Sohag University
Sohag faculty of medicine
3/10/2011
Surgery department
Time allowed: 30 minutes
MD Pre-exam

 

1)With regard to appendicitis:
1.
McBurney's point lies one third of the way along a line drawn from the   umbilicus
to the right anterior superior iliac spine.
2.
The presence of an appendix mass necessitates immediate surgical intervention.
3.
A normal white cell count excludes appendicitis
4.
Loss of appetite is a common feature of acute appendicitis
5.
Rovsing's sign is an increase in pain in the left iliac fossa when the right iliac fossa
is palpated


2)With respect to gallstones:
1.
Most people with gallstones are asymptomatic.
2.
CT is the imaging modality of choice in diagnosing gallstones.
3.
Approximately 90% of gallstones are visible on plain abdominal x-ray.
4.
Gallstone ileus occurs when a gallstone travels through the bile duct into the small
bowel and causes an obstruction.
5.
Mirizzi's syndrome is caused by a stone in the common bile duct


3)With regards to Peptic ulcer disease:
1.
A minority of duodenal ulcers are caused by Helicobacter Pylori infection.
2.
A raised serum creatinine is a sign of a significant upper GI bleed.
3.
Triple therapy for H. Pylori eradication involves the combination of an H2 receptor
antagonist, a proton pump inhibitor and an antibiotic.
4.
Following endoscopic therapy for a bleeding ulcer, a rebleed warrants immediate
open surgical intervention.
5. A bleeding ulcer can be managed by under-running the bleeding vessel.


4)With regards to Inguinal hernias:
1.
A direct hernia passes through the deep inguinal ring into the inguinal canal.
2.
A femoral hernia is more common than an inguinal hernia in females.
3.
An inguinal hernia can be distinguished from a femoral hernia by its relationship to
the inguinal ligament.
4.
The superior epigastric vessels lie medial to the deep inguinal ring.
5.
The floor of the inguinal canal is formed by the conjoint tendon.


5)With regards to the acute abdomen:
1.
Mesenteric adenitis is a common cause of abdominal pain in children.
2.
The absence of free air on an erect chest x-ray excludes an intra-abdominal
perforation.
3.
Free air under the right hemi-diaphragm can be mistaken for gas within the
stomach.
4.
A raised serum amylase is diagnostic of acute pancreatitis.
5.
Diverticulosis is a common cause of acute left iliac fossa tenderness assosciated
with pyrexia and a raised white cell count.


6)With regards to Testicular pain:
1.
Testicular torsion can present with lower abdominal pain
2. Testicular pain in children is commonly due to epididymo-orchitis.
3.
Torsion can be easily excluded on careful clinical examination alone.
4.
A varicocoele will readily transilluminate.
5.
Testicular pain is not classically associated with viral infections.


7)With regards to Colorectal cancer:
1.
Most tumours occur in the right side of the colon.
2. Neo-adjuvant radiotherapy has no role in the management of rectal tumours.
3.
Rights sided tumours are more likely to obstruct than Left sided tumours.
4.
Colorectal cancer has been associated with a diet high in fibre and low in saturated
fat.
5.
Villous adenomas have a greater malignant potential than tubular adenomas.


8)Most common extraintestinal manifestation of Crohn's disease of small intestine is:
1. Ankylosing Spondylitis
2. Erythema Nodosum
3. Iritis
4. Ureteral Obstruction


9)Which of the following has least incidence of malignancy:
1. Insulinoma
2. Gastrinoma
3. VIPoma
4. Glucagonoma


10)Which of the following is the most common cause of death in Crohn's disease of
small intestine:
1. Malignancy
2. Sepsis
3. Electrolyte Disorders
4. Thromboembolic Phenomenon


11)Which of the following investigations has the highest sensitivity to
diagnose gastrinoma:
1.
CT scan Abdomen
2.
Portal Venous Sampling
3.
Arteriography
4.
Somatostatin receptor scintigraphy


12)Right sided colon conduit after esophagectomy is based on:
1.
Ileo colic artery
2.
Right colic artery
3. c) Middle colic artery
4. Left colic artery


13)Which of the following is not true about Pneumatosis intestinalis of small intestine:
1.
It is seen equaly and males and females
2.
Most common location is subserosa in the jejunum
3.
Operative Procedures are required in most of the cases
4.
It is associated with COPD and immunodeficiency states


14)Which of the following regarding biliary strictures in chronic pancreatitis is not
true:
1.
Endoscopic stenting is a primary modality of management
2.
Most of the patients are asymptomatic
3.
All patients should undergo evaluation to rule out malignancy
4.
Main factor for development of chronic pancreatitis is the proximity to head of
pancreas


15)What is not true about blind loop syndrome:
1.
It manifets as diarrhoea, weight loss and deficiency of fat soluble vitamins.
2.
Megaloblastic anemia is commonly seen
3.
Surgery is almost always required to correct small bowel syndrome
4.
Broad spectrum antibiotics are the treatment of choice