UNIVERSITY OF MEDICINE, MAGWAY

DEPARTMENT OF SURGERY

FINAL PART II, Group ( D ) Completion Test

Section(B) Multiple short questions

All questions are to be answered Date:10.8.2012

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

1. Define open fracture. How do you treat a case of open fracture tibia?
2. What are the causes of acute retention of urine? Describe the clinical
features, investigations and treatment of benign prostatic hyperplasia.
3. Describe clinical features and management of a case of severe tetanus.
4. How would you diagnose carcinoma of breast? Outline the management of
early breast cancer?
5. Enumerate the causes of scrotal swelling. Describe clinical features and
management of strangulated inguinal hernia.
6. What are the causes of Gastric Outlet Obstruction? Describe clinical features
and management of carcinoma of stomach.
7. Add notes on:
A. Keloid scar
B. Couvoisier’s law
C. Perthe’s test
 UNIVERSITY OF MEDICINE, MAGWAY
DEPARTMENT OF SURGERY
FINAL PART II, Group (D) Completion Test
Section (A) Multiple Choice Questions
All questions are to be answered Date: 10.8.2012
Time allowed: 3 hours for both section (A) and section (B)

1. A Colles’ fracture
A. Is usually caused by fallen on out-stretched hand
B. Is common in elderly women
C. Is the fracture distal end of radius
D. May be associated with osteonecrosis
E. causes distal end of radius shifted and tilted dorsally

2. Regarding Pott’s spine ( spinal TB )

A. It is a secondary lesion
B. It is most frequent in lower thoracic ( T9 – 12 )
C. Half of the skeletal TB has spinal involvement
D. Affects two adjacent vertebrae
E. Usually results sensory disturbances

3. Acute osteomyelitis
A. Can be fatal in children
B. Is a haematogenous infection
C. Begins in epiphysis
D. Begins under the periosteum
E. Causes infarction of bone

4. Concerning sterilization
A. Ethylene oxide is utilized for heat-sensitive materials
B. Gamma rays is particularly appropriate for sterilization of syringe, catheter and cannular.
C. Autoclaving is by keeping 134 C’ , 30 lbs/sq –inch for 3 minutes
D. Sterilization by hot air is efficient compared to moist stream sterilization
E. HIV and heat-resistant spores are not killed by autoclaving

5. Acute appendicitis
A. Is not common in women
B. Can be diagnosed by clinical history and physical examination alone
C. Always need surgical treatment
D. Should have persistent vomiting
E. Usually present with high fever with rigors

6. Plain X’ray abdomen can reveal following features in splenic rupture

A. Subdiaphragmatic gas shadow
B. Elwvation of psoas shadow
C. Obliteration of psoas shadow
D. Free fluid between fas filled intestinal coils
E. Gas in the biliary tree
7. Intussusception
A. Is common in under one year of age
B. Can present with blood and mucous stool
C. Mucosal polyp can be a lead point
D. Can not be diagnosed with ultrasound abdomen
E. Crab-claw deformity in barium enemaX ray is the positive finding

8. Causes of acute retension of urine in female include

A. Interstitial cystitis
B. Retrovertd gravid uterus
C. Uretheral caruncle
D. Cervical fibroid
E. Myoma of uterus

9. Metabolic alkalosis
A. Is most commonly due to repeated vomiting caused by pyloric stenosis
B. Is frequently manifested as tetany
C. May give rise to polyuria
D. Is usually accompanied by hyperkalaemia
E. Is usually associated with intracellular alkalosis

10. Complications of gall stone include

A. Mucocoele of the gall bladder
B. Intestinal obstruction at ileocaecal junction
C. Perforation at body of gall bladder
D. Acute pancreatitis
E. Malignant change in gall bladder

11. Advantages of Laparoscopic surgery include

A. Rapid recovery
B. Less postoperative pain
C. Small scar
D. No need for general anaesthesia
E. Earlier return to work

12. Features of increased intracranial pressure include

A. Tachycardia
B. Raised systolic pressure
C. Projectile vomiting
D. Pin-point pupil
E. High fever

13. Carcinoma of esophagus

A. May be adenocarcinoma in lower third
B. Usually squamous cell carcinoma in upper third
C. Usually present with progressive dysphagia
D. Can be treated by radiotherapy alone in upper third lesion
E. Can be diagnosed by Plain Chest X’ ray
14. A fistula will persist if
A. A foreign body is present
B. Tuberculosis is present
C. The wall becomes lined with epithelium
D. There is unrelieved proximal obstruction
E. There is intervening abscess cavity

15. An anal fissure

A. Is an ulcer of the anal mocosa
B. Usually lies anteriorly
C. May be associated with hypertrophic skin tag
D. Is more common in men
E. Can always be treated successfully with conservative treatment

16. Gynaecomastia
A. May be due to drugs like cimetidine
B. May be due to cirrhosis of liver
C. May be due to puberty
D. Always need surgery
E. May relate to Henson’s disease

17. Haemorrhoids
A. May present with malaena
B. Is a pre cancerous condition
C.Can cause iron drficiency ananemia
D. Is always treated by haemorrhoidectomy
E. May cause portal pyaemia when strangulated

18. Sebaceous cyst

A. Is a benign tumour
B. Is arises from subcutaneous plane
C. Can lead to abscess
D. Is a retention cyst
E. Is translucent

19. An ischiorectal abscess

A. Can spread to opposite ischiorectal fossa through the post sacral space
B. Can cause horse-shoe shaped abscess
C. Can result in fistula in ano
D. Always cause fever and constituitional symptom
E. Always need surgical operation

20. Perianal abscesses

A. Are commonly due to anal gland infection
B. Can lead to fistula in ano
C. May extend laterally into ischiorectal fossa
D. May be effectively treated by antibiotics
E. Septicaemia in a common complication
21. Regarding postoperative fever
A. It may be caused by sputum retention
B. It may be reactionary in first 48 hours
C. It may be due to wound sepsis in first 24 hours
D. It may be due to deep vein thrombosis
E. It may be related to tubes and catheters

22. Regarding tongue ulcers

A. Malignant ulcers are usually squamous cell carcinoma
B. Dental ulcers are always at the sides of the tongue
C. Gummatous ulcers are very painful
D. Tuberculous ulcers are often multiple
E. Aphthous ulcers are commonly at the tip or sides of the tongue

23. Causes of dysphagia include

A. Achalasia cardia
B. Retrosternal goiter
C. Bulbar paralysis
D. Cardiac dilatation
E. Pernicious anaemia

24. Haematuria
A. May be due to renal injury
B. May be painful in stone disease
C. May be painless in CA bladder
D. Is terminal in renal cell carcinoma
E. Is total ( throughout the urinary stream ) in BPH

25. Surgical filter

A. Is a process for surgical case management
B. Means investigations for surgical patient
C. Is a mental work for provisional diagnosis
D. Is applied after history taking from surgical patient
E. Is only used by surgeons

26. Regarding parotid tumours

A. Malignant tumours are more common than benign ones
B. Pleomorphic adenoma is the commonest parotid tumours
C. Adenolymphoma is known as Warthin tumours
D. Facial nerve palsy is associated with malignant change
E. Pain is common in benign tumours

27. Regarding urinary stones

A. Phosphate stone are usually radioopaque
B. Uric acid stones are usually radiolucent
C. Cystine stones are radiolucent
D. Oxalate stones have sharp projection causing frequent pain
E. Stag-horn stones are triple phosphate stones
28. Regarding calcium haemostasis
A. The main body store of calcium is bone tissue
B. The active form of calcium is bound to albumin
C. Calcium levels are regulated by parathyroid hormone, vitamin D and calcitonin
D. A deficiency of vitamin D causes osteomalacia
E. Calcitonin plays a major role in calcium homeostasis in humans

29. With regard to the appendix

A. The surface marking is at McBurney’s point
B. The position of the base is inconstant
C. The tip lies most commonly in the retrocaecal position
D. The appendicular artery is functionally an end-artery
E. It is a portion of hind gut

30. Regarding gall stones

A. Most are visible on plain X’ray
B. Pure cholesterol stones comprise less than 10% of gall stones
C. Oestrogen facilitates the chance of stone formation
D. Clofibrate, a cholesterol-lowering agent inhibit stone formation
E. Bile pigment stones are formed from conjugated bilirubin
 Keys for MCQ, FP2 Group D, 10-8-12

1. ABCE
2. BCD
3. ABE
4. ABC
5. BC

6. BCD
7. ABCE
8. BCD
9. ABC
10. ADE

11. ABCE
12. BC
13. ABCD
14. ABCE

15. AC
16. ABC
17. E
18. CD

19. BCE
20. ABC

21. ABDE
22. ABDE
23. ABCD
24. ABC
25. C

26. BCD
27. ABDE
28. ACD
29. ACD
30. BC