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Hospital Surgery Flashcards

1
Q
  1. Which of the following investigation is a decisive method for diagnosing acute dysfunction of mesenteric blood circulation?
    1. Examination of a patient.
    2. Plain abdominal X-ray.
    3. Angiography of visceral blood vessels.
    4. Siphon enema.
  2. Retropneumoperitoneum.
A

*3.Angiography of visceral blood vessels.

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2
Q
  1. Select an optimal method for treatment of atherosclerotic occlusion of popliteal artery, if anterior and posterior tibial arteries are patent.
    1. Conservative treatment.
    2. Lumbar sympaticectomy
    3. Tromb-intima-ectomia of popliteal artery.
    4. Auto-venous femoral-bitibial shunting.
A

*4.Auto-venous femoral-bitibial shunting.

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3
Q
  1. Three main symptoms of Lerisha [LERSCHE ]syndrome are:
    1. Acute oedema of lower extremities.
    2. Absence of arterial pulsation of lower extremities.
    3. Superficial varicose veins.
    4. Intermittent limping { Jimmy / Jitter legs}
    5. Impotence.
A
  • 2.Absence of arterial pulsation of lower extremities.
    * 4.Intermittent limping { Jimmy / Jitter legs}
    * 5.Impotence.
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4
Q
  1. In obliterans endo-arteritis, the typical localization of impairment of blood vessels is in:
    1. Aorta
    2. Iliac artery.
    3. Iliac and femoral arteries.
    4. Femoral and popliteal arteries.
    5. arteria pedis and popliteal.
A

*4.Femoral and popliteal arteries.

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5
Q
  1. Select two correct methods for topical diagnosis of thromboembolysis of pulmonary artery:
    1. ECG.
    2. Perfusion scanning of lungs.
    3. Chest X-ray
    4. Tomography
    5. Angio-pulmonary-graphy
A
  • 2.Perfusion scanning of lungs.

* 5.Angio-pulmonary-graphy

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6
Q
  1. Which two diseases are common cause for embolism of the major circulating system:
    1. Rheumatic mitral valve heart defect.
    2. Aneurism of aorta and its large branches.
    3. Atherosclerosis of aorta.
    4. Ischemic heart diseases and its complications.
    5. Cancer.
A
  • 1.Rheumatic mitral valve heart defect.

* 4.Ischemic heart diseases and its complications.

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7
Q
  1. Lerisha (Lersch) syndrome is ;
    1. Non-specific brachio-cephalic arteritis.
    2. Atherosclerotic occlusion of the abdominal aorta bifurcation.
    3. Capillary pathology of distal parts of extremities.
    4. Migrating thrombo-vasculitis.
    5. Occlusion of lower vena cava.
A

*2.Atherosclerotic occlusion of the abdominal aorta bifurcation.

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8
Q
  1. Which functional test is used to value blood flow in the deep veins of lower extremities?
    1. Talmann.
    2. Sheinice
    3. hakkenburg
    4. Meiyo-Prett.
    5. Brody-Trayanova-Tenderlenburg.
A

*4.Meiyo-Prett.

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9
Q
  1. Name the basic treatment for pericardial effusion.
    1. Administration of inotpropic substance.
    2. Administration of diuretics.
    3. Administration of anticoagulants.
    4. Pericardial puncture.
    5. Subtotal pericardiotomy.
A

*4.Pericardial puncture.

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10
Q
  1. Which are possible complications after angiography of the lower limbs?
    1. Acute renal insufficiency.
    2. Arterial occlusion.
    3. Formation of pseudo aneurysm.
    4. Stroke (cerebral thrombosis).
A
  • 1.Acute renal insufficiency.
    * 2.Arterial occlusion.
    * 3.Formation of pseudo aneurysm.
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11
Q
  1. Mention group of people who are liable to get endarteritis obliterans?
    1. Children up to 15 years.
    2. Youths 15 – 20 years.
    3. Males 20 – 40 years.
    4. Females 20 – 40 years.
    5. Males 60 -80 years.
A

*4.Females 20 – 40 years.

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12
Q
  1. Mention two forms of the arterial obliteration, most frequently encountered in peacetime:
    1. Acute thrombosis.
    2. Trauma of the arteries.
    3. Emboli.
    4. Spasm of the arteries.
A
  • 1.Acute thrombosis.

* 3.Emboli.

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13
Q
  1. A patient in gynecological department, on 10th day after operation, developed thrombosis of iliac vein. Right tactic is:
    1. Start anticoagulant therapy.
    2. Investigate coagulation system.
    3. Transfer the patient to surgical dept.
A

*3.Transfer the patient to surgical dept.

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14
Q
  1. Main cause of acute thrombosis of main arteries is:
    1. Trauma of arteries.
    2. Acute thrombosis of concomitant vein.
    3. Atherosclerotic lesion of arteries.
    4. Rheumatic mitral valve defect.
    5. Malignant tumor.
A

*3.Atherosclerotic lesion of arteries.

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15
Q
  1. Hypertension, associated to renal arterial defect, is characterized by the following signs:
    1. Sudden onset of disease in youth age.
    2. Beside hypotensive therapy, BP is uncontrollable.
    3. Sudden rise of BP in patient with compensated hypertension.
    4. Occurrence of murmur over the arteries of the lumbar region.
    5. Leucocytes content in urine is increased.
A
  • 1.Sudden onset of disease in youth age.
    * 2.Beside hypotensive therapy, BP is uncontrollable.
    * 3.Sudden rise of BP in patient with compensated hypertension.
    * 4.Occurrence of murmur over the arteries of the lumbar region.
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16
Q
  1. Clinical occurrence of varicose disease include following symptoms:
    1. Thrombosis of deep veins.
    2. Positive Tredelenburg test.
    3. Valvular incompetence in veins.
    4. Local bleeding.
    5. Pain relief after wearing elastic tights/pantyhose.
A

*2.Positive Tredelenburg test.

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17
Q
  1. Post operative phlebo-thrombosis of lower limbs is dangerous because:
    1. They can be a cause of thrombo-emboli of pulmonary arteries.
    2. Can lead to varicose vein of the lower limbs.
    3. Can cause gangrene of lower limbs.
    4. They can be a cause of emboli of brain blood vessels.
    5. They can be a cause of post operative pneumonia.
A

*1.They can be a cause of thrombo-emboli of pulmonary arteries.

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18
Q
  1. Which of the following statement is true about co-arctation of aorta?
    1. It is twice frequent in girls than in boys.
    2. Objectively weak pulse is felt on upper and lower extremities.
    3. Operative treatment is indicated in all patients at age of 1-2 years.
    4. Hypotension is a common complication in post-operative period.
    5. Child complains of headache, weakness of lower extremities and dizziness.
A

*5.Child complains of headache, weakness of lower extremities and dizziness.

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19
Q
  1. Mention possible complication of post-infarction aneurysm of left ventricle:
    1. Thromboembolism of pulmonary artery.
    2. Systemic embolism.
    3. Cardiac insufficiency.
    4. Rapture of aneurysm with cardiac tamponade.
A
  • 3.Cardiac insufficiency.

* 4.Rapture of aneurysm with cardiac tamponade.

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20
Q
  1. Which of the following symptoms are important in deep vein thrombosis of lower extremities?
    1. Edema.
    2. Absence of pulse on foot.
    3. Pulsating pain.
    4. Pain along the vessel bundle.
A
  • 1.Edema.
    * 3.Pulsating pain.
    * 4.Pain along the vessel bundle.
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21
Q
  1. Select 3 etiological factors for varicose disease of lower extremities.
    1. Hereditary or non-hereditary insufficiency of connective tissue.
    2. Increased catecholamine levels in blood.
    3. Blood flow difficulty in venous system of lower extremities.
    4. Blood outflow from deep vein to superficial veins via inter-communicant veins.
    5. Deep vein occlusion.
A
  • 1.Hereditary or non-hereditary insufficiency of connective tissue.
    * 3.Blood flow difficulty in venous system of lower extremities.
    * 4.Blood outflow from deep vein to superficial veins via inter-communicant veins.
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22
Q
  1. Mention 3 main etiological factors in acute venous thrombosis:
    1. Age of a patient.
    2. Slow blood flow.
    3. harmful habits
    4. Trauma of venous wall.
    5. Thrombosis conditions in haemostatis.
A
  • 1.Age of a patient.
    * 3.harmful habits
    * 4.Trauma of venous wall.
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23
Q
  1. Which treatment is recommended in a 19 year old patient suffering from obliterating endarteritis (spastic stage)?
    1. Complex conservative treatment.
    2. Lumbar sympathectomy.
    3. Thrombectomy from femoral artery.
    4. femoral- tibial shunt
A

*1.Complex conservative treatment.

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24
Q
  1. 3 main clinical signs for obliterating endarteritis are:
    1. “High” intermittent limping.
    2. “Low” intermittent limping.
    3. Trophic changes of the skin.
    4. Acute edema of limbs.
    5. Cyanosis of toes.
A
  • 2.“Low” intermittent limping.
    * 3.Trophic changes of the skin.
    * 5.Cyanosis of toes.
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25
Q
  1. For a fast progressive gangrene of the foot, it’s necessary to do the following:
    1. Multiple incisions on the skin of the foot.
    2. Urgent amputation.
    3. Perform shunting of arteries.
    4. Try to turn wet gangrene into dry.
    5. Give high dose of antibiotics.
A

*2.Urgent amputation.

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26
Q
  1. Clinical manifestations for open [Botallo’s] ductus arteriosus
    1. Bright/rosy flush.
    2. BP fluctuation due to diastolic pressure.
    3. Systolic-diastolic murmur at 2-3rd intercostals left of sternum.
    4. Diastolic murmur at 3rd intercostal right of sternum.
A
  • 1.Bright/rosy flush.
    * 3.Systolic-diastolic murmur at 2-3rd intercostals left of sternum.
    * 4.Diastolic murmur at 3rd intercostal right of sternum.
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27
Q
  1. Which method is optimal for prevention of pulmonary artery embolism incase of floating thrombi of vena cava inferior?
    1. Plication of vena cava inferior.
    2. To perform aortal-vena cava anastomosis.
    3. To implant a cava- filter.
    4. To remove floating thrombus.
    5. Ligation of iliac vein.
A

*3.To implant a cava- filter.

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28
Q
  1. Which type of operation can help to prevent recurrence of trophic ulcer in re-canalizing form of post thrombosis disease?
    1. Troyanova-Trendelenburg operation.
    2. Linton operation.
    3. Plication of vena cava inferior by machine stitch.
    4. Implantation of umbrelliferous cava-filter.
A

*2.Linton operation.

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29
Q
  1. Name 3 complications of varicose disease of lower extremities.
    1. Acute thrombophlebitis.
    2. Foot gangrene.
    3. Trophic ulcer of legs.
    4. Bleeding.
    5. Hyperkeratosis, shedding/falling off of hairs on legs.
A
  • 1.Acute thrombophlebitis.
    * 3.Trophic ulcer of legs.
    * 4.Bleeding.
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30
Q
  1. Which method of treatment is indicated in stenosis of terminal part of aorta and iliac artery with satisfactory distal blood flow?
    1. Roentgen-endovascular dilatation.
    2. Bifurcational aorta-femoral shunting.
    3. Bifurcational aorta-femoral prosthetics.
    4. Aorta-femoral shunting with crossed femoral-femoral shunt.
    5. Lumbar sympathectomy.
A

*2.Bifurcational aorta-femoral shunting.

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31
Q
  1. What is typical for acute disorder of mesenteric artery blood circulation?
    1. Low hemoglobin.
    2. Leukocytosis.
    3. Increased diastase.
    4. Hyperglycemia.
A

*2.Leukocytosis.

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32
Q
  1. Which operation is most advisable to perform in mitral stenosis with marked calcinosis of mitral valve?
    1. Closed, finger mitral commissurotomy.
    2. Closed instrumental mitral commissurotomy.
    3. Open mitral commissurotomy.
    4. Mitral valve replacement.
A

*4.Mitral valve replacement.

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33
Q
  1. What complications are possible in aneurysm of heart?
    1. Hypoxia of brain.
  2. Thromboembolism.
  3. Cardiac insufficiency.
  4. Liver cirrhosis.
A
  • 2.Thromboembolism.
  • 3.Cardiac insufficiency.
  • 4.Liver cirrhosis.
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34
Q
  1. In case of inter-atrium defect, saturation of oxygen in blood increases in which chambers of the heart?
    1. Right atrium.
    2. Right ventricle.
    3. Pulmonary artery.
    4. Left atrium.
    5. Left ventricle.
A
  • 1.Right atrium.
    * 2.Right ventricle.
    * 3.Pulmonary artery.
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35
Q
  1. Mention three symptoms which are specific for constrictive pericarditis.
    1. Absence of apex beat.
    2. Presence of heart murmurs.
    3. Hepatomegalia.
    4. Ascites.
    5. Splenomegalia.
A
  • 1.Absence of apex beat.
    * 3.Hepatomegalia.
    * 4.Ascites.
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36
Q
  1. Peculiarities of coarctation of aorta are:
    1. Common localization is distal from left subclavicular artery.
    2. BP difference between upper and lower extremities.
    3. Ladder step ribs.
    4. Left ventricular hypertrophy.
    5. Right ventricular hypertrophy.
A
  • 1.Common localization is distal from left subclavicular artery.
    * 2.BP difference between upper and lower extremities.
    * 3.Ladder step ribs.
    * 4.Left ventricular hypertrophy.
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37
Q
  • 37.Select three indications for surgical treatment in ischemic heart disease.
    1. Instable angina pectoris.
    2. Stable angina pectoris.
    3. Acute myocardial infarction.
    4. Instable angina pectoris.
    5. Post myocardial infarction complications (aneurysms of heart, mitral insufficiency, defect of inter ventricular septum)
A
  • 1.Instable angina pectoris.
    * 2.Stable angina pectoris.
    * 5.Post myocardial infarction complications (aneurysms of heart, mitral insufficiency, defect of inter ventricular septum)
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38
Q
  1. Fallot’s tetralogy have the following defects:
    1. Inter-ventricular septal defect.
    2. Inter-atrium septal defect.
    3. Dextral position of aorta.
    4. Arch of aorta is right sided.
    5. An obstruction of the right ventricular outflow tract.
A
  • 1.Inter-ventricular septal defect.
    * 3.Dextral position of aorta.
    * 5.An obstruction of the right ventricular outflow tract.
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39
Q
  1. Choose 2 signs which are significant in intra uterine blood circulation.
    1. Most of the blood volume from vena cava superior flows through foramen ovale into left atrium.
    2. Most of the blood volume from vena cava inferior directly flows’ through tricuspid valve.
    3. Little amount of blood from right ventricle passes through open ductus arteriosus into descending aorta.
    4. Pulmonary-vascular resistance is increased.
    5. Pressure in left atrium exceeds pressure in right atrium.
A
  • 3.Little amount of blood from right ventricle passes through open ductus arteriosus into descending aorta.
    * 4.Pulmonary-vascular resistance is increased.
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40
Q
  1. Main advantage of heart valve bioprosthesis over mechanical heart valve is.
    1. Hemodynamical characteristics.
    2. Technically easy to make.
    3. Highly thrombo- resistance, less thrombo-embolic complications.
    4. Highly mechanical durability.
    5. Simple to implant.
A

*3.Highly thrombo- resistance, less thrombo-embolic complications.

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41
Q
  1. Decisive factor for operable patient with inter ventricular septal defect is.
    1. Size of defect.
    2. Localization of defect.
    3. Pressure in pulmonary artery.
    4. Pulmonary-vascular resistance.
    5. Age of the patient.
A

*4.Pulmonary-vascular resistance.

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42
Q
  1. Permanent implantation of pacemaker is indicated in the following pathology.
    1. Complete (third degree) atrioventricular heart block.
    2. Sick (weak) sinus syndrome.
    3. Post-surgical cardiac blockade.
    4. Carotid sinus [Charcot-Weiss-Baker] syndrome.
    5. Acute myocardial infarct.
A
  • 1.Complete (third degree) atrioventricular heart block.
    * 2.Sick (weak) sinus syndrome.
    * 3.Post-surgical cardiac blockade.
    * 4.Carotid sinus [Charcot-Weiss-Baker] syndrome.
43
Q
  1. Which of the following is typical for emphysema of the mediastinum?
    1. Cyanosis.
    2. Acute left ventricular insufficiency.
    3. Retrosternal pain.
    4. Throat pain.
  2. Crepitations/crackling during palpation.
A
  • 1.Cyanosis.
    * 3.Retrosternal pain.
    * 4.Throat pain. *5.Crepitations/crackling during palpation.
44
Q
  1. Most reliable cause of mitral restenosis after commissurotomy is.
    1. Calcinosis of mitral valve.
    2. Progressive fibrosis due to tubular blood flow through the valve.
    3. Repeated rheumatic attacks.
    4. Not adequate commissurotomy.
A

*4.Not adequate commissurotomy.

45
Q
  1. pulmonary hypertension can develop in patients with the following two defects:
    1. Inter-ventricular septal defect.
    2. Fallot’s tetralogy.
    3. Complete drainage abnormality of pulmonary vein.
    4. Pulmonary artery stenosis.
A
  • 1.Inter-ventricular septal defect.

* 3.Complete drainage abnormality of pulmonary vein.

46
Q
  1. Treatment of acute purulent pericarditis in early stage should include:
    1. Paracentesis, aspiration of the contents in the pericardium to confirm the diagnosis.
    2. Antibiotics and its administration in pericardium cavity.
    3. Repeated paracentesis of pericardium and aspiration of the pus.
    4. Thoracotomy and excision of affected pericardium with wide drainage.
A
  • 1.Paracentesis, aspiration of the contents in the pericardium to confirm the diagnosis.
    * 2.Antibiotics and its administration in pericardium cavity.
    * 3.Repeated paracentesis of pericardium and aspiration of the pus.
47
Q
  1. A patient admitted with stab wound on the left half of thoracic cage, hypotension, intensive pulsation of the cervical veins and tachycardia. The most expedient diagnostic and treatment tactic in this situation will be:
    1. Chest x-ray.
    2. Measure central venous pressure.
    3. Left-sided thoracotomy.
    4. Pericardiocentesis.
A

*4.Pericardiocentesis.

48
Q
  1. In which complications of myocardial infarction, surgical correction is indicated?
    1. Interventricular septal defect.
    2. Papillary muscle abruption.
    3. Left ventricular aneurysm.
    4. Myocardial rapture.
    5. Post-infarction cardiosclerosis.
A
  • 1.Interventricular septal defect.
    * 2.Papillary muscle abruption.
    * 3.Left ventricular aneurysm.
    * 4.Myocardial rapture.
49
Q
  1. Which of the following heart defects causes increased blood flow in pulmonary (lesser) circulation:
    1. Inter-atrium septal defect.
    2. Fallot’s tetralogy.
    3. Interventricular septal defect.
    4. Common arterial trunk.
A
  • 1.Inter-atrium septal defect.
    * 3.Interventricular septal defect.
    * 4.Common arterial trunk.
50
Q
  1. Patients with artificial mechanical valves should get anticoagulants:
    1. Throughout the hospitalized period.
    2. The whole first year after operation.
    3. For life time.
    4. Only in case of thrombo-embolic complications.
A

*3.For life time.

51
Q
  1. The following signs approves for heart injury:
    1. Localization of the wound.
    2. Acute fall in blood pressure, tachycardia.
    3. External clinical features of the patient.
    4. Increased venous pressure.
    5. Hemoptysis.
A
  • 1.Localization of the wound.
    * 2.Acute fall in blood pressure, tachycardia.
    * 3.External clinical features of the patient.
    * 4.Increased venous pressure.
52
Q
  1. The Principle characteristic of pediatric surgery is:
    1. Surgery of children with low body weight.
    2. Surgery of a growing organism of a child.
    3. Surgery of an infected child.
A

*2.Surgery of a growing organism of a child.

53
Q
  1. The following factors plays a great role in purulent surgical infections in children:
    1. Lymphoid tissue is rich in children.
    2. Generalized reaction to infection.
    3. Increased permeability of natural barrier components.
    4. Relatively immature organs and tissues.
A
  • 1.Lymphoid tissue is rich in children.
    * 2.Generalized reaction to infection.
    * 3.Increased permeability of natural barrier components.
54
Q
  1. The cause of increased number of patients with surgical sepsis is:
    1. Mutation of flora.
    2. Micro-floral resistance to antibiotics.
    3. Prevalence of inter-hospital infection.
A
  • 1.Mutation of flora.
    * 2.Micro-floral resistance to antibiotics.
    * 3.Prevalence of inter-hospital infection.
55
Q
  1. Principles of diagnosing purulent surgical infection are:
    1. Detection of primary foci.
    2. Study the reactivity of the child organism.
    3. Micro-biological investigation.
A
  • 1.Detection of primary foci.
    * 2.Study the reactivity of the child organism.
    * 3.Micro-biological investigation.
56
Q
  1. What are the principles of treatment of acute purulent surgical infection in children?
    1. Act on microorganism.
    2. Act on microorganism.
    3. Act on primary foci.
A
  • 1.Act on microorganism.
    * 2.Act on microorganism.
    * 3.Act on primary foci.
57
Q
  1. A child 5 months old had a multiple dome-shaped abscesses without purulent cores/points. What is the probable diagnosis?
    1. Furunculosis. 2.Pseudofurunculosis.
    2. Hypodermic tissue abscess.
    3. Phlegmon.
    4. Erysipelatous inflammation.
A

*2.Pseudofurunculosis.

58
Q
  1. Which of the following diagnostic method for acute osteomyelitis is the most accurate?
    1. Diagnostic puncture of the soft tissues. 2.Osteophlebography.
    2. X-ray.
    3. Measuring increased intraosseous pressure.
A

*4.Measuring increased intraosseous pressure.

59
Q
  1. Which clinical symptoms are significant in early childhood developing acute hematogenic osteomyelitis?
    1. Tenderness on palpation.
    2. Loss of function.
    3. Edema of soft tissues.
    4. Increased local temperature.
    5. Fluctuation.
A
  • 2.Loss of function.
    * 3.Edema of soft tissues.
    * 4.Increased local temperature.
60
Q
  1. Management of a child with chronic osteomyelitis which has developed hollow sequestration should be.
    1. Sequestrectomy.
    2. Observation.
    3. Course of physiotherapy.
    4. Administration of intraosseous sensitive antibiotics.
A

*1.Sequestrectomy.

61
Q
  1. The period of formation of pulmonary defects is:
    1. 3-4 weeks of intra uterine development.
    2. 6-8 weeks of intra uterine development
    3. 10-12 weeks of intra uterine development
A

*1.3-4 weeks of intra uterine development.

62
Q
  1. Pathogenesis factors for lung abscess formation are.
    1. Decreased immune resistance of the organism and presence of conditional-pathogenic microflora.
    2. Chronic respiratory insufficiency.
    3. Bronchial drainage dysfunction.
    4. Compression by abnormal bypass of blood vessels.
    5. Regional microcirculation impairment.
A

*1.Decreased immune resistance of the organism and presence of conditional-pathogenic microflora.
cy.
*3.Bronchial drainage dysfunction.
*5.Regional microcirculation impairment.

63
Q
  1. The general condition of the patient is severe. Dyspnea, fever. Chest X-ray presents a cavity with liquid levels over the right upper lobe projection. What is the probable diagnosis?
    1. Pyopneumothorax.
    2. Bullous form/type of lung destruction.
    3. Lung abscess.
    4. Pyothorax.
    5. Mediasternal emphysema.
A

*3.Lung abscess.

64
Q
  1. A cyst in the lung was found in a 6 month child during investigation. Respiration insufficiency is not present. General condition is satisfactory. What measures are you going to take?
    1. Draining the cyst.
    2. Planned operative treatment.
    3. Conservative treatment.
    4. Puncture the cyst.
A

*2.Planned operative treatment.

65
Q
  1. Which branches of the bronchi is affected in bronchoectasis?
    1. 2nd-3rd.
    2. 4th-5th.
A

*1.2nd-3rd.

66
Q
  1. What could it be if a child, due to respiratory insufficiency, had periodically “crack (Herman’s) sign”?
    1. Foreign body in the esophagus.
    2. Foreign body in the larynx.
    3. Floating foreign body in the trachea.
A

*3.Floating foreign body in the trachea.

67
Q
  1. A 5 year old child with paroxysmal abdominal pain persisting for 12 hours, vomiting and flatulence. He had appendectomy a year ago. What investigation will you start with?
    1. Give barium meal per os.
    2. Hypertonic enema.
    3. Plain abdominal X-ray.
    4. Per rectum examination.
    5. Abdominal palpation under anaesthetic.
    6. Pneumoirrigography.
A

*3.Plain abdominal X-ray.

68
Q
  1. An 8 months child had vomiting and repeatedly paroxysmal abdominal pain for 10 hrs. On palpation - a round mass is palpable on the right iliac region. On per rectal examination - blood stained fecal matter. What is the most probable diagnosis?
    1. Acute appendicitis.
    2. Intussusception.
    3. Appendicular infiltration.
    4. Intestinal infection.
    5. Abdominal cavity tumor
A

*2.Intussusception.

69
Q
  1. Optimal age for surgical treatment for children with inguinal hernia is.
    1. Up to 6 months.
    2. From age of 1 to 3 years.
    3. Elder than 6 years.
    4. Elder than 10 years.
    5. Soon after confirmation of diagnosis.
A

*5.Soon after confirmation of diagnosis.

70
Q
  1. Optimal variant of surgical treatment of acute hematogenic osteomyelitis in children is:
    1. Incision of soft tissues and drainage.
    2. Incision and osteotomoy.
    3. Urgent osteoperforation.
    4. Osteoperforation after preoperative preparation.
A

*4.Osteoperforation after preoperative preparation.

71
Q
  1. The most informative signs of an acute appendicitis in children are.
    1. Local tenderness on palpation.
    2. Tension of anterior abdominal wall and vomiting.
    3. Tension of anterior abdominal wall and local tenderness.
    4. Blumberg’s sign (guarding symptom).
A

*3.Tension of anterior abdominal wall and local tenderness.

72
Q
  1. Additional methods of diagnostics of an acute appendicitis in children are:
    1. Thermography.
    2. X-ray.
    3. Electromyography.
  2. Rectoromanoscopy.
  3. Laparoscopy.
A
  • 1.Thermography.
  • 3.Electromyography.
  • 5.Laparoscopy.
73
Q
  1. Name the specificity of examinating a child up to the age of 3 years.
    1. Examinating under medicinal sleep.
    2. Per rectum examinating.
    3. Comparatively palpation.
    4. Thermometry.
    5. Estimation of leukocytosis.
A
  • 1.Examinating under medicinal sleep.

* 3.Comparatively palpation.

74
Q
  1. Which symptoms are defined during examination of a child with acute appendicitis under medicinal sleep?
    1. Repulsion symptom.
    2. Active muscle tension of anterior abdominal wall.
    3. Muscle tension over the right iliac region.
    4. Kulenkampff’s symptom.
A
  • 1.Repulsion symptom.

* 3.Muscle tension

75
Q
  1. Complications of acute appendicitis in children are.
    1. Peritonitis.
    2. Intra abdominal bleeding.
    3. Appendicular infiltration.
    4. Periappendicular abscess.
    5. Pylephlebitis.
    6. Suppuration of post-operative wound
A
  • 1.Peritonitis.
    * 3.Appendicular infiltration.
    * 4.Periappendicular abscess.
    * 5.Pylephlebitis.
76
Q
  1. When are the first clinical signs of pylorospasm appear?
    1. The first hour after birth.
    2. From the first day after birth.
    3. The second day after birth.
    4. A third week after birth.
    5. A month after birth
A

*2.From the first day after birth.

77
Q
  1. What type of vomiting is in pylorostenosis?
    1. Scanty regurgitation.
    2. Profuse regurgitation.
    3. Fountain type.
    4. Indomitable vomiting.
    5. Vomitus is less than the volume of milk sucked for one time.
A

*3.Fountain type.

78
Q
  1. A 1.5 month old child with severe regurgitation, less weight gain. Vomitus is mixed with mucus and blood. Restlessness during breast feeding. Hacking (semi-cough) while sleeping. What is the probable diagnosis?
    1. Pylorospasm.
    2. Diaphragmatic hernia.
    3. High partial intestinal obstruction.
    4. Post hypoxic encephalopathy.
    5. Mucoviscidosis.
A

*2.Diaphragmatic hernia.

79
Q
  1. The most specific symptom for inguinal hernia in children is.
    1. Nausea and vomiting
    2. High temperature.
    3. Elastic outpouching at inguinal area.
    4. Abdominal pain.
    5. Poor appetite.
A

*3.Elastic outpouching at inguinal area.

80
Q
  1. A child with strangulated intestinal obstruction. What is important to do?
    1. Conservative treatment.
    2. Observation.
    3. Give barium meal and conservative management for 3-6 hours.
    4. Urgent operation.
    5. Operate after pre-operative manipulation.
A

*5.Operate after pre-operative manipulation.

81
Q
  1. Which method of treatment is optimal for congenital high intestinal obstruction?
    1. Conservative therapy.
    2. Surgical therapy.
    3. Physiotherapy therapy.
    4. Combined therapy.
A

*2.Surgical therapy.

82
Q
  1. What type of discharge from rectum in children with Intussusception?
    1. Mucus stained fecal matter.
    2. Bloody discharge after defecation.
    3. Blood stained fecal matter “raspberry jelly like”.
    4. Blood streaks in feces.
A

*3.Blood stained fecal matter “raspberry jelly like”.

83
Q
  1. Which diagnostic method is more informative in children with closed trauma of the abdomen?
    1. Plain abdominal X-ray.
    2. Abdominal ultrasound investigation.
    3. Laparoscopic investigation.
    4. Scintigraphy.
A

*3.Laparoscopic investigation.

84
Q
  1. Which 3 types of bone injuries are common only in children?
    1. Displaced fracture.
    2. Undisplaced fracture.
    3. Comminuted (splintered) fracture.
    4. Epiphysiolysis.
    5. Subperiosteal [intraperiosteal] fracture.
    6. Greenstick fracture.
    7. Impacted fracture.
A
  • 4.Epiphysiolysis.
    * 5.Subperiosteal [intraperiosteal] fracture.
    * 6.Greenstick fracture.
85
Q
  1. Optimal management of closed transverse diaphyseal fracture of humerus on mid third part of a bone is.
    1. Reposition and fixation with plaster-cast splint.
    2. Reposition and fixation on abducting splint.
    3. Reposition and fixation with 2 Kirschner’s wire.
    4. Skeletal traction.
A

*1.Reposition and fixation with plaster-cast splint.

86
Q
  1. Severity of craniocerebral injury in children is defined by.
    1. Level of consciousness.
    2. Neurological (focal) symptoms.
    3. Clinical form of craniocerebral injury.
    4. General cerebral symptoms.
A

*3.Clinical form of craniocerebral injury.

87
Q
  1. Which 2 signs during per vaginal examination can differentiate between appendicitis and adnexitis?
    1. Shortening of fornix of vagina.
    2. Hanging-down of fornix of vagina.
    3. Promptov’s symptom.
    4. Krymov’s symptom.
A
  • 1.Shortening of fornix of vagina.
    * 2.Hanging-down of fornix of vagina.
    * 3.Promptov’s symptom.
88
Q
  1. Select 2 symptoms which are specific for acute appendicitis when the appendix is retrocecally positioned.
    1. Obrtsov’s.
    2. Bartomye-Mickelson’s.
    3. Voskresensky’s.
    4. Rosving’s
A
  • 1.Obrtsov’s.

* 2.Bartomye-Mickelson’s.

89
Q
  1. What are the peculiarities of acute appendicitis in elderly?
    1. Flaccid, latent and with no clear signs of disease.
    2. Intermittent fever.
    3. Predominance of catarrhal changes in appendix.
    4. Predominance of destructive changes in appendix.
    5. Increased abdominal muscle tension.
A
  • 1.Flaccid, latent and with no clear signs of disease.
    * 2.Intermittent fever.
    * 3.Predominance of catarrhal changes in appendix.
90
Q
  1. What is the most informative diagnostic method in suspected case of tumor of mediastinum? 1.Pneumomediastinoscopy.
    1. Bronchoscopy.
    2. Bronchography. 4.Pneumomediastinography.
    3. Artificial pneumothorax.
A
  • 1.Pneumomediastinoscopy.
    * 2.Bronchoscopy.
    * 3.Bronchography.
91
Q
  1. Most common cause of acute mediastinitis is:
    1. Rapture of esophagus.
    2. Surgical manipulation.
    3. Purulent lymphadenitis.
    4. Spreading of suppurative process in the neck.
    5. Pulmonary tuberculosis.
A
  • 1.Rapture of esophagus.
    * 2.Surgical manipulation.
    * 3.Purulent lymphadenitis.
    * 4.Spreading of suppurative process in the neck.
92
Q
  1. What signs are significant in case of pneumothorax due to thoracic injury?
    1. Cervical venous distension, dilatation of mediastinum, tachycardia.
    2. Subcutaneous emphysema, hemoptysis, muffled heart sounds.
    3. Dyspnea, mediastinal displacement, tachycardia.
    4. Enlargement of heart, bradycardia, retrosternal pain.
A
  • 1.Cervical venous distension, dilatation of mediastinum, tachycardia.
    * 2.Subcutaneous emphysema, hemoptysis, muffled heart sounds.
    * 3.Dyspnea, mediastinal displacement, tachycardia.
93
Q
  1. Most frequent cause of spontaneous pneumothorax can be.
    1. Bullous formation in alveoli and lung cyst.
    2. Parapneumatic abscess of the lung.
    3. Lung cancer.
    4. Bronchoectasis.
    5. Pulmonary tuberculosis.
A

*1.Bullous formation in alveoli and lung cyst.

94
Q
  1. First emergency action to be taken in case valvular pneumothorax is.
    1. Tracheostomy.
    2. Puncture and drainage of pleural cavity.
    3. Intercostal nerve block.
    4. Fixation of thoracic cage.
    5. Diaphragmatic nerve block.
A
  • 2.Puncture and drainage of pleural cavity.

* 3.Intercostal nerve block.

95
Q
  1. Types of bronchoectasis are.
    1. Cavernous.
    2. Cystic.
    3. Cylindrical.
    4. Saccular.
A
  • 3.Cylindrical.

* 4.Saccular.

96
Q
  1. What blood vessels are damaged causing Hemoptysis in chronic non specific diseases of lungs?
    1. Pulmonary artery and vein.
    2. Pulmonary capillaries.
    3. Intercostal arteries.
    4. Bronchial arteries.
A

*4.Bronchial arteries.

97
Q
  1. Which main diagnostic method is used to confirm the condition of bronchi in case of chronic non specific diseases of lungs?
    1. Tomography.
    2. Bronchial arteriography.
    3. Bronchography.
    4. Pulmonary angiography.
    5. Bronchoscopy with biopsy.
A
  • 3.Bronchography.

* 4.Pulmonary angiography.

98
Q
  1. Indications for operative treatment in chronic pancreatitis are.
    1. Cysts and prolonged unhealing of external pancreatic fistula.
    2. Pancreatic duct stones.
    3. Pancreatic duct stenosis with out-flow blockade of pancreatic juice.
    4. Pseudo-tumor pancreatitis with jaundice.
    5. Constant pain in the epigastrium.
A
  • 1.Cysts and prolonged unhealing of external pancreatic fistula.
    * 4.Pseudo-tumor pancreatitis with jaundice.
99
Q
  1. Best treatment for congenital pancreatic cyst is.
    1. Medicinal therapy.
    2. Marsupialization.
    3. Resection of pancreas body.
    4. Cystenterostomy.
    5. Cystectomy.
A

*3.Resection of pancreas body.

100
Q
  1. In treatment of pancreatic cyst quite often we put gastrointestinal anastomosis. Which is the best?
    1. Cystogastrostomy. 2.Cystojejunostomy with inter enteroanastomosis.
    2. Cystojejunostomy with closed loop.
A

*2.Cystojejunostomy with inter enteroanastomosis.

101
Q
  1. In treatment of pancreatic cyst we use cystogastrostomy, most frequent complication after this operation is.
    1. Esophagitis, due to tripsin inflow.
    2. Cyst recurrence.
    3. Post operative hemorrhage.
    4. Infection.
    5. Malignancy regeneration.
A

*2.Cyst recurrence.

102
Q
  1. Patient with chronic pancreatitis had moderate, low-grade pain syndrome. Choose preferable methods of treatment.
    1. Puestow’s operation.
    2. Pancreatectomy ( 95% of pancreas)
    3. Distal pancreatectomy with intestinal pancreatic duct drainage.
    4. Conservative therapy.
    5. Duval’s operation
A

*2.Pancreatectomy ( 95% of pancreas)

103
Q
  1. Select most appropriate operative method for treatment of chronic pancreatic pseudo-cyst.
    1. Transcutaneous drainage of cyst.
    2. Internal drainage of cyst.
    3. Pancreatectomy.
    4. Excision of cyst.
    5. Resection of the tail of pancreas with anastomosis between the remaining part of pancreas and intestine.
A

*4.Excision of cyst.

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