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REVIEW

QUESTIONS FOR SURGERY 5. Full thickness skin grafts are indicated


MD3 2017-2018 for coverage in which of these
situations?
Plastic Surgery, Head and Neck a. lower eyelid defect following
ablation of BCC
1. Early signs & symptoms of life- b. full thickness V-shaped defect of
threatening smoke inhalation injury the lower lip post excision of
include: capillary hemangioma
a. stridor c. wound defect due to deep partial
b. wheezes thickness burns over the R cheek
c. progressive hoarseness of voice d. full thickness scalp defect with
d. laryngeal edema exposure of calvarium

2. Silver sulfadiazine the gold standard 6. abdominal dermolipectomy is a
for topical management of wounds: cosmetic surgical procedure that
a. has a broad spectrum involves
antimicrobial coverage against a. removal of excess localized fat
both gram (+) and gram (-) from the ant abdomen through
bacteria including Pseudomonas liposuction
spp, E. coli, P. vulgaris b. excision of skin +fat on the ant
b. may cause leukocytosis as a abdominal wall from below the
reversible side effect umbilicus down to the suprapubic
c. penetrates burn eschar area
effectively to reach the surface of c. repositioning of the umbilicus
wound downwards through the new skin
d. delays wound epithelialization drape
d. thinning out of the fascia and
3. Cleft palate repair is done: repair of the linea alba on the ant
a. under local anesthesia abdominal wall
b. simultaneously with cleft lip
repair at 3 months of age 7. lab exam included in the systemic
c. between ages 18 months to 15 prep of Px w/ wound defects
yrs of age requiring coverage:
d. as early as possible in order to a. wound biopsy & culture
maximize the recovery b. total CHON determination
c. FBS determination
4. Thin split- thickness skin grafts are d. 2D-echocardiography
characterized as:
a. containing epidermis and the 8. The rule of tens used as criteria for
upper half of the dermis timing of repair of cleft lip deformities
b. ranging between .008-.020 inch in prescribes surgery at:
thickness a. 10 months of age
c. more prone to primary & b. Hgb level at least 10gm/dl
secondary contaction c. WBC count of at least 10,000
d. with cosmetic appearance better d. Weight of at least 10kg
than thicker grafts

9. A tripod facial bone fracture involves b. Mn
which of these bones? c. Fe
a. mandible d. Cu
b. orbit
c. nasal 15. The MC cause of skin graft failure is:
d. ethmoid a. infection
b. seroma formation
10. Primary survey of the Px w/ traumatic c. necrosis
injuries entails: d. hematoma
a. ensuring a patent airway free of
foreign materials 16. Recommended management of a fresh
b. local wound management mandibular condyle fracture without
c. nutritional support dislocation is
d. infection control a. conservative non-surgical
approach
11. Deterrents of wound healing include: b. intermaxillary fixation alone
a. chemotherapeutic agents c. open reduction + interosseous
b. zinc plate fixation
c. ascorbic acid d. open reduction + interosseous
d. corticosteroids plate fixation + intermaxillary
fixation
12. Alginates, hydrogels & hydrocolloids
are considered ideal dressing 17. Valid statement regarding management of
materials for wounds because they facial bone fractures:
a. prevent maceration of the a. conservative non surgical approach is
periwound area reserved for unstable fractures
b. maintain enough moisture on the b. open reduction + interosseous plate
wound surface fixation + intermaxillary fixation is
c. prevent punctate hemorrhages surgical procedure for Lefort II
on the wound bed fractures
d. have broad spectrum c. generally, mandibular fractures heal
antibacterial coverage faster than maxillary fractures
d. pure blowout orbital fractures
13. in which of the following chemical present with orbital rim and floor
processes does the action of Vit C or involvement
ascorbic acid become important in
wound healing? 18. Rhytidoplasty is a cosmetic surgical
a. hydroxylation of AA procedure to remove:
b. prevention of bacterial a. eye bags
translocation b. facial wrinkles
c. collagen fiber re-alignment c. witchs chin
d. blocking the adverse effects of d. crows feet
steroids
19. Which of the ff statements regarding SIRS
14. Which among these materials has the the MC cause of mortality among burn Px is/
same action as Vit C in wound are valid?
healing? a. Langhans cells and keratinocytes in
a. Zn skin lose their immune function due
to coagulation of CHONs on the c. Better drainage of seroma/
surface of the burn wounds hematoma
b. Burn wound infection and pneumonia d. Lower failure rates
often progressing into sepsis usher in
SIRS 24. Sequelae of burn injuries:
c. Clinical S/S of SIRS like fever, a. Sepsis
tachycardia, changes in sensorium & b. Marjolins ulcer
restlessness usually manifest w/in the c. Burn scar contractures
1st 72 hrs ff burn injuries d. Loss of limbs (post amputation)
d. Use of systemic broad spectrum
antibiotics together w/ topical 25. Among the ff burn Px, who will need to be
antibacterial like silver sulfadiazine admitted to hospital for Tx?
prevent SIRS a. Middle aged housewife w/ multiple
small scalding burn lesions both
20. The most preferred dressing materials for upper extremities sustained while
wounds are those that: frying milkfish
a. Are both bacteriostatic and b. Grade school pupil w/ a 5cm bulla at
bactericidal the R calf area from contact w/
b. Dont require frequent change thus motorcycle muffler
cost effective c. 20 yr old coed w/ extensive sunburn
c. Lessen the pain on the wound area over the whole back extending from
such that the Px doesnt need the nape down to the lumbar area
analgesics then the back of both thighs
d. Maintain moisture on the surface of d. electrician w/ a .3cm point of contact
wound burn on the palm of the R hand & no
point of grounding evident elsewhere
21. The goals of reconstruction include
a. Provision of cosmetically superior 26. Which of the ff fat soluble Vit reverses the
coverage effects of glucocorticoids which in turn delay
b. Restoration of form and function wound healing?
c. Primary closure of wide defects a. A
d. Use of grafts or flaps depending on b. D
the nature and extent of defect c. E
d. K
22. Random pattern flaps are characterized as
a. Having better vascular supply than 27. Among the ff wound defects which should
axial pattern flaps be covered w/ a skin graft?
b. Dependent on the cutaneous blood a. Full thickness scalp loss
supply b. Partial avulsion of the nasal tip
c. Subject to width and length ratio of c. Complete defect of the oral cavity
1:3 wall ff wide excision of SCC
d. Always pedicled d. Full thickness burn injuries

23. Advantages of meshed split thickness skin A 16 month old baby boy is admitted due to
grafts include: scalding injuries over the ant chest, abdomen
a. Superior cosmetic appearance & thighs after accidental spillage of hot water
b. Easier revascularization from dispenser sustained about 15 min prior
to consultation at ER. Based on the Lund- c. topical SSD+ cerium nitrate over burn
Browder chart TBSA amounted to 15% wounds
d. enteral feedings instead of parenteral
28. Using the Parkland formula, how much hyperalimentation
fluid should be ordered in the 1st 8 hrs?
a. 250-300 ml 33. Recommended timing of debridement of
b. 500-600ml burns in this case must be:
c. 800-1000 cc a. as soon as patients vital signs stabilize
d. 1,200- 1500cc b. within the first 48-72 hours
c. after 5-7 days post burn
29. Primary survey in this patient includes d. direct to OR from ER
which of the following measures?
a. local wound care 34. Which of the following statements
b. NGT insertion regarding hypospadias is /are valid?
c. tracheostomy
d. warm blankets a. Recommended timing of surgical
repair is at pre-school age to spare
Physical examination revelaed a well- the child some psychosocial
nourished, well developed male infant, crying problems.
uncontrollably, afebrile, with stable VS. Chest b. Multistage repair procedures present
auscultation revealed occasional respiratory less risk for fistula formation
wheezes, R basal rales, tachycardia, with c. Creation of a neo-urethra on the
normal heart rhythm. Multiple bullous lesions ventral aspect of the penis is done on
admixed with pale skin patches are scattered stage II repair.
all over the anterior chest, abdomen, and d. Circumcision is recommended during
anteriror thighs. the neonatal period ensure proper
urination.
30. Considering the offending agent and the 35. Nasal bone fractures;
manner of the injury, the burns are most
probably; a. if without accompanying dislocation, are
a. superficial usually managed conservatively with
b. superficial + deep partial thickness analgesics and alternating cold & hot nasal
c. deep partial thickness compress.
d. full thickness b. may not be shown on skull x-rays but
usually diagnosed on proper & thorough
31. Monitoring parameters useful during the physical examination
first 48 hrs include: c. will usually heal externally with 2-3weeks
a. conversion of burn depth d. are ideally managed with open reduction,
b. body temperature interosseous plate fixation and application of
c. bipedal edema nasal splint for 1-2 weeks.
d. hourly urine output
36. How long will the maturation of scar
32. Prevention of SIRS entails institution of generally require?
which therapeutic course; a. 4-6 weeks after injury
a. emergency escharectomy in the first 8 b. 3-6 months in children
hours after burn injury c. 9-12 months- beyond 12 y.0
b. systemic broad spectrum antibiotics d. 12-18 months between 0-12 y.o
starting on admission
37. Radiologic signs of facial bone fractures. a. A random-pattern flap, dependent on
a. enophthalmos the cutaneous blood supply of
b. malocclusion overlying skin.
c. diplopia b. The coverage of choice for composite
d. periorbital ecchymoses defects over the upper half of the
face and neck.
38. Which of the following statements c. Difficult to delineate with a skin
regarding hemangiomas is/are valid? paddle in female patients with big
breasts.
a. Carvenous heamangiomas are d. Used as an osteomyocutaneous flap,
generally superficial and grow using the 7th or 8th rib to cover
alarmingly in the first year of life. complex oral cavity lesions in
b. Strawberry type of hemangiomas conjunction segmental
appear reddish, with skin tags and do mandibulectomy.
not resolve with age if mucosal
tissues are involved. 41. The most common site for squamous cell
c. Port wine nevus requires surgery carcinoma over the face is the;
because of its predilection for
malignant degeneration later in life. a. lower lip
d. Scharotics and iiradiation are b. eyelids
effective modalities for treatment of c. nose
small hemangiomas. d. upper lip

39. Biologic dressings maintain moisture on 42. The Lund-Browder chart measures which
the surface of the wound, thereby enhancing characteristics of the burn wounds?
wound healing. What other statement is
about them is/are true? a. depth
b. severity
a. irradiated frozen cadaver skin can c. body surface area involved
acts as skin graft substitute. Wounds d. infection
heal underneath them since the skin
is revascularized within 4-6 weeks. 43. Forces or pressure applied anteriorly to
b. Amnion taken from healthy placentas the chin, as when a patient fails facedown on
can be used directly over wounds a concrete pavement with the chin jutting
with less pain and better scar out, commonly results in fracture over the;
formation.
c. Porcine xenografts work like human a. shaft of the mandible
cadaver grafts in hastening and being b. mandibular condyle
subsequently revascularized and c. angles of the mandible
become definitive coverage. d. parasymphyseal area
d. Honey impreganated on gauze and
applied over the wounds hasten A 64 y.o traffic policeman presents with a
wound healing by nourishing the 5cm lesion on R nasolabial area, characterized
bacteria on the wound surface. as a central ulcer, with hyperpigmented
borders, which easily come off when washing
40. The pectorlais major mm. myocutaneous the face, with resultant minimal bleeding.
flap is:
44. Whats the most possible diagnosis?
d. Post nasal Drip
a. Squamous cell Carcinoma
b. Basal Cell Carcinoma 50. A 45 y.o. Man brought to the ED due to
c. Malignant Hematoma MVA. On P.E patient able to open his eyes
d. Soft Tissue Carcinoma with painful stimuli, confused and able to
localized pain. What is his GCS?
45. Diagnosis is confirmed using which
procedure? a. 13
b. 12
a. FNAC c. 11
b. Incisional Biopsy d. 10
c. Excisional biopsy
d. Wide exclusion 51. A 28yo male sustained a sucking chest (R)
wound secondary to stab wound. What would
46. The recommended margins of resection be the most initial treatment for the patient?
during definitive surgical ablation for this
conditionare: a. Suture the wound do a needle
thoracotomy
a. 0.1-0.2 cm b. CTT (R)
b. 0.5- 1.5 cm c. Do an immediate Chest x-ray
c. 1.5-3.0 cm d. Occlusive Dressing on 3 out 4 sides
d. 3.0- 5 cm
52. Which trauma patient that
47. Using the reconstructive ladder-elevator cricothyroidotomy is contraindicated?
principle, the best form of coverage of the
ensuing defect in this case would be; a. a 43yo male with facial fractures
a. a random-pattern, advancement flap b. a 78yo female with GSW to the neck
b. full-thickness skin graft c. a 15yo male with stab wound to the
c. median forehead flap neck
d. rhomboid flap d. a 5yo female with blunt neck trauma

48. Cleft lip deformities are; 53. A 4yo female patient brought to the ED
due to fall from a height of 10feet. On PE,
a. More common among females than in patient able to open his eyes with painful
males. stimuli, persistently irritable and shows
b. Mostly heredofamilial than environmental abnormal flexion. What is the GCS of the
etiology patient?
c. Associated with short stature in about 1/3
of cases. a. 10
d. More common on the right than on the b. 8
left. c. 6
d. 4
49. These are all major factors associated with
a history of rhinosinusitis, except? 54. All are life-threatening injuires to be
identified during the primary survey under
a. Facial Congestion Breathing except?
b. Facial pain
c. Maxillary dental pain a. Massive Hemothorax
b. Tension Pneumothorax 59. In the above case, what would be your
c. Open Pneumothorax initial management?
d. Flail Chest with underlying pulmonary
contusion a. Occlusive Dressing on 3 of sides
b. CTT left
55. A 36yo male sustained a stab wound c. Needle Thoracotomy
above the angle of the mandible, brought to d. Observation
the ED. The patient is hemodynamically stable
and asymptomatic. All of the following are 60. In Otitis Externa, the most common
correct management except? causative organism is?

a. Mandatory neck exploration a. Streptococcus pneumonia
b. CT Angiography b. Staphylococcus aureus
c. Esophagoscopic examination c. Pseudomonas aeruginosa
d. Observation d. Viruses

56. All of the following are soft sign in 61 . The following statement are true
penetrating neck injuries, except? about Ramsay Hunt Syndrome,
except?
a. Subcutaneous Emphysema
b. Stridor a. Full recovery in all patients
c. Chest pain b. The causative agent is Varicella zoster
d. Odynophagia virus
c. Patient has severe otalgia
57. A 32yo male was brought to the ED with a d. Treatment is similar to Bells Palsy
GSW below the angle of the mandible, with
unstable vital sign a have a massive 62 . Which of the following statement do
hemoptysis, what is the most appropriate not describes the anatomy of the oral
management to the patient? activity?

a. Mandatory neck exploration a. Superiorly, hard-palate/soft-palate
b. Request for a CT Angiography junction
c. Flexible Esophagoscopic Examination b. Laterally; anterior tonsillar pillars
d. Observation c. Extends from the posterior nasal
septum and choana to the skull base
58. A 24yo male patient with a stab wound on d. Regional metastatic spreads to the
the left anterior thorax was brought to the ED submandibular and the upper jugular
with the following VS BP-80/60, HR 115bpm, region.
RR 35 cpm. Upon PE decrease breath sounds
on the affected side, subcutaneous 63. These are the major sites within the
emphysema. What would be your diagnosis? oropharynx, except?

a. Cardiac tamponade a. Hard palate
b. Tension Pneumothorax b. Soft palate
c. Open Pneumothorax c. Tonsillar region
d. Sucking Chest Wound d. Base of the tongue

64. Which of the following Statements 68. Factors associated with increased
about Recurrent Respiratory Papillomatosis incidence of the head and neck cancers
(RRP) is true? include all of the following, except?
a. Long term use of the betel nut quid
a. Infected with HPV subtype 16 & 18 b. Reflux esophagus
b. Pharynx is the most frequently c. Ultraviolet light exposure
involved site d. Plummer-Vinson Syndrome
c. Present in early childhood secondary 69. Most common site of mandibular fracture
to viral acquisition during vaginal is?
delivery a. Condylar process
d. Can be treated and be cured if b. Angle of the mandible
diagnosed early c. Body of the mandible
65. A 52yo male smoker has a painless 1 cm d. Ramus of the mandible
nodule in her right anterior cervical triangle
found to be SCC. On examination of the head 70. All of the following are included in the
and neck is unremarkable. The most likely supraglottic larynx, except?
source for the primary tumor is? a. False Vocal cords
b. Epiglottis
a. tonsil c. Medial surface of the aryepiglottic
b. tongue folds
c. palate d. Floor of the laryngeal ventricle
d. pharynx
71. A 64yo man with history of chronic
66. A 55yo male diagnose to have thyroglossal smoking with a biopsy result showed SCC
duct cyst, underwent a systrunk procedure to from a 3cm ulcerating located at the right
a 2 cm midline neck mass, the thyroid is anterior portion of the tongue. CT of the neck
normal and there is no palpable adenopathy. showed an enlarged 2cm lymph node in the
Final pathologic report showed a 0.5cm well- level II region on the right side. Chest X-ray
differentiated papillary carcinoma within the are negative, what is the TNM score of the
wall of the cyst, negative margins. The next patient?
step in management should be? a. T1, N1, M0
a. Observation b. T2, N2a, M0
b. Subtotal thyroidectomy with central c. T2, N1, M0
neck dissection d. T2, N2c, M0
c. Total thyroidectomy
d. MRND 72. In the above case, what is the stage of the
patient?
67. A 60yo female consulted for a 2cm a. Stage I
painless nodule on the anterior border of the b. Stage II
sternocleidomastoid inferior to the angle of c. Stage III
the mandible. Which is the most appropriate d. Stage IV
next step?
a. FNA 73. Which of the major salivary gland have a
b. Core needle Biopsy higher incidence of malignancy?
c. Incisional Biopsy a. Parotid Gland
d. Endoscopic Biopsy b. Submandibular gland
c. Sublingual Gland
d. None of the above
b. Stage II
74. All of the statements are true about the c. Stage III
salivary glands, except? d. Stage IV

a. All major salivary glands are paired Matching Type
b. 2/3 of malignant tumors occur in the
parotid Patterns of Lymph Node Metastasis
c. Benign parotid tumors are common in the a. Level I
superficial lobe b. Level II
d. 70% of all malignant salivary tumor occur in c. Level III
the submandibular gland d. Level IV
e. Level V
75. A 56yo female have a SCC of the midline C 79. Middle jugular chain nodes; inferior to
of the upper lip, primary lymphatic drainage the hyoid, superior to the level of the cricoid,
of the midline of the upper lip? deep to SCM muscle from posterior border of
the muscle to the strap muscles medially.
a. Preauricular nodes E 80. Posterior triangle Nodes
b. Submandibular Nodes A 81. The submental and submandibular
c. Submental Nodes nodes
d. Level IV D 82. Lower jugular chain nodes
B 83. Submuscular recess; superior to spinal
76. Nodes located in the inferior to the hyoid, accessory nerve to the level of the skull base
superior to the suprasternal notch, medial to
the lateral extent of the strap muscles Primary site for metastatic disease of cervical
bilaterally is? lymph nodes.

a. Level IV A. Level I
b. Level V B. Level II
c. Level VI C. Level III
d. Level VII D. Level IV
E. Level V
77. A 64yo man with a history of chronic
smoking with a biopsy result showed SCC E 84. Breast
from a 3cm ulcerating located at the right A 85. Floor of the mouth
anterior portion of the tongue. CT of the neck B 86. Parotid gland
showed an enlarged 2cm lymph node in the D 87. Virchows Node
level II region on the left side. Chest Xray are A 88. Anterior Tongue
negative, what is the TNM score of the
patient? Matching Type
a. T1, N1, M0
b. T2, N2a, M0 A 89. The Palatal vault is mobile while
C. T2, N2b, M0 the nasal pyramid and orbital ruins
d. T2, N2c, M0 are stable.
A 90. Involve the inferior nasal
78. In the above case, what is the stage of the aperture
patient? C 91. Also known as craniofacial
disjunction
a. Stage I
B 92. Fracture arch passes through b. Medial
posterior alveolar ridge, lateral walls of c. Posterior
maxillary sinuses, inferior orbital rim and d. Lateral
nasal bones
B 93. The nasal dorsum, palate and 5. In the functional anatomy of the liver,
medial part of the infraorbital rim are mobile. what structure is located in the main
scissura and separates the right and
Matching Type left lobes?
A. Supraomohyoid Neck Dissection a. Left hepatic vein
B. Jugular Neck Dissection b. Common bile duct
C. Central Compartment Neck Dissection c. Common hepatic artery
D. Posterolateral Neck Dissection d. Middle hepatic vein
E. Classical radical Neck Dissection
E 94. Includes removal of the SCM, UV and 6. What is the origin of the common
SAN hepatic artery?
A 95. Levels I, II, I& III a. Direct from the abdominal aorta
D 96. Nodes at the posterior and occipital b. Gastroduodenal artery
triangles c. Celiac axis
B 97. Also called anterolateral neck Dissection d. Splenic artery
C 98. Usually done in thyroid cancer.
7. What main veins formed the portal
Liver, Mesentery and Omentum vein?
a. Inferior mesenteric and splenic
1. What ligament of the liver separates veins
the left lateral from the left medial b. Superior and inferior mesenteric
segment? veins
a. Coronary c. Hepatic and splenic veins
b. Round d. Splenic and superior mesenteric
c. Triangular veins
d. Falciform
8. What ligament of the liver is the
2. The caudate lobe corresponds to ligamentum teres found?
what specific segment of the liver? a. Coronary
a. Segment II b. Falciform
b. Segment I c. Right triangular
c. Segment III d. Left triangular
d. Segment IV
9. The left portal vein divides which
3. Segment IV is also known as what particular segments of the liver?
lobe of the liver? a. II, III, and IV
a. Caudate lobe b. IV, V, and VI
b. Right lobe c. I, II, and III
c. Quadrate lobe d. VI, VII, and VIII
d. Left lobe
10. What is the normal pressure of the
4. Segments V and VIII are located on portal vein?
which side of the right lobe? a. 4-8 mmHg
a. Anterior b. 0-3 mmHg
c. 2-5 mmHg c. Serum albumin and PT
d. 5-10 mmHg d. ALT and Alkaline phosphatase

11. Which particular segments of the liver 17. Prothrombin time is a test used to
drain into the middle hepatic vein? determine or measure which of the
a. II and III following clotting factors produced in
b. V to VIII the liver?
c. IV, V, and VIII a. II, V, VII, and X
d. III to VII b. II, VII, IX, and X
c. V, VII, VIII, and IX
12. What biliary duct has a longer d. V, VIII, IX, and X
extrahepatic course and divides into
segmental branches? 18. How much is the bilirubin blood level
a. Cystic duct if one presents with
b. Common hepatic duct hyperbilirubinemia in the test and
c. Pancreatic duct jaundice clinically?
d. Common bile duct a. >1-1.5 mg/dL
b. >1.5-2.0 mg/dL
13. The Calots triangle node are c. >2.0-2.5 mg/dL
described as enlarged lymph nodes d. >2.5-3.0 mg/dL
found primarily where? 19. What radiologic procedure of the liver
a. Common bile duct can be used intra-operatively and is
b. Retropancreatic area the standard for detecting lesion of
c. Celiac area the liver?
d. Hilar cystic duct a. Ultrasound
b. Computed tomography
14. Ammonia is produced in the liver c. Magnetic resonance imaging
coming what process? d. Positron emission tomography
a. Protein metabolism
b. Gluconeogenesis 20. In the classification of acute liver
c. Lipid metabolism failure, which type does jaundice and
d. Glycogenolysis encephalopathy occur 29 days 12
weeks with infrequent cerebral
15. Of the following enzymes requested edema and has a poor prognosis?
in the liver function test, which of the a. Hyper-acute
following is found more in the liver b. Acute
but non-specific? c. Sub-acute
a. Aspartate transaminases d. Late onset
b. Alkaline phosphatase
c. Alpha-glutaryl transpeptidase 21. What is the particular stage of hepatic
d. Alanine transaminases encephalopathy wherein one feels
drowsy, disoriented, agitated and
16. Among the following liver function with the presence of asterixis?
test, which is considered as the best a. Stage I
test to indicate hepatic synthesis b. Stage II
function? c. Stage III
a. AST:ALT ratio d. Stage IV
b. Prothrombin time and INR
22. How do you call a liver described as a b. Hydatid disease
final sequelae of chronic hepatic c. Ascariasis
insult with the presence of fibrous d. Amebic liver abscess
septa throughout?
a. Chronic liver failure 28. Which condition produces a liver
b. Hepatic encephalopathy mass which is hereditary in nature
c. Hepatic steatosis and causes intra-cystic haemorrhage,
d. Liver cirrhosis infection and post-traumatic rupture?
a. Biliary cystadenoma
23. Which of the following imaging b. Congenital cyst
procedures is considered the most c. Hydatid cyst
accurate in detecting portal d. Polycystic liver disease
hypertension?
a. Ultrasound abdomen 29. What liver disease or condition is
b. Doppler ultrasound considered a syndrome wherein there
c. Hepatic venography is a malformation of the intrahepatic
d. CT arteriography bile ducts?
a. Polycystic liver disease
24. What major group in portal b. Hemangioma
hypertension does the c. Carolis disease
schistosomiasis belong to? d. Biliary cystadenoma
a. Pre-sinusoidal
b. Intra-hepatic sinusoidal 30. Which among the benign liver
c. Intra-hepatic post-sinusoidal diseases is described as solid,
d. Post-hepatic post-sinusoidal common in women, do not rupture
spontaneously nor undergo malignant
25. The gastro-esophageal varices gets its transformation?
major blood supply from which of the a. Focal nodular hyperplasia
following veins? b. Adenoma
a. Right gastric vein c. Hemangioma
b. Left gastroepiploic vein d. Bile duct hamartoma
c. Left gastric vein
d. Right gastroepiploic vein 31. The presence of the Klatskins tumor
is associated with what type of
26. The caput medusa are collaterals malignant liver tumor?
and dilated veins formed by which a. Metastatic liver disease
vein? b. Hepatocellular carcinoma
a. Inferior hemorrhoidal veins c. Cholangiocarcinoma
b. Superior epigastric veins d. Gallbladder cancer
c. Umbilical veins
d. Inferior epigastric veins 32. From where is the most common
primary source of cancer that cause
27. Which of the following infections of liver metastasis?
the liver produces anaphylactic a. Lung
reactions and usually involves the b. Gastric
anterior or posterior inferior c. Small bowel
segments of the right lobe? d. Colorectal
a. Pyogenic liver abscess
33. Which one of the following 37. Which of the following is not true
descriptions best describes the about the epithelial cells of the
mesentery? stomach?
a. Single layer of peritoneum that a. Chief cell production of
walls the abdomino-pelvic pepsinogens I and II, and of lipase
cavities b. Mucous neck cell
b. Double layer of visceral Heterogeneous granules 1-2 m
peritoneum in diameter dispersed throughout
c. Double layer of parietal the cytoplasm
peritoneum c. Surface-foveolar mucous cells
d. Single layer of peritoneum that Apical stippled granules up to 1
walls the abdominal cavity only m in diameter
d. Oxyntic (parietal) cell
34. Among the ligaments found in the production of pepsinogen II
lesser omentum, which of them
contains the common bile duct, 38. An incidental findings on a chest x-ray
hepatic proper artery, and portal PA of a 35 y/o male showed an air-
vein? fluid level behind the cardiac shadow,
a. Hepatoduodenal what is your diagnosis?
b. Hepatoesophageal a. Paraesophageal hernia
c. Hepatogastric b. GERD
d. Hepatosplenic c. Schatzkis ring
d. Zenker diverticulum
35. Upper respiratory tract infection is
considered as a common precedence 39. True about the thoracic portion of the
for this particular condition which esophagus?
may not be surgical in nature. What is a. Approximately 5cm long
this called? b. Recurrent laryngeal nerves lie in
a. Tabes mesenterica the right and left grooves
b. Mesenteric cyst c. Crosses both the bifurcation of
c. Omental adhesions the trachea and the left main
d. Mesenteric lymphadenitis stem bronchus
d. Descends between the trachea
36. Which of the following is true and the vertebral column
regarding the anatomy of the
stomach? 40. A 45 y/o male consulted at the ER due
a. The left and right gastric arteries to dysphagia, associated .
form an anastomotic arcade characteristic wet voice. What is
along the greater curvature. your initial diagnosis?
b. Right gastric artery arises directly a. Paraesophageal hernia
from the celiac trunk. b. GERD
c. The veins draining the stomach c. Schatzkis ring
generally parallel the arteries. d. Zenkers diverticulum
d. Left gastroepiploic artery, which
arises consistently from the 41. In the above patient, what is the best
gastroduodenal artery. diagnostic modality to be requested?
a. Manometry
b. Contrast esophagogram
c. Endoscopy motility disorder that the patient
d. Plain chest x-ray have?
a. Achalasia
42. The most appropriate treatment for b. DES
the above patient? c. Nutcracker esophagus
a. Observe d. Hypertensive lower esophageal
b. Acid suppression sphincter
c. Partial fundoplication (Toupet)
d. Diverticulectomy with primary 47. Surgical option in the treatment in
repair and cricopharyngeal patient with intractability/nonhealing
myotomy duodenal ulcer, except?
a. Highly selective vagotomy
43. A 48 y/o male come in due to chest b. Gastrojejunostomy
pain and dysphagia. A barium swallow c. Vagotomy and drainage
was requested and revealed a ringed d. Vagotomy and antrectomy
esophagus? The most appropriate
management would be, except? 48. Which of the following gastric cells
a. Proton pump inhibitors secrete intrinsic factor?
b. Corticosteroids a. Chief cells
c. Elimination of food allergies b. Parietal cells
d. Rigid dilators c. G cells
d. D cells
44. Most of the parietal cells are located
in the? 49. Which of the following gastric ulcer is
a. Fundus associated with acid hypersecretion?
b. Cardia a. Cardia
c. Body b. Fundus
d. Antrum c. Angularis Incisiura
d. Pylorus
45. All of the following statements are
true about left gastric artery to the 50. Procedure of choice in low-risk
stomach, except? patient with perforated duodenal
a. Largest artery to the stomach ulcer?
b. Arises directly from the celiac a. Graham patch with HSV
trunk b. Distal gastrectomy
c. Divides into an ascending and c. Truncal vagotomy with
descending branch along the antrectomy
greater gastric curvature d. Vagotomy and drainage
d. Supplies the aberrant vessel that
travels in the gastrohepatic 51. All of the following stimulate gastric
ligament acid secretion except?
a. Acetylcholine
46. Patients manometric study showed b. Gastric distention
an incomplete lower esophageal c. Intraluminal protein
sphincter (LES) relaxation and d. Somatostatin
aperistalsis in the esophageal body,
what type of primary of primary 52. What is the stage of the patient with
SCC that invades muscularis propria,
with no regional lymph node
metastasis nor distant metastasis? 56. Repetitive and multipeaked
a. Stage I contractions with intermittent normal
b. Stage II peristalsis
c. Stage IIIA 57. Incomplete lower esophageal
d. Stage IIIB sphincter (LES) relaxation (<75%
relaxation) and aperistalsis in the
53. Which of the following is not true esophageal body
about Mallory-Weiss Syndrome? 58. Elevated LES pressure (26mmHg)
a. Presents with upper GI bleeding, and normal LES relaxation
often with hematemesis 59. Dilated esophagus with a tapering,
b. Endoscopy confirms the diagnosis birds beak-like narrowing of the
and may be useful in controlling distal end
the bleeding 60. Decreased or absent amplitude of
c. A congenital arteriovenous esophageal peristalsis (<30mmHg)
malformation 61. Elevated LES pressure 26 mmHg and
d. Use of balloon tamponade to increased intraesophageal baseline
control bleeding pressures relative to gastric baseline
62. Barium esophagogram showed
54. Indication to an antireflux procedure pseudodiverticulosis
in patients with GERD, except? 63. A disorder resulting from increased
a. Extraesophageal atypical reflux intensity of esophageal contraction is
symptoms rather than disordered contraction
b. Ulceration 64. Barium studies are usually normal
c. Barretts mucosa with high-grade 65. Pathogenesis is presumed to be a
dysplasia neurogenic degeneration, which is
d. Noncompliance with medical either idiopathic or due to infection
therapy
Benign gastric ulcer
55. Three normal areas of esophageal
narrowing, except? a. Type I
a. Level of the cricopharyngeal b. Type II
muscle c. Type III
b. Level of the aortic arch d. Type IV
c. Level of the carina e. Type V
d. Level of the diaphragm
66. Body of stomach, incisura + duodenal
Matching type: ulcer (active or healed)
Manometry in primary esophageal motility 67. Prepyloric
disorder 68. 60% of benign gastric ulcers and not
associated with acid hypersecretion
a. Achalasia 69. Treatment is cessation of the
b. DES offending agent and the addition of a
c. Nutcracker esophagus proton pump inhibitor (PPI) or
d. Hypertensive lower esophageal histamine blocker
sphincter 70. Proximal location along the lesser
e. Ineffective esophageal motility curvature near the gastroesophageal
disorder junction
Gallbladder d. Choledochal cyst

1. Regarding the extrahepatic biliary and 5. What would be the most common
vascular anatomy, which of the etiology for the diagnosis made?
following is true? a. Primary pigment stones
a. The boundaries of the triangle of b. Secondary CBD stones
calot include the common hepatic c. Hepatitis virus
duct, cystic duct, and cystic d. Adenocarcinoma
artery.
b. The CBD courses downward 6. Which of the following radiologic
posterior to the portal vein in the studies is not indicated for the
free edge of the lesser omentum. diagnosis of this disorder?
c. The right branch of the hepatic a. Abdominal CT scan
artery crosses the main bile duct b. ERCP
posteriorly. c. HIDA scan
d. The cystic artery usually crosses d. PTC
the common hepatic duct
posteriorly. 7. What is the most appropriate
treatment for this patient?
2. What is the normal amount of bile a. Antibiotics and urgent surgical
produced by the liver daily? biliary
a. 500-1000 mL b. Antibiotics and endoscopic biliary
b. 1000-2000 mL decompression
c. 1000-1500 mL c. Antibiotics and percutaneous
d. 200-400 mL transhepatic biliary
decompression
3. A 30-year-old male with a known d. Antibiotics, surgical
haemolytic disorder comes to the decompression, and
surgery clinic with an ultrasound that cholecystectomy
shows gallstones. What type of
gallstones would you expect to find? 8. What is the most common gallbladder
a. Cholesterol stones tumor?
b. Black pigmented stones a. Adenocarcinoma
c. Brown pigmented stones b. Papillary carcinoma
d. Ca+ stones c. Mucinous carcinoma
d. Oat cell carcinoma
Questions no. 4-7
A 42-year-old female comes to ER 9. After uneventful laparoscopic
complaining of RUQ abdominal pain for the cholecystectomy in a 55-year-old
last 36h associated with fever up to 39C, male, the biopsy demonstrates a
bilious emesis, and jaundice. Direct bilirubin gallbladder carcinoma invading, but
2.2, alkaline phosphatase 450, WBC 19,000, not penetrating the muscularis layer.
AST 24, ALT 19. What is the most appropriate next
step in the management of this
4. What is the most probable diagnosis? patient?
a. Acute cholecystitis a. No more treatment needed
b. Acute cholangitis b. En bloc resection of gallbladder
c. Pancreatic cancer bed including the segment four to
five of the liver and region at a. Cystic artery from right hepatic
lymph nodes artery, about 70-80%
c. Postoperative chemotherapy b. Cystic artery from right hepatic
d. Biliary enteric bypass artery, about 60-70%
c. Cystic artery from right hepatic
10. A 50-year-old male underwent artery, about 80-90%
laparoscopic cholecystectomy for GB d. Cystic artery from right hepatic
stones. On post-op day 4, he artery, about 90-100%
complains of abdominal pain and
nausea. Labs showed WBC 10,000 14. Indications for prophylactic
and direct bilirubin 2.5. What is the cholecystectomy in asymptomatic
most appropriate study? patient, except?
a. MRC a. Populations with increased risk of
b. Abdominal US gallbladder cancer
c. ERCP b. Porcelain gallbladder
d. HIDA scan c. For individuals who will be
isolated from medical care for
11. The following are true regarding the extended periods of time
ERC, except? d. Young patients with RUQ pain
a. The common bile duct can be
cannulated and a cholangiogram Questions no. 15-16
performed using fluoroscopy A 75-year-old man presents with cholangitis,
b. Is the diagnostic and often choledocholithiasis and asymptomatic
therapeutic procedure of choice cholelithiasis
for obstruction
c. Direct visualization of the 15. The best treatment for him
ampullary region and direct a. ERCP followed by
access to the distal CBD cholecystectomy
d. No needs of IV sedation for the b. Laparoscopic cholecystectomy
patient with common bile duct
exploration
12. Which of the following statement is c. ERC and endoscopic
false? sphincterotomy
a. Women are three times more d. ERC followed by open
likely to develop gallstones cholecystectomy
b. Most patients will remain
asymptomatic from their 16. What antibiotics will you give him?
gallstones throughout life a. Cefuroxime + Metronidazole
c. Approximately 3% of b. Cefuroxime + Clindamycin
symptomatic individuals become c. Cefuroxime + Cefoxitin
asymptomatic per year d. Cefuroxime + Ceftriaxone
d. Gallstones in patients without
biliary symptoms are commonly Questions no. 17-25
diagnosed incidentally A 44-year-old woman presented to the
emergency department with a 1-day history
13. Which is/are true regarding the of constant abdominal pain and vomiting. The
arterial supply to the gallbladder? pain came on suddenly, shortly after eating
her evening meal. This was followed by
intermittent bouts of bilious vomiting. She 21. What definitive diagnostic test will
has diabetes and is concerned about her you request?
blood sugars as she has not been able to eat a a. Ultrasound of the HBT
normal diet since the pain started. Her bowels b. Ultrasound of the upper
have opened normally and she has no urinary abdomen
symptoms. c. CT scan
d. ERCP
Examination: The patient is febrile with a
temperature of 38C and a pulse rate of 22. Whats your initial treatment on the
116/min. She is clinically jaundiced. On above case?
examination of the abdomen, she is found to a. Emergency decompression by PTC
have tenderness in the right upper quadrant, b. Emergency decompression under
which is worsened by placing two fingers local anesthesia
beneath the tip of the ninth costal cartilage c. ERC and PTC
during inspiration. A tender mass is palpable d. IV antibiotics and fluid
in the right upper quadrant. The urine is clear resuscitation
and rectal examination is normal.
23. What sign is elicited on examination
17. On the above case, all of the following of the abdomen?
organ or anatomic part are directly a. Murphys sign
affected, except? b. Morphys sign
a. CBD c. Murphys sign
b. Intrahepatic duct d. Memphys sign
c. Cystic duct
d. Gallbladder 24. Once the patient normalized, when
will you schedule your patient for
18. Working diagnosis? definitive surgery?
a. Acute cholecystitis a. 3rd-5th hospital days
b. Acute cholangitis b. 2nd-3rd hospital days
c. Chronic cholecystitis c. 7th hospital day
d. Chronic cholangitis d. 6 weeks after decompression

19. If blood pressure drop to 80/50 25. If the jaundice of the patient is
mmHg with change in mental status, continuous and deepening, what is
what findings do you notice? your consideration?
a. Reynold pentad a. Choledocholithiasis
b. Reymonds pentad b. Cystolithiasis
c. Renolds pentad c. Malignancy
d. Reynolds pentad d. Cholelithiasis

20. On the case above, what findings did 26. Initial investigation of any patient
you notice? suspected of disease of the biliary
a. Reynolds pentad tree?
b. Becks triad a. MRCP
c. Charcots triad b. UTZ or U/S
d. Ponce octad c. CT scan
d. ERC

27. UTZ sensitivity and specificity? c. 30% chance of metastasis
a. Sensitivity and specificity of >60% d. 40% chance of metastasis
b. Sensitivity and specificity of >70% e. 50% chance of metastasis
c. Sensitivity and specificity of >80%
d. Sensitivity and specificity of >90% 3. The following belong to the
translocation-associated sarcomas,
28. Indicative of chronic cholecystitis as except:
seen on U/S? a. Ewings sarcoma
a. Contracted, thin-walled b. Dermatofibrosarcoma
gallbladder protuberance
b. Contracted, thick-walled c. Pleomorphic sarcoma
gallbladder d. Synovial sarcoma
c. Contracted, thick-walled e. Myxoid liposarcoma
gallbladder 2 hours after meal
d. Thick-walled gallbladder 4. Most common site of Gastro-
intestinal Stromal Tumors:
29. Biliary leaks as a complication of a. Esophagus
surgery of the gallbladder or the b. Stomach
biliary tree can be confirmed and c. Small intestine
frequently localized by? d. Large intestine
a. MRCP e. Anus
b. ERCP
c. HIDA scan 5. The gold standard for histologically
d. UTZ documenting sarcomas:
a. Fine needle aspiration cytology
30. What is your important tool in staging b. Core needle biopsy
carcinoma of the gallbladder? c. Incisional biopsy
a. UTZ d. Excisional biopsy
b. ERCP e. Frozen section biopsy
c. HIDA
d. CT scan 6. Non-operative management may be
an option for this sarcoma:
Urology, small and large intestines, soft a. Leiomyosarcoma
tissue sarcomas and appendix b. Fibroids
c. Rhabdomyosarcoma
1. The following sarcoma has very low d. Synovial sarcoma
propensity for lymph node e. Desmoid
metastasis:
a. Liposarcoma 7. Which is not a chronic effect of
b. Pediatric rhabdomyosarcoma radiation therapy:
c. Angiosarcoma a. Osteitis
d. Clear cell sarcoma b. Lymphedema
e. Synovial sarcoma c. Contractures
d. Stomatitis
2. Intermediate grade sarcomas, e. Fractures
generally have:
a. 10% chance of metastasis
b. 20% chance of metastasis
8. The technique whereby radio-active d. Commonly found in the lower
beads are embedded in the tumor extremities
site is: e. Can metastasize
a. Adjuvant chemotherapy
b. Induction chemotherapy 14. The grading system which provides
c. Neo-adjuvant irradiation the best prognostic capability is the:
d. Isolated limb perfusion a. AJCC
e. Brachytherapy b. NCCN
c. FFCC
9. Sarcomas most commonly d. NCI
metastasize to the: e. ACS
a. Other extremity
b. Lungs 15. In Dermatofibrosarcoma
c. Liver protuberance, the gene involved in
d. Bone the mutation is the:
e. Brain a. JAZFI-JJAZI
b. PDFGB-COL1A1
10. The following are endodermal c. FUS-CREB312
derivatives except: d. FUS-ATFI
a. Lung e. EWS-ATFI
b. Liver
c. Stomach 16. A marine derived alkaloid which
d. Kidneys shows benefit for advanced
e. Pancreas leiomyosarcoma:
a. Ifosfamide
11. According to FNCLCC, Grade 2 tumors b. Sorafenib
have a 5-year survival rate of: c. Dasatinib
a. 40% d. Imatinib
b. 50% e. Trabectedin
c. 60%
d. 70% 17. The recommended number of cycles
e. 80% pre-operative chemotherapy is given:
a. Two
12. The oncogenes associated with b. Three
sarcomas are the following, except: c. Four
a. C-erbB2 d. Five
b. MDM2 e. Six
c. PDGFRA
d. N-myc 18. The most important prognostic factor
e. RAS for sarcomas is:
a. Tumor size
13. The following characteristics of the b. Patients age
myxoid type of liposarcoma are true, c. Patients sex
except: d. Nodal status
a. Peaks at old age e. Histologic grade
b. Low grade
c. Deep tumors 19. One of the following is linked to
radiation exposure as a risk factor:
a. Malignant Fibrous Histiocytoma e. 8 cm
b. Malignant Mixed Muellerian
tumor 25. From the time of diagnosis, without
c. Dermatofibrosarcoma intervention, sarcomas metastasize to
protuberance the lungs in:
d. Rhabdomyosarcoma a. 6 months
e. Myxoid liposarcoma b. 12 months
c. 18 months
20. Neo-adjuvant imatinib allows surgery d. 24 months
to be performed in patients with large e. 48 months
GIST:
a. 1 month after 26. Also known as Lobsteins cancer:
b. 2 months after a. Gastrointestinal Stromal Tumor
c. 3 months after b. Gastro intestinal Sarcoma
d. 5 months after c. Cystosarcoma phyllodes
e. 6 months after d. Desmoids
e. Retroperitoneal sarcomas
21. Rhadomyosarcomas have a disease
free survival rate of: 27. Most common presenting sign of
a. 55% Gastrointestinal sarcoma is:
b. 60% a. Abdominal pain
c. 65% b. Abdominal mass
d. 70% c. Abdominal distension
e. 75% d. Gastrointestinal colic
e. Gastrointestinal bleeding
22. Generally not considered a sarcoma:
a. Cystosarcoma Phyllodes 28. The following cancer syndromes are
b. Ewings sarcoma associated with pediatric sarcomas,
c. Desmoid except:
d. Dermatofibrosarcoma a. Retinoblastoma
protuberans b. Werners syndrome
e. Malignant Mixed Mullerian c. Familial adenomatous polyposis
Tumor d. Neurofibromatosis
e. Wernickes syndrome
23. The retroperitoneal space is bordered
by the following, except: 29. Primary resistance to imatinib usually
a. Diaphragm occurs in:
b. Peritoneum a. 6 months
c. Psoas b. 9 months
d. Spine c. 12 months
e. Pelvic diaphragm d. 24 months
e. 36 months
24. The following are acceptable
radiation margins, except: 30. In FNCLLC grading, Grade 2 has a
a. 4 cm score of:
b. 5 cm a. 1
c. 6 cm b. 3
d. 7 cm c. 5
d. 7 invested in a fibro-fatty layer:
e. 9 fascia of Zuckerkandl posteriorly
and Gerotas fascia anteriorly.
31. Trauma is a risk factor in developing b. Posterolaterally, the kidneys are
which of the following sarcomas: bordered by the quadratus
a. Fibrosarcoma lumborum and posteromedially
b. Ewings sarcoma by the psoas muscle.
c. Synovial sarcoma c. Anteriorly, they are confined by
d. Angiosarcoma the posterior layer of the
e. None of the above peritoneum.
d. All of the above
32. Radiation is usually associated with e. None of the above
sarcomas with mutations in:
a. KIT 37. True about the adrenal glands except:
b. P53 a. The adrenal glands lie
c. cErb superomedially to the kidneys
d. N-myc within Gerotas fascia
e. MDM2 b. The arterial supply of the adrenals
derives from the inferior phrenic,
33. Sarcoma common at the reproductive aorta, and small branches from
age: the renal arteries
a. Leiomyosarcoma c. The venous drainage on the left is
b. Endometrial Stromal Sarcoma mainly through the inferior
c. Malignant Mixed Mullerian phrenic vein and through the left
Tumor renal vein via the inferior adrenal
d. Undifferentiated Endometrial vein
Sarcoma d. All of the above
e. Desmoid e. None of the above

34. tumors are tumors that are: 38. Which of the following is/are true of
a. 5 cms in size the ureters
b. More than 5 cms in size a. The blood supply of the proximal
c. 15 cms in size ureter derives from the aorta and
d. More than 15 cms in size renal artery and comes mainly
e. None of the above from the lateral direction.
b. Distally, it derives its blood supply
35. The following includes features that medially from branches from the
define the grade of the tumor, iliac arteries.
except: c. Mobilizing the distal ureter for
a. Pleomorphism anastomosis requires releasing its
b. Mitoses medial attachments, which
c. Necrosis results in ischemia.
d. Cellularity d. All of the above
e. No exception e. None of the above

36. True about the kidneys except: 39. True about the anatomy of the
a. The kidneys are paired urinary bladder, except:
intraperitoneal organs that are
a. Urinary bladder is situated in the function as two separate
retropubic space in an compartment.
extraperitoneal position. d. The sinusoidal tissue is innervated
b. A portion of the bladder dome is by the cavernosal nerves, which
adjacent to the peritoneum, so are autonomic nerves that
ruptures at this point can result in originate in the hypogastric
intraperitoneal urine leakage. plexus and play a critical role in
c. At physiologic volumes (200-400 erection.
mL), the bladder projects e. The tip of the penis, called the
modestly into the abdomen. glans, is in continuity with the
d. All of the above corpus spongiosum
e. None of the above
42. A 27y/o patient was rushed into the
40. Which of the following statements ER after a vehicular accident. Kidney
is/are true of the prostate: injury is suspected. As the ER resident
a. The prostate has a significant on duty, you know that several
component of smooth muscle structures would be compromised
and can provide urinary should the left renal vein be injured
continence even in the absence of as it receives drainage from the
the external striated sphincter. following, except?
b. The puboprostatic ligaments a. Left gonadal vein
connect the prostate to the pubic b. Left inferior phrenic vein
symphysis, and pelvic fractures c. Left internal pudendal vein
often result in proximal urethral d. Left suprarenal gland
injuries due to the traction that
these ligaments provide. 43. Which of the following is/are true of
c. Between the prostate and the the ureters
rectum lies Denonvilliers fascia, a. The blood supply of the proximal
which is the main anatomic ureter derives from the aorta and
barrier that prevents prostate renal artery and comes mainly
cancer from regularly penetrating from the lateral direction.
into the rectum. b. Distally, it derives its blood supply
d. All of the above medially from branches from the
e. None of the above iliac arteries.
c. Mobilizing the distal ureter for
41. True about the penis, except: anastomosis requires releasing its
a. The corpora cavernosum are the medial attachments, which
paired, cylinder-like structures results in ischemia.
that are the main erectile bodies d. All of the above
of the penis. e. None of the above
b. The corpora cavernosum consist
of a tough outer layer called the 44. On physical examination, which
tunica albuginea and spongy, technique is better for diagnosing a
sinusoidal tissue inside that fills distended bladder?
with blood to result in erection. a. Inspection
c. The two corpora cavernosum b. Auscultation
have no vascular c. Palpation
interconnections, so they d. Percussion
d. Category III
45. All of the following statements about
the physical examination are true, 49. Following documentation of a firm
except: mass in the testes by ultrasound in a
a. The left kidney is generally 32 year old male, tissue sample for
palpable in men biopsy should be obtained for
b. Transillumination of the kidney diagnosis by
may be helpful in children a. Fine needle aspiration
younger than 1 year of age b. Core needle biopsy
c. The adult bladder cannot usually c. Open scrotal biopsy
be palpated or percussed until d. Inguinal orchiectomy
there is 150 mL of urine in it
d. Bimanual examination of the 50. A 28-year-old white male presents
bladder to assess tumour extent with asymptomatic testicular
is best done under anaesthetic enlargement. Which of the following
e. A lower ureteric calculus may be statement(s) is/are true concerning
palpable per vagina his diagnosis and management?
a. Tumor markers, -fetoprotein
46. A 60 year old male patient with a PSA (AFP) and -human chorionic
of >100ng/mL, is suspected for a gonadotropin (HCG) will both be
metastatic prostate cancer. Biopsy of value in the patient regardless
confirmed your suspicion. The most of his ultimate tissue type
common site of spread of prostate b. Orchiectomy should be
cancer is: performed via scrotal approach
a. Kidney and liver c. The diagnosis of seminoma
b. Testes and urinary bladder should be followed by
c. Lungs and Mediastinum postoperative radiation therapy
d. Pelvic lymph nodes and bones d. With current adjuvant
chemotherapy regimens,
47. Diagnostic imaging to demonstrate retroperitoneal
the site of metastasis in this pt (#46) lymphadenectomy is no longer
except: indicated for non-seminomatous
a. CT scan of the abdomen testicular tumors
b. Bone scan
c. Both A & B 51. A 23-year-old man has a solid mass in
d. None of the above his left testis about 10 cm in size.
Which of the following is an
48. A 52 year old patient was suspected appropriate work-up for the patient:
as having kidney CA and was a. Request for tumor markers AFP,
submitted for CT scan for BHCG and LDH
classification. Upon imaging, the scan b. Obtain a complete history and
showed homogeneously, hyperdense physical examination
cysts measuring about 7 cm, and few c. Scrotal US
hairline septa. What would be the d. All of the above
interns answer?
a. Category II 52. If the serum levels of alpha
b. Category II F fetoprotein is elevated in this patient
c. Category VII (#51) with a firm testicular mass,
which of the following diagnoses d. Surgical resection with
most likely? radiotherapy
a. Seminomatous germ cell tumor
b. Nonseminomatous germ cell 56. A 68 year old man with a history of
tumor radical prostatectomy 4 years earlier
c. Leydig cell tumor for Prostatic CA, but was
d. Sertoli cell tumor subsequently to follow-up, came to
your office for pain on the ribs. If you
53. After radical orchiectomy (#51), the are the physician, the next best step
pathology reveals an embryonal in managing this patient is to:
carcinoma with a teratoma. Which a. Tell him its normal
additional tests is appropriate? b. Perform a rib biopsy
a. Repeat the serum tumor markers c. Give medications that lower
b. Chest CT scan serum testosterone
c. Abdominal CT scan d. Order for PSA testing
d. All of the above e. Perform orchiectomy
e. None of the above
57. Which of the following statement is
54. The CT scan of the abdomen (#51) false concerning the detection and
reveals 8cm of lymphadenopathy in diagnosis of prostatic cancer?
the periaortic nodes. What is the a. An elevation of prostate specific
recommended treatment? antigen (PSA) is highly sensitive
a. Modified nerve-sparing and specific for prostatic
retroperitoneal lymph node carcinoma
dissection b. American blacks have an
b. Full bilateral retroperitoneal increased risk of prostatic
lymph node dissection carcinoma
c. Chemotherapy with Paclitaxel c. Autopsy series would suggest that
(Taxol), Gemcitabine and Cisplatin 10% of men in their 50s will have
d. Chemotherapy with Cisplatin, small latent prostatic cancers
Etoposide, and Bleomycin d. Transrectal prostatic biopsy is
e. Chemotherapy plus indicated for a palpable 1 cm
retroperitoneal radiation prostate nodule
e. Serum prostatic acid phosphatase
55. A 59 year old Filipino man is told by remains the most useful tumor
his primary care physician that his marker for prostatic carcinoma
prostatic specific antigen (PSA) has
gone up significantly since his last 58. A 70-year-old man with a long
visit. He has no palpable smoking history presents with
abnormalities in his prostate by rectal painless gross hematuria. A CT
exam. Whats the initial urogram is performed as part of the
management? diagnostic evaluation. CT urogram
a. Transrectal needle biopsy shows nonvisualization of the left
b. Transrectal needle biopsy guided kidney. There is a filling defect in the
by finger bladder, in addition, the right kidney
c. Transrectal needle biopsy guided has a standing column of contrast to
by sonogram or MRI the middle third of the ureter and
early hydronephrosis evidenced by
blunting of the forniceal angles. examination. The most appropriate
Which of the following statements initial diagnostic test is:
are true: a. IVP
a. The likely diagnosis is muscle b. Retrograde urethrogram
invasive transitional cell c. Cystogram
carcinoma of the bladder d. Pelvic CT scan
b. Obstruction of the left ureter can e. Peritoneal lavage
cause nonfunction of the left
kidney 62. A 26 y/o male patient goes to the ER
c. The findings on the right are with a complaint of hematuria after a
suspicious for transitional cell motor vehicle accident which
cancer of the ureter happened 3 days prior. You suspect
d. All are true an isolated urinary system injury and
e. None would suggest imaging studies. What
is the gold standard for genitourinary
59. A 20 y/o, male patient came in due to imaging in renal trauma?
a blunt trauma on the flank, a. Retrograde pyelogram
secondary to motor vehicular b. Radiographic imaging
accident. What is/are the finding/s on c. Contrast-enhanced computed
CT that will raise suspicion for major tomography
renal injury? d. MRI
a. Medial hematoma
b. Medial urinary intravasation 63. A 55-year-old male patient is
c. Lack of contrast enhancement of admitted @ ED due to severe scrotal
the parenchyma and perineal pain. Upon history and
d. Both A and C physical examination, the patient is
diagnosed with Fourniers Gangrene.
60. If a patient with documented Which of the following is LEAST likely
uncomplicated extraperitoneal the anticipated management in this
bladder rupture, what is your initial case?
management? a. Prompt debridement of the
a. Cystoscopy is necessary to verify nonviable tissue
the rupture b. Broad antibiotics should be
b. Urethral catheter drainage alone administered
c. Schedule the patient for surgery c. Damage to external anal
immediately sphincter requires colostomy
d. None of the above d. Testes are usually threatened and
need to be removed
61. A 25-year-old pedestrian is struck by
an automobile. On arrival in the 64. A patient came in for penile swelling.
emergency room, a plain film of the Patient reported hearing an audible
pelvis reveals a left superior and pop during sexual intercourse with
inferior pubic ramus fracture as well his partner. Upon inspection of the
as a fracture of the sacroiliac joint. perineum, you noticed a butterfly
Examination of the patient reveals a sign. What is your initial diagnosis?
suprapubic mass. Blood is noted at a. Penile fracture only
the meatus and the prostate is in the b. Penile fracture, with disrupted
normal position on digital tunica albuginea
c. Penile fracture, with disrupted a. It is useful to apply firm pressure
Bucks fascia to the edematous distal penis for
d. Penile fracture, with disrupted several minutes to reduce the
Dartos fascia glans
b. Reduction in penile edema can be
65. A 12-year-old boy presents in the the key to success
emergency room with very severe c. If the foreskin cannot be manually
pain of sudden onset in his right reduced, surgical intervention is
testicle. There is no fever, pyuria, or required
history of recent mumps. Testis is d. None of the above
swollen, tender, exquisitely painful, e. All of the above
and high-riding. What is your
diagnosis? 69. A 45-year-old male patient presented
a. Testicular cancer with complaints of high grade fever
b. Acute epididymitis and fairly rapid onset unilateral
c. Testicular torsion painful swelling of the testis. Upon
d. Epididymo-orchitis inspection, the scrotum was also
erythematous. Blood work shows
66. Patricio, 37-year-old taxi driver came elevated WBC. What is your
in for persistent penile erection that management for this condition?
lasted for 4 hours. On examination, a. Continue observation
the penis is very tender and both b. Oral antibiotics
cavernosal bodies are rigid while the c. Hospitalization and parenteral
glans are flaccid. What is the most antibiotics
likely diagnosis? d. Penile block
a. Testicular torsion
b. Paraphimosis 70. Patient in #69 was observed and the
c. Fourniers gangrene next day you noted pus coming out
d. Priapism from the scrotum with areas of
necrosis. Fever persisted despite the
67. A 5 y/o male child was brought to antibiotics. On examination, you
your office for a possible tuli. On noted crepitations on the scrotum.
examination, you forcedly retracted Your impression at this time is:
the prepuce to visualize the glans. a. Acute epididymitis
However, several hours later, the b. Acute orchitis
patient was rushed to the ER. On c. Fourniers gangrene
examination, the prepuce is d. Scrotal abscess
edematous and engorged distal to the
phemotic ring. In this patient, the 71. A 25 y/o woman is 40 weeks
most likely problem is: pregnant, consulted at the ER for
a. Acute urinary retention right-sided abdominal pain,
b. Testicular torsion associated with nausea and vomiting,
c. Fourniers gangrene fever with leucocytosis. What is the
d. Priapism best management of this patient?
e. Paraphimosis a. Antibiotics alone
b. Perform an abdominal ultrasound
68. True about paraphimosis: c. Schedule for laparoscopic surgery
d. Schedule for E explor lap
b. Arterial supply of the appendix is
72. A 32 y/o male, consulted at the ER for from the appendicular branch of
a hx of 6 hours of migratory right the ileocolic a.
quadrant pain, associated with c. Immunologic organ that secretes
nausea and vomiting, anorexia at PE, immunoglobulin A
positive for direct and rebound d. Lymphoid aggregates occur in the
tenderness and laboratory showed submucosal layer
leucocytosis. What is your Alvarado
score to this patient? 77. A 27-year-old male consulted at the
a. 6 ER due to abdominal pain associated
b. 7 with vomiting and fever. PE revealed
c. 8 equivocal findings at the abdomen,
d. 9 what would be the preferred
management for this patient?
73. In the above patient, what would be a. Discharged and prescribed
the best management? analgesic
a. Request for UA b. Abdominal ultrasound
b. Do abdominal ultrasound c. CT scan of the abdomen
c. Schedule for E appendectomy d. Schedule for E appendectomy
d. Discharge the patient
78. The following statement are true
74. A 32 y/o male diagnosed as acute about the anorectal vascular supply,
abdomen prob secondary to ruptured except?
viscus most prob sec to ruptured a. Superior rectal a. upper rectum
acute appendicitis, what is the b. Inferior rectal vein drains into the
recommended antibiotics to this internal pudendal vein
patient? c. Inferior rectal artery arises from
a. Cefoxitin the internal pudendal artery
b. Enapenem d. Middle rectal artery arises from
c. Ampicillin-sulbactam the terminal branch of the
d. Gentamicin + clindamycin inferior mesenteric artery

75. Differential diagnosis of acute 79. Type of adenomatous polyp that have
appendicitis depends on four major a higher risk for malignant
factors, except? degeneration?
a. Patients age a. Tubular
b. Gender b. Villous
c. Timing of the pain c. Tubulovillous
d. Anatomic location of the inflamed d. Hamartomatous
appendix
80. Patient with colorectal cancer with
76. The following statement are true TNM scoring of T3, N0, M0. What is
about the appendix, except? the stage of the patient?
a. The tip of the appendix is located a. Stage IIa
at the confluence of the 3 tenia b. Stage IIb
coli c. Stage IIIa
d. Stage IIIc

81. A 45 y/o male consulted for d. Cigarette smoking is protective
hematochezia and pain with
defecation. Pt. is diagnosed as acute 87. Which of the following pathology
anal fissure. What is the treatment of warrants APR?
choice for this patient? a. Circumferential adenocarcinoma
a. Lateral internal sphincterotomy just above the dentate line
b. Botulinum injection b. Intraluminal mass at the
c. Laxatives and warm sitz baths rectosigmoid
d. Observe c. Intraluminal adenocarcinoma 12
cm from the anal verge
82. An internal haemorrhoid that d. Upper rectal mass
prolapses past the dentate line with
straining is a 88. A disorder in which patients develop
a. First-degree haemorrhoid gastrointestinal polyposis in
b. Second-degree haemorrhoid association with cutaneous
c. Third-degree haemorrhoid pigmentation, and atrophy of the
d. Fourth-degree haemorrhoid fingernails and toenails?
a. Peutz-Jehgers syndrome
83. The treatment of choice for first- b. Cronkite-Canada syndrome
degree internal haemorrhoids is? c. Cowdens syndrome
a. PPH d. Familial juvenile polyposis
b. Infrared coagulation
c. Dietary and lifestyle changes 89. True about Goodsalls rule, except?
d. Surgical procedure a. Used as a guide in determining
the location of the external
84. All are characteristics of ulcerative opening
colitis, except? b. Fistulas with an external opening
a. Bimodal age distribution posteriorly track in a curvilinear
b. Involves the small bowel fashion to the posterior midline
c. Backwash ileitis c. Anteriorly based fistulas typically
d. Cigarette smoking is protective have a radial course to the
internal opening
85. A disorder in which patient manifest d. External opening is greater than 3
hamartomas of the colon and rectum cm from the anal margin, usually
associated with melanin spots on the track to the posterior midline
buccal mucosa and lips of the
patient? 90. A 1 cm appendiceal carcinoid located
a. Peutz-Jeghers syndrome at the base of the appendix. What is
b. Cronkite-Canada syndrome the appropriate management?
c. Cowdens syndrome a. Observe
d. Familial juvenile polyposis b. Appendectomy alone
c. Right hemicolectomy
86. All of the following statements are d. Total colectomy
true about Crohns colitis, except?
a. Complex anal fistulae and/or Matching type
abscesses
b. Creeping fat a. Somatostatin
c. Cobble stone b. Cholecystokinin
c. Motilin b. Internal spermatic fascia
d. Neurotensin c. Peritoneum and extraperitoneal
e. Secretin connective tissue
d. Weak fascia of the transversus
91. Inhibits gastrointestinal secretion, abdominis muscle lateral to the falx
motility, and splanchnic perfusion (A)
92. Stimulates exocrine pancreatic 2. During explorative surgery, the
secretion, stimulates intestinal incidental finding is herniation
secretion (E) between the lateral edge of rectus
93. Stimulates intestinal motility (C) muscle, the inguinal ligament and the
94. Stimulates pancreatic exocrine inferior epigastric vessels. Based on
secretion, stimulates gallbladder the boundaries, the type of hermia is
emptying, inhibits sphincter of Oddi a. Congenital inguinal hernia
contraction (B) b. Direct inguinal hernia
95. Stimulates intestinal mucosal growth c. Femoral inguinal hernia
(D) d. Indirect inguinal hernia
e. Incisional inguinal hernia
a. Right colectomy
b. Extended right colectomy 3. The processus vaginalis regresses to
c. Total and subtotal colectomy form what structure?
d. Low anterior resection A. Tunica vaginalis
e. Abdominoperineal resection B. Canal of nuck
C. Spermatic cord
96. Removal of the entire rectum, anal D. Falx inguinalis
canal, and anus with construction of a
permanent colostomy from the 4. Most common inguinal hernia in
descending or sigmoid colon. women
97. Required for patients with fulminant A. Direct
colitis B. Femoral
98. Most appropriate operation for C. Indirect
curative intent resection of proximal D. Umbilical
colon carcinoma
99. Used for curative intent resection of 5. Where does protrusion occur in
lesions located at the hepatic flexure indirect (congenital) hernia?
or proximal transverse colon A. Deep inguinal ring
100. Used to remove lesions in the B. Superficial inguinal ring
upper and mid rectum C. ?
D. Canal of nuck
Breast, Thyroid, Parathyroid, Venous and E. Falx inguinalis
Lymphatics
6. Virchows triad except:
1. A 45-year-old poerter develops a A. Endothelial Injury
direct inguinal hernia. If the hernia B. Stasis of blood flow
extended through the superficial C. Hypercoagulability
inguinal ring, it would be surrounder D. Hypersensitivity
by all of the abdominal layers EXCEPT
the: 7. A 35-year old professional dancer
a. External spermatic fascia presents with a well-defines, tense,
smooth mass in the upper outer C. Left thyroid lobectomy w/ postop I-
quadrant of the left breast. She states 131
that the mass becomes larger just D. Total thyroidectomy w/ postop I-
before onset of her periods. 131
Aspiration yeilds a clear yellow fluid E. Total thyroidectomy alone
and the mass disappears. The most
likely diagnosis is: 13. 17 y.o. with right cervical node.
A. Fibroadenoma in a cyst positive calcitonin serum calcium
B. Fibrocystic disease of the breast elevated. What is the diagnosis?
C. Carcinoma in a cyst A. Familial mtc
D. Lipoma B. FTC
E. Galactocele C. Men1
D. Men2a
E. Men2b
8. Varicose veins are common and are
present in atleast 10% of the general 14. All is true about the anatomy of the
population. Findings may include: thyroid. Review lg guys. Choices are in
a. Dilated and tortuous veins long statements.
b.Telangiectasias
b. fine reticular varicoses 15. Which of the following is "produced?"
c. all of the above by the thyroid follicle?
d. none of the above
A. Triiodothyronine
9. Risk factors for varicose veins: B. Calcitonin
A. Malignancy C. Iodine
B. Obesity D. Nakalimot ko huhu
C. Female
D. Inactivity 16. Which of the ff is correct in the
E. Family history thyroid hormone
A. Formation of thyroif hormone
10. Primary varicose veins results from depends on endogenous
A.) Deep venous insufficiency B. Iodine converted to iodide in
B.) Supeficial venous insufficiency diodenum
C.) Intrinsic abnormalities of venous wall C. Iodine is pass through ....... blablabla
D.) DVT ATP
D. Iodine is linked .... blablabla g
11. Patient with varicose may complain of something blablabla
A.) Aching
B.) Heaviness 17. Thyroid-stimulating antibodies
C.) Pruritus stimulate the thyrocytes to grow and
D.) All of the above synthesize excess thyroid hormone.
12. 27 y/o woman Left sided neck mass Nakalimut ko sa choices guys ug sa
2.5 cm FNA - papillary thyroid answer haha sorry
neoplasm No palpable Lymph Node
A. Left thyroid lobectomy w/ radical 18. 20 yr-old college student. Fatigability,
neck dissection Irritibality, weight loss. PROMINENCE
B. Total thyroidectomy w/ bilateral OF THE EYES. choices:
modified radical neck dissection
A. GRAVE's disease
B. Hashimotos
C. Plummers disease
D. Subacute thyroiditis

19. The management/treatment at this
moment is:
A. Anti thyroid drugs
B. Surgery
C. Radioactive ablation
D. Iodone

20. 45 yr old woman had a thyrodectomy.
But the nurse reported 6 packs of
dressing was already in use due ro
bleesding. What shpuld the doctor
do.
A . CT, BT and PTT
B. K drip Mao ra ako madumduman taas
au ang case

21. A 30 years old patient post total
thyroidectomy complain of fatigue
and numbness in her finger. What's
your immediate management?
A. Check ionized calcium level
B. Give O2 per cannula
C. Start IV Ca immediately
D. Check serum Na and K level

22. The ff drugs that may help relieve
pain in Px with severe mastalgia
except:
a. danozol
b. tamoxifen






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my goals and be with the people who truly matter.
I hope you would too