history and medication have to be * Which of the following statements is true
checked . regarding varicocele ?
A . They should be looked for while the patient is
supine .
B . They usually result infertility .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 41
C . They may affect sperm motility and count . E . Uric acid stones are not visualized by CT scan .
D . They result in lower testicular temperature .
E . They should always be required when
identified .
* A postoperative patient is being managed on a * All sentences about abdominal hernias are true
intensive care unit following subtotal colectomy . except ?
Blood result shows the phosphate level is 0.25 A . Most umbilical hernias in adult are acquired .
mmol/L . Which one of the following statement B . Incisional hernia results from a failure of
regarding intravenous phosphate is incorrect ? fascial tissue to heal and close after surgery .
A . May cause Hypercalcemia . C . Incisional hernia is more common after open
B . Should never be given at rate greater than 30 compared with laparoscopic operation .
mmol over 6 hours . D . Lumbar hernia is not common hernia .
C . Should preferentially be given via a central E . Divarication of rectus abdominis muscles in
line . elderly necessities surgical repair .
D . May cause metastatic calcification .
E . Should be used even if the patient is * Optimal medical therapy in a patient with
asymptomatic . carotid artery stenosis would include ?
A . Smoking cessation .
* 25 years old female patient presented to B . Antiplatelet agent's .
emergency room after being involved in road C . Control HTN .
traffic accident, 2.5 hours ago as a driver . She D . Statins drug's .
complains of right sided headache and can't E . All are true .
remember the accident . Examination showed a
deformed fracture on the right side of her skull . * Skin cancer can result from exposure to one of
You sent the patient for CT of her head . After CT the following ?
the patient suddenly became unresponsive . The A . Microwave .
CT will most likely show ? B . Ionizing radiation .
A . Epidural hematoma . C . Solar ultraviolet A .
B . Chronic subdural hematoma . D . X ray .
C . Subarachnoid bleeding . E . Infrared rays .
D . Intraventricular bleeding .
E . Diffuse axonal injury . * Acute pyelonephritis is best diagnosed by ?
A . Vesicoureteral reflux .
* Routine tracheostomy , with few exceptions is B . Bacteriuria and pyuria .
typically performed at the level of ? C . Delayed renal function .
A . Cricoid cartilage . D . Focal scar in renal cortex .
B . Cricothyroid membrane . E . Chills , fever and flank pain
C . Cricoid and first ring .
D . Second ring and third ring . * All sentences about appendicitis are true
E . Fifth and sixth tracheal ring . except
A . Mcburney point corresponds to the location
* Which of the following diagnosis is most likely of the tip of appendix .
in a child with HTN and past history of UTI ? B . Psoas sign is elicited by extension of the right
A . Ureteropelvic junction obstruction . hip .
B . Reflux nephropathy . C . Laparoscopy is one of the diagnostic
C . Wilms tumor . methods
D . Renal artery stenosis . D . Rovsing sign is elicited by pressing in the left
E . Posterior urethral valve . iliac fossa causing pain in the right iliac fossa .
E . Alvardo score is not routinely calculated for
* All of the following are true regarding the diagnosis of appendicitis .
computerized tomography used in urology
except * One of the following vaccines can't be given to
A . CT without contrast is the imaging of choice immunocompromised patient ?
for acute flank pain . A . Hepatitis B .
B . CT with contrast is preferred in renal trauma . B . DPT .
C . MRI is more sensitive in evaluating adrenal C . Influenza vaccine .
masses . D . Inactivated polio vaccine .
D . CT is not operator dependent . E . Oral polio vaccine .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 42
 D . The cause of tea color urine is increased
* All of the following are true regarding conjugated bilirubin in urine .
Hirschsprung disease except ? E . The serum liver function test will most likely
A . There is no ganglion cells in Auerbach plexus show decreased alkaline phosphatase .
B . There is an increased incidence of Down
syndrome .
C . It is more common in girls .
D . On X _ ray the affected bowel is narrowed
distally , while the normal bowel * Regarding breast cancer , all of the following is
is dilated proximally . true except ?
A . Peau d Orange appearance of the breast
* All of the following are true about diverticulosis indicate advanced stage .
coli except ? B . Eczema around the nipple should always be
A . Sigmoid colon in the commonest site . investigated .
B . Are considered false diverticulum and it C . Trucut biopsy is more accurate than the
mucosa is lined by normal colonic cell . needle aspiration ( FNA) .
C . The affected patient may present with D . Bloody nipple discharge could be due to a
bleeding per rectum . benign cause .
D . Surgery is the primary treatment for E . Palpable lymph node supraclavicular fossa
diverticulosis . indicate distant metastasis .
E . Low fiber diet is a risk factor for this condition
* A 25 years old lady was admitted via
* All sentences about neck of femur fracture are emergency complaining of abdominal pain and
true except ? suspected to have acute gallstone pancreatitis
A . Typically occur in elderly female patient . based on symptoms and blood tests . What is
B. Leg may be shortened and internally rotated in the best initial imaging study in this situation ?
displaced fracture . A . Abdominal and pelvic computerized
C . AVN is more common in this place than at tomography .
other site's in the body . B . Endoscopic ultrasound .
D . Almost always will require corrective surgery . C . MRCP .
E . Prognosis is poor in general . D . ERCP .
E . Abdominal ultrasound .
* All of the following sentences about hernia are
true except ? * In infantile hypertrophic pyloric stenosis , one of
A . Inguinal hernia is the most common hernia in the following statements is false ?
both females and male's . A . The infant usually presents with projectile
B . Femoral hernias are most common in females bilious vomiting .
than male's . B . The treatment is surgical by Ramstedt
C . Morbidity is increased after emergency operation .
compared with elective repair of hernia . C . Symptoms commence at the age of 3 _ 4
D . Urinary hesitancy and straining increase the weeks .
risk for hernia formation . D . A palpable olive shaped mass is usually felt in
E . Open is always better and safer than the classical case .
laparoscopic approach for hernia repair E . Ultrasound is usually diagnostic .

* A 28 years old female , previously healthy , * At 2 day's after a motor vehicle crash , an
presented as an emergency with abdominal pain otherwise healthy 30 years old man is recovering
aggravated by fatty meals , and associated with in the ICU from rib fractures , pulmonary
jaundice , vomiting , itching , clay color stool , tea contusion , and a liver laceration . He complains
color urine , no history of weight loss . All are true of increasing right upper quadrant pain and
except ? vomits bright red blood . Which of the following
A . This patient need admission , pain killer's , approaches is best ?
rehydration , IV fluids + _ antibiotics . A . Operative exploration and liver resection .
B . The most likely diagnosis gallstones and B . Hepatic artery ligation .
stone in the common bile duct . C . Angiographic arterial embolization .
C . The cause of clay color stool is absence of D . ERCP with sphincterotomy .
stercobilinogen from stool .

‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬

Page 43
* 50 years old woman came to your clinic stating A . It's complication include stenosis , aneurysm
that she has a one month history of a palpable and heart failure .
right breast lump . On examination , you can feel B . Renal dialysis is the most common indication
a 1 cm mobile , firm nodule at 2 o'clock position . to create it .
Your first diagnostic test of choice is ? C . Palpable thrill and audible bruit over the fistula
A . Excisional biopsy . indicate that is thrombosed .
B . Incisional biopsy . D . Paleness and coldness of the hand during
C . CT scan . exercise and dialysis indicate the presence of
D . Mammogram . steal syndrome .
* A 41 year old gentleman came to your clinic E . The three most common sites are
complaining of respiratory symptoms . Your radiocephalic , brachiocephalic , and
differential diagnosis is pleural effusion versus brachial artery to transposed basilic vein .
pneumothorax . Which of the following physical
findings will best help you differentiate between * Regarding the preoperative management all
these two possibilities ? sentences are true except ?
A . Respiratory rate 33 breaths / minute . A . A recent myocardial infarction is the most
B . Agitation due to respiration distress . important risk factor for perioperative myocardial
C . Decreased breath sounds over the affected infarction .
hemithorax . B . Patients should take their regular
D . Dullness to percussion over the affected Antihypertensive drug's even on the day of
hemithorax . surgery .
C . History and examination alone are not usually
* All of the following are classic signs of basal sufficient in evaluating the risk of bleeding .
skull fracture except ? D . LMWH is used in venous thromboembolism
A . Raccoon eyes . prophylaxis .
B . Battle sign . E . Poorly controlled blood sugar in the
C . Hemotympanum . preoperative period increases the risk for
D . Dilated non reactive pupils . surgical site infections .
E . Cerebrospinal fluid rhinorrhea .
* 40 year old male come to your clinic asking for
* All of the following are true about the advice about his anal fissure . One of the
assessment of bleeding except ? following sentences is an appropriate advice ?
A . Taking blood sample at the time of bleeding A . Surgery is primary treatment for acute anal
gives an accurate level of haemoglobin . fissure .
B . Hypovolemia increase the risk of tissue B . Anal fissures are usually located in the lateral
hypoxia and multi organ failure . aspect of the canal .
C . Blood loss could be estimated from the size C . Anal fissure in patients with Crohn disease
of blood clot and the weight of swabs used . usually indicate malignancy .
D . Any thirsty patient should be considered D . Medical treatment is successful in 20% of
Hypovolemic . case's .
E . Arterial blood gas is a quick method to E . Surgical treatment may be complicated by
measure hemoglobin incontinence

* All of the following sentences are true about * 53 year old female presented as an emergency
pathophysiology of shock with crampy abdominal pain for 4 days and
except ? associated with vomiting , abdominal distention
A . Shock means inadequate oxygen delivery to and constipation . Patient denies weight loss .
meet metabolic demands . Her past history was only significant for previous
B . Shock may occur without loss in the open appendectomy and open cholecystectomy .
circulating volume . Abdominal examination did not reveal an
C . Severe infection may lead to decreased Incisional hernia . All of the following sentences
cardiac preload . are true except ?
D . Serum lactate decreases in shock . A . She should be admitted for intravenous fluid
E . The function of phagocytes is decreased in hydration and electrolyte replacement .
shock . B . As female patient , groin examination can be
postponed for few days .
* All sentences about arteriovenous fistula are C . Adhesion are the most likely cause for her
true except ? condition .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 44
D . It is essential is to obtain an upright chest x D . Diminished left sided breath sounds , tracheal
Ray . deviation to right .
E . It is essential is to obtain an abdominal x Ray E . Hypotension , adjacent three fractured in two
places .
* All of the following are symptoms and signs of
hypothyroidism except ?
Low body temperature
Amenorrhea * All of the following are true regarding chronic
Constipation lymphocytic ( Hashimoto ) thyroiditis except ?
Weight gain It is the most common inflammatory thyroid
* All of the following sentences about gallstones disorder .
are true except ? Leading cause of hypothyroidism .
A . Gallstones in diabetic patients are more Autoimmune , inherited .
dangerous due to silent cholecystitis . Malignancy found in 15% of the cases .
B . Obesity and sickle cell anemia are risk factors Age of presentation is 30_50 years
for gallstones formation .
C . Cholecystectomy can be performed in * All of the following are indications for
pregnant woman . thyroidectomy in thyroid cyst except ?
D . Every patient undergoing cholecystectomy Failure to do complete aspiration .
should be consented about bile leak . Large cyst > 4 cm .
E . Extracorporeal shock wave lithotripsy is one Complex cyst ( solid _ cystic ) .
of the effective treatments for gallstones . Recurrence after frequent aspirations .
If it is painless .
* All sentences about sialolithiasis are true
except ? * The most common malignant liver mass ?
A . Parotid gland is the most common site of Hepatocellular carcinoma
salivary calculi . Hepatoblastoma
B . Salivary calculus contains debris bacteria , Angiosarcoma
mucous , magnesium and phosphates . Lymphoma
C . Easily demonstrated by x Ray . Metastatic tumor
D . Most occur in middle aged adults .
E . The main symptoms are pain and swelling * Most of the cases of liver cancer are advanced
before and during eating . at time of diagnosis because all of the following
except ?
* A 42 year old morbidly obese white woman Symptoms usually don't appear until late in the
( BMI = 40 ) presents to your office requesting disease .
information on screening for colon cancer , she is Liver cancer grow quickly .
asymptomatic and has a colonoscopy for her is Liver tumors resemble those of other medical
which of the following ? conditions .
A . She should have received a colonoscopy Liver cancer can't be diagnosed using a standard
between age 10 _ 12 . liver tests .
B . She should have received a colonoscopy Liver tissue is not able to regenerate to replace
between age 20 _ 25 . the damaged tissue
C . She should have received a colonoscopy at
age 40 . * Mondors disease is a variant of
D . She should receive a colonoscopy at age 45 . Thrombophlebitis that involves the superficial
E . She should receive a colonoscopy at age 50 . veins of ?
The anterior chest wall and breast .
* A 39 year old patient presented to you at the The thighs .
emergency room after chest trauma . Which of The legs .
the following scenarios is most consistent with The scrotum .
left tension pneumothorax ? The vagina .
A . Hypotension , distended neck veins , midline
trachea and muffled heart sounds . * The dominant etiologic factor in Acute
B . Hypotension , open 4 cm 215 , 4 cm lateral appendicitis is ?
chest wound . Travelling infection from large bowel .
C . Hypotension , diminished breath sound on the Decrease local immunity of appendix .
left tracheal opacification of the left hemithorax . Part of inflammatory bowel disease .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 45
Obstruction of the lumen by fecaliths .
Distal colonic obstruction .

* The Body mass index of the normal weight is ? * A 15 year old boy awakens with sudden onest
15_19 kg/m2 of right scrotal pain and tenderness
20_25 kg/m2 accompanied by nausea and vomiting . Which of
26_29 kg/m2 the following is the most appropriate diagnosis
30_34 kg/m2 and represents a surgical emergency ?
35_39 kg/m2 Acute prostatitis
Acute epididymitis
* Disadvantages of laparoscopy when compared Torsion of the testicle
with laparotomy include all of the following Acute appendicitis
except which ? Orchitis
Difficulty controlling severe bleeding .
Poorer visualization of the operative fields . * All are true regarding achalasia except ?
Greater difficulty placing sutures . Dysphagia to both solids and liquid is classic .
Loss of tactile sensation . Barium swallow reveals a birdlike narrowing in
Higher operating room costs . the distal esophagus .
Treatment of choice is total gasterectomy .
* Laparoscopic Cholecystectomy is indicated for Usually associated with weight loss .
all of the following conditions except which ? The underlying defect is failure of the lower
Biliary dyskinesia . esophageal sphincter to relax .
Initial treatment in patients with severe
Cholangitis . * One of the following is the most common
Acute Cholecystitis . cause of massive upper GI bleeding ?
Symptomatic cholelithiasis . Gastritis
Biliary pancreatitis . Duodenal ulcer
Oesophagitis
* The most common cause of pyogenic liver Mallory Weiss syndrome
abscess is ? Esophageal varices
Hematogenous infection .
Lymphatic spread . * What is the most reliable method for precisely
Secondary to infected abdominal viscera . locating the site of Upper GI bleeding ?
Secondary infection of a Hydatid . Barium meal study
Biliary obstruction . Exploratory laparotomy
Arteriography
* Which of the following conditions are Upper endoscopy
associated with increased risk of breast cancer ? Radionuclide scanning
Fibrocystic mastopathy
Fibroadenoma * One of the following is not true regarding
Atypical hyperplasia Meckels diverticulum ?
Papillomatosis It is the most common diverticulum of the GI
Breast Lipoma tract
It can cause bleeding .
* All of the following are true regarding It can cause intussusception and obstruction .
Fibroadenoma of the breast except ? Asymptomatic Meckels diverticulum should be
It is the most common breast tumor in resected .
adolescents and young women . More common in males .
Painless , mobile and slow growing mass .
Firm and rubbery texture . * Uncomplicated acute pancreatitis is best
Are not Premalignant lesions . managed with all of the following except ?
Excisional biopsy is necessary for every Intravenous hydration .
Fibroadenoma . Naso_gastric decompression .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 46
Abdominal imaging with ultrasound and / or CT Peritonitis .
scan . Persistent shock .
Strong painless killer . If there is no intra abdominal free fluid on CT scan
Urgent laparotomy to clean the abdomen . and ultrasound .
Uncontrolled hemorrhage .
Gunshot wounds .

* The most common complication after * The following would be indications to transfer a
hemorrhoidectomy is which of the following ? patient to a burns centre except ?
Urinary retention Chemical burns .
Rectal bleeding Burns involving inhalation injury .
Incontinence Circumferential burns of the extremities .
Wound infection Third degree burn to the genital organs .
Intestinal obstruction First degree burn of 15 % of TBSA to the chest of
an adult man .
* Which of the following types of colonic polyps
is associated with the highest incidence of * The following are risk factors for perioperative
malignant degeneration ? DVT except ?
Tubular adenoma Obesity
Tubulovillous adenoma Operation with long duration
Villous adenoma Patient with malignancy
Hamartomatous polyp Pelvic operations
Lipomatous polyp Young age

* The major problem with Ogilvie syndrome * The best policy to treat postoperative pain is to
( Acute obstruction of the colon in the absence of give ?
any identifiable mechanical obstructing lesion ) NSAIDs
is the risk of ? Subcutaneous morphine
Cecal perforation Paracetamol
Malignancy Regional anesthesia
Rectal prolapsed Multimodal analgesia
Duodenal ulcer
Small bowel perforation * What is the most common breast condition that
a middle aged woman can have of the following ?
* Characteristic injuries of blunt thoracic include Breast cancer
all the following except ? Fibroadenoma
Fractured sternum Fibrocystic disease
Transected aorta Ductectasia
Pulmonary contusion Lipoma
Ruptured urinary bladder
Bilateral rib fractures * Ketamine is contraindicated ?
In an asthmatic patient
* Concerning clinical evaluation of pelvic injuries , For cesarean section
one is true ? In a patient with facial burns
Rectal examination is often unnecessary . In a patient with increased ICP
The patient should have a urethral catheter In hypotensive patient
inserted in all cases to monitor urine output .
Lateral compression injuries are usually more * A 45 years old man presents with progressive
severe than antero_posterior cervical lymph nodes enlargement , since 4
compression injuries . months , the most appropriate investigation is ?
Pelvic stabilization is the first priority . X Ray soft tissue
Unstable pelvic ring fractures are associated with FNAC
a high mortality . Lymph node biopsy
Thyroid isotope scan
* The following are indications for laparotomy in Tuberculin test
abdominal trauma except ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 47
* Clinical features of paralytic ileus include the
following except ? * Which of the following is not a sign of portal
Effortless vomiting hypertension ?
Absolute constipation Caput medus
Abdominal distension Hepatomegaly
Severe abdominal pain Ascites
Absent bowel sounds Splenomegaly
Lower limb varicose veins

* The most precise diagnostic screening

procedure for differentiating benign thyroid * All of the following are common causes of
nodules from malignant ones is ? small bowel obstruction except ?
Thyroid ultrasonography Post surgical adhesion
Thyroid scintiscan Inguinal hernia
Thyroid hormone level Incisional hernia
Neck CT scan Small bowel tumor
FNAB Fecal impaction

* The mainstay of therapy for all forms of shock * The etiology of anal fistula includes ?
is Anal gland infection
IV fluid Ulcerative colitis
Epinephrine Ischemic colitis
Phenylephrine Anal warts
Red blood cells Levator ani syndrome
Oxygen
* The most common cause of
* All of the following are expected in a patient Hypoparathyroidism is ?
with Pheochromocytoma except ? Congenital absence of the parathyroids .
HTN Autoimmune parathyroid failure .
Palpitations Parathyroid cancer .
Headache Surgical removal of the parathyroids at total
Anhydrosis thyroidectomy .
Nausea and vomiting Acute bacterial infection .

* Which of the following is the best guide to fluid * Which of the following is an indication for
replacement in a burns patient ? removal of a Lipoma ?
Hemoglobin and haematocrit . 3 cm Lipoma in the tibialis anterior .
Urine output . 3 cm Lipoma in the subcutaneous fat of the
Urine osmolality . anterior abdominal wall .
Plasma volume . 3 cm Lipoma in the subcutaneous fat of the
Specific gravity . buttock .
A Lipoma of many years standing which has not
* The first manifestation of Iatrogenic removal of changed in size .
all parathyroid glands after total thyroidectomy is A Lipoma on CT scanning of homogeneous
Carpal spasm . density
Facial twitching on tapping the facial nerve .
Circumoral numbness . * Which of the following is not considered an
Pedal spasm . immediate threat to life ?
Diarrhea . Fracture of T8 with a complete spinal cord
transaction .
* The best prophylaxis against infection in dirty Splenic injury with ongoing bleeding .
wounds is achieved by ? Open pneumothorax .
Avoiding the use of local anesthesia . Rapidly rising intracranial pressure .
Inserting a drain into the wound . Aspiration .
Administrating a large dose of an appropriate
antibiotic . * Hypovolemic shock can result from any of the
Administrating tetanus antitoxin . following except ?
Removing foreign bodies and devitalized tissues Pulmonary laceration
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 48
Extradural hemorrhage Hypothyroidism.
Pelvic fracture Rectocele .
Femur fracture Obstruction from colorectal cancer .
Laceration to scalp Inadequate dietary fiber and fluids

* The cardinal feature of a compartment * The incorrect statement regarding passage of

syndrome is ? black and tarry stools is ?
Hyperthermia It is usually an indication of bleeding from the
Rubor upper GI tract .
Ecchymosis It can be mimicked by the ingestion of iron
Limb hyperactivity medication .
* In assessing the severity of an acute fracture , It is commonly a symptom of a cancer of the
one must always ? colon .
Examine for subcutaneous emphysema . * All of the following are diagnostic tools for
Examine for evidence of gangrene . dysphagia except ?
Examine the status of the neurovascular system Upper GI endoscopy.
of the fractured part . Barium swallow examination .
Examine for a temperature and arrhythmia . Upper abdominal ultrasound examination .
Examine for evidence of a fat embolism . CT examination of the chest .
Esophageal manometry .
* Which of the following steps is not part of the
primary survey in a trauma patient ? * Acute epididymo_Orchitis is characterized by
Insuring adequate ventilatory support . the following features except ?
Measurement of blood pressure and pulse . History of urinary tract infection .
Neurologic evaluation . Rapid onest of pain .
Protection of the cervical spine . Swollen tender testes .
Deep cut wound exploration and suturing . Tenderness of the cord .
Pyrexia and Leucocytosis .
* In obstructive jaundice , bleeding tendency is
due to deficiency of the following clotting factors * All of the following are risk factors for SCC of
except ? esophagus except ?
2 Alcohol
7 Tobacco
8 Achalasia
9 Plummer Vinson syndrome
10 Barrett esophagus

In the treatment of head injury , one of the * All of the following are manifestations of
following is true ? hypervolemia except ?
Steroids are regularly used . Confusion or lethargy
Patient with Glasgow coma score less than 8 are Peripheral edema
usually intubated and ventilated Slow and weak pulse
Antibiotics are routinely used . Dyspnea and crackles in lungs
Pyrexia is nearly always due to severe infection . Weight gain
Severe fluid restriction is necessary
* Pain in the hypogastrium when internal rotation
* Which of the following is true about the diabetic of the hip is ?
foot complications ? The pointing sign
The neuropathy is only sensory . The psoas sign
There is no relation to ongoing smoking . The Obturator sign
The metatarsal phalangeal joints do not Rovsing sign
dislocate Blumbert sign
The prognosis is worse with arterial disease and
ongoing smoking . * Which is the least common cause of pain in
There is no place for surgical management . right iliac fossa in pregnant woman ?
Acute appendicitis
* The most common cause of Constipation ? Ectopic pregnancy
Slow transit constipation Right acute pyelonephritis
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 49
Adenopathy Metastasis
Twisting ovarian cyst
* All are true about back pain except ?
* The initial response to vessel injury is ? Most common cause is disc prolapse .
Vasodilatation Prevalence is almost 100% in a life time .
Vasoconstriction In elderly and very young patients should warrant
Platelet aggregation investigation .
Platelet plug formation Most patients improve without investigation on
Thromboxane A2 production pain killers and muscle relaxants
When persists more than 4 weeks should be
investigated .

* The most common late complication of a

colostomy is ? * All of the following are indications for urgent
Colostomy necrosis surgical treatment of a depressed skull fracture
Retraction except ?
Obstruction A.Neurological deficit .
Parastomal hernia B .Decreased level of consciousness .
Prolapse C .If associated with mandibular fracture .
D .Underlying Subdural hematoma causing mass
* The initiating event that leads to acute effect .
calculous Cholecystitis is the obstruction of ? E .Cosmetic .
Common bile duct
Common hepatic duct * Regarding the metabolic abnormalities in
Cystic duct Pyloric stenosis all are true except ?
Right hepatic duct Hyponatremia
Left hepatic duct Hypochloremia
Hyperkalemia
* The most common complication after open Primary metabolic alkalosis
splenectomy is ? Compensatory respiratory acidosis
Left lower lobe lung Atelectasis .
Pleural effusion and pneumonia . * The early clinical presentation of
Subphrenic hematoma . Tracheosophageal fistula consists of all of the
Subphrenic abscess . following except ?
Pancreatitis . Choking on first feed
Coughing
* Signs of severe varicose veins include all of the Cyanosis
following except ? Excessive salivation
Thrombophlebitis Aspiration pneumonia
Hyperpigmentation
Ulceration * The most common perianal fistula type is ?
Compressible upon pressure Transsphincteric fistulae
Bleeding Extrasphincteric fistulae
Intersphincteric fistulae
* All of the following increase intracranial Suprasphincteric fistulae
pressure except ? Infrasphincteric fistulae
Pain
Fever * All of the following statements are true about
Cough the Lateral internal sphincterotomy except ?
Constipation Overall healing rates of 90_100% .
Sleeping Recurrence rate is low , the majority in the range
of 1_3% .
* Most common brain tumor in adults is ? The treatment of choice for anal fissure
Glioblastoma multiforme refractory to non surgical therapy .
Medulloblastoma Incontinence sufficient to cause any measurable
Meningioma impairment quality of life is uncommon , in the
Pituitary tumors range of 3%.
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
Page 50
LIS is inferior to fissurectomy and posterior Stone impaction in CBD .
midline sphincterotomy with respect to healing Cancer head of the pancreas .
rates , pain relief and incontinence . Cholangiocarcinoma .
Lymphadenopathy of the porta hepatis .
* The most common site of metastasis in Ruptured Hydatid cyst into the biliary tree
patients with Hepatocellular carcinoma is ?
Adrenal glands * In monitoring the hourly urinary output of a
Lymph nodes patient with 60 kg body weight , the amount of
Lungs urine that is considered minimal acceptable is ?
Bone 60 ml
Brain 45 ml
30 ml
100 ml
75 ml

* Which of the following congenital anomalies * The calf pressure that should cause the
occurs most frequently in patients with an surgeon to do fasciotomy is :
Imperforate anus ? 1- 10 cm H2O
Esophageal atresia 2- 20 cm H2O
Presacral dermoid 3- 30 cm H2O
Urological anomaly 4- 40 cm H2O
Tethered spinal cord 5- 50 cm H2O
Cleft palate
* The most common complication of acute
* One of the following is not presentation of right appendicitis :
side colonic tumor ? 1- Intra abdominal abscess
Melena 2- Pneumonia
IDA 3- Wound infecion
Abdominal mass 4- Bowel obstruction secondary to adhesion
Obstruction 5- Incisional hernia
Anorexia and weight loss
* The major methods of date collection from the
* The most common histological type of community is:
colorectal cancer is ? 1- Observation , interview, examinations
Adenocarcinoma 2- Observation only
Lymphoma 3- Morbidity and mortality data
Carcinoid 4- Civil registry
Melanoma 5- Health information
Mesenchymal tumor
* All of the following are early complications of
* All of the following are parts of prognostic head injury except:
Ranson criteria except ? 1- Brain concussion
Age 2- Meningitis
Blood sugar 3- Brain contusion
Serum amylase 4- Epilepsy
White cell count 5- CSF leak
LDH
* All of the following have been reported to
* Which of the following hernia may close increase the risk of gastic cancer except:
spontaneously in children ? 1- Smoking
Inguinal hernia 2- Alcohol
Umbilical hernia 3- H. Pylori infection
Incisional hernia 4- Chronic atrophic gastritis
Bochdalek hernia 5- Previous gastric resection
Paraumbilical hernia
* The most common cause of wound infection
* The commonest cause of ascending is :
Cholangitis is ? 1- Streptoccuspyogen
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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2- E.coli * Second-degree burn may heal without
3- Bacteroidfragilis grafting.which of the following is source of new
4- Staphylococcus aureus skin cells ?
5- Staphylococcus epidemis 1- Inrtadermal macrophages
2- Migratory dendritic cell
* The most difficult mode of transmission to 3- Dermatocyte
prevent is: 4- Melanocytes
1- Person to person spread 5- Epidermal appendeges
2- Droplet spread
3- Vector spread * Concerning base skull fracture of the anterior
4- Vehicle spread fossa all of the following tureexcept :
5- Airborne spread 1- Epistaxis
2- CSF rhinorrhea
3- Blindness
4- Raccon eyes
5- Battle sign
* One the following is false about the
Closrtidiumtetani : * The most common hernia to strangutateis :
1- Causes gas gangrene 1- Indirect inguinal hernia
2- Produces an exotoxin 2- Femoral hernia
3- Has a terminal spore 3- Direct inguinal hernia
4- Is an obligatory anaerobe 4- Epigastric hernia
5- Is motile 5- Slidling hiatus hernia

* The most common complication post * The risk of cholangiocarcinoma is not

hemorriodectomyis : increased in patients with :
1- Bleeding 1- Gallstones
2- Urine retention 2- Choledochal cyst
3- Anal stenosis 3- Clonorchissinensis
4- Incontinence 4- Primary sclerosing cholangitis
5- Infection 5- Hepatolithiasis

* Diagnosis of acute mesenteric ischemia is * The contraindication for medical treatment of

most likely when the patient has : gallstone include all the following except:
1- Elevation of WBC 1- Non functioning gallbladder
2- Elevation of serum amylase level 2- Porcelain gallbladder
3- Bloody stool in the rectum 3- Emphysematous gallblader
4- Diffuse pain out of proportion to tenderness 4- Stone less than 15 mm in size
5- Gas in cecum on abdominal X ray 5- Calcium bilirubinate and oxalate stones

* All of the following signs of hypovolemic shock * The most common complication post
except: splenectomy is :
1- Hypothemia 1- Wound infection
2- Tachypenia 2- Gastric dilatation
3- Pulsusparadoxus 3- Hemorrhage
4- Cool skin 4- Atelactasis
5- Hypotension 5- Pancreatitis

* Which of the following can be diagnosed with * Which is the single most avoidable factor
100 % sensitivity and specificity responsible for deaths:
using FNA ? 1- Cigarette smoking
1- Medullary cancer 2- Diabetes
2- Colloid nodule 3- End stage renal disease
3- Anaplastic cancer 4- Dyslipedemia
4- Follicular cancer 5- Depression
5- Papillary cancer
* Conrtaindication to liver transplantation include
1- fulminant hepatic failure with hepatic coma
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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2- chronic active hepatitis 2- Papiloma
3- hepatic malignancy 3- Duct ectasia
4- portal vein thrombosis 4- Sclerosingadenosis
5- uncontrolled sepsis 5- Fibroadenoma

* which of the following is an element of health * H.pylori infection in the stomach is associated
promotion: with each of the following except:
1- early diagnosis 1- chronic atrophic gastric gastritis
2- proper treatment 2- Gasrtic ulcer
3- health education 3- Duodenal ulcer
4- disability limitation 4- Gastric adenocarcinoma
5- rehabilitation 5 Squamous cell carcinoma of gastroesophagal

* complications of massive transfusion include * Elevated serum gastrin is found in all the
all of the following except: following except :
1- acidosis 1- Duodenal ulcer associated with H.pylori
2- alkalosis 2- Retained antrum
3- hypercalcemia 3- Gastric outlet obstruction
4- hypothermia 4- Postvagotomy
5- coagulopathy 5- Pernicious anemia

* All of the following are risk factors for * The oxygen-hemoglobin dissociation curve is
hepatocellular carcinoma except: shifted towards the left by all the following
1- hemochromatosis factors except:
2- alpha 1 antitripsin deficiency 1- Hypothermia
3- hepatitis B infection 2- Decreased PaCO2
4- hepatitis C infection 3- Acidosis
5- oral contraceptive usage 4- Increased PH
5- Dcreased (2,3-DPG)
* what is false about acute epiglottitis :
1- commocn in children * What is the borders of Hessilbach triangle?
2- caused by H.influenzae Ans: inferior epigastric vessels inguinal ligament
3- hoarsenness is presenting symptom rectus sheath
4- painfull swallowing
5- orooling of saliva * Which of the following is the most resonable
biochemical marker to follow after total
* Hyper- metabolism in sever burns is related to : thyroidectomy for papillary carcinoma :
1- Glutamine synthesis 1- Calcitonin
2- Hypocortisolemia 2- Ionized calcium
3- Decreased catecholamine activity 3- Carcinoembroynic antigen
4- Hyperinsulinemia 4- Thyroglobin
5- Hepatic glycongen synthesis 5- Serum thyroid- stimulating hormone

Extra adrenal pheochromocytomas * Post- renal causes of acute renal failure incule
predominantly secrete: all of the following except:
1- Epinephrine 1- Ureteral obstruction due to stones
2- Norepinephrine 2- Urethral obstruction due to prastatic
3- Dopamine enlargement
4- Metanephrine 3- Blocked folet catheter
5- Vanillymandelic acid 4- Bladder dysfunction due to nerve injury
5- Myoglobinuria
* The most common cause of bloody nipple
discharge is : * Undescended testes :
1- Breast cancer 1- Best treated surgically at the age of one year
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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2- Best managed conservatively with hormons 1- Acute renal failure
3- Best corrected at or around puberty 2- Hypoxia
4- Have no malignat potential 3- Intestinal obsruction
5- Are usually bilateral 4- Hypercarbia
5- Elevated urinary bladder pressure
* The most common perianal fistula type is :
1- Transsphincteric fistulae * The best screening method for DDH in infants
2- Extrasphincteric fistulae 1- X-ray
3- Intrasphincteric fistulae 2- Bone scan
4- Suprasphincteric fistulae 3- U/S
5- Both A+D 4- MRI
5- CT scan
* The most important indicator of a population
health is : * LMWH produces its primary effects because of
1- Crude birth rate its inhibition of which factor:
2- Crude mortality rate 1- 2a
3- Infant mortality rate 2- 9a
4- Maternal mortality rate 3- 10a
5- Total fertality rate 4- 11a 5- 12a
* Which of the following statements about * Initial treatment of acute gastrointestinal
Hicshsprungs disease is not true: bleeding includes:
1- It is more in girls 1- H2- receptor antagonist
2- It may invole the small bowel 2- Angiography
3- It may be associated with enterocolitis 3- Sucralfate
4- There is an increased incidence of Downs 4- Gastrointestinal endoscopy
syndrome 5- Aggressive volume resuscitation
5- There are no ganglionic cells seen in Auerbach
plexus * The wound healing impaiment caused by
corticosteroid administration can be reversed
* All the following are used to reduce intracranial by :
pressue after head injury 1- Vit A
except: 2- Vit C
1- Head elevated to 30 degrees 3- Vit K
2- Avoid neck and chest compression like 4- Vit B12
bandages and wraps 5- Zinc
3- Intubation and mechanical ventilation to
achieve a normal ABGs * The most common organ injured in
4- Controlled hypothermia penentrating abdominal injury is:
5- Evacuation of extradural haematomas 1- Liver
2- Samll bowel
* Treatment of shunt infection include all of the 3- Spleen
following except: 4- Stomach
1- Intraventricular antibiotic 5- Colon
2- Systemic antibiotic
3- Immdediate replacement of shunt * Posterior urtheral valve is the best visualized by
4- External drainage 1- Bladder U/S
5- Removal of infected shunt 2- Static cystogram
3- MCUG
* All of the following can causes Hyperkalemia 4- CT cystogram
except: 5- Retograde urethrogram
1- Acidosis
2- Insulin deficiency * Which of the following is the most important
3- Hypomagnesemia prognostic determinant of survival after
4- Cell lysis syndrome treatment for colorectal cancer:
5- Renal failure 1- Lymph node involvement
2- Transumural extension
* An abdominal compartment syndrome 3- Tumor size
produces all of the following except: 4- Histologic differentiation
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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5- DNA content C . Hx of endometrial cancer .
D . Multiparity .
* The major component of the bile: E . Late menopause .
1- Bilirubin
2- Bile acid * Coarctation of the aorta most commonly occur
3- Water in ?
4- Cholesterol A . Ascending thoracic aorta .
5- Lecithin B . Transverse thoracic aorta .
C . Thoracic aorta just proximal to left Subclavian
* All of the following are true except ? artery .
A . The best test for platelet function is bleeding D . Thoracic aorta just distal to left Subclavian
time . artery .
B . FFP is the most effective way to acutely E . Descending thoracic aorta just above
correct INR . diaphragm .
C . Factor 8 is synthesized in the liver .
D . Calcium is required for normal coagulation . * Which of the following is not an indication for
surgical intervention in a patient with aortic
stenosis ?
B . Angina pectoris .
C . Poor ventricular function .
D . Valve area less than 0.5 cm2 .
* All are true statement except ? E . Calcification of the stenotic valve .
A . The most predominant cell at day 3_4 after a * A 65 year old female presents with a massive
wound is macrophages . lower GIT bleeding . In ER BP 80/40 , HR 120
B . The most predominant cell in the first 24 BPM . After fluid resuscitation the blood pressure
hours of the wound is PMN . 120/80 , HR 100 . A Nasogastric tube aspirate is
C . The order of cell arrival in wound is negative for blood. The best next step is ?
macrophages , platelets , PMNs , fibroblasts . A . Mesenteric Arteriography .
D . The most predominant cell type in a 7 day old B . Upper GI endoscopy .
wound is fibroblasts . C . Exploratory Laparotomy .
D . Lower GI endoscopy .
* The principle cells involved in acute organ E . Observation .
rejection is ?
A .B_cell . * Which of the following is true regarding
B . T_cell . ulcerative colitis and colon cancer ?
C . Macrophages . A . The risk of cancer unrelated to the extent of
D . Platelets . inflammation .
E . Monocyte . B . The malignancy typically develops in a polyp .
C . The risk of cancer related to disease duration
* The appendiceal artery is a branch of ? D . Random endoscopy and biopsies ineffective .
A . Right colic artery . E . CEA level are useful Guid _ when to perform a
B . Middle colic artery . colonoscopy .
C . Left colic artery .
D . Ileocolic artery . * A 65 year old man presents with a 2 day history
E . Hypogastric artery . of left quadrant abdominal pain , nausea , low
grade fever . Temperature 39 , WBC 14000 ,
* The most common presentation for localized moderate left lower quadrant pain . The
Appendiceal adenocarcinoma is ? best next step in management ?
A . Acute appendicitis . A . NG tube .
B . Ascites . B . IV antibiotics .
C . Chronic anemia . C . Flexible sigmoidscopy .
D . Palpable abdominal mass . D . Barium Enema
E . Incidental finding . E . Gastrograffin enema

* All of the following are considered risk factors * In female patients with a family history of
for breast cancer except ? HNPCC , which of the following is recommended
A . Obesity . beginning at age 25 . In addition to screening
B . Hx of ovarian cancer . colonoscopy ?
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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A . Annual mammography E . Excision of the neck mass .
B . Annual CT abdomen
C . Annual endometrial biopsy * All are true about carcinoma of the lip except ?
D . Annual ovarian ultrasound A . 95% of lip carcinoma in the Lower lip .
E . Annual brain CT B . Sun exposure and smoking are risk factors .
C . More common in elderly white men .
* A 63 year old man is restless and ataxic and D . Radiation therapy is the treatment of choice .
has tonic spasms . Serum osmolality 330 E . The majority presents as ulcerative lesion .
mosm/kg . The most likely diagnosis ?
A . Hyponatremia * Which of the following is true regarding Mallory
B . Hypercalcemia Weiss syndrome ?
C . Hyperkalemia A . Spontaneous perforation of the esophagus .
D . Hypernatremia B . Forceful vomiting followed by hematemesis .
E . Hypermagnesemia C . It's usually associated with air in the
mediastinum .
* Which of the following statement about D . Endoscopy is contraindicated .
esophageal leiomyoma is false ? E . Prompt surgical management is the best .
A . It is the most common benign esophageal
neoplasm .
B . Most common sites middle and lower third
C . They have risk of malignant degeneration * All are true about salivary glands neoplasms
D . Preoperative endoscopic biopsy should be except ?
done . A . Mostly arise in the Parotid gland .
E . Treatment of choice is endoscopic B . Warthin tumors are the second most common
enucleation benign salivary glands tumor and
strongly related to smoking .
* Jaundice with absent urine urobilinogen is C . Mucoepidermoid carcinoma is the most
most likely consist with ? common malignant salivary glands
A . Hepatitis tumor .
B . Cirrhosis D . Pleomorphic adenoma does not undergo
C . Hemolysis malignant degeneration .
D . Biliary obstruction E . Minor salivary glands tumor are more likely to
E . Sepsis be malignant than submandibular gland tumors .

* Management of nasopharyngeal carcinoma * The first step in process of hemostasis after

consist primarily by ? vessel injury is ?
A . Radiation A . Platelet adherence
B . Chemotherapy B . Platelet aggregation
C . Surgical excision C . Vasoconstriction
D . Combined chemo_radio D . Release of thromboxane
E . Combined chemo_radio followed by surgery E . Thrombus activation

* Barrett esophagus ? * The most useful laboratory test to assess risk

A . It is a congenital anomaly . of bleeding and response to therapy in patient
B . When diagnosed , should be treated by with Uremia is ?
surgery . A . Bleeding time
C . Occurs in 5% of patient with Achalasia . B . Platelet count
D . More common in females . C . INR
E . Presence of intestinal Goblet cells . D . PTT
E . Thrombin time
* A 65 year old male presents with a persistent
firm lateral neck mass that measures * Which of the following is the best method to
approximately 2.5 cm . The best next step in prevent a first bleed in a patient with known
management is ? esophageal varices ?
A . Positron emission tomography . A .B blockers
B . CT scan of the head and neck . B . TIPS surgery
C . Fine needle aspiration cytology . C . Sclerotherapy
D . Chest radiography . D . Endoscopic ligation
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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E . Nitrate C . Hypocalcemia
D . Hypercalcemia
* A 45 year old female presents with intermittent E . Polycythemia
vague right upper quadrant pain and jaundice . In
addition she notes having floating fatty stool . * The organism most common associated with
Ultrasound : gallstone in gallbladder and mass in acute mesenteric Lymphadenitis is ?
pancreatic head . The most likely diagnosis ? A . Campylobacter jejuni
A . Vipoma B . E coli.
B . Glucagonoma C . Enterococcus
C . Somatostatinoma D Yersinia enterocolitica
D . Gastrinoma E . Pinworms
E . Insulinoma
* All are true about Crohn disease except ?
* Which of the following is true regarding A . It's more common in individual of low socio-
esophageal atresia and TE fistula ? economic status .
A . The most common type is the H type . B . It's most common primary surgical disease of
B . It is suspected prenatally by Oligohydramnios the small bowel .
C . In most cases gastrostomy is required before C . It's more common in smokers .
surgical repair . D . Early sign is aphthous ulcer
D . 20 % of patient have cardiac anomalies . E . Extensive mesenteric fat wrapping
E . This condition is more in females .
* Management of pancreatic lymphoma is by ?
A . Pancreaticoduodenectomy * Diagnosis of Carcinoid syndrome is best by ?
B . Chemotherapy A . Serum Serotonin level
C . Radiotherapy B . Serum substance P levels
D . Pancreaticoduodenectomy followed by radio C . 24 hour urinary 5_HIAA
E . Chemo_radio therapy D . Serum Neurotensin levels
E . Serum Neurokinin A levels .
* A 32 year old woman notes that her hands
become cold and painful when exposed to cold * The most sensitive and specific diagnostic test
temperature . Change in color ( pale _ blue _ for Gastrinoma is ?
red ) , vascular pulse is normal , the best next A . Octreotide scan
step in management ? B . Fasting serum gastrin
A . Upper limbs sympathectomy C . Calcium stimulation test
B . Prostaglandins D . Secretin stimulation test
C . Fluoxetine E . Basal and stimulated gastric acid outputs
D . Arteriography
E . Diltiazem * The treatment of choice for high grade primary
gastric lymphoma ?
* The initial step in management of SIADH ? A . Total gastrectomy
A . Furosemide B . Subtotal gastrectomy
B . Hypertonic saline C . Chemo_radio therapy
C . Demeclocycline D . Total gastrectomy followed by chemotherapy
D . Isotonic saline E . Radiation therapy
E . Restriction of free water
* Cryoprecipitate contains high concentrations of
* The most common presentation of all of the following
Pheochromocytoma ? except ?
A . Excess sweating A . Fibrinogen
B . Palpitations B . Factor 8
C . Chest pain C . VWF
D . Headache D . Fibronectin
E . HTN E . Factor 11

* The first biochemical abnormality detected in * All are true about malignant tumors of the small
the majority of patient with MEN1 ? bowel except ?
A . Hypoglycemia A . Adenocarcinoma most commonly in the
B . Hyperchloremia duodenum .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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B . Adenocarcinoma and Carcinoid are the most
common types . * After splenectomy for trauma the optimal
C . Gastrointestinal stromal tumors are timing for administration of the pneumococcal
associated with acquired immunodeficiency vaccine is postoperative day ?
syndrome . A.1
D . Lymphoma most commonly in the Ileum . B. 4
E . Majority of small bowel malignancy are C.7
treated surgically D . 10
E . 14
* The best test to confirm eradication of H pylori
after treatment is ? * All of the following are true about TTP except ?
A . H pylori serology A . It does not lead to Hemolysis .
B . Urea breath test B . The Coombs test is negative .
C . Histologic biopsy C . Lower limbs petechiae are the most common
D . Rapid urease test presentation .
E . Antral mucosal biopsy and culture D . Seizures and coma are common
complications .
* Which of the following antibiotics can cause E . The first line of treatment is plasma exchange
Red man syndrome if given Rapid IV ?
A . Clindamycin
B . Gentamicin
C . Levofloxacin
D . Vancomycin
* The body response to hypothermia includes all
of the following except ? * Which of the following describes the
A . Decreased platelet function association between Sister Mary Joseph nodule
B . Decreased cardiac output and stomach cancer ?
C . Tachycardia A . Metastatic left axiallary lymph nodes .
D . Cardiac arrhythmia B . Metastatic left supraclavicular lymph node .
E . Increased risk of wound infection C . Ovarian mass .
D . Umbilical metastasis .
* Abdominal compartment syndrome should be E . Anterior nodule palpable on rectal exam .
suspected when bladder pressure exceed ?
A . 10 cm H2o * Peripheral neuropathy with prolonged use is
B . 25 cm H2o most commonly associated with ?
C . 35 cm H2o A . Clindamycin
D . 40 cm H2o B . Metronidazole
E . 50 cm H2o C . Ciprofloxacin
D . Gentamicin
* After excision of multiple lipomas under E . Vancomycin
anaesthesia . A 42 year old male seizes . The
surgeon should be aware that the maximum safe * Bacteremia from which of the following
dose of local anesthetic in 70 kg patient ? organism is associated with colon cancer ?
A . 10_20 ml 1% lidocaine . A . Streptococcus bovis
B . 40_50 ml 2% lidocaine with epinephrine . B . C difficile
C . 40_50 ml 1% lidocaine with epinephrine . C . MRSA
D . 40_50 ml 0.5% lidocaine D . H pylori
E . 40_50 ml 1% lidocaine without epinephrine E . Streptococcus viridans

* All are true about Peutz_Jeghers syndrome * Most common cause of SVC syndrome ?
except ? A . Radiation therapy
A . Typical small bowel lesion adenomatous B . Malignancy
polyps . C . Infections
B . It's autosomal dominant . D . Idiopathic
C . Small bowel obstruction is the most common E . Post central line insertion
presentation .
D . There is increased risk of small bowel cancer * Small cell lung carcinoma is managed by ?
E . There is increased risk of breast cancer . A . Chemotherapy followed by surgery .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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B . Surgical resection . B . Subdural hematoma are due to laceration of
C . Radiation therapy . bridging veins .
D . Combination chemo_radio therapy . C . Epidural hematoma are usually associated
E . Radiotherapy followed by surgery . with a skull fracture .
D . CT scan shows convex lens hematoma in
* All of the following are true regarding blood epidural hematoma .
supply to the thyroid , parathyroid glands except E . Epidural hematoma generally have a worse
A . The parathyroid glands are usually supplied by prognosis than Subdural hematoma .
the superior thyroid arteries
B . The superior thyroid artery is the first branch * Which of the following is the most common risk
of the external carotid artery . factor for spontaneous venous
C . The recurrent laryngeal nerves are at risk of thromboembolism
injury during ligation of the inferior thyroid A . Antithrombin 3 deficiency
arteries B . Factor 5 Leiden
D . The external branch of the superior laryngeal C . Protein C deficiency
nerve is at risk of injury when the superior D . Protein S deficiency
laryngeal arteries are ligated . E . Antiphospholipid syndrome
E . The thyroidea ima artery usually arises from
the aorta . * All are true about Achalasia except ?
A . It can be congenital or acquired .
B . In young patient , myotomy is the best
treatment .
C . CCB exacerbate this condition .
D . Caused by neurogenic degeneration .
E . Dysphagia , regurgitation , weight loss .
* A 60 year old male smoker presents with
radicular right arm pain . A chest radiograph
reveals a bulky mass in the posterior apex of the * Which of the following is least likely associated
chest in the superior sulcus . All of the following with Hyperparathyroidism ?
are commonly associated with this mass except A . Cholelithiasis and urolithiasis .
A . Ptosis B . Acute pancreatitis .
B . Right eye miosis C . Osteitis fibrosa cystica
C . Right facial anhidrosis D . Diarrhea
D . Right eye exophtalmus E . PUD
E . Non small cell lung cancer
* A 30 year old man is brought into the
* A patient presents with fatigue and bone pain . emergency room after 20 foot fall . He is noted to
Serum calcium level is 11.1 mg/dl , PTH is speak using inappropriate words . He with draws
elevated . The best next step is ? and open his eyes to pain only , Glasgow coma
A . Operative exploration scale score is ?
B . Neck CT scan A .10
C . Technetium 99m sestamibi imaging B .9
D . MRI C .8
E . Ultrasound scan D .7
E .6
* Factors related to increased risk of thyroid
cancer include all of the following except ? * Trauma patients are at highest risk of venous
A. Family history thromboembolism is ?
B . Hx of radiation A .Head trauma
C . Smoking B .Femur fracture
D . Female C .Pelvic fracture
E . Low iodine diet D .Splenectomy
E .Spinal cord injury
* All of the following are true regarding head
injury except ? * All are true about Bochdalek hernia except ?
A . Epidural hematoma are associated with lucid A . It is type of congenital Diaphragmatic hernia .
interval . B . Newborn presents with respiratory distress at
birth .
‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬
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C . It is more common in left side .
D . It is associated with intestinal Malrotaion and
obstruction .
E . Can result in pulmonary hypoplasia of both
lung .

* The definitive management of Hyperkalemia is

A. Calcium chloride
B . Dextrose
C . Dialysis
D . Fluid hydration
E. Salbutamol

* One of the following is most likely to be present

in a patient with severe magnesium deficiency ?
A .Respiratory depression
B .Cardiac depression
C .Tetany
D .Hypotension
E .Loss of patellar reflex

* Which of the following is an appropriate

definition of shock ?
A . Low blood pressure
B . Low cardiac output
C . Low circulating volumes
D . Inadequate tissue perfusion .
E . Abnormal vascular resistanc

‫ اﺳﺎﻣﻪ اﻟﺨﺰاﻋﻠﻪ‬: ‫اﻟﺪﻛﺘﻮر‬ ‫اﺳﺌﻠﺔ اﻟﺠﺮاﺣﺔ اﻟﻌﺎﻣﻪ‬

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