MCQDr:- Ashraf .I. Obaid

1. Which? 2. The most common -------is3. Regarding 4. All of the following are true about neurogenic

shock except:5. The following --------------------- except :6. Heparin7. Which of the following is false:

•Which hypersensitivity reaction is associated with a tuberculin reaction? 1.Type I: immediate 2.Type II: cytotoxic 3.Type III: immune complex 4.Type IV: cell mediated

•The most common location for a gastric ulcer is1. Fundus2. Greater curvature3. Cardia4. Body5. Antrum

1.Regarding the management of major trauma1.Deaths follow a trimodal distribution2.Cardiac tamponade is characterised by raised BP, low JVP and muffled heart sounds3. Assessment of uncomplicated limb fractures should occur during the primary survey4. Deterioration of the casualty during the primary survey should lead to the secondary survey5.All are false

•Which hypersensitivity reaction is associated with a tuberculin reaction? 1.Type I: immediate 2.Type II: cytotoxic 3.Type III: immune complex 4.Type IV: cell mediated

•The most common location for a gastric ulcer is1. Fundus2. Greater curvature3. Cardia4. Body5. Antrum

1.Regarding the management of major trauma1.Deaths follow a trimodal distribution2.Cardiac tamponade is characterised by raised BP, low JVP and muffled heart sounds3. Assessment of uncomplicated limb fractures should occur during the primary survey4. Deterioration of the casualty during the primary survey should lead to the secondary survey5.All are false

•All of the following are true about neurogenic shock except:a. There is a decrease in systemic vascular resistance and an increase in venous

capacitance.b. Tachycardia or bradycardia may be observed, along with hypotension.c. The use of an alpha agonist such as phenylephrine is the mainstay of treatment.d. Severe head injury, spinal cord injury, and high spinal anesthesia may all cause

neurogenic shock.•The following cause hypercalcaemia except :

a. Sarcoidosisb. Primary hyperparathyroidismc. Acute pancreatitisd. Metastatic bronchial carcinomae. Milk-Alkali syndrome

•For a 40-kg baby the maintenance daily fluid requirement is approximately which of the following?

a. 1100 mlb. 1250 mlc. 1550 mld. 1700 mle. 2000 ml

•All of the following are true about neurogenic shock except:a. There is a decrease in systemic vascular resistance and an increase in venous

capacitance.b. Tachycardia or bradycardia may be observed, along with hypotension.c. The use of an alpha agonist such as phenylephrine is the mainstay of treatment.d. Severe head injury, spinal cord injury, and high spinal anesthesia may all cause

neurogenic shock.•The following cause hypercalcaemia except :

a. Sarcoidosisb. Primary hyperparathyroidismc. Acute pancreatitisd. Metastatic bronchial carcinomae. Milk-Alkali syndrome

•For a 40-kg baby the maintenance daily fluid requirement is approximately which of the following?

a. 1100 mlb. 1250 mlc. 1550 mld. 1700 mle. 2000 ml

•. Infantile hypertrophic pyloric stenosisa. Occurs with a male: female ratio of 4:1.b. Presents between six and eight months of agec. Typically presents with bile stained projectile vomitingd. Surgical treatment is by Heller's Cardiomyotomye. all are false

• . Which of the following do you consider to be the most important clinical sign in acute appendicitis,

a. Abdominal tenderness around the umbilicus b. Abdominal tenderness in the RIF c. Tenderness over McBurney’s point d. Rovsing’s sign positive e. Suprapubic tenderness

• Heparina. Acts as an anti-platelet b. Acts as an anti-thromboplastin c. Acts as an antithrombin d. All of the above e. None of the above

•. Infantile hypertrophic pyloric stenosisa. Occurs with a male: female ratio of 4:1.b. Presents between six and eight months of agec. Typically presents with bile stained projectile vomitingd. Surgical treatment is by Heller's Cardiomyotomye. all are false

• . Which of the following do you consider to be the most important clinical sign in acute appendicitis,

a. Abdominal tenderness around the umbilicus b. Abdominal tenderness in the RIF c. Tenderness over McBurney’s point d. Rovsing’s sign positive e. Suprapubic tenderness

• Heparina. Acts as an anti-platelet b. Acts as an anti-thromboplastin c. Acts as an antithrombin d. All of the above e. None of the above

10. All of the following are mechanisms of urinary calculi formation except,a. Hypoparathyroidism b. Prolonged recumbency c. Infection with urea-splitting organisms d. Foreign body e. Urinary tract obstruction

11. Which of the following are not found in peritonitis?a. Patient is lying still b. Guarding c. Rebound tenderness d. Hyperactive bowel sounds e. Rigid abdomen

12-Which one of the following suggest a diagnosis of Hirschsprung's disease? a. A contrast-study showing dilatation of the aganglionic bowel segment. b. Early presentation with vomiting.   c. Neonatal large bowel obstruction.   d. Presentation after 1 year of age.e. Red current jelly stools.

10. All of the following are mechanisms of urinary calculi formation except,a. Hypoparathyroidism b. Prolonged recumbency c. Infection with urea-splitting organisms d. Foreign body e. Urinary tract obstruction

11. Which of the following are not found in peritonitis?a. Patient is lying still b. Guarding c. Rebound tenderness d. Hyperactive bowel sounds e. Rigid abdomen

12-Which one of the following suggest a diagnosis of Hirschsprung's disease? a. A contrast-study showing dilatation of the aganglionic bowel segment. b. Early presentation with vomiting.   c. Neonatal large bowel obstruction.   d. Presentation after 1 year of age.e. Red current jelly stools.

13-Which of the following regarding the anatomy of the heart is true? A.The aortic valve is tricuspid.   B.The ascending aorta is entirely outside the pericardial sac.  

C.The left atrial appendage is identified readily by transthoracic echocardiography.  D.The pulmonary trunk lies anterior to the ascending aorta.E.The right atrium is posterior to the left atrium.

14-Which of the following is true concerning Scaphoid fractures? A.Rarely occur in young adults   B.when complicated by avascular necrosis the proximal pole is usually affected 

C.should be treated by bone grafting and internal fixation even if undisplaced  D.wrist fractures are uncommonE.anteriorposterior and lateral radiographs reveal most fractures

15-Which of the following statements is true of upper limb nerve injuries? A.Injury to the median nerve results in a wrist dropB.Injury to the radial nerve results in loss of sensation over the palmar aspect of the index finger C.Injury to the median nerve results in loss of sensation in the anatomical snuffbox D.Injury to the ulnar nerve results in a claw handE.Injury to the ulnar nerve results in loss of sensation over the thumb

13-Which of the following regarding the anatomy of the heart is true? A.The aortic valve is tricuspid.   B.The ascending aorta is entirely outside the pericardial sac.  

C.The left atrial appendage is identified readily by transthoracic echocardiography.  D.The pulmonary trunk lies anterior to the ascending aorta.E.The right atrium is posterior to the left atrium.

14-Which of the following is true concerning Scaphoid fractures? A.Rarely occur in young adults   B.when complicated by avascular necrosis the proximal pole is usually affected 

C.should be treated by bone grafting and internal fixation even if undisplaced  D.wrist fractures are uncommonE.anteriorposterior and lateral radiographs reveal most fractures

15-Which of the following statements is true of upper limb nerve injuries? A.Injury to the median nerve results in a wrist dropB.Injury to the radial nerve results in loss of sensation over the palmar aspect of the index finger C.Injury to the median nerve results in loss of sensation in the anatomical snuffbox D.Injury to the ulnar nerve results in a claw handE.Injury to the ulnar nerve results in loss of sensation over the thumb

16- Regarding intravenous solutions:a. Normal saline contains 180mmol/l of sodium b. Ringer's lactate solutions is designed for intracellular fluid replacement c. Sodium bicarbonate 8.4% is a hyperosmolar solution d. Normal saline with added potassium is appropriate therapy to correct a

respiratory alkalosise. All are True

17-Which of the following concerning the Femoral sheath is false: a. Contains the femoral artery b. Contains lymph nodesc. Contains the femoral canald. Contains femoral nervee. Contains the femoral vein

18-The following is true of the spleen:a. Is the largest lymphoid organ in the bodyb. Lies obliquely between the seventh and tenth ribc. The lower pole extends beyond the mid-axillary lined. Is usually palpable when normale. Usually measures 16cm in maximum length when healthy

16- Regarding intravenous solutions:a. Normal saline contains 180mmol/l of sodium b. Ringer's lactate solutions is designed for intracellular fluid replacement c. Sodium bicarbonate 8.4% is a hyperosmolar solution d. Normal saline with added potassium is appropriate therapy to correct a

respiratory alkalosise. All are True

17-Which of the following concerning the Femoral sheath is false: a. Contains the femoral artery b. Contains lymph nodesc. Contains the femoral canald. Contains femoral nervee. Contains the femoral vein

18-The following is true of the spleen:a. Is the largest lymphoid organ in the bodyb. Lies obliquely between the seventh and tenth ribc. The lower pole extends beyond the mid-axillary lined. Is usually palpable when normale. Usually measures 16cm in maximum length when healthy

19-Breast cancer risk is increased in association with the following factors except:

a. Nulliparityb. Immediately after pregnancy c. Early menarched. Early age at first pregnancye. Late menopause

20-In tension pneumothorax the following signs are present except:a. Hypoxiab. Hyperresonance to percussion on the affected sidec. Tracheal deviation to the ipsilateral sided. Distended neck veinse. Tachycardia

21- The most common hernia in females is:a. Femoral hernia.b. Direct inguinal hernia.c. Indirect inguinal hernia.d. Obturator hernia.e. Umbilical hernia.

19-Breast cancer risk is increased in association with the following factors except:

a. Nulliparityb. Immediately after pregnancy c. Early menarched. Early age at first pregnancye. Late menopause

20-In tension pneumothorax the following signs are present except:a. Hypoxiab. Hyperresonance to percussion on the affected sidec. Tracheal deviation to the ipsilateral sided. Distended neck veinse. Tachycardia

21- The most common hernia in females is:a. Femoral hernia.b. Direct inguinal hernia.c. Indirect inguinal hernia.d. Obturator hernia.e. Umbilical hernia.

22-. The most helpful diagnostic radiographic procedure in small bowel obstruction is:

a. CT of the abdomen.b. Contrast study of the intestine.c. Supine and erect x-rays of the abdomen.d. Ultrasonography of the abdomen.e. MRI Abdomen

23- In role of nine extent of burn if entire trunk is burned it will be equal to:a. 9% body surface area.b. 18% body surface area.c. 36% body surface area.d. 27% body surface area.e. 45% body surface area.

24-. If torsion of the testicle is suspected, surgical exploration:• Can be delayed 24 hours and limited to the affected side.• Can be delayed but should include the asymptomatic side.• Should be immediate and limited to the affected side.• Should be immediate and include the asymptomatic side.

22-. The most helpful diagnostic radiographic procedure in small bowel obstruction is:

a. CT of the abdomen.b. Contrast study of the intestine.c. Supine and erect x-rays of the abdomen.d. Ultrasonography of the abdomen.e. MRI Abdomen

23- In role of nine extent of burn if entire trunk is burned it will be equal to:a. 9% body surface area.b. 18% body surface area.c. 36% body surface area.d. 27% body surface area.e. 45% body surface area.

24-. If torsion of the testicle is suspected, surgical exploration:• Can be delayed 24 hours and limited to the affected side.• Can be delayed but should include the asymptomatic side.• Should be immediate and limited to the affected side.• Should be immediate and include the asymptomatic side.

25- Hyperthyroidism can be caused by all of the following except:a. Graves' disease.b. Plummer's disease.c. Struma ovarii.d. Hashimoto's disease.e. Medullary carcinoma of the thyroid.

26- A 9 month old boy presents with an acute scrotal swelling. The following diagnoses are likely:

a. Epididymitis b. Orchitis c. Torsion of the testicular appendage d. Irreducible inguinal hernia e. Acute idiopathic scrotal oedema

27. The evaluation of a comatose patient with a head injury begins with:a.The cardiovascular system.b. Pupillary reflexes.c. Establishment of an airway.d. Computed tomography (CT) of the braine .insertion of Intravenous canula

25- Hyperthyroidism can be caused by all of the following except:a. Graves' disease.b. Plummer's disease.c. Struma ovarii.d. Hashimoto's disease.e. Medullary carcinoma of the thyroid.

26- A 9 month old boy presents with an acute scrotal swelling. The following diagnoses are likely:

a. Epididymitis b. Orchitis c. Torsion of the testicular appendage d. Irreducible inguinal hernia e. Acute idiopathic scrotal oedema

27. The evaluation of a comatose patient with a head injury begins with:a.The cardiovascular system.b. Pupillary reflexes.c. Establishment of an airway.d. Computed tomography (CT) of the braine .insertion of Intravenous canula

28. The following is an indication for thoracotomy in chest injury,a. Cardiac tamponade b. Uncontrolled pulmonary air leakage c. Perforation of thoracic esophagus d. Blood loss of 200ml/hr for 2-3 hrs via chest tube e. All of the above

29. Regarding Gallstones all of the following are true except:-a. Prevalence increases with advancing ageb. 30% of gallstones are radio-opaque c. Cholesterol stones result from a change in solubility of bile constituents d. Biliary infection, stasis and changes in gallbladder function can precipitate

stone formation e. Gram-negative organisms are the most common isolated

30.In obstructive jaundice:a. Urinary conjugated bilirubin is increasedb. Serum unconjugated bilirubin is increasedc. Urinary urobilinogen increased d. Serum conjugated bilirubin is reducede. Faecal stercobilinogen is increased

28. The following is an indication for thoracotomy in chest injury,a. Cardiac tamponade b. Uncontrolled pulmonary air leakage c. Perforation of thoracic esophagus d. Blood loss of 200ml/hr for 2-3 hrs via chest tube e. All of the above

29. Regarding Gallstones all of the following are true except:-a. Prevalence increases with advancing ageb. 30% of gallstones are radio-opaque c. Cholesterol stones result from a change in solubility of bile constituents d. Biliary infection, stasis and changes in gallbladder function can precipitate

stone formation e. Gram-negative organisms are the most common isolated

30.In obstructive jaundice:a. Urinary conjugated bilirubin is increasedb. Serum unconjugated bilirubin is increasedc. Urinary urobilinogen increased d. Serum conjugated bilirubin is reducede. Faecal stercobilinogen is increased