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Mcqs Mock Exams For General Surgery Board Exam
Mcqs Mock Exams For General Surgery Board Exam
Mcqs Mock Exams For General Surgery Board Exam
Share from Dr. Muhanad Deeb. Riyadh, King Faisal Hospital (muhanad.deeb.5facebook.com)
References:
1. Comprhensive "AIO" Revision on SURGERY by Dr.Adel Abdel Hamid. 2008
2. Lange Q & A 5th Edition.
Breast
1. After intraductal papilloma, unilateral bloody nipple discharge from one
duct orifice is most commonly caused by which of the following pathologic
conditions?
A. Paget's disease of the nipple.
B. Intraductal carcinoma.
C. Inflammatory carcinoma.
D. Subareolar mastitis.
Answer: B
Endocrine
5. When progressive enlargement of a multinodular goiter causes
symptomatic tracheal compression, the preferred management in otherwise
good-risk patients is:
A. Iodine treatment.
B. Thyroid hormone treatment.
C. Surgical resection of the abnormal thyroid.
D. Radioactive iodine treatment.
Answer: C
Abdumin
9. The most common hernia in females is:
A. Femoral hernia.
B. Direct inguinal hernia.
C. Indirect inguinal hernia.
D. Obturator hernia.
E. Umbilical hernia.
Answer: C
11. Staples may safely be placed during laparoscopic hernia repair in each
of the following structures except:
A. Cooper's ligament.
B. Tissues superior to the lateral iliopubic tract.
C. The transversus abdominis aponeurotic arch.
D. Tissues inferior to the lateral iliopubic tract.
E. The iliopubic tract at its insertion onto Cooper's ligament.
Answer: D
Osop & Dudenum
12. Which of the following statements about the anatomic course of the
esophagus is correct?
A. The cervical esophagus passes behind and to the right of the trachea.
B. The thoracic esophagus enters the posterior mediastinum anterior to the
aortic arch.
C. The thoracic esophagus passes behind the right mainstem bronchus and
the pericardium.
D. The esophagus enters the diaphragmatic hiatus at the level of T8.
E. The esophagus deviates anteriorly and to the left as it enters the
abdomen.
Answer: E
13. Which of the following statements about esophageal anatomy is correct?
A. The esophagus has a poor blood supply, which is segmental in distribution
and accounts for the high incidence of anastomotic leakage.
B. The esophageal serosa consists of a thin layer of fibroareolar tissue.
C. The esophagus has two distinct muscle layers, an outer, longitudinal one
and an inner, circular one, which are striated in the upper third and smooth
in the distal two thirds.
D. Injury to the recurrent laryngeal nerve results in vocal cord dysfunction
but does not affect swallowing.
E. The lymphatic drainage of the esophagus is relatively sparse, localized
primarily to adjacent paraesophageal lymph nodes.
Answer: C
14. Which of the following statements about the lower esophageal sphincter
(LES) mechanism, or high-pressure zone (HPZ), is true?
A. The LES is a circular smooth muscle ring that is 3 to 5 cm. long.
B. In assessing esophageal manometric data, mean HPZ pressure less than
6 mm. Hg or overall length less than 2 cm. is more likely to be associated
with incompetence of the LES and gastroesophageal reflux.
C. Esophageal manometry and the acid perfusion (Bernstein) test reliably
identify the patient with an incompetent LES mechanism.
D. Distal HPZ relaxation occurs within 5 to 8 seconds of initiating a swallow.
E. Twenty-fourhour distal esophageal pH monitoring is achieved with an
intraesophageal pH electrode positioned at the esophagogastric junction.
Answer: B
Intestine
15. The most common site of adenocarcinoma of the small intestine is the:
A. Duodenum.
B. Jejunum.
C. Ileum.
Answer: A
16. The most common benign tumor of the small intestine is:
A. Adenoma.
B. Hemangioma.
C. Leiomyoma.
Answer: C
17. An 80-year-old man who has been bedridden for many years following a
stroke presents with acute onset of abdominal distention, obstipation, and
colicky abdominal pain. Abdominal x-rays reveal dilated loops of small bowel
and a dilated sigmoid colon resembling a bent inner tube. Examination
reveals distention with mild direct tenderness but no rigidity or rebound
tenderness. Initial management should consist of:
A. Barium enema examination.
B. Laparotomy with resection of descending colon and descending colostomy.
C. Multiple cleansing enemas to remove impacted feces.
D. Rigid sigmoidoscopy and decompression of the sigmoid colon.
Answer: D
18. A 45-year-old man complains of burning epigastric pain that wakes him
up at night. The pain is relieved by eating or using over-thecounter antacids
and H2 blockers. Diagnosis is best confirmed by which of the following?
(A) Urea breath test
(B) Serum gastrin levels
(C) Barium meal examination
(D) Upper endoscopy
(E) Upper endoscopy and biopsy
Answer: (E) Duodenal ulcer is best diagnosed by upper endoscopy and
biopsy. Findings of gastritis and the presence of H.pylori are indications to
prescribe appropriate therapy. This typically includes a PPI and two
antibiotics (one regimen includes amoxicillin and clarithromycin). Although
the urea breath test is the most sensitive and specific test used to detect H.
pylori, it is not readily available in all settings.
Liver
21. Which of the following clinical situations are considered good indications
for PVS?
A. A 50-year-old cirrhotic man had an emergency portacaval shunt for
bleeding varices and postoperatively had an ascites leak and mild superficial
wound infection.
B. A 57-year-old woman with primary biliary cirrhosis (PBC) has difficult to
control ascites and diuretic-induced encephalopathy.
C. A 46-year-old resistant alcoholic has chronic ascites uncontrolled by
diuretics combined with repeat paracentesis.
D. A 34-year-old woman taking BCPs had rapid onset of ascites and is found
to have hepatic vein thrombosis causing the Budd-Chiari syndrome.
Answer: C
Spleen
22. Hodgkin's disease is a malignant lymphoma with four histologic
subtypes. Which of the following is not one of the subtypes?
A. Lymphocyte predominance.
B. Nodular sclerosis.
C. Mixed cellularity.
D. Lymphocyte depletion. E. Leukocyte-lymphocyte dominance.
Answer: E
Genato urenery
23. Ureteral obstruction:
A. Is associated with hematuria.
B. Is associated with deterioration of renal function and rising blood urea
nitrogen (BUN) and creatinine values.
C. Is commonly caused by a urinary tract calculus.
D. Usually requires open surgical relief of the obstruction. E. Is usually
associated with infection behind the obstruction.
Answer: C