Question bank

A. Multiple choice questions:

1. A patient with spinal shock may have all of the following

except:
A. Hypotension.
B. Tachycardia.
C. Warm dry skin.
D. Sensory loss in both lower limbs.
2. Patients with septic shock may have:
A. Bradycardia
B. Hypertension.
C. Polyuria.
D. Cold clammy skin
3. Patients with septic shock may have:
A. Low PO2
B. Low PCO2
C. Low HCO3 .
D. High pH.
4. Patients in hypovolaemic shock have all of the following except:
A. Flushed.
B. Hypotension.
C. Tachycardia.
D. Oliguria.
5. Healing by first intention means:
A. Using catgut suture
B. Obtaining union between 2 edges of an incision with a nice scar.
C. Immediate use of protective dressing.
D. Using staples
6. Which of the following is not a complication of massive blood
transfusions?
A Coagulopathy
B Hypercalcaemia
C Hyperkalaemia
D Hypokalaemia
E Hypothermia.
7. Which of these factors influences healing of a wound?
A Vascular insufficiency
B Diabetes mellitus
C Malnutrition
D Site of wound
E. All of the above
8. Which of the following are useful in the treatment of keloids?
A Elasticated garments
B Silicone gel sheeting
C Excision and steroid injection
D Excision and radiotherapy
E All of the above
9. The following diseases predispose to surgical wound infection
except:
a. Obesity
b. Hypertension
C. DM
d. Malignancy
10. The following disease may be transmitted during blood
transfusion except:
a. CMV
b. Malaria
c. Hepatitis A
d. Brucellosis
11. As regard TPN:
a. It is the only route of nutrition in short bowel syndrome.
b. Not indicated except if necessary.
c. May lead to sepsis and pneumothorax.
d. Always indicated in conditions requiring NPO.
e. All of the above.
12. The most urgent measure in the management of a severely
injured patient in the reception room is:
a. Control of active bleeding.
b. Toking blood sample for grouping and cross matching.
c. Establishing an intravenous line.
d. Securing clear airway and adequate pulmonary ventilation.
e. providing tetanus prophylaxis.
13. The hyperdynamic phase of septic shock is characterized by
the following signs except:
a. Hyperventilation.
b. Hypotension.
c. Tachycardia.
d. pale cold extremities.
e. Oliguria.
14. Concerning post-operative wound infection, which of the
following statement is wrong?
a. Is most often due to dead space.
b. Can always be prevented by prophylactic antibiotics.
c. Frequently takes the form of stitch abscess.
d. May precipitate fatal secondary hemorrhage.
e. May end fatally by septic shock.
15. The most serious complication of blood transfusion is:
a. Pyrogenic reactions.
b. Thrombophlebitis of recipient vein.
c. Circulatory overloading.
d. Incompatibility reactions.
e. Viral hepatitis.
16. A 35-year-old multiparous female presented with a reducible,
right inguinal swelling which was diagnosed as a hernia. This
hernia is most probably:
a. Femoral.
b. Direct inguinal.
c. indirect inguinal.
d. Obturator.
e. Spigelian.
17. The commonest complicated hernia is:
a- Femoral
b- Inguinal
c- Lumbar
d- Epigastric
18. The following organ can not herniate:
a- Bladder
b- Pancreas
c- Caecum
d- All of the above
19. As regards clinical picture of hernia:
a- Scar of site of hernia has no medical importance
b- Irreducibility predisposes to complications
c- Hernia is always painful
d- All of the above.
20. Etiology of breast abscess include:
a- Mostly in lactating women.
b- Due to Staph from baby mouth.
c- Bad hygiene.
d- All of the above.
21. Signs of pus formation are the following except:
a- Hectic fever.
b- Edema of overlying skin.
c- No response to medical treatment for 48 hours.
d- Fluctuation occurs early in breast abscess.
22. Clinical findings of fibroadenosis include:
a- Cyclic pain.
b- Cyclic swelling.
c- Cyclic discharge.
d- All of the above.
23. Contraindications to conservative surgery include:
a- Large tumor.
b- Paget's disease of nipple.
c- Previous irradiation.
d- Distant metastasis.
e- All of the above.
24. Adjuvant chemotherapy is indicated in:
a- +ve LN biopsy.
b- -ve hormonal receptors.
c- Poor prognosis of the case.
d- All of the above.
25. As regard incidence of cancer breast all correct except:
a- Most common female malignancy.
b- Rare in nulliparous females.
c- Very rare below 20 years.
d- Males are rare to be affected but with grove prognosis.
26. Incurable breast cancer in premenopausal females may be
treated by the following except:
a- Local mastectomy
b- Radiotherapy
c- Estrogen administration
d- Chemotherapy
e- Tamoxifen
27. Most diagnostic single investigation for toxic adenoma is:
a. T3-T4.
b. US.
c. Thyroid scan.
d. FNABC.
28. Toxic goiter has the following signs except:
a. Flapping tremors of the hand
b. Exophthalmos
c. Diarrhea
d. Menstrual irregularities
29. 3 hours post-thyroidectomy, 30-year out woman developed
agitation and difficulty breathing, tachycardia and dry dressing
but anterior cervical swelling. The most appropriate immediate
step is
a. Insertion of on oro-tracheal tube
b. Reopening of the cervical wound
c. Estimation of serum calcium level
d. IV morphine
30. A thyroid nodule could be malignant if it shows:
a. rapid growth
b. Pain referred to the ear
c. Hardness
d. Associated hoarseness of voice
e. All of the above
31. Hoarseness of voice denote
a. Compression of the superior laryngeal nerve
b. Infiltration of the recurrent laryngeal nerve
c. Infiltration of the superior laryngeal nerve
d. Tracheal compression
32. Recurrent goiter may be due to:
a. Inadequate initial removal.
b. Persistence of etiology.
c. Foreign body reaction.
d. Any of the above.
33. The best routine treatment for multinodular goitre is by:
a. Hemithyroidectomy.
b. Partial thyroidectomy.
c. Bilateral wedge resection.
d. Subtotal thyroidectomy.
e. Thyroxine administration.
34. Voice fatigue after thyroidectomy is due to injury to which of
the following nerves?
a. Superior laryngeal.
b. External laryngeal.
c. Internal laryngeal.
d. Recurrent laryngeal.
e. Vagus.
35. Acute perforation of duodenal ulcer may present by the
following except:
a. Severe generalized abdominal pain.
b. Colicky pain in lower abdomen.
c. Septic peritonitis if neglected.
d. Massive hematemesis if posterior ulcer eroding gastroduodenal
artery.
e. X-ray films show gas under diaphragm.
B. True or false questions:

1. Acute post-traumatic renal failure may be due to

hypovolemia & poor tissue perfusion. (True)
2. IV parentral feeding is without complications with
present day solutions & methods of administration.
(False)
3. Shock can be most comprehensively defined as a sudden
large volume blood loss. (False)
4. In all forms of shock there is an impairment of cellular
oxygenation (True)
5. Important & urgent measures in the diagnosis &
treatment of shock is warming the patient. (False)
6. Hypovolemic shock may result from generalized
peritonitis. (True)
7. Appropriate immediate IV infusions in all cases of non
cardiogenic shock is whole blood. (False)
8. Septic shock is only caused by gram negative organisms.
(False)
9. A blood transfusion reaction may produce renal damage.
(True)
10. Massive blood transfusions may be complicated by
hepatic coma. (True)
11. As regard to risk factors for breast cancer, most
important risk factor for cancer breast are obesity,
nulliparity and alcohol (False)
12. Fibroadenoma of the breast are commonest in early
adult life. (True)
13. Fibrocystic disease of the breast is precancerous.
(False)
14. Breast cancer often presents with a history of breast
pain. (False)
15. Symptoms of hypothyroidism include intolerance to
cold. (True)
16. As regard incidence of different types of hernia the
most common hernia in females is femoral hernia.
(False)
17. As regard incidence of different types of hernia more
than 10% of cases of inguinal hernia are bilateral (True)
18. Inguinal hernia in young adults are most commonly of
the direct type. (False)
19. Strangulated contents of hernial sacs are usually
irreducible. (True)
20. Incisional hernia are related to obesity. (True)
21. Hernia in the umbilical region usually occur in males
(False)
22. As regard complications of hernia, umbilical hernia is
rare to strangulate. (False)
23. As regard bowel obstruction, in case of simple
mechanical small bowel obstruction, loss of water and
electrolyte is caused mainly secondary to intestinal
distension (False)
24. As regard intestinal obstruction peritoneal adhesions
account for over half of the cases of small bowel
obstruction (True)
25. As regard paralytic ileus clinically, auscultation
reveals exaggerated intestinal sounds . (False)
26. Internal hemorrhoids will often resolve after
conservative treatment. (True)
27. An anal fissure usually lies anteriorly (False)
28. As regard acute appendicitis, appendicitis is the most
common cause of acute abdomen in young adults (True)
29. Acute appendicitis is most common in the 30 - 40 year
age group (False)
30. Appendicitis is more common in females (False)
31. The physical signs of early appendicitis do not include
rectal tenderness. (True)
32. Patients with early appendicitis usually present with
central abdominal pain. (True)
33. Investigation of a case of acute appendicitis will
usually reveal a polymorph-nuclear leucocytosis (True)
34. Likely differential diagnosis in a young woman with
appendicitis include ovulatory pain (True)
35. Hypovolemic shock may result from intestinal
obstruction. (True)