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

M.S.C General Surgery
Paper III

I- Discuss postoperative jaundice.
(20 marks)
II- Write short account on:- (10 marks for each)
1- Clinical features of thoracic outlet syndrome.
2- Treatment of Pott's paraplegia.
3- Splenic salvage operations.
4- Pathophysiology of septic shock.
5- Complications of bariatric surgery.
6- Treatment of hydatid cyst of the liver.

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

1.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

2.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

3.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

4.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

5.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

6.Which is the most appropriate form of biopsy for a major salivary gland tumour?
a) Open surgical biopsy to allow histology.
b) Salivary washings.
c) Frozen section during formal excision.
d) Fine-needle aspiration cytology.
e) Biopsy is contraindicated.

7.Which of the following is true regarding sick euthyroid syndrome?
a) It can be present as high T3 and T4
b) TSH may be high
c) TSH is usually suppressed
d) Thyroid replacement is favoured

8.Which of the following is true regarding Cushing's disease?
a) Patients with Cushing's disease are at increased risk of hospital-acquired infections.
b) Patients do not require prophylactic anticoagulation.
c) Following surgical removal of unilateral adrenal adenomata, cortisol supplementation is
not necessary.
d) Nelson's syndrome is a cause of Cushing's disease.
e) Cushing's-associated medical conditions need not be treated medically preoperatively.

b)Cavernous haemangioma.
c)Sebaceous cyst.
d)Dermoid cyst.

10.In tongue cancer, the site least affected is:
a)Lateral margin.
b)Ventral surface.
c)Dorsal surface.
e)Posterior portion.

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 intact.

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

17.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

18.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

19.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

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