1. Which of the following is not associated with mitral stenosis?

- Ventricular hypertrophy
- Pulmonary hypertension
- Embolization
- Increased pressure of the right atrium
- Dilatation of the left atrium

2. Which one is most important in diagnosis?
- Medical History
- Physical examination
- Review of systems

3. Which of the following is false about HCC?
- Comprises 90% of all primary malignant liver tumors
- 50% are secondary to HBV and HCV infections
- Imaging is the corner stone in diagnosis

4. Which of the following is false about liver tumors?
- Focal nodular hyperplasia is an indication for surgery
- Hemangioma is the most common benign liver tumor
- Hemangioma appears on T2 MRI
- Liver adenoma is seen in ladies with history of OCPs

5. Which is true about congenital diaphragmatic hernia?
- Mostly through Morgagni's foramen
- Presents as respiratory distress in the neonate
- Surgery is indicated right after delivery

6. Which is wrong about Meckel's diverticulum
- 2-4% of population
- Diverticulectomy is indicated when you find it incidentally
-Most common complication is bleeding
- Least common complication is diverticulitis

7. Which is the most likely cause of massive lower GI bleeding (bright
red) in a 5 year old
- Hemorrhoids
- Rectal polyp

8. Which is the mostly likely cause of massive upper GI bleeding (bright
red) in children
- Varices
-Pharyngeal polyp
- lower esophageal ulcers
- bleeding duodenal ulcer

9. In the management of UGIB, which is most important?
- UGI endoscopy
- resuscitation

10. The strongest layer in the esophagus is
- Muscularis
- Muscularismucosea
- Submucosa
- Adventitia

11. All of the following are risk factors for SCC of the esophagus except
- Obesity
- Leukplakia
-Plummer-Vinson
- Achalasia

12. Wrong about pheochromocytoma:
- Always arises from the adrenal medulla
- Arises from the chromaffin cells
- Can cause sudden death

13. Carotid body tumor (the same in past years)

14. Most consistent with incisional hernia
-wound infection
-obesity
-steroid
-suture material

15. Which is wrong about appendicitis in the elderly
- 50% mortality rate
- 60% - 90% of perforation due to late Dx
- Omentum can't wall off the inflammation

16. Most common organism to cause wound infection after
appendectomy
- E.coli
- Bacteroides fragilis
- Staph aureus
- Strep fecalis

17. All of the following can cause anal fistula except
- Ulcerative proctocolitis
- Bilharziasis
- Diverticulosis
- TB proctitis
- Crohn's colitis

18. What is the most common presentation of chronic anal fissure
- Anal mass
- Profuse bleeding
- Painful bleeding
Painless bleeding

19. Which of the following is true about colorectal cancer
- Most arise on top of polyps
- Polyps is a pathological term

20. What is true about colorectal cancer
- Left-sided tumors usually present with altered bowel habit
- Rectal tumors usually present with intestinal obstruction
- Right-sided tumors usually present with obstruction

21. A child swallowed a coin shelen. All of the following are possible
sites it can stop in except
- Pylorus
- Cervical esophagus
-LES
- Ileocecal valve
- Splenic flexure

22. Which is wrong about branchial cyst
- Bright Transillumination
- 2nd cleft

23. Which is wrong about hydatid disease
- Minor leak of fluid can cause anaphylaxis
- Antibody detection in serum can aid in Dx
- Most common symptom is RUQ discomfort
- Most common organ involved is the liver
- Can easily leak into peritoneal cavity

24. A known case of Hepatitis B presented with Jaundice, Abdominal
Discomfort , what is the most valuable test you can use?
- B-HCG
- AFP
- Ca 19.9
- CEA

25. Which of the following cancers is least responsive to chemotherapy
- Melanoma
- Teratoma
- Lymphoma
- Choriocarcinoma

26. Which of the following lung tumors has the best prognosis?
- Bronchioalveolar CA
- Small cell CA
- Typical carcinoid
- Squamous cell
- Adenocarcinoma

27. Which of the following is false about TNM staging
- good indicator of tumor grade
- can be used to guide treatment
- can be used to predict prognosis
- can be used to compare treatment results in different centers

28. Which of the following is wrong about prostate cancer
- Obturator lymph nodes are the first to be affected in locally advanced
disease
- Usually occurs in peripheral zones
- abnormal DRE is the most common indication for biopsy
- more in blacks
- PSA screening is advised after the age of 50

29. Which of the following is most likely to produce cloudy urine
- Bacterial cystitis
- Significant proteinuria
- Yeast overgrowth

30. A child presented with hypertension and past Hx of UTI, most likely
cause
- Renal artery stenosis
- Reflux nephropathy
- Pelviureteric junction obstruction

31. Which of the following is best to diagnose kidney stones
- non-enhanced CT
- enhanced CT
- IVU

32. Which of the following tumors is not associated with viral infection
- nasopharyngeal
- Adult T-cell leukemia/lymphoma
- clear renal cell carcinoma

33. Which of the following is the most common presentation of renal
cell carcinoma
- abdominal mass
- hematuria
- unexplained fever

34. A pt with pelvic fracture that caused injury to the bladder, what's the
hallmark symptom
- hypotension
- hematuria
- frequency
- dysuria

35. A pt with chronic urine retention, which is false
- usually there's no suprapubic tenderness
- high riding prostate on DRE
- the cause is usually infravesical
- there's high residual urine

36. Which of the following makes you suspect the validity of midstream
urine sample?
- Bacteria
- Squamous epithelial cells
- RBC casts
- WBCs

37. Which of the following is best use to diagnose ruptured urethra?
- retrograde urethrogram
- IVU

38. Which of the following is wrong about pelvic abscess management
- Trans rectal drainage is dangerous and should be avoided
- U/S is useful in Dx and Rx
- presents with abdominal pain, diarrhea and hectic fever

39. Coarctation of the aorta can cause all except
- rib notching
- hypotension

40. The most common solid abdominal tumor in children is
- Neuroblastoma
- Hepatoblastoma
- Wilm's tumor

41. Which is wrong about intussusception
- Most common between 6-18 months
- Has the characterestic doughnut sign
- Most common in the ileum
- most common leading points are peyer's patch and meckel's
- presents with few clinical signs

42. Which is wrong about spleen
- lies against the lowest three ribs

43. What is the least feared complication for duodenal ulcer
- Malignant transformation
- Bleeding
- Penetration
- Perforation
- gastric outlet obstruction

44. That famous revised trauma scale question > 6

45. What's wrong about Mg
- Mainly extracellular

46. What is normal daily requirement of Na in adults
- 6 g
- 4 g
- 2 g
- 10 g

47. Which is wrong about fresh frozen plasma
- indicated for christmas disease until specific factor is available
- indicated in liver failure surgery
- 4 hrs to extract from whole blood aw hekeshi
- contains normal serum albumin concentration

48. Which is wrong about blood transfusion
- increases pH
- increases potassium

49. Which is wrong about management of transfusion reaction
- Stop transfusion
- Recheck donor blood group
- serumHb and bilirubin
- IV antibiotics

50. Which is wrong about mesenteric ischemia
-Abdominal X-Ray is diagnostic
- Associated with high rate of mortality
- Pain and history not going with physical exam
51. In which hernia the least complications can occur: inguinal
hernia femoral hernia paraumbilical hernia epigastric hernia

52. Which of the following surgeries needs antibiotic prophylaxis
- Varicose vein stripping
- Synthetic artery graft
- resection of lipoma in the lumbar region
- correction of inguinal hernia
- something about artificial material

53. The cause for hernial complication is the content The ring The
sac The neck

54. all in tension pneumothorax except
decrease ventilation
increase hear rate
decrease stroke volume
increase shunts

55. all can be demonstrated using isotope study of the thyroid except
hot nodule
warm nodule
cold nodule
malignant nodule

56. What is wrong about papillary thyroid cancer
- Most cases in children and young adults
- iodine rich countries
- Lymphatic spread
- Tumor size doesn't correlate with ... (eshi )

57. What is wrong about the anatomy of the inguinal region
- Internal oblique make part of anterior wall
- The internal ring is a U-shaped defect in the transversus abdominis
- The cremasteric muscle is derived from the internal obliue
- Conjoint tendon is the roof

58. What is wrong about the submandibular glands
- Most of tumors are benign
- Most affected by stones
- Most stones are radiolucent

59. What is wrong about the thyroid nodules
- Painful nodules is most likely inflammation
- acute enlargement of existing nodule means secondary infection
- you should exclude malignancy in the definitely solitary nodule

60. Which is true about presentation of breast CA
- 90% present with palpable nodes
- can present with supraclavicular lymph node enlargement
- a 15 year old with breast mass probably has cancer

61. risk factor for pancreatic cancers except :
-smoking
-alcohol
-associated MEN
-ahydro..

62. wrong about pancreatic cancer :
-body is the most common site
-Jaundice if the CA is in the head of pancreas

64. Which of the following suggests venous system pathology
- unilateral lower limb swelling
- acute pain and pallor
- gangrene

65. Which of the following is not in the criteria to diagnose critical lower
limb ischemia
- ABPI < 0.4
- Rest pain for the last 3 weeks
- Chronic pain when walking relieved by slowing down
- Gangrene
- eshikaman in the last 3 weeks

66. All are done in the burn unit except
- escharotomy
- Albumin in the 1st 24 hours

67. Which is true about burns
- Escharotomy is indicated in circumferential deep partial thickness burn
- majro burn needs intubation
- full thickness burn needs washing

68. Which is least important in wound infection development
- Dead tissue
- Pathogenecity of microrganism
- Foreign bodies
- Blood supply compromise
- Degree of contamination

69. What is wrong about testicular torsion
- Orchidopexy should also be done to the contralateral testis
- After 6 hrs it's unlikely to save the testis
- Doppler ultrasound should invariably be used to diagnose torsion

70. another question about torsion, what is right
- appendix testis torsion mimics testicular torsion

71. Wrong about Conn's syndrome
- Hyperkalemia
- 1% of pt with hypertension

72. (which is wrong) testicular tumors are part of MEN II

73. all of the following can cause pneumaturia except
- Diverticulitis
- Colon CA
- Crohn's disease
- c Ectopic ureter


74. Which of the following goes with the diagnosis of fibroadenoma
- Skin changes
- Free mobility
- Palpable nodes

75. What is wrong about necrotizing fasciitis
- Debridement is the most important step
- Vaccination against organism is important
- caused by C. perfringens

76. The lease important step in management of dirty wounds
- check anti-tetanus status
- debridement
- local antibiotics

77. About chemical injuries
- Topical Cagluconate is useful in acid injuries

78. Wrong about lactated Ringer's
- Contraindicated in metabolic acidosis

79. What is wrong about appendicitis
- Peak incidence in the 5th and 6th decades

80. What is the most likely cause of involuntary bladder contractions
- Cystitis
- Sacral spinal injury
- Suprasacral spinal injury
- Infrasacral spinal injury

81. What is true about piles
- Hemorrhoids above the dentate line may bleed


84. Which of the following is wrong about the association of Gastric
Cancer:
-B12 deficiency and gastrectomy
-Intestinal type responds to imatinib
-Helicobacter Pylori and Gastritis

85. Sloping edge is associated with:
-Rodent Ulcer
-Healing Ulcer
-Ischemic Ulcer


86. Which of the following is associated with an increase in Alpha-
Fetoprotein:
-Non-Seminomatious Testicular Tumor
-Malignant Thymoma
-Mature Teratoma


87. Which of the following is false regarding a Pilonidal Sinus:
-Congenital in origin
-Occurs in the natal cleft
-Occurs more in hairy men
-presents with pain and soiling
-recurs after surgery

88. Regarding the ABCDE of primary survey which is wrong :
- A for Airway
- B for Bone fracture splinting
- C for Circulation
- D for neurological defects
- E for exposure

89. Regarding IBD which is true
- incrohn's disease surgery is indicated only for complications
- extraintestinal manifestations are indication for surgery

90. Most common cause of intestinal obstruction
-Post surgical adhesions
-Congenital bands