‫اسئلة وزارة الصحة لاللتحاق‬

‫ببرنامج االقامة واالمتياز‬

‫( ‪) 2018 -2013‬‬

‫بفضل للا قمت باعادة جمع وتنسيق اسئلة‬

‫الدورات السابقة‪ ,‬الصادرة من وزارة الصحة‬
‫المتحانـــات االقامـــة واالمتيــاز لالعـــوام‬
‫( ‪ , ) 2018 -2013‬بعد جهـــد وعنــاء ‪,‬‬
‫وحلها باالستعانة بالمراجع والكتب المختلفة‬
‫لتوخي الدقة في نشر المعلومة الصحيحــة‬
‫للزمالء والزميالت ‪ ,‬فإن ( احسنت فمن للا ‪,‬‬
‫*****‬
‫وان اسأت فمن نفسي ) ‪ ,‬واني اقـــدم هذا‬
‫العمل خالصا لوجه للا تعالى ‪ ,‬راجيا المولى‬
‫القبول ‪ ,‬وان ينال اعجابكم ‪.‬‬
‫‪SURGERY‬‬
‫اللهم استودعك ما قرأت وما حفظت وتعلمـت‬
‫‪ ،‬فـرده لـي عنـد حاجتـي اليه ‪ ,‬إنـــك على ما‬
‫تشاء قدير‬
‫*****‬
‫اخوكم الدكتور ‪ :‬اسامـه الخزاعلـه‬
‫نسخة مدققة‬
‫‪0799430239‬‬
‫طـــب عـــام وجراحــه‬
* 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 foot
from inflammatory bowel disease , which of the . 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
A . Curling ulcer doses of 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 of
* Which of the following skin tumors is the most 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 .
D . The floor is formed by the adductor longus * In the management of pyloric stenosis , which
and pectineus muscle medially . of the following is true ?
E . The floor is formed by the Iliopsoas muscle A . Acidosis should be corrected first .
laterally . B . Chloride level is normal in spite alkalosis .
C . Hypokalemia should be corrected .
* A 54 year old man on renal dialysis is found to D . Usually there is compensatory hypocarbia .
have raised serum calcium and PTH . This is E . Paradoxical aciduria is not a feature .
called ?
A . Primary hyperparathyroidism . * Differential diagnosis of right iliac fossa pain
B . Secondary hyperparathyroidism . includes all of the following except ?
C . Tertiary hyperparathyroidism . A . Tubo _ ovarian mass
D . Hypercalcemia of malignancy . B . Acute pyelonephritis
E . Hypoparathyroidism . C . Crohn disease
D . Empyema of the gallbladder
* Most common cause of non pitting edema ? E . Splenic vein thrombosis
A . Iatrogenic
B . Filariasis
C . Lymph node resection surgery .
D . Leptospirosis
E . Chagas disease

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 2
* 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 pain A . Descending colon
and is able to speak , but appear confused . He B . Sigmoid
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 ,
C . Paresthesia . the junction of the neck and body of the
D . Calor = Heat . pancreas and the junction of the cystic and
E . Paralysis . common bile duct .
D . The tail of pancreas
* 80 year old woman presents with hematemesis E . The triangle formed by the inferior edge of the
. She has had intermittent epigastric pain after liver , the cystic duct , and the common hepatic
food for the past 6 months . She has lost weight duct .
about 4 kg . She was recently started on
Diclofenac . The most likely cause for her * An 18 year old female patient develops urticaria
condition ? and wheezing after injection of intravenous
A . Mallory Weiss tear contrast for an abdominal CT scan . Her BP
B . Esophagitis 120/60 ,HR 155 / min , RR 30 / min , which of the
C . Gastric malignancy following is the most appropriate immediate
D . Aortoenteric fistula therapy ?
E . Gastric ulcer A . Intubation
B . Epinephrine
* Which of the following is not an increased risk C . B _ blockers
for venous Thromboembolism ? D . Iodine
A . Active cancer E . Fluid challenge
B . Age greater than 60
C . Thrombophilia * Which is gram negative organism ?
D . Obesity BMI > 30 A . Group A Streptococcus
E . Surgery to excise scalp lipoma B . MRSA
C . Pseudomonas aeruginosa
* What is the first parameter to change in early D . Clostridium tetani
hypovolemic shock ? E . Listeria
A . Systolic blood pressure
B . Pulse rate * The most reliable indicator of the adequacy of
C . Diastolic blood pressure burn resuscitation is ?
D . Respiratory rate A . CVP
E . Level of consciousness B . PCWP
C . Urine output
* A 32 year old man presents with Hematuria . A D . Blood pressure
KUB X_Ray reveals a staghorn calculus in the E . Heart rate per minute
right kidney and midstream urine , sample grows
proteus . The most likely stone type is ? * The most common site for SCC of the lips is ?
A . Bile pigment stone A . Upper lip midline
B . Calcium oxalate B . Upper lip laterally
C . Calcium phosphate C . Lower lip midline
D . Cholesterol stone D . Lower lip laterally
E . Cystine stone E . Oral commissure

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 3
* A 39 year old man presents with severe * The spleen filters all of the following particles
epigastric pain and right upper quadrant pain . cells except ?
Radiating to the back associated with nausea A . Malformed erythrocytes
and vomiting . Inspection of the abdomen shows B . T lymphocytes
bruising below the inguinal ligament . This sign is C . Malarial parasites
called ? D . Streptococcus pneumonia
A . Cullen sign E . Platelets
B . Boas sign
C . Fox sign * Which of the following is not a feature of Crohn
D . Grey turner sign disease ?
E . Murphy's sign A . Involvement from mouth to anus .
B . Risk of flare up is decreased with smoking
* Pleomorphic adenomas of the salivary glands C . Macroscopically demonstrates cobblestone .
are characterized by one of the following ? D . Endoscopically demonstrates skip lesions .
A . They occur only in the parotid glands . E . Histologically demonstrates transmural
B . They grow rapidly . granulomatous inflammation .
C . They rarely recur if simply enucleated .
D . They present as rock _ hard masses . * A 45 year old female . Patient presented to E.R
E . They are common benign salivary tumors . complaining of right hypochondriac pain and
nausea with repeated vomiting for the last few
* A 20 year old man involved in RTA sustains hours . She recalls eating a cheese cake earlier
bilateral fractured femurs . On assessment , he is that day . Examination showed right
anxious and confused , with a pulse of 130 / min hypochondriac tenderness but otherwise soft and
and BP of 70/50 mmhg . Urine output over 1 hour lax . Her laboratory results were normal . The
is 10 ml . This patient has hemorrhagic shock most appropriate next investigation ?
type ? A . Erect abdominal X_Ray
A . Class 1 B . Endoscopy
B . Class 2 C . CT abdomen
C . Class 3 D . Ultrasound of the abdomen
D . Class 4
E . Class 5 * A 50 year old man presented to E.R
complaining of severe epigastric pain of 5 hours
* All of the following are branches from the duration . The pain is radiating to his back
external carotid artery except ? associated with recurrent vomiting . His amylase
A . Superior thyroid artery is 2017 u/ L . All of the following criteria are used
B . Ascending pharyngeal artery to predict the severity of the case during
C . Lingual artery admission except ?
D . Inferior thyroid artery A . Age over 55 years
E . Facial artery B . Blood sugar more than 200 mg/dl .
C . AST more than 250 u/ L
* On postoperative day 5 post hepatic resection a D . WBC less than 5000 /UL
healthy 55 year old patient is noted to have fever E . LDH more than 350 u/ L
38.6 c . Which of the following is the most
ommon associated ? * The highest potassium concentrate in ?
A . UTI A . Saliva
B . Wound infection B . Gastric juice
C . Pneumonia C . Bile
D . Intra_abdominal abscess D . Ileal
E . Intravenous catheter related infection
* Regarding abdominal trauma in pediatric age
* One of the following statement is incorrect ? group , which of the following is true ?
A . Elevated CA125 is ass with ovar carcinoma . A . Clinical examination , stabilization and
B . Elevated CEA is associated with resuscitation are not of priority .
chondrosarcoma . B . Ultrasound is the diagnostic tool of choice .
C . Elev CA 15_3 is ass with certain breast CA . C . Blood transfusion should be started
D . Elevated B_HCG is associated with certain immediately .
testicular cancer . D . Peritoneal lavage is contraindicated .
E . Elevated CA 19_9 is associated with E . Splenectomy is not a routine management
pancreatic cancer . for all types of Splenic injuries .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 4
* 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 * Which of the following statements is true
inguinal 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
* Which of the following is not true regarding duct .
sepsis ? C . Ectopic colonic epithelium is found in it .
A . Tachycardia and / or tachypnea may be a D . Diagnosis is best made by CT_ scan .
sign . E . It's usually found on the mesentric border of
B . Sepsis is defined as systemic inflammatory the bowel .
response syndrome in the presence
of infection . * A 34 years old male patient presented after
C . Leukocytosis or leukopenia may be a sign . being in RTA with severe shortness of breath .
D . Sepsis and hypotension is defined as Examination revealed a deviated trachea to the
septic shock . left side . Absent breath sounds on the right side
E . Temperature greater than 38 or less than 36 of the chest . The best initial management option
may be a sign . for this patient is ?
A . Intubate the patient .
* Regarding the oxygen dissociation curve , one B . Insert a chest tube on the right side .
is true ? C . Do a chest X_Ray then manage accordingly .
A . Is shifted to the left by increase 2.3 _ DPG . D . Insert a needle thoracostomy followed by
B . Is Sigmoid shape for both hemoglobin and a chest tube in the right side of chest .
myoglobin . E . Insert 2 large bore cannulas and give 1 liter of
C . Is shifted to the left when one ascends to high ringer lactate .
altitude .
D . Is shifted to the right by an increase in the PH * All of the following are true regarding colon
E . Is ideally 50% saturated at a PO2 of 28 cancer except ?
mmhg A . It's the second most common cause of cancer
related death in Jordan .
* One of the following passes through the aortic B . A ( T1 N1 M0 stage 3 ) tumor is equivalent to
hiatus in the diaphragm ? Duke stage C tumor .
A . Vagal trunks C . A majority of colorectal cancers occur in
B . Right phrenic nerve the descending colon .
C . Thoracic duct D . FAP and HNPCC are two inherited causes of
D . Esophagus colorectal cancer .
E. Branches from left gastric artery E . Patients with primary sclerosing cholangitis
and ulcerative colitis have increased risk of
* A 62 year old male patient presented developing colon cancer .
complaining of bloody diarrhea and cramps , he
has recently been started on Clindamycin for * One of the following is false regarding
septic arthritis . As he is allergic to penicillin . crystalloid solutions ?
Which of the following is the most likely diagnosis A . Osmolarity of RL solution 273 mosm L .
A . Campylobacter jujeni diarrhea . B . Ringer lactate contain 154 meq/L sodium .
B . Pseudomembranous colitis . C . Readily pass through semi _ permeable
C . Salmonella typhi diarrhea . membrane , therefore they are considered
D . Rectal cancer . extravascular space expanders .
E . Hemorrhoids . D . Have poor capillary perfusion and no allergic
reaction and short intravascular half life 20_30 m
E . Hartmann solution , 0.9% NaCl solution , 5%
Dextrose in water are isotonic crystalloid
solutions .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 5
* 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 =
B . 170 40 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
* What is the most likely diagnosis in a 45 year E . Crohn disease
old male patient with HTN , development of facial
hair and 7cm suprarenal mass ? * Which of the following vaccines are live ?
A . Myelolipoma A . H influenza type B
B . Cushing disease B . Diphtheria
C . Adrenocortical adenoma C . OPV
D . Pheochromocytoma D . Hepatitis B
E . Carcinoid tumor E . H influenza A

* 60 kg woman involved with extensive burns . * One of the following is true regarding the
On physical exam found to have pink to red skin electrolyte concentration in Hartmann solution ?
colour , slightly swelling and pain , dry skin on the A . Chloride 200 mmol/L
head . Her left arm and leg have dry white B . Lactate 70 mmol/L
painless burns and her anterior torso has C . Sodium 131 mmol/L
Erythematous painful burns with blistering. How D . Potassium 40 mmol /L
much fluid she require ? E . Calcium 15 mmol/L
A . 2500 ml
B . 10800 ml * All are true regarding Heparin except ?
C . 8640 ml A . It's heterogeneous mixture of sulfated
D . 12960 ml polypeptides .
E . 17280 ml B . Potentiates the actions of antithrombin 3 .
C . Has a half life of a 90 minutes .
D . Can be reversed by protamine sulphate .
E . Can induce an idiosyncratic
thrombocytopenia .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 6
* 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
A . Injuries are generally more superficial than sixth 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 .
D . Evaluation for fracture of the other * The most common blood transfusion reaction is
extremities and visceral injury is A . Clerical error
indicated . B . ABO incompatibility
E . Cardiac conduction abnormalities are unlikely C . Delayed hemolysis
D . Febrile reaction
* 5_HIAA is tested in which of these disease ? E . Transfusion related acute lung injury
A . Medullary carcinoma of the breast .
B . Papillary thyroid carcinoma . * Sludging in the gallbladder and cholestatic
C . Giant cell carcinoma of the pancreas . jaundice is characteristic for
D . Carcinoid tumor . which of the following antibiotics ?
E . Ganglioneuromas . A . Quinolones
B . Metronidazole
* Capillary refill time is elicited by ? C . Ceftriaxone
A . Pressing over the skin for 3 seconds , D . Erythromycin
normally return perfusion by 2 seconds . E . Ampicillin
B . Pressing over the skin for 5 seconds ,
normally return perfusion by 2 seconds . * The composition of Ringer lactate is ?
C . Pressing over the skin for 5 seconds, A . Na 145 , Cl 109 , K 4 , Ca 2.7 , HCO3 28 .
normally return perfusion by 5 seconds B . Na 130 , Cl 103 , K 4 , Ca 2.7 , HCO3 28 .
D . Pressing over the skin 10 seconds , normally C . Na 154 , Cl 109 , K 4 , Ca 4 , HCO3 28 .
return perfusion by 5 seconds . D . Na 130 , Cl 109 , K 4 , Ca 2.7 , HCO3 28 .
E . Pressing over the skin for 2 seconds ,
normally return perfusion by 5 seconds .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 7
* 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 stimuli
A . Lung cancer , 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
* The most important prognostic factor for breast E.4
cancer devoid of systemic metastasis is ?
A . Node status * A patient stops making urine after surgery . All
B . Size of tumor of the following values are consistent with
C . Tumor grade prerenal renal failure except ?
D . Gender of patient A . Urine Na 5 meq/L
E . Comorbidities B . BUN/cr ratio 35
C . Fe Na = 0.3%
* The most predominant cell type in a 7 day old D . Urine osmolality = 200 mosm/ L .
wound is ? E . Urine specific gravity = 1.050
A . PMNs
B . Macrophages * The initial treatment of choice in a patient with
C . Lymphocytes Hyperkalemia and arrhythmia is ?
D . Fibroblasts A . Insulin and glucose
E . Platelets B . Amiodarone
C . Calcium resonium
* All are true about keloid scar except ? D . Calcium gluconate
A . They are confined to the original scar area E . Dialysis
B . Can be treated with silicon , steroid or
radiotherapy . * A 50 years old man has a mass 1cm anterior to
C . Occur mainly on the ear lobe , shoulders , the ear . The mass causes him pain and facial
sternal notch , rare across drop . CT of the head shows mass in both the
joints . deep and superficial part of the parotid glands .
D . More common in dark skin . The most likely diagnosis ?
E . More common in females than males . A . Mucoepidermoid carcinoma .
B . Adenoid cystic carcinoma .
C . Pleomorphic adenoma .
D . Warthins tumor .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 8
* 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
making the diagnosis ? peristals .
A . Urine cortisol C . Increased of LES pressure and normal
B . Urine aldosterone peristals .
C . Urine VMA And metanephrines D . Increased of LES pressure and high peristals
D . Urine epinephrine E . Low of LES pressure and absent peristals .
E . Urine norepinephrine
* A 60 years old man develops TIAs and has a
* A 30 years old woman recently diagnosed with carotid ultrasound that shows an 80% stenosis .
MEN1 syndr.ome . Develops confusion The next appropriate next step is ?
somnolence , and short QT interval on the ECG , A . Plavix
the next appropriate next step is ? B . ASA
A . Alpha blockade C . Warfarin
B . Beta blockade D . Carotid endarterectomy
C . CCB E . Observation
D . IV fluid and lasix
E . Dialysis * Intrinsic factor of the stomach binds to ?
A . Fe
* Which of the following lab values is most B . Cu
effective at picking up recurrent Papillary or C . Vitamin B12
follicular thyroid cancer ? D . Folate
A . TSH E. Vitamin K
B . Free T4
C . Thyroglobulin * Barrett esophagus refers to ?
D . Transferrin A . The change in esophageal mucosa from
E . TRH columnar to squamous .
B . The change in esophageal mucosa to
* While performing a MRM in the patient with transitional epithelium .
breast cancer , you cut the thoracodorsal nerve . C . Keratinization of the esophageal mucosa .
Postoperative this patient is most likely to have ? D . Change in esophageal mucosa from
A . Weak adduction squamous to columnar epithelium .
B . Winged scapula E . Cancer of the esophagus .
C . Weak abduction
D . Paralyzed diaphragm * A 50 years old man presents with epigastric
E . Facial drop pain unrelieved by PPI . You perform an upper
endoscopy , mass in the mucosa only . You
* Which lung cancer is most likely to be biopsy it and it was lymphoproliferative tissue ,
associated with a paraneoplastic syndrome ? the next appropriate therapy ?
A . Small cell lung cancer A . Total gasterectomy
B . Adenocarcinoma B . Partial gasterectomy
C . SCC C . Chemotherapy
D . Large cell cancer D . Radiotherapy
E . Mesothelioma E . Triple therapy for H pylori

* The most common location for a Boerhaves * A 25 years old woman develops jaundice and
syndrome is ? Ascites 2 week after childbirth , the most likely
A . The left posterior lower esophagus . related to ?
B . The left posterior middle esophagus . A . Retained placenta
C . The left posterior upper esophagus . B . Hepatic vein thrombosis
D . The right posterior middle esophagus . C . HCC
E . The right posterior upper esophagus . D . Biliary cystadenocarcinoma
E . Hepatitis

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 9
* 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 , * If the anal fissure was located laterally , what
the 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 D . Descending colon
fairly 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
D . Lumbosacral nerve
* A 50 years old woman with a pancreatic mass E . Femoral nerve
in the tail of the pancreas develops watery
diarrhea and Hypokalemia . The most likely * A 65 years old woman presents with a tender
diagnosis is ? medial thigh mass . The pain increases with
A . Glucagonoma internal rotation of the thigh . The most likely
B . Gastrinoma diagnosis ?
C . Somatostatinoma A . Inguinal hernia
D . Vipoma B . Obturator hernia
E . Insulinoma C . Ventral hernia
D . Femoral hernia
* The right gastric artery is normally a branch of E . Howship Romberg hernia
the ?
A . Gastroduodenal artery * Anterior dislocation of the shoulder is most
B . Right gastro_epiploic artery likely to injury the ?
C . Pancreatoduodenal artery A . Subclavian vein
D . Proper common hepatic artery B . Subclavian artery
E . Right hepatic artery C . Axillary artery
D . Axillary nerve
* All of the following are true about TTP except ? E . Thoracic duct
A . Enlarged spleen .
B . Loss of platelets inhibition .
C . Splenectomy is usually indicated .
D . The primary therapy is plasmapheresis .
E . Thrombosis .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 10
* A 2 year old is brought into your office for an * A severe overdose of Diazepam is treated with
umbilical hernia . All of the following are true A . Flumazenil
except ? B . Nalxone
A . Patient should have surgery at about age 5 C . Neostigmine
year if it fails to close . E . Atropine
B . Patient is at high risk for incarceration .
C . This hernia are increased in African patients . * The true composition of normal saline ?
D . This hernia are increased in premature A . Na 154 , CL 154 , K 4
pediatric . B . NA 154 , CL 154
E . Associated with congenital hypothyroidism C . NA 130 , CL 109 , K 4 , Ca 2.7
D . NA 130 , CL 130
* A newborn infant fails to pass meconium in the
first 48 hours of life and subsequently gets * A 3 month old child has persistent vomiting
progressive abdominal distension . Your order associated with Pyloric stenosis , the common
plain films which show distended loops of small metabolic change is ?
bowel , but no air _ fluid levels . The colon is A . Hypochloremic hypokalemic metabolic
totally decompressed . The transition point in the alkalosis .
RLQ . On exam , the has an anus located in the B . Hypochloremic hyperkalemic metabolic
proper position . The most appropriate next step alkalosis .
A . Upper GI endoscopy C . Hyperchloremic hyperkalemic metabolic
B . Rectal biopsy alkalosis .
C . Barium enema D . Hypochloremic hypokalemic metabolic
D . Upper GI series alkalosis
E . Enteroclysis
* What should the maintenance fluid rate to 50 kg
* The most common type of Tracheoesophageal medically free boy ?
fistula is ? A . 120 ml/hour
A . Type A B . 90 ml/hour
B . Type B C . 60 ml/hour
C . Type C D . 30 ml/hour
D . Type D
E . Type E * Ileal resection can result in all except ?
A . Decreased B12 uptake
* The most common blood transfusion reaction ? B . Megaloblastic anemia
A . ABO incompatibility reaction C . Increased bile salt uptake
B . Acute lung injury D . Gallstones formation
C . Delayed Hemolytic reaction
D . Febrile non Hemolytic reaction * Hemorrhagic cystitis is characteristic of one of
E . Hypocalcemia the following chemotherapy ?
A . Cisplatin
* The most common blood product containing B . Bleomycin
bacterial contamination ? C . Cyclophosphamide
A . Red blood cells D . Methotrexate
B . Platelets E . Tamoxifen
C . Cryoprecipitate
D . Fresh frozen plasma * The most predominant cell type in the first 24
E . WBC hours of a wound ?
A . PMNs
* Each of the following antibiotics is bacteriostatic B . Macrophages
except ? C . Lymphocytes
A . Sulfonamides D . Fibroblasts
B . Tetracycline
C . Erythromycin * The earliest cell type involved in wound healing
D . Gentamycin A . PMNs
E . Azithromycin B . Macrophages
C . Platelets
D . Lymphocytes
E . Fibroblasts

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 11
* The vitamin that prevent the negative effects of * The tumor most likely to involve bilateral parotid
steroids on wound healing ? glands at the time of presentation ?
A . Vitamin B12 A . Mucoepidermoid carcinoma
B . Vitamin A B . Adenoid cystic carcinoma
C . Vitamin D C . Pleomorphic adenoma
D . Vitamin C D . Warthin tumors
E . Vitamin E
* A 5 year old girl present with a midline anterior
* A 26 year old female involved in RTA , she is neck mass painless mass that moves with
hypotensive . Blood pressure 85/40 , heart rate tongue protrusion and swallowing . The most
120 . Was intubated , she has distended common cause ?
abdomen , you give her 2 liter ringer lactate and A . Thyroid tumor
start packed red blood cells . However she B . Branchial cleft cyst
remain hypotensive , the best next step ? C . Dermoid cyst
A . Abdomen CT scan D . Thyroglossal duct cyst
B . Angiogram
C . FAST scan * A 28 year old male patient , suffers severe
D . Exploratory laparotomy second and third degree burns , he is intubated
and started IV fluid resuscitation . Patient has a
* The initial treatment of choice in a patient with circumferential burn to his right arm with pale
Hyperkalemia and arrhythmia ? cyanotic his right arm . The best next step ?
A . DC shock A . Fasciotomy
B . Insulin and glucose B . Arm elevation
C . Calcium gluconate C . Thrombectomy
D . Kaexylate D . Streptokinase
E . Dialysis E . Escharotomy

* The highest concentration of angiotensin * The most common organism involved in burn
converting enzyme is in ? wound sepsis ?
A . Liver A . Staphylococcus aureus
B . Kidney B . Pseudomonas
C . Lung C . Streptococcus viridans
D . Bone D . Klebsiella
E . Colon
* The best test for the diagnosis of adrenal
* All of the following values are consistent with medulla tumor ?
prerenal acute renal failure except ? A . 24 hour urine metanephrine
A . Urine NA 10 B . 24 hour urine cortisol
B . BUN / creatinine ratio 30:1 C . 24 hour urine Aldosterone
C . Fe Na 0.5% D . 24 hour urine epinephrine and
D . Urine osmolality 200 norepinephrine
E . Creatinine / creatinin plasma 50
* The blood supply to the parathyroid glands ?
* A 25 year old man involved in a MVA will open A . Superior thyroid arteries for both glands .
his eyes only to pain , formes incomprehensible B . Inferior thyroid arteries for both glands .
sounds , and withdraw to pain , this patient C . Superior thyroid arteries for superior glands .
Glasgow coma score ? D . Superior thyroid arteries for inferior glands .
A . 10 E Transverse cervical artery for both glands .
B.8
C.6 * A 30 years old female recently diagnosed with
D.4 MEN1 syndrome , develops confusion ,
E.3 Somnolence , constipation , short QT interval on
ECG , the best next step ?
* The treatment of choice for severe burn with A . Alpha B blockers
myoglobinuria ? B . B blockers
A . Broad spectrum antibiotic C . Calcium gluconate
B . Inotropic support D . IV fluid normal saline and Lasix
C . Fluid resuscitation and bicarb
D . Lasix

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 12
* The first drug you must be prescribe for patient * The most common nerve injured after MRM ?
with adrenal medulla tumor ? A . Long thoracic nerve
A . Propranolol B . Thoracodorsal nerve
B . Phenoxybenzamine C . Phrenic nerve
C . Hydralazine D . Intercostal brachiocutaneous nerve
D . Enalapril
E . Lowsartane * The most common nerve injured with carotid
endarterectomy ?
* Most common cause of Hypoparathyroidism ? A . Vagus
A . Previous thyroid surgery B . Hypoglossal
B . Radiation therapy C . Lingual
C . Chemotherapy D . Glossopharyngeal
D . Malignancy
* Most common artery ligated in AAA repair ?
* The best initial treatment of thyroid storm ? A . Right colic artery
A . Dantrolene B . Inferior mesenteric artery
B . Propranolol C . Superior mesenteric artery
C . Emergency thyroidectomy D . Middle colic artery
D . Steroids E . Inferior rectal artery

* While performing a modified radical * Parietal cells of the stomach secrete ?

mastectomy , the surgeon cut the long thoracic A . HCL and I.F
nerve , the patient postoperatively mostly have ? B . Pepsinogen
A . Weak adduction C . Secretin
B . Weak abduction D . Cholecystokinin
C . Paralyzed diaphragm
D . Winged scapula * Most common problem following Vagotomy and
Pyloroplasty ?
* Which lung cancer is most likely associated A . Diarrhea
with Paraneoplastic syndrome ? B . Dumping syndrome
A . Small cell cancer C . Gallstones
B . Adenocarcinoma E . Reflux gastritis
C . SCC
D . Large cell cancer * The LES pressure at rest and during a swallow
in normal person ?
* The most common location for a Boerhaave A . 70 mmHg and 15 mmHg
syndrome ? B . 15 mmHg and 70 mmHg
A . Left posterior lower 3d of the esophagus . C . 15 mmHg and 0 mmHg
B . Left posterior middle third of the esophagus . D . 0 mmHg and 15 mmHg
C . Left posterior upper third of the esophagus .
D . The upper stomach . * Barrett esophagus refers to ?
A . The change in esophageal mucosa from
* A 50 year old woman present with chief columnar to squamous epithelium .
complaint of dysphagia and odynophagia , the B . The change in esophageal mucosa to
best first step to do ? transitional epithelium .
A . EGDS C . Keratinization of the esophageal mucosa .
B . Chest CT scan D . Change in esophageal mucosa from
C . Abdomen CT scan squamous to columnar epithelium .
D . Barium swallow
E . Esophageal manometry * The best first step in treatment of gastric
mucosa associated with lymphoproliferative
* A 65 year old cachetic man smoker with an tissue tumor ( MALTOMA) ?
apical lung cancer ( Pancoast tumor ) present A . Total gasterectomy
with Ptosis , Myosis and Anhydrosis . The most B . Partial gasterectomy
likely cause ? C . Chemo_radio therapy
A . Paraneoplastic syndrome D . Triple therapy for H pylori infection
B . Invasive CA to brachial plexus
C . Invasive CA to SVC
D . Invasive CA to sympathetic chain at T1

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 13
* 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 ?
pressure 85/40 heart rate 125 , temperature 39 , A . Chemotherapy
the best next step ? B . Radiotherapy
A . Emergency Cholecystectomy C . Right Hemicolectomy
B . Emergency ERCP D . Chemo_radio therapy
C . Emergency PTC placement
D . IV fluid and IV antibiotics * All are true about TTP except ?
A . Loss of platelet inhibition and thrombosis
* All are true about ITP except ? formation .
A . Splenomegaly B . Splenomegaly .
B . In children less than 10 years usually resolves C . Splenectomy is rarely indicated .
spontaneously . D . The primary therapy is steroids .
C . The primary treatment is steroids . E . Associated with HUS .
D . Splenectomy is indicated if medical therapy
fails or chronic ITP . * A 50 year old woman develops DM and severe
E . Anti platelets antibodies . migratory Erythematous skin rash , on abdomen
CT scan found to have pancreatic mass, the
* Most common congenital abnormality requiring most likely
splenectomy ? diagnosis ?
A . Hereditary spherocytosis A . Glucagonoma
B . Hereditary elliptocytosis B . Gastrinoma
C . Protein kinase deficiency C . Vipoma
D . B Thalassemia minor D . Insulinoma
E . Somatostatinoma
* The right gastric artery is normally a branch of
the ? * Posterior dislocation of the Hip is most common
A . Gastro_doudenal artery to injure the ?
B . Right gastro_epiploic artery A . Femoral artery
C . Pancreato_duodenal artery B . Femoral vein
D . Proper hepatic artery C . Femoral nerve
D . Sciatic nerve

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 14
* All are true about urinary bladder cancer except * Anterior dislocation of the shoulder is most
A . The most common is TCC . commonly to injure the ?
B . Schistosomiasis infection is risk factor for A . Subclavian vein
SCC . B . Subclavian artery
C . TCC limited to Submucosal , can be treated C . Axillary nerve
with intra_vesical BCG or TURT . D . Thoracic duct
D . TCC with invasive to muscle (T* is best
treated with wedge resection . * Treatment of choice of Mucoepidermoid
carcinoma of salivary glands ?
* A 65 year old woman present with a tender A . Superficial paratidectomy
mass just below the inguinal ligament , the most B . Total paratidectomy
likely diagnosis ? C . Chemotherapy
A . Inguinal hernia D . Radiotherapy
B . Femoral hernia
C . Obturator hernia * Most common benign salivary glands tumor ?
D . Ventral hernia A . Warthin tumors
E . Richter hernia B . Pleomorphic adenoma
C . Mucoepidermoid adenoma
* All of the following are true about HNPCC D . Adenoid cystic adenoma
except ?
A . Colon cancer are right sided . * Most common cancer that give metastasis to
B . Associated with ovarian, breast , stomach the small bowel ?
cancer . A . Lung cancer
C . Patient have thousands of polyps . B . Colon cancer
D . Needs to be in 3 primary relatives , over 2 C . Prostatic cancer
generation , with one person D . Melanoma
being less than 50 years old at the time of E . Breast cancer
diagnosis
* Erythema multiforme is most commonly with
* The most common nerve injured in inguinal which of the following antibiotics ?
hernia repair ? A . Quinolones
A . Genitofemoral nerve B . Bactrim( CO_ trimoxazole )
B . Ileoinguinal nerve C . Erythromycin
C . Sciatic nerve D . Ceftriaxone
D . Lumbosacral nerve E . Vancomycin

* A 1 year old baby found to have umbilical * The mechanism of action for Fluoroquinolones
hernia all are true except ? A . Inhibition of RNA polymerase
A . Check thyroid function is important . B . Inhibition of DNA gyrase
B . More common in premature baby . C . Inhibition of ribosomes
C . More common in African babies . D . Production of oxygen radicals
D . Surgery treatment at about 5 year old if
hernia fails to close . * The most common malignancy following organ
E . High risk for incarceration . transplantation ?
A . Lung cancer
* A 15 year old develops sudden , severe scrotal B . Prostatic cancer
pain, and high riding right C . Skin cancer
testicle , the best next step ? D . Breast cancer
A . Bilateral exploration of testicles through E . Colon cancer
inguinal incision .
B . Unilateral exploration of testicles through * Diaphragm injuries ?
inguinal incision . A . More common in the right .
C . Bilateral exploration of testicles through B . More common in the left .
scrotal incision . C . Most common cause is penetrating trauma .
D . Unilateral exploration of testicles through D . Easy to find with CT scan .
scrotal incision .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 15
* A 22 years old male patient suffers a severe * All of the following are true about thyroid gland
pelvic fracture and has Hematuria , on retrograde except ?
cysto_urethrogram found to have extraperitoneal A . Thyroid gland is one of the largest endocrine
bladder rupture . The most appropriate therapy ? glands .
A . Foley catheter for 7 days . B . Thyroid gland consists of 2 lobes ( right , left )
B . Exploratory laparotomy and surgical repair . , isthmus and pyramidal lobe in 50% of
C . Cystoectomy . population .
D . Nothing to do and observation . C . Hormones secreted by the thyroid are not
surgery 7,2018 affected by the pituitary gland .
D . Thyroid gland has 2 arteries and 3 veins .
* The first systemic complication after a major E . The thyroid gland develops at 4 week of
burn injury ? gestation
A . Hemodynamic instability .
B . Metabolic acidosis . * In graves disease all are true except ?
C . Renal failure . A . It is the most common cause of
D . Hyperkalemia . Thyrotoxicosis .
E . Sepsis . B . More common in women .
C . Treatment includes medical , iodine ablation
* A 56 years old man presents with constipation , and surgery .
abdominal pain , kidney stones and suffers with D . In graves disease TSH increased while T4
depression . Which of the following is the most markedly decreased .
possible ? E . Diarrhea , palpitation and heat intolerance
A . Hypercalcemia . can be found in graves disease .
B . Hypokalemia .
C . Hypothyroidism . * Helicobacter pylori may cause the following
D . Dehydration . conditions in the stomach and duodenum except
E . DM . A . Gastric ulcer .
B . Duodenal ulcer .
* Life threatening causes of abdominal pain . All C . Gastric lymphoma .
are true except ? D . Gastrointestinal stromal in the stomach .
A . Perforation . E . Gastric adenocarcinoma .
B . Gastroduodenitis .
C . Acute pancreatitis . * A child with abdominal pain is suspected of
D . Ruptured ectopic pregnancy . having an intussusception One is true ?
E . Referred pain ( MI , aortic dissection ) . A . The condition occurs in 3 months old in 70%
of case's .
* Which of the following signs does not suggest a B . Ileocolic intussusception is most common
tension pneumothorax ? C . Vomiting occur early in the presentation .
A . Hypotension D . Fever excludes intussusception as the
B . Tachycardia diagnosis .
C . Dyspnea E . Plain abdominal X_Ray is diagnostic .
D . Tracheal deviation
E . Subcutaneous emphysema * All of the following are risk factors for breast
cancer except ?
* In bowel obstruction , which one of the following A .Obesity .
features is suggestive of strangulation ? B . Low bone mineral density .
A . Intermittent pain . C . High breast density .
B . Acidosis . D . Smoking .
C . Alkalosis . E . First full term pregnancy at age of 35 years .
D . Heavy watery diarrhea .
E . Reducible hernia . * All of the following are complication of colonic
diverticulosis except ?
* Worrying features of acute abdominal pain . All A . Diverticulitis .
are true except ? B . Hemorrhage .
A . Tachycardia C . Fistulae .
B . Hypotension D . Cancer .
C . Anorexia E . Abscesses .
D . Persistent vomiting
E . Massive rectal bleeding

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 16
* Adenocarcinoma of the small intestine is most * Which of the following most reliably
commonly associated with ? distinguished erysipelas from other causes of
A . Familial adenomatous polyposis . skin infection ?
B . Tuberculosis of the small bowel . A . Associated abscess .
C . Lymphoma . B . Increased margin of infection .
D . Prolonged use of cytotoxic chemotherapy for C . Patients non toxic appearance .
breast cancer . D . Usually caused by group B Streptococcus .
E . Ulcerative colitis . E . Usually seem on chest .

* Femoral hernia is differentiated from all the * The most sensitive image for urinary tract
following diseases except ? stones is ?
A . Bartholin gland cyst . A . MRI .
B . Lipoma . B . Ultrasound .
C . Cold abscess . C . Intravenous pyelogram .
D . Varicose node . D . Enhanced urinary tract CT .
E . Inguinal hernia . E . Unenhanced urinary tract CT

* Asthenic man with chronic symptoms of * All of the following are known complication of
proximal bowel obstruction , which vessel is the gallbladder stones except ?
most suggestive cause of obstruction ? A . Obstructive jaundice .
A . Inferior vena cava . B . Cholangitis .
B . Superior mesentric artery . C . Acute pancreatitis .
C . Superior epigastric artery . D . Liver cirrhosis .
D . Celiac trunk . E . Cholecystoduodenal fistula .
E . Abdominal aorta .
* Tetanus , all are true except ?
* All are indications for surgery in benign A . Tetanus is a serious toxin mediated disease .
prostatic hyperplasia except ? B . Tetanus is with a mortality of up to 50% .
A . Large prostate 100 grams . C . Gram positive anaerobic organism .
B . Refractory urinary retention . D . Culture is essential for diagnosis .
C . Renal impairment . E . Causes diffuse muscle rigidity .
D . Recurrent UTI .
E . Recurrent gross Hematuria. * Which artery is considered to be differentiate
between site of origin in inguinal hernia ?
* A 41 years old male smoker is diagnosed with A . Cremasteric artery .
low grade gastric lymphoma . After a successful B . Superior epigastric artery .
treatment , he underwent surveillance upper C . Inferior epigastric artery .
endoscopy that showed a complete cure . What D . From artery .
is the type of treatment he received ? E . Superficial circumflex iliac artery .
A . Medical treatment .
B . Surgical treatment . * Which of the following is true regarding breast
C . Chemotherapy . cancer ?
D . Observation . A . The majority of case's with breast cancer are
E . Surgical and chemotherapy familial in origin .
B . The most important risk factor for developing
* At what age is surgical orichidopexy breast cancer is age .
recommended for a child with unilateral C . Breast density has no correlation with the risk
undescended testes ? of breast cancer .
A . 4 _ 5 years . D . Up to 10% of breast cancer is hereditary .
B . 5 _ 6 years . E . BRCA1 mutation is associated with significant
C . Any time prior puberty . increase in breast and endometrial cancer risk
D . 1 year .
E . Promptly upon discovery , regardless of age . * Which of the following is the greatest risk factor
for developing anaortic aneurysm ?
A . Age
B . History of smoking
C . History of HTN
D . Metabolic disturbances
E . Male factor

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 17
* 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 , conjoint
C . Ganglion cyst . 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
obstruction is ? external 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 ?
E . PUD . A . Low fiber diet .
B . Constipation .
* All of the following are branches of External C . Pregnancy .
carotid artery except ? D . Laxative abuse .
A . Posterior auricular artery . E . Old age .
B . Ascending pharyngeal artery .
C . Mandibular artery . * All of the following are risk factors for
D . Maxillary artery . Hepatocellular carcinoma except ?
E . Superior thyroid artery . A . Hepatitis B virus .
B . Wilson disease .
* Circle of willis is composed of all of the C . Alcohol .
following arteries except ? ‫كل االجابات صحيحه‬ D . OCPs .
A . Anterior communicating artery . E . Alpha one antitrypsin deficiency .
B . Posterior communicating artery .
C . Internal carotid artery . * All of the following are risk factors for
D . Middle cerebral artery . Cholesterol gallbladder stones except ?
E . Anterior cerebral artery A . Obesity .
B . Crohn disease .
* A alcoholic patient was admitted to hospital 30 C . Multiparity .
min after the fight , he was excited , there were D . Cirrhosis liver .
ecchymosis and abrasion on left temporal region E . Starvation .
. 6 hours later consciousness was 8 point by
GCS , weakness of the right limbs , left mydriasis * One is true about Hashimoto thyroiditis ?
. What is the most likely cause ? A . Most common cause of hyperthyroidism
A . SAH . worldwide .
B . Subdural hematoma . B . Women to men ratio 1:20 .
C . Intraventricular hemorrhage . C . Autoimmune disease .
D . Focal edema of the brain . D . Local enlargement of thyroid gland .
E . Alcoholic coma . E . Strongly associated with HLA_DR4 and
HLA_B4 .
* All are true about base of skull fracture except ?
A . Base of skull fracture are often missed on * Which of the following bad prognostic factor for
plain skull X_Ray . acute pancreatitis ?
B . Base of skull fractures are often A . Very high amylase serum level .
diagnosed on head CT scan . B . Very high lipase serum level .
C . Cerebrospinal fluid otorrhea and rhinorrhea C . Low PaO2 less than 60 mmhg .
are signs of BSF . D . Pseudocyst .
E . Very high LDH serum level .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 18
* Treatment of choice of papillary thyroid cancer? * Signs of metastatic gastric carcinoma include
A . Radiotherapy . all of the following except ?
B . Chemoradiotherapy . A . Virchow node .
C . Chemotherapy . B . Blumer shelf .
D . Observation . C . IDA .
E . Total thyroidectomy and neck dissection . D . Sister mary Joseph node .
E . Irish node .
* One of the following infections spread mainly by
airborne route ? * All are true about femoral hernia except ?
A . Warts A . Most common groin hernia in women .
B . Impetigo B . It goes into femoral canal .
C . Tuberculosis C . It goes below inguinal ligament .
D . Malaria D . It lies medial to femoral vein .
E . Chickenpox E . It is high risk for strangulation .

* The treatment of choice for neonates with * Most common presentation of left colon
uncomplicated meconium ileus is ? adenocarcinoma ?
A . Observation . A . Weight loss .
B . Emergency laparotomy . B . IDA .
C . IV hydration and hypertonic gastrografin C . Bowel obstruction .
enema . D . Abdominal pain .
D . Sweat chloride test and pancreatic enzyme E . Rectal bleeding .
therapy .
E . Lower GI endoscopy . * All of the following are clean or clean _
contaminated surgery except ?
* Branchial cleft remnants most often present A . Hernia repair .
with which of the following clinical problems ? B . Thyroidectomy .
A . Airway obstruction . C . Laparoscopic cholecystectomy .
B . Hemorrhage . D . Bowel obstruction .
C . Malignancy . E . Radical mastectomy .
D . Pain .
E . Infection . * Most common site of needle thoracostomy in
management of tension pneumothorax is ?
* All are true matching about thyroid gland cancer A . First intercostal space mid clavicular line .
except ? B . 2d intercostal space mid axillary line .
A . Papillary carcinoma _ best prognosis . C . 2d intercostal space mid clavicular line .
B . Follicular carcinoma _ blood spread . D . Fifth intercostal space mid clavicular line .
C . Anaplastic carcinoma _ Multiple endocrine E . Fifth intercostal space anterior axillary line
neoplasia .
D . Lymphoma _ treatment chemoradiotherapy . * Which of the following is true regarding breast
E . Medullary carcinoma _ secrete calcitonin . cancer ?
A . The majority of case's with breast cancer are
* A 3 kg neonate with excessive salivation familial in origin .
develops respiratory distress . Attempts to pass B . The most important risk factor for developing
and orogastric tube failure . A chest film shows breast cancer is age .
right upper lobe atelectasis and a gasless C . Breast density has no correlation with the risk
abdomen , the most likely diagnosis ? of breast cancer .
A . Proximal esophageal atresia with distal D . Up to 10% of breast cancer is hereditary .
Tracheosesophageal fistula . E . BRCA1 mutation is associated with significant
B . H type Tracheosesophageal fistula . increase in breast and
C . Congenital esophageal stricture . endometrial cancer risk .
D . Proximal esophageal atresia without a
fistula . * The goal of primary prevention is ?
E . Esophageal atresia with both proximal and A . Early detection of disease .
distal Tracheosesophageal B . Minimize the complication of disease .
fistula . C . Prevent disease Onest .
D . Rehabilitation of disease .
E . Prevent progression of disease

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 19
* Ideal criteria for screening test in all of the * Which of the following statement about the
following except ? anatomy of the esophagus is correct :
A . High specificity . A) The cervical esophagus passes behind and to
B . Low sensitivity . the right of the trachea
C . Safe , rapid and easy . B) The esophagus deviates anteriorly and to
D . Cost effective . the left as it enters the abdomen
E . For significant suffering disease . C) The thoracic esophagus enters the posterior
mediastinum anteriorly to the
* Mortality from all causes of death per 1000 in aortic arch
population is called ? D) The thoracic esophagus passes behind the
A . Life expectancy . right mainstem bronchi and the
B . Infant mortality rate . pericardium
C . Crude death rate . E) The esophagus enters the diaphragmatic
D . Crude death ratio . hiatus at the level of T8
E . Total death rate .
* A 35 years old man with known ulcerative colitis
* An outbreak or excessive rate of disease that , which of the following is an indication for total
rapidly spread over a wide area , crossing proctocolectomy :
international boundaries is called ? A) Occasional attack of colic and diarrhea
A . Epidemia . B) Sclerosing Cholangitis
B . Pandemia . C) Arthritides
C . Endemia . D) Toxic megacolon
D . Outbreak . E) IDA
E . Virulence .
* The most common type of intracranial
* At which level , end of the spinal cord : hemorrhage :
A) 4th lumbar vertebrae A) Extradural
B) L3_L4 inter space B) Subdural
C) Second lumbar vertebrae C) Subarachnoid
D) T12_L1 inter space D) Intracerebral
E) S2_S3 inter space E) Intraventricular

* A 20 years old with a bloody single duct * One is true regarding the electrolyte
discharge and a palpable mass at the areola , no concentration in Hartmann solution :
malignant cells and isolated from discharge . The A) chloride 200 mmol / L
likely diagnosis is : B) Lactate 70 mmol /L
A) Ductal carcinoma C) Na 131 mmol/L
B) Duct ectasia D) K 40 mmol/L
C) Intraductal papilloma E) Calcium 15 mmol/L
D) Prolactinoma
E) Periductal mastitis * Most common hernia in females :
A) Femoral hernia
* A 50 years old man , presented to E.R with B) Umbilical hernia
severe Epigastric pain of 5 hours duration . The C) Obturator hernia
pain radiating to back , associated with recurrent D) Direct inguinal hernia
vomiting , Amylase level is high , all of the E) Indirect inguinal hernia
following criteria are used to peridict mortality
and morbidity during admission except : * A 73 years old man, known of IHD , presented
A) Age over 55 years complaining of severe abdominal pain . In ABG
B) Blood sugar more than 200 mg / dl shows PH = 7.31 , PCO2 = 25 mmhg , PO2= 73
C) AST more than 250 u/ L mmhg , HCO3 = 14 mmol /L , BE = 15.9 . The
D) WBC less than 5000/mm3 diagnosis is :
E) LDH more than 350 u/ L A ) Metabolic acidosis
B) Metabolic acidosis with respiratory
* All are true about Crohn disease except : alkalosis compensation
A) Stenosis more seen in ulcerative colitis C) Respiratory acidosis
B) Macroscopically cobblestoning D) Respiratory acidosis with metabolic
C) Endoscopically skip lesions compensation
D) Histologically transmural Granulomas E) Metabolic and respiratory acidosis mixed

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 20
* 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
C) Dislocated hip tenderness
D) Nerve supply of the upper limb D) WBC count > 20.000
E) Blood supply of the hand E) None of above

* All are features of tumor lysis syndrome except * Which of the following is not true regarding
A) Hyperkalemia sepsis :
B) Hyperphosphatemia A) Tachycardia and / or tachypnea may be a sign
C) Hypercalcemia B) Sepsis is defined as systematic inflammatory
D) Hyperurecemia response in the presence of infection
E) High BUN C) Leucocytosis or Leukopenia may be a sign
D) Sepsis and hypotension despite IV fluid is
* The preferred operation for initial management defined as septic shock
of a thyroid nodule that is considered suspicious E) Temperature greater than 38 or less than 36
of malignancy by FNAB is : may be a sign
A) Nodule excision
B) Partial lobectomy * Which of the following statement is true about
C) Total lobectomy and isthmusectomy drug therapy for Crohn disease :
D) Total thyroidectomy A) Corticosteroids effective treat acute attack and
E) Near total thyroidectomy to prolong remission
B) Sulfasalazine for acute attack involving small
* A 50 years old man is admitted to hospital with bowel
severe bleeding and bruising . He is on warfarin C) Azathioprine and immunosuppressive drugs
and INR is 10 , For rapid complete reversal . The for remission
best is : D) Low dose cyclosporine for patients with both
A) Platelets low and high disease activity
B) FFP and vitamin K E) All of the above
C) IV vitamin K
D) Whole blood and vitamin K * The spleen filters all of the following particles
E) FFP and vitamin C cells except :
A) Malformed RBCs
* A 36 years old woman , 20 weeks pregnant , B) T lymphocytes
was in investigating a 1.5 cm right thyroid nodule C) Malarial parasites
, fine needle aspiration is consistent with D) Streptococcus pneumonia
Papillary neoplasm , which of the following E) Platelets
methods of treatment is contraindicated :
A) Right thyroid lobectomy * Hyperthyroidism can be caused by all of the
B) Subtotal thyroidectomy following except :
C) Total thyroidectomy A) MTC
D) Total thyroidectomy with lymph node B) Graves disease
dissection C) Plummer disease
E) Radioactive iodine ablation of thyroid D) Struma ovarii
gland E) Hashimoto disease

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 21
* 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
D) Exploration and ligation under local femoral 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 :
E) Hypertrophy of glandular tissue A) Superior thyroid arteries
B) Inferior thyroid arteries
* Post mastectomy and axially clearance for a C) Thyroidea ima arteries
patient with breast cancer , the patient was found D) Parathyroid arterial branches from external
to have a winging scapula , the most likely cause carotid arteries
A) Patient suffered a TIA E) Highly varible
B) Damage to thoracodorsal nerve during
surgery * Most common cause of Goitrous
C) Damage to long thoracic nerve during hypothyroidism in adults is :
surgery A) Hashimoto disease
D) Damage to serratus anterior muscle B) Graves disease
E) Dislocated scapula C) Riedels thyroiditis
D) De Quervain thyroiditis
* Regarding abdominal trauma in pediatric group E) Iodine deficiency
, one is true :
A) Splenectomy is not a routine for all types of * A 25 years old . Underwent an antrectomy. and
splenic injuries vagotomy , he is complaining of nausea, vomiting
B) Peritoneal lavage is contraindicated , diarrhea , dizziness , fatigue , bloating . Within
C) Blood transfusion must be started immediately 15_30 min from meal ingestion , and low blood
D) Ultrasound is the diagnostic tool of choice sugar within 2 hours from meal . The most likely
E) Clinical exam , stabilisation , resuscitation are diagnosis :
not of priority A) Anemia
B) Jejunogastric intussusception
* All of the following is true regarding the femoral C) Dumping syndrome
triangle except : D) Afferent loop syndrome
A) The inguinal ligament forms the base E) Alkaline reflex gastritis
B) The medial border _ lateral border of adductor
longus muscle * A 32 years old man present with Hematuria. A
C) The lateral border _medial border of sartorius KUB X_Ray reveals a staghorn calculus in the
D) The floor _ adductor longus and oblique right kidney and mid stream urine sample grows
muscle medially proteus . The most likely stone type is :
E) The floor _ iliopsoas muscle laterally A) Bile pigment stone
B) Calcium oxalate
* Capillary refill time is elicited by : C) Calcium phosphate
A) Pressing over the skin for 3 seconds , D) Cholesterol stone
normally return of perfusion by 2 seconds E) Cysteine stone
B) Pressing over the skin for 5 seconds ,
normally return of perfusion by 2 seconds * The first step in management hypercalcemia is :
C) Pressing over the skin for 5 seconds , A) IV hydration normal saline 0.9%
normally return of perfusion by 5 seconds B) Hydrocortisone
D) Pressing over the skin for 10 seconds , C) Dialysis
normally return of perfusion by 5 seconds D) Administration of Furosemide
E) Administration of mithramycin

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 22
* A 54 years old man on renal dialysis is have to * Colon pseudo_obstruction is caused by all ,
raised serum calcium and PTH this is called : except :
A) Primary Hyperparathyroidism A) Systemic illness
B) Secondary Hyperparathyroidism B) Electrolyte imbalance
C) Tertiary Hyperparathyroidism C) Fecal impaction
D) Hypercalcemia on malignancy D) Opioids
E) Hypoparathyroidism E) Hypothyroidism

* One of the following is an indication for * All predispose to necrotizing fascitis except :
nasogastric tube insertion : A) Diabetes
A) Recent esophageal surgery B) Severe head injuries
B) Suspected esophageal perforation C) Cortisone therapy
C) PE D) Advance malignancy
D) Perforated stomach E) Renal failure
E) Colovesical fistula
* A 59 years old patient presented with left upper
* All of the following are true regarding nick abdominal discomfort . His physical exam reveals
lumps except : left upper quadrant tenderness . A CT scan of
A) Thyroglossal cyst moves upward on protrusion abdomen _ spleen infarction . Most common
of tongue cause of of his splenic infarction :
B) Branchial cysts typically present in the first A) Aplastic anemia
decade of life B) ITP
C) Thyroid masses move upwards on swallowing C) Gilbert disease
D) Cystic hygromas are lymphatic malformation D) Atrial fibrillation
E) Parotid glands are not normally palpable E) Idiopathic pulmonary fibrosis

* Assessment of a breast lump include all , * A 62 years old female was recently diagnosed
except : with an adenocarcinoma of the Sigmoid colon .
A) Clinical examination You are concerned about the possibility of
B) Mammography metastasis. Which of the following is most
C) Core biopsy suggestive of metastatic disease :
D) FNA A) Multiple hepatic hypoechoic lesions on
E) Mastectomy abdominal ultrasound
B) Mild elevation of carcinoembryonic antigen
* Influenza is one of the greatest pandemic C) Abdominal pain
disease because of : D) Severe constipation
A) Mutation of the virus E) Abundant blood per rectum
B) Spread by water
C) Long incubation period * Carpal tunnel syndrome is due to compression
D) High fatality rate A) Median nerve
E) Lack of specific vaccines B) Ulnar nerve
C) Radial nerve
* The most important indicator of a population D) Radial artery
health : E) Ulnar artery
A) Crude birth rate
B) Crude mortality rate * The most precise diagnostic screening
C) Infant mortality rate procedure for differentiating benign thyroid
D) Maternal mortality rate nodules from malignant ones is :
E) Total fertility rate A) Thyroid ultrasonography
B) Thyroid scintiscan
* Which of the following is not associated with C) Thyroid hormone suppression
compartment syndrome : D) FNAB
A) Disproportionate level of pain E) CT scan
B) Absent distal pulse
C) Paresthesia
D) Heat
E) Paralysis

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 23
* 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
D) CBD stone D) 70 ml/hour
E) Sepsis E) 80 ml/hour

* Which of the following is true regarding * The test with highest sensitivity for
gallstones type's : Pheochromocytoma is :
A) Pure cholesterol stone are the commonest A) Plasma catecholamine
B) Brown stones usually from Hemolysis B) Plasma metanephrine
C) Black stones usually with bacterial infection C) Urinary catecholamine
D) Pigment stones are dark because of D) Urinary metanephrine
presence of calcium bicarbonate E) Urinary VMA
E) Most cholesterol stones are radiopaque
* Which intestinal cells have been implicated in
* A strong correlation exists between the formation of GIST :
Nasopharyngeal carcinoma and : A) Goblet cells
A) White race B) APUD cells
B) EBV C) Cajal cells
C) Betel nut chewing D) Paneth cells
D) Alcohol E) G cells
E) Plummer Vinson syndrome
* Which of the following is the best first line
* All of the following are true regarding option for an acute exacerbation of Crohn
Clopidogrel except : disease :
A) It inhibits activation of glycoprotein 2B/3A A) Sulfasalazine
complex B) Mesalamine
B) The risk of bleeding is increased if it is used C) Natalizumab
with aspirin D) Prednisone
C) When discontinued , bleeding time normalizes E) Infliximab
in approximately 2_3 days
D) It inhibits platelet aggregation within 2 hours of * A hernia sac containing a Meckels diverticulum
oral administration is called :
A) Petit hernia
* Management of Ascites due to liver cirrhosis B) Littre hernia
includes all except : C) Spiglian hernia
A) TIPS D) Richter hernia
B) Paracentesis E) Grynfeltt hernia
C) Spironolactone
D) Furosemide * The most common organism associated with
E) Sodium restriction overwhelming post splenectomy sepsis :
A) Group A Streptococcus
* All of the following are part of the child pugh B) Haemophilus influenzae
scoring system for portal HTN except : C) Streptococcus pneumonia
A) Hemoglobin level D) Meningococcus
B) Ascites E) Babesia microti
C) Encephalopathy
D) Serum bilirubin

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 24
* 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
C) Increase in arterial oxygenation C) The risk of colon cancer is 100% by age 50
D) Decrease in thirst D) Once a polyp is detected total
E) Decrease in tachycardia proctocolectomy is recommended
E) There is no association with upper GIT
* Which of the following is the most common malignancy
neoplasm of the appendix :
A) Mucinous adenocarcinoma * According to Parkland formula , the amount of
B) Carcinoid tumor crystalloid fluids , that should be administered to
C) Malignant mucocele the first 8 hours to a 70 kg man with a 15% TBSA
D) Lymphoma first degree burns , 50 % TBSA second degree
E) Lymphosarcoma burn , 20% TBSA third degree burn :
A) 5000 ml
* Which of the following is the most reliable in B) 6500 ml
confirming the diagnosis of acute appendicitis : C) 7350 ml
A) Classic history of initial periumbilical pain D) 9800 ml
shifting to the right lower quadrant E) 11900 ml
B) Rebound tenderness
C) Localized tenderness at Mcburneys point * Regarding the preoperative management , all
D) Psaos sign presence sentences are true except ?
E) Rovsing sign presence A . A recent MI is the most important risk factor to
preoperative MI .
* The primary adverse reaction to Trastuzumab : B . Patients should stop taking their regular
A) Liver toxicity antihypertensive drugs on the day of surgery
B) Renal toxicity C . History and examination alone are usually
C) Thromboembolic events sufficient in evaluating the risk of bleeding .
D) Cardiac toxicity D . LMWH is used in venous thromboembolism
E) Aplastic anemia prophylaxis .
E . Poorly controlled blood sugar in the
* After a modified radical mastectomy , A 45 preoperative period increases the risk for surgical
years old woman reports weakness in her arm . site infection .
On exam she has mild weakness . When she
internally rotates and adducts her arm . The most * In infantile hypertrophic pyloric stenosis, one of
likely injured nerve is : the following is false ?
A) Intercosto_brachial A . The infant usually presents with projectile
B) Long thoracic non bilious vomiting .
C) Supraclavicular B . The treatment is surgical by Ramstedt
D) Medial pectoral operation .
E) Thoracodorsal C . Symptoms commence at age of 3 _ 4 weeks .
D . A palpable olive shaped mass is usually felt in
the epigastric region in the classical case .
E . Usually ultrasound is not sufficient for
diagnosis .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 25
* A 62 years old male patient presented with * Regarding breast cancer , all of the following
nocturia ( 4 time / night ) , weak stream , are true except ?
intermittency and frequency , his DRE revealed A . Tumor speed to the skin means T4 on TNM
induration of the right lobe of prostate gland , all classification .
of the following sentences are true except ? B . Eczema around the nipple should always be
A . Treat the obstructive symptoms . investigated .
B . Perform ultrasound for residual urine C . True cut biopsy is more accurate than fine
assessment . needle aspiration .
C . Request blood sample for prostate specific D . Bloody nipple discharge is always due to
antigen . cancer .
D . Unlikely this patient will need biopsy from E . Metastasis usually involve lung , liver and / or
prostate . bone .
E . His past history and medications have to be
checked * The most common presenting symptom in
patient with pancreatic cancer is ?
* All sentences about wound healing are correct A . Midepigastric pain .
except ? B . Nausea .
A . Presence of a foreign body delays the wound C . Malaise .
healing . D . Anemia .
B . The final strength of a healed wound is E . Anorexia .
greater than that of the surrounding skin .
C . The surgical wound of a thyroid operation is * All of the following are true regarding
considered a clean wound . Hirschsprungs disease except ?
D . Staphylococcus aureus is the most common A . There is no ganglion cell's seen in Auerbach
cause of wound infection following surgery . plexus .
E . Hand wash and hygiene decrease community B . There is increased Incidence of Down
and hospital acquired wounds infections . syndrome .
C . It is more common in boy's .
* A 65 years old gentleman presented to you at D . May be familial .
the emergency room after road traffic accident E . On X_Ray the affected bowel is narrowed
complaining of left chest pain , his vital signs proximally while the normal bowel is dilated
were blood pressure 110/50 , HR 100 , RR 20 , distally .
GCS 14/15 . One examination , he was found to
have diminished breath sounds on the left side . * All sentences about skin cancers are true
CXR demonstrated opacification of the left except ?
hemithorax . What is the most likely diagnosis ? A . BCC are faster growing than SCC .
A . Left hemothorax . B . Malignant melanoma are the most aggressive
B . Left pneumothorax . skin tumors .
C . Cardiac tamponade . C . SCC is often seen in areas exposed to
D . Splenic injury . sunlight such as a scalp and face .
E . Left tension pneumothorax . D . Rodent ulcer is a BCC .
E . Marjolin ulcer is a SCC .
* All of the following can cause bilious vomiting in
an infant or child except ? * In a patient with hypovolemic shock , which
A . Intestinal malrotation and volvulus . cannula size would you ideally choose for
B . Pyloric stenosis . infusion ?
C . Duodenal atresia . A . 19 G .
D . Small bowel obstruction . B . 21 G .
E . Ulcerative colitis with colonic obstruction C . 14 G .
D . 26 G .
* A 5 year old boy is referred to you as an E . 30 G .
emergency with right groin and hip pain . All of
the following are important differential diagnosis * Which is not a cause of pancreatitis ?
except ? A . Hypercalcemia .
A . Inguinal hernia . B . Hypokalemia .
B . Acute appendicitis . C . Hypertriglyceridemia .
C . Testicular torsion . D . Obstruction of ampulla of vater .
D . Congenital hip abnormality . E . Thiazides .
E . Sigmoid diverticulitis .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 26
* 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 . D . Strictures are common indications for surgery
D . Call the surgeon for immediate Laparotomy . in ulcerative colitis .
E . CT scan of the abdomen . E . Recurrence is rare after surgery for Crohn
disease
* All sentences about appendicitis are true except
A . Psoas sign is elicited by extension of the right * A 50 year old male felt a pain in his groin after
hip . lifting a heavy box . He was advised an operation
B . Rovsing sign is elicited by pressing in the left . During the surgery a hernial sac with a small
iliac fossa causing pain in the right iliac fossa . knuckle of intestine was found protruding just
C . Pain is less after laparoscopic compared with below the inguinal ligament . The hernia was
open appendectomy . diagnosed as ?
D . Wound infection is less after laparoscopic A . Direct inguinal hernia .
compared open appendectomy . B . Indirect inguinal hernia .
E . In female patients , open approach is C . Incisional hernia .
preferred over the laparoscopic D . Femoral hernia .
appendectomy . E . Congenital inguinal hernia .

* All sentences about trauma are true except ? * Imaging in surgery , all are true except ?
A . The term triage is generally used in acute A . In abdominal X_Ray , the transverse colon
trauma life support ( ATLS ) . can be seen in various locations in the centre of
B . The rationale behind triage is for the benefit of the abdomen because it is a totally
the majority . intraperitoneal organ .
C . The role of the designated triage person is B . Gallstones are usually seen on X_Ray .
only to triage and not to treat . C . The presence of gas in the small bowel raise
D . The triage process must be constantly the suspicion of bowel obstruction .
repeated . D . Ultrasound is better than CT scan for
E . Coma correspond to a GCS of more than gallstones detected .
8. E . Ultrasound can assess solid organs better
than gas filled organs .
* When total number of death's due to measles is
presented in relation to the total case's of * All of the following sentences about gallstones
measles , it is best labeled as ? are true except ?
A . Cause specific death rate . A . Obesity and bariatric surgery are risk factors
B . Incidence rate . for gallstones formation .
C . Prevalence rate . B . Cholecystectomy can be performed in
D . Case fatality rate . pregnant women .
E . Proportional mortality . C . Every patient undergoing Cholecystectomy
should be consented about bile leak .
* Which is not contributory to GCS ? D . Extracarporeal shock wave lithotripsy is not
A . Obey commands . an effective treatment for gallstones .
B . Localizes painful stimuli . E . Most gallstones are seen on X_Ray .
C . Open eyes to calling .
D . Incomprehensible sounds .
E . Pupils size .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 27
* Which of the following statement regarding the A . Perianal fistula .
differentiation of Keloid scar from hypertrophic B . Anal fissure .
scar is false ? C . Incontinence .
A . Keloid scars are most often seen in dark skin D . Complication of her hemorrhoids .
people . E . Necrotizing fasciitis .
B . Hypertrophic scars respond better to
treatment than Keloid scars . * Paget disease of the breast ?
C . Keloid scars occur when scar cross joints A . Present any where on the breast skin .
at right angle . B . Usually bilateral .
D . Keloid scars outgrow the wound area . C . Uncommon breast carcinoma .
E . Keloid scars have a familial predisposition D . Bad prognosis .
E . It's diagnosed by mammogram .
* Spot diagnosis to differentiate Lipoma and
sebaceous cysts is ? * Informed consent for a surgical procedure
A . Consistency . involves discussion all of the following except ?
B . Compressibility . A . The main treatment available .
C . Fluctuation . B . The individual benefits and risks associated
D . Attachment to deep muscle . with each treatment option .
E . Slippery edge of the lipoma and the punctum C . Wether the operation is entirely necessary
of the sebaceous cyst . and the effects of possibly not having the
procedure at all .
* All of the following sentences about hernia are D . It is acceptable not to mention some risks that
true except ? may upset your patient or his family .
A . Inguinal hernia is the most common in both E . It's good idea to have such discussion in
females and male's . the presence of the close relative .
B . Incisional hernia is more common after open
compared with laparoscopic operation . * 10 cases of food poisoning had been reported
C . Open is always better and safer than in hospital . 2 out these developed mild GI
laparoscopic approach for hernia repair . symptoms . 4 out these developed moderate
D . Divarication of rectus abdominis muscles in dehydration but recovered . The characteristic of
elderly does not necessitate surgical repair . the organism of food poisoning that produces
E . Morbidity is increased after emergency the severest form of the disease ?
compared with elective repair of hernia . A . Infectivity .
B . Pathogenicity .
* A 63 years old male presented as emergency C . Resistibility .
with crampy abdominal pain for 4 days and D . Communicability .
associated with vomiting and abdominal E . Virulence .
distension and constipation , patient denies
weight loss . His past history was only significant * All of the following increase suspicion of
for previous open appendectomy and open malignant thyroid nodule except ?
Cholecystectomy . All of the following sentences A . Age less than 20 years .
are true except ? B . Age more than 60 years .
A . Abdominal X_Ray ( upright and supine ) C . Pain and tenderness .
can be postponed for few days . D . New Onest of hoarseness .
B . It is essential to obtain an upright CXR . E . Male gender .
C . Adhesions are possible cause for this
condition . * A 35 years old lady who's otherwise fit and
D . Abdominal and groin examination should be healthy , was admitted via emergency
carried out to rule out hernia . complaining of upper abdominal pain associated
E . He should be admitted for IV fluid hydration with nausea and fever . Her initial blood test
and electrolyte replacement . showed WBC 16 , HB 12 . What is the best
imaging study in this situation ?
* A 35 years old female patient underwent A . Abdominal ultrasound .
incision and drainage of a perianal abscess 2 B . MRCP .
months ago . Now she presented to your clinic C . ERCP .
with an intermittent pain and smelly discharge D . Endoscopic ultrasound .
from the site of previous surgery . What is the E . Abdominal and pelvic computed
most common problem that would expect and tomography scan .
you should check for ?

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 28
* A 70 years old woman presented to the * A 25 years old thin and tall man suddenly
emergency department with 3 days history of develops left sided chest pain with cough and
worsening abdominal pain , vomiting , dyspnea . Provisional diagnosis is ?
constipation . On examination you find that she A . Atelectasis .
has abdomen distended , generalized tenderness B . Pulmonary embolism .
, high pitched bowel sounds . All of the following C . MI .
are important differential diagnosis except ? D . Bronchopneumonia .
A . Colorectal cancer . E . Pneumothorax .
B . Sigmoid diverticulitis .
C . Gastroenteritis . * The earliest indication of hypocalcemia is
D . Sigmoid volvulus . usually ?
E . Femoral hernia . A . Tachycardia .
B . Positive Chvostek sign .
* At what age is intussusception most frequent ? C . Carpopedal spasm .
A . Newborns . D . Hyperthermia .
B . Preschool . E . Tingling of face , nose , hands .
C . School .
D . Adult . * A 60 years old patient is diagnosed with
E . Infants . colorectal cancer , all sentences are true except
A . Most cases are sporadic ( not related to
* A 40 years old female previously healthy , inheritance ) .
presented as an emergency with abdominal pain B . Cure is possible if the disease is localized .
aggravated by fatty meals , associated with C . Chemotherapy could be given before or after
yellowish discoloration of her sclera , vomiting , surgery .
itching , clay color stool and dark urine . No D . Bleeding per rectum usually indicates that
history of weight loss . All are true except ? the cancer in the Cecum .
A . The cause of dark urine is the increased E . CT scan for chest , abdomen , pelvis is the
conjugated bilirubin in urine . usual imaging test for staging .
B . The serum liver function tests will most likely
shows increase alkaline phosphatase . * In a 3 years old boy , painless ballotable mass
C . The serum will most likely show increased in the right flank , can be all of the following
level of amylase with decrease level of lipase except ?
D . The most likely diagnosis in this patient is A . Wilms tumor .
gallstones and stones in the common bile duct . B . Neuroblastoma .
E . This patient need admission , painkillers , C . Urinary bladder tumor .
rehydration IV fluid , antibiotics and arrangement D . Mesoblastic nephroma .
for ERCP . E . Hyderonephrotic kidney

* A 28 years old lady complains of painful The following are principles of primary health
defecation associated with fresh per rectal blood care except ?
. Possible diagnosis to consider is ? A . Equity .
A . Hidradenitis suppurativa . B . Community participation .
B . Dermoid cyst . C . Use of sophisticated technology .
C . Pilonidal sinus . D . Integrated comprehensive services .
D . Anal fissure . E . Multi _ sectoral approach
E . Pruritus ani .
Which of the following is true for BCC ?
* One of the following is false concerning A . Painful ulcer is the usual presentation .
gastrointestinal stoma ? B . Metastasis to lymph node is very rare .
A . Patient with colorectal abdominal perianal C . UV light is not a cause .
resection require a permanent stoma . D . The growth is rapid .
B . Ileostomy is usually fashioned with aspout to E . Treatment of choice is radiotherapy .
avoid skin irritation .
C . Colostomy is usually constructed in the
right iliac fossa .
D . Stoma may be indicated in patients with
bowel ischemia .
E . Patients with Ileostomy may be need water
and electrolyte replacement by IV route .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 29
* 40 years old male with ulcerative colitis , now D . Prostate specific antigen estimation is
the exacerbation of GI symptoms . You can currently the best screening tool for prostatic
assess severity with ? cancer .
A . Erythema nodosum . E . It takes approximately 10 years for colorectal
B . Anemia . polyp to develop into a cancer .
C . Dose of Salazopyrin .
D . Ankylosing spondylitis . * All sentences about cancer surgery is true
E . Dysplasia on colonoscopy except ?
A . It is called preventive when it removes a
* In patient who develop a documented episode potential source of malignancy .
of DVT , the most significant long term sequelae B . It is called curative or primary when it is the
is ? definitive treatment for the present tumor .
A . Claudication . C . It is called palliative when the aim is to relieve
B . Recurrent foot infection . symptoms and improve the quality of the life
C . Development of stasis ulcer . rather than prolong survival .
D . Pulmonary embolization . D . It is called emergency when it deals with
E . Diminished arterial perfusion . problem such as obstruction or perforation .
E . Neoadjuvant chemo or radiotherapy are
* The commonest hernia type that can been always required before cancer therapy .
strangulated is ?
A . Incisional * 65 year old male has an entero_cutaneous
B . Inguinal fistula originating from the jejunum , suffered
C . Paraumbilical from inflammatory bowel disease , which of the
D . Femoral following would be the most appropriate
E . Linea alba replacement of his losses ?
A . DW5%
* Which of the following is the most likely B . N/S 3%
diagnosis in head trauma patient who loses C . Ringer lactate
consciousness recovers to have a lucid interval D . 0.9% sodium chloride
and again loses consciousness ? E . 6% sodium bicarbonate solution
A . Epidural hematoma .
B . Subdural hematoma . * A 84 year old man presents with a small ulcer
C . SAH . on the bridge of his nose . It has been present for
D . Concussion . a number of months . On examination it has
E . Contusion . pearly white rolled edges . The type of ulcer is ?
A . Curling ulcer
* All sentences about burn are correct except ? B . Cushing ulcer
A . Burn area's can be calculated by the rule of C . Marjolin ulcer
nines . D . Rodent ulcer
B . Fluid resuscitation is calculated based on E . Venous ulcer
burn area .
C . IV fluid resuscitation is necessary in child with * Which of the following skin tumors is the most
10% partial thickness burn . common in whites ?
D . Prophylactic intubation is rarely indication in A . SCC
inhalation burn . B . BCC
E . Full thickness burns extends into deep C . Malignant melanoma
reticular dermis , yellow white appearance , D . Merkel cell tumor
fairly dry texture , painful , needs 3 _ 8 weeks E . Dermatofibrosarcoma
for healing .
* All of the following is true regarding the femoral
* All sentences about screening test are true triangle except ?
except ? A . The inguinal ligament forms the base .
A . Screening tests are available for all common B . The medial border is formed by the lateral
cancers . border of the adductor longus .
B . Most screening tests are not 100% sensitive . C . The lateral border is formed by the medial
C . No benefit has yet been shown for breast border of the Sartorius .
screening in women under age 40 years . D . The floor is formed by the adductor longus
and pectineus muscle medially .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 30
* A 54 year old man on renal dialysis is found to * Differential diagnosis of right iliac fossa pain
have raised serum calcium and PTH . This is includes all of the following except ?
called ? A . Tubo _ ovarian mass
A . Primary hyperparathyroidism . B . Acute pyelonephritis
B . Secondary hyperparathyroidism . C . Crohn disease
C . Tertiary hyperparathyroidism . D . Empyema of the gallbladder
D . Hypercalcemia of malignancy . E . Splenic vein thrombosis
E . Hypoparathyroidism .
* The GCS for 25 year man involved in RTA in a
* Most common cause of non pitting edema ? head on collision with a lorry . On examination he
A . Iatrogenic is unable to obey commands but localizes to pain
B . Filariasis and is able to speak , but appear confused . He
C . Lymph node resection surgery . only opens his eyes to pain ?
D . Leptospirosis A.4
E . Chagas disease B.6
C.7
* A 19 year old man involved in RTA , found to D . 10
have a femur fracture and crush injury to his foot E . 13
. After fixation he becomes dyspneic and
hypoxemic . The most likely etiology ? * Which of the following is not associated with
A . Aspiration compartment syndrome ?
B . Atelectasis A . Disproportionate level of pain .
C . Fat embolism B . Absent distal pulses .
D . Fluid overload C . Paresthesia .
E . Pneumonia D . Calor = Heat .
E . Paralysis .
* After exposure to suspected rabied animal ,
which of the following should be given ? * 80 year old woman presents with hematemesis
A . Rabies immunoglobulin and one dose of . She has had intermittent epigastric pain after
vaccine as soon as possible . food for the past 6 months . She has lost weight
B . Rabies immunoglobulin then several about 4 kg . She was recently started on
doses of vaccine . Diclofenac . The most likely cause for her
C . Rabies immunoglobulin alone . condition ?
D . Rabies immunoglobulin and antibiotic . A . Mallory Weiss tear
E . Vaccine and antibiotics . B . Esophagitis
C . Gastric malignancy
* Which of the following supports the diagnosis of D . Aortoenteric fistula
Hypovolemia ? E . Gastric ulcer
A . Urine sodium 28 meq/L
B . Urine chloride 15 meq/L * Which of the following is not an increased risk
C . Fe Na < 1 for venous Thromboembolism ?
D . Urine / serum creatinine ratio of 20 A . Active cancer
E . Urine Osmolarity of 350 mosm/ kg B . Age greater than 60
C . Thrombophilia
* Calcitonin sometimes elaborated by which one D . Obesity BMI > 30
of the following tumors ? E . Surgery to excise scalp lipoma
A . Medullary carcinoma of the breast .
B . Medullary carcinoma of the thyroid . * What is the first parameter to change in early
C . Giant cell carcinoma of the pancreas . hypovolemic shock ?
D . Carcinoid tumor of appendix . A . Systolic blood pressure
E . Ganglioneuromas . B . Pulse rate
C . Diastolic blood pressure
* In the management of pyloric stenosis , which D . Respiratory rate
of the following is true ? E . Level of consciousness
A . Acidosis should be corrected first .
B . Chloride level is normal in spite alkalosis .
C . Hypokalemia should be corrected .
D . Usually there is compensatory hypocarbia .
E . Paradoxical aciduria is not a feature .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 31
* 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
C . Calcium phosphate
D . Cholesterol stone * A 39 year old man presents with severe
E . Cystine stone epigastric pain and right upper quadrant pain .
Radiating to the back associated with nausea
* Most common site of volvulus in the colorectal and vomiting . Inspection of the abdomen shows
region ? bruising below the inguinal ligament . This sign
A . Descending colon is called ?
B . Sigmoid A . Cullen sign
C . Transverse colon B . Boas sign
D . Rectum C . Fox sign
E . Ascending colon D . Grey turner sign
E . Murphy's sign
* 52 year old male patient was found to have
Gastrinoma , which of the following is the most * Pleomorphic adenomas of the salivary glands
likely location for Gastrinoma ? are characterized by one of the following ?
A . Fundus of stomach A . They occur only in the parotid glands .
B . Antrum of stomach B . They grow rapidly .
C . The triangle formed by the junction of the C . They rarely recur if simply enucleated .
second and third portion of the duodenum , D . They present as rock _ hard masses .
the junction of the neck and body of the E . They are common benign salivary tumors .
pancreas and the junction of the cystic and
common bile duct . * A 20 year old man involved in RTA sustains
D . The tail of pancreas bilateral fractured femurs . On assessment , he is
E . The triangle formed by the inferior edge of the anxious and confused , with a pulse of 130 / min
liver , the cystic duct , and the common hepatic and BP of 70/50 mmhg . Urine output over 1 hour
duct . is 10 ml . This patient has hemorrhagic shock
type ?
* An 18 year old female patient develops urticaria A . Class 1
and wheezing after injection of intravenous B . Class 2
contrast for an abdominal CT scan . Her BP C . Class 3
120/60 ,HR 155 / min , RR 30 / min , which of the D . Class 4
following is the most appropriate immediate E . Class 5
therapy ?
A . Intubation * All of the following are branches from the
B . Epinephrine external carotid artery except ?
C . B _ blockers A . Superior thyroid artery
D . Iodine B . Ascending pharyngeal artery
E . Fluid challenge C . Lingual artery
D . Inferior thyroid artery
* Which is gram negative organism ? E . Facial artery
A . Group A Streptococcus
B . MRSA * On postoperative day 5 post hepatic resection a
C . Pseudomonas aeruginosa healthy 55 year old patient is noted to have fever
D . Clostridium tetani 38.6 c . Which of the following is the most
E . Listeria common associated ?
A . UTI
* The most reliable indicator of the adequacy of B . Wound infection
burn resuscitation is ? C . Pneumonia
A . CVP D . Intra_abdominal abscess
B . PCWP E . Intravenous catheter related infection
C . Urine output
D . Blood pressure
E . Heart rate per minute

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 32
* One of the following statement is incorrect ? * The highest potassium concentrate in ?
A . Elevated CA125 is associated with ovarian A . Saliva
carcinoma . B . Gastric juice
B . Elevated CEA is associated with C . Bile
chondrosarcoma . D . Ileal
C . Elevated CA 15_3 is associated with certain E . Duodenum
breast cancer .
D . Elevated B_HCG is associated with certain * Regarding abdominal trauma in pediatric age
testicular cancer . group , which of the following is true ?
E . Elevated CA 19_9 is associated with A . Clinical examination , stabilization and
pancreatic cancer . resuscitation are not of priority .
B . Ultrasound is the diagnostic tool of choice .
* The spleen filters all of the following particles C . Blood transfusion should be started
cells except ? immediately .
A . Malformed erythrocytes D . Peritoneal lavage is contraindicated .
B . T lymphocytes E . Splenectomy is not a routine management
C . Malarial parasites for all types of Splenic injuries .
D . Streptococcus pneumonia
E . Platelets * Which of the following is true regarding the
femoral pulse ?
* Which of the following is not a feature of Crohn A . It is usually felt at the midpoint of inguinal
disease ? ligament .
A . Involvement from mouth to anus . B . The femoral nerve is medial to the femoral
B . Risk of flare up is decreased with smoking pulse .
C . Macroscopically demonstrates cobblestone . C . The femoral pulse is lateral to the deep
D . Endoscopically demonstrates skip lesions . inguinal ring .
E . Histologically demonstrates transmural D . The femoral pulse is felt at the mid
granulomatous inflammation . inguinal point .
E . A Radio_femoral delay is usually felt in aortic
* A 45 year old female . Patient presented to E.R stenosis .
complaining of right hypochondriac pain and
nausea with repeated vomiting for the last few * Which of the following is not true regarding
hours . She recalls eating a cheese cake earlier sepsis ?
that day . Examination showed right A . Tachycardia and / or tachypnea may be a
hypochondriac tenderness but otherwise soft and sign .
lax . Her laboratory results were normal . The B . Sepsis is defined as systemic inflammatory
most appropriate next investigation ? response syndrome in the presence of infection .
A . Erect abdominal X_Ray C . Leukocytosis or leukopenia may be a sign .
B . Endoscopy D . Sepsis and hypotension is defined as
C . CT abdomen septic shock .
D . Ultrasound of the abdomen E . Temperature greater than 38 or less than 36
E . H1 breath test for H pylori may be a sign .

* A 50 year old man presented to E.R * Regarding the oxygen dissociation curve , one
complaining of severe epigastric pain of 5 hours is true ?
duration . The pain is radiating to his back A . Is shifted to the left by increase 2.3 _ DPG .
associated with recurrent vomiting . His amylase B . Is Sigmoid shape for both hemoglobin and
is 2017 u/ L . All of the following criteria are used myoglobin .
to predict the severity of the case during C . Is shifted to the left when one ascends to high
admission except ? altitude .
A . Age over 55 years D . Is shifted to the right by an increase in the PH
B . Blood sugar more than 200 mg/dl . E . Is ideally 50% saturated at a PO2 of 28
C . AST more than 250 u/ L mmhg
D . WBC less than 5000 /UL
E . LDH more than 350 u/ L

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 33
* One of the following passes through the aortic C . A majority of colorectal cancers occur in
hiatus in the diaphragm ? the descending colon .
A . Vagal trunks D . FAP and HNPCC are two inherited causes of
B . Right phrenic nerve colorectal cancer .
C . Thoracic duct E . Patients with primary sclerosing cholangitis
D . Esophagus and ulcerative colitis have increased risk of
E. Branches from left gastric artery developing colon cancer .

* A 62 year old male patient presented * One of the following is false regarding
complaining of bloody diarrhea and cramps , he crystalloid solutions ?
has recently been started on Clindamycin for A . Osmolarity of Ringer lactate solution 273
septic arthritis . As he is allergic to penicillin . mosm L .
Which of the following is the most likely diagnosis B . Ringer lactate contain 154 meq/L sodium .
A . Campylobacter jujeni diarrhea . C . Readily pass through semi _ permeable
B . Pseudomembranous colitis . membrane , therefore they are considered
C . Salmonella typhi diarrhea . extravascular space expanders .
D . Rectal cancer . D . Have poor capillary perfusion and no allergic
E . Hemorrhoids . reaction and short intravascular half life 20_30
minutes .
* One of the following is not a complication of E . Hartmann solution , 0.9% NaCl solution , 5%
gallstones ? Dextrose in water are isotonic crystalloid
A . Intestinal obstruction solutions .
B . Mucocele .
C . Acute cholycystitis . * How much calories per liter in D_Dextrose 5% ?
D . Liver cirrhosis . A . 150
E . Pancreatitis . B . 170
C . 180
* Which of the following statements is true D . 200
concerning Meckels diverticulum ? E. 250
A . It's found within 2 inches of the ileocecal
valve . * A 66 years old woman falls fracturing the
B . It's a remnant of the embryonic vitelline surgical neck of humerus . Sex months later she
duct . is unable to abduct her arm's above her hand .
C . Ectopic colonic epithelium is found in it . Most likely nerve injury ?
D . Diagnosis is best made by CT_ scan . A . Median nerve
E . It's usually found on the mesentric border of B . Radial nerve .
the bowel . C . Ulnar nerve
D . Axillary nerve
* A 34 years old male patient presented after E . Musclo_cutaneous nerve
being in RTA with severe shortness of breath .
Examination revealed a deviated trachea to the * A 45 years old female found to have wasting of
left side . Absent breath sounds on the right side intrinsic muscle , of the hand , weakness and
of the chest . The best initial management option pain in the wrist , most likely nerve injury ?
for this patient is ? A . Ulnar nerve
A . Intubate the patient . B . Radial nerve
B . Insert a chest tube on the right side . C . Median nerve
C . Do a chest X_Ray then manage accordingly . D . Axillary nerve
D . Insert a needle thoracostomy followed by E . Thenar and hypothenar nerves
a chest tube in the right side of chest .
E . Insert 2 large bore cannulas and give 1 liter of The following causes of Hypercalcemia except ?
ringer lactate . A . Sarcoidosis
B . Primary hyperparathyroidism
* All of the following are true regarding colon C . Acute pancreatitis
cancer except ? D . Metastasis bronchial carcinoma
A . It's the second most common cause of cancer E . Milk Alkali syndrome
related death in Jordan .
B . A ( T1 N1 M0 stage 3 ) tumor is equivalent to
Duke stage C tumor .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 34
* What is the most likely diagnosis in a 45 year * Which of the following vaccines are live ?
old male patient with HTN development of facial A . H influenza type B
hair and 7cm suprarenal mass ? B . Diphtheria
A . Myelolipoma C . OPV
B . Cushing disease D . Hepatitis B
C . Adrenocortical adenoma E . H influenza A
D . Pheochromocytoma
E . Carcinoid tumor * One of the following is true regarding the
electrolyte concentration in Hartmann solution ?
* 60 kg woman involved with extensive burns . A . Chloride 200 mmol/L
On physical exam found to have pink to red skin B . Lactate 70 mmol/L
colour , slightly swelling and pain , dry skin on the C . Sodium 131 mmol/L
head . Her left arm and leg have dry white D . Potassium 40 mmol /L
painless burns and her anterior torso has E . Calcium 15 mmol/L
Erythematous painful burns with blistering. How
much fluid she require ? * All are true regarding Heparin except ?
A . 2500 ml A . It's heterogeneous mixture of sulfated
B . 10800 ml polypeptides .
C . 8640 ml B . Potentiates the actions of antithrombin 3 .
D . 12960 ml C . Has a half life of a 90 minutes .
E . 17280 ml D . Can be reversed by protamine sulphate .
E . Can induce an idiosyncratic
* A patient has the following ABG , PH = 7.56 , thrombocytopenia .
PCO2 = 50 mmhg , PO2 = 85 mmhg , HCO3 =
40 meq/L . What is the acid base abnormality ? * All of the following fistulas are unlikely to close
A . Uncompensated metabolic alkalosis . spontaneously except ?
B . Respiratory acidosis with metabolic A . Fistulas secondary to malignancy .
compensation . B . Fistulas due to Crohn disease .
C . Combined metabolic and respiratory alkalosis C . Fistulas with epithelized track .
D . Metabolic alkalosis with respiratory D . Fistulas with long track .
compensation . E . Fistulas with foreign bodies .
E . Mixed respiratory and metabolic alkalosis .
* A palpable radial pulse indicate a systolic blood
* Most common thyroid tumor that spread via pressure greater than ?
lymphatics ? A . 40 mmhg
A . Follicular B . 60 mmhg
B . Anaplastic C . 80 mmhg
C . Medullary D . 100 mmhg
D . Papillary E . 120 mmhg
E . Lymphoma
* The main reason of delay of eradication of
* All of the following are causes of blood stained measles in Jordan is ?
nipple discharge except ? A . Migration or refugee from neighbor Arab
A . Intraductal papilloma countries ( Iraq , Syria ) due to
B . Carcinoma unstable conditions in their countries .
C . Ductectasia B . Immunization coverage rate is low in Jordan .
D . Fibrocystic disease C . High cost of vaccine .
E . Fat necrosis of breast D . Cold chain of vaccine is not accurate .

* Which of the following pathologies is thought to * One is true regarding electric burns ?
have no malignant potential ? A . Injuries are generally more superficial than
A . Ulcerative colitis those with thermal burns .
B . Villous adenoma B . Intravenous fluid replacement is based on the
C . FAP percentage of body surface area burnt .
D . Hyperplastic polyps C . Electric burns often result in transient
E . Crohn disease traumatic optic neuropathy .
D . Evaluation for fracture of the other
extremities and visceral injury is indicated . E
. Cardiac conduction abnormalities are unlikely .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 35
* 5_HIAA is tested in which of these disease ? * Most common symptom in rectal cancer ?
A . Medullary carcinoma of the breast . A . Bleeding per rectum
B . Papillary thyroid carcinoma . B . Weight loss .
C . Giant cell carcinoma of the pancreas . C . Pain per rectum .
D . Carcinoid tumor . D . Change bowel habits .
E . Ganglioneuromas . E . Constipation .

* Capillary refill time is elicited by ? * Most common cause of Acute pancreatitis in

A . Pressing over the skin for 3 seconds , children ?
normally return perfusion by 2 seconds . A . Alcohol .
B . Pressing over the skin for 5 seconds , B . Congenital .
normally return perfusion by 2 seconds . C . Drugs .
C . Pressing over the skin for 5 seconds, D . Blunt trauma
normally return perfusion by 5 seconds . E . Gallbladder stone
D . Pressing over the skin 10 seconds , normally
return perfusion by 5 seconds . * Most significant initial complication of acute
E . Pressing over the skin for 2 seconds , pancreatitis is ?
normally return perfusion by 5 seconds . A . DM .
B . Pseudocyst .
* All of the following are true regarding neck C . ARDS
lumps except ? D . Exocrine insufficiency .
A . Thyroglossal cysts move upwards on E. Hemorrhagic peritonitis
protrusion of tongue .
B . Branchial cysts typically present in the first * Most important point in diagnosis acute
decade of life . appendicitis ?
C . Thyroid masses move upwards on swallowing A . Laboratory result .
D . Cystic hygromas are lymphatic malformation . B . Pain in right lower quadrant .
E . Parotid glands are not normally palpable . C . Shifting of pain .
D . History and physical exam
* A 50 years old man is admitted to hospital with E . Low grade fever and Leucocytosis .
severe bleeding and bruising . He is on warfarin
and his INR is 10 . For rapid complete reversal of * Most common site of ischemic colitis ?
his INR , which of the following mostly used ? A . Splenic flexure
A . Platelets . B . Hepatic flexure
B . FFP and vitamin K . C . Ascending colon
C . IV vitamin K . D . Transverse colon
D . Whole blood and vitamin K . E . Iliocecal valve
E . Fresh frozen and vitamin C .
* Most common site of Angiodysplasia ?
* All are true about thyroid gland except ? A . Rectum
A . It's composed of two lobes , weighs 25 grams B . Transverse colon
in adult , each lobe 5 cm long , 3 cm wide , 2 cm C . Descending colon
thick . D . Ascending colon
B . Epiglotic cartilage lie just above the gland . E . Cecum
C . It extends from first tracheal ring up to
sixth tracheal ring . * Most common site for distant metastasis for
D . Infrahyoid muscles lie in front , and breast cancer ?
sternocleidomastoid muscle to the side of the A . Bone
gland . B . Lung .
E . It has follicles , follicular cells , and C . Brain .
parafollicular cells . D . Liver .
E . Lymphatic nodes .
* The major risk factor for mastitis ?
A . DM . * Most common soft tissue tumor ?
B . Twins . A . Osteoma
C . Breast cancer . B . Epithelioma
D . Breast feeding C . Lipoma
E . Bad hygiene . D . Rodent ulcer
E . Melanoma

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* Most sensitive laboratory test for thyroid * Most common cause of bleeding per nipple ?
function ? A . Fibrocystic disease of breast .
A . T3 B . Intraductal papilloma
B . T4 C . Breast cancer .
C . TSH D . Paget disease .
D . TRH E . Fibroadenoma .
E . TBG
* Most common thyroid gland cancer ?
* Most common type of anal cancer ? A . Anaplastic
A . Adenocarcinoma B . Papillary
B . Melanoma C . Follicular
C . SCC D . Medullary
D . BCC E . Lymphoma
E . Cloacogenic carcinoma
* Treatment of choice of liver cancer mostly ?
* Most common cause of anal stricture ? A . Palliative
A . Post hemorrhoidectomy B . Surgical resection
B . Hemorrhoids C . Radiation
C . Anal fissure D . Chemotherapy
D . Perianal abscess E . Symptomatic
E . Perianal hematoma
* First anatomical structure that compressed in
* Shock is defined as ? compartment syndrome ?
A . Bradycardia . A . Fascia
B . Hypothermia . B . Muscles
C . Hypoperfusion at the tissue level C . Arteries
D . Hypotension . D . Veins
E . Loss of consciousness E . Nerves

* Most common cause of upper GI bleeding ? * The first Sign of compartment syndrome ?
A . Chronic gastric ulcer . A . Pallor and pulselessness
B . Mallory Weiss syndrome . B . Coldness
C . Chronic duodenal ulcer C . Tingling and Paresthesia
D . Gastric cancer . D . Pain
E . Varicose veins of esophagus E . Paralysis

* Most common cause of lower GI bleeding ? * One of the following a cause of increasing
A . Colorectal cancer . intracranial pressure ?
B . Ischemic colitis . A . Exercise
C . Angiodysplasia . B . Fever
D . Diverticular disease C . Stress
E . Hemorrhoids . D . Pulmonary embolism
E . Valsalva maneuver
* Lateral internal sphincterotomy is the treatment
of choice for ? * It is difficult to diagnose acute appendicitis in all
A . Hemorrhoids . of the following
B . Anal fissure except ?
C . Perianal abscess . A . Old age
D . Perianal hematoma . B . Athletes
E . Intrasphincteric abscess C . Children
D . Pregnancy
* First priority in multiple injured patient is ? E . HIV patients
A . Ribs fracture .
B . Cut wound .
C . Tension pneumothorax
D . Femur fracture .
E . Subdural hematoma .

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Page 37
* One of the following is contraindication for * All are risk factors for colorectal cancer except
surgical treatment of varicose veins ? A . Ulcerative colitis
A . DVT B . Juvenile polyposis
B . Old age C . Crohn disease
C . Pregnancy D . FAP
D . Bilaterally E . Gardner syndrome
E . Peripheral vascular disease
* Transformation of ulcerative colitis to
* Most common microorganism that cause malignancy is related to ?
infection in diabetic foot ? A . Activity of disease
A . Staphylococcus aureus B . Race of the patients
B . Pseudomonas C . Immunity of the patients
C . Mixed D . Duration of disease
D . Listeria E . Drugs administration
E . Clostridium perfringens
* All are causes of persistent Hypotension except
* Most common salivary glands cancer ? A . Heart failure stage 4
A . Warthin tumors B . Pneumothorax
B . Mucoepidermoid carcinoma C . Inadequate IV fluids in shock patients
C . Adenoidcystic cancer D . Persistent external bleeding
D . Adenocarcinoma E . Hidden internal bleeding
E . Malignant mixed cancer
* One of the following is contraindication for NG
* Treatment of choice in Hypovolemic shock ? tube placement ?
A . 0.45% Normal saline A . Acute pancreatitis
B . Albumin B . Intestinal obstruction
C . Blood products C . Drug poisoning
D . 0.9% Normal saline D . Basal skull fracture
E . Ringer lactate E . Laparoscopic surgery

* Most specific tool for spleen injury ? * All are causes of Hypersplenism except ?
A . CT scan A . Liver cirrhosis
B . Abdominal ultrasound B . Portal HTN
C . Abdominal X_Ray C . Sarcoidosis
D . DPL D . HCC
E . Angiography E . Papillary thyroid cancer

* Most common cause of Incisional hernia ? * Most common liver cancer ?

A . Wound infection A . Hepatoblastoma
B . COPD B . Fibrolamellar carcinoma
C . Acute appendicitis C . Adenocarcinoma
D . Wound hematoma D . HCC
E . Ascites E . SCC

* First to do in multiple trauma patients ? * Most important point in intravenous fluid of

A . Immobilization patient with burn ?
B . Breathing A . Body surface area percentage
C . Blood pressure B . Grade of burns
D . Pupil reaction C . Site of burns
E . Airway obscure D . Type of burns
E . Clinical picture of the patient
* Most common cause of large bowel obstruction
A . Polyps of the colon * Gas that used in laparoscopic operations ?
B . Hirschsprung disease A . O2
C . Colon cancer B . N2O
D . Ischemic colitis C . N2
E . Ulcerative colitis D . Co2
E . He

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 38
* Anesthetic drug that has analgesic and * Percentage of liver tissue that should be
anesthetic effect ? maintain after liver resection
A . Isoflurane for donation porpoises ( if liver was completely
B . Sevoflurane healthy ) ?
C . Thiopental sodium A . 0.8
D . Suxamethonium B . 8%
E . Ketamine C . 80%
D . 20%
* All of the following side effects of morphine E . 0.2%
except ?
A . Nausea * Newborn presented with hypersalivation ,
B . Vomiting irritability , Cyanosis , coughing , choking ,
C . Cough gagging , malpositioning of a NG tube . The most
D . Myosis likely diagnosis ?
E . Respiratory depression A . Duodenal atresia
B . Pyloric stenosis
* The strongest relation between lung cancer and C . Esophageal atresia
one of the following ? D . Diaphragmatic hernia
A . Tuberculosis E . GERD
B . Asbestosis
C . Byssinosis * 7 years old child , presented with submental
D . Pneumoconiosis swelling , hotness , redness , it was very painful ,
E . Silicosis the most likely diagnosis ?
A . Cystic hygroma
* All of the following operations need antibiotics B . Thyroglossal cyst
prophylaxis except ? C . Lipoma
A . Thyroidectomy D . Dental caries
B . Hemicolectomy E . Submental abscess
C . Appendectomy
D . Pulmonary lobectomy * 5 years old child presented with midline neck
E . Cholecystectomy swelling , that protruded with swallowing or no
protrusion of the tongue , the most likely
* Glasgow coma scale includes . All of the diagnosis ?
following except ? A . Thyroglossal cyst
A . Motor response B . Cystic hygroma
B . Eye's movement C . Thyroid lymphoma
C . Verbal response D . Cleft bronchial cyst
D . Pain response E . Thyroiditis
E . Pupil reaction to night
* 35 years old male patient present with painless
* One of the following is water borne disease ? pulsatile femoral swelling in the inguinal area ,
A . Scabies the most likely diagnosis ?
B . Mycoplasma A . Inguinal hernia
C . Chlamydia B . Femoral hernia
D . Typhoid fever C . Varicose veins
E . Hepatitis C D . Lipoma
E . Aneurysm
* All are specific complications of thyroid surgery
except ? * One of the following is true about inguinal
A . Dental caries hernia ?
B . Airway obstruction A . Femoral hernia is more common than inguinal
C . Convulsions B . Direct hernia is more common than indirect .
D . Hypoparathyroidism C . Treatment of choice is Herniorrhaphy
E . Hypothyroidism D . Most common seen in females .
E . Direct inguinal hernia is a congenital hernia .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 39
* The true arrangement for gastrointestinal tract * You have been asked to consent a patient for
recovery after any abdominal surgery ? insertion of a central line you counsed the patient
A . Stomach then colon then small bowel . * through the reason for the procedure, what is
B . Colon then small bowel then stomach . the most common immediate complications of
C . Stomach then small bowel then colon . central line insertion ?
D . Small bowel then stomach then colon A. Infection .
E . Small bowel then colon then stomach . B. Thrombus .
C. Hemorrhage .
*One of the following is false concerning D. Pneumothorax .
gastrointestinal stoma ? E. Air embolism .
A. Patient with abdomenoperitoneal reaction
require a permanent stoma . * which of the following is true about testicular
B. Iliostomy is usually fashioned with a spout to tumors ?
avoid skin irritation . A. The incidence of germ cell tumors has
C. Colostomy is usually constructed in the Rt decreased over the past 20 years .
iliac Fossa . B. An elevated lactate dehydrogenase is
D. Patient with Iliostomy may need water and indicator of good prognosis .
electrolytes replacement by IV . C. Orchidectomy should be performed only after
E. Stoma may be indicated in patient with bowel confirmation of diagnosis with
ischemia frozen section .
D. Elevated alfa feto protein is found in 75%
* all sentences About a colles fracture are true of patient with pure seminoma .
except ? E. Orchidectomy and nodal radiotherapy result in
A. A fracture with mild angulation may require a cure rate of 98% in stage 1 seminoma .
closed reduction .
B. Usually produced by fall on out stretched hand * Regarding simple appendicitis , all are true
C. Defined as a fracture of the distal radius except ?
with ventral displacement . A . Periumbilical pain is visceral in nature and
D. Occur more frequently in elderly persons as a occurs early .
result of osteoporosis . B . Right iliac fossa pain is somatic in nature and
E. Could be complicated by neuropathy and occurs later .
volkman ischemic contracture . C . Positive rebound tenderness means
peritoneal irritation .
* All the following are true about pulse oximetry D . CT scan is the preferred imaging test for
except ? appendicitis in females and children .
A. Presence of smoke inhalation injury and may E . Meckel diverticulum may mimic the clinical
lead to a falsely elevated pulse picture of appendicitis .
oximetry .
B. Nails Polish should be removed before any * 57 years old patient presented with nocturia ( 3
surgery because it affects reading time / night ) , weak stream intermittency and
on the pulse oximeter . frequency , his digital rectal examination revealed
C. Ear probes can detect changes on oxygen induration of the right lobe of prostate . All of the
saturation faster than finger probes . following statements are appropriate except ?
D. It depends on the fact that oxygenated and A . Treat the obstructive symptoms .
deoxygenated Hb absorb red and B . Perform ultrasound for residual urine
infra red light differently . assessment .
E. It's reading are not affected by the C . Blood sample for prostate specific antigen is
temperature of patient hand. not usually required .
D . This patient most likely needs prostate
biopsy
E . His past history and medication have to be
checked .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 40
* Severe electrical burn , one is true ? * A postoperative patient is being managed on a
A . Causes most of it's damage of the exit site . intensive care unit following subtotal colectomy .
B . Is usually more sever it caused by direct Blood result shows the phosphate level is 0.25
current rather than alternating current . mmol/L . Which one of the following statement
C . Frequently causes a muscle injury more like regarding intravenous phosphate is incorrect ?
crush injury . A . May cause Hypercalcemia .
D . Tends to resolve quickly in patients who B . Should never be given at rate greater than 30
survive the initial injury . mmol over 6 hours .
E . Is usually treated according to the extent C . Should preferentially be given via a central
of thermal and underlying subcutaneous line .
tissue damage . D . May cause metastatic calcification .
E . Should be used even if the patient is
* All sentences about burn are correct except ? asymptomatic .
A . Circumferential superficial partial thickness
burn causes compartment syndrome . * 25 years old female patient presented to
B . Deep partial thickness burn appears more emergency room after being involved in road
pale and mottled to superficial degree . traffic accident, 2.5 hours ago as a driver . She
C. Blister can form in both superficial and complains of right sided headache and can't
deep partial thickness . remember the accident . Examination showed a
D . Sun burn cause superficial partial thickness deformed fracture on the right side of her skull .
burn . You sent the patient for CT of her head . After CT
E . Skin grafts are not required in managing the patient suddenly became unresponsive . The
partial thickness . CT will most likely show ?
A . Epidural hematoma .
* To allow kidney donation from a young patient B . Chronic subdural hematoma .
intubated in the ICU , a brain death need to C . Subarachnoid bleeding .
confirmed first , all of the following examination D . Intraventricular bleeding .
finding are consistent with brain death except ? E . Diffuse axonal injury .
A . Dilated non reactive pupils .
B . Absent oculocephalic reflex . * Routine tracheostomy , with few exceptions is
C . Extensor posturing . typically performed at the level of ?
D . Absent gag reflex . A . Cricoid cartilage .
E . Absent corneal reflex . B . Cricothyroid membrane .
C . Cricoid and first ring .
* A 56 years old woman presented with sever D . Second ring and third ring .
upper abdominal pain related to her back and E . Fifth and sixth tracheal ring .
associated with nausea and vomiting , her serum
lipase level was 6300 u/ L . The patient was * Which of the following diagnosis is most likely in
given intravenous analgesia . What is the best a child with HTN and past history of UTI ?
and most important next step in management ? A . Ureteropelvic junction obstruction .
A . Begin intravenous fluid resuscitation and B . Reflux nephropathy .
oxygen supplement . C . Wilms tumor .
B . Begin prophylactic antibiotics to minimize the D . Renal artery stenosis .
risk of pancreatic infection . E . Posterior urethral valve .
C . Change her diet to clear liquids by mouth only
D . Obtain a contrast enhanced CT scan of the * All of the following are true regarding
abdomen . computerized tomography used in urology except
E . Obtain a right upper quadrant ultrasound . A . CT without contrast is the imaging of choice
for acute flank pain .
* Which of the following statements is true B . CT with contrast is preferred in renal trauma .
regarding varicocele ? C . MRI is more sensitive in evaluating adrenal
A . They should be looked for while the patient is masses .
supine . D . CT is not operator dependent .
B . They usually result infertility . E . Uric acid stones are not visualized by CT
C . They may affect sperm motility and count . scan .
D . They result in lower testicular temperature .
E . They should always be required when
identified .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 41
* All sentences about abdominal hernias are true D . On X _ ray the affected bowel is narrowed
except ? distally , while the normal bowel
A . Most umbilical hernias in adult are acquired . is dilated proximally .
B . Incisional hernia results from a failure of
fascial tissue to heal and close after surgery . * All of the following are true about diverticulosis
C . Incisional hernia is more common after open coli except ?
compared with laparoscopic operation . A . Sigmoid colon in the commonest site .
D . Lumbar hernia is not common hernia . B . Are considered false diverticulum and it
E . Divarication of rectus abdominis muscles mucosa is lined by normal colonic cell .
in elderly necessities surgical repair . C . The affected patient may present with
bleeding per rectum .
* Optimal medical therapy in a patient with D . Surgery is the primary treatment for
carotid artery stenosis would include ? diverticulosis .
A . Smoking cessation . E . Low fiber diet is a risk factor for this condition
B . Antiplatelet agent's .
C . Control HTN . * All sentences about neck of femur fracture are
D . Statins drug's . true except ?
E . All are true . A . Typically occur in elderly female patient .
B. Leg may be shortened and internally
* Skin cancer can result from exposure to one of rotated in displaced fracture .
the following ? C . AVN is more common in this place than at
A . Microwave . other site's in the body .
B . Ionizing radiation . D . Almost always will require corrective surgery .
C . Solar ultraviolet A . E . Prognosis is poor in general .
D . X ray .
E . Infrared rays . * All of the following sentences about hernia are
true except ?
* Acute pyelonephritis is best diagnosed by ? A . Inguinal hernia is the most common hernia in
A . Vesicoureteral reflux . both females and male's .
B . Bacteriuria and pyuria . B . Femoral hernias are most common in females
C . Delayed renal function . than male's .
D . Focal scar in renal cortex . C . Morbidity is increased after emergency
E . Chills , fever and flank pain compared with elective repair of hernia .
D . Urinary hesitancy and straining increase the
* All sentences about appendicitis are true except risk for hernia formation .
A . Mcburney point corresponds to the location of E . Open is always better and safer than
the tip of appendix . laparoscopic approach for hernia repair
B . Psoas sign is elicited by extension of the right
hip . * A 28 years old female , previously healthy ,
C . Laparoscopy is one of the diagnostic methods presented as an emergency with abdominal pain
D . Rovsing sign is elicited by pressing in the left aggravated by fatty meals , and associated with
iliac fossa causing pain in the right iliac fossa . jaundice , vomiting , itching , clay color stool , tea
E . Alvardo score is not routinely calculated color urine , no history of weight loss . All are true
for the diagnosis of appendicitis . except ?
A . This patient need admission , pain killer's ,
* One of the following vaccines can't be given to rehydration , IV fluids + _ antibiotics .
immunocompromised patient ? B . The most likely diagnosis gallstones and
A . Hepatitis B . stone in the common bile duct .
B . DPT . C . The cause of clay color stool is absence of
C . Influenza vaccine . stercobilinogen from stool .
D . Inactivated polio vaccine . D . The cause of tea color urine is increased
E . Oral polio vaccine . conjugated bilirubin in urine .
E . The serum liver function test will most
* All of the following are true regarding likely show decreased alkaline phosphatase .
Hirschsprung disease except ?
A . There is no ganglion cells in Auerbach plexus
B . There is an increased incidence of Down
syndrome .
C . It is more common in girls .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 42
* Regarding breast cancer , all of the following is * A 41 year old gentleman came to your clinic
true except ? complaining of respiratory symptoms . Your
A . Peau d Orange appearance of the breast differential diagnosis is pleural effusion versus
indicate advanced stage . pneumothorax . Which of the following physical
B . Eczema around the nipple should always be findings will best help you differentiate between
investigated . these two possibilities ?
C . Trucut biopsy is more accurate than the A . Respiratory rate 33 breaths / minute .
needle aspiration ( FNA) . B . Agitation due to respiration distress .
D . Bloody nipple discharge could be due to a C . Decreased breath sounds over the affected
benign cause . hemithorax .
E . Palpable lymph node supraclavicular fossa D . Dullness to percussion over the affected
indicate distant metastasis . hemithorax .

* A 25 years old lady was admitted via * All of the following are classic signs of basal
emergency complaining of abdominal pain and skull fracture except ?
suspected to have acute gallstone pancreatitis A . Raccoon eyes .
based on symptoms and blood tests . What is the B . Battle sign .
best initial imaging study in this situation ? C . Hemotympanum .
A . Abdominal and pelvic computerized D . Dilated non reactive pupils .
tomography . E . Cerebrospinal fluid rhinorrhea .
B . Endoscopic ultrasound .
C . MRCP . * All of the following are true about the
D . ERCP . assessment of bleeding except ?
E . Abdominal ultrasound . A . Taking blood sample at the time of
bleeding gives an accurate level of
* In infantile hypertrophic pyloric stenosis , one of haemoglobin .
the following statements is false ? B . Hypovolemia increase the risk of tissue
A . The infant usually presents with projectile hypoxia and multi organ failure .
bilious vomiting . C . Blood loss could be estimated from the size
B . The treatment is surgical by Ramstedt of blood clot and the weight of swabs used .
operation . D . Any thirsty patient should be considered
C . Symptoms commence at the age of 3 _ 4 Hypovolemic .
weeks . E . Arterial blood gas is a quick method to
D . A palpable olive shaped mass is usually felt in measure hemoglobin
the classical case .
E . Ultrasound is usually diagnostic . * All of the following sentences are true about
pathophysiology of shock
* At 2 day's after a motor vehicle crash , an except ?
otherwise healthy 30 years old man is recovering A . Shock means inadequate oxygen delivery to
in the ICU from rib fractures , pulmonary meet metabolic demands .
contusion , and a liver laceration . He complains B . Shock may occur without loss in the
of increasing right upper quadrant pain and circulating volume .
vomits bright red blood . Which of the following C . Severe infection may lead to decreased
approaches is best ? cardiac preload .
A . Operative exploration and liver resection . D . Serum lactate decreases in shock .
B . Hepatic artery ligation . E . The function of phagocytes is decreased in
C . Angiographic arterial embolization . shock .
D . ERCP with sphincterotomy .
* All sentences about arteriovenous fistula are
* 50 years old woman came to your clinic stating true except ?
that she has a one month history of a palpable A . It's complication include stenosis , aneurysm
right breast lump . On examination , you can feel and heart failure .
a 1 cm mobile , firm nodule at 2 o'clock position . B . Renal dialysis is the most common indication
Your first diagnostic test of choice is ? to create it .
A . Excisional biopsy . C . Palpable thrill and audible bruit over the
B . Incisional biopsy . fistula indicate that is thrombosed .
C . CT scan . D . Paleness and coldness of the hand during
D . Mammogram . exercise and dialysis indicate the presence of
steal syndrome .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 43
E . The three most common sites are * All of the following sentences about gallstones
radiocephalic , brachiocephalic , and are true except ?
brachial artery to transposed basilic vein . A . Gallstones in diabetic patients are more
dangerous due to silent cholecystitis .
* Regarding the preoperative management all B . Obesity and sickle cell anemia are risk factors
sentences are true except ? for gallstones formation .
A . A recent myocardial infarction is the most C . Cholecystectomy can be performed in
important risk factor for perioperative myocardial pregnant woman .
infarction . D . Every patient undergoing
B . Patients should take their regular cholecystectomy should be consented about
Antihypertensive drug's even on the day of bile leak .
surgery . E . Extracorporeal shock wave lithotripsy is one
C . History and examination alone are not usually of the effective treatments for gallstones .
sufficient in evaluating the risk of bleeding .
D . LMWH is used in venous thromboembolism * All sentences about sialolithiasis are true
prophylaxis . except ?
E . Poorly controlled blood sugar in the A . Parotid gland is the most common site of
preoperative period increases the risk for surgical salivary calculi .
site infections . B . Salivary calculus contains debris bacteria ,
mucous , magnesium and phosphates .
* 40 year old male come to your clinic asking for C . Easily demonstrated by x Ray .
advice about his anal fissure . One of the D . Most occur in middle aged adults .
following sentences is an appropriate advice ? E . The main symptoms are pain and swelling
A . Surgery is primary treatment for acute anal before and during eating .
fissure .
B . Anal fissures are usually located in the lateral * A 42 year old morbidly obese white woman (
aspect of the canal . BMI = 40 ) presents to your office requesting
C . Anal fissure in patients with Crohn disease information on screening for colon cancer , she is
usually indicate malignancy . asymptomatic and has a colonoscopy for her is
D . Medical treatment is successful in 20% of which of the following ?
case's . A . She should have received a colonoscopy
E . Surgical treatment may be complicated by between age 10 _ 12 .
incontinence B . She should have received a colonoscopy
between age 20 _ 25 .
* 53 year old female presented as an emergency C . She should have received a colonoscopy at
with crampy abdominal pain for 4 days and age 40 .
associated with vomiting , abdominal distention D . She should receive a colonoscopy at age 45 .
and constipation . Patient denies weight loss . E . She should receive a colonoscopy at age
Her past history was only significant for previous 50 .
open appendectomy and open cholecystectomy .
Abdominal examination did not reveal an * A 39 year old patient presented to you at the
Incisional hernia . All of the following sentences emergency room after chest trauma . Which of
are true except ? the following scenarios is most consistent with
A . She should be admitted for intravenous fluid left tension pneumothorax ?
hydration and electrolyte replacement . A . Hypotension , distended neck veins , midline
B . As female patient , groin examination can trachea and muffled heart sounds .
be postponed for few days . B . Hypotension , open 4 cm 215 , 4 cm lateral
C . Adhesion are the most likely cause for her chest wound .
condition . C . Hypotension , diminished breath sound on
D . It is essential is to obtain an upright chest x the left tracheal opacification of the left
Ray . hemithorax .
E . It is essential is to obtain an abdominal x Ray D . Diminished left sided breath sounds , tracheal
deviation to right .
* All of the following are symptoms and signs of E . Hypotension , adjacent three fractured in two
hypothyroidism except ? places .
Low body temperature
Amenorrhea
Constipation
Weight gain

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 44
* All of the following are true regarding chronic * The Body mass index of the normal weight is ?
lymphocytic ( Hashimoto ) thyroiditis except ? 15_19 kg/m2
It is the most common inflammatory thyroid 20_25 kg/m2
disorder . 26_29 kg/m2
Leading cause of hypothyroidism . 30_34 kg/m2
Autoimmune , inherited . 35_39 kg/m2
Malignancy found in 15% of the cases .
Age of presentation is 30_50 years * Disadvantages of laparoscopy when compared
with laparotomy include all of the following except
* All of the following are indications for which ?
thyroidectomy in thyroid cyst except ? Difficulty controlling severe bleeding .
Failure to do complete aspiration . Poorer visualization of the operative fields .
Large cyst > 4 cm . Greater difficulty placing sutures .
Complex cyst ( solid _ cystic ) . Loss of tactile sensation .
Recurrence after frequent aspirations . Higher operating room costs .
If it is painless .
* Laparoscopic Cholecystectomy is indicated for
* The most common malignant liver mass ? all of the following conditions except which ?
Hepatocellular carcinoma Biliary dyskinesia .
Hepatoblastoma Initial treatment in patients with severe
Angiosarcoma Cholangitis .
Lymphoma Acute Cholecystitis .
Metastatic tumor Symptomatic cholelithiasis .
Biliary pancreatitis .
* Most of the cases of liver cancer are advanced
at time of diagnosis because all of the following * The most common cause of pyogenic liver
except ? abscess is ?
Symptoms usually don't appear until late in the Hematogenous infection .
disease . Lymphatic spread .
Liver cancer grow quickly . Secondary to infected abdominal viscera .
Liver tumors resemble those of other medical Secondary infection of a Hydatid .
conditions . Biliary obstruction .
Liver cancer can't be diagnosed using a standard
liver tests . * Which of the following conditions are
Liver tissue is not able to regenerate to associated with increased risk of breast cancer ?
replace the damaged tissue Fibrocystic mastopathy
Fibroadenoma
* Mondors disease is a variant of Atypical hyperplasia
Thrombophlebitis that involves the superficial Papillomatosis
veins of ? Breast Lipoma
The anterior chest wall and breast .
The thighs . * All of the following are true regarding
The legs . Fibroadenoma of the breast except ?
The scrotum . It is the most common breast tumor in
The vagina . adolescents and young women .
Painless , mobile and slow growing mass .
* The dominant etiologic factor in Acute Firm and rubbery texture .
appendicitis is ? Are not Premalignant lesions .
Travelling infection from large bowel . Excisional biopsy is necessary for every
Decrease local immunity of appendix . Fibroadenoma .
Part of inflammatory bowel disease .
Obstruction of the lumen by fecaliths .
Distal colonic obstruction .

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* A 15 year old boy awakens with sudden onest * The most common complication after
of right scrotal pain and tenderness accompanied hemorrhoidectomy is which of the following ?
by nausea and vomiting . Which of the following Urinary retention
is the most appropriate diagnosis and represents Rectal bleeding
a surgical emergency ? Incontinence
Acute prostatitis Wound infection
Acute epididymitis Intestinal obstruction
Torsion of the testicle
Acute appendicitis * Which of the following types of colonic polyps is
Orchitis associated with the highest incidence of
malignant degeneration ?
* All are true regarding achalasia except ? Tubular adenoma
Dysphagia to both solids and liquid is classic . Tubulovillous adenoma
Barium swallow reveals a birdlike narrowing in Villous adenoma
the distal esophagus . Hamartomatous polyp
Treatment of choice is total gasterectomy . Lipomatous polyp
Usually associated with weight loss .
The underlying defect is failure of the lower * The major problem with Ogilvie syndrome (
esophageal sphincter to relax . Acute obstruction of the colon in the absence of
any identifiable mechanical obstructing lesion ) is
* One of the following is the most common cause the risk of ?
of massive upper GI bleeding ? Cecal perforation
Gastritis Malignancy
Duodenal ulcer Rectal prolapsed
Oesophagitis Duodenal ulcer
Mallory Weiss syndrome Small bowel perforation
Esophageal varices
* Characteristic injuries of blunt thoracic include
* What is the most reliable method for precisely all the following except ?
locating the site of Upper GI bleeding ? Fractured sternum
Barium meal study Transected aorta
Exploratory laparotomy Pulmonary contusion
Arteriography Ruptured urinary bladder
Upper endoscopy Bilateral rib fractures
Radionuclide scanning
* Concerning clinical evaluation of pelvic injuries ,
* One of the following is not true regarding one is true ?
Meckels diverticulum ? Rectal examination is often unnecessary .
It is the most common diverticulum of the GI tract The patient should have a urethral catheter
It can cause bleeding . inserted in all cases to monitor urine output .
It can cause intussusception and obstruction . Lateral compression injuries are usually more
Asymptomatic Meckels diverticulum should severe than antero_posterior
be resected . compression injuries .
More common in males . Pelvic stabilization is the first priority .
Unstable pelvic ring fractures are associated
* Uncomplicated acute pancreatitis is best with a high mortality .
managed with all of the following except ?
Intravenous hydration . * The following are indications for laparotomy in
Naso_gastric decompression . abdominal trauma except ?
Abdominal imaging with ultrasound and / or CT Peritonitis .
scan . Persistent shock .
Strong painless killer . If there is no intra abdominal free fluid on CT
Urgent laparotomy to clean the abdomen . scan and ultrasound .
Uncontrolled hemorrhage .
Gunshot wounds .

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Page 46
* The following would be indications to transfer a * The most precise diagnostic screening
patient to a burns centre except ? procedure for differentiating benign thyroid
Chemical burns . nodules from malignant ones is ?
Burns involving inhalation injury . Thyroid ultrasonography
Circumferential burns of the extremities . Thyroid scintiscan
Third degree burn to the genital organs . Thyroid hormone level
First degree burn of 15 % of TBSA to the Neck CT scan
chest of an adult man . FNAB

* The following are risk factors for perioperative * The mainstay of therapy for all forms of shock is
DVT except ? IV fluid
Obesity Epinephrine
Operation with long duration Phenylephrine
Patient with malignancy Red blood cells
Pelvic operations Oxygen
Young age
* All of the following are expected in a patient
* The best policy to treat postoperative pain is to with Pheochromocytoma except ?
give ? HTN
NSAIDs Palpitations
Subcutaneous morphine Headache
Paracetamol Anhydrosis
Regional anesthesia Nausea and vomiting
Multimodal analgesia
* Which of the following is the best guide to fluid
* What is the most common breast condition that replacement in a burns patient ?
a middle aged woman can have of the following ? Hemoglobin and haematocrit .
Breast cancer Urine output .
Fibroadenoma Urine osmolality .
Fibrocystic disease Plasma volume .
Ductectasia Specific gravity .
Lipoma
* The first manifestation of Iatrogenic removal of
* Ketamine is contraindicated ? all parathyroid glands after total thyroidectomy is
In an asthmatic patient Carpal spasm .
For cesarean section Facial twitching on tapping the facial nerve .
In a patient with facial burns Circumoral numbness .
In a patient with increased ICP Pedal spasm .
In hypotensive patient Diarrhea .

* A 45 years old man presents with progressive * The best prophylaxis against infection in dirty
cervical lymph nodes enlargement , since 4 wounds is achieved by ?
months , the most appropriate investigation is ? Avoiding the use of local anesthesia .
X Ray soft tissue Inserting a drain into the wound .
FNAC Administrating a large dose of an appropriate
Lymph node biopsy antibiotic .
Thyroid isotope scan Administrating tetanus antitoxin .
Tuberculin test Removing foreign bodies and devitalized
tissues
* 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

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Page 47
* All of the following are common causes of small * In assessing the severity of an acute fracture ,
bowel obstruction except ? one must always ?
Post surgical adhesion Examine for subcutaneous emphysema .
Inguinal hernia Examine for evidence of gangrene .
Incisional hernia Examine the status of the neurovascular
Small bowel tumor system of the fractured part .
Fecal impaction Examine for a temperature and arrhythmia .
Examine for evidence of a fat embolism .
* The etiology of anal fistula includes ?
Anal gland infection * Which of the following steps is not part of the
Ulcerative colitis primary survey in a trauma patient ?
Ischemic colitis Insuring adequate ventilatory support .
Anal warts Measurement of blood pressure and pulse .
Levator ani syndrome Neurologic evaluation .
Protection of the cervical spine .
* The most common cause of Deep cut wound exploration and suturing .
Hypoparathyroidism is ?
Congenital absence of the parathyroids . * In obstructive jaundice , bleeding tendency is
Autoimmune parathyroid failure . due to deficiency of the following clotting factors
Parathyroid cancer . except ?
Surgical removal of the parathyroids at total 2
thyroidectomy . 7
Acute bacterial infection . 8
9
* Which of the following is an indication for 10
removal of a Lipoma ?
3 cm Lipoma in the tibialis anterior . In the treatment of head injury , one of the
3 cm Lipoma in the subcutaneous fat of the following is true ?
anterior abdominal wall . Steroids are regularly used .
3 cm Lipoma in the subcutaneous fat of the Patient with Glasgow coma score less than 8
buttock . are usually intubated and ventilated
A Lipoma of many years standing which has not Antibiotics are routinely used .
changed in size . Pyrexia is nearly always due to severe infection .
A Lipoma on CT scanning of homogeneous Severe fluid restriction is necessary
density
* Which of the following is true about the diabetic
* Which of the following is not considered an foot complications ?
immediate threat to life ? The neuropathy is only sensory .
Fracture of T8 with a complete spinal cord There is no relation to ongoing smoking .
transaction . The metatarsal phalangeal joints do not dislocate
Splenic injury with ongoing bleeding . The prognosis is worse with arterial disease
Open pneumothorax . and ongoing smoking .
Rapidly rising intracranial pressure . There is no place for surgical management .
Aspiration .
* The most common cause of Constipation ?
* Hypovolemic shock can result from any of the Slow transit constipation
following except ? Hypothyroidism.
Pulmonary laceration Rectocele .
Extradural hemorrhage Obstruction from colorectal cancer .
Pelvic fracture Inadequate dietary fiber and fluids
Femur fracture
Laceration to scalp * The incorrect statement regarding passage of
black and tarry stools is ?
* The cardinal feature of a compartment It is usually an indication of bleeding from the
syndrome is ? upper GI tract .
Hyperthermia It can be mimicked by the ingestion of iron
Rubor medication .
Ecchymosis It is commonly a symptom of a cancer of the
Limb hyperactivity colon .

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* All of the following are diagnostic tools for * The most common late complication of a
dysphagia except ? colostomy is ?
Upper GI endoscopy. Colostomy necrosis
Barium swallow examination . Retraction
Upper abdominal ultrasound examination . Obstruction
CT examination of the chest . Parastomal hernia
Esophageal manometry . Prolapse

* Acute epididymo_Orchitis is characterized by * The initiating event that leads to acute

the following features except ? calculous Cholecystitis is the obstruction of ?
History of urinary tract infection . Common bile duct
Rapid onest of pain . Common hepatic duct
Swollen tender testes . Cystic duct
Tenderness of the cord . Right hepatic duct
Pyrexia and Leucocytosis . Left hepatic duct

* All of the following are risk factors for SCC of * The most common complication after open
esophagus except ? splenectomy is ?
Alcohol Left lower lobe lung Atelectasis .
Tobacco Pleural effusion and pneumonia .
Achalasia Subphrenic hematoma .
Plummer Vinson syndrome Subphrenic abscess .
Barrett esophagus Pancreatitis .

* All of the following are manifestations of * Signs of severe varicose veins include all of the
hypervolemia except ? following except ?
Confusion or lethargy Thrombophlebitis
Peripheral edema Hyperpigmentation
Slow and weak pulse Ulceration
Dyspnea and crackles in lungs Compressible upon pressure
Weight gain Bleeding

* Pain in the hypogastrium when internal rotation * All of the following increase intracranial
of the hip is ? pressure except ?
The pointing sign Pain
The psoas sign Fever
The Obturator sign Cough
Rovsing sign Constipation
Blumbert sign Sleeping

* Which is the least common cause of pain in * Most common brain tumor in adults is ?
right iliac fossa in pregnant woman ? Glioblastoma multiforme
Acute appendicitis Medulloblastoma
Ectopic pregnancy Meningioma
Right acute pyelonephritis Pituitary tumors
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 .

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Page 49
* All of the following are indications for urgent * Which of the following congenital anomalies
surgical treatment of a depressed skull fracture occurs most frequently in patients with an
except ? Imperforate anus ?
A.Neurological deficit . Esophageal atresia
B .Decreased level of consciousness . Presacral dermoid
C .If associated with mandibular fracture . Urological anomaly
D .Underlying Subdural hematoma causing mass Tethered spinal cord
effect . Cleft palate
E .Cosmetic .
* One of the following is not presentation of right
* Regarding the metabolic abnormalities in side colonic tumor ?
Pyloric stenosis all are true except ? Melena
Hyponatremia IDA
Hypochloremia Abdominal mass
Hyperkalemia Obstruction
Primary metabolic alkalosis Anorexia and weight loss
Compensatory respiratory acidosis
* The most common histological type of
* The early clinical presentation of colorectal cancer is ?
Tracheosophageal fistula consists of all of the Adenocarcinoma
following except ? Lymphoma
Choking on first feed Carcinoid
Coughing Melanoma
Cyanosis Mesenchymal tumor
Excessive salivation
Aspiration pneumonia * All of the following are parts of prognostic
Ranson criteria except ?
* The most common perianal fistula type is ? Age
Transsphincteric fistulae Blood sugar
Extrasphincteric fistulae Serum amylase
Intersphincteric fistulae White cell count
Suprasphincteric fistulae LDH
Infrasphincteric fistulae
* Which of the following hernia may close
* All of the following statements are true about spontaneously in children ?
the Lateral internal sphincterotomy except ? Inguinal hernia
Overall healing rates of 90_100% . Umbilical hernia
Recurrence rate is low , the majority in the range Incisional hernia
of 1_3% . Bochdalek hernia
The treatment of choice for anal fissure refractory Paraumbilical hernia
to non surgical therapy .
Incontinence sufficient to cause any * The commonest cause of ascending
measurable impairment quality of life is Cholangitis is ?
uncommon , in the range of 3%. Stone impaction in CBD .
LIS is inferior to fissurectomy and posterior Cancer head of the pancreas .
midline sphincterotomy with respect to healing Cholangiocarcinoma .
rates , pain relief and incontinence . Lymphadenopathy of the porta hepatis .
Ruptured Hydatid cyst into the biliary tree
* The most common site of metastasis in patients
with Hepatocellular carcinoma is ? * In monitoring the hourly urinary output of a
Adrenal glands patient with 60 kg body weight , the amount of
Lymph nodes urine that is considered minimal acceptable is ?
Lungs 60 ml
Bone 45 ml
Brain 30 ml
100 ml
75 ml

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 50
* The calf pressure that should cause the * One the following is false about the
surgeon to do fasciotomy is : Closrtidiumtetani :
1- 10 cm H2O 1- Causes gas gangrene
2- 20 cm H2O 2- Produces an exotoxin
3- 30 cm H2O 3- Has a terminal spore
4- 40 cm H2O 4- Is an obligatory anaerobe
5- 50 cm H2O 5- Is motile

* The most common complication of acute * The most common complication post
appendicitis : hemorriodectomyis :
1- Intra abdominal abscess 1- Bleeding
2- Pneumonia 2- Urine retention
3- Wound infecion 3- Anal stenosis
4- Bowel obstruction secondary to adhesion 4- Incontinence
5- Incisional hernia 5- Infection

* The major methods of date collection from the * Diagnosis of acute mesenteric ischemia is most
community is: likely when the patient has :
1- Observation , interview, examinations 1- Elevation of WBC
2- Observation only 2- Elevation of serum amylase level
3- Morbidity and mortality data 3- Bloody stool in the rectum
4- Civil registry 4- Diffuse pain out of proportion to
5- Health information tenderness
5- Gas in cecum on abdominal X ray
* All of the following are early complications of
head injury except: * All of the following signs of hypovolemic shock
1- Brain concussion except:
2- Meningitis 1- Hypothemia
3- Brain contusion 2- Tachypenia
4- Epilepsy 3- Pulsusparadoxus
5- CSF leak 4- Cool skin
5- Hypotension
* All of the following have been reported to
increase the risk of gastic cancer except: * Which of the following can be diagnosed with
1- Smoking 100 % sensitivity and specificity
2- Alcohol using FNA ?
3- H. Pylori infection 1- Medullary cancer
4- Chronic atrophic gastritis 2- Colloid nodule
5- Previous gastric resection 3- Anaplastic cancer
4- Follicular cancer
* The most common cause of wound infection is : 5- Papillary cancer
1- Streptoccuspyogen
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

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Page 51
* The most common hernia to strangutateis : * complications of massive transfusion include all
1- Indirect inguinal hernia of the following except:
2- Femoral hernia 1- acidosis
3- Direct inguinal hernia 2- alkalosis
4- Epigastric hernia 3- hypercalcemia
5- Slidling hiatus hernia 4- hypothermia
5- coagulopathy
* The risk of cholangiocarcinoma is not increased
in patients with : * All of the following are risk factors for
1- Gallstones hepatocellular carcinoma except:
2- Choledochal cyst 1- hemochromatosis
3- Clonorchissinensis 2- alpha 1 antitripsin deficiency
4- Primary sclerosing cholangitis 3- hepatitis B infection
5- Hepatolithiasis 4- hepatitis C infection
5- oral contraceptive usage
* The contraindication for medical treatment of
gallstone include all the following except: * what is false about acute epiglottitis :
1- Non functioning gallbladder 1- commocn in children
2- Porcelain gallbladder 2- caused by H.influenzae
3- Emphysematous gallblader 3- hoarsenness is presenting symptom
4- Stone less than 15 mm in size 4- painfull swallowing
5- Calcium bilirubinate and oxalate stones 5- orooling of saliva

* The most common complication post * Hyper- metabolism in sever burns is related to :
splenectomy is : 1- Glutamine synthesis
1- Wound infection 2- Hypocortisolemia
2- Gastric dilatation 3- Decreased catecholamine activity
3- Hemorrhage 4- Hyperinsulinemia
4- Atelactasis 5- Hepatic glycongen synthesis
5- Pancreatitis
Extra adrenal pheochromocytomas
* Which is the single most avoidable factor predominantly secrete:
responsible for deaths: 1- Epinephrine
1- Cigarette smoking 2- Norepinephrine
2- Diabetes 3- Dopamine
3- End stage renal disease 4- Metanephrine
4- Dyslipedemia 5- Vanillymandelic acid
5- Depression
* The most common cause of bloody nipple
* Conrtaindication to liver transplantation include discharge is :
1- fulminant hepatic failure with hepatic coma 1- Breast cancer
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

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* Elevated serum gastrin is found in all the 5- Total fertality rate
following except : * Which of the following statements about
1- Duodenal ulcer associated with H.pylori Hicshsprungs disease is not true:
2- Retained antrum 1- It is more in girls
3- Gastric outlet obstruction 2- It may invole the small bowel
4- Postvagotomy 3- It may be associated with enterocolitis
5- Pernicious anemia 4- There is an increased incidence of Downs
syndrome
* The oxygen-hemoglobin dissociation curve is 5- There are no ganglionic cells seen in
shifted towards the left by all the following factors Auerbach plexus
except:
1- Hypothermia * All the following are used to reduce intracranial
2- Decreased PaCO2 pressue after head injury
3- Acidosis except:
4- Increased PH 1- Head elevated to 30 degrees
5- Dcreased (2,3-DPG) 2- Avoid neck and chest compression like
bandages and wraps
* What is the borders of Hessilbach triangle? 3- Intubation and mechanical ventilation to
Ans: inferior epigastric vessels inguinal ligament achieve a normal ABGs
rectus sheath 4- Controlled hypothermia
5- Evacuation of extradural haematomas
* Which of the following is the most resonable
biochemical marker to follow after total * Treatment of shunt infection include all of the
thyroidectomy for papillary carcinoma : following except:
1- Calcitonin 1- Intraventricular antibiotic
2- Ionized calcium 2- Systemic antibiotic
3- Carcinoembroynic antigen 3- Immdediate replacement of shunt
4- Thyroglobin 4- External drainage
5- Serum thyroid- stimulating hormone 5- Removal of infected shunt

* Post- renal causes of acute renal failure incule * All of the following can causes Hyperkalemia
all of the following except: except:
1- Ureteral obstruction due to stones 1- Acidosis
2- Urethral obstruction due to prastatic 2- Insulin deficiency
enlargement 3- Hypomagnesemia
3- Blocked folet catheter 4- Cell lysis syndrome
4- Bladder dysfunction due to nerve injury 5- Renal failure
5- Myoglobinuria
* An abdominal compartment syndrome
* Undescended testes : produces all of the following except:
1- Best treated surgically at the age of one year 1- Acute renal failure
2- Best managed conservatively with hormons 2- Hypoxia
3- Best corrected at or around puberty 3- Intestinal obsruction
4- Have no malignat potential 4- Hypercarbia
5- Are usually bilateral 5- Elevated urinary bladder pressure

* The most common perianal fistula type is : * The best screening method for DDH in infants
1- Transsphincteric fistulae 1- X-ray
2- Extrasphincteric fistulae 2- Bone scan
3- Intrasphincteric fistulae 3- U/S
4- Suprasphincteric fistulae 4- MRI
5- Both A+D 5- CT scan

* The most important indicator of a population * LMWH produces its primary effects because of
health is : its inhibition of which factor:
1- Crude birth rate 1- 2a
2- Crude mortality rate 2- 9a
3- Infant mortality rate 3- 10a
4- Maternal mortality rate 4- 11a 5- 12a

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Page 53
* Initial treatment of acute gastrointestinal * All are true statement except ?
bleeding includes: A . The most predominant cell at day 3_4 after a
1- H2- receptor antagonist wound is macrophages .
2- Angiography B . The most predominant cell in the first 24
3- Sucralfate hours of the wound is PMN .
4- Gastrointestinal endoscopy C . The order of cell arrival in wound is
5- Aggressive volume resuscitation macrophages , platelets , PMNs , fibroblasts .
D . The most predominant cell type in a 7 day old
* The wound healing impaiment caused by wound is fibroblasts .
corticosteroid administration can be reversed by :
1- Vit A * The principle cells involved in acute organ
2- Vit C rejection is ?
3- Vit K A .B_cell .
4- Vit B12 B . T_cell .
5- Zinc C . Macrophages .
D . Platelets .
* The most common organ injured in E . Monocyte .
penentrating abdominal injury is:
1- Liver * The appendiceal artery is a branch of ?
2- Samll bowel A . Right colic artery .
3- Spleen B . Middle colic artery .
4- Stomach C . Left colic artery .
5- Colon D . Ileocolic artery .
E . Hypogastric artery .
* Posterior urtheral valve is the best visualized by
1- Bladder U/S * The most common presentation for
2- Static cystogram Appendiceal adenocarcinoma is ?
3- MCUG A . Acute appendicitis .
4- CT cystogram B . Ascites .
5- Retograde urethrogram C . Chronic anemia .
D . Palpable abdominal mass .
* Which of the following is the most important E . Incidental finding .
prognostic determinant of survival after treatment
for colorectal cancer: * All of the following are considered risk factors
1- Lymph node involvement for breast cancer except ?
2- Transumural extension A . Obesity .
3- Tumor size B . Hx of ovarian cancer .
4- Histologic differentiation C . Hx of endometrial cancer .
5- DNA content D . Multiparity .
E . Late menopause .
* The major component of the bile:
1- Bilirubin * Coarctation of the aorta most commonly occur
2- Bile acid in ?
3- Water A . Ascending thoracic aorta .
4- Cholesterol B . Transverse thoracic aorta .
5- Lecithin C . Thoracic aorta just proximal to left Subclavian
artery .
* All of the following are true except ? D . Thoracic aorta just distal to left
A . The best test for platelet function is bleeding Subclavian artery .
time . E . Descending thoracic aorta just above
B . FFP is the most effective way to acutely diaphragm .
correct INR .
C . Factor 8 is synthesized in the liver . * Which of the following is not an indication for
D . Calcium is required for normal coagulation . surgical intervention in a patient with aortic
stenosis ?
B . Angina pectoris .
C . Poor ventricular function .
D . Valve area less than 0.5 cm2 .
E . Calcification of the stenotic valve .

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Page 54
* A 65 year old female presents with a massive D . Preoperative endoscopic biopsy should
lower GIT bleeding . In ER BP 80/40 , HR 120 be done .
BPM . After fluid resuscitation the blood pressure E . Treatment of choice is endoscopic
120/80 , HR 100 . A Nasogastric tube aspirate is enucleation
negative for blood. The best next step is ?
A . Mesenteric Arteriography . * Jaundice with absent urine urobilinogen is most
B . Upper GI endoscopy . likely consist with ?
C . Exploratory Laparotomy . A . Hepatitis
D . Lower GI endoscopy . B . Cirrhosis
E . Observation . C . Hemolysis
D . Biliary obstruction
* Which of the following is true regarding E . Sepsis
ulcerative colitis and colon cancer ?
A . The risk of cancer unrelated to the extent of * Management of nasopharyngeal carcinoma
inflammation . consist primarily by ?
B . The malignancy typically develops in a polyp . A . Radiation
C . The risk of cancer related to disease B . Chemotherapy
duration C . Surgical excision
D . Random endoscopy and biopsies ineffective . D . Combined chemo_radio
E . CEA level are useful Guid _ when to perform E . Combined chemo_radio followed by surgery
a colonoscopy .
* Barrett esophagus ?
* A 65 year old man presents with a 2 day history A . It is a congenital anomaly .
of left quadrant abdominal pain , nausea , low B . When diagnosed , should be treated by
grade fever . Temperature 39 , WBC 14000 , surgery .
localized moderate left lower quadrant pain . The C . Occurs in 5% of patient with Achalasia .
best next step in management ? D . More common in females .
A . NG tube . E . Presence of intestinal Goblet cells .
B . IV antibiotics .
C . Flexible sigmoidscopy . * A 65 year old male presents with a persistent
D . Barium Enema firm lateral neck mass that measures
E . Gastrograffin enema approximately 2.5 cm . The best next step in
management is ?
* In female patients with a family history of A . Positron emission tomography .
HNPCC , which of the following is recommended B . CT scan of the head and neck .
beginning at age 25 . In addition to screening C . Fine needle aspiration cytology .
colonoscopy ? D . Chest radiography .
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
has tonic spasms . Serum osmolality 330 choice .
mosm/kg . The most likely diagnosis ? E . The majority presents as ulcerative lesion .
A . Hyponatremia
B . Hypercalcemia * Which of the following is true regarding Mallory
C . Hyperkalemia Weiss syndrome ?
D . Hypernatremia A . Spontaneous perforation of the esophagus .
E . Hypermagnesemia B . Forceful vomiting followed by
hematemesis .
* Which of the following statement about C . It's usually associated with air in the
esophageal leiomyoma is false ? mediastinum .
A . It is the most common benign esophageal D . Endoscopy is contraindicated .
neoplasm . E . Prompt surgical management is the best .
B . Most common sites middle and lower third
C . They have risk of malignant degeneration

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Page 55
* All are true about salivary glands neoplasms * Management of pancreatic lymphoma is by ?
except ? A . Pancreaticoduodenectomy
A . Mostly arise in the Parotid gland . B . Chemotherapy
B . Warthin tumors are the second most common C . Radiotherapy
benign salivary glands tumor and D . Pancreaticoduodenectomy followed by radio
strongly related to smoking . E . Chemo_radio therapy
C . Mucoepidermoid carcinoma is the most
common malignant salivary glands * A 32 year old woman notes that her hands
tumor . become cold and painful when exposed to cold
D . Pleomorphic adenoma does not undergo temperature . Change in color ( pale _ blue _ red
malignant degeneration . ) , vascular pulse is normal , the best next step in
E . Minor salivary glands tumor are more likely to management ?
be malignant than submandibular gland tumors . A . Upper limbs sympathectomy
B . Prostaglandins
* The first step in process of hemostasis after C . Fluoxetine
vessel injury is ? D . Arteriography
A . Platelet adherence E . Diltiazem
B . Platelet aggregation
C . Vasoconstriction * The initial step in management of SIADH ?
D . Release of thromboxane A . Furosemide
E . Thrombus activation B . Hypertonic saline
C . Demeclocycline
* The most useful laboratory test to assess risk of D . Isotonic saline
bleeding and response to therapy in patient with E . Restriction of free water
Uremia is ?
A . Bleeding time * The most common presentation of
B . Platelet count Pheochromocytoma ?
C . INR A . Excess sweating
D . PTT B . Palpitations
E . Thrombin time C . Chest pain
D . Headache
* Which of the following is the best method to E . HTN
prevent a first bleed in a patient with known
esophageal varices ? * The first biochemical abnormality detected in
A .B blockers the majority of patient with MEN1 ?
B . TIPS surgery A . Hypoglycemia
C . Sclerotherapy B . Hyperchloremia
D . Endoscopic ligation C . Hypocalcemia
E . Nitrate D . Hypercalcemia
E . Polycythemia
* A 45 year old female presents with intermittent
vague right upper quadrant pain and jaundice . In * The organism most common associated with
addition she notes having floating fatty stool . acute mesenteric Lymphadenitis is ?
Ultrasound : gallstone in gallbladder and mass in A . Campylobacter jejuni
pancreatic head . The most likely diagnosis ? B . E coli.
A . Vipoma C . Enterococcus
B . Glucagonoma D Yersinia enterocolitica
C . Somatostatinoma E . Pinworms
D . Gastrinoma
E . Insulinoma * All are true about Crohn disease except ?
A . It's more common in individual of low socio-
* Which of the following is true regarding economic status .
esophageal atresia and TE fistula ? B . It's most common primary surgical
A . The most common type is the H type . disease of the small bowel .
B . It is suspected prenatally by Oligohydramnios C . It's more common in smokers .
C . In most cases gastrostomy is required before D . Early sign is aphthous ulcer
surgical repair . E . Extensive mesenteric fat wrapping
D . 20 % of patient have cardiac anomalies .
E . This condition is more in females .

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* Diagnosis of Carcinoid syndrome is best by ? * The body response to hypothermia includes all
A . Serum Serotonin level of the following except ?
B . Serum substance P levels A . Decreased platelet function
C . 24 hour urinary 5_HIAA B . Decreased cardiac output
D . Serum Neurotensin levels C . Tachycardia
E . Serum Neurokinin A levels . D . Cardiac arrhythmia
E . Increased risk of wound infection
* The most sensitive and specific diagnostic test
for Gastrinoma is ? * Abdominal compartment syndrome should be
A . Octreotide scan suspected when bladder pressure exceed ?
B . Fasting serum gastrin A . 10 cm H2o
C . Calcium stimulation test B . 25 cm H2o
D . Secretin stimulation test C . 35 cm H2o
E . Basal and stimulated gastric acid outputs D . 40 cm H2o
E . 50 cm H2o
* The treatment of choice for high grade primary
gastric lymphoma ? * After excision of multiple lipomas under
A . Total gastrectomy anaesthesia . A 42 year old male seizes . The
B . Subtotal gastrectomy surgeon should be aware that the maximum safe
C . Chemo_radio therapy dose of local anesthetic in 70 kg patient ?
D . Total gastrectomy followed by chemotherapy A . 10_20 ml 1% lidocaine .
E . Radiation therapy B . 40_50 ml 2% lidocaine with epinephrine .
C . 40_50 ml 1% lidocaine with epinephrine .
* Cryoprecipitate contains high concentrations of D . 40_50 ml 0.5% lidocaine
all of the following E . 40_50 ml 1% lidocaine without epinephrine
except ?
A . Fibrinogen * All are true about Peutz_Jeghers syndrome
B . Factor 8 except ?
C . VWF A . Typical small bowel lesion adenomatous
D . Fibronectin polyps .
E . Factor 11 B . It's autosomal dominant .
C . Small bowel obstruction is the most common
* All are true about malignant tumors of the small presentation .
bowel except ? D . There is increased risk of small bowel cancer
A . Adenocarcinoma most commonly in the E . There is increased risk of breast cancer .
duodenum .
B . Adenocarcinoma and Carcinoid are the most * After splenectomy for trauma the optimal timing
common types . for administration of the pneumococcal vaccine is
C . Gastrointestinal stromal tumors are postoperative day ?
associated with acquired immunodeficiency A.1
syndrome . B. 4
D . Lymphoma most commonly in the Ileum . C.7
E . Majority of small bowel malignancy are D . 10
treated surgically E . 14

* The best test to confirm eradication of H pylori * All of the following are true about TTP except ?
after treatment is ? A . It does not lead to Hemolysis .
A . H pylori serology B . The Coombs test is negative .
B . Urea breath test C . Lower limbs petechiae are the most common
C . Histologic biopsy presentation .
D . Rapid urease test D . Seizures and coma are common
E . Antral mucosal biopsy and culture complications .
E . The first line of treatment is plasma exchange
* Which of the following antibiotics can cause
Red man syndrome if given Rapid IV ?
A . Clindamycin
B . Gentamicin
C . Levofloxacin
D . Vancomycin

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

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* Which of the following describes the association * A 60 year old male smoker presents with
between Sister Mary Joseph nodule and stomach radicular right arm pain . A chest radiograph
cancer ? reveals a bulky mass in the posterior apex of the
A . Metastatic left axiallary lymph nodes . chest in the superior sulcus . All of the following
B . Metastatic left supraclavicular lymph node . are commonly associated with this mass except
C . Ovarian mass . A . Ptosis
D . Umbilical metastasis . B . Right eye miosis
E . Anterior nodule palpable on rectal exam . C . Right facial anhidrosis
D . Right eye exophtalmus
* Peripheral neuropathy with prolonged use is E . Non small cell lung cancer
most commonly associated with ?
A . Clindamycin * A patient presents with fatigue and bone pain .
B . Metronidazole Serum calcium level is 11.1 mg/dl , PTH is
C . Ciprofloxacin elevated . The best next step is ?
D . Gentamicin A . Operative exploration
E . Vancomycin B . Neck CT scan
C . Technetium 99m sestamibi imaging
* Bacteremia from which of the following D . MRI
organism is associated with colon cancer ? E . Ultrasound scan
A . Streptococcus bovis
B . C difficile * Factors related to increased risk of thyroid
C . MRSA cancer include all of the following except ?
D . H pylori A. Family history
E . Streptococcus viridans B . Hx of radiation
C . Smoking
* Most common cause of SVC syndrome ? D . Female
A . Radiation therapy E . Low iodine diet
B . Malignancy
C . Infections * All of the following are true regarding head
D . Idiopathic injury except ?
E . Post central line insertion A . Epidural hematoma are associated with lucid
interval .
* Small cell lung carcinoma is managed by ? B . Subdural hematoma are due to laceration of
A . Chemotherapy followed by surgery . bridging veins .
B . Surgical resection . C . Epidural hematoma are usually associated
C . Radiation therapy . with a skull fracture .
D . Combination chemo_radio therapy . D . CT scan shows convex lens hematoma in
E . Radiotherapy followed by surgery . epidural hematoma .
E . Epidural hematoma generally have a
* All of the following are true regarding blood worse prognosis than Subdural hematoma .
supply to the thyroid , parathyroid glands except
A . The parathyroid glands are usually * Which of the following is the most common risk
supplied by the superior thyroid arteries factor for spontaneous venous thromboembolism
B . The superior thyroid artery is the first branch A . Antithrombin 3 deficiency
of the external carotid artery . B . Factor 5 Leiden
C . The recurrent laryngeal nerves are at risk of C . Protein C deficiency
injury during ligation of the inferior thyroid arteries D . Protein S deficiency
D . The external branch of the superior laryngeal E . Antiphospholipid syndrome
nerve is at risk of injury when the superior
laryngeal arteries are ligated . * All are true about Achalasia except ?
E . The thyroidea ima artery usually arises from A . It can be congenital or acquired .
the aorta . B . In young patient , myotomy is the best
treatment .
C . CCB exacerbate this condition .
D . Caused by neurogenic degeneration .
E . Dysphagia , regurgitation , weight loss .

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

Page 58
* Which of the following is least likely associated * Which of the following is an appropriate
with Hyperparathyroidism ? definition of shock ?
A . Cholelithiasis and urolithiasis . A . Low blood pressure
B . Acute pancreatitis . B . Low cardiac output
C . Osteitis fibrosa cystica C . Low circulating volumes
D . Diarrhea D . Inadequate tissue perfusion .
E . PUD E . Abnormal vascular resistanc

* A 30 year old man is brought into the

emergency room after 20 foot fall . He is noted to
speak using inappropriate words . He with draws
and open his eyes to pain only , Glasgow coma
scale score is ?
A .10
B .9
C .8
D .7
E .6

* Trauma patients are at highest risk of venous

thromboembolism is ?
A .Head trauma
B .Femur fracture
C .Pelvic fracture
D .Splenectomy
E .Spinal cord injury

* All are true about Bochdalek hernia except ?

A . It is type of congenital Diaphragmatic hernia .
B . Newborn presents with respiratory distress at
birth .
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

‫ اسامه الخزاعله‬: ‫الدكتور‬ ‫اسئلة الجراحة العامه‬

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