Surgery part 1

Organised & solved for Sudanese doctors Musab Bashir U of K 2009

Alfrazdaq Hassan UofG 2003
SURGERY Part 1
1-Regarding cholelithiasis:
a-are found in 10% in the population. F
b-biliary colic occurs only when the stone descend in the common bile duct. F
c-in ascending cholangitis ,broad spectrum antibiotic should be given . T
d-terminal ileal resection leads to cholesterol gallstones. T
e-in laparoscopic cholecystectomy ,hospital stay is less than open cholecystectomy. T
2--Recognised radiological features of splenic rupture:
a-subdiaphragmatic air. ?
b-elevation of the left diaphragm. T
c-eventration in the left hemi-diaphragm. F
d-oblitration of the psoas shadow. T
e-free fluid between coils of air-containing bowel. T
3--Radiological features which require breast biopsy are:
a-smooth rounded mass . F
b-stellate-shaped mass . T
c-a mass with ill defined borders. T
d-area with distorted breast architecture. T
e-calcification more than 2mm. ?
4-The following procedures are correctly associated:
a-central venous line & pneumothorax. T
b-Hickman IV line & endocarditis of the mitral valve. ?
c-paracentesis & hepatic coma. T
d-urethral catheterisation & predominantly. Gm ve bacteraemia. T
e-continues suction through naso-gastric tube & acidosis. F
5-Renal calculi:
a-mostly due to cystine F
b->90% can be visualised by IVU . T
c-can cause post renal failure T
d- if cause renal colic ,it is unlikely to pass down. F
e- commonly treated by extra-corporeal shock wave lithotripsy . F
6-Abdominal aortic aneurysm :
a-there is strong family predisposition. T
b-it may cause ureteric obstruction. T
c-if > 6 cm ,it predict rupture. T
d-treated by endovascular repair. T (stenting)
e-smoking is a risk factor. T
7-Inguinal hernia:
a-traverse inguinal canal. T
b-commonly occur below and lateral to pubic tubercle . F
c-more likely to strangulate than femoral hernia. F
d-indirect hernia passes through deep inguinal ring. T
e-if it strangulate ,commonly treated conservatively. F
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
8-Intusseption :
a-present at age 5 month to 9 month. ? (5-12mo)
b-early diagnosis is essential. T
c-bloody diarrhoea is an early sign. F
d-is usually painless. F
e-is the commonest cause of intestinal obstruction in infants in after the neonatal
period. T

9-Pleomorphic adenoma of the parotid gland ,appropriate management include:
a-biopsy should always be done. F
b-surgical treatment is advisable. T
c-has a true capsule. F
d-partial removal with conservation of the fascial nerve. T
e-radiotherapy is effective. F

10-Adequate management of 65 years old male with # 7th ,8th,9th ribs:
a-chest wall adhesive plaster should be fixed. F
b-physiotherapy to the chest and postural drainage. T
c-intercostal nerve block . T
d-Arterial blood gases measurement. T
e-hospitalisation. F

11-Fractures:
a-Compound indicate multiple fragments of bone. F
b-at the site of metastasis could be a pathological fracture. T
c-if complicated by compartment syndrome, treated by reduction and fasciotomy. T
d-fracture ilium commonly associated with fat embolism. F(femur)
e-pelvic fracture may be associated with hypovolaemic shock. T

12-Normal chest X-Ray, the border of the left mediastinum should show the following:
a-Rt. Ventricle F
b-Lt. Ventricle. T
c-Lt. Atrium. ?(auricle)
d-Pul. Artery. T
e-ascending aorta. F

13-Regarding oesophagus:
a-rolling hiatus hernia causing compression of the oesophagus. T
b-portal hypertension causing varices . T
c-in achalasia , the a ganglionic segment is due to deficient Auerbach nerve plexus. T
d-carcinoma usually adenocarcinoma. F (at the lower end)
e-reflux commonly treated by Nissen fundoplication. F


Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
14- Congenital Pyloric Stenosis:
a. Develops at 4-6 weeks of life. T
b. More in the first born female. F
c. Causes Hypochloraemic Alkalosis. T
d. Diagnosed by barium enema. F
e. The bowel is distended with feeding. F
15- The following are true about Acute Pancreatitis:
a. Can cause tetanus. F
b. Commonest cause in Ireland is Gallstones & Alcohol. T
c. Difficult to differentiate from ischaemic bowel. T
d. Can lead to hypokalaemia, hypocalcaemia & hypoalbuiminaemia. F
e. Associated with hypercalcaemia. T

16- Colorectal Ca:
a. Most common in the rectum than any other part of the colon. T
b. Staged by TMN system. ?(DUKES)
c. Commonly present with obstruction. T
d. Long standing Ulcerative Colitis is a predisposing factor. T
e. In Caecum is treated by Colostomy. F

17- Malignant Melanoma:
a. Is caused by sunburn on young patients. T
b. Lentigo Maligna is the commonest type. F
c. Has poor response to chemotherapy. T
d. Prognosis is related to the thickness of the lesion . T
e. Of superficial type involves the sole, palm & per-ungual region. F

18- Varicose veins:
a. Is more common in men than women. F ( 1:2)
b. Common in small than large Saphenous vein. F
c. Injection Sclerotherapy of varicose veins above the knee is better than surgery. F
d. Are associated with oedema, ulceration, eczema & liposclerosis. T
e. Are diagnosed by digital Subtraction Angiography. F

20- Paediatric Surgery:
a. Intussusseption is treated by barium and air enema if confined to ileocolic area.T
b. Testicular torsion must be explored surgically. T
c. Mal-rotation of the bowel is treated conservatively. F
d. Congenital Pyloric Stenosis leads to hyperkalaemic alkalosis. F
e. Undesended testes can lead to malignant changes. T


21- In a multiply injured patient:
a. The priority is for IB fluid replacement. F
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b. Clinical pneumothorax should be diagnosed by chest X-ray. F
c. Oropharyngeal airway prevents aspiration. F
d. Pelvic fractures commonly present with shock. T
e. Blunt trauma of the spleen should be treated by splenectomy. F
22- Orthopedics:
a. Fracture neck of the femur is commonly treated by skeletal traction. F
b. In Scaphoid fracture Avascular Necrosis occurs in the proximal fragment of the
bone. T
c. Comminuted fracture is associated with laceration of the skin. ?
d. Lumbar Disc Prolapse can cause Paralytic ileus. ?

23- Post-operative complications:
a. Dehydration is a common cause of renal failure. T
b. In a patient with a calf pain, pulmonary embolism can occur. T
c. Secondary bleeding occurs in the first 6 hours. F
d. K + requirements are reduced in the post-operative period. T
24- Regarding neck lumps:
a. Branchial cysts occur in midline, F
b. Naso-pharyngeal Ca should be excluded. T
c. TB is the commonest cause in Ireland. F
d. Lower motor Neurone lesions of the face occur with benign parotid tumours. F
e. Parathyroid tumours are rarely palpable. T

25- the following are true about thyroid lumps:
a. FNA is an initial investigation if available. T
b. Medullary Ca is associated with MEN type II. T
c. Papillary Ca early spread by lymphatics. T
d. Solitary nodule is commonly part of multinodular goitre. F
e. Goitre with exophthalmos occurs in Grave disease. T
26- In iscahemic limb:
a. If gangrene has developed, it is treated by ilio-femoral bypass. F
b. If due to embolism, commonly treated by urgent embolectomy. T
c. Can be assessed by ankle-radial index. F
d. If due to small segment atherosclerosis, can be treated by pulling out of a
catheter balloon. T

27-Gall Stone:
a. when lead to Intestinal Obstruction show in the Biliary Tree. F
b. oral Cholangiogram is done for diagnosis when the pt is Jaundiced. F
c. can never cause Pancreatitis. F
d. cholycystitis can not occur without stones. F
e. 10% are radio-opaque. T
28-In carcinoma Rectum:
a. It usually presents with Intestinal Obstruction. ?
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b. metastasize to the Inguinal Lymph Nodes. F
c. cancer Cells are usually Adenocarcinoma. T
d. it Responds to Radiotherapy. T
e. it constitutes 45% of Large Bowed Carcinoma. ?

29-Carpal Tunnel Syndrome:
a. usually presents with Pain & Paraesthesia. T(nocturnal)
b. causes Waisting of the Ulnar side of the hand. F
c. affects Adductor Digiti Minimi. F
d .Tinel test in the wrist is Positive. T
e. pain awakens the patient from sleep. T

30-Concerning Basal Cell Ca:
a. metastasize through Lymph Nodes. F
b. occurs exclusively on the head & Neck. F
c. may be clinically confused with Malignant Melanoma. ?
d. histologically is characterized by Keratin Pearl Formation. ?
e. responds to radiation therapy. T

31-Strawberry Naevi:
a. are present at Birth. T
b. should be excised.. F
c.are Haemangiomas. T
d.indicate the presence of ipsilateral intracranial haematoma. F
e. if coexist with stridor indicates subglotic hemangioma. T

32-Regarding Malignant Melanoma:
a. depth correlate with Prognosis. T
b. amelanotic Melanomas have good Prognosis. F
c. doppler Ultrasound is a useful Diagnostic Tool. F
d. is extremely rare in Dark Skinned People. F
e. is more common in female. T
f.occurs only in Skin. F

33-In a pt. with Head injury, Signs suggesting Increased Tension are:
a. small Pupils. F
b. Deterioration in the Level of Consciousness. T
c. Hypotension. F
d. Tachycardia. F
e. Increasing GCS score. F


34- Painless gross Haematuria occurs in:
a. Ca bladder. T
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b. Renal Cell Ca. T
b. Urethral Stricture. F
c. Posterior Urethral Valve. F
d. UTI. F
35-In Urogenital Malignancies:
a. Ca Prostate usually presents with Painless Haematuria. F
b. Ca Bladder is usually treated by Cystoscopy. T
c. Ca Penis increases in incidence if the patient is circumcised. F
d. Testicular Ca is usually treated by chemotherapy without the need for
Orchidectomy. F e. Renal Cell Ca can be treated by Immuno-chemotherapy. T

36- The following are true about Ulcers:
a. Ischaemic Ulcers are Painless. F
b. Malignant Ulcers are characterized by Everted Edges. T
c. Ischaemic Ulcers occur on the Lateral aspect of the leg. T
d. Venous ulcers are punched out. T
e. Margolin Ulcers are Precancerous. ?( are malignant)
37- In Blind Loop Conditions:
a. The Iliocaecal Valve should be Competent. ?
b. Diabetic Autonomic Neuropathy is a Recognized cause. ?
c. Anaemia is typically due to Folate deficiency. F
d. The treatment with IV Antibiotics is Advisable f?
e. Creation of ilio-colic Fistula should be considered. ?(as a cause)
38- In the Management a Multiply injured Patient:
a. Stabilization of Fractures has priority to Airway Inspection. F
b. Management of Intra-Abdominal Bleeding has priority to Stabilization of
Fractures. T
c. Rectal Examination is Mandatory before inserting a Urinary Catheter. T
39-The following are True about Acute pancreatitis:
a. Flank Pigmentation is a finding. T
b. Can cause tetany. T
c. Commonest cause in Ireland is Gallstones & Alcohol. T
d. Renal failure is a Complication. T
e. Difficult to differentiate from Ischaemic Bowel. T
40-Paediatric Surgery:
a. Testicular torsion must be explored Surgically. T
b. Enema & Inflation of air can treat intussusception. T
41-In a Limping Child:
a. Flat Foot is a common cause. F
b. Perths disease is a cause. T
c. Slipped Femoral Epiphysis occurs at the Pupertal Growth Spur. T
d. Upper Respiratory Tract infection associated with Transient Synovitis. T
42-In a patient with Multiple Injuries:
a.Tension Pneumothorax is diagnosed by Chest X- Ray. F
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
c. Priority for IV fluid replacement. F
d. Pelvic fracture can present with Shock. T
e. Naso-gastric Tube prevents Aspiration into Lungs. T
f. Oro-pharyngeal Intubation is Mandatory. F
43-Orthopedic:
a.# Neck of the Femur is commonly treated by skeletal Traction. F
b. In Scaphoid Fracture, Avascular Necrosis occurs in the Proximal Fragment of the
bone. T
c. Fracture Neck of the Femur common in the elder females. T
d. Lumbar Disc Prolapse can cause Paralytic Ileus. F
44-Post-operative Compilations:
a. In a patient with Calf Pain, Pulmonary Embolism can occur. T
b. Secondary bleeding occur in the 1st hours. F
c. Widened Gap of the wound induces Healing. F
45-mid Line Lump in the Neck:
a. Cystic Hygroma. F
b. Naso-pharyngeal Carcinoma. F
c. Parotid tumor. F
d. Branchial Cyst F
46-The following are acceptable Contra-indications for resection of Ca Bronchus:
a. Forced expiratory volume of less than I litre. F (0.8)
b. Hoarseness of voice. T
c. Collapsed Rt. middle lobe. F
d. Secretion of Anti-diuretic. F
e. Elevation of the Diaphragm. T
47-The following are causes of painful swelling in the groin:
a. Undescended testis. F
b. Encysted Hydrocele of the cord. F
c. Septic Arthritis of the Hip. T
d. Strangulated femoral hernia. T
e. Inguinal Lymphadenitis. T

48-Regarding Ca Colon:
a. More common in rectum than Caecum. T
b. Proctitis is a common presentation. F
c. Commonly treated by Abdomino-Perineal Resection . F

49- Regarding polycystic disease of the kidney:
a. May be autosomal recessive. T
b. Associated with Interstitial Hemorrhage. F
c. Is Premalignant. F
d. Causes renal failure. T
50- Pyloric Stenosis:
a. There is Hypokalaemic alkalosist. T
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b. PH of 7.04. F
c. Hyperkalaemia. F

51- In Osteomalacia:
a. Increased Ca. F
b. Decreased PO4. T
c. Increased PTH. T
d. Decreased alkaline Phosophatase. F
e. Causes pathological fractures. T

52- Chronic Pancreatitis:
a. Continuous abdominal pain is a presenting feature. T
b. Treatment includes small amount of alcohol. F
c. Should have fat free diet. ?

53- Regarding haematuria:
a. IVP is an urgent investigation. F
b. Cystoscopy is mandatory. F
c. Can be treated conservatively. T
d. Urethral catheter should be inserted to prevent obstruction. F
e. Urgent CT scan should be done. F
54- In Peptic Ulcer disease:
a. Most patients present with shock. F
b. Perforation occurs more in antral ulcers. F
c. In stomach, ulcers are more common in the greater curvature. F
d. X-ray shows air under the diaphragm. F

55- Head injury:
a. There is diminished BP due to Cerebral vasodilatation. F
b. There is bradycardia. T

56- In Perianal Fistula:
a. It is common above the pelvic diaphragm. F
b. High fistula is common than low fistula. F

57-Gastric carcinoma:
Associated with pernicious anaemia. T
Associated with blood group A. T
Is a cause of iron deficiency anaemia. T
The lesser curvature is the commonest site. F (the antrum)
Mostly will be cured by surgery. F

58-Late complications of partial gastrectomy include:
Dumping syndrome. T
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
Osteomalacia. T
Iron deficiency anaemia. T
Recurrence of ulcer at the site of anastomosis. T
59-The following fractures are characterized by slow healing and non-union:
a. Carpal scaphoid. T
b. Distal tibia. T
c. Intertrochanteric fracture of the neck of the femur. F
d. Shaft of the humerus. F
e. Shaft of the femur. F
60-Undescended testes:
Never occur bilaterally. F
Associated with inguinal hernia. T
Should be treated in the first 6 months of life. F
Liable to torsion following trauma. T
Spermatogenesis can be preserved if treated surgically at adolescence. F

61-Chronic pancreatitis:
Can be caused by mumps. F
Early surgical intervention improves the outcome. F
30% develop diabetes mellitus. ?
X-ray calcification supports the diagnosis. T
Commonly caused by gallstones. F

62-Tension pneumothorax presents with:
Low voltage ECG. ?
Raised JVP. T
Cyanosis. T
Decreased expansion of the affected side. T

63-In Breast lump:
Fat necrosis resembles carcinoma. T
Fibroadenosis closely resembles cystic fibroadenoma. T
If it is painful is not a cancer. F
Fibroadenomas are associated with nulliparity. F
50% of lumps with nipple discharge are due to Pagets disease. ?
Microdochotomy should be performed to all lumps. F

64-Testicular tumours: STOP
Are characteristically resistant to radiotherapy. F
When metastasis occurs the tumour is incurable. T
Never occur bilaterally. F
Most patients are below 40 years of age. T
65-Carcinoma of the prostate:
Acid phosphatase is always high. ?
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
Microscopic carcinoma is common in the elderly. T
Can present with backache for the first time. T
Showed sclerotic metastasis. T
Orchidectomy improves the prognosis. T

66-Mixed parotid tumours:-
Commonly develop in the superficial lobe. T
Usually start as benign the n become malignant . F(rarely)
Facial nerve is early affected. F

67- Indications for diagnostic peritoneal tab in a patient with multiple injuries include :
Unexplained hypotension. T
Penetrating injuries. F
Paralytic ileus. F
Haematuria. F
68-In colo-rectal carcinoma:
a. Duke stage C indicates liver metastasis. F
b. Most commonly are poorly differentiated. F
c. Are resected by abdomino-perineal approach. ?(only low rectal)
d. Usually arise from adenomatous polyp. T
e. In 10% of patients there is synchronous tumour growth. ?

69-Fracture:
a. Is pathological if the artery is entrapped within fractured ends. F
b. Is closed if there is laceration above it. ?
c. Is open if is involving the joints. F
d. Is compound if more than one fragment is present. F
e. Is comminuted if the skin is open. F

70-In pyloric stenosis:
a. There is succession splash. T
b. Bilious vomiting occurs. F
c. There is visible peristalsis. T
d. There is metabolic acidosis. F
e. There is discoloration of the flanks. F

71-The following are associated with acute pancreatitis:
a. Hypoglycemia. F
b. Sentinel loop on X-Ray. T
c. Hypercalcaemia. T
d. Grey-Turner sign. T
e. Ca pancreas. T
72-In hydrocele:
a. The testis is palpable. ?
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b. Translucency on illumination. T
c. Is compressible by squeezing. F
d. It is posterior to the testis. F
e. It extends up to the external inguinal ring. F
73-Glue Ear:
a. The Drum is Dull, Blue & Congested. F
b. Can Present with Hearing Difficulty in Childhood. T
c. Can result in Sensory Neural Deafness. F
d. Associated with congenital deafness. F

74-The following are True about Renal Calculi;
a. Commonly detected by Plain X-Ray. T
b. Haematuria is common Presentation. T
c. Commonly associated with UTI. T
d. Mostly due to Calcium Oxalate. T
e. Commonly treated surgically. F
75- In neck Examination:
a. Thyroglossal Cyst ascends with protrusion of the tongue T
b. Branchial Cyst found behind the lower third of Sternocleidomastiod Muscle. F
c. Virchows node found in the left supra-clavicular fossa. T
d. Jugular vein distension occurs with Pancoast tumor. ?
e. Thyroid swelling may cause Stridor. T

76- In upper Limb Examination:
a. Carpal Tunnel Syndrome causes Thenar muscle wasting t.
b. Dupuytrens Contracture usually occurs in males. t
c. Palmer Erythema occurs in Thyrotoxicosis.t
d. Radial nerve injury causes Wrist Drop.t
e. Brachial Artery usually found medial to the Biceps muscle tendon. T
77-The following are included in Ransons Criteria:
1. WBCs> 15000/cubic mm. T
2. Serum Alfa Amylase. F
3. Hyperglycemia. T
4. PaO2. T
5. Hypercalcaemia. F

78- In the Acute Appendicitis
Rovsings Sign is Positive. T
Typically characterized by high-grade fever. F
Visceral pain occurs in Para-umbilical area. T
There is Tenderness in Rectal Examination. T

79- The following are True about Ca Prostate:
Can be diagnosed by rectal Examination. F
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
May Co-exist with Benign Prostatic Hypertrophy. T
Usually arise from the Medial Zone. F
Does not metastasize to bone. F
Can cause Obstructive Uropathy. T

80- The causes of Enlarged Nodes in the Groin include:
a. Testicular tumor. F
b. Uterine & Cervical Cancer. F
c. Lymphoma. T
d. Lower limb Cellulitis. T
e. Anal Canal tumors. T

81. Peptic Ulcer is associated with:
Hypercalcaemia. T
Head injury. T
Burns. T
Iron Deficiency Anemia. T
Acute Pancreatitis. T

82- Inguinal Hernia:
Indirect Hernia can be closed by pressure over the deep ring. T
Is associated with Undscended Testis. T
Appears Inferior & Medial to the pubic Tubercle. F
Less likely to strangulate than femoral hernia. T
The Hernial Sac may contain Omentum. T

83-In lower Back Pain:
About 90% of cases are due to Mechanical Causes. T
In the Elderly is of Degenerative Type. T
May be the presenting feature of Metastatic Cancer. T
If it is radiating to the Posterior thigh is always due to Disc Prolapse. ?

84-Malignant Melanoma:
In the lower Limb is of poor Prognosis than in the Neck and Trunk. F
Can arise in any pigmented tissue in the body. T
Commonly Metastasize by Lymphatics. T
Breslowss Staging depends on Depth spread. T
Itching is an alarming symptom. T




85-In Snake Bite:
1. Anti-venom can reverse the Action of the Venom. F
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
2. Anti-venom should always be given. F
3. The type of Snake should always be known. T
4. Arterial Tourniquet should always be applied over the site of the Bite. F
5. Anti-tetanus Toxoid should be given. T
86-In the 1st 24hrs post operative period
a. fever is usually due to atelectasias T
b. increased ADH T
c. oligouria is treated by dieresis F
d. k requirement is increased F

87-Daily nutritional requirements :-
e. 35kcal\kg for an adult. T
f. 5g\day nitrogen F
g. daily fatty acids is require to prevent deficiency F
h. carbohydrates provide 4kcal\gm T
i. amino acids in TPN are light sensitive. ?

88-In pre-operative patient:-
j. A high risk patient must be fully anticoagulated T
k. aspirin must be stopped 3 wks before the operation F
l. oral contraceptive must be stopped 6 wks pre-operatively . F
m. a diabetic pt. Must receive his regular dose on the day of surgery . F
n. a hypertensive pt. must receive his regular medication. T
89-Pancreatitis is associated with ;-
o. mumps . T
p. ERCP . T
q. Hypercalcaemia . T
r. Alcohol consumption . T
s. Biliary disease . T

90-DVT:-
t. investigation of choice is ascending venography . F
u. below knee need no treatment . F
v. pt. Should be mobilized early after surgery to prevent it. T

91-Ca prostate :-
y. occur in most men above 80 yrs. of old . T
z. PSA more than 100ng/ml is highly suggestive of metastasis. T
aa. PSA >10ng/ml is diagnostic. F
bb. Bilateral orchidectomy cure early disease. F
cc. A normal x ray is enough to disregard bone scan. F

92-Renal Ca :-
a. usually present late . T
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b. sensitive to chemotherapy. F
c. Bilateral in 40 % . F
d. commonly present with hydronephrosis. F
e. Raised RBC mass. T
93-An ischaemic limb :-
dd. usually painful. T
ee. Claudication in distance less than 500 m requires surgery. F
ff. Ankle-brachial index > 1 indcates claudication. F (0.8)
gg. Presence of dorsalis pedes pulse excludes peripheral vascular disease. F
94-tonsilectomy is indicated if :-
ii. tonsils are persistently enlarged . T
jj. peritonsilar abscess. T
kk. Nasal obstrucion. F
ll. TB lymphadenitis F
mm. More than 29% absenteeism from school. T
95-in fractres:-
a. slipping of the femoral epiphesis is common before the age of 8 years. F
b. Is compound if associated with vascular injury. F
c. In smiths # there is anterior displacement of the distal fragement. T
d. Osteomyelitis is caused by staph .albus. F
e. Around the elbow in children may involve the epiphyseal line resulting in
shortening . T
96-Plastic Surgery:
a. Basal Cell Carcinoma metastasizes to Regional Lymph Nodes. F
b. Squamous Cell Carcinoma increases in-patients with Renal Transplantation. T
c. Burns to the Face rarely needs Admission. F
d. Burn to the whole lower Limb in an adult represents 10& of Body Surface Area.
F
e. Exposed Tendons & bones always need Split Thickness Skin Graft. F
97-The following increase the Incidence of Oesphageal Carcinoma:
a. Columnar Metaplasia in the Oesophagus. T
b. Achalasia. T
c. Smoking. T
d. Blood group A F
e. Helicobacter pylori. F

98-Oesphageal Stricture:
a. The commonest cause is Reflux Oesophagitis. T
b. Frequently responds to Dilatation. T
c. May be due to Lime Ingestion. T
d. Usually needs Colonic Replacement. F
e. May present with Aspiration Pneumonia. T
99-The following are:
a. Dorsal Angulation is Characteristic of Colles Fracture. T
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b. Ulnar Impaction is seen in Smiths Fracture. F
c. Scaphoid Fracture Treatment needs Immobilization of the First Joint of the
Thumb. T
d. Bennitts Fracture involves the Radius. F
e. Frozen Shoulder may complicate Wrist Fracture. F
100-In Diabetic Patients:
a. There is Resistance to infection. F
b. There is Increased Insulin Requirements Peri-operatively. T
c. They should be on the Top of the Operative list. T
d. They should be monitored by Urinalysis Post- operative period. F
e. They have Poor Wound Healing. T
101-The following are found in Pyloric Stenosis:
a. Metabolic Acidosis. F
b. Succusion Splash. T
c. Billious vomiting. F
d. Visible Peristalsis. T
e. Discoloration of the urine. F
102-Breast Cancer:
a. Incidence is 1:20 in Western Countries. F
b. Chemotherapy is Contra-indicated in Inflammatory Carcinoma. F(indicated)
c. Tamoxifen may be used as Prophylaxis in High-risk patients. F
d. Post-menopausal patients with Ca Breast, Node + ve & Oestrogen Receptor +ve,
should be treated by Adjuvant Therapy. T
103-The following are True about Groin Hernias:
a. Symptomatic Femoral Hernias are Irreducible . ?
b. The Absence of Obstruction excludes Strangulation. F
c. Scrotal Extension is more with indirect Hernias than Direct Hernias. T
d. Small Defects do not need Repair. F
e. They are associated with Hypertrophy of the Prostate. T
104-in hernia:
Reducible femoral hernia can be controlled by pressure above and lateral pubic
tubercle. F
Inguinal hernia in achild should not be treated <5yrs. F
Femoral hernia always have positive cough impulse. F
Incisional hernia common with AAA than with colonic resection. T
Indirect inguinal hernia benign cause than direct H. T
105-the following are indication for surgical intervention:
Umbilical hernia in1yr child. F(2yr)
Strawberry nevus Rt arm in 18 yrs girl. F
Hydrocele 3 month child . F
Obstructed hernia in6month child. T
Saceral pit in neonate. F
106-the following may present with dysphagia:
Mallory Wies syndrome . F
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
Diabetes . T
Sjogrene syndrome. T
Systemic sclerosis. T
Achalasia. T
107--breast reconstruction
It may done at time of mastectomy T
Silicon gel has no side effects ?
Can be done by inflation technique T
Tissue expanders frequently used T
Skin flap can be usedt T
108-perforated peptic ulcer:
Haematemesis T
Decrease liver dullness T
Decrease intestinal motility T
Rigidity T
Colicky abdominal pain F
109-Lumps in the neck:
Branchial cyst in the midline F
Parathyroid adenoma rarely palpable T
Nasopharyngeal CA should be excluded T
T B adenitis is common in Ireland F
Parotid gland (benign carotid tumor )fascial nerve palsy. F
110-Orthopaedics:
Smith fracture distal radius displaced anterioly . T
Compound fracture imply vascular injury . F
Elbow fracture in children interfere with bone growth . ? (if affect the plate)
Osteomyelitis is mainly due to staph epdermidis F
Epiphyseal fracture <8yrs . F

111-spleenic repair is indicated in the following:
Supcapsular and parenchymal injuries. ?
In children for fear of post splenectomy sepsis. T
Children with spherocytosis. F
If monitoring and follow up facilities available ?
In the presence of contaminated peritoneum. F
112-thoracic surgery:
Chest tube inserted in the 4th and 5th intercostals mid axillary line. T
GCS<8 is indication for intubation. T
Angiography is gold standard test to diagnose ruptured aortic aneurysm. T
Tension pneumothorax is diagnosed by X ray F
Fractured is treated by internal fixation. F

113-spleenectomy can lead to:
a.leucocytosis. T
Surgery part 1
Organised & solved for Sudanese doctors Musab Bashir U of K 2009
Alfrazdaq Hassan UofG 2003
b.increased platelets count. T
c.increased RBCs fragility. F
d.decreased blood viscosity. F
e.increased incidence of thrombo-embolic phenomenon. T




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