HAAD GENERAL SURGERY EXAM 6Welcome to HAAD GENERAL SURGERY EXAMEXAM MODEExam mode Enhance you to attend the Questions with a time limit. At the end of the exam you will get the result and you can review the correct answersPlease click on the Next Button to Start the ExamNameBusinessEmailPhone NumberPatient with strong genetic factor for colon cancer, what is the medication that could decrease the risk of colon cancer? Vitamin EVitamin CZincFolic acidHintWater in the body: Difference depend on age and sex40 %HintCase scenario (patient present planter fasciitis) Treatment: SiliconCorticosteroid injectionHintPatient with heart disease complain of lower limb ischemia your advice : Vascular surgeryStart heparinReferred to cardiologyHint70 years old patient presented with wight loss , fatigue , anemia , upper quadrant pain :Chronic pancreatitisPancreatic carcinomaAcute pancreatitisHintPatient has car accident which of the following trauma will happen to him? flail chestpneumothoraxTamponade of the heartall of the aboveHintChild has tracheoesophageal fistula, all can be used in management, except : Insertion of NGTPulmonary toiletInsertion of chest tubeGastrostomyHint37 years old post cholecystectomy came with unilateral face swelling and tenderness. Past history of measles when he was young. On examination moist mouth, slightly cloudy saliva with neutrophil and band cells. Culture of saliva wasn't diagnostic. What is the diagnosis? Salivary gland stoneParotid cancerSalivary gland tumorBacterial SialadenitisSjogren SyndromeSarcoidosisHintFemale patient is complaining of abdominal distension, fever and nausea abdominal x-ray showed "Ladder sign" management is: Ileus treatmentRectal de-obstructionColostomyexploratory laparoscopyHintAcute appendicitis: With perforation will show fecoliths in 10% of casesPresents with vomiting in 25% of cases.Without perforation will show fecoliths in fewer than 2% of casesOccurs equally among men and womenHas decreased in frequency during the past 20 years.HintA 48 years old man complaining of right lower quadrant pain, bleeding per rectum, nausea & vomiting. What is the best pre-operative investigation? Fecal occult bloodCBCAir contrast enemaColonoscopyHintThe management of breast engorgement: cold compression with stoppage of breast feedingcloxacillin with continue breast feedingWarm compression with continue breast feedingHint15 years old with pilonidal sinus so treatment : local antibioticdaily cleanIncision surgeryHint40 years old male drug addicted and alcoholic of 25 years duration admitted with a 12-Ib weight loss and upper abdominal pain of three weeks duration. Examination reveals a mass in the epigastrium. His temperature is 99F and white cell count is 14,000.The most likely diagnosis is : Sub-hepatic abscessSplenic vein thrombosisBiliary pancreatitisPancreatic pseudocystHepatic abscessHintBest investigation to visualize the cystic breast masses is: CTMammogramMRIUSHintCost effective to decrease incidence of getting DVT post op :Unfractionated heparinWarfarinLM heparinASAHintFactor which determine recurrence of breast cancer : Number of lymph nodesPositive estrogen receptorSite & size of breast massPositive progesterone receptorHintSurgery in C3 colon cancer : PalliativeDiagnosticCurativeHintWhat is the most common complication of acute pancreatitis? PseudocystBowel obstructionAbscessHintPatient is complaining of 10 days anal fissure: So deep reaching the sphincterAt site of 12:00Conservative managementAssociated with loose bowel motionHintMiddle age male came to you gunshot to his femur, when you explore you found a 5 cm destroy of the superficial femoral artery what you will do? Debridement and saphenous graftDebridement and prosthetic graftDebridement and venous graftLigation and ObservationDebridement and arterial graftHintA 55 yr old man presenting with history of streaks of blood in stool and dull pain on defecation that persists for half an hour after defecation, on examination there was a 3x2 cm thrombosed mass at 3 o’clock. What is the management? Application of local anesthetic and incision.Application of local anesthetic and incision.Application of antibioticSitz bath 5 times/ dayBand ligation and wait for it to fallHintFacial suture, when should it be removed: 3 to 5 Days2 weeksU should use absorbable sutureHintUseful finding in acute appendicitis: WBC more than 14.000AgeHint2 years old boy has rectal pain, bleeding with perianal itching and constipation for 3 days, physical examination revealed a perianal erythematous rash which extend 2 cm around the anal ring, most likely Dx: Rectal polypMalacoplakiaUlcerative colitisAnal fissureStreptococcal infectionHint RTA with hip dislocation and shock so causes of shock is: NeurogenicBlood loseHint15 years old boy with dark urine, dark brown stool, positive occult test, what to do? Abdomen ultrasoundX-RayIsotope scanbariumHintWhich of the following is true concerning inhalation injury? Normal bronchoscopic exam upon admission excludes the diagnosis.Fluid administration rate should not be decreased because of the lung injury.History of injury in open space excludes the diagnosis.Carboxyhaemoglobin level of 0.8% excludes the diagnosis50% of patients with positive bronchoscopy require ventilatory supportHintWhat is the percentage of The Benign tumors of the Stomach? 20%77%7%90%Hint Case of burn swelling, redness and hotness: 1st degree of burn2nd degreeprodermal3rd degreeHintWhich role used to calculate burn surface area in case of burn:SevensixNineHint35 years old smoker, on examination sown white patch on the tongue, management:No treatmentClose observationAntibioticsExcisional biopsyHintPatient presented with leg swelling, what is the best method to diagnose DVT?Duplex USvenographyHint 43 year old sustained traumas to the chest present with severe short of breath with cyanosis, his right lung is silent with hyper-resonance. The FIRST step to treat this patient: endotracheal tubeseries x-raypneomonectomyO2 maskchest tube for drainage tube thoracostomyHint Newborn baby with umbilical hernia what you will say to his family? Surgical management is needed urgentlySurgical management is needed before school ageReassurance that commonly will resolved in year of lifeGive appointment after 1 monthHintPatient with submandibular swelling associated with pain during eating, what is your first investigation? MRICTX-rayUSHint Which of the following is the most potent known stimulator of gastric acid secretion? GastrinCholecystokininAcetylcholine BPepsinogenEnterogastroneHintCase scenario patient present with acute symptoms of bloody diarrhea, Diagnosis, acute ulcerative colitis, the initial treatment for this patient : methotrexateAminosalicylic acidcorticosteroid therapysulfasalzineHintPatient with long history of UC on endoscopes see polyp and cancer lesion on left colon so ttt : Left hemicolectomytotal colectomytreatment of anemiaremove polypHintThe single blood test performed by a good laboratory that would be expected to be the most sensitive for determining whether the patient is euthyroid, hypothyroid or hyperthyroid is: Total T3Free T4.Total 4.T3 uptake.TSH (thyroid stimulating hormone)HintThe most common cause of dysphagia in adults is:Paraesophageal hernia.Esophageal diverticulum.Sliding hiatus herniaAchalasiaCarcinomaHintPatient has history of adult respiratory distress syndrome develop pneumothorax what is the cause? O2Positive ventilation pressureHintThe most common cause on chronic interrupted rectal bleeding is:HemorrhoidsDiverticulosisHintAll are complication of laparoscopic cholecystectomy EXCEPT: Restlessness rate increasesEarly mobilizationAdmission duration usually less than 2 daysWound infection is the common complicationHintConcerning the treatment of breast cancer, which of the following statement is false? The treatment of choice for stage 1 disease is modified mastectomy without radiotherapyA transverse mastectomy incision simplifies reconstruction.Patients receiving radiotherapy have a much lower incidence of distant metastasesPatients who are estrogen-receptor-negative are unlikely to respond to anti-estrogen therapy.Antiestrogen substances result in remission in 60% of patients who are estrogen-receptor-positiveHint Which vitamin has a protective effect against colon cancer : vitamin DFolic acidvitamin KVitamin CHintWhich of the following breast mass is bilateral? Lobular carcinomaMucinous carcinomaPaget diseaseHintFemale about 30 years with breast cancer (given CBC, chemistry and ravel low hemoglobin and hematocrit), what is the next step in management? LumpectomyMastectomyStagingChemotherapyHintMale singer with colon cancer stage B2: which of the following correct? One lymph node metastasisTwo lymph node metastasisNo lymph node metastasesLymph node metastasis + distant metastasisHintPatient with mastitis the most suitable antibiotic : Dicloxacillinanti staphcloxacillinDoxycyclineFlucloxacillinHintpatient sustained abdominal trauma and was suspect intra-peritoneal bleeding, the most important diagnostic test : Diagnostic peritoneal lavage DPLCT scan if the patient stableHintAbout hemorrhoid: More in people more than 50 years & pregnant ladiesInternal hemorrhoid is painless unless associated with prolapseHint 30 years old female presented with painless breast lump. Ultrasound showed a cystic lesion. Aspiration of the whole lump content was done and was a clear fluid. Your NEXT step is: Send the aspirated content for cytology and if abnormal do mastectomy.Put the patient on contraceptive pills and send her home.Reassure the patient that this lump is a cyst and reassess her in 4 weeks.Do nothing and no follow-up.Book the patient for mastectomy as this cyst may change to cancer.Hint 2 tests are most specific in screening of hepatocellular cancer : Ultrasound and alpha Fetoproteinliver biopsy and Alfa Fetoproteinct and liver function testU/S and liver biopsyHint42 year old woman presented with a painful breast mass about 4 cm in the upper lateral quadrant. It increases in size with the menstrual period. Examination showed a tender nodularity of both breasts. What is the management: Hormonal treatment with danazolLumpectomyHormonal treatment with oral contraceptive pillsObservation for 6 monthsHint58 years old very heavy alcoholic and smoker. You find 3 cm firm mass at Right Mid cervical lymph node, Most appropriate next step is : CT of trachea.Indirect laryngoscopy.Fine needle aspiration biopsy.CT of brainExcisional biopsy.HintComplications of colostomy are all the following EXCEPT:ProlapseExcoriation of skin.RetractionMalabsorption of waterObstructionHintFree fluid accumulate in abdominal cavity cause: Cardiogenic shockSepsisHypovolemic shockEmesisHintFacial nerve when it exits the tempromandibular joint and enter parotid gland it passes: Deep to retromandibular veinBetween ext. carotid artery and retromandibular vesselsSuperficial to retromandibular vein and external carotid arteryDeep to ext. carotid arteryHint The most common cause of esophageal perforation is: Postemetic rupture.Instrumentation.Carcinoma of the esophagus.Penetrating trauma.Caustic ingestion.HintChild swallowing battery in the esophagus management: Insert Foley catheterObservation 12hrsbronchoscopeRemove by endoscopeHintWhich of the following is true concerning hemorrhoids? They are: Which of the following is true concerning hemorrhoids? They are:Usually associated with anemiaDue to high bulk diet.Usually due to cirrhosis.A source of pain and purities.Hint36 years old female with breast mass mobile and change with menstrual cycle, no skin dimple or fathering. Your advice is Make biopsyFine needle aspirationRepeat exam after 2 cycleOral contraceptionHintStress ulcers can be found in all EXCEPT: AspirinCNS lesions.BurnsPenicillinHintAll of these diseases are predisposing to gastric cancer except: H. pyloriLinitis plasticapernicious anemiaPeptic ulcerAll of the aboveHintPost laparoscopic cholecystectomy patient presented with progressive Jaundice. The most appropriate investigation is: IV cholangiogramERCPHintIndication of tracheotomy, all true except: Left recurrent nerve cutCA larynxforeign body in larynxIn some procedure which involve in radiation exposureNone of the aboveHintPapillary carcinoma of the thyroid is characterized by all of the following EXCEPT: Older patients have a worse prognosis than younger patients.The tall-cell variant has a worse prognosis.It is associated to childhood exposure to x-ray irradiation.Commonly metastasizes to the paratracheal nodes adjacent to the recurrent nervesOlder patients are more likely to have nodal metastases.HintThe greatest risk of developing chronic hepatitis and cirrhosis occurs after: Hepatitis B infectionHepatitis C infectionHepatitis A infectionHintPatient was presented by constipation, vomiting, abdominal distension, with old scar in the lower abdomen, X ray showed dilated loops with air in the rectum, what is the best initial management? Rectal decompression and antibiotics.SuppositoriesSuppositoriesHintWhich of following mostly occur in a patient with intracranial abscess?VomitingEar dischargeCoughFrontal sinusitisHintA wound stays in its primary inflammation until : Epitheliazationafter 24 hoursEscher formationWound cleaningHintFemale with neck swelling firm, large, and lobulated, positive antibodies against thyroid peroxidase, what is the diagnosis? gravesHashimoto's thyroiditisHintA patient with mixed 1st& 2nd degree burns in head & neck region, what is the most appropriate management? Apply cream to 2nd degree burns and cover them, give IV fluidsDebridement of 2nd degree burns .Apply silver sulfadiazine and cream to all burned areas, cover them, IVF & admit to hospitalApply silver sulfadiazine then Vaseline ointment to all areas then discharge the patientHintThe most accurate tool for diagnosis of appendicitis: Diagnostic laparoscopyCT scanUSHintPatient with scrotal pain & swelling, on examination: tender swelling & tender node in groin, increased intestinal sounds, one episode of vomiting & abdominal pain, management? Refer to surgeonRefer to urologistAsk ultrasoundHintThe most lethal injury to the chest is : Rupture aortaflail chestpneumothoraxcardiac contusionHint17 year complaining of right iliac fossa pain rebound tenderness +ve guarding what is the Ix that u will do? ultrasoundCT scanLaparoscopyHint Patient diagnosed with obstructive jaundice best to diagnose common bile duct obstruction: USERCPHintBreast cancer in female under 35 years all of the following are true EXCEPT: The sensitivity of the mammogram alone is not enough for diagnosisFamily history of benign or malignant disease is predictive of diagnosisDiagnosis and treatment are delayed due to the enlarged number of benign diseaseAll discrete breast lumps need fine needle aspirationHint45 year old female come to the ER complaining of right hypochondrial pain which increases with respiration , on Ex there is tenderness over the right hypochondrium, Next investigation is : US of upper abdomenCTX-rayHint 46-year-old female presents with a painful mass I x2 cm in the upper outer quadrant of the left breast. There are areas of ecchymosis laterally on both breasts. There is skin retraction overlying the left breast mass. What is the most likely diagnosis?ThrombophlebitisSclerosing adenosisHematomaFat necrosisIntraductal carcinomaHintParaplegia patient with ulcer in lower back 2+2 cm and lose of dermis and epidermis these ulcer in stage: IIIIIIIVHint Best diagnostic tool in acute diverticulitis : Barium enemacolonoscopyCTsigmoidoscopyHint Patient with testicular mass non tender and growing on daily basis. On examination epididymis was normal, what you will do? Refer him to do US and surgical openingRefer pt to do open biopsy or percutaneous biopsyHintLactation mastitis treatment is :CiprofloxacinCephalexinDoxycyclinGentamicinHintWhich of the following liver tumors is often associated with oral contraceptive agents? Liver cell adenomasKlatskin's tumorFocal nodular hyperplasiaHepatocellular carcinomasAngiosarcomsHint Female com with lump in breast which one of the following makes you leave her without appointment? Blood on aspirationSolidCystic lesion with serous fluid that not refill againFibrocystic change on histological examinationHintRelative to the complications that may be associated with thyroidectomy, which of the following statements is correct? The clinical manifestations of postoperative hypoparathyroidism are usually evident within 24 hours.Inadequately treated permanent hypoparathyroidism can lead to mental deterioration.A non-recurrent left anterior laryngeal nerve is present in every 100 to 200 patientsTracheostomy should be performed routinely after surgical evacuation of a postoperative hematomaWhen papillary carcinoma metastatizes to the lateral neck nodes, the internal jugular vein is routinely removed during the dissectionHintVictim of RTA came with multiple injuries to abdomen, chest and limbs. BP is 80/ 50. upper limb has upper third near amputation that bleeds profusely , what is your first thing to do : tourniquet the limb to stop the bleedingcheck the airway and breathingcall orthopedicgive IV fluidHintPatient came with redness of finger, you give augmentin for one week but no improvement, so what you will do now? Incision and drainage under local anesthesiaGive augmentin for another weekIncision and drainage under general anesthesiaChange antibioticHintElderly male patient underwent colectomy for colon cancer in which micrometastais was detected in the lymph nodes, what is the best explanation? Good prognosis.It is sensitive to chemotherapy.It is locally advanced.HintPatient with right upper quadrant pain, fever, sweating, on examination tender Hepatomegaly, the investigation shows positive amoeba: what is your diagnosis? Amebic liver abscessPyogenic liver abscessHintFemale patient presented with tender red swelling in the axilla with history of repeated black head and large pore skin in same area: treatment is : Topical antibioticCold compressorImmediate surgeryOral antibioticHint6 months baby with undescending testis which is true: in most of the cases spontaneous descent after 1 yearsurgery indicated when he is 4 yearsTell the mother that he need surgeryunlikely to become malignantHintPatient with bilateral breast cancer which type? Invasive ductal carcinomaLobulatedHintThe most common cause of hypercalcaemia in a hospitalized patient is: Drug related, such as the use off thiazide diureticsDehydrationGranulomatous diseaseDietaryCancerHintRegarding infection in the finger bulb, all true except:Has loose fibrous attachmentCauses throbbing painCan progress to collar abscessHintFemale 13 years old , came complaining of mass in her left breast in lower outer quadrant , it is soft tender about 2 cm in size , patient denies its aggravation and reliving by special condition her menarche is as age of 12, what is diagnosis : Fibrocystic diseaseFibroadenomaHintWhich of the following diseases is NOT frequently associated with pyogenic liver abscesses : DiverticulitisOmphalitisUrinary tract infectionCholangitis secondary to biliary obstructionHepatic artery thrombosis post liver transplantHintBe sure to click Submit Exam to see your results! Time's upSubmit a Comment Cancel replyYour email address will not be published. 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