UZ archives

1. Fractures- True or False

a. Greenstick fractures of the forearm usually require 8 to 10 weeks immobilization in a

plastercast
b. A displaced closed simple tibial fracture in an adult usually unites 6-8 weeks after an injury
c. Isolated closed humeral fractures frequently result in non-union when conservative
treatment is applied
d. An impacted subcapital neck of humerus fracture is frequently complicated by avascular
necrosis
e. A fracture of a long bone in an adult is considered a “nonunion” if no union is present 3
months after the injury

2. Two hours after application of the plaster cast for supracondylar fracture the patient comes with
severe pain and swollen and cyanotic hand. The best course would be to

a. Observe the patient

b. Administer vasodilators

c. Administer analgesics

d. Cut open the plaster cast near the fingers

e. Cut open the entire plaster cast immediately

3. Infection
a. Osteomyelitis caused by salmonella orgasim should arouse suspicion of sickle cell anemia or
some other hemoglobinopathy
b. Penicillin G is the drug of choice for non penicillinase producing staphylococci
c. If on radiological examination the periosteum is elevated or bine is destroyed, then
osteomyelitis has been present for at least 5 days
d. Radionuclide bone scans have proved to be helpful in the early diagnosis of osteomyelitis
e. When osteomyelitis is suspected in the metaphysis of the proximal femur in association with
a septic arthritis of the hip it is better to decompress the intertrochanteric area together
with the hip joint

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4. Amputations
a. When performing an amputation the periosteum should be stripped excessively to avoid
sequestra or reactive bone formation
b. Amputation of all toes causes severe disturbances in ordinary slow walking
c. The ideal level of amputation below the knee is 14cm below the knee
d. The stump after a knee disarticulation is an end-bearing stump
e. The ideal level of an above knee amputation is just above the condyles

5. Traumatic infections of the joints

a. The lateral meniscus is more frequently injured than the medial
b. The majority of ligamentous sprains of the lateral ankle can be treated by immobilization
c. A painful arc syndrome of the shoulder is the main clinical symptom of full ruptures of the
rotator cuff
d. Isolated anterior cruciate ligament ruptures of the knee are relatively rare
e. In tennis elbow the pain is localized to the medial epicondyle

6. Consider plaster casts

a. Fractures of the scaphoid should be immobilized with the thumb extension
b. Fractures of the tibia and fibula require a full leg plaster
c. Solitary fractures of the ulna mid shaft without displacement require a below elbow plaster
d. It is good standard practice to take arm plasters as far distally as the proximal finger crease
e. Colle’s fracture requires an above-elbow plaster

7. Complications of pelvic fractures

a. Hemorrhage
b. Rupture of the bladder
c. Rupture of the urethra
d. Osteoarthritis of the hip
e. Leg length discrepancy

8. Sciatica from an actual prolapsed intervertebral disc

a. Most commonly occurs in the over 40 year age group
b. Rarely occurs in women
c. Is usually caused by a sudden twisting injury of the spine
d. Most commonly involves the second lumbar nerve root
e. Requires urgent operative treatment to relieve pain

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9. The basic principle of treatment of fractures of both bones of the forearm is to
a. Reduce the angulation of the ulnar
b. Reduce the angulation of the radius
c. Prevent overriding the fragments
d. Restore the normal relationship of the radius and ulnar
e. Immobilise the elbow only

10. In congenital dislocation of the hip

a. The diagnosis is usually established at 3 years of age
b. Abducting the flexed hip causes a click
c. Abduction of the flexed hip is not limited
d. Apparent lengthening of the affected thigh with the hip and knees flexed may be seen
e. Initial treatment is by open reduction

11. Initial treatment of a midshaft femoral fracture in an adolescent is

a. Open reduction and internal fixation
b. Closed reduction and internal fixation with Kuntscher nail
c. Skeletal traction
d. Cast brace
e. 1 ½ hip spica

12. Pathological fractures occur in

a. Tumors
b. Developmental diseases
c. Metabolic conditions
d. Infections
e. Sarcoidosis

13. Bone tumors

a. The commonest malignant tumor of bone is osteogenic sarcoma
b. The prognosis is of osteosarcoma following Paget’s diseases is good
c. The osteosarcoma is the commonest benign tumor affecting long bones
d. The osteosarcoma seen in the teenage group may mimic acute osteomyelitis
e. Histologically it may be difficult to differentiate a Ewig’s sarcoma from high grade
lymphoma.

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14. Bone tumors
a. Bone marrow aspiration is a diagnostic technique in suspected malignances that involve
bone
b. With the exception of Ewig’s tumor, lymphoma, leukemia and myeloma most malignant
tumors are relatively radio resistant and surgery offers better local control than
radiotherapy
c. In unicameral cysts surgery is indicated primarily because of diminished strength of bone
and risk of sustaining s pathological fracture
d. Osteosarcoma is most frequently seen around the ankle and wrist
e. Multiple myeloma is a malignant neoplasm derived from the plasma cells and usually a
normal protein synthesis is seen

15. Regeneration of a peripheral nerve is

a. From Schwann cells
b. At a rate of 1,5mm/day
c. Complete if continuity is intact
d. Impaired by infection
e. Improved by steroid therapy

16. A blow-out fracture of the orbit is characterized by

a. Enophthalmos
b. A fractured orbital roof
c. A fractured orbital floor
d. Free mobility of the eye movement
e. Inability to look up and down

17. Intracranial hematoma commonly results in

a. Mass effect
b. Anemia
c. Cranial nerve palsies
d. Paraplegia
e. Hypertension

18. Mixed parotid tumors (pleomorphic adenoma) are

a. Commonly situated over the angle of the mandible

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 b. Best treated by radiotherapy alone
c. Likely to recur if enucleated from surrounding tissue
d. Commonly present with facial palsy
e. Never malignant

19. With which of the following primary sites are malignant cervical glands commonly associated
a. Nasopharynx
b. Vocal cords
c. Maxillary sinus
d. Tonsil

20. A 20 year old male sustains a depressed fracture of the skull, 3cm in diameter. There is overlying
5cm scalp laceration but no other abnormal findings. Which of the following courses would you
recommend
a. Immediate elevation of the depressed fracture
b. Close the scalp laceration and send the patient home immediately
c. Close the scalp laceration and admit for observation, planning to elevate the depressed
fracture later
d. Give antibiotics
e. Be prepared to operate if the patients level of consciousness deteriorates

21. In total transection of the spinal cord following vertebral injury there is immediate
a. Spastic paralysis and positive Babinski sign:in spinal cord injury
b. Loss of motor power but no to sensation
c. Loss of sensation but not motor power
d. Flaccid paralysis and loss of all modalities of sensation ?
e. Transitory loss of consciousness

22. Retinoblastoma may clinically present as

a. White reflex in pupillary area
b. Strabismus of the affected area
c. Enlarged hazy cornea
d. Secondary glaucoma
e. Proptosis of the affected eye

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23. Which of the following conditions may occur as sequels to a head injury
a. Hypersomnia
b. Pulmonary oedema
c. Pulsating exophthalmos
d. Epilepsy
e. Diabetes Mellitus
24. In acute head injury cerebral angiography is indicated by
a. Presence of sever focal neurological deficit
b. Failure in improvement of mild focal neurological deficit
c. Failure improvement of depressed level of consciousness
d. Progression of focal neurological deficit
e. Decreasing level of consciousness

25. The neuromuscular blocking effect of curare is reversed by *

a. Di-ethyl ether
b. Cholinesterase
c. Gallamine triethiode
d. Neostigmine
e. Adrenaline

26. A patient with partial respiratory obstructions using his accessory respiratory muscle
a. He may be intubated awake under local analgesia
b. He may be slowly anaesthetized with an inhalation agent before intubation
c. He may be deeply anaesthetized with Thopentone and paralyzed with Suxamethrium
before intubation
d. He should be intubated
e. He should not be anaesthetized

27. A caudal epidural provides good analgesia for

a. Operations on the face
b. Dilatation of the cervix
c. Thoracotomy
d. Hemorrhoidectomy
e. Reduction of Colles fractures

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28. Which of the following compounds may form explosive mixture in oxygen at one atmosphere
pressure
a. Di-ethyl ether
b. Halothane
c. Methane
d. Chloroform
e. Ethyl chloride
29. Patients receiving medication with the following drugs run the risk of hypotension during
anesthesia because of their effect on the cardio-vascular system:
a. Reserpine
b. Cortisone
c. Neomycin
d. Codeine
e. Propranolol
30. Which of the following features occur with eosophageal atresia without trachea-esophageal
fistula?
a. Maternal hydraminos
b. Multiple fluid levels on abdominal X-ray
c. No sign of gas in the gut on the abdominal X-ray
d. Frothing at the mouth with attempts at feeding
e. A pigmented area over the sacrum
31. An otherwise normal, full-term infant is born with a ruptured exomphalos. The extruded gut is
viable. Which of the following forms of treatment would you advise?
a. Do nothing
b. Cover the gut with Vaseline gauze and prescribe antibiotics
c. Perform an operation to restore the contents to the abdomen
d. Perform an operation, resecting the extruded contaminated gut and closing the
abdominal wall
e. Perform an operation to enclose the extruded gut in an artificial covering nit reducing it
into the abdominal cavity
32. Radiotherapy to the brain is indicated during the course of routine treatment of which of the
following diseases?
a. Carcinoma of bronchus
b. Meningitis
c. Subdural hematoma
d. Acute leukemia
e. Hydrocephalus
33. The administration of radiotherapy to the abdomen may give rise to
a. Nausea
b. Diarrhea
c. Alopecia of scalp
d. Venous thrombosis

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 e. Renal stones
34. A patient is admitted to the hospital 30 minutes after sustaining deep burns of the head and
neck, trunk and upper limbs. The total area involved is 40% body surface and the patient is 25
years old and weighs 70kg. Which of the following procedures and courses of action would you
carry out?
a. Administer morphine, in fractional does, by intravenous injection.
b. Set up an intravenous drip of 5% Dextrose water to run at 8 drops per minute for the
next 48hours
c. Admit the patient in the hospital and administer copious oral fluids
d. Order the patient to receive anti-tetanous toxoid
e. Set up an intravenous drip, with a planned regime related to body weight and area
burned
35. A lobulated of the lobe of the ear on the young girl following piercing of the ear should be
treated by:
a. Simple excision
b. Simple excision followed by radiotherapy
c. Radiotherapy followed by local excision
d. Shaved down with a sharp knife
e. Injection of the sclerosant solution
36. A patient is involved in a motor vehicle accident and his right hand is abraded against the road,
causing the loss of all the skin on the dorsum of the hand, together with the extensor tendons
and periosteum of the metacarpals. There are no other serious injuries. Which of the following
procedures should be carried out?
a. Split thickness skin graft (Thiersh)
b. Full thickness skin graft (Wolfe)
c. Full thickness flap form the chest
d. Amputation through the forearm
e. Daily toilet and dressing and await healing
37. A man has cut the palmar aspect of his wrist with a sharp knife, and is bleeding profusely.
Haemostasis should be obtained immediately by which of the following?
a. 10cc of Premarin by iv injection
b. Local application of adrenaline solution 1:10 000
c. The application of a tourniquet around the middle forearm
d. Elevation of the and application of a firm bandage over the wound
e. The use of artery clamps
38. A patient with 30% burns of the limbs is brought in 8 Hrs after the burn. He has had no
treatment. What does he need urgently
a. Correct splinting and antiseptic dressing
b. A full lab assessment of the electrolytes and proteins before treating
c. IV line and cvp set up and a urinary catheter inserted
d. A cold bath
e. IV analgesia in fractional doses

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 39. Match the comments in column B with the diagnosis in column A

Diagnosis Answer Comment

Keloid Gingival
fibroma
Desmoid Hypertrophied
wound scar
Epulis Fibroma with
mucoid
material
Giant cell Fibroma of
tumor anterior
abdominal
fascia
Myxoma Tendon
sheaths

40. A barium swallow radiograph in a patient complaining of difficulty in swallowing shows ireegular
asymmetric stricture with shouldering in its distal third. This suggests which of the following?
a. Cardiospasm (Achlasia of eosophahus)
b. Carcinoma of esophagus
c. Benign stricture
d. A dilated left atrium
e. Plummer-Vinson syndrome
41. A patient presents with cold hands. Which of the following X rays would be helpful?
a. Skull
b. Cervical spine
c. Thoracic inlet
d. Hands
e. Chest
42. An IVU reveals absence of excretion on the left side only. This may be due to the following
conditions?
a. Renal agenesis
b. Raised blood urea
c. Large vesical calculus
d. Obstructed ureter
e. Crossed ectopic kidney
43. Spleno-portography is valuable in the investigation of portal hypertension because:
a. It usually demonstrates the site of venous obstruction
b. It demonstrates the size of spleen
c. It indicated the degree of hypersplenism present
d. It enables the portal venous pressure to be indirectly measured
e. It helps the surgeon in siting a porto-systemic anastomosis

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44. A 50 year old patient, who had a partial gastrectomy for chronic duodenal ulceration 10 years
previously, is found on barium meal examination to have gastro-colic fistula. The most likely
cause is:
a. Carcinoma of the stomach
b. Ischemic bowel disease
c. Carcinoma of colon
d. Ulcerative colitis
e. Stoma ulceration
45. Which prostate surgery approach carries the lowest morbidity?
a. Transurethral
b. Suprapubic
c. Retropubic
d. Transperineal
e. Transabdominal
46. If an ileal conduit for urinary diversion is too long (eg 30 cm) it may cause:
a. Difficulty in constructing the left uretero-ileal anastomosis
b. Poor drainaige system
c. Eventual herniation of the stoma
d. Hyperchloremic acidosis
e. Hyponatremia
47. Recto-urethral fistulae are found with
a. Exstrophy of the bladder (ectopia vesicae)
b. Watering-can scrotum
c. Anorectal malformations
d. Double ureter
e. Hypospadias
48. In renal transplantation
a. Bilateral nephrectomy is preferred prior to transplant
b. Any evidence of infection in the recipient is a contraindication
c. Urine formation should be almost immediate after transplantation
d. The right kidney is preferred because its vessels are longer
e. Early sign of rejection are fever and reduced kidney function
49. For the definite diagnosis of a Wilm’s tumor the following investigations are important
a. IV urogram
b. Voiding cystourethrogram
c. USS of abdomen
d. Renal arteriogram
e. Vena cavogram
50. Bladder rupture
a. May be intraperitoneal
b. May be extraperitoneal
c. Is best diagnosed with cystogram

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d. Best diagnosed with an urethrocystoscopy
e. Has a high mortality rate when surgically dealt with after 24 hrs

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