1.

CS The test with the highest diagnostic yield for detecting a

colovesical fistula is:
A.Barium enema.
B.Colonoscopy.
C.Computed tomography (CT).
D.Cystography.
E.Cystoscopy.
E

2.CS Which of the following about diverticular disease is not

true:
A.It is more common in the United States and Western Europe
than in Asia and Africa.
B.A low-fiber diet may predispose to development of
diverticulosis.
C.It involves sigmoid colon in more than 90% of patients.
D.Eighty percent of general people develop diverticulitis
sometime during their lifetime.
E.It is the most common cause of massive lower gastrointestinal
hemorrhage.

3.CS The most common indication for surgery secondary to

acute diverticulitis is:
A.Abscess.
B.Colonic obstruction.
C.Colovezical fistula.
D.Free perforation.
E.Hemorrhage
A

4.CS Which of the following statements about familial

adenomatous polyposis (FAP) is true?
A.Inherited in an autosomal-dominant manner, this genetic
defect is of variable penetrance, some
patients having only a few polyps whereas others develop
thousands.
B.The phenotypic expression of the disease depends mostly on
the genotype.
C.Appropriate surgical therapy includes total abdominal
colectomy with ileorectal anastomosis
and ileoanal pull-through with rectal mucosectomy.
D.Panproctocolectomy with ileostomy is not appropriate therapy
for this disease.
E.Pharmacologic management of this disease may be
appropriate in some instances.

5.CS Surgical alternatives for the treatment of ulcerative colitis

include all of the following
except:
A.Colectomy with ileal pouch–anal anastomosis.
B.Left colectomy with colorectal anastomosis.
C.Proctocolectomy with Brooke ileostomy or continent
ileostomy.
D.Subtotal colectomy with ileostomy and Hartmann closure of
the rectum.
E.Subtotal colectomy with ileorectal anasthomosis.

B
6.CS Which finding suggest the diagnosis of chronic ulcerative
colitis as opposed to Crohn's
colitis?
A.Endoscopic evidence of back-wash ileitis.
B.Granulomas on biopsy.
C.Anal fistula.
D.Rectal sparing.
E.Cobblestone appearance on barium enema

7.CS Which of the following would be the least appropriate in

the management of acute
suppurative mediastinitis?
A.Wide débridement.
B.Irrigation under pressure.
C.Topical antibacterials.
D.Long-term systemic antibacterials.
E.Closure with muscle flaps.

8.CS Each of the following is appropriate for managing acute

suppurative mediastinitis except:
A.Alloplastic material and skin flaps.
B.Rectus abdominis muscle flaps.
C.Omentum.
D.Pectoralis major muscle flaps.
E.Rigid internal fixation.

9.CS The principal etiologic factor in lung abcess and gangene

is:
A.Bronchogenic.
B.Trauma.
C.Bronchiectatic disease.
D.Septic embolism.
E.Adjacent purulent focuses.

10.CS Wich microflora more frequently provokes developing of

pulmonary gangrene?
A.Protozoas.
B.Fungs.
C.Aerobic gram-positive microflora.
D.Aerobic gram-negative microflora.
E.Anaerobic nonclostridial microflora.

11.CS The most frequent localization of aspiration lung abcesses

is:
A.Basal anterior segments of inferior lobes.
B.Lateral segments of inferior lobes.
C.Apical segments of superior lobes.
D.Anterior segments of superior lobes.
E.Posterior segments of lung /predominantly superior lobes/.

12.CS Which of the following would be the least appropriate in

the management of acute suppurative
mediastinitis?
A.Wide débridement.
B.Irrigation under pressure.
C.Topical antibacterials.
D.Long-term systemic antibacterials.
E.Closure with muscle flaps.

D
13.CS Each of the following is appropriate for managing acute
suppurative mediastinitis except:
A.Alloplastic material and skin flaps.
B.Rectus abdominis muscle flaps.
C.Omentum.
D.Pectoralis major muscle flaps.
E.Rigid internal fixation.

14.CS When progressive enlargement of a multinodular goiter

causes symptomatic tracheal compression,
the preferred management in otherwise good-risk patients is:
A.Iodine treatment.
B.Thyroid hormone treatment.
C.Surgical resection of the abnormal thyroid.
D.Radioactive iodine treatment.
E.Immunosupresive treatment

15.CS The most precise diagnostic screening procedure for

differentiating benign thyroid nodules from malignant is:
A.Thyroid ultrasonography.
B.Thyroid scintiscan.
C.Fine-needle-aspiration biopsy (FNAB).
D.Thyroid hormone suppression.
E.Laringoscopy
C

16.CS The preferred operation for initial management of a

thyroid nodule that is considered
suspicious for malignancy by FNAB is:
A.Excision.
B.Partial lobectomy.
C.Total lobectomy and isthmusectomy.
D.Total thyroidectomy.
E.Enucleation of the nodule.

17.CS All of the following are components of the MEN type 2B

syndrome except:
A.Multiple neuromas on the lips, tongue, and oral mucosa.
B.Hyperparathyroidism.
C.MTC.
D.Pheochromocytoma.
E.Gastrinoma.

18.CS Addisonian crisis, or acute adrenocortical insufficiency:

A.Occurs only in patients with known adrenal insufficiency or in
those receiving long-term
supraphysiologic doses of exogenous steroids.
B.Can mimic an acute abdomen with fever, nausea and
vomiting, abdominal pain, and
hypotension.
C.May cause electrolyte abnormalities, including hypernatremia,
hypokalemia, hypoglycemia,
and hypercalcemia, as well as eosinophilia on peripheral blood
smear.
D.Should be diagnosed with the rapid ACTH stimulation test
before steroid replacement is
instituted.
E.May be effectively treated with intravenous “stress-dose”
glucocorticoid and mineralocorticoid
replacement.

19.CS Hyperthyroidism can be caused by all of the following

except:
A.Graves' disease.
B.Plummer's disease.
C.Struma ovarii.
D.Hashimoto's disease.
E.Medullary carcinoma of the thyroid

20.CS The most common cause of goitrous hypothyroidism in

adults is:
A.Graves' disease.
B.Riedel's thyroiditis.
C.Hashimoto's disease.
D.de Quervain's thyroiditis.
E. Plummer's disease.

21.CS Which of the following is the principal blood supply to

the parathyroid glands?
A.Superior thyroid arteries.
B.Inferior thyroid arteries.
C.Thyroidea ima arteries.
D.Parathyroid arterial branches directly from the external carotid
artery.
E.Highly variable.

22.CS The definitive treatment of choice for toxic multinodular

goiter is?
A.Total thyroidectomy.
B.Bilateral subtotal thyroidectomy.
C.Unilateral total lobectomy on the side of dominant disease.
D.131I treatment.
E. Thyroid hormone treatment

23.CS The goiter situated in mediastinum considered as:

A.Normotopic.
B.Ectopic.
C.Aberrant.
D.Mediastinal.
E.Sublingual.

24.CS Exophtalmus at patient with goiter is a result of the

compression of:
A.Internal jugular vein.
B.Internal carotid artery.
C.Recurrent nerve.
D.Cervical simpathecus.
E.None of above-mentioned.
D

25.CS Normal radioiodine uptake in 2 houres is:

A.10%.
B.20%.
C.30%.
D.50%.
E.70%.

26.CS All of the following are complications of peptic ulcer

surgery except:
A.Duodenal stump blowout.
B.Dumping.
C.Diarrhea.
D.Delayed gastric emptying.
E.Steatorrhea

27.CS The presentation of Zollinger-Ellison syndrome includes

all of the following except:
A.Hyperparathyroidism in patients with multiple endocrine
neoplasia type 1 (MEN 1) syndrome.
B.Diarrhea.
C.Migratory rash.
D.Jejunal ulcers.
E.Duodenal ulcers

C
28.CS All affirmations about the dumping syndrome are true
except:
A.Symptoms can be controlled with a somatostatin analog.
B.Diarrhea is always part of the dumping syndrome.
C.Flushing and tachycardia are common features of the
syndrome.
D.Separating solids and liquids in the patient's oral intake
alleviates some of the symptoms of the
syndrome.
E.Early postoperative dumping after vagotomy often resolves
spontaneously.

29.CS In patients with bleeding duodenal ulcers, the endoscopic

finding associated with the
highest incidence of rebleeding is:
A.Visible vessel.
B.Cherry-red spot.
C.Clean ulcer bed.
D.Duodenitis.
E.Shallow, 3-mm. ulcer

30.CS All of the following measures have been recommended

for control of acid secretion in
patients with Zollinger-Ellison syndrome except:
A.Antrectomy.
B.Highly selective vagotomy.
C.Total gastrectomy.
D.Vagotomy and pyloroplasty.
E.Medical therapy with Prilosec (omeprazole).
A

31.CS All of the following contribute to peptic ulcer disease

except:
A.Cigarette smoking.
B.Nonsteroidal anti-inflammatory drugs.
C.Helicobacter pylori.
D.Gastrinoma.
E.Spicy foods.

32.CS Which of following clinical situations after stomach

surgery sometimes need near total
gastrectomy?
A.Early dumping syndrome.
B.Late dumping syndrome.
C.Postsurgical gastroparesis.
D.Alcalina reflux gastritis.
E.Postvagotomic diarrhoea.

33.CS Which is the operation of choice in gastro-jejuno-colic

fistulas:
A.Double resection.
B.Triple resection with gastrojejunal and colo-colonic
anasthomosis.
C.Double-stage operation.
D.Triple-stage operation.
E.Total gastrectomy.
B

34.CS First of all the frequency of postoperative peptic ulcer is

determined by:
A.Age of the patient.
B.Anamnesis of the disease.
C.Ulcer’s localization and size.
D.Ulcer’s complications at the time of operation.
E.Type of primary operation.

36.CS After what type of operation for duodenal ulcer the

appearance of postoperative peptic
ulcer is less possible?
A.Gastroenteroanastomosis.
B.Partial gastrectomy.
C.Trunkular vagotomy with draining operation.
D.Trunkular vagotomy with antrumectomy.
E.High selective vagotomy

37SC. Fibroscopy reveals the third grade esophageal varices

which bleed,the gastric mucosa
without ulceration. Name the first method of hemostasis
A.Esophageal varices ligation
B.The resection of inferior esophagus with gastroesophageal
anastomosis
C.Plugging with Blackmore probe, pituitrina intravenous
D.Azygo-portal deconnection
E.Spleno-renal anastomosis
C

38.SC. What is the most safest and objective method of

diagnosing upper digestive
haemorrhages?
A.Fibro esophagogastroduodenoscopy
B.Barium radiography
C.Scintigraphy
D.Angiography
E.Diagnostic laparoscopy

39.SC. In treatment of cirrhous portal hypertension,what method

can be useful?
A.Drainage of Wirsung
B.Truncal vagotomy
C.Lien transplantation
D.Azygo-portal deconection
E.Left splenopancreatectomy

40.SC. What is the most common cause of portal hypertension?

A.Congestive pericarditis
B.The Budd-Chiari syndrome
C.Liver cirrhosis with intrahepatic dam
D.Quadrifurcation of the portal vein
E.The lien vein thrombosis
C

41.SC.In cirrhotic patients with portal hypertension,to assess the

liver function is used:
A.Ranson score
B.Algover index
C.Apgar score
D.Child criteria
E.Glasgow score

42.SC. The indication for Tanner surgery is:

A.Encefalopathy
B.Refractory ascites to medical treatment
C.Haemorrhagy through rupture of esophageal varices
D.Haemorrhagy through rupture of colonic varices
E.Haemorrhagy through rupture of rectal varices

43.SC.What is the wrong affirmation about the prehepatic form

of portal hypertension?
A.Occurs more frequently in children
B.Causes intermittent claudication
C.Distal spleno-renal anastomosis reduces portal pressure
D.Is caused by the development of congenital anomalies of the
portal vein
E.Causes the onset of digestive haemorrhagy
B

44.CS. Intermediate host for Echinococcus granulosus may be

any of the ones listed, except:
A.Sheep
B.Pig
C.Human
D.Dog
E.Horse

45.CS.Complications of the Hydatid disease of the liver are the

following, except:
A.The rift in the pleura, bronchi
B.The rupture in the abdominal cavity
C.The rupture in the biliary pathways
D.Pileflebita
E.Suppuration

46CS.What statement concerning the liver hydatid cyst is

incorrect:
A.Usually it’s unique
B.It is most commonly located in the left lobe of the liver
C.Serology is often positive for hydatidosis
D.It may erupt in biliary, pleura, abdominal cavity
E.Surgery is necessary

47.CS.The most common benign tumor of the liver is

represented by:
A.Liver lipoma
B.Liver hemangioma
C.Liver cystadenoma
D.Liver leiomyoma
E.Liver fibroma

48.CS.What statement concerning the hepatic alveolar

echinococcosis is true:
A.Ultrasound shows a single cystic image
B.It is transmitted primarily through foxes
C.It is often met especially in Moldova and southern Ukraine
D.It is caused by Echinococcus granulosus
E.Surgical treatment consists in the cysts liner

49.CS.One of the statements related to not parasitic liver cyst is

incorrect:
A.It has acute onset
B.It can appear after trauma
C.It is often without symptoms
D.Ecoguided punction is the optimal treatment solution
E.Some complications may appear in evolution

50.CS. The treatment of choice in hydatid cyst of liver is:

A.Chemotherapy
B.Surgery
C.Actinic therapy
D.Hormone therapy
E.Antibiotic therapy

B
51.CS.Marginal hepatic resection is indicated in liver
hydatidosis in the following situations:
A.In all kinds of hydatid cysts whatever their evolutionary stage
is
B.In suppurated hydatid cyst with liver piosclerosis
C.In hepatic hydatid cyst complicated with biliary fistula
D.Eruption in the abdominal cavity
E.In hepatic hydatid cyst located marginal

52.SC. The following radiological methods are used to diagnose

the mediastinal tumors and cysts,
excepting:
A.Radioscopy and radiography in two projections
B.Computed tomography
C.Pneumomediastinography
D.Angiography
E.Cystoscopicurography

53.SC.Which of the listed investigations confirms the

histogenesis of the mediastinal tumors?
A.Magnetic resonance imaging (MRI)
B.Computed tomography
C.Mediastinography
D.Morphological test
E.Pneumomediastinography

D
54.SC.Mediastinal tumors of embryonic origin are, excepting:
A.Dermoid cysts and teratomas
B.Primitive seminomas
C.Benign and malignant mesenchimal tumors
D.Primitive chorioepithelioma
E.Chordoma

55.SC.Mediastinal cysts of embryonic origin are, except:

A.Pleuropericardial mesothelial cysts
B.Bronchogenic cysts
C.Gastroenterogencysts
D.Parasophageal cysts
E.Meningocele

56. SC. The most frequent complication of mediastinal primitive

cysts is:
A.Malignant degeneration
B.Compression of adjacent organs
C.Haemorrhage
D.Perforation
E.Inflammation and suppuration

57. SC. Which affirmationis correct in the treatment tactics of

benign tumors and mediastinal
cysts?
A.Observation in dynamics
B.Surgical treatment
C.Radiotherapy
D.Chemotherapy
E.Combined treatment

58. SC. The most effective method of treatment in mediastinal

malignant tumors is:
A.Surgical treatment
B.Radiotherapy
C.Chemotherapy
D.Radiotherapy and chemotherapy
E.Combined surgical and chemotherapeutic treatment

59.SC.The basic (main) method in the treatment of primitive

malignant lymphomas of the
mediastinum is:
A.Surgical treatment
B.Radiotherapy
C.Chemotherapy
D.Surgical and chemotherapeutic treatment
E.Combined chemoradiotherapeutic treatment

.60.The following statements regarding the risk factors in the

development of cardiovascular
pathology are true except:
A.Hypertension
B.The high level of HDL cholesterol (high density cholesterol
fraction)
C.Age
D.Male gender
E.Diabetes mellitus

61.SC.The most rare atherosclerotic conditions are localized in:

A.The abdominal aorta
B. Intramural coronary arteries
C.Leg arteries
D.Brain arteries
E.External coronary arteries

62.SC.For radionuclear angiography, the following statements

are true, except:
A.The procedure performed for the first time allows the left and
right ventricle to be studied
B.The term - ejection fraction, is not based on geometric
parameters
C.Due to the high resolution properties, the first-time procedure
allows the morphological
valvular study
D.Radionuclear angiography may be useful in detecting
coronary heart disease caused by effort
E.This investigation may be useful for the prognosis of patients
who have had infarction

C
63.SC.Which of the following congenital heart disease are at
risk of septic endocarditis:
A.Persistent arterial duct
B.Tetrada Fallot
C.Subvalvular aortic stenosis
D.Interatrial septal defect
E.Interventricular septal defect

64.SC.One of the most important clinical investigations for the

differential diagnosis between the
foramen ovale (ostium secundum) of the interatrial septum and
ostium primum is:
A.Diffusion of the II sound
B.Prominence of the left sternal wall at palpation
C.Mezodiastolic sound in the lower left stern
D.Incomplete block of the left branch of Hiss bundle
E.Left axis deviation of the heart

65.CS For aortic coarctation it is not characteristic:

A.More commonly occurs in men
B.Frequently is associated with Turner syndrome
C.Frequently associated with the aneurysm in the circle of Willis
D.Frequently associated with the biluminal aortic valve
E.Increases the risk of aortic rupture in the first trimester of
pregnancy

E
66SC. Indicate what is not specific for the persistent arterial
duct:
A.It is more common in women
B.More frequently occurs in newborns with mothers who have
had rubella in the first trimester
of pregnancy
C.More frequently occurs in newborns with mothers who
underwent toxoplasmosis in the first
trimester of pregnancy
D.More often occurs in premature births
E.More often in newborns at high altitude conditions

67.CS.Which of the following is the fundamental

anatomopathological lesion of chronic
pancreatitis?
A.Wirsungian litiasis
B.Necrosis
C.Fibrosclerosis
D.Suppuration
E.Pseudocysts

68.CS. Which of the following are absent at the abdominal

radiographs specific to chronic
pancreatitis?
A. The sentinel loop
B.Calcifications in the pancreas area
C.Colonic pneumatosis
D.Hydroaergic images
E.Wirsungian stenosis

69.CS. Which of the following dietary measures have more

importance in the treatment of chronic
pancreatitis?
A.Increased intake of vitamins
B.Increased protein intake
C.Reduction of carbohydrate rations
D.Refuse of alcohol
E.Increased of plant intake

70.CS. Which of the following medical treatments can improve

the symptoms of chronic
pancreatitis?
A.Drugs with vasodilatation efects
B.Vitamins
C.Pancreatic substitution enzymes
D.Choleretics drugs
E.Propanolol

D
71.CS. Which of the following is the main indication of surgical
treatment in chronic pancreatitis?
A.Weight loss
B.Portal hypertension
C.Pseudocysts
D.Pain
E.Pancreatic calcifications

72.CS. Which of the following situations is indicate of the

Puestow operation (wirsungojejunostomy)?
A.Multiple Pseudochists
B.Infected Pseudocysts
C.Wirsung dilatation
D.Normal Wirsung
E.None of them

73.CS.The preferate method in the treatment of postnecrotic

pseudocyst of the pancreas in the
method up to 3 months is:
A.External drainage
B.Cystodigestive derivatives
C.Drainage of wirsung
D.The left splenopancreatectomy
E.Total pancreatectomy

74.CS.Pancreas cancers are translated by the following

phenomens, except:
A.Progressive Icter
B.Large palpable gallbladder
C.Pruritus
D.Angiocolitis
E.Atrophic liver
E

75.CS.Which method of treating the pancreatic pseudocyst is

preferable?
A.Exterpation
B.Marsupialization
C.Transparietal drainage
D.Internal derivation
E.None of them

76.CS. Gastro-duodenal BaSO4 transit and hypotonic

duodenography may next objectiv in
postcolecystectomic syndrome:
A.Tumors of the ampulla
B.Indirect signs of pancreatic tumor
C.Gastric tumors with invasion in the hepatic ligament
D.Duodenal disorders
E.All of those

77.CS. Retrograde endoscopic colangiopancreatography in

postcolecistectomic syndrome reveals:
A.Stenosis of papilla duodenalis mayor
B.Cholecystitis
C.Main benign and malignant biliary duct stenosis
D.Sclerogenic Angiocollitis
E.All of those
E

78.CS.In the profilaxy of postcolecistectomic syndrome is

important:
A.Complete pre- and intraoperative diagnosis
B.Correct surgical technique
C.A surgical tactic as appropriate as clinical situation
D.Using intraoperative colangiography
E.All of those

E
79.CS. Mechanical jaundice is caused by the following
pathological situations, except:
A.Choledocholithiasis
B.Cancer of the pancreas and papilla duodenalis mayor
C.Liver and gallbladder cancer
D.Primary and secondary malignant tumors of the liver
E.Duodenal malrotation

80.CS.Which of the surgical methods of recovery the bile

passage in the digestive tract in case of
tumors of the hepatopancreatoduodenal area are applicable
except:
A.Biliodigestive anastomoses with tumor removal
B.Biliodigestive by-pass anastomoses
C.Transtumoral stanting
D.External drainage associated with microjejunostomy type
Delany
E.Pancreatojejunostomy

E
81.CS.Which of the next afirmations are characteristic of acute
angiocolitis:
A.Fever with hectic thermal curve,
B.Fever with chills,
C.Sweating and thirsting,
D.Hepatomegaly,
E.All of those
E

82.CS.The primary bile duct need to be examined

intraoperatively at the patients with the
following pathologies, except:
A.Mechanical jaundice
B.Pseudotumorous chronic pancreatitis with jaundice
C.Dilatation of hepatocholedocus
D.Choledocholithiasis
E.Duodenal diverticol

83.CS.Malignant obstructive jaundice is usually expressed by

the following signs, except:
A.Fever with chills,
B.Jaundice
C.Weight loss,
D.Skin pruritus,
E.Dyspeptic sign

84.CS.What is the main anatomical element of intraoperative

exploration at the patient with
mechanical jaundice:
A.Liver,
B.Spleen,
C.Duodenum,
D.Bile duct,
E.Right colon.

85.CS.Which of the ways to penetrate biliary tract infections is

the main one:
A.The arterial way
B.Venous way
C.The lymphatic pathway
D.From the duodenum
E.By artero-venous shifts

86.CS.The scintigraphic image of the toxic adenoma shows:

A.Diffuse and homogeneous capture of the radioactive tracer
B.Diffuse but non-homogeneous capture of radioactive tracer
C.Catch in "chessboard"
D."Hot Node"
E."Cold node"

87. CS.Radioactive treatment with iodine in thyrotoxicosis has

the following indications:
A.Basedow disease
B.The toxic adenoma
C.Association of hyperthyreoidism with thyroid cancer
D.Thyroid hormone which induced the thyreoxicosis
E.Secondary hyperthyroidism of secondary thyroid tumors

88.CS.What drugs we used to treat thyreotoxicosis:

A.Mebendazole
B.Biseptol
C.Mercazolil
D.Omeprazole
E.Ampicillin

89.CS. 24 hours after a subtotal thyreoidectomy for

thyreotoxicosis, it occurs: agitation,
predelirium state, tachycardia - 180 /min, arhythmia,
hyperthermia. You're thinking ....
A.Paralysis of recurrenc nervs
B.Hipertireosis
C.Hipoparatireosis
D.Tyreotoxic crisis
E.Embolises

90. CS.Thyroid disorder complications include the following,

except:
A.Paresis of recurrent nervs
B.Mexedem
C.Tetanus crisis
D.Tyreotoxic crisis
E.Exoflatmic syndrome
D

91. CS. Which of the following changes produced by

compression of thyroid hypertrophy on
cervical sympathy nervs are correctly exposed:
A.Turgery, face cyanosis
B.Cardio-respiratory and gastric disorders
C.Bitonal voice, aphonia
D.Miosis, enophthalmia, bradycardia, palpebral ptoza
E.Cerebral disorders, lipotimia

92.CS. Which of these statements are correct:

A. In chronic thyroiditis Hashimoto, we detect anti-thrombolytic
and antimicrosomal antibodies
B. Basedov's disease reveals tireostimulatory immunoglobulins
(LATS-P)
C. Thyroid benign tumors are adenomas
D. Timoma is a thymus tumor
E. All statements are correct

93.CS.What is the exact name for the thyroid toxic adenoma?

A.It is also called Graves-Basedov's disease
B.It's called the Hashimoto goiter
C.It's called Plummer's disease
D.It is called the Ridel goiter
E.All statements are false

C
94.CS.The factors that trigger thyroid crisis are:
A.Suspension of therapy
B.Infective aggression or neuropsychiatric aggression
C.Insufficiently surgical interventions
D.All statements are false
E.All statements are correct

95.CS.The most sensitive and specific method of identifying

patients with Zollinger-Ellison
syndrome is:
A.Serum titration of anti-thyroid antibodies
B.Dosage of serum gastrinemia
C.Appreciation of kateholamines
D.Gastric juice Ph-metria
E.All listed
B

96.CS.The source of hemorrhage in digestive tract is localized

more frequently in:
A.Esophagus
B.Stomach
C.Duodenum
D.Small bowel
E.Colon

97.CS.Where is the demarcation line, starting from where we

can talk about upper and lower
digestive tract haemorrhages:
A.At the level of papilla of Vater
B.At the level of inferior duodenal flexion
C.At the duodenol-jejunal angle
D.With 30-50 cm distally from ligament Treitz
E.At the level of Bauhin valv

98.CS. From the clinical signs of haemorrhage the less relevant

as the criteria of severity of blood
loss is:
A.Hematemesis
B.Characteristics of pulse and arterial blood pressure level
C.Respiratory rate
D.Signs of peripheral vasoconstriction
E.Melena

99CS.The folowing system does not participate in the blood loss

compensation:
A.Nervous vegetative system
B.Cardiovascular system
C.Endocrine system
D.Hematopoietic system
E.Immune system

100.CS.About the influence of poor microcirculation on internal

organs in conditions of
hypovolemia, caused by blood loss, it is more easier to estimate
the functional disorders of:
A.Brain
B.Cord
C.Lngs
D.Large and small bowel
E.Kidneys

101.CS.From the methods of diagnosis of upper digestive

haemorrhage the priority has:
A.Endoscopy
B.X-ray with barium.
C.Scintigraphy
D.Angiography
E.Diagnostical laparotomy

102.CS. One of the most common causes of enteromezenteric

infarction is:
A. Obstruction of the arteries through embolism or thrombosis
B .Mesenteric venous thrombosis
C.Outside compression of the mesenteric vessels
D.Heart failure, arrhythmias, hypovolemia
E.Ttraumatic injuries of mesenteric vessels

103.CS. The main source of arterial embolism is:

A.Deep veins thrombosis of of lower limbs
B.Pathological processes in the left cord
C.Cord and artery operations
D. Aortic ulcer ateromatosis
E.Aortic aneurysm
B

104.CS. Spontaneous detachment and primitive thrombus

fragmentation may be favored by the
following factors, except:
A.Changes in strength and rhythm of cardiac contractions
B.Variations of TA
C. Physical and mental o overexertion
D. Autolysis of thrombotic masses
E. Administration of synthetic anticoagulants

105.CS. The relatively higher frequency of upper mesenteric

artery embolism than the inferior
artery is not related to:
A.Topography of the vessels
B.Caliber of the vessel
C.Angle of derivation from of the aorta
D.Atherosclerotic vessel changes
E.There is nothing of the above

106.CS. Ischemia of the entire small bowel and ceco-ascendent

segment occurs in case of
obstruction of:
A.Superior mesenteric artery in segment I
B.Superior mesenteric artery in segment II
C.Ileocolic artery
D.Left colic artery
E.Inferior mesenteric artery

107.CS. Organic changes caused by various pathological

processes are the main premise of
thrombosis of the superior mesenteric artery. More often in this
role is presented:
A.Obliterative thrombangeitis
B.Atherosclerosis
C.Periarteritis nodosa
D.Non-specific aorto-arteritis
E.Fibromuscular hyperplasia

108CS. In which aortic pathology the obstruction of superior

and inferior mesenteric arteries may
be simultaneous:
A.Atherosclerosis
B.Nonspecific arteritis
C.Dissecting aneurysm
D.Thrombosis
E.Embolism of bifurcation of aorta

109.CS. All factors, listed below, may contribute to the

appearance of non-occlusive mesenteric
circulation disorders, except:
A.Heart failure
B.Arithmia
C.Hypovolemia
D.Adrenomimetics
E.Cardiac glycosides

110.CS.In atherosclerotic stenosis of the internal carotid artery,

the method of choice of treatment
consists in:
A.Thrombendarterectomy
B.Resection with end-to-end anastomosis
C.By-pass
D.Ligation of the internal carotid artery
E.Administration of anti-thrombotic agents

111.CS.Treatment of arteriovenous fistula consists in:

A.Excision of fistula with restoration of vessels continuity
B.Ligation of the artery distally from the fistula
C.Amputation of the member of extremity
D.Ligation of the vein distally from fistula
E.Only medical treatment
E

112.CS. Intermittent claudication due to advanced

atherosclerosis of external iliac arteries is more
effectively treated by:
A.Lumbar sympathectomy
B.Gymnastics performed daily
C.By-pass
D.Vasodilators
E.Resection of the affected segment with anastomosis
C

114CS.Arterial emboli fixes more often to:

A.Aortic bifurcation
B.Common iliac artery
C.Common femoral artery
D.Cerebral vessels
E.Popliteal artery

115.CS.Restoring blood circulation in the acute arterial

insufficiency of the limb is absolutely
contraindicated in:
A.Ischemia gr.Ia slow progressive
B.Ischemia gr. Ilb patient with myocardial infarction
C.Ischemia gr. IIIa in the patient with stroke
D.Ischemia gr. IIIc
E.Patient age > 85 years

116.CS.Which statement about the particularities of Burger

disease is incorrect:
A.More frequent incountered in men
B.Is observed between 20 and 40 years
C.Is accompanied by intermittent claudication
D.Is closely related to smoking
E.Represents a particular form of atherosclerosis

E
117.CS.In the femoral artery embolism with grade III ischemia
(leg contraction) the method of
choice is:
A.Urgent embolectomy
B.Thrombolytic therapy
C.Therapy with anticoagulants
D.Symptomatic therapy
E.Primary leg amputation

118.CS. Amputation as an elective operation in acute limb

arterial insufficiency is indicated:
A.In advanced atherosclerosis of magistral limb vessels with
early begining manifestations of
acute thrombosis
B.In aged patients
C.Grade IIIb ischemia
D.Only in Grade IIIc of ischemia
E.In late patient hospitalization

119.CS.In gastro-esophageal reflux, the following statements are

true, except:
A.Alcohol consumption and smoking are important aggravating
factors
B.Is often associated with disordered esophageal motility
C.A hiatus hernia is invariably present
D.Barrett’s esophagus may develop
E.Iron deficiency anemia may occur as a result of chronic blood
loss
C

120.CS.Which is more frequent complication of Zenker

diverticula:
A.Hemorrhage
B.Perforation
C.Malignancy
D.Pulmonary complications
E.Peridiverticula phlegmon

121.CS.Which affirmation regarding to Zenker diverticula is

fals?
A.Is a pulsative diverticula
B.Is situated in ½ superior of esophagus
C.The rupture could appear in time of endoscopy
D.Diverticula walls consists only from mucosa
E.Operation is indicated in only symptomathic diverticula

122.CS.Which complication is more frequent in esophageal

ulcer:
A.Hemorrhage
B.Perforation
C.Stenosis
D.Malignancy
E.Pulmonary complications

A
123.CS.Which of the following statements about epiphrenic
diverticula of the esophagus is correct:
A.They are traction diverticula that arise close to the
tracheobronchial tree.
B.They characteristically arise proximal to an esophageal reflux
stricture.
C.The degree of dysphagia correlates with the size of the pouch.
D.They are best approached surgically through a right
thoracotomy.
E.The operation of choice is a stapled diverticulectomy, long
esophagomyotomy, and
partial fundoplication.

124.CS. The best management for a 48-hour-old distal

esophageal perforation is:
A.Antibiotics and drainage.
B.Division of the esophagus and exclusion of the perforation.
C.Primary repair with buttressing.
D.Resection with cervical esophagostomy, gastrostomy, and
jejunostomy.
E.T-tube fistula and drainage.

125. CS. In which of the following should antibiotic prophylaxis

not be considered?
A. Prosthetic heart valves.
B. Previous history of endocarditis.
C. Severe neutropenia.
D. Chronic liver disease undergoing variceal sclerotherapy.
E. Previous cholecystectomy.
Answer: E

126. CS. Which of the following statements regarding

endoscopy are true?
A. It is easy to get views beyond the ligament of Treitz during
an oesophagogastroduodenoscopy
(OGD) with a standard endoscope.
B. The current state-of-the-art endoscope is the fibreoptic
endoscope.
C. It is not necessary to stop clopidogrel before a colonoscopic
polypectomy.
D. Verbal consent for an endoscopy is acceptable practice.
E. Perforation and haemorrhage are uncommon but significant
complications of the procedure.

Answer: E

127. CS. Which of the following are not risk factors for post-
ERCP (endoscopic retrograde cholangiopancreatography)
pancreatitis?
A. Young age.
B. Difficult cannulation.
C. Increased bilirubin.
D. Pancreatic sphincterotomy.
E. Balloon dilatation of biliary sphincter.

Answer: C

128. CS. Which of the following about recent developments in

endoscopy are false?
A. Chromoendoscopy involves the use of stains or pigments to
improve tissue localisation.
B. Narrow-band imaging relies on an optical filter technology
that radically improves the visibility
of veins and capillaries.
C. High-resolution magnifying endoscopy achieves near cellular
definition of the mucosa.
D. Capsule endoscopy acquires video images during natural
propulsion through the gut.
E. Balloon enteroscopy permits visualisation of the small bowel
but is unable to perform therapeutic
procedures.

Answer: E

129. SC. Which of the following are true regarding medical

therapy for thyrotoxicosis?
A. Propranolol and nadolol reduce free T3 (fT3) and free T4
(fT4) levels.
B. Antithyroid drugs most often cure thyrotoxicosis due to a
toxic nodule.
C. Carbimazole can be safely given in pregnancy and lactation.
D. Agranulocytosis is an uncommon problem with antithyroid
drugs.
E. Patients with ophthalmopathy respond best to medical
management.

Answer: D

130. SC. Which of the following statements are true?

A. Patients with Cushing’s are at increased risk of hospital-
acquired infections.
B. Patients do not require prophylactic anticoagulation.
C. Following surgical removal of unilateral adrenal adenomata,
cortisol supplementation is not
necessary.
D. Nelson’s syndrome is a cause of Cushing’s disease.
E. Cushing’s-associated medical conditions need not be treated
medically preoperatively.

Answer: A

131. SC. A short synacthen test was performed in a 26-year-old

male admitted to the ITU with multiorgan failure. The results
are as follows: 0 min, 300 mmol/L; 30 min, 450 mmol/L; 60
min, 390
mmol/L. What is this suggestive of?
A. Adrenal failure.
B. Pituitary failure.
C. Sepsis.
D. Cushing’s syndrome.
E. None of the above.

Answer: A

132. SC. Which of the following statements about

cardiopulmonary bypass is false?
A. Cardiopulmonary bypass has brought about remarkable
progress in cardiac surgery.
B. The cardiopulmonary bypass circuit consists of a venous
reservoir, oxygenator, heat exchanger,
filter and roller pump.
C. Cardiopulmonary bypass is not used outside cardiac surgery.
D. Patients require full-dose heparin with the use of
cardiopulmonary bypass.
E. Cardiopulmonary bypass can cause serious systemic
complications.

Answer: C

133. SC. Which of these is not a risk factor for ischaemic heart
disease?
A. Smoking.
B. Obesity.
C. Advancing age.
D. Reduced physical activity.
E. Female gender.

Answer: E

134. SC. Which of the following statements is false?

A. Aortic stenosis is associated with a risk of sudden death
related to the severity of stenosis.
B. Rheumatic heart disease can cause both aortic stenosis and
aortic regurgitation.
C. Distinguishing between aortic stenosis and chronic aortic
regurgitation is usually difficult on
clinical grounds alone.
D. Aortic valve repair is not a common practice like mitral valve
repair.
E. None of the above.

Answer: C
135. SC. Which of the following statements about congenital
heart disease is false?
A. Cyanotic heart diseases are often more complex compared
with acyanotic diseases, and result
from a right-to-left shunt or a pulmonary circulation that runs in
parallel to systemic circulation, or
abnormal connection of blood vessels to the heart.
B. Acyanotic heart diseases are more common that cyanotic
heart diseases, and usually cause heart
failure in infancy.
C. The coexistence of ventricular septal defect, overriding aorta,
pulmonary stenosis and right
ventricular hypertrophy is referred to as Fallot’s tetralogy.
D. Four types of atrial septal defects are perimembranous,
muscular, atrioventricular and subarterial.
E. In septal defects (atrial and ventricular) a left-to-right shunt
causes an increase in pulmonary
blood flow and pulmonary vascular resistance. Progressive
changes occur if the defects are not
closed, leading to Eisenmenger’s syndrome.

Answer: D

136. SC. Which one of these statements about the thoracic aorta
and pericardial disease is false?
A. Common causes of thoracic aortic aneurysm are
atherosclerosis and connective tissue disorders.
B. Indication for surgery in thoracic aneurysm depends on the
part of the thoracic aorta involved.
C. Paraplegia, renal failure and ventricular dysfunction are some
complications of descending
aneurysm repair.
D. Stanford types A and B aortic dissection require emergency
repair.
E. Pericardial effusion causes an increase in intrapericardial
pressure and compression of the atria
when this pressure exceeds the atrial pressure. This decreases
venous return, cardiac output and
blood pressure (cardiac tamponade).

Answer: D

137. SC. Which of the following statements about lung’s

anatomy and physiology is false?
A. The lungs are derivatives of the primitive foregut.
B. The left lung has more lobes and segments than the right
lung.
C. Bronchial arteries arise directly from the thoracic aorta to
provide systemic blood supply to the
trachea and bronchi.
D. Anatomical differences between the right and left main
bronchi favour the inhalation of foreign
bodies into the right.
E. Pulmonary function tests assess the functional capacity, the
severity of pulmonary disease and
help to predict response to treatment.

Answer: B

138. SC. Which one of these statements about primary lung

cancer is false?
A. Lifetime cigarette smoking, quantified as ‘pack-years’, is a
major risk factor for bronchial
carcinoma.
B. Compared with non-small-cell cancer, small-cell lung cancer,
formerly known as oat cell cancer,
is less common, metastasises early and is less amenable to
surgery.
C. Finger clubbing and hypertrophic pulmonary
osteoarthropathy, sometimes described as clinical
features of lung cancer, are usually incidental findings and not
due to primary lung cancer.
D. The appropriate treatment strategy is dependent on tumour
type, tumour stage, and the general
fitness and lung function of the patient.
E. Late survival has a direct relationship with the tumour stage
at the time of treatment.

Answer: C

139. SC. Which one of these statements about bronchial

carcinoma is true?
A. Chest radiograph yields very useful information about
primary lung cancer.
B. Computed tomography (CT) is only useful for guiding fine-
needle aspiration.
C. Positron emission tomography (PET) has high specificity for
bronchial carcinoma.
D. Sputum cytology has a high sensitivity.
E. Invasive procedures such as mediastinoscopy,
mediastinotomy and thoracoscopy are not staging
procedures.

Answer: A
140. SC. Which of the following statements is false?
A. Bronchopulmonary carcinoid tumours usually arise from
neuroendocrine cells in major bronchi,
are very vascular and slow-growing, and, although benign,
sometimes metastasise.
B. Surgery has a limited role in the treatment of bronchiectasis
and tuberculosis.
C. Blunt and penetrating chest trauma can cause death from
hypovolaemia, hypoxaemia and
tamponade.
D. Diaphragmatic hernia through the foramen of Morgagni is
usually posterior, while
herniation through the foramen of Bochdalek lies more
anteriorly.
E. Pectus carinatum and pectus excavatum are chest wall
deformities that require surgery mainly for

cosmetic reasons. Answer: D

141. SC. Which of the following statements regarding

claudication are true?
A. Intermittent claudication may be present at rest.
B. Intermittent claudication is commonly relieved by getting out
of bed.
C. Intermittent claudication is most commonly felt in the calf.
D. Intermittent claudication distance is usually inconsistent on a
day-to-day basis for a given patient.
E. Intermittent claudication is thought to be due to nerve
compression in the leg muscle
compartments.
Answer: C
142. SC. Which of the following drugs have been shown to
improve claudication?
A. Beta-blockers.
B. Aspirin.
C. Oxpentifylline.
D. Simvastatin.
E. Prostacyclin.

143. SC. Which of the following is not a cause of gangrene?

A. Buerger’s disease.
B. Infection.
C. Intra-arterial drug injection.
D. Frostbite.
E. Deep vein thrombosis insufficiency.

Answer: E

144. SC. Which of the following regarding varicose veins are

true?
A. Varicose veins may cause venous claudication.
B. Varicose veins may be associated with the fOXC2 gene.
C. The prevalence of varicose veins is twice as common in
women than in men.
D. Right leg varicose veins are more common than left leg
varicose veins.
E. Handheld Doppler provides an accurate assessment of
saphenopopliteal competence.

Answer: B
145. SC. Which of the following statements regarding
lymphoedema are true?
A. Primary lymphoedema occurs in more than 5 per cent or the
population.
B. Early treatment is usually successful.
C. Early treatment includes surgical drainage.
D. Fluid is relatively low in protein in lymphoedema.
E. Lymphoedema often involves the muscle compartments.

Answer: B

146. SC. Which of the following is not a risk factor for

lymphoedema?
A. Limb surgery (e.g. varicose vein operation).
B. Obesity.
C. Family history.
D. A Baker’s cyst.
E. Air travel.

Answer: D

147. SC. How is hydatid disease transmitted?

A. By eating infected meat and it therefore affects only non-
vegetarians .
B. By the faeco-oral route through ingestion of eggs.
C. Through penetration of the skin of unshod feet by larvae.
D. It may be vector-borne.
E. It spreads by droplet infection.

Answer: B

148. SC. Surgery for ileal and ileocaecal tuberculosis may

involve:
A. Stricturoplasty.
B. Limited ileocolic resection.
C. Right hemicolectomy.
D. Ileo-transverse anastomosis.
E. All of the above.

149. SC. Which of the following are presenting features of

amoebiasis?
A. Chronic diarrhoea, often bloodstained, with colicky
abdominal pain.
B. Pain in the upper right abdomen with right shoulder-tip pain,
hiccoughs and a painful dry cough.
C. An apple-core lesion on barium enema due to the formation
of a chronic granuloma. This is most
commonly seen in the caecum.
D. Features of peritonitis with shock.
E. All of the above.

Answer: E

150. SC. Which of the following statements about diverticular

disease of colon are false?
A. In the Western world, 60 per cent of the population over the
age of 60 have diverticular disease.
B. A low-fibre diet causes the disease.
C. These diverticula consist of mucosa, muscle and serosa.
D. Those with perforation have a 10 times higher mortality than
those with an inflammatory mass.
E. Sepsis is the principal cause of morbidity.
Answer: C

151. SC. Which of the following is not a complication of

diverticular disease of the colon?
A. Paracolic abscess.
B. Fistulae.
C. Lower gastrointestinal haemorrhage.
D. Carcinoma.
E. Stricture.

Answer: D

152. SC. Which of the following is not a cause of vesico-colic

fistula?
A. Carcinoma of rectosigmoid.
B. Radiation enteritis.
C. Crohn’s colitis.
D. Diverticular disease.
E. Amoebic colitis.

Answer: E

153. SC. Which of the following is not a complication of UC?

A. Carcinoma.
B. Primary sclerosing cholangitis.
C. Internal fistulae.
D. Ankylosing spondylitis.
E. Perforation.

Answer: C
154. SC. Which of the following is not a barium enema finding
in UC?
A. Loss of haustrations.
B. Narrow contracted colon.
C. Increase in the presacral space.
D. Cobblestone appearance.
E. Backwash ileitis.

Answer: D
155. SC. Which of the following criteria do not indicate severe
disease in UC?
A. More than four motions a day.
B. Pyrexia of over 37.5°C.
C. Tachycardia >90/min.
D. Tachypnoea >20/min.
E. Hypoalbuminaemia ˂30 g/l.

Answer: D

156.SC. Which of the following drugs are not used in the

medical treatment of UC?
A. Prednisolone.
B. 5-ASA compounds.
C. Predsol enema.
D. Azathioprine.
E. Isoniazid.
Answer: E

157. SC. In the management of a severe attack of UC, which of

the following is not true?
A. Every patient needs a proctocolectomy after resuscitation.
B. Daily plain abdominal X-ray is taken to assess transverse
colon dilatation.
C. Parenteral high-calorie alimentation is instituted.
D. Intravenous hydrocortisone is given.
E. Azathioprine or cyclosporin A is given.

Answer: A

158. SC. Which of the following statements regarding surgery in

UC is false?
A. In the emergency situation, total abdominal colectomy and
ileostomy should be the procedure of
choice. B. Proctocolectomy and ileostomy are associated with
the lowest complication rate.
C. Restorative proctocolectomy with an ileoanal pouch should
be considered in all patients.
D. Colectomy with ileorectal anastomosis is the most favoured
procedure.
E. Ileostomy with a continent intraabdominal pouch is not often
done.

Answer: D
159. SC. Which of the following statements is not true of
Crohn’s disease (CD)?
A. The ileum is affected in 60 per cent of cases.
B. It affects the entire thickness of the bowel.
C. Non-caseating granulomas are found in only 60 per cent of
patients.
D. One in 10 patients have a first-degree relative with the
disease.
E. A patient can be cured of CD once the diseased small or large
bowel is removed.

Answer: E
160. SC. Which of the following pathological features is not
found in CD?
A. Internal fistulae.
B. Serpiginous and aphthous ulcers.
C. Chronic inflammation involves all layers of the bowel wall.
D. Pseudopolypi.
E. Cobblestone mucosa.

Answer: D

161. SC. Which of the following can cause acute presentation of

CD?
A. Mimicking acute appendicitis.
B. Perforation.
C. Intestinal obstruction.
D. Toxic megacolon.
E. All of the above.

Answer: E

162. SC. Which of the following is not a clinical presentation of

CD?
A. Bloodstained diarrhea.
B. Intermittent abdominal pain.
C. Mass in the right iliac fossa.
D. Typical evening rise of temperature.
E. Pneumaturia and urinary tract infections.

Answer: D

163. SC. Which of the following statements about imaging in

CD are true?
A. Small-bowel enema is the imaging of choice in small-bowel
disease.
B. Barium enema and colonoscopy should be done for large-
bowel disease.
C. MRI is the ‘gold standard’ for perianal fistulae.
D. CT scan is used for suspected intraabdominal abscess and
internal fistulae.
E. All of the above.

Answer: E
164. SC. Which of the following drugs are used in the treatment
of CD?
A. Steroids.
B. 5-ASA compounds.
C. Azathioprine.
D. Infliximab.
E. Metronidazole.
F. All of the above.
Answer: F
165. SC. Which of the following operations is not done in CD?
A. Segmental resections.
B. Strictureplasty.
C. Proctocolectomy and ileostomy.
D. Colectomy and ileorectal anastomosis.
E. Restorative proctocolectomy with ileoanal pouch.

Answer: E
166. SC. Which of the following statements about inflammatory
bowel disease (UC and CD) is not
true?
A. Patients must be managed jointly by the physician and
surgeon.
B. Surgery, when indicated, must be as radical as possible.
C. Patients must be given a good trial of optimum medical
treatment prior to surgery.
D. There is more chance of a cure after surgery in UC than in
CD.
E. In emergency presentation, patients must be vigorously
resuscitated prior to operation and
managed in the ITU postoperatively.

Answer: B
167. SC. In familial adenomatous polyposis (FAP), which of the
following statements is false?
A. It is inherited as a Mendelian dominant condition.
B. More than 80 per cent occur in patients with a positive family
history.
C. The majority will become malignant.
D. The condition usually manifests by the age of 15 years.
E. Family members should be offered genetic testing in their
early teens.
F. At-risk family members should be offered annual
colonoscopic surveillance from the age of 12
years.

Answer: C

168. SC. Which of the following statements are true with regard
to colorectal cancer?
A. Almost 60 per cent occur in the rectosigmoid region.
B. Reduced dietary fibre is associated with an increased risk.
C. The least malignant form is the cauliflower type.
D. 20 per cent present as an emergency with intestinal
obstruction.
E. All of the above.

Answer: E
169. SC. Which of the following statements are false?
A. Right colonic cancers present with features of anaemia.
B. Left colonic cancers present with rectal bleeding and
obstructive symptoms.
C. Even for an experienced colonoscopist, the failure rate to
visualise the caecum is 10 per cent.
D. Intravenous urography (IVU) should be routinely done.
E. Synchronous cancers occur in 5 per cent.

Answer: D
170. SC. Which of the following is false with regard to an
entero-cutaneous fistula?
A. The commonest cause is postoperative.
B. A high-output fistula is defined as one where there is >1
L/day.
C. They should be thoroughly assessed with barium studies and
CT scans.
D. They always need an operation to cure the problem.
E. Hypoproteinaemia and sepsis often accompany the condition.

Answer: D

171. SC. Which of the following is not a mechanism of rectal

injury?
A. Falling over a pointed object, causing impalement.
B. Sexual assault.
C. Crush injury during prolonged childbirth from the fetal head.
D. Penetrating injuries, including gunshot trauma.
E. Road traffic accidents.

Answer: E
172. SC. Which of the following statements regarding the
treatment of rectal injuries are false?
A. A computed tomography (CT) scan with rectal contrast is
useful for assessment.
B. Intraperitoneal tear is treated by closure and defunctioning
left iliac proximal colostomy.
C. In extraperitoneal injury, debride ment of the external wound
with left iliac defunctioning
colostomy is carried out.
D. In a large defect, resection of the damaged bowel with end-
to-end anastomosis is done.
E. Broad-spectrum antibiotic cover is mandatory.

Answer: D
173. SC. In rectal prolapse which of the following statements are
true?
A. In children the prolapse is partial or mucosal.
B. Full-thickness prolapse commences as an intussusception.
C. Full-thickness prolapse is much more common in women.
D. Children are treated conservatively.
E. All of the above.
Answer: E
174. SC. Assessment in rectal cancer should include:
A. Sigmoidoscopy and biopsy.
B. Colonoscopy or CT colonography or barium enema to
exclude synchronous cancer.
C. CT scan of liver and chest.
D. Magnetic resonance imaging (MRI) of pelvis and
endoluminal ultrasound.
E. All of the above.
Answer: E

175. SC. Which of the following are true with regard to the
clinical features of peptic ulcers?
A. The pain never radiates to the back and this differentiates this
from biliary colic.
B. Vomiting is a notable feature.
C. Bleeding is rare.
D. They may cause gastric outlet obstruction.
E. Weight loss is a typical symptom.
Answer: D
176. SC. Which of the following are true with regard to spread
of gastric cancer?
A. Tumour reaching the serosa usually indicates incurability.
B. Blood-borne metastases commonly occur in the absence of
lymph node spread.
C. Krukenberg’s tumours are always associated with other areas
of transcoelomic spread.
D .Sister Joseph’s nodule is diagnostic of gastric cancer.
E. The lymphatic vessels related to the cardia have no relation to
the oesophageal lymphatics.

Answer: A

177. SC. With regard to splenic abnormalities, which one of the

following statements is false?
A. Splenunculi are present in approximately 10–30 per cent of
the population.
B. Splenic artery aneurysm can occur as a complication of acute
pancreatitis.
C. Plain abdominal X-ray is the ideal imaging modality.
D. A massively enlarged spleen is prone to infarction.
E. The splenic hilum is a common site for the development of a
pseudocyst of the pancreas.

Answer: C

178. SC. With regard to investigations of the pancreas, which of

the following statements are false?
A. Ultrasonography (US) is the initial investigation of choice in
the jaundiced patient.
B. When doing a computed tomography (CT) scan, initially an
unenhanced scan must be done
followed by a scan after intravenous contrast injection (CECT).
C. While doing a magnetic resonance cholangiopancreatography
(MRCP), intravenous secretin
injection helps to determine any obstruction to the pancreatic
duct.
D. An increase in serum amylase is diagnostic of acute
pancreatitis.
E. Endoscopic retrograde cholangiopancreatography (ERCP)
should always be preceded by a plain
radiograph.

Answer: D

179. With regard to pancreatic injury, which of the following

statements is false?
A. All patients with pancreatic trauma should undergo an
exploratory laparotomy.
B. Pancreatic duct disruption requires surgical exploration.
C. Severe injury to the duodenum and the head of the pancreas
requires a pancreatoduodenectomy.
D. After conservative management for pancreatic injury, duct
stricture and pseudocyst may occur as
complications.
E. During splenectomy, iatrogenic injury to the pancreatic tail
can occur.
Answer: A
29
180. SC. Which of the following statements about acute
pancreatitis is false?
A. Acute pancreatitis accounts for 3 per cent of hospital
admissions for abdominal pain.
B. Acute pancreatitis is classified into mild and severe.
C. 80 per cent of cases are mild acute pancreatitis, with a
mortality rate of 1 per cent.
D. 20 per cent are severe acute pancreatitis, with a mortality of
20–50 per cent.
E. In all cases of acute pancreatitis, there is a marked rise in
serum amylase.

Answer: E
181. SC. Which one of the following causes of acute pancreatitis
is due to a congenital anatomical
variation?
A. Gallstones.
B. Hereditary pancreatitis.
C. Pancreatic divisum.
D. Autoimmune pancreatitis.
E. Hyperparathyroidism.

Answer: C

182. SC. Which of the following are not parameters to assess the
severity of acute pancreatitis in either
Ranson or Glasgow score?
A. Age.
B. White cell count.
C. Serum amylase.
D. Serum calcium.
E. Blood urea.
F. Lactate dehydrogenase (LDH) and aspartate transaminase
(AST).
Answer: C

183. SC. The radical curative operation of

pancreatoduodenectomy for carcinoma of the head of the
pancreas, periampullary carcinoma or the lower end of CBD
goes by which name?
A. Millin.
B. Billroth.
C. Whipple.
D. Wertheim.
E. Ombrédanne.
Answer: C