General Surgery Exam Questions 2021-2022 - University of Mosul - PDF

‫الجراحة العامة‬ ‫المرحلة الرابعة‬ ‫جامعة الموصل‬ 2022-2021 ‫اسئلة امتحانات نصف السنة للعام الدراسة‬...

‫الجراحة العامة‬ ‫المرحلة الرابعة‬ ‫جامعة الموصل‬ 2022-2021 ‫اسئلة امتحانات نصف السنة للعام الدراسة‬ DR.Abd alsalam 1- Regarding polycystic kidney acidosis which statement are false a- it is hereditary and fatal disesse , transmitted by either parents , autosomal dominant trait.. b- usually detected at the 2nd & 3rd decades of life. c- loss of normal characteristics of kidney. d- the kidneys are small in size. e- symptoms started at >30 yrs of age. 2. Regarding congenital anomalies of kidneys all true except; a- Agenesis of one kidney it occurs 1:400 , usually symptomless discovered accidently b- duplication of kidney c- an ectopic kidney ( pelvic , iliac , crossed ectopia )found in 1:1000 d- horse shoe kidney isn't congenital abnormality e- S_shape kidney crossed ectopic kidney with or without fusion 3-Not used in investigation of Ureterocele. a- KUB b- CT c- lVU d- US e- cystoscopy 4- One of the following not cause extramural pressure on ureter : a- Tumors b- Inflammatory masses c- Enlarged retroperitoneal lymph node. d- Idiopathic retroperitoneal fibrosis e- ureteric stones Dr.Zaid 5- All the following regarding Idiopathic calcium urolithiasis except : a- there is unexplained hypercalciuria but a normal serum calcium b-It is classified as renal (more common in adult) or absorptive (more common in children) c- coexists with minimal hyperoxaluria d- often coexist hyperuricosuria e- associated with incomplete renal tubular acidosis 6- Regarding Schistosomiasis, the development of balharzial nodules, sandy patches and granulomas depend on a- the length of time for which the disease has b- Age c- gestational diabetes d- sex  7 -Regarding Emphysematous pyelonephritis all the following true except a - 90% of cases occur in diabetic patients b - caused by gas-forming organisms, including E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Proteus mirabilis c - Gas can be detected on a plain film, on USS or more probably on a CT scan. d - nephrectomy is contraindicated in management 8 -Regarding Emphysematous pyelonephritis all the following true except a - PUJ b - Ureter crosses aorta c - ureteric orifice d -when ureter enter bladder wall e - juxtaposition vas deferens or round ligament 9 - Regarding TB in genital urinary tract all the following true except a- the healing process produce fibrous tissue & calcification b-Is always either re-infection or reactivation of old TB c- ultra sound the most sensitive modality for visualizing renal calcifications d- progressive hydronephrosis results in very thin parenchyma, mimicking multiple thin- walled cysts e- Spread to the collecting tubule & once calyx is stenosis it is rare to restore connection Dr.Noman 10 -a 45 years man, undergo cystoscopy incidentally found a 1 cm mass in the bladder without any other symptoms , what is the next step to do a- transurthroscopic tumour resection and biopsy b- active surveillance c-reassure the patient d-total cystectomy e- partial cystectomy 11- 20 years old _male fallen astride and sustained perineal trauma.. Presented with bleeding per urethral and butterfly hematoma in perineum The injury is: a- penile urethral injury b- bulbar urethral injurt c- membranous urethral injury d- prostatic urethral injury e- Bladder injury 12-35 years old male have a mass , The mass contain fat ( which has negative density on CT scan ) What is most likely diagnosis ? a- Angiomyolipoma b- renal cell carcenoma c- Angioma 13- A female present with hematuria, right loin pain and mass on ultra sound show a mass in right kidney،، what is the diagnosis ? a- Renal cell carcinoma b- Wilm's tumor c- Transition cell carcinoma Dr. Firas 14 -A young male with history of abdominal pain, disinclined to move,with rapid shallow respiration, all the followings are correct, except: a- board like rigidity b- liver dullness is diminished c- chest radiography is required d- surgery involves suturing the omentum e- i‌m‌m‌e‌d‌i‌a‌t‌e‌g‌a‌s‌t‌r‌o‌d‌u‌o‌d‌e‌n‌o‌s‌c‌o‌p‌y 15-one of the following not include in the mangement of the gastric outlet obstruction due to peptic ulceration? a - Nasogastric suction b - intravenous H2 antagonist c -Potassium supplement d -Immediate surgery e -Gastroscopy to exclude gastric cancer....... 16- 70 years old man present with epigastric mass for 2years with dyspepsia, who was diagnosis as gastrointestinal stromal disease. spot is corrected? a- there is involve small intestine more than 50%. b- always perforated to tumor c- peritoneal and liver metastasis are common d- lymphadenectomy during surgery is required. e- tumor less than 5 cm can cause metastasis 17- The most common presentations of gastric cancer is a- hematemesis and melena b- Acute abdominal pain due to perforations. c- vague pain in epigastrium and weight lose. d- epigastric mass e- dysphagia Dr. Zyad 18-boy present with sudden sever right iliac fossa, the diagnosis of appendicitis can not be excluded, on operation the appendix was normal, but 60 cm from it there was a diverticular that was inflamed, what is incorrect regrading this? a-it present in 2% of population b- presentation is similar to acute appendicitis c- develop as the result of mucosal herniation through the point of entry of blood vessels d-It contain hetrectopic tissue(colonic, gastric , pancreatitic ) e. situated in the anti-mesnteric border of the small intestine  19- Regarding peutz _joghers syndrome ,which is false :: a-it is important to female to attend cervical & breast managment. b-Autosomal dominant disease c-melanosis of oral mucus membrane & lips ( non pathgnomonic ) d-long term follow up in patirnt with peutz _ jaughres is shown to reduce the secondary tumor e-resection is needed for severe bleeding Dr.sameer 20- Patient presented with abdominal pain Murphy sign +ve, the most common diagnosis is: a- empyma of gallbladder b-mucocele c- acute pancreatits d- acute cholycysitis e-carcioma of gallbladder 21- False about Cholesterol stones a-Contain mainly pure cholesterol b-Mostly single ( cholesterol solitaire) c- Obesity d- low-calorie diets Dr.Ali 22- about ulcerative colitis , one correct a- Rectum is spared b- Terminal ileitis is most common presentation c- possibility of developing Cancer increase with length of disease duration d- smoking is risk facator 23- About Familial adenomatous polyposis (FAP) one is true : a- FAP is inherent on X chromosome b- The lifetime risk of colorectal cancer is 80 % c- defined clinically by the presence of more than 100 colorectal adenomas d- Carcinoma of the large bowel develops 30 years after the onset of the polyposis 24-in spleen rupture one of the following is false a-blunt upper abdomenal truma is recognized cause. b- splenectomy is always indicated. c- trauma in the left lower chest fracture ribs may be a cause. d-splenomegaly is considered a risk. e-iatrogenic injury may be a cause.  Dr.Omar 25- one of flowing true regard acute pancreatitis a-ultrasound has no rule in diagnosis b-amylase normal within 48 h c-lipase more specific than amylase d-amylase more specific than lipase e-ct scan has no rule in diagnosis 26-one of the following statements more accurate aboute pancreatic fistula a-nutritional suuport not indicated b- ERCP not valuable c- occur in 30% of people in post pancreatic injury d- CT scan is not useful as dealing with this case e- reoperative is contraindicated Dr.nashwan 27- Regarding ultra sound in thyroid diseases, All are true except: a-Differentiate cyctic from solid masses b- information about size and multi centricity c-Differentiate between follicular and medullary carcinoma d-assess cervical lymph nodes e-guides for FNAC 28- A 30 years old women, who has a history of cold last week, Presented with high temperature and elevated ESR after completely treatment of goiter and showen Cold RAI، sudden painful swelling, what is the diagnosis a- Subacute thyroiditis b- acute thyroiditis c- hashimotos thyroiditis d- riedels thyroiditis 29- Thyroid tumor that arise from parafollicullar cells is : a-Papillary carcinoma b-Medullary carcinoma c-Follicular carcinoma d-Anaplastic carcinoma 30- Immediately Fever, delirium ,seizure, coma developed in boy 11 years undergoes appendectomy his mother mentioned he has graves and withdrawal the drug of graves before 2 weeks, what is the diagnosis a- anaphylactic shock b- sepsis c- thyroid storm d- peritonitis Dr.Khalaf 31- A 85 year man who has benign prostatic hyperplasia BPH and history of urine retention, present with rectal prolapse which of the following false regarding management of this case a-treatment of BPH b- perineal approach is safer in such patient c-abdominal approach has a lower rate of recurrence d- Thiersch operation is indicated as main line for treatment e- operation in such case in recommened 32- Which of following can not mask the signs of appendicitis a- obese b- old age c- thin d-pregnancy c-unconsious patient 33- Regarding the pathogenisis of appendicitis all are true except: a-atrophy of lymphoid tissue in elderly b- Lymphoid hyperplasia narrows the lumen of the appendix, leading to luminal obstruction c-increase mucos secretion leading to increase intraluminal pressure d-increase intraluminal pressure lead to lymphatic obstruction e-when appendicular obstruction is developed,mucus secretion is continued 34- Female suffer from right iliac fossa pain and tenderness she diagnosis to have appendicular mass , which of the following incorrect regard the case a-the mass should be made using a skin pencil and the abdomen regularly re-examined b-Temperature and pulse rate should be recorded 4-hourly. c- Antibiotic and a fluid balance should be started d- A contrast-enhanced CT examination of the abdomen should be performed e-Immediately appendectomy Dr,karam 35-Which of following are true a-Incidince of Post cancer of tongue is more than anterior b-non healing tongue ulcer for more than 4 weeks need investigation c-trismus appear in the early stage of CA d- ipsilateral otalagia appear in the early stage of CA 36-A female patient after laparotomy for sever days , she had Left parotid purulent discharge And fever. What is the initial management : a- IV antibiotic b- Anticholinergic c-norepinephrine 37- 7 years old boy presented to you with a right sided neck mass. The mass is fluctuant. And a small pore anterior to the sternocleidomastoid with clear fluid exudation. What's is the diagnosis a- 1st branchial cleft cyst b- 1st branchial cleft fistula c- 2nd branchial cleft cyst d- 2nd branchial cleft fistula e-3rd branchial cleft cyst 38- 7years old boy presented with mass in his neck move upward when he protrude his tongue.the diagnosis is: a- thyroglossal duct cyst b-cystic hygroma 39- middle aged man present with right lower jaw swelling, on examination it was firm irregular mass, He denied any pain or other symptoms, with asymmetrical smile, diagnosis is a- Plemorphic adenoma b-Parotid cancer c- Warthin tumor d-mumps 40-All the following are congenital abnormalities of the gall bladder except: a. absence of gall bladder ‫سؤال تابع‬ b. floating gall bladder ‫سمير‬.‫لمادة د‬ c. Double gall bladder d. ducts of Luschka e. high insertion of cystic duct Essay questions Q1 (Dr.Ali) 68 yrs female , she lost 15kg over last 3 months ،and she develop iron deficiency anemia , and has a mass in right iliac fossa. A- what is the diagnosis colorectal cancer B-what is the best investigation for this case Colonoscopy C-mention the available investigations 1- Double-contrast barium 2-computed tomography (CT) virtual colonoscopy 3-Spiral CT of the chest , abdomen and pelvis 4-chest x-ray and liver ultrasound Q2 A-What's the clinical presentation of of Meckel's diverticulum? ( Dr. Zyad) 1- severe hemorrhage 2- intussusception 3- Acute appendicitis 4- Chronic peptic ulceration 5- Intestinal obstruction B- enumerate findings may raised the possibility of renal involvement in trauma (Dr.abd alsalam) 1- Trauma to loin 2- Fractured lower ribs 3- Ecchymosis and bruises at upper abdomen and lower chest 4- hematuria Q3 45 year old multiparous woman she complains that something is out of her anus (DR.khalaf) A-what's the provisional diagnosis? Rectal prolapse B-What are the complication 1-Rectal ulceration 2- bleeding 3- incarceration 4- strangulation of the rectum Q4 A-(Dr.Zaid) A patient came to emergency room with left ureteric colic pain. How you mange him (emergency) The patient is usually given a non-steroidal anti-inflammatory drug such as diclofenac for pain relief and observed for further episodes of pain, but also temperature, pulse, blood pressure and white blood count are monitored for signs of developing infection and the estimated glomerular filtration rate (eGFR) is monitored for signs of a decline in renal function. It should be noted that the eGFR should remain within normal limits in the presence of a normal contralateral kidney with normal function A CT scan confirms the diagnosis, small stones (