SMLE 11 (surgary) Flashcards
1
Q
- Child examination: look to the wall , bend forward this examination of waht?
A. Scoliosis
B. Sexual abuse
C. rectum prolapse
Better recall: Doctor ask the child to face the wall and bend forward and hanging his
arms unsupported, this test for :
A. scoliosis
B. leg length symmetry
C. rectal prolapse
D. sexual abuse
A
A. scoliosis
2
Q
- female after MVA admitted for observation was vitaly stable x ray showed
fracture in 3and7 rib …then she devolution shortness of breath (only) ..what is the
cause ?
A. flial chest
B. PE
C. tension pneumothorax
D. ?
A
C. tension pneumothorax
3
Q
- 43male have family history of colon cancer underwent sigmoidoscopy for
polyp removal Histopathology showed tubular adenoma completely removed
..how to follow?
A. 3-6 month
B. 3years
C. 5 years
D. no need
Another recall: Patient did a colonoscopy 1 polyp size 1.5cm and a biopsy showed
tubular adenoma. Interval of screening?
A. 6 month
B. 3years
C. 5-10 years
D. no need
A
B. 3years
4
Q
- 37 years old female her father has colon cancer when he was 55 and her mom
had breast cancer when she was 43, asking about screening?
A.She should do mammogram annually
B.Start mammogram at 40
C.Start mammogram at 40 and colonoscopy at 55
D.Colonoscopy at 50
A
A.She should do mammogram annually
5
Q
- X ray Picture: Elderly with abdominal pain, and vomiting. On abdominal x ray
you see a cofffee been shape in the intestines with part of the large colon twisting
to the upper right hypochondirum what’s the diagnosis?
A
A. Sigmoid volvulus
6
Q
- A patient came to ER (long scenario) he has weakness and Paresthesia in left
leg with power of 2/5. Other limbs normal. What is the cause?
A- Migraine
B- Right MCA
C- Right ACA
D- Basilar
A
C- Right ACA
7
Q
- 18 years male came with stap wound injury next to umblicus with small
opening clean and bleeding stopped
Vitally stable with normal lab results
Ct : smal splenic laciration with minemum fluid surrounding it .
What is the best definite management
A) wound closure
B) AB
C) splenictomy
D) exploratory labromyomy
A
A) wound closure
8
Q
- 36 year-old female presented with left neck mass 2x2cm in posterior angle of
mandible. US: Normal thyroid, left large LN with cystic component. FNA: All
smear shows follicular thyroid What is the most likely diagnosis?
A. Metastatic thyroid cancer
B. Apparent thyroid
C. Ectopic thyroid (in the pathway of thyroid )
D. Thryoglossal cyst
A
A. Metastatic thyroid cancer
9
Q
33yo male with painless swelling in the posterior triangle of his neck. On US thyroid
is normal and the swelling has cystic component. FNA shows complete follicular
cells. What is the most likely diagnosis?
A- Papillary thyroid cancer
B- Follicular thyroid cancer
C- Ectopic thyroid
D- Thyroglossal cyst
A
A- Papillary thyroid cancer
10
Q
- unilateral neck swelling in the RT side by investigations : hot thyroid nodule
remaining of the gland cold TSH is low, T3, T4 high No LN enlargement (dx
hyperthyroidism toxic nodule) What is the initial Treatment?
A- Antithytoid med
B- Radioactive ablation
C- lobectomy
D- Total thyrodectomy
A
A- Antithytoid med
11
Q
- Cold thyroid nodule 3x3 was removed by thyroid lobectomy , 8mm papillary
will defined focus was found distant to the leison, what is the appropriate?
A. Complete thyroidectomy
B. Follow up 3 months
C .RAI
A
B. Follow up 3 months
12
Q
- Middle age Pt with papillary thyroid cancer , planned for total
thyroidectomy how to follow up ?
1- serial post op US
2- calcitonin
3- TSH , T3 , T4
4- Thyroglobulin
A
4- Thyroglobulin
13
Q
- 28 year old female presented following radiation of neck with neck swelling.
Ultrasound showed swelling in the left lobe of the thyroid of 3x4cm of papillary
thyroid cancer. Which of the following is the best management?
A) Left Lobectomy
B) Left Lobectomy with Isthmusectomy
C) Subtotal Thyroidectomy
D) Total Thyroidectomy
A
D) Total Thyroidectomy
14
Q
- 48 yo lady with diffuse goiter, high T4 low TSH, US show bilateral thyroid
nodules , right 3x4 in size , left is 1x2 size what to do?
A. FNA both
B. FNA the larger one
C. total thyroidectomy
A
C. total thyroidectomy
15
Q
- 2 weeks post thyroidectomy came with high tsh how to manage?
A. reevaluate after 2-3 months
B. Increase or decrease the dose
A
A. reevaluate after 2-3 months
16
Q
- old patient came with subdural hematoma with signs of lateralization imaging
revealed 13 mm shifting. his GCS 7/15 then was intubated and resuscitated what
to do next
A- iv mannitol
B- elevate head of bed
C-hyperventilate
D- urgent craniotomy
A
D- urgent craniotomy
17
Q
- Pediatric patient had a fall from 1 story high and direct trauma to the head,
presents with hemotympanum No loss of consciousness, no vomiting , neuro exam
Normal Ear : Ruptured tympanic membrane with intact external auditory canal
Most likely bone fracture:
A. Mastoid
B. Maxillary
C. Basal skull
A
C. Basal skull
18
Q
- stroke patient developed new weakness on ex papilledema CT finding:
hemorrhagic stroke. Most definitive Mx ?
A. Craniotomy and decompression
B. Iv mannitol
C. iv dexa
A
A. Craniotomy and decompression
19
Q
- A patient who presented with signs of stroke and a CT shows subarachanoid
hemorrhage. He was resuscitated but he is still hypotensive. What is the next best
step?
A. Craniotomy and evacuation
B. Iv mannitol
A
A. Craniotomy and evacuation
20
Q
- Old man after episode of cough has SOB and abdominal pain on X- ray there
is air fluid level in the neck and under the diaphragm and left pleural effusion . BP:
90/65 HR : 115/ min RR : 25 . SO2: 90 on room air what is the most important
mangment ]
A- Bulla of lung
B- Laparotomy (perforated viscus )
C- Chest tube drainage-
D- Observation
A
B- Laparotomy (perforated viscus )
21
Q
- Female came to ER with sign and symptoms of appendicitis, appendectomy
was done , surgeon discover the appendix was normal , what surgeon should be do
?
A. Tell pt what happened and that was routine and no complication
B. Not tell the pt
C. Write report about what happened and give it to hospital committee
A
A. Tell pt what happened and that was routine and no complication
