Sohag University
Sohag faculty of medicine
24/4/2016
Surgery department
Time allowed: 3 hours

M.S.C General Surgery
Paper I

I- Discuss the following questions - (20 marks for each)
1) Aetiology and management of postoperative wound infection.
2) Management of penetrating neck injuries.


II- Write short account on:- (10 marks for each)
1- Treatment options of pancreatic pseudocyst.
2- Complications of burn injuries and causes of death in a burn
victim.
3- Management of solitary thyroid nodule.
4- Surgical causes of neonatal cholestasis.
5- Types and treatment options of colorectal polyps.

Choose the best single answer (10 marks):-
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 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


3) 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


4) 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


5) 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


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

7) 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


8) 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


9) 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.


10) 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