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4. SMLE (difficult Qs) > SURGERY > Flashcards

SURGERY Flashcards

1
Q

HX OF hernia 2 yrs back now present with symptoms of bowel obstruction, the skin over the hernia is red in color what is the complication that the patient develop

A-obstructed
B-incarcerated
C- strangulated

A

C- strangulated

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2
Q 
45yo female has dysphagia with liquids only retrosternal pain and regurgitation of food, what is the test of high diagnostic value?
A. UGD. 
B. Barium swallow. 
C. Low esophageal manometry.
D. CT with contrast
A

C. Low esophageal manometry.

Key word: dysphagia to liquate = achalasia
Dysphagia to liquate and solid = GERD

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3
Q

female patient complains of urinary dribbling, dyspareunia, dysuria. What is the most likely diagnosis?

A. Overflow incontinence
B. Urethral diverticulum
C. Stress incontinence

A

B. Urethral diverticulum

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4
Q

pain ,paresthesia ,pallor ,,Hx of MI before weeks ,Dx?

A. Acute arterial thrombosis
B. Acute arterial embolism
C. DVT

A

A. Acute arterial thrombosis

Key word: 3ps= pain, paresthesia , pallor =acut ar throm

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5
Q

toxic nodule and rest of the gland is suppressed ?

A

If small go for radio. If large or causing compression, go for hemithyroidectomy.

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6
Q

pt admitted for Rt adrenalectomy because of Cushing what to give?
A. post op fludrocortisone
B. peri op corticosteroid

A

B. peri op corticosteroid ✅ (NOT pre op)

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7
Q

female present with bilateral lower limb swelling non putting not known to have any medical illness :
A-CT angio B-duplex ultrasound

A

B-duplex ultrasound

Best investigation=ct

  • Treat non pitting edema= if no swelling =bandage,
    if swelling =lymphatic message
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8
Q

Patient RTA had a chest tube for a pneumothorax or hemothorax and had femoral fracture Needed to transfer him to another hospital, suddenly while that he started to be hypotensive and tachycardic and his O2 drops What will you do?
1- continue transfer while doing nothing
2- intubate the patient
3- check the femoral fracture for bleeding
4- check chest tube for place and obstruction

A

4- check chest tube for place and obstruction

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9
Q 
Female in 20s has diabetic present with confusion. The patient has a long history of type 1 diabetes. She also complains of periorbital swelling, rhinorrhea and black necrotic spot over the face. labs show glucose 600 mg/ dl and ketones. Ct scan shows obliteration of all the sinuses. Which of the following is the causative organism?
A. Rhizopus oryzae
B. Candida albicans
C. Moraxella catarrhalis 
D. Staph. Aureus
A

A. Rhizopus oryzae

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10
Q

What is the favorable place for AV fistula? A-brachial artery basilic vein
B-brachial artery cephalic vein
C-radial artery basilic vein
D-radial artery cephalic vein

A

D-radial artery cephalic vein

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11
Q

Give vesicoureteral barium and there’s dilatation in one of ureter & bladder & pelvic?

A

cystourethral reflux

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12
Q

patient with abdominal mass after lifting heavy objects mass not change with cough. Dx?
a) rectus sheath hematoma b) hernia

A

a) rectus sheath hematoma

key word: not change with cough

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13
Q

Case of nephrotic syndrome complaining of abdominal pain, diarrhea and vomiting, with rebound tenderness, what most likely diagnosis
A. Gastritis
B. Peritonitis

A

B. Peritonitis

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14
Q

High TSH , low T4 ,T3 , high ESR diagnosis?

A

Subacute thyroiditis

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15
Q

showed BIRADS IV, your next step ?

A

Core biopsy

keyword: birads
- 1.2.3.=follow up
- 4.5 = core biopsy
- 6= surgery

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16
Q

patient came with melena and they did upper gi endoscopy and found 1cm bleeding duodenal ulcer and they ask about the duration of ppi ?
A. oral ppi
B. iv ppi for 24 hours then convert to oral
C. iv ppi for 72 hours then convert to oral

A

C. iv ppi for 72 hours then convert to oral

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17
Q 
DM Rt leg swelling .. Angiography showed diffuse disease 2 days later developed firm tender partially mobile swelling irreducible nonexpansile below the inguinal crease .dx ?
A. Psoas abscess
B. Saphena varix
C. Femoral hernia
D. Pseudoaneurysm
A

D. Pseudoaneurysm

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18
Q

Elderly pt underwent for a major surgery ..he need blood transfusion 15 PRBCs .. after that he start bleeding from wounds, nose, from NGT (stomach) .. what is the cause:

A- vWBD.
B- thrombocytopenia
C- hemophilia.

A

B- thrombocytopenia✅.

D- no DIC in choices

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19
Q

military with hx of prolonged standing c/o flat feet and pain in medial foot what tendon involved ?

A

spiral ligament also called calcanenoavicular

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20
Q

GIST tumor in the Body of the stomach , it’s size about 3cm what you will do ?
A- total Gastrectomy
B- WLE with clear margin
C- Observation

A

B- WLE with clear margin

> 4cm or mets —>surgery + “imatinib”

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21
Q

Patient with liver mass Ct first stage filling periphery late washout centrally :
A-Hepatoma
B-hemangioma
C-metastatic

A

B-hemangioma

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22
Q

decrease in left testicular size post hernia repair ?

A. Testicular artery occlusion
B. pampiniform plexus occlusion

A

B. pampiniform plexus occlusion

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23
Q

Patient admitted for thyroid surgery because of progressive compression symptoms . Hemithyrodectomy done and biopsy showed 8mm papillary carcinoma , whats the next step ?

A

Follow up

Key word:
papillary carcinoma → after hemothyriodectomy no need for radiation

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24
Q

-45 year-old female developed hernia located inferior and lateral to pubic tubercle. What is the Type?
A. Femoral hernia
B. Obturator hernia

A

A. Femoral hernia

(Note= Direct hernia > medial to inferior epigasrtic artery Indirect hernia > lateral to inferior epigastric artery Femoral hernia > inferior lateral for pubic tubercle)

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25
Q 
-Q/ femal with LT leg swelling, intact distal pulse. Best investigation? 
A⁃ doppler venous
B ⁃ Doppler arterial
C ⁃ CT angio
D ⁃ CT venum
A

D ⁃ CT venum

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26
Q

Patient has nerve radial injury , where level of injury ?

A

spiral groove humerus

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27
Q

Patient child with fever , abdominal pain and splenomegaly and the spleen is tender what culture is important ?
A/Single blood culture
B/Multiple blood cultures
C/bone marrow aspirate culture

A

B/Multiple blood cultures

most likely typhoid: Bone morrow as most Sensitive, but invasive so multiple blood culture better .

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28
Q

old male with abdominal pain and was not passing gas he presented to the ER 24 hrs ago. WBC 20,000. Imagine showed Y sign
A. observation
B. colonoscopy
C. sigmoid resection with colostomy

A

C. sigmoid resection with colostomy

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29
Q

mass in post triangle of neck?
A- Apparent thyroid
B- ectopic
C- metastatic

A

C- metastatic

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30
Q

Patient has angel of mouth pain for 2 days , he had a history of prior laparoscopic cholecystectomy before 8 days
On vital the patient was alert and stable except for mild fever , what is the most appropriate next step ?
A- antibiotics
B- CT
C- x-ray
D- paracetamol

A

A- antibiotics

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31
Q

80 y old man with bilateral hydronephrosis on Us images ?

A. Prostate enlargement / Ca
B. Bladder ca
C. urethral stricture
D_benign prostatic hyperplasia

A

D_benign prostatic hyperplasia

B. Bladder ca > come more aggressive pain, hematuria

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32
Q

Patient RTA with head trauma, increased urine output , decrease in Urine osmolarity increased blood osmolarity

A

A-Central diabetes insipidus

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33
Q 
Fracture, xray shows multiple saddle stones, recurrent. All labs are normal except PTH was very high. What else you want to do? Literally that was it
A) Sistamibi scan
B) alkaline phosphatase
C) Intravenous pyelogram 
D) If remembered
A

A) Sistamibi scan

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34
Q

positive valgus test ?

A

Medial collateral ligament sprain

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35
Q

Most common site of thoracic aortic blunt trauma: A. Aortic arch
B. aorto-ligament
C. proximal to subclavian artery
D. distal to left subclavian artery

A

D. distal to left subclavian artery

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36
Q 
Post appendectomy female came with LR abdomen mild tenderness Ex Normal By CT there is 2*2 collection in Retrocecal:
A. Exploring laparotomy
B. percutaneous drainage symptomatic
C. laparoscopic
D. conservative with Antibiotic
A

D. conservative with Antibiotic

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37
Q

Epilepsy pt posterior dislocation, which joint?

A

A. Subacromial

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38
Q

Trauma patient has injury In membranous urethra, initial Mx:

A

Suprapubic catheter

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39
Q

Most common tumer in small bowel ?

A

A-carcinod

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40
Q

Post colectomy for colon cancer she is Diabetic, received dextrose and Insulin for 2 days, then she developed confusion and agitation. Lab : hypoNA hypoK, urine osmolality normal, serum 270. Most likely cause?

A-Water overload.
B-Addison disease.
C-SIADH

A

A-Water overload.

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41
Q

Pt develops hyperthermia generalized muscles rigidity, altered mental status, tachycardia, HTN. Labs show elevated creatine kinase, he started metoclopramide two weeks ago to treat diabetic gastroparesis. Which of the following drugs can also cause these symptoms?

A

Fluphenazine

NOTE (Neuroleptic malignant syndrome came days to weeks after taking drug like metoclopramide and fluphenazine)

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42
Q

Oval with smooth surface 2*2cm not painful ?

A

fibroadenoma

Keyword: fibroadenoma= attack of hormone associated with menstrual cycle, painless, mobile, smooth surfers or firm,

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43
Q

pancreatitis case managed conservatively at the day 3 the pt improving clinically and laboratory . Every thing normal except Amylase 250 . US showed» Gallstone at the gall bladder with dilated extra hepatic ducts ( nothing was mentioned about CBD). What is the appropriate management:
A. lap chole before discharge
B. elective lap chole
C. ERCP

A

A. lap chole before discharge ✅

If there’s no evidence of CBD stone ( jaundice, dilated CBD, elevated ALP ) > no need for ERCP

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44
Q 
Patient lost sensation over medial side of leg but motor function is intact. Which nerve is injured?
A-Obturator 
B-Femora 
C-Saphenous
D-Sciatic
A

C-Saphenous

lost sensation over = Mid thigh = obturator
lost sensation over = medial side of leg = saphenous

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45
Q

Pt did hernia repair 5 years ago came with swelling at site of surgery, on examination no redness no hotness only mild tenderness, -ve cogh implies
A- seruoma
B-Recurrent
C-absis

A

A- seruoma

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46
Q

Pleural effusion due to Malignancy did multiple pleural tap what will you do now?

A

A. Chemical pleurodesis

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47
Q 
with hx of IHD with no fever, low CO, low wedge pressure and normal Rt ventricular pressure. Whats the type of shock?
A - Septic
B - Cardiogenic
C - Anaphylactic
D - Hypovolemic
A

D - Hypovolemic

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48
Q

Infant with Bilateral non tender scrotal edema and redness extending to groin. What’s the diagnosis?

A. Testicular torsion
B. Epididymo-orchitis
C. Edema of testicular appendages
D. Idiopathic testicular edema

A

D. Idiopathic testicular edema

coz infant

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49
Q

Open fracture came 4 days later to ER with signs of infection ( blue, necrosis) what’s the most common organism ?
A-clostridium
B- Staph aureus
C- Actinomyces israelii

A

A-clostridium

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50
Q

6 yrs old, female presented with nausea and recurrent vomiting of every intake , pt became lethargy with decreased skin turgor and cry with tears. Investigation revealed Normal investigations apart from :High Na Low glucose What is the best next management :

A. isotonic saline 20ml/kg
B. D10% with 1/2 saline
C. oral rehydration solution

A

A. isotonic saline 20ml/kg

Hypovolemic Hypernatremia First correct the volume with half normal saline then once the
patient euvolemic shift to slow D5W infusion.

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51
Q

Case of pain on defeation , patient was pale on ex. and the doctor was trying to do PR examination and was not able to because of pain :
A- examine under anesthesia
B- LIS
C-Internal LIS

A

A- examine under anesthesia

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52
Q

Old pt. C/O fatigue , on & off stool mixed with blood . O/E 2 degree hemorrhoid , and low Hb Dx :
A) rectal cancer
B) Chronic bleeding hemorrhoid

A

A) rectal cancer

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53
Q 
women with 11*12 breast mass, examination showed no palpable LN. Core biopsy was taken and showed malignant phylloid tumor, what’s the next appropriate step?

A.WLE 
B.PET scan 
C.Chest CT without contrast
A

C.Chest CT without contrast✅

  • Keyword: malignant
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54
Q 
Female 16 week pregnant, came with right sided abdominal pain (RLQ)associated with nausea and vomiting. The doctor ruled out all pregnancy related abdominal pain. What's the most likely diagnosis?
A - Gastritis
B - Pancreatitis
C - Cholecystitis 
D - Appendicitis
A

D - Appendicitis

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55
Q

Pt with UC the most associated risk of Cancer is?

A

primary sclerosing cholangitis

56
Q

Trauma patient has basal skull fracture that includes the jugular foramen what will the patient have:
A. ipsilateral vocal cord paralysis
B. Paralysis of the muscles of mastication
C. Can’t abduct eye

A

A. ipsilateral vocal cord paralysis

57
Q

best method for pancreatic pseudocyst drain ?

A

Endoscopic

Keyword:

  • pseudo cyst drain if no infective= endoscopic
  • If infective(fever , leukocytosis ) = precutanous drainage
58
Q

Patient has hx of RTA since 2 weeks came today with SOB the chest x ray has shown haemothorax you have put him on chest tube and want to transfer him to higher center while he was in the ambulance the pulse oximetry drop suddenly what to do ?

A. continue the journey to the higher center
B. check the potency of the chest tube
C. triphasic chest intubation

A

B. check the potency of the chest tube

59
Q

Paraesthesia and numbness with wrist drop (shows radial nerve injury) at which Part ?
A. Groove of the humerus.
B. Carpal tunnel.
C. Olecranon

A

A. Groove of the humerus.

Wrist = Radial.

60
Q

24- All things are normal but have pain in his neck . They check his left neck and found small mass 5*7 mm what is the most important thing to do ?
A. FNA. B. complete his thyroid investigation

A

B. complete his thyroid investigation

61
Q

Pediatric with supracondylar fracture, with no pulse

A- Observation
B- K wire
C- Elevate hand
D- Surgical exploration

A

D- Surgical exploration

NOTE = Note:
Always try reduction first then:
If no pulse + pale = surgical exploration
If no pulse + well perfused = k wire fixation)

62
Q

Pt diagnosed with thigh sarcoma. What the staging method?
A - Bone scan
B-CT of the chest

A

B-CT of the chest

63
Q

Crush injury to his feet , after stebalization of the patient , o/e cold and decreased pulse in the affected foot . What is the (((best next step )) u will do ?

A. ct angio
B. angio
C. duplex US
D. compartment compression

A

C. duplex US

Key word: if there swelling and pain =D If hard signs = A

64
Q

Breast mass 2*2 describe as Oval shape painful:

A

breast cyst

65
Q

sign in radiology for duodenal ulcer?

A

clover leaf

66
Q

Patient with congested throat symptoms and 2 cm palpable cervical lymph nodes. What is the most appropriate investigation?

A

FNA of the lymph nodes

67
Q

1 month Post partum female came complaining of abdominal fullness and pain with nausea and vomiting
She mentioned history of epigastric pain radiating to the back during pregnancy
On examination there’s 8x8 cm epigastric mass
What the diagnosis:

A- hydated cyst
B- pseudo cyst
C- epigastric mass or something like that

A

B- pseudo cyst

NOTE = could be previous pancreatitis complicated by pseudocyst

68
Q 
60years old man had an Open surgery and he noticed 20ml fluid come from midline abdomen what’s your appropriate management
A: Dressing 
B: Antibiotics
C: Ct abdomen
D: Wound exploration
A

A: Dressing

69
Q

Female , with lateral mass (lymph node) , thyroid was normal , biopsy showed normal follicular cells, what is the diagnosis?

A

metastasis

70
Q

Tibial shaft fracture after RTA High velocity And absent dorsalis pedis pulse and posterior tibial pulse, numbness in the lower limb In severe pain What is the appropriate management ?

A

Fasciotomy

71
Q

Case of adult with open compound fracture :

A

Urgent Debridement with intamedullary nail External fixation

72
Q 
After “ trauma “ Best test to rule out cervical spine? 
A.MRI cervical
B.AP x ray of cervical
C. Ct
D. clinical exam
A

C. Ct

73
Q

Football player received a trauma to lateral side of his left knee, the patient now is complaining of severe pain and swelling of the medial side of his left knee, positive valgus and (-) anterior drawer and lachman, most likely diagnosis:

A

Medial collateral ligament sprain

74
Q

Pt do surgery then Loss of sensation in ear pinna and upper neck what nerve is injured ?

A

Great auricular nerve

75
Q

hematochezia: NGT greenish, colonoscopy done was normal , what’s the investigation help determine source of bleeding?

A

A. Technetium 99

76
Q

Young male, post MVA Opens eyes spontaneously Responds to verbal Commands Shrugs shoulders Shallow breathing Left chest wall contusion Cannot flex elbows or move lower limbs Respiratory rate: ?BP: hypotensive Most likely diagnosis:

A

High spinal injury

77
Q

Patient with pain when writing at keyboard, some test showed hypoperfusion to superficial palmar arch, what’s the artery affected?

A

ulnar

78
Q

15 yo came with groint pain and lower flank pain for (4h) or (8h) P/E: the testes is slightly ascended and tender in touch and no fever. And Redness. What the appropriate next step?
A- Dopller US
B- Expiratory surgery
C- Abx

A

A- Dopller US

79
Q

Colorectal surgeon performing a low anterior resection for CRC and the pelvis won’t stop bleeding, so he consults a vascular surgeon and he does:

A-Heavy packing of pelvis
B-Arteriography intra operatively
C-Infraceliac clamp

A

A-Heavy packing of pelvis

NOTE: If he did packing then C

80
Q

pt. k/c of crohn’s after colon surgery developed severe diarrhea what you will give ?

A. mesalamine.
B. cholystaimne

A

B. cholystaimne

81
Q

After right hemithyroidectomy On biopsy found follicular lesion 8cm from the?

A

Complete thyroidectomy.

82
Q 
Young female c/o fatigue and jaundice high ALP and high bilirubin Us: no any finding MRCP : multiple stricture Next step to *confirm* Dx ?
A. Liver biopsy.
B. Antinuclear antibody 
C. Repeat US 
D. Colonoscopy
A

A. Liver biopsy

Key word: high ALP + bilirubin multiple stricture

83
Q
  • 50 year old man presents with progressive jaundice, dark urine, and right upper quadrant pain and distention. On physical examination he has a palpable gall bladder. Imaging shows an enlarged gall bladder and dilated Intrahepatic duct. Amylase = 481. diagnosis is?

A. klatskin tumorn
B. Pancreatic cancer
C. Cholecystitis
D. Mirrizi’s syndrome

A

B. Pancreatic cancer

84
Q

Male have problem initiating urination , bladder fell un empty after , no dribbling or ((urge felling)) , type of incontinence ?
A. Overflow
B. Reflex
C. Urge

A

A. Overflow

85
Q

Old pt-fatigue sign of anaemia hb8 , stools with streak of blood -has hemorrhoids stage 2 ?
A. Sigmoid ca.
B.rectal ca
C.chronic hemorrhoid

A

B.rectal ca

86
Q

diabetic patients with unhealed ulcer for 5 years and biopsy showed pseudoepitheliomatous hyperplasia?

A. Biopsy
B. Debridement

A

B. Debridement

87
Q

Membranous urethra injury management?

A. Folly Catheter B. Retropubic catheter C. Retropubic repair

A

B. Retropubic catheter

88
Q

Color of discharge in intraductal papilloma ?

A

Red

89
Q

What is hard sign of vascular surgery?

A-Weak pulse B-Skin color change C-bruit

A

C-bruit

detect pulsetile bleeding

90
Q

Urethral trauma with bleeding post MVC. Next step?

A

Suprapubic catheter

91
Q

PT admitted due to MI after 2 days of discharge developed sever pain in his leg Dx?

1/ acute arterial thrombosis
2/ Acute Arterial Embolus
3/ DVT

A

2/ Acute Arterial Embolus

if old will be 1

92
Q

Patient did retinal operation DVT prophylaxis what to give?
A- heparin
B- enoxaparin
C- mechanical compression

A

C- mechanical compression

93
Q

virchow’s lymph node Associated with which cancer?

A

Gastric cancer

94
Q

child fall down of stairs and hit her head, blood coming out from ear, perforation of tympanic membrane?
A-Subachanoid Hemorrhage
B-Ventricles hemorrhage
C-Basel skull fracture

A

C-Basel skull fracture

95
Q 
Patient had loss of sensation on the snuff box and dorsum of the medial hand, hand wrist drop. At which level is the radial nerve injured?
A. Axilla. 
B. Humerus groove
C. Olecranon 
D. Carpal tunnel.
A

B. Humerus groove

96
Q

Normal follicular thyroid cells, how to manage?

A

Hemithyroidectomy

97
Q 
Pedia 4 days with jaundice and his brother had the same thing Direct bilirubin and total bilirubin was high what is the diagnosis:
High direct bilirubin in neonates:
A. Biliary atresia
B. Choledochal cysts
C. Neonatal hepatitis
A

B. Choledochal cysts

98
Q 
Pt with s&s of intestinal obstruction imaging shows proximal ilium diltation and 3 strictures involve (30 cm) from proximal ilium. No constitutional symptoms mentioned. What’s the dx:
A- TB entritis
B- Crohn’s
C- Small intestine lymphoma 
D- GIST
A

B- Crohn’s

99
Q

chronic pancreatitis what you will find?

A

increase lipolysis

  • Keyword: chronic pancrititis will found increase of lipolysis and hyperglaicemia and hypocalcemia
100
Q

types of shock?

A

check pic

101
Q

Patient post graham patch surgery, what is the most appropriate management?
A. High dose PPI
B. IV ppi for 24 hours followed by oral PPI
C. IV ppi for 48 hours followed by oral PPI

A

C. IV ppi for 48 hours followed by oral PPI

102
Q 
diagnostic for sarcoma 
A . Incisional
B. Excisional
C. Core needle
D. Forget maybe aspiration
A

C. Core needle ✅

103
Q

Tubuvillous adenoma pink color Most common site =

A

rectum

104
Q 
A 60 years old patient complaining of dull aching swelling non tender found to have a retro-peritoneal mass of a 20×20 cm size, and multiple masses in the liver. Most likely diagnosis:
A. Liposarcoma
B. Germ cell tumor
C. Neural tube something 
D. Lymphosarcoma
A

A. Liposarcoma

105
Q

Pt come to clinic, she is a typer and complain of left hand and fingers pain. It shows defect in superficial palmer arch. Which artery is affected?

A

A-Ulnar

106
Q

-Pt postoperative day 3 has gram negative bacteremia how it rech to blood ?

A

UTI.

Key word: 
0-2 day = atelectasis or pneumonia 
3-5day= UTI
5-7=DVT
7 day = wound infection
8-15= drug fever or deep abscess
107
Q

An elderly man came with lateral malleolus ulcer, he is hypertensive but not diabetic What is the first thing to do:
A. venous duplex B. check pulse C. ABI

A

B. check pulse

108
Q

B. Bladder ca > come more aggressive pain, hematuria ?

A

Bulbar if not penile.

BUT in case of fracture - posterior urethra and membranous.

109
Q

years lady with breast lump 2*2 i think for year suddenly the mass increased in size?

A

phylloids

ttt Keyword:

  • phylloid less than 10cm benign = wide locl excision
  • Above 10 cm simple mastectomy
110
Q

Pt is with non-acth dependent cushing for rr adrenalectomy ..what is the postoperative management?

A. postoperative fludrocortisone
B. postoperative metatone.
C. preoperative hydrocortisone.
D. pre operative (drug for pheochromocytoma forget its name )

A

C. preoperative hydrocortisone.

111
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✅

Key word: big size

112
Q

Patient came with testicular enlargement after an exercise what will you do for him?

A

US

Key word: after exercise = testicular torsion =US

113
Q

Patient with jerky carotid?

A

Hypertrophic cardio myopathy

114
Q

Pt with dysuria and cloudy urine with bubbling for 2 months, hx of recurrent left iliac fossa pain for the past 2 years ! Colonoscopy: no diverticulosis or polyp Cystoscopy: erythema on dome of the bladder. Most likely diagnosis:

A. disease Diverticular.
B. sq. Cell bladder cancer
C. transitional cell bladder cancer

A

A. disease Diverticular.

Key word: recurrent left iliac fossa pain + cloudy =diverticular

115
Q

Old patient in ICU with acalculous cholecystitis, best management?
A. Cholecystectomy tube
B. Lap chole
C. Open chole

A

A. Cholecystectomy tube ✅

116
Q 
Male adult with perianal swelling and discharge, then ruptured ,Dx: 
A.Anal fissure
B.hemorrhoid 
C.anal abscess
D.fistula
A

D.fistula

117
Q 
Strongest indication of surgery in graves:
A. -pediatric
B. -presence of eye symptoms.
C. -presence of anti tsh .
D. -failed antithyroid meds.
A

mmm B

118
Q

30 yo multigravida mother complain of perianal pain and absolute constipation for 2days. During exam anal cushions are irreducible and inflamed. Vitals normal BP, tachycardia, normal Temp. What is the diagnosis?
A. perianal abscess
B. Thrombosed pile
C. Anal cancer

A

B. Thrombosed pile ✅

119
Q

Young unilateral testicular swelling since 1 day, on exploration viable but cord edematous :
A-Torsion
B- Incarcerated inguinal hernia
C- Appendicular torsion

A

C- Appendicular torsion

Key word: unilateral and cord edematous

120
Q

Patient present with painful of cord like swelling of left leg and she has hx of vircous vein 20 years back Best initial treatment?

a) NSAID
b) Celxan.
c) Heparien

A

a) NSAID

121
Q 
Diabetic patient with pseudo hyper epithelialization in situ, what you should do:
A. Amputate toe
B. ulcer Debridement
C. follow up
D. Repeat biopsy
A

D. Repeat biopsy

122
Q

Pt with pelvic fx and bleeding per rectum&raquo_space; urethrogram > retroperitoneal urethra injury Mx?

A-Folly’s cath
B-Supra pubic cystostomy
C-Labroscopic repair

A

B-Supra pubic cystostomy

make sure its cystostomy not cystectomy

123
Q

duct ectasia, color of discharge?

A

Green

124
Q

Pt with malignant phylloid tumor what is next?
A.Contrast ct of chest
B.pet scan

A

A.Contrast ct of chest

125
Q

Thenar atrophy caused by which never:
A. median ✅
B. Ulnar
C. radial

A

A. median

Ulnar hypothenar

126
Q

Neck mass biopsied showing (thyroid folicullar cells)?

A

Ectopic thyroid

127
Q
  • female 50 y/o with leg non pitting edema with skin discoloration and thickening ask about best test ?
A

Lymphoscintigraphy

If say initial Venous duplex

128
Q

What of the following pass through deep inguinal ring:
A- Round ligament
B- illo-inguinal nerve

A

A- Round ligament

Keyword: round ligament in female Spermtic cord in male

129
Q

Male with colicky upper abdominal pain aggravated by morphine and its derivatives, US shows mildly dilated CBD (I think it was 9 mm not sure) and dilated intrahepatic ducts, what’s the Dx?
A. Sphincter of oddi dysfunction
B. Pancreatitis

A

A. Sphincter of oddi dysfunction

130
Q

Athlete with pain during standing PE: tenderness in medline planter surface?

A

Plantar fasciitis.

131
Q

Female complaining of tingling sensation in her ring finger increase when she raise her hand , in the examination positive arm elevation test?

A

carpel tunnel syndrome ✅

Keyword: tingling + ring finger

132
Q

Medullary thyroid cancer mangement?

A

Total thyroidectomy

133
Q

Dm pt with unilateral leg erythema Increases in dependant position, Cold, Femoral pulse is present, distal pulse can be palpated No tenderness, no swelling, no fever Otherwise unremarkable Dx?

A.Cellulitis
B. Arterial insufficiency
C.Superficial thrombophlebitis

A

C.Superficial thrombophlebitis

134
Q 
In a patient post mastectomy, they do for for her reconstruction from rectus muscle, what is the vessels to be injured or effected?
A. Inferior Epigastric artery 
B. Superior Epigastric artery
C. Intercostal artery
D. Internal thoracic artery
A

A. Inferior Epigastric artery

135
Q

40 years old man underwent open hernia relain and 2 weeks later presented with tenderness at the site of hernia repair and severe parasthesia/numbness/tingling around his thigh that went down his leg= management?

A. remove mesh staples.
B. Neurectomy and mesh removal.
C. NSAID

A

C. NSAID

Key word: this case of ilioinguinal nerve inj need to NSAID for long time maybe month if no response then nerve block and last resort is neurecromy can be done

4. SMLE (difficult Qs) (6 decks)

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