Sohag University
Sohag faculty of medicine
Surgery department
Time allowed: 3 hours

M.S.C General Surgery
Paper I


I- Discuss management of blunt abdominal trauma.
(20 marks)
II- Write short account on:- (10 marks for each)

1- Complications of penetrating stab in left 6th 
intercostal space,mid clavicular line.
2- Management of diabetic foot ulcer.
3- Methods of feeding in postoperative patients.
4-Classification and treatment of gastroesophageal reflux disease.
5- Clinical features of acute pancreatitis.
6- Breast conservation surgery .

M.S.C General Surgery
MCQ Examination
Answer all questions in the same sheet
Student's Name:
Secret Number:

1)Most common extraintestinal manifestation of Crohn's disease of small intestine is:
a) Ankylosing Spondylitis
b) Erythema Nodosum
c) Iritis
d) Ureteral Obstruction

2)Which of the following is the most common cause of death in Crohn's disease of
small intestine:
a) Malignancy
b) Sepsis
c) Electrolyte Disorders
d) Thromboembolic Phenomenon

3)Which of the following is not a common site for gastrinoma:
a) 1st part of duodenum.
b) 2nd part of duodenum
c) 3rd part of duodenum
d) 4th part of duodenum

4)Right sided colon conduit after esophagectomy is based on:
a) Ileo colic artery
b) Right colic artery
c) Middle colic artery
d) Left colic artery

5)Which is not true regarding BRCA mutations in breast cancer:
a) BRCA 1 tumors are high grade as compared to BRCA 2
b) BRCA 1 breast cancer are hormone receptor positive
c) BRCA 1 breast tumor are aneuploid
d) BRCA 1 breast cancer have an incraesed S phase fraction

6)Minimum number of lymph nodes to be dissected in Axillary sampling in breast
conservation surgery is:
a) 2
b) 3
c) 4
d) 5

7)In Breast Reconstructive surgery after mastectomy which of the following is not true
regarding TRAM flap:
a) TRAM flap may be based on a pedicled Superior Epigastric artery
b) TRAM flap can be transferred as a free flap
c) It is a type of myocutaneous flap
d) It uses supraumbilical fat

8)Which of the following is not true for Acalculus cholecystitis:
a) It accounts for 5-10% cases of Acute Cholecystitis.
b) This entity has a more fulminant course of disease progression
c) More commonly seen after burns trauma or major cardiac surgeries.
d) Cholescintigraphy is the investigation of choice for detecting Acute
Acalculus Cholecystitis

9)Which is not a paraneoplastic syndrome for Hepatocellular Carcinoma:
a) Hypercalcemia
b) Hypoglycemia
c) Erythrocytosis
d) Hyperglycemia

10)Which of the following is not true for Hashimoto thyroiditis:
a) It is an autoimmune disease caused by CD4 cells with specificity to thyroid antigens
b) commonly presents as hypothyroidism
c) Surgery is required in almost all cases
d) Hashimoto thyroiditis can progress to lymphoma of thyroid

11)Pain in the arm due to cervical rib is caused by:
a)Compression of T1 root
b)Compression of C7 root
c)Muscle ischemia
d)Compression of brachial plexus
e)Phrenic nerve

12)What is the management of choledochal cyst adherent to portal vein?
a) Excision and Roux en y hepaticojejunostomy
b)Internal drainage into roux en y jejunal limb
c) Hepatic lobectomy
d) The internal lining of the cyst can be excised, leaving the external portion of the cyst wall

13)Regarding bone metastases all are true except:
(a)less than 5% of patients with malignant disease develop bone metastases
(b)10% of patients with bone metastases develop a pathological fracture
(c)breast cancer is the commonest cause of bone metastases in women
(d)radiological changes are seen early in the disease process
(e)prostate cancer can cause osteosclerotic lesions

14)After intraductal papilloma, unilateral bloody nipple discharge from one duct orifice is
most commonly caused by which of the following pathologic conditions?
(a) Paget's disease of the nipple.
(b) intraductal carcinoma.
(c) inflammatory carcinoma.
(d) Subareolar mastitis.

15)Malocclusion results from:
(a) fracture maxilla
(b) fracture mandible
(c) fracture zygoma
(d) a&b
(e) non of the above.

16)Which of the following is not true about Pneumatosis intestinalis of small intestine:
a) It is seen equally in males and females
b) Most common location is subserosa in the jejunum
c) Operative procedures are required in most of the cases
d) It is associated with COPD and immunodeficiency states

17)Which of the following regarding biliary strictures in chronic pancreatitis is not true:
a) Endoscopic stenting is a primary modality of management
b) Most of the patients are asymptomatic
c) All patients should undergo evaluation to rule out malignancy
d) Main factor for development of chronic pancreatitis is the proximity to head of pancreas

18)What is not true about blind loop syndrome:
a) It manifets as diarrhoea, weight loss and deficiency of fat soluble vitamins.
b) Megaloblastic anemia is commonly seen
c) Surgery is almost always required to correct small bowel syndrome
d) Broad spectrum antibiotics are the treatment of choice

19)Parenteral nutrition leads to liver failure in 15% of patients. All of the following
prevents liver failure except:
a) Prevent sepsis and bacterial overgrowth
b) Give mixed fuels with less than 30% fat
c) Avoid overfeeding
d) Avoid Zinc and Molybedynum

20)Which of the following can be seen in systemic inflammatory response syndrome?
a) Hypothermia (< 36° C)
b) White cell count < 4 X 1000/ dl
c) No documented infection
d) Tachycardia (>90/min)
e) Tachypnea (>20/min)
f) All of the above