surgical diseases - MIDTERM

Total points35/40

II ADM-I

Email address *

NAME/SURNAME *

Barium meal X-ray features Niche on lesser curve with

notch on greater curve is indicative of: *
1/1

a) Peptic Ulcer

b) Cirrhosis
c) Crohn’s disease
d) Ulcerative colitis

Portal Triad consists of following structures, EXCEPT *

1/1

a) Portal vein
b) Hepatic Artery
c) Bile duct
d) Hepatic Vein

PASSPORT NUMBER *

Collections of nondigestible materials, usually of vegetable

origin, but can also be of hair origin, most commonly found
in patients who have undergone surgery of the stomach and
have impaired gastric emptying are known as? *
1/1

a) Dieulafoy's lesions
b) Gastric Ulcers
c)Volvulus
d)Bezoar

what is the differential diagnostic of diverticulitis? *

1/1

a) apendicitis
b) crohns disease
c) ectopic pregnancy
d) all above

all are risk factors in development of HCC, EXCEPT *

1/1

a) HCV
b) Alcohol
c) drugs
d) IBS

what does porto-caval shunt stands for? *

1/1

a) connection between vena cava superior and inferior

b) connection between portal venous system and caval venous system

c) type of operation
d) anomaly

Select the Congenital Pancreatic Anomaly *

1/1

a) Pancreas Divisum
b) Annular Pancreas
c) Developmental Pancreatic Cysts
d) All of the above

Treatment of choice for amebic abscesses is? *

1/1

a) metronidazole

b) B-blockers
c) dexketoprofen
d) Adrenaline

the best therapy for Pancreatic cancer have been achieved

using? *
1/1

a) radiation therapy combined with either 5-fluorouracil or gemcitabine.

b) Intraoperative radiation therapy

c) Transduodenal fine-needle aspiration of the tumor with endoscopic ultrasound
guidance
d) Radition therapy alone

Select the Incorrect Statements- *

1/1

a) bilirubin is deconjugated by intestinal bacteria to a group of compounds known as

urobilinogens

b) urobilinogens are oxidized and reabsorbed into the enterohepatic circulation and
secreted into bile.
c) A small percentage of the reabsorbed urobilinogens are excreted into urine.
d) Biliverdin contributes to the yellow color of urine and the brown color of stool.

What is the correct order of the layers of abdominal wall

( from external to internal)? *
1/1

a) skin> superficial fascia> subcutaneous tissue> transversalis fascia> Abdominal

muscles> preperitoneal adipose and areolar tissue> peritoneum.
b) skin> subcutaneous tissue> superficial fascia> Abdominal muscles> transversalis
fascia> preperitoneal adipose and areolar tissue> peritoneum.

c) skin> superficial fascia> Abdominal muscles> transversalis fascia> subcutaneous

tissue> preperitoneal adipose and areolar tissue> peritoneum.
d) skin> subcutaneous tissue> superficial fascia> Abdominal muscles> preperitoneal
adipose and areolar tissue> transversalis fascia> peritoneum.
which instrumental investigation is essential for diagnosis
of colo-rectal neoplasia? *
1/1

a) Angiography
b) abdominal X-ray
c) abdominal ultrasound
d) colonoscopy

which synthetic material is usually used to repair hernia? *

1/1

a) cat gut
b) polysacharide bandage
c) synthetic mesh

d) spider web

most common benign tumor of the liver? *

1/1

a) Intrahepatic Cholangicarcinoma
b) Hemangiona

c) Focal Nodular Hyperplasia

d) Hepatocellular Ademonas

most widely used pancreatic cancer serum markers are *

1/1

a) CEA
b) CA 19-9.
c) Human Chorionic Gonadotropin
d) Both a and b

what is the common symptom of diverticulitis? *

1/1
a) abdominal pain
b) fever
c) nausea
d) all above

what is diagnostic of a serous cystadenoma of pancreas? *

1/1

a) cysts lined by a columnar, mucin-producing, papillary epithelium

b) finding of glycogen-rich cells on cytologic examination

c) columnar mucin-producing cells that develop papillary projections

d) All of the above

Clinical Findings of Spigelian Hernia are? *

1/1

a) Patients often present with localized pain in the area without a bulge
b) develop during the fourth to seventh decades of life
c) A spigelian hernia occurs through the spigelian fascia
d) All of the above

Characteristic Triad in Budd-Chiari syndrome *

1/1

a) fever, jaundice, abdominal pain

b) fever, ascites, jaundice
c) hepatomegaly, ascites, abdominal pain

d) jaundice, abdominal pain, ascites

Select the hernia that is rare and occurs when the hernia
sac lies between layers of the abdominal wall? *
1/1

a) Lumbar Hernia
b) Sciatic Hernia
c) Interparietal hernias

d) Obturator Hernia
in dieulafoy’s lesion there is a : *
1/1

a) Hypertropic Gastropathy
b) gastroptosis
c) gastric neoplasm
d) abberant submucosal arteriole

which pathological process suggests portal

hypertension? *
1/1

a) Melena
b) dilated jugular vein
c) esophageal varices

d) left atrial hypertrophy.

which vein is a part of portal system? *

1/1

a) spleen vein

b) femoral vein
c) azygos vein
d) cephalic vein

which vascular obstruction can cause intestinal

ischemia? *
1/1

a) splenic artery
b) popliteal artery
c) mesenteric artery

d) hypogastric artery

The line of the main scissure of liver is also known as *

1/1

a) Pectinate Line
b) Cantlie's line

c) Arcuate Line
d) Transverse Line

Indications of Liver Transplantation, EXCEPT *

0/1

a) cirrhosis
b) biliary atresia

c) fulminant hepatitis
d) Malignancy outside the Liver

Correct answer
d) Malignancy outside the Liver

Select the Incorrect statement. *

1/1

a) the left and right gastric arteries supply the lesser curvature.
b) the left and right gastroepiploic arteries supply the greater curvature.
c) The left gastric (coronary) and right gastric veins usually drain into the superior
mesenteric vein.

d) most of the blood supply to the stomach is from the celiac artery.

All of these cause Hydatid cyst except? *

1/1

a) Echinococcus granulosus
b) E. coli

c) E. multilocularis
d) E. oligartus

which technique eradicates the cancer by using an

electrocautery device that destroys the tumor by creating a
full-thickness eschar at the tumor site, requires extension
of the eschar into the perirectal fat, thus destroying both
the tumor and the rectal wall? *
1/1

a) Fulguration

b) Thermal Cauterization
c) Electrocoagulation
d) All of the above

What is true about Colonoscopy? *

1/1

a) Colonoscopy is the gold standard for establishing the diagnosis of colon cancer.
b) Colonoscopy is generally performed even after a cancer is detected by barium
enema to obtain a biopsy.
c) to detect (and remove) small polyps that may be missed by the contrast study.
d) all of the above.

what is a difference between normal and strangulated

hernia? *
1/1

a) normal hernias tend to be more complicated

b) normal hernias need imediate intervention
c) during strangulation tissue becomes ischemic

d) strangulated hernias have better outcome then normal.

what is the first line investigation method for diagnosing

hernias? *
0/1

a) CT scan

b) MRI
c) X-ray
d) palpation

Correct answer
d) palpation

What does the Clinal Triad of ZES consist of- *

1/1

a) gastric acid hypersecretion, severe PUD, and non-β islet cell tumors of the
pancreas.

b) Esophagitis, gastroesophageal reflux and trophic effect of hypergastrinemia

c) gastric acid hyporsecretion, severe PUD, and β islet cell tumors of the pancreas.
d) diarrhea, increased gastric acid secretion and steatorrhea.

what is a diverticula? *
1/1

a) anatomical structure
b) small bulging pouch in intestine wall

c) neoplasia
d) none

which veins are part of porto-caval shunts? *

0/1

a) esophageal veins
b) abdominal subcutan veins

c) rectal veins
d) all above

Correct answer
d) all above

what is the imaging finding in pancreatic cancer? *

1/1

a) It may have a more hypodense center, indicating either central necrosis or cystic
change
b) the pancreatic duct to the left of the lesion may be dilated
c) hypodense mass with poorly demarcated edges
d) All of the above
which nerve is most commonly damaged in inguinal hernia
repair *
1/1

a) Genitofemoral
b) iliohypogastric
c) ilioinguinal

d) iliopsoas

which pathology can be differentiated with hernia? *

0/1

a) lipoma
b) pleuromesothelioma
c) borelioses

d) osler nodes

Correct answer
a) lipoma

Where is the Gastro Esophageal Junction located? *

1/1

a) 5-6 cm below the diaphragmatic esophageal hiatus

b) 2-3 cm above the diaphragmatic esophageal hiatus
c)2-3 cm below the diaphragmatic esophageal hiatus

d) 5-6 cm above the diaphragmatic esophageal hiatus

Surgical Treatment of Bleeding Stomach Ulcer (Type 1 )

is : *
0/1

a) wedge resection of gastric ulcer

b) ligation of bleeding vessels

c) distal Gastrectomy

Correct answer
c) distal Gastrectomy

This form was created inside of Batumi Shota Rustaveli State University.

Forms

surgical diseases - MIDTERM

Total points33/40

IIADM-II

Email address *

What is the correct order of the layers of abdominal wall ( from external to internal)? *
1/1

a) skin> superficial fascia> subcutaneous tissue> transversalis fascia> Abdominal muscles> preperitoneal adipose and areolar
tissue> peritoneum.
b) skin> subcutaneous tissue> superficial fascia> Abdominal muscles> transversalis fascia> preperitoneal adipose and areolar
tissue> peritoneum.

c) skin> superficial fascia> Abdominal muscles> transversalis fascia> subcutaneous tissue> preperitoneal adipose and areolar
tissue> peritoneum.
d) skin> subcutaneous tissue> superficial fascia> Abdominal muscles> preperitoneal adipose and areolar tissue> transversalis
fascia> peritoneum.

What does the Clinal Triad of ZES consist of- *

1/1

a) gastric acid hypersecretion, severe PUD, and non-β islet cell tumors of the pancreas.

b) Esophagitis, gastroesophageal reflux and trophic effect of hypergastrinemia

c) gastric acid hyporsecretion, severe PUD, and β islet cell tumors of the pancreas.
d) diarrhea, increased gastric acid secretion and steatorrhea.

Portal Triad consists of following structures, EXCEPT *

1/1

a) Portal vein
b) Hepatic Artery
c) Bile duct
d) Hepatic Vein

Clinical Findings of Spigelian Hernia are? *

1/1

a) Patients often present with localized pain in the area without a bulge
b) develop during the fourth to seventh decades of life
c) A spigelian hernia occurs through the spigelian fascia
d) All of the above
which technique eradicates the cancer by using an electrocautery device that destroys the
tumor by creating a full-thickness eschar at the tumor site, requires extension of the eschar
into the perirectal fat, thus destroying both the tumor and the rectal wall? *
1/1

a) Fulguration

b) Thermal Cauterization
c) Electrocoagulation
d) All of the above

NAME/SURNAME *

how can portal hypertension be managed? *

0/1

a) TIPS *
b) liver resection

c) whipple procedure
d) none

Correct answer
c) whipple procedure

which statement regarding hernia is true? *

1/1

a) femoral hernias are only met in female patients

b) inguinal hernias are never met in female patients
c) femoral hernias are more common in female patients then male

d) none

which pathology causes portal hypertension? *

1/1

a) liver hemangioma
b) Hydatic cyst
c) liver cirrhosis

d) all above

Treatment of choice for amebic abscesses is? *

1/1

a) metronidazole

b) B-blockers
c) dexketoprofen
d) Adrenaline

which symptoms are common for strangulated hernia? *

1/1
a) vomiting
b) pain
c) constipation
d) all above

what does caput medusae stands for? *

1/1

a) inflammation of the cerebral veins

b) dilatation of esophageal veins
c) dilution of abdominal subcutaneous veins

d) bleeding from rectal veins

which nerve is most commonly damaged in inguinal hernia repair *

1/1

a) Genitofemoral
b) iliohypogastric
c) ilioinguinal

d) iliopsoas

what is the screening test for colorectal cancer? *

1/1

a) hemoccult test

b) PAP test
c) PSA test
d) none

what is diagnostic of a serous cystadenoma of pancreas? *

1/1

a) cysts lined by a columnar, mucin-producing, papillary epithelium

b) finding of glycogen-rich cells on cytologic examination

c) columnar mucin-producing cells that develop papillary projections

d) All of the above

what is the imaging finding in pancreatic cancer? *

1/1

a) It may have a more hypodense center, indicating either central necrosis or cystic change
b) the pancreatic duct to the left of the lesion may be dilated
c) hypodense mass with poorly demarcated edges
d) All of the above

what is the differential diagnostic of diverticulitis? *

0/1

a) apendicitis
b) crohns disease
c) ectopic pregnancy
d) all above

Correct answer
d) all above

Surgical Treatment of Bleeding Stomach Ulcer (Type 1 ) is : *

1/1

a) wedge resection of gastric ulcer

b) ligation of bleeding vessels
c) distal Gastrectomy

d) pyloroplasty by Heinike-mickulicz

which procedures can be used to manage intestinal neoplasia? *

1/1

a) chemotherapy
b) radiotherapy
c) surgical treatment
d) all above

Select the hernia that is rare and occurs when the hernia sac lies between layers of the
abdominal wall? *
1/1

a) Lumbar Hernia
b) Sciatic Hernia
c) Interparietal hernias

d) Obturator Hernia

The line of the main scissure of liver is also known as *

1/1

a) Pectinate Line
b) Cantlie's line

c) Arcuate Line
d) Transverse Line

Select the Congenital Pancreatic Anomaly *

1/1

a) Pancreas Divisum
b) Annular Pancreas
c) Developmental Pancreatic Cysts
d) All of the above

Where is the Gastro Esophageal Junction located? *

1/1

a) 5-6 cm below the diaphragmatic esophageal hiatus

b) 2-3 cm above the diaphragmatic esophageal hiatus
c)2-3 cm below the diaphragmatic esophageal hiatus

d) 5-6 cm above the diaphragmatic esophageal hiatus

when should a person undergo screening for colorectal cancer? *

1/1

a) above 20y
b) above 70y
c) above 30y
d) above 50y

PASSPORT NUMBER *

which statement regarding hernia is false? *

1/1

a) hernias are only met in obese patients

b) hernias are never met in bodybuilders
c) only intestine can be herniated
d) all above

most common benign tumor of the liver? *

1/1

a) Intrahepatic Cholangicarcinoma
b) Hemangiona

c) Focal Nodular Hyperplasia

d) Hepatocellular Ademonas

All of these cause Hydatid cyst except? *

1/1

a) Echinococcus granulosus
b) E. coli

c) E. multilocularis
d) E. oligartus

What is true about Colonoscopy? *

1/1

a) Colonoscopy is the gold standard for establishing the diagnosis of colon cancer.
b) Colonoscopy is generally performed even after a cancer is detected by barium enema to obtain a biopsy.
c) to detect (and remove) small polyps that may be missed by the contrast study.
d) all of the above.

which pathology can cause portal hypertension? *

1/1

a) liver cirrhosis
b) portal vein thrombosis
c) budd-chiari syndrome.
d) all above

Collections of nondigestible materials, usually of vegetable origin, but can also be of hair
origin, most commonly found in patients who have undergone surgery of the stomach and have
impaired gastric emptying are known as? *
1/1

a) Dieulafoy's lesions
b) Gastric Ulcers
c)Volvulus
d)Bezoar

most widely used pancreatic cancer serum markers are *

0/1

a) CEA
b) CA 19-9.

c) Human Chorionic Gonadotropin

d) Both a and b

Correct answer
d) Both a and b

which statement regarding hernia is correct? *

0/1

a) hernias are always symptomatic

b) hernias are always painfull
c) normal hernias usualy dont cause any complaints
d) all above

Correct answer
c) normal hernias usualy dont cause any complaints

which symptoms are common for normal hernia? *

0/1

a) nausea
b) colicky abdominal pain
c) abdominal distension

d) none

Correct answer
d) none

which investigation helps us to ensure the diagnosis of hernia? *

1/1
a) x-ray
b) PET-CT
c) ultrasound

d) endoscopy

the best therapy for Pancreatic cancer have been achieved using? *
1/1

a) radiation therapy combined with either 5-fluorouracil or gemcitabine.

b) Intraoperative radiation therapy

c) Transduodenal fine-needle aspiration of the tumor with endoscopic ultrasound guidance
d) Radition therapy alone

Select the Incorrect Statements- *

1/1

a) bilirubin is deconjugated by intestinal bacteria to a group of compounds known as urobilinogens

b) urobilinogens are oxidized and reabsorbed into the enterohepatic circulation and secreted into bile.
c) A small percentage of the reabsorbed urobilinogens are excreted into urine.
d) Biliverdin contributes to the yellow color of urine and the brown color of stool.

Select the Incorrect statement. *

1/1

a) the left and right gastric arteries supply the lesser curvature.
b) the left and right gastroepiploic arteries supply the greater curvature.
c) The left gastric (coronary) and right gastric veins usually drain into the superior mesenteric vein.

d) most of the blood supply to the stomach is from the celiac artery.

which statement about diverticulitis is correct? *

0/1

a) only conservative treatment is an option

b) only surgical treatment is an option
c) requiers lifelong sugar intake restriction

d) non of them

Correct answer
d) non of them

Barium meal X-ray features Niche on lesser curve with notch on greater curve is indicative
of: *
0/1

a) Peptic Ulcer
b) Cirrhosis
c) Crohn’s disease

d) Ulcerative colitis

Correct answer
a) Peptic Ulcer
which instrumental investigation is a golden standard for colorectal cancer screening? *
1/1

a) Pet-CT
b) CT angiography
c) coloscopy

d) ultrasound

which statement regarding esophageal varices is correct? *

1/1

a) bleeding from varices is life treatening condition

b) varices can be ligated
c) blackmore drain Tube is fastest way to stop bleeding from varices
d) all above

This form was created inside of Batumi Shota Rustaveli State University.

Forms