1.

A 24 years’ young lady who is currently breast feeding her first born child, develops an
increasing erythematous indurated area of her right breast with overlying skin edema, pain
and hectic fever of 5 days’ duration. Which of the following statements is true concerning
her management?
a) Open surgical drainage under general anesthesia
b) Breast feeding should be discontinued
c) Treatment with antibiotics till complete resolution
d) True cut needle biopsy for malignancy

2. Which of the following is true about breast cancer?

a) For most women a specific cause of breast cancer is known
b) Prognosis is worse for ER and PR positive breast cancer
c) Women with history of breast cancer have 10-fold increasing risk of developing another
breast cancer
d) Incidence of breast cancer is decreasing

3. Which of the following statements is true of breast cancer treatment?

a) Mastectomy is superior to conservative surgery
b) Chemotherapy can be used safely in the first trimester of pregnancy
c) Radiotherapy should be given to the remaining breast tissue and tumor bed after
conservative breast surgery
d) All cases of Pagets disease of the nipple should be treated with wide local excision

4. A10 year old female presented with accidently discovered swelling of the front of neck of
few months’ duration. The swelling was slowly increasing in size. She didn’t receive any
treatment. General examination was unremarkable. On local exam; there was a solitary
cystic swelling moving with deglutition & protrusion of the tongue. The swelling was neither
tender nor pulsating. The most likely diagnosis is:
a) Cystic hygroma
b) Thyroglossal cyst
c) Cyst of the thyroid gland
d) Sequestration dermoid cyst

5. True statement regarding parotid tumors:

a) 40% of parotid tumors are malignant
b) TRU cut biopsy is needed prior to surgery
c) Radiological assessment with CT scanning is indicated for all parotid tumors
d) Fascial nerve should be preserved during total parotidectomy for all parotid tumors
e) Superficial conservative parotidectomy is the operation of choice for benign tumors not
affecting the deep lobe
6. Indications of surgery for simple multinodular goitre does NOT include:
a) Large goitre causing disfigurement with just mild symptoms
b) Impalpable lower border of the gland
c) Nodules limited to one lobe
d) Goitre in a patient under 30 years of age

7. All of the following are considered an increased risk factor of cancer in a patient with
thyroid mass EXCEPT:
a) Rapid growth
b) Family history
c) Hard in consistency
d) Hot nodule on thyroid uptake scan
e) Solid solitary nodule in U/S scan

8. Preferred management of multinodular goitre with tracheal compression is:

a) Iodine treatment
b) Thyroid hormone treatment
c) Radioactive iodine treatment
d) Tracheostomy & isthmectomy
e) Total thyroidectomy

9. The most precise diagnostic screening procedure for differentiating benign solitary thyroid
nodule for a malignant one is:
a) Thyroid hormone essay
b) Thyroid ultrasonography
c) Thyroid scintiscan
d) Fine needle aspiration (FNAB)
e) Tumor marker

10. A 25 years old female presented with graves’ disease. She received medical treatment for
one year and went into remission. Few months later she complains of insomnia & rapid
palpitation. T4 was high. What is the best definitive treatment?
a) Antithyroid drugs
b) Antithyroid drugs, propranolol & Lugol’s iodine
c) Total thyroidectomy
d) Radioactive iodine
e) None of the above

11. One of the characteristics of complicated GERD is:

 a) Postprandial heartburn when bending down
b) Epigastric pain not responding to PPI
c) Repeated eructation during fasting
d) Waking in early morning on cough attacks
e) Transient lower esophageal sphincter relaxations (TLESR)foe 30 minutes/24hours

12. The most appropriate treatment for Barrett’s Esophagus with low grade dysplasia is:
a) Medical treatment with proton pump inhibitors
b) Fundoplication (antireflux operation) only
c) Endoscopic mucosal resection of endoscopic submucosal dissection followed by
fundoplication
d) Esophagectomy

13. Perforated duodenal ulcer is best treated by:

a) Conservative management with antibiotics & proton pump inhibitors
b) Several days of nasogastric suction and stomach wash using normal saline to
decompress and clean the stomach
c) Emergency laparotomy and closure with omental patch
d) Endoscopic cauterization using bipolar cautery, Laser or heater probe
e) Endoscopic Sclerotherapy using ethanolamine oleate

14. A case of gastric carcinoma of the body staged T2N1M0 is best treated by:
a) R1 (D1) gastrectomy
b) R1 (D1) gastrectomy with chemoradiation therapy
c) R2 (D2) gastrectomy
d) R2 (D2) gastrectomy with chemoradiation therapy

15. Which statement is true about cancer head of pancreas?

a) It is adenocarcinoma in 40% of cases
b) It constitutes 50% of pancreatic cancer
c) Thrombophlebitis migrans is presented in 60% of cases
d) Presented with obstructive jaundice in 90% of cases
e) Curative surgery can be done in 90% of cases

16. Whipple triad is associated with one of the following conditions:

a) Glocagonoma
b) Insulinoma
c) Pancreatic exocrine tumor
d) Cholangiocarcinoma
e) Obstructive jaundice
17. Ultrasonography is indicated in patients with an acute cystitis when:
a) The pathogen is E-coli
b) Three repeated episodes of cystitis in female
c) The urine culture is 10.000-50.000col/ml
d) The patient presented with fever for 48 hours
e) Urine culture is positive but blood cultures are negative

18. A 3 cm lower calyceal radio-opaque stone is best managed by:

a) Extracorporeal shock wave lithotripsy (ESWL)
b) Chemo-dissolution
c) Percutaneous nephrolithotomy (PCNL)
d) Uretero-renoscopy

19. Nephron sparing surgery for treatment of renal cell carcinoma is indicated for tumors up to
the size of:
a) 8 cm
b) 7cm
c) 6 cm
d) 5 cm
e) 4 cm

20. Which of the following should always be managed by surgical exploration?

a) Intraperitoneal rupture of urinary bladder due to blunt trauma
b) Extraperitoneal rupture of urinary bladder due to blunt trauma (uncomplicated)
c) Grade 1, 2 renal injury
d) Subcapsular hematoma of the kidney

21. Contraindications of pneumatic reduction in infant suspected to have intussusception

include the following:
a) Repetitive attacks of colics
b) Passage of red colored jelly stools
c) Air under diaphragm in abdominal X-ray
d) Palpable sausage shaped mass

22. A neonate born with high anorectal malformation. The 1st line of management is:
a) Defunctioning colostomy
b) Invertogram
c) Iv fluids
d) Abdominal US
23. VATER syndrome include the following anomaly
a) Intestinal atresia
b) Epispadias
c) Anorectal atresia
d) Biliary atresia
e) Congenital dislocation hip

24. Which of the following statements is correct about the definitive treatment of
Hirschsprung’s disease?
a) Permanent colostomy is indicated in most cases
b) It is indicated above 6 years’ age
c) The commonest complication of surgery is bladder & ureters injury
d) The main aim of surgery is to excise the aganglionic segment and restore continuity
e) The posterior sagittal approach can be used

25. Keloid s are treated by:

a) Surgical excision
b) X-ray therapy
c) Triamcilone injection locally
d) Laser therapy
e) All of the above

26. Malignant transformation in naevi is suspected by:

a) Spontaneous ulceration and bleeding
b) Enlargement or darkening of the lesion
c) Pigmented satellite lesion
d) Lymph node swelling in the drainage area
e) All of the above

27. Goals of lip repair (Cheiloplasty) include the following EXCEPT:

a) To correct all lip deficits
b) To reconstitute orbicularis oris
c) To restore speech/velopharyngeal (VP) competence
d) To restore all anatomical landmarks
e) To correct nasal deformity
28. According to the classification proposed by Swanson for congenital hand deformity, failure
of differentiation includes:
a) Syndactyly
b) Polydactyly
c) Macrodactyly
d) Brachydactyly
e) Constriction band syndromes

29. Which of the following clinical findings has the priority for operation in hernia patients?
a) Recent irreducibility
b) Patient presenting with vomiting and abdominal distention
c) Tense tender hernia sac
d) Hernia reaching the scrotum
e) Bilateral inguinal hernia

30. All of the following are sequestration dermoid cysts EXCEPT:

a) Sublingual and submental dermoid
b) Internal or external angular dermoid
c) Post-anal dermoid
d) Post auricular dermoid
1- Which is NOT a component of systemic inflammatory response syndrome (SIRS)
a) Temperature
b) White blood cell (WBC) count
c) Hypertension
d) Heart rate
e) Respiratory rate
2- An ICU patient with pH 7.29, HCO3 = 18 mEq/L and Pco2 = 27 mmHg. This patient has:
a) Metabolic alkalosis with partially compensated respiratory acidosis
b) Metabolic acidosis with partially compensated respiratory alkalosis
c) Respiratory acidosis with partially compensated metabolic alkalosis
d) Respiratory alkalosis with partially compensated metabolic acidosis
3- Principles of treatment of surgical infections include the following EXCEPT:
a) Remove dead and devascularized tissue
b) Drain collections of pus
c) Remove foreign bodies
d) Drain obstructed hollow viscera
e) Only Antibiotic therapy is enough
4- Female 50 years old patient c/o of multiple swellings of her upper back of 6 months duration.
The swellings are increasing in size and became painful. O/E: the swellings are soft, mobile with
slippery edge and not tender. The most probable diagnosis is
a) Multiple neurofibromatosis.
b) Durcum's disease (multiple lipomatosis).
c) Multiple sebaceous cyst.
e) Multiple haemangiomas.
5- A 35 years old patient presented with a non-tender 4cm rounded swelling related to the
upper pole of the testes, smooth and cystic. Rest of inguinoscrotal examination showed no
other pathology. Patient refused surgery and six month later he came back with acute local pain
and the swelling showed increase in size and tenderness. What is the cause of this recent
change?
a) Haematoma of the cyst
b) Torsion of the cyst
c) Strangulated hernia
d) Thrombosis in the varicocele
6- In patients with Burger's disease and critical limb ischemia, we don’t perform bypass surgery
because:
a) The saphenous vein is affected by recurrent thrombophlebitis
b) There is no patent runoff artery
c) Corkscrew collaterals compensate for arterial occlusion
d) The entire neurovascular bundle is inflamed
 d) Patients usually cannot stop smoking
7- A patient with critical LL ischemia, palpable popliteal pulse and absent pedal pulses.
Angiography showed localized occlusions of the anterior and posterior tibial arteries. The
treatment of choice for this patient is:
a) Balloon angioplasty of the tibial arteries
b) Vasodilators and antiplatelets
c) Lumbar sympathectomy
d) Below knee amputation
e) Arterial embolectomy
8- Which of the following is compatible with 1ry Raynaud's disease?
a) Elevated ESR
b) Normal digital arteries on angiography
c) Positive immune markers
d) Digital trophic changes
9- Which ONE of these statement about ruptured abdominal aortic aneurysms is correct?
a) They mostly present in elderly women
b) They are mostly infra-renal in location
e) They must be treated within 12 hours for a successful outcome
c) They are usually mycotic in nature
d) They usually rupture into the free peritoneal cavity
10- In Chronic Liver Disease the precautions during general anaesthesia should be:
a) Use N2O
b) Increase doses of opioids
c) Use long acting muscle relaxants
d) Just to avoid hypoxia and maintain normal PaCO2