Professional Documents
Culture Documents
Surgery Mock 1
Surgery Mock 1
Surgery Mock 1
References:
1. Comprhensive "AIO" Revision on SURGERY by Dr.Adel Abdel Hamid. 2008
2. Lange Q & A 5th Edition.
Breast
1. After intraductal papilloma, unilateral bloody nipple discharge from one
duct orifice is most commonly caused by which of the following pathologic
conditions?
A. Paget's disease of the nipple.
B. Intraductal carcinoma.
C. Inflammatory carcinoma.
D. Subareolar mastitis.
Answer: B
2. Which of the following conditions is associated with increased risk of
breast cancer?
A. Fibrocystic mastopathy.
B. Severe hyperplasia.
C. Atypical hyperplasia.
D. Papillomatosis.
Answer: C
3. Which of the following breast lesions are noninvasive malignancies?
A. Intraductal carcinoma of the comedo type.
B. Tubular carcinoma and mucinous carcinoma.
C. Infiltrating ductal carcinoma and lobular carcinoma.
D. Medullary carcinoma, including atypical medullary lesions.
Answer: A
4. A 36-year-old woman complains of a 3-month history of bloody discharge
from the nipple.
At examination, a small nodule is found, deep to the areola. Careful
palpation of the nippleareolar
complex results in blood arrearing at the 3 Oclock position. Mammogram
findings are normal. What is the likeliest diagnosis?
(A) Intraductal papilloma
(B) Breast cyst
(C) Intraductal carcinoma
(D) Carcinoma in situ
(E) Fat necrosis
Answer: (A) Intraductal papilloma is the most common cause of bloody
discharge from the nipple. The lesion is treated by excision and is benign in
Answer: D
18. A 45-year-old man complains of burning epigastric pain that wakes him
up at night. The pain is relieved by eating or using over-thecounter antacids
and H2 blockers. Diagnosis is best confirmed by which of the following?
(A) Urea breath test
(B) Serum gastrin levels
(C) Barium meal examination
(D) Upper endoscopy
(E) Upper endoscopy and biopsy
Answer: (E) Duodenal ulcer is best diagnosed by upper endoscopy and
biopsy. Findings of gastritis and the presence of H.pylori are indications to
prescribe appropriate therapy. This typically includes a PPI and two
antibiotics (one regimen includes amoxicillin and clarithromycin). Although
the urea breath test is the most sensitive and specific test used to detect H.
pylori, it is not readily available in all settings.
19. A 25-year-old male develops diarrhea and colicky abdominal pain.
Ulcertive colitus is
diagnosed on colonoscopy. Which of the following findings is consistent with
the diagnosis?
(A) The rectum is not involved.
(B) The disease is confluent, there are no
skip areas in the colon and the rectum is involved.
(C) The full thickness of the bowel wall is involved.
(D) Microscopic examination of the mucosa reveals normal cells without
evidence of dysplasia.
(E) The incidence of colorectal cancer is equal to that of the general
population.
Answer: (B) Ulcerative colitis is a disease of unknown etiology, which
involves the colon and rectum
and spares the remainder of the GI tract. Its clinical course is variable with
inflammatory
changes and clinical symptoms ranging from mild to severe. The process is
confined to the
mucosa and the submucosa and does not extend through the full thickness
of the bowel
wall. Inflammatory changes are confluent with no skip areas. The risk of
dysplasia and colorectal
cancer is higher in ulcerative colitis than in the general population.
20. A 1-week-old infant is brought to the hospital because of vomiting. An
upper gastrointestinal (GI) series reveals duodenal obstruction. On
laparotomy, annular pancreas is found. Which of the following statements
about annular pancreas is TRUE?
(A) Resection is the treatment of choice.
(B) It is associated with Downs syndrome.
(C) Symptoms usually begin with back pain.
(D) It is most likely due to abnormal rotation encircling the third part of the
duodenum.
Liver
21. Which of the following clinical situations are considered good indications
for PVS?
A. A 50-year-old cirrhotic man had an emergency portacaval shunt for
bleeding varices and postoperatively had an ascites leak and mild superficial
wound infection.
B. A 57-year-old woman with primary biliary cirrhosis (PBC) has difficult to
control ascites and diuretic-induced encephalopathy.
C. A 46-year-old resistant alcoholic has chronic ascites uncontrolled by
diuretics combined with repeat paracentesis.
D. A 34-year-old woman taking BCPs had rapid onset of ascites and is found
to have hepatic vein thrombosis causing the Budd-Chiari syndrome.
Answer: C
Spleen
22. Hodgkin's disease is a malignant lymphoma with four histologic
subtypes. Which of the following is not one of the subtypes?
A. Lymphocyte predominance.
B. Nodular sclerosis.
C. Mixed cellularity.
D. Lymphocyte depletion. E. Leukocyte-lymphocyte dominance.
Answer: E
Genato urenery
23. Ureteral obstruction:
A. Is associated with hematuria.
B. Is associated with deterioration of renal function and rising blood urea
nitrogen (BUN) and creatinine values.
C. Is commonly caused by a urinary tract calculus.
D. Usually requires open surgical relief of the obstruction. E. Is usually
associated with infection behind the obstruction.
Answer: C
24. A20-year-old unrestrained driver was involved in a motor-vehicle crash.
A computed tomography
(CT) of the abdomen revealed a large hematoma in the second portion of
duodenum. The rest of the abdomen is normal. The initial management of
this duodenal hematoma should be:
(A) Operative evacuation