‫بسم هللا الرحمن الرحيم‬

‫الحمدهلل رب العالمي‬
3rd year residency exam
June 2023
50 QUESTION
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1 -In performing hepatic resection, knowledge of the different lobes and segments of the liver is
mandatory. The right and left lobes of the liver are separated by an imaginary plane (Cantlie’s line)
that passes between the inferior vena cava (IVC) and which of the following?
A. Portal vein.
B. Falciform ligament.
C. Left margin of the quadrate lobe.
D. Gallbladder
E. Left margin of the caudate lobe.
ANSWER: D

2 -Regarding Intermittent claudication, which of the following is 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

3 -Anuria in the postoperative period one is true:

A. Is defined as the production of less than 500 ml of urine/day.
B. Should be treated with an initial water load i.e. 4 liter fluid infusion.
C. Is associated with hypernatremia and dehydration.
D. Is usually treated by renal dialysis.
E. Mostly be due to prerenal cause.
ANSWER: E

1 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

4 -The strongest chemotactic factor for fibroblasts is
A. Histamine
B. Serotonin
C. Platelet derived growth factor
D. Transforming growth factor beta
E. Tumor necrosis factor alpha
ANSWER: C

5 -one of the following is not contraindication for breast conserving surgery

A. small size breast
B. large size breast
C. multifocal multicentric tumor
D. age more than 70
E. Pregnancy
ANSWER: D

6 -Glucagon-like-peptide 1 (GLP-1) is best characterized by all of the following except:

A. Peptide YY is secreted by the same cells
B. Stimulates insulin secretion while inhibiting glucagon release
C. Secreted by parietal cells of the stomach
D. It contributes to the ‘ileal brake’
E. It decreases appetite and induces satiety
ANSWER: C

7- A 22-year-old man presents with a pelvic fracture and hematuria. A retrograde cysto-
urethrogram shows urethral injury. The most appropriate next step is:
A. Exploration and repair
B. Foley catheter drainage
C. Observation
D. Cystectomy
E. Suprapubic trans-cutaneous drainage
ANSWER: E

2 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

8- A 24-year-old woman in the second trimester of pregnancy, presented with right lower
quadrant pain, leukocytosis and an ultrasound suspecting appendicitis. You consider laparoscopic
appendectomy. Which of the following is true?
A. Laparoscopic appendectomy is contraindicated in pregnancy
B. The patient should be tilted to left side
C. Pneumoperitoneum should reach 16 mmHg
D. Laparoscopic appendectomy cannot be performed in the second trimester
E. Fetal loss is 10% in non-perforated appendicitis
ANSWER: B

9 - What is an effective strategy to minimize risk for acute kidney injury in a polytrauma patient
expected to receive multiple contrast-enhanced imaging studies?
A. Normal Saline and Sodium bicarbonate
B. Sodium bicarbonate
C. Normal Saline with N- Acetylcysteine
D. Normal Saline only
E. Hydrocortisone
ANSWER: D

10 - Parkland formula is used to calculate fluid requirements of burn patients. For a 70-kg adult
with a 30% second degree burn, the total fluid requirements in the first eight hours is:
A. 2.8 liters
B. 5.6 liters
C.. 4.2 liters
D. 7.6 liters
E. 12.8 liters
ANSWER: C

11- The peritoneal space located to the left and posterior to Foramen of Winslow is:
A. Rutherford Morison’s pouch (hepatorenal pouch)
B. Right subphrenic space
C. Right paracolic gutter
D. Lesser sac
E. Left spleen- renal space
ANSWER: D

3 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

12 . post mastectomy and axillary node dissection , numbness in axilla and medial aspect of arm ,
which nerve injury:
A. ……….
B. axilla nerve
C. long thoracic nerve
D. intercostal brachial nerve
E. ………….
ANSWER: D

13 All of the following can be treated with FFP except ?

A. consumptive coagulopathy
B. Factor 8
C. Von Willebrand Disease
D. Factor 5
E. Factor 13
ANSWER:

14 One of the following is gas sterilisation?

A. Nitric oxide
B. Methane
C. Ethanol glycol
D. Hydrogen
E. Hydrogen peroxidase
ANSWER: C

15 About keloid one of the following is False ?

A. Genetic predisposing
B. Most commonly on African women
C. Frequently Turn Malignancy
D. Caused by Burn
E. Common site on anterior chest ,face
ANSWER: C

4 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

16 Charcot foot it's?
A. Venous ulcer
B. Ischemic
C. sensory
D. Decrease motor
E. Treated by medical boat
ANSWER: C

17 years old patient presented to hospital as sever pain in scrotum since 5 hours duration , PE:
tenderness , swelling , no cremastric reflux what your management?
A. Scrotal ultrasound
B. Give oral antibiotic
C. NSADS
D. Urgent exploration
E…………
ANSWER: D

18 All of the following are type of melanoma except ?

A. Lantigo maligna
B. Superficial spread
C. Congenital nevi
D. Noduler
E. Acral lantigous
ANSWER: C

19 One of the following drug is given for thyrotoxicosis, and don't effect of thyroid hormon ?
A.propylthiouracil
B. methimazole
C. Iodine
D. Propranolol
E…………
ANSWER: D

5 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

20 All of the the following causes gynecomastia except ?
A. Lung cancer
B. Marfan syndrome
C. alcohol
D. cirrhosis
E. …………
ANSWER: B

21 PNS abscess , Which is true

A. Should be excised Abscess PNS with skin surrounding
B. Simple Primary incision and drainage can lead to chronic PNS abscess
C. ………….
D. ……………
E. Off midline clean less recurucce than midline closure
ANSWER: B

22 characteristics of ulcerative colitis ?

A. Cobblestones
B. Granuloma
C. Crypt Abscess
D. Skip lesion
ANSWER: C

23 All are true about Acute appendicitis except ?

A. All patient with acute appendicitis should imaging by radiography…
B. ……….
C. …….
D. ………..
E. ……..
ANSWER: A

6 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

24 One of the following you find in labaratory test by aspiration of chylothorax ?
A. WBC
B. Amyles
C. Lactate Dehydrogenase
D. Chylimicrons
E. Protein
ANSWER: C

25 Pyogenic Abscess one of the following is False ?

A. Percutaneous drainage is contraindication
B. …….
C. ……….
D. ………..
E. ……..
ANSWER: A

26 patient male presented with micturation , pneumaturia , brown color of urine by which of
theses diseases most commonly found ?
A. Ulcerative colitis
B. Crones disease
C.sigmod diverticular disease
D. ………………..
E. …………….
ANSWER: C

27 patient presented as stabbing wound in chest inserted chest tube , noted at insertion 800 cc
blood , then after 1 hour 300 , then 240 respectively, what you next management?
A. 2nd chest tube at same site
B. left Thoracotomy
C. Observation
D. Vast
E. Median sternotomy
ANSWER: B

7 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

28 Most common organism associated with VAP In ICU patients at 1st ( 4days ) ?
A. Pseudomonas aeruginosa
B. Escherichia coli
C. Klebsiella pneumoniae
D. Acinetobacter
E. Staphylococcus aureus
ANSWER: E

29 Most common cause of gastric outlet obstruction is ?

A. Gastric adenocarcinoma
B. Gastric SCC
C. P.U.D
D. duodenal ulcer
E. Ulcerative colitis
ANSWER: C

30 number of disease cases present in a particular population at a given time it's meaning?
A. Incidence
B. Prevalence
C. Case study
D. Retrospective
E. ……………..
ANSWER: B

31 All of the following are indication for surgical intervention for varicose vein removal except ?
A. DVT
B. Bleeding
C. PE
D. …
E …...
ANSWER: A

8 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

32 Radiation therapy can induced one of the following?
A. Acute cholecystitis
B. Diverticulitis
C. Appendicitis
D. Tensile Abscess
E. ……….
ANSWER: A

33 Which of the following sites for central venous catheter placement is associated with the
lowest rate of catheter-associated blood stream infections?
A. Internal jugular vein
B. Subclavian vein
C. Femoral vein
D. Both A and B are equivalent
E. All sites are equivalent if sterile technique is maintained
ANSWER: B

34 A 40-year-old man who weighs 65 kg is being observed in the ICU. Twenty-four hours
postoperatively, he develops convulsions. His serum sodium is 118 mEq/L. Appropriate
management includes which of the following?
A. Administration of normal saline (0.9%)
B. Administration of hypertonic saline (3%)
C. Emergency hemodialysis
D. Administration of vasopressin
E. Administration of Lasix, 40 mg intravenously (IV)
ANSWER: B

35 All of the following causes scc except

A. Venous stasis
B. PNS abscess
C. Burn
D. ..
E. …
ANSWER: B

9 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

36 Stab wound, which of the following result of DPL is the minimum to confirm positive tist
A. RBC >10000
B. WBC > 250
C. AMYLASE >100
D. ALP > 180
E. BILURUBIN > 1
ANSWER: A

37 Which of the following chemo drug is antimetabolite drug

A. Methotrexate
B. Cyclophosphamide
C. Vincristine
D. Cyclosporine
E. ..
ANSWER: A

38 early complication of surgery of TEF , except ?

A. Anastamosis leak
B. Stricture
C. Recurrence fistula
D. ….
E. Inadvertent anastamosis
ANSWER: C

39 Fistula in-ano all true except ?

A. Intrasphincter type is the most common
B. …..
C. Contraindication to do fistulectomy in high fistula
D. ….
E. Should be biopsied
ANSWER: E

10 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

40 A 55 yo man with epigastric pain that is not responsive to PPI’s undergoes an EGD. A mass is
noted in the stomach and biopsied. The biopsy comes back as lympho proliferative tissue. The
next most appropriate therapy is:
A. Triple treatment eradication for h.pylori
B. Radiation only
C. Chemoradiation
D. Total gastrectomy
E. ……….
ANSWER: A

41- question about antibiotic

A. …………..
B. Wide spectrum antibiotic is used for treatment of MRSA.
C. …………………
D. ……………….
E. Rotating antibiotic used for oppurtinic
ANSWER: E

42 Melanoma with positive lymph node , most important prognosis factor

A. Size of lymph node
B. Number of lymph node
C. Thickening
D. Depth
E. …….
ANSWER: B

43 Umbilical hernia in adult , true

A. …..
B. If it is small and asymptomatic leave it
C. ………….
D. ………..
E. ……………..
ANSWER :B

11 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

44- Qq about PTH function
A. -----
B. -------
C. Effect on osteoclasr to release ca from bobe
D. Effect on vit d on kidney
E. ………..
ANSWER: D

45- about Inguinal hernia anatomy

A. ……….
B. …….
C. …….
D. ………
ANSWER: ……..

46 – about HLA , which is wrong

A. All nucleated cell express HLA 1
B. B lymphocytes express HLA 2
C. Present protein fragment to B lymphocytes
D. ….
E. …….
ANSWER: C

47 about Bochdalek hernia , which is true

A. ……..
B. Most common in left of diaphragm
C. ……..
D. ……..
E. ……..
ANSWER: B

12 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

48- Distance between upper esophageal sphincter to aortic arch
A. 10 m
B. 15 cm
C. 25 cm
D. 40 cm
E. 50 cm
ANSWER: A

49 – pyogenic liver abscess , which is wrong

A. …….
B. Contraindication to do percutaneous drainage
C. …
D. …..
E. ….
ANSWER: B

50- most common site of cholangiocarcinoma

A. ……
B. …….
C. …..
D. …..
E. Perihilar
ANSWER: E

13 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

MiniOSCE
1- Squamous cell Carcinoma
Lower lip
Drain to sumbmandibular Lymph nodes
Excisional bx for Dx

2- contrast study in 9 month old male

Intussusception (ileocolic)
Physical finding:
Empty RLQ/RIF
red currant jelly stool

3- Gallstone ileus
Most common location, terminal ileum/ileocecal valve
Treatment:
Proximal longitudinal entorotomy
Stone extraction
Transverse repair

4- acute lower limb ischemia

Most common emblic origin
Tx: embolectomy

5- SOB, Tachycardia, hypotension, distended neck veins:

Dx: rt sided tension pneumothorax
Needle thoracostomy before chest tube

6- open drain system

Penrose drain
Bulky gauze dressing and antibiotics for output control

7- Lt femoral hernia
Tx: hernia repair dur high risk of strangulation

8- case of hypercalcemia with sistamibi scan image:

sistamibi scan
Parathyroid adenoma
Excision, parathyroidectomy

14 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT

9- rt sided scrotal swelling
Transillumnation test
Rt hydrocele
1 year

10_ lipoma ,
excision ,
low risk malignancy

OSCE
1- BASIC OF SURGERY : DVT
2- PATHOLOGY : BREAST CA CLASSIFICATION
3- OPERATIVE : LAP CHOLE OPERATION
4- HISTORY : CHRONIC CHOLYSYSTITIS
5- LONG CASE : BLEEDING PER RECTUM- COLON CA
6- EMERGENCT : ACUTE PANCREATITIS WITH SHOCK

‫شكر خاص لكل من ساهم يف وصول هذه االسئلة بي ايديكم‬

‫التميم‬
‫ي‬ ‫د محمد‬
‫ أحمد ياسي‬.‫د‬
‫ صهيب الناطور‬.‫د‬
‫حلم‬
‫ي‬ ‫ مأمون‬.‫د‬
‫ شكري سعادة‬.‫د‬

‫واخر دعوانا ان الحمد هلل رب العالمي‬

15 | DR. MOHAMMAD ALI FAYIZ ALTAMIMI | GENERAL SURGERY RESIDENT