UNIVERSITY OF MEDICINE, MAGWAY

DEPARTMENT OF SURGERY

FINAL PART II, Group ( B ) Completion Test

Section(B) Multiple short questions

All questions are to be answered Date: 13.03.2012

Time allowed: 3 hours for both section (A) and section (B)

1. Describe the management of haematogenous acute osteomyelitis.

2. Describe the principles of management in resuscitation of a trauma patient.

3. Describe various treatments for common malignant diseases in surgical practice.

4. Classify thyroid swellings. Describe clinical assessment and management of a patient with long-standing
multinodular goiter.

5. List the causes of acute pancreatitis. Describe the management of the patients with acute pancreatitis.

6. Describe causes, clinical features and management of intestinal obstruction.

7. Add Notes

A. Triple assessment for breast cancer

B. Nutritional assessment of surgical patients

C. Murphy’s Triad
 UNIVERSITY OF MEDICINE, MAGWAY
DEPARTMENT OF SURGERY
FINAL PART II, Group (B ) Completion Test
Section (A) Multiple Choice Questions

All questions are to be answered Date: 13.03.2012

Time allowed: 3 hours for both section (A) and section (B)

1. In Pott’s paraplegia
A. Lumber region is most commonly affected
B. Sensory disturbance is usually present
C. Flaccid paralysis is common
D. The earliest sign spinal involvement is ankle clonus
E. Gibbus is common sign

2. Colles’fracture
A. Is a fracture around the ankle joint
B. Is common in elderly women
C. Is a fracture at the distal end of radius
D. May be associated with osteonecrosis
E. Causes distal end of radius dorsal shift and tilt

3. Reactionary haemorrhage
A. Is delayed haemorrhage occurring within 24 hours after operation
B. Is associated with infection
C. Is usually venous bleeding
D. Is usually caused by clot dislodgement as normalization of blood pressure or ligature slippage
E. Can be significant requiring re-exploration

4. Conditions having increased risks of breast cancer include

A. Breast cyst
B. Duct ectasia
C. Fibroadenoma
D. Florid hyperplasia in fibrocystic disease
E. Atypical lobular hyperplasia

5. Fracture lines can be described as being

A. Comminuted
B. Butterfly
C. Spiral
D. Compression
E. Twisted

6. Regarding shock
A. Endocrine shock is the most common form of shock
B. Common causes of obstructive shock include cardiac tamponade and tension pneumothorax
C. Septic shock is distributic shock
D. Mornitoring in shock patient include temperature
E. Is a systemic state of low tissue perfusion
7. Which of the following causes raised intracranial pressure?
A. Hypoxia
B. Hypercapnia
C. Hypernatraemia
D. Fever
E. Hydrocephalus

8. Complications of gastrectomy include

A. Megaloblastic anaemia
B. Increased risk of malignancy
C. Dumping syndrome
D. Increased risk of pulmonary tuberculosis
E. Folic acid malabsorption

9. The followings have a role in wound healing

A. Vitamin A
B. Zinc
C. Copper
D. Vitamin C
E. Vitamin B

10. A Cystic hygroma is a

A. Type of hydrocele
B. Type of lymphangioma
C. Type of branchial cyst
D. Cystic sweat gland tumour
E. Cystic rodent

11. In a diabetic ischaemic foot

A. Infection spreads upward by subfascial plane
B. A plain X’ray of the foot is mandatory
C. Rest pain is troublesome
D. An above knee amputation of the leg is likely outcome
E. A neuropathic ankle joint is likely to be present

12. Regarding benign prostate hyperplasia

A. It typically affects peripheral zone
B. It is a premalignant condition
C. Serum PSA is raised above 10 nmol/L
D. It can be treated by TURP.
E. Retrograde ejaculation is common complication of prostatectomy

13. Regarding sterilization

A. It is the process which destroys micro-organisms except bacterial spore
B. Autoclave is medical device which sterilizes instruments by steam under pressure
C. Sterilization by ethylene oxide is recommended for ventilator or respiratory equipment
D. Sterilization by hot air oven can be used for substances such as rubber and plastics
E. Sterilization by irradiation is an industrial process
14.Regarding upper gastrointestinal haemorrhge
A. Flexible endoscopy is the investigation of choice
B. Elderly and unfit patients should not undergo urgent surgery
C. Mallory-Weiss tear is a longitudinal tear above the gastro-esophageal junction
D. Medical treatment is more effective than therapeutic endoscopy
E. Bleeding peptic ulcer is commonly associated with ingestion of NSAIDs.

15. On gross pathological examination, intestinal tuberculosis can be

A. Ulcerative
B. Hypertrophic
C. Atrophic
D. Ulcerohypertrophic
E. Metaplastic

16. In metabolic response to trauma and sepsis

A. Increased energy requirement
B. Increases nitrogen requirement
C. Reduced resistance to insulin and glucose intolerance
D. Increased gluconeogenesis and protein catabolism
E. Adaptive ketogenesis

17. Regarding tetanus

A. It is due to gram-negative rod with terminal spore
B. Organism produces the endotoxin
C. Facial muscle spasm is known as Resus Sardonicus
D. It can cause respiratory muscle spasm
E. It can occur in neonate following the application of cow dung on the umbilicus

18. Tension pneumothorax

A. Develops when a ‘one-way valve’ air leak
B. The mediastinum is displaced to the affected side
C. Increases venous return to heart
D. Compress the opposite lung
E. May be due to subclavian central venapuncture

19. Indications for emergency thoracotomy

A. Internal cardiac massage
B. Control of haemorrhage from injury to the heart
C. Control of haemorrhage from injury to the lung
D. Control of massive intrathoracic fluid collection
E. Control of massive air leak

20. Regarding colorectal cancer

A. FAP is a premalignant lesion
B. Radiation proctocolitis is one of the aetiological factors
C. Pain is the earliest symptom
D. Is mainly treated by chemotherapy
E. Liver secondary is a contraindication for APR
21. Viruses associated with human cancer include
A. HIV
B. Hepatitis B Virus
C. Herpes zoster virus
D. Human papilloma virus
E. Epstein-Barr virus

22. Acute retention of urine is said when

A. Sudden inability to pass urine with painful bladder distension
B. Sudden inability to pass urine without bladder distension
C. Patients complain no urine output with absolute constipation
D. Gradual inability to pass urine
E. Mass in SPA

23. Wound dehiscence

A. Usually occurs in transverse wounds
B. May occur because of anastomotic leakage
C. Is prone in diabetic patient
D. Can develop incisional hernia
E. Occurs more often in smokers

24. Abnormal discharge from nipple can be due to

A. Ductal carcinoma
B. Fibrocystic disease
C. Duct papilloma
D. Duct ectasia
E. Giant fibroadenoma

25. Causes of persistent of sinus and fistula include

A. Foreign body
B. Radiation
C. Infection
D. Malnutrition
E. Distal obstruction

26. Right sided colonic carcinoma frequently present with

A. Anaemia
B. Rectal bleeding
C. Intestinal obstruction
D. Abdominal mass
E. Weight loss

27. Solitary thyroid nodule

A. Are more prevalent in women
B. In the adult population less than 10% are malignant
C. More than 50% of scintigraphically cold nodules are malignant
D. The risk of a hot nodule being malignant is negligible
E. Should be surgically removed in all patients
28. Flail chest injury
A. Occurs when several adjacent ribs are fractured in two places
B. Results in paradoxical movement
C. Causes a left to right shunt
D. Requires endotracheal intubation in severe cases
E. Itself is not an indication for thoracotomy

29. The followings are primary brain injury

A. Cerebral contusion
B. Cerebral concussion
C. Cerebral laceration
D. Extradural haematoma
E. Subdural haematoma

30. Recognized associations of carcinoma of stomach include

A. Krukenberg’s tumour
B. Blood group A
C. Trosier’s sign
D. Linitis plastica
E. Volvulus of the stomach
Keys for MCQ , Gp A , FP2 13-3-2012

1. DE
2. BCE
3. ADE
4. DE
5. ABC

6. BCE
7. ABDE
8. ABCD
9. ABCD
10. B

11. ABE
12. DE
13. BE
14. AE
15. ABD

16. ABD
17. CDE
18. ADE
19. ABCE
20. AB

21. ABDE
22. A
23. BCDE
24. ABCD
25. ABCE

26. ADE
27. ABD
28. ABD
29. ABC
30. ABCD