1- Male patient has history of leukemia presented with features of anal cancer underwent

surgical excision of the tumor , margin was not free what wil you do ??

A. Excision with free margin

B. Radiotherapy ????
C. Wide local excision and flap

2- 85 yr old female with sypmtoms of acute cholycstitis , without stones , high WBCS ,HOW TO
MANAGE ??
A. Lap chole
B. Open chole
C. Cholycystostomy
D. Medical management

3- A case of rupture AAA , blood pressure 80/40 what will you do ??

A. Us
B. Ct
C. Urgent exploration
D. Resuccitation and reassess

4- Diabetic patient presented with foul smelling from dorsal foot wound associated with
crepitus extended to mid thigh , management ?
A. Amputation
B. Debridement
C. Antibiotic
5- Female pt diabetic with past history of DVT 25 yrs back , and underwent excision of
malignant melanoma of 2 yrs back , presented with painful selling of the leg showing ugly
limb with crsutation , what is the diagnosis ?? ‫صورة‬

A. Haemosidrin
B. Necrobiosis lipodica diabeticorum
6- The best investigation for pancreatic divisum ??
A. Ct
B. Us
C. Ercp
D. Mrcp

7- During laparoscopic cholecystectomy , complete transection of CBD just above the

duodenum , how to manage this complication ??

A. Choledochojejonostomy
B. Choledochodudenostomy
 C. Repait over T – tube

8- Safety margin of scc ??

A. 3 mm
B. 4mm
C. 5mm
D. 10mm

9- Origin of BCC
Pluripotential cells of basal layer of epidermis or follicular structures

10- Origin of SCC

Keratinizing cell layer of the epidermis

11- Patient with inflammatory swelling with fluctuation , over the dorsum of foot , Doppler US
showing all vessels triphasic except dorsalis pedis is monophasic , what will you do ??
‫سيناريو غامض حد فاهم حاة ؟؟‬

A. Debridement
B. Amputation

12- 8 yr old boy with intusseception ‫ صورة‬, what is the most common cause of this ?

A. Pyers patches enlargement

B. Benign polyp
C. Cancer
D. Congenital band
13- What is the appropriate management ?? ‫السؤال كان كدا واالختيارات ملهاش عالقة ببعض‬

Systemic anticoagulant
I & D of perineal collection
Analgesic and antipyretic

14- 8 years old boy presented with stap neck in the middle and lateral side of neck , patient is
stable , but has expanding haematoma , management ??

A. Exploration
B. Embolization
C. Angiography
D. Conservative
15- Capacitative coupling , cause of thermal injury ??
a-Electric current transfer to organ touched by the metal trocher
 b-sandwiching
16- Scenario of a case doctor prescribed clindamycin for patient , later culture show resistant to
the antibiotic , doctor was not informed about the result he continued same adrug and
patiend died from sepsis , how to minimize this ??

A. Drug code
B. Reco
C. Poor system communication

17- what is the most appropriate management, without senario.

18- MRI rectum ‫مكرر السؤال مرتين مع اختالف االجابات‬ ‫صورة‬

19- a case of gastric outlet obstruction, + ve suction splash what is the electrolyelte
abnormality?

A. metabolic alkalosis
B. hypochloremic alkalosis
C. hypokalemia
20- 23 yr old female presented withh symptoms of gerd with worsening dysphagia, next step??

A. endoscopy
B. manometry
C. ph monitoring
21- capacitative coupling, what is the cause??

A. wrong eneergy
B. failure of insulation
C. sandwitch 😂
D. touch another instrument.
22- patient underwent total gastrectomy, at 4 th day post op. patient has leakage from
anastomosis, no sepsis, what you will manage??

A. conservative
B. omental patch
C. endoscopic stabling
D. redo of anastomosisj
23- female 56 yrs old, loss of weight, hx of constipation, x ray abdomen show air under
diaphragm, what the surgeon will do for diagnosis?? ‫ال يوجد اختيارات اسالوا عزت‬
24- a case of male patient with signs of achalasia, small tapering, and proximal esophageal
dilatation, how to manage?? Dx.manometery
 A. intial treatment?? Ballon dilatation
B. best treatment?? Heller myotomm
(( best is lap myotomy with fundoplication)) in another question

25- Female patient 4 times CS presented with incisional hernia , what is the most appropriate
factor for management plan ??
A. Size of the defect
B. Location
C. Content of the hernia
26- Same scenario , what is the most appropriate investigation for incisional hernia ??
A. US
B. Laparoscopy
C. CT
27- FEMALE Patient underwent lap chole 10 months back , presented with irreducible epigastric
mass 2*3 cm with discofort no impulse on cough , what is the most appropriate investigation
?
Ct
Us
Laparoscopy

28- Gastrochiasis associated anomaly ?

Intestinal atresia

29- The highest body fluid rich in k is ??

Saliva
30- Scenario of list of two cases for cochlear implant , one will do left side cochlear implant and
the other will do bilateral , the turn now for the case of bilateral , but the patient was
cancelled for some reasons and no body informed the surgeon and they pushed the one for
unilateral left side and the surgeon opened on the right side , then they discovered this
mstake intraoperatively , where is the defect ??
Booking defect
Marking defect

31- Scenario of surgeon did site mark on left foot will go for amputation , but the nurse sterilized
and prepaired the right , the surgeon remembered the correct site from previous marking .
Near miss

32- Which of the following prevent confuse to the site of surgery ??

Time out
Operative technician do side marking
Senior resident do side marking
33- How to train the junior resident ?
Prepair curriculum
Round meetings

34- 85 yrs old female patient diabetic, with acute choleycstitis , how to manage ?? without any
parameters
A. Open cholecystectomy
B. Medical ttt
C. Laparoscopic cholecystectomy
D. Cholecystostomy

35- Female with abdominal pain , fever , jaundice

36- Patient underwent lap cholecystectomy , 2 nd day post op ,drain show 100 cc bile , abdomen
is soft and lax , wha is next ??
A. Us
B. Mrcp
C. Ercp
D. HIDA scan

37- Male patient , COPD , underwent anterior resection ,epidural catheter was inserted for pain
management , 8 hrs post operative developed fever , what do you think , the cause of fever ?
A. Atelectasis
B. Body reaction to surgery
C. Pneumonia
D. Epidural abscess
38- Male patient with cancer rectosegmoid started to develop SOB of 2 weeks ,what is the cause
??
A. Anxiety
B. Metastasis
C. Aspiration

39- Patient COPD , has fracture neck femer , pulmonogy consultation was done and the doctor
prescribed aggressive treatment for 4 days ,patient developed pulmonary embolism , what is
the cause ??
A. Immobilization
B. Steroids
40- Patient with flank pain , bone pain ,with hard neck mass , with hypercalcemia , what is the
most likely diagnosis ??
A. Parathyroid carcinoma
B. Metatstasis from anaplastic carcinoma of thyroid
41- Patient with midline firm solid neck nodule , move with deglution and swallowing , which of
the following investigation confirm the diagnosis ??
A. US
B. TSH
C. CT
D. Radioactive iodine
42- 57 yrs old female with pic of thyroglossal cyst ‫ صورة‬appered 2 month ago , move with
deglution only , patient refused surgery , what is the fate of this swelling ?
A. Infection
B. Maliganancy
C. Laryngeal compression
D. No complication
E. Spontaneous resolution
43- Neck mass , hard , fixed suffering from progressive hoarsness of voice , appered 10 weeks
ago , what is the best diagnostic investigation ??

A. FNAC
B. Core biobsy
C. Isthmectomy

44- Patient admitted for treatment of pulmonary embolism , received multiple injections aal the
day and night , patient suffered from difficulty of sleeping and become agitated , and the staff
loss the control , what is the cause ??

A. Hospital delirium
B. Intracranial he
45- Newborn with congenital hernia , parents sought medical advise for their infant in the clinic ,
what is the management ?
A. Expeditious elective surgery
B. Elective surgery at age of 3 m
C. Wait until body weight be 10 kg
D. After 2 yrs
46- What is the most reliable investigation in obstructive jaundice ?
A. Bilirubin
B. Alkaline phosphatase
47- Case of vipoma
48- Case of glucagonoma
49- Scenario of features of insulinoma . patient underwent CT but not confirmatory for the
diagnosis , what is the other option investigation for diagnosis ?/
EUS
50- Patient with MEN2 , has medullary thyroid carcinoma , what is the most common associated
diseases ??
 Pheochromocytoma , hyperparathyroidism

51- CT of rupture spleen , and asked for diagnosis ‫صورة‬

52- CT of GIST , asked for diagnosis . ‫صورة‬

53- Patient with abdominal trauma , presented with generalized abdominal pain, on exam , patient
had guarding ,ecchymosis in the flanks , high amylase , CT done showing tear bu t there is no
duct injury , what will you do ??

A. Observation
B. External drainage

54- 3 questions of sport hernia

Diagnosis??
*Investigation?? mri
*Pathophysiology ?? post wall injury of ing. canal

55- Scenario of duodenal haematoma , asked for treatment ??

A. Conserve

56- Scenario tension pneumothorax

57- Acase of rupture diaphragm , underwent thoracoscopic repair , after 4 hrs he developed
tachycardia dyspnea , cyanosis , what happened ??
A. Pneumothorax
B. Air embolism

58- Scenario abdominal pain , guarding , very high amylase , bruising in the flanks , diagnosis ??

59- Scenario for patient of stab chest and developed cardiac tamponade

60- Female patient during ERCP for stone extraction , failed due to perforation , and she
developed haematemesis and melena and mild tenderness BL.Pr 80/50 , how to manage ??
A. Endoscopy repeat
B. Laparoscopy
C. Celiac angiography

61- Same lasr scenario and asked about the cause of epigastric tenderness ??

A. Duodenal perforation
B. Pancreatic injury
 C. Stone empaction
62- Picture of DIULAFOY lesion ‫ صورة‬diagnosis ??

63- Female patient with duodenal ulcer, shocked , received blood , what will you do after
resuccitaion ?

a. Endoscopy and cauterize bleedere

b. Surgery and sewing of duenum
c. Laparoscopic
d. Celiac angiography

64- A case of major case of burn admitted to burn ICU , patient developed massive bleedin per
rectum , what is the initial step after resuccitation ??
A. NgT
B. Laparoscopy
C. Endoscopy
D. Colonoscopy
E. Gastrographin

65- A case of huge divertivular abecess you did percautaneus drainage , when will you do the
definitive surgery ??
A. After 6 wks
B. After 8 wks
C. After 12 wks
66- A case of metabolic acidosis , low HCO3 , with intestinal fistula , what is the cause of this
condition ??
A. Intestinal fistula
B. Hypovolemic shock

67- Sever e hypernatremia , resuccitation or treatment ??

Hypotonic saline
Isotonic saline
Starch

68- Scenario of MRI of anal fistula without external opening ??‫سؤالين مكررين باختيارات مختلفة‬
Fistula
Submucous abscess
Pelvi rectal abscess
‫اختيارات لسيناريو مش كامل‬
69- A case of colovesical fistula , what is the best investigation ??

A. CT abdomen and pelvis

B. Double contrast barium

70- What is the indication of neoadjuvant chemotherapy in case of cancer rectum 5 cm from
anal verge , no lymph node , high grade adenocarcinoma ??
A. Mesorectum invasion
B. Near sphincter
C. 5cm from anal verge
D. High grade tumor

71- What is the indication of neoadjuvant chemotherapy in case of cancer colon ??

E. Pericolic fat infiltration

72- Anal carcinoma , main treatment ??

A. Radiotherapy
B. Chemoradiotherapy
C. Surgery

73- Patient with leukemia , underwent excision of anal mass , excision was not complete with
positive margins , what will you do ?
A. Rexcision till free margin
B. Wide local excision and graft
C. Radiotherapy

74- In case of hypovolemic shock , in which organ autoregulation of its own blood supply ?
A. Kidney
B. Brain
C. Intestine
D. Muscle

75- What is true regard acute cholecystitis ??

A. 75% associated with stone
B. Positive with organism
C. HIDA scan normal even with acute cholecystitis
76- Patient with cancer colon , cancer prostate and developed liver mets , what is the best
marker you will search for ??
A. CEA
B. APC
 C. PSA
77- A case of female patient with myeloproliferative disease , presented with severe left
hypochondrial pain referred to the shoulder , blood film normal , what will you do ??
A. Lap splenectomy
B. Open splenectomy
C. Endovascular stent
D. Conserve
78- A case of necrotizing fasciitis or gas gangrene , culture show gram positive rods , what is the
best antibiotic you will give ?
A. Penicillin
B. Tetracyclin
C. Clindamycin
79- Female patient developed pulmonary embolism what is the best investigation ??
A. ECG
B. X ray
C. ABG
80- What is the finding with fine needle aspiration from mucinous cystadenoma ??
A. High CEA
B. High amylase
C. High glucagon
81- Patient with GERD not responding to medical treatment , which surgery will do ??
A. Nissen total fundoplication
B. Partial fundoplication
C. Dor’s fundoplication
D. Toupet fundoplication
E. Belsy fundoplication

82- Obese female patient , uncontrolled diabetic with GERD,what is the best bariatric surgery for
her ?
A. Reux en y bypass
B. Gastric sleeve
C. Adjustable Gastric band
D. Gastric ballon
83- Obturator hernia , after reduction of the intestinal loop , small segment was necrotic from
the site of constricting ring , what is type of necrosis ??
A. Haemorragic
B. Liquifactive
C. Coagulative
84- Patient with symptoms GERD , on diet and loose 6 kg from his body weight , developed
worsening of symptoms and develop chest infection ? which symptom you should take care
of it ?
A. Dysphagia
 B. Recurrent chest infection
C. Weight loss
85- 50 yr old female patient with history of constipation and weight loss , with x ray showing air
under diaphragm , what next investigation is more helpful for diagnosis ??
A. CT
B. Gastrographin
C. US
D. MRI
86- SCENARIO of a child with subdural hge , need to enter the OR , what will you do ?
A. Take consent from father by phone
B. Take consent from the nearest relative
C. Take another advise from your collegue

87- What is cntridication for anti reflux measures ??

A. Motitity disorder
B. Barret esophagus

88- Scenario of surgeon ligate CBD 3 times during lap chole , what will you do ??
Write on operative notes what happened

89- 35 yr old male presented with bilateral crush injury both thighs with fracture femur , what
should be in mind regard this patient ?
A. Hge
B. Myoglobinuria
C. Hypotension
D. Fracture
90- Patient with hyperkalemia k 6.5 , what is the risk for this patient ?
A. Cardiac arrest
91- The most serious problem to give parentral nutrition in central line ?
A. Infection
B. Electrolyte imbalance
C. Intestinal atrophy
92- Terminal ilium with gryish exudate , with adhesion , firm and rubbery , diagnosis ??
A. Crohn;s disease
B. TB
C. UC
93- A case of rectal cancer invading serosa with +ve pelvic lymph node , what is the staging ??
A. Stage A
B. Stage B
C. Stage C1
 D. Stage C2
94- A case of during inguilal hernia repair , you find mickel’s diverticulum , how to manage ??
A. Hernia repair only
B. Hernia repaie with mesh
C. Hernia repaie without mesh
D. Resection anastomosis with hernia repair
E. diverticulectomy and hernia repair
95- a case of features of gastric outlet obstruction incluing +ve suction splash , asked about the
cause of this condition ?
A. metabolic alkalosis
B. hypochloremic alkalosis
C. hypokalemia
96- what is the best indicator of resuccitation in case of hypocolemic shock ??
A. CVP
B. UOP
C. Peripheral oxygen saturation
97- A case presented with intestinal obstruction , during laparotomy , you found amass in the in
the rectosegmoid area whay will you do ??
A. Radical left hemicolectomy
B. Colostomy
C. Biobsy and extrorization
D. cecostomy
98- female patient with dysphagia and chest pain of 6 months , stomach is up and parallel to the
esophagus , LES is in place what is the diagnosis ?
A. rolling hiatus hernia complicated with gastric volvulus

99- same scenario gastric volvulus , management ?

A. anatomical repair
B. fundoplication

100- a case of malignant tumor in the bone associated with onion peel sign , diagnosis ??
A. ewing sarcoma
B. osteo sarcoma