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Channel Posts
🛑🛑
مع إنو اتأخرت شديد وممكن الناس ما تلحق تقراها كلها لكن كدا خلاص كل شيتات السيرجري خلصت وكل شيت فيهو اسئلة عبارة عن cases و mcqs عادية
في باقي الزمن دا الما قرا نهائي يشوف المواضيع المهمة بس و اللي هي:
Breast
tgyroid
Colorectal carcinoma
و ربنا يوفقكم جميعاً🖤✨
🛑🛑
| 2 | 🛑🛑Common surgical problems of the small and large🛑🛑☝️ | 334 |
| 3 | Surgical Problem of intestine MCQS
1. What is the most common congenital anomaly of the small intestine?
A) Meckel's diverticulum
B) Crohn's disease
C) Mesenteric vessel ischaemia
D) Small bowel tumors
Answer: A
2. Which investigation is considered very useful for detecting Meckel's diverticulum, especially in children presenting with bleeding?
A) Technetium (Tc99) radioisotope scan
B) Plain X-ray abdomen
C) Barium meal follow through
D) CT scan
Answer: A
3. What is the typical location of carcinoid tumors in the small intestine?
A) Appendix
B) Ileum
C) Jejunum
D) Duodenum
Answer: B
4. What are the characteristic findings on barium meal follow through in Crohn's disease?
A) Straightening of valvulae conniventes
B) Multiple defects (cobble-stone appearance)
C) Rose thorn appearance of the bowel wall
D) All of the above
Answer: D
5. What is the normal value of 5-hydroxyindoleacetic acid (5HIAA) in urine?
A) 2-8 mg/24 hrs
B) 5-10 mg/24 hrs
C) 10-15 mg/24 hrs
D) 15-20 mg/24 hrs
Answer: A
6. What are the protective factors against malignancy in the small bowel?
A) Rapid transit time
B) Alkaline mucus rich luminal content
C) Enzyme benzopyrene hydroxylase
D) All of the above
Answer: D
7. What is the pathological feature of Crohn's disease that results in granuloma formation?
A) Transmural inflammation
B) Thickening of the bowel wall
C) Adhesions
D) Fistula formation
Answer: A
8. What is the most common complication of ulcerative colitis?
A) Pseudopolyposis
B) Malignancy
C) Stricture formation
D) Toxic megacolon
Answer: B
9. What is the best method to diagnose diverticular disease of the colon?
A) Barium enema
B) Sigmoidoscopy
C) Colonoscopy
D) CT scan
Answer: A
10. What are the clinical features of mesenteric vessel ischaemia?
A) Pain around the umbilicus
B) Persistent vomiting
C) Bloody diarrhea
D) All of the above
Answer: D
11. What is the typical location for ischaemic colitis to affect?
A) Splenic flexure
B) Ascending colon
C) Descending colon
D) Sigmoid colon
Answer: A
12. What is the most common presentation of ulcerative colitis?
A) Proctitis
B) Left sided colitis
C) Total proctocolitis
D) Isolated rectal involvement
Answer: A
13. What is the diagnostic finding on barium enema in ischaemic colitis?
A) Thumb-print sign
B) Sawteeth appearance
C) Champagne glass sign
D) Cobble-stone appearance
Answer: A
14. What is the most common site for carcinoid tumors in the GIT?
A) Appendix
B) Ileum
C) Rectum
D) Stomach
Answer: A
15. What is the cell of origin for GIST (Gastrointestinal stromal tumour)?
A) Enterochromaffin cells
B) Interstitial cell of Cajal
C) Kulchitsky cells
D) Goblet cells
Answer: B
16. What is the typical distribution of GIST in the GIT?
A) Stomach > small bowel > colon
B) Small bowel > stomach > colon
C) Colon > stomach > small bowel
D) Stomach > colon > small bowel
Answer: A
17. What is the typical gender distribution for GIST?
A) More common in males
B) More common in females
C) Equal in both sexes
D) More common in children
Answer: C
18. What is the typical age group for the occurrence of small bowel tumors?
A) Young adults
B) Middle-aged adults
C) Elderly men
D) Elderly women
Answer: C
19. What is the typical presentation of small bowel tumors?
A) Vague symptoms
B) Obstruction
C) Intussusception
D) All of the above
Answer: D
20. What is the most common cause of massive hemorrhage in ulcerative colitis?
A) Pseudopolyposis
B) Malignancy
C) Stricture formation
D) Toxic megacolon
Answer: B | 333 |
| 4 | 15. A patient presents with abdominal pain and is found to have a small bowel tumor. Which of the following is the most common type of small bowel tumor?
A) Adenoma
B) Carcinoid tumor
C) Lipoma
D) Haemangioma
Answer: B
16. A patient with a history of ulcerative colitis presents with abdominal pain and is found to have a malignancy. What is the most common complication associated with malignancy in ulcerative colitis?
A) Dysplasia
B) Adenocarcinoma
C) Lymphoma
D) Carcinoid tumor
Answer: B
17. A patient presents with abdominal pain and is found to have a small bowel tumor. Which of the following is the most common symptom associated with small bowel tumors?
A) Vague abdominal discomfort
B) Obstruction
C) Intussusception
D) Bleeding
Answer: A
18. A patient with a history of ulcerative colitis presents with abdominal pain and is found to have a toxic megacolon. What is the most common location for toxic megacolon to occur?
A) Rectum
B) Sigmoid colon
C) Transverse colon
D) Ascending colon
Answer: C
19. A patient presents with abdominal pain and is found to have a small bowel tumor. Which of the following is the most common complication associated with small bowel tumors?
A) Obstruction
B) Intussusception
C) Bleeding
D) Perforation
Answer: A
20. A patient with a history of ulcerative colitis presents with abdominal pain and is found to have a fistula. What is the most common complication associated with fistula formation in ulcerative colitis?
A) Perianal disease
B) Septicaemia
C) Toxic megacolon
D) Stricture formation
Answer: A | 237 |
| 5 | Surgical Problem of intestine MCQS Cases
1. A 35-year-old male presents with abdominal pain, bloody diarrhea, and weight loss. Colonoscopy shows aphthoid ulcers and reddened mucosal margins. What is the most likely diagnosis?
A) Crohn's disease
B) Ulcerative colitis
C) Meckel's diverticulum
D) Small bowel tumors
Answer: A
2. A 10-year-old child is suspected of having Meckel's diverticulum with bleeding. Which investigation is most likely to confirm the diagnosis?
A) Technetium (Tc99) radioisotope scan
B) Plain X-ray abdomen
C) Barium meal follow through
D) CT scan
Answer: A
3. A patient with a history of Crohn's disease presents with abdominal pain and obstructive symptoms. What is the most likely complication?
A) Stricture formation
B) Fistula formation
C) Toxic megacolon
D) Pseudopolyposis
Answer: A
4. A 50-year-old female presents with severe abdominal pain, vomiting, and bloody diarrhea. On examination, there is guarding and rigidity. What is the most likely diagnosis?
A) Mesenteric vessel ischaemia
B) Carcinoid tumor
C) Ulcerative colitis
D) Diverticular disease
Answer: A
5. A patient with a history of ulcerative colitis develops severe abdominal pain and distension. What is the most feared complication?
A) Toxic megacolon
B) Stricture formation
C) Pseudopolyposis
D) Fistula formation
Answer: A
6. A 60-year-old male presents with abdominal pain and is found to have a carcinoid tumor. Which investigation would be most useful to assess the tumor's extent?
A) Urine 5-hydroxyindoleacetic acid (5HIAA) levels
B) CT scan
C) Colonoscopy
D) Barium meal follow through
Answer: B
7. A patient with a history of ulcerative colitis presents with watery diarrhea and blood-stained discharge per rectum. What is the most common pattern of disease progression?
A) Proctitis to left sided colitis to total proctocolitis
B) Left sided colitis to proctitis to total proctocolitis
C) Total proctocolitis to proctitis to left sided colitis
D) Proctitis to total proctocolitis to left sided colitis
Answer: A
8. A patient presents with abdominal pain and is found to have a small bowel tumor. Which of the following is the most common presentation?
A) Vague abdominal discomfort
B) Obstruction
C) Intussusception
D) Bleeding
Answer: A
9. A patient with a history of Crohn's disease presents with abdominal pain and is found to have a fistula. What is the most common pathological feature of Crohn's disease that leads to fistula formation?
A) Transmural inflammation
B) Thickening of the bowel wall
C) Adhesions
D) Granuloma formation
Answer: A
10. A patient presents with abdominal pain and is found to have ischaemic colitis. Which investigation is most likely to be diagnostic?
A) Barium enema showing thumb-print sign
B) Colonoscopy
C) CT scan
D) Sigmoidoscopy
Answer: A
11. A patient with a history of ulcerative colitis presents with abdominal pain and is found to have a stricture. What is the most common location for stricture formation?
A) Rectum
B) Sigmoid colon
C) Transverse colon
D) Ascending colon
Answer: B
12. A patient presents with abdominal pain and is found to have a carcinoid tumor in the small intestine. What is the most common site for carcinoid tumors within the GIT?
A) Appendix
B) Ileum
C) Rectum
D) Stomach
Answer: A
13. A patient presents with abdominal pain and is found to have a small bowel tumor. Which of the following investigations is most useful for assessing the small bowel?
A) CT scan
B) Video capsule endoscopy
C) Barium meal follow through
D) Colonoscopy
Answer: B
14. A patient with a history of ulcerative colitis presents with abdominal pain and is found to have a perforation. What is the most common complication associated with perforation in ulcerative colitis?
A) Peritonitis
B) Septicaemia
C) Toxic megacolon
D) Fistula formation
Answer: A | 145 |
| 6 | 🛑🛑دا كدا شيت ال DVT🛑🛑👆🏻 | 135 |
| 7 | 16. A 65-year-old male patient presents with a history of intermittent claudication in the left calf for the past 6 months. On examination, his resting femoral and distal pulses are palpable, but he has decreased pedal pulses. His ABI is 0.7 at rest. What is the most appropriate first-line treatment for this patient?
A. Immediate surgical intervention
B. Medical therapy with risk factor modification
C. Endovascular options
D. Amputation
Answer: B
17. A 50-year-old female patient is diagnosed with acute arterial ischemia of the right leg due to an embolus. She has severe pain, pallor, pulselessness, paresthesias, and paralysis. What is the immediate management for this patient?
A. Administration of heparin and urgent surgical embolectomy
B. Observation and medical management with antiplatelet therapy
C. Immediate amputation due to the severity of symptoms
D. Noninvasive angiography to plan for endovascular intervention
Answer: A
18. A 70-year-old male patient with a history of claudication and rest pain has an ABI of 0.3 at rest. He has significant tissue loss and ulceration at the tips of his toes. What is the most appropriate management for this patient?
A. Medical therapy with risk factor modification
B. Open surgical therapy such as aortobifemoral grafting
C. Endovascular options
D. Amputation
Answer: B
19. A 40-year-old male patient presents with acute ischemia of the left leg following a penetrating trauma. He has "hard" signs of arterial injury. What is the most appropriate next step in management?
A. Urgent surgical intervention without preoperative angiography
B. Noninvasive angiography to assess the extent of injury
C. Observation and serial examinations to monitor for deterioration
D. Immediate amputation due to the severity of injury
Answer: A
20. A 60-year-old male patient with a history of atherosclerosis presents with acute arterial ischemia. He is undergoing thrombolysis and is being monitored in the ICU. Which of the following laboratory values should be monitored closely to limit the risk of hemorrhage?
A. Platelet count and hemoglobin level
B. Fibrinogen level and PTT
C. White blood cell count and serum creatinine
D. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
Answer: B | 135 |
| 8 | DVT And Limb MCQS Cases
1. A 55-year-old male patient presents with sudden onset of chest pain and difficulty breathing. An ECG is performed, which shows an S wave in lead I, Q waves, and inverted T waves in lead III. What is the classical ECG finding suggestive of?
A. Myocardial infarction
B. Pulmonary embolism
C. Atrial fibrillation
D. Ventricular tachycardia
Answer: B
2. A postoperative patient develops unexplained fever, rapid heart rate, and increased breathing rate. These symptoms may be indicative of which condition?
A. Pulmonary embolism
B. Pneumonia
C. Deep Vein Thrombosis (DVT)
D. Myocardial infarction
Answer: A
3. A patient with a history of DVT is found to have a resistance to heparin therapy. What may be the first manifestation of this disorder?
A. Increased clotting time
B. Decreased clotting time
C. Normal clotting time
D. Heparin overdose
Answer: B
4. A patient with suspected pulmonary embolism undergoes a V/Q lung scan. What is the purpose of this scan?
A. To visualize the embolus in the pulmonary arteries
B. To assess the ventilation and perfusion of the lungs
C. To measure the cardiac output
D. To detect pleural effusions
Answer: B
5. A patient with a massive pulmonary embolism is described as having embolic obstruction of what percentage of the pulmonary vasculature?
A. 20-30%
B. 40-50%
C. 60-70%
D. 80-90%
Answer: B
6. A patient with iliofemoral thrombosis presents with pain, swelling, and discoloration of the leg. What is this condition called?
A. Phlegmasia alba dolens
B. Phlegmasia caerulea dolens
C. Venous gangrene
D. Pulmonary infarction
Answer: B
7. A patient with suspected pulmonary embolism has a chest X-ray performed. What is the likelihood of specific changes being detected on the chest radiograph?
A. Very high
B. High
C. Low
D. Very low
Answer: D
8. A patient with pulmonary embolism is started on anticoagulation therapy. Which of the following is the target APTT for heparin administration?
A. Between 20 and 30 seconds
B. Between 30 and 40 seconds
C. Between 50 and 80 seconds
D. Between 80 and 100 seconds
Answer: C
9. A patient with a history of DVT is at risk of developing which of the following complications?
A. Pulmonary hypertension
B. Right heart failure
C. Lung abscess
D. All of the above
Answer: D
10. A patient with a non-fatal pulmonary embolism may present with which of the following symptoms?
A. Sudden chest pain and shortness of breath
B. Haemoptysis
C. Epigastric pain
D. All of the above
Answer: D
11. A patient with a suspected pulmonary embolism has a low Pao2 and a high pH. What does this indicate?
A. Pulmonary embolism is unlikely
B. Pulmonary embolism is possible
C. Pulmonary embolism is confirmed
D. Pulmonary embolism is ruled out
Answer: B
12. A patient with a massive pulmonary embolism may present with which of the following symptoms?
A. Crushing substernal chest pain and dyspnea
B. Circulatory arrest
C. Death
D. All of the above
Answer: D
13. A patient with a pulmonary embolism is treated with which of the following as the first line of therapy?
A. Thrombolysis
B. Embolectomy
C. Anticoagulation
D. Surgical intervention
Answer: C
14. A patient with a pulmonary embolism is at risk of developing which of the following conditions?
A. Pulmonary hypertension
B. Right heart failure
C. Cor pulmonale
D. All of the above
Answer: D
15. A patient with a large pulmonary embolus may require which of the following interventions?
A. Pulmonary embolectomy
B. Thrombolysis
C. Anticoagulation
D. All of the above may be considered
Answer: D | 121 |
| 9 | 29. What is the recommended management for patients with rhabdomyolysis following reperfusion?
A. Aggressive hydration and diuresis promotion with mannitol
B. Intravenous infusion of bicarbonate to alkalinize the urine
C. Monitoring of electrolytes and pH changes
D. All of the above
Answer: D
30. What is the critical time period for restoration of blood flow in acute limb ischemia to prevent irreversible changes?
A. 4 to 6 hours
B. 6 to 8 hours
C. 8 to 12 hours
D. 12 to 24 hours
Answer: A | 113 |
| 10 | 15. What are the complications associated with pulmonary embolism?
A. Haemoptysis, lung abscess, pulmonary hypertension, and right heart failure
B. Haemoptysis, lung abscess, pulmonary hypertension, and left heart failure
C. Haemoptysis, lung abscess, systemic hypertension, and right heart failure
D. Haemoptysis, lung abscess, systemic hypertension, and left heart failure
Answer: A
16. What is the role of anticoagulation in the treatment of pulmonary embolism?
A. To prevent further embolism
B. To dissolve the existing clot
C. To remove the embolus physically
D. To improve the outlook for valve function
Answer: A
17. What is the incidence of the classical ECG findings in pulmonary embolism?
A. 10-20% of patients
B. 20-30% of patients
C. 30-40% of patients
D. 40-50% of patients
Answer: A
18. What is the target APTT for heparin administration in pulmonary embolism?
A. Between 50 and 80 s
B. Between 30 and 60 s
C. Between 10 and 20 s
D. Between 80 and 100 s
Answer: A
19. What is the treatment of choice for impending venous gangrene due to DVT?
A. Thrombolysis
B. Thromboectomy
C. Anticoagulation
D. Embolectomy
Answer: B
20. What are the less obvious presentations of pulmonary embolism in the postoperative or postpartum period?
A. Unexplained pyrexia, tachycardia, or tachypnoea
B. Unexplained bradycardia, bradypnoea, or hypothermia
C. Unexplained hypertension, tachycardia, or dyspnea
D. Unexplained hypotension, bradycardia, or bradypnoea
Answer: A
21. What is the primary method for quantifying the degree of ischemia in patients with suspected arterial disease?
A. Segmental arterial Doppler readings with waveforms
B. Transcutaneous measurement of local tissue oxygenation
C. Digital subtraction arteriography
D. Ankle-brachial index (ABI)
Answer: D
22. Which of the following is considered the gold standard for evaluating the arterial tree before planned revascularization?
A. Noninvasive angiography using magnetic resonance
B. Noninvasive angiography using computer tomography
C. Digital subtraction arteriography
D. Transcutaneous measurement of local tissue oxygenation
Answer: C
23. What is the first-line treatment for patients with intermittent claudication?
A. Open surgical therapy
B. Endovascular options
C. Medical therapy with risk factor modification
D. Amputation
Answer: C
24. Which of the following is an indication for surgical intervention in patients with chronic arterial occlusive disease?
A. Claudication alone
B. Rest pain and severe ischemia
C. Normal resting waveforms
D. Postexercise ABI measurements
Answer: B
25. What is the treatment of choice for low-risk patients with diffuse aortoiliac stenoses and occlusions?
A. Aortobifemoral grafting
B. Femorofemoral, ilioiliac, or iliofemoral bypasses
C. Aortoiliac endarterectomy
D. Sympathectomy
Answer: A
26. What is the recommended management for patients with acute arterial ischemia due to emboli or thrombi?
A. Immediate administration of heparin
B. Surgical therapy such as embolectomy
C. Monitoring in the intensive care unit (ICU) during thrombolysis
D. All of the above
Answer: D
27. Which of the following is a constellation of symptoms that results from the gradual occlusion of the terminal aorta?
A. Leriche syndrome
B. Femoral-popliteal disease
C. Tibial-peroneal disease
D. Aortoiliac occlusive disease
Answer: A
28. What are the five Ps of acute ischemia?
A. Pain, pallor, pulselessness, paresthesias, paralysis
B. Pain, pallor, paresthesias, paralysis, peritoneal signs
C. Pain, pallor, pulselessness, paresthesias, peritoneal signs
D. Pain, pallor, paresthesias, paralysis, peritoneal signs
Answer: A | 117 |
| 11 | DVT And Limb MCQS
1. What is the classical ECG finding in pulmonary embolism?
A. S wave in lead I and Q waves and inverted T waves in lead III; S1QT3
B. Q wave in lead I and S waves and inverted T waves in lead III; Q1ST3
C. T wave in lead I and S waves and inverted Q waves in lead III; T1SQ3
D. None of the above
Answer: A
2. Which of the following laboratory findings may indicate pulmonary embolism?
A. Low Pao2 with hypocarbia and alkalosis
B. High Pao2 with hypocarbia and acidosis
C. Low Pao2 with hypercarbia and acidosis
D. High Pao2 with hypercarbia and alkalosis
Answer: A
3. What is the definition of a massive pulmonary embolus?
A. Embolic obstruction of 40-50% of the pulmonary vasculature
B. Embolic obstruction of 20-30% of the pulmonary vasculature
C. Embolic obstruction of 60-70% of the pulmonary vasculature
D. Embolic obstruction of 80-90% of the pulmonary vasculature
Answer: A
4. What are the specific measures for managing DVT?
A. Anticoagulation, thrombolysis, and thrombectomy
B. Anticoagulation, fibrinolysis, and embolectomy
C. Heparin therapy, warfarin therapy, and thrombectomy
D. Thrombolysis, embolectomy, and antifibrinolysis
Answer: A
5. What is the first manifestation of heparin resistance in DVT?
A. Increased clotting time
B. Decreased clotting time
C. Normal clotting time
D. Heparin overdose
Answer: B
6. What is the role of D-dimers in the diagnosis of DVT?
A. D-dimers are specific for DVT and confirm the diagnosis
B. D-dimers are non-specific but can help rule out DVT if normal
C. D-dimers are not useful in the diagnosis of DVT
D. D-dimers are specific for DVT and rule it out if normal
Answer: B
7. What is the annual death rate due to DVT in the USA as per the National Hospital Discharge Survey?
A. 5,000 deaths
B. 10,000 deaths
C. 15,000 deaths
D. 20,000 deaths
Answer: B
8. What is the recommended treatment for uncomplicated pulmonary emboli?
A. Subcutaneous low-molecular-weight heparin
B. Oral anticoagulation with warfarin
C. Thrombolysis with t-PA
D. Surgical embolectomy
Answer: A
9. What is the clinical presentation of iliofemoral thrombosis?
A. Pain, extensive pitting edema, and blanching of the limb
B. Pain, extensive pitting edema, and cyanosis of the limb
C. Painless, extensive pitting edema, and blanching of the limb
D. Painless, extensive pitting edema, and cyanosis of the limb
Answer: A
10. What are the clinical features of pulmonary embolism?
A. Crushing substernal chest pain, dyspnea, circulatory arrest, and death
B. Mild chest pain, shortness of breath, and cough
C. Abdominal pain, nausea, and vomiting
D. Joint pain, fever, and chills
Answer: A
11. What is the role of chest X-ray in diagnosing pulmonary embolism?
A. It is very specific and can confirm the diagnosis
B. It is very sensitive and can rule out the diagnosis
C. It is non-specific and rarely shows specific changes
D. It is specific and can rule out the diagnosis
Answer: C
12. What is the initial treatment for pulmonary embolism?
A. A large bolus dose of heparin followed by continuous infusion
B. A small bolus dose of heparin followed by intermittent injections
C. Oral anticoagulation with warfarin only
D. Thrombolysis with t-PA only
Answer: A
13. What is the gold standard for diagnosing DVT?
A. Bilateral ascending venography (phlebography)
B. Doppler ultrasound
C. Duplex imaging
D. MRI venography
Answer: A
14. What is the classical presentation of non-fatal emboli?
A. Sudden chest pain, dyspnea, and pleuritic pain
B. Sudden chest pain, dyspnea, and epigastric pain
C. Sudden chest pain, dyspnea, and haemoptysis
D. Sudden chest pain, dyspnea, and circulatory arrest
Answer: B | 124 |
| 12 | 🛑🛑Appendix🛑🛑☝️ | 113 |
| 13 | Appendix MCQS Cases
1. A 25-year-old male presents with sudden onset of pain around the umbilicus, which has now localized to the right iliac fossa. He also has nausea, vomiting, and fever. What is the most likely diagnosis?
A) Acute appendicitis
B) Perforated peptic ulcer
C) Acute cholecystitis
D) Right ureteric colic
Answer: A) Acute appendicitis
2. A 30-year-old female is 28 weeks pregnant and presents with pain in the upper abdomen, more lateral than usual. She has tenderness in the right iliac fossa and a positive Rovsing’s sign. What is the most likely diagnosis?
A) Acute appendicitis
B) Ruptured ovarian cyst
C) Acute pancreatitis
D) Right acute pyelonephritis
Answer: A) Acute appendicitis
3. A 65-year-old male with a history of Crohn’s disease presents with pain in the right iliac fossa, fever, and elevated white blood cell count. What is the most likely diagnosis?
A) Acute appendicitis
B) Crohn’s disease flare-up
C) Pseudoappendicitis
D) Meckel’s diverticulitis
Answer: A) Acute appendicitis
4. A 15-year-old male presents with a 3-day history of pain in the right iliac fossa, which has now become a palpable mass. He has no fever or leukocytosis. What is the most likely diagnosis?
A) Appendicular mass
B) Appendicular abscess
C) Carcinoid tumour
D) Mucocele of the appendix
Answer: A) Appendicular mass
5. A 40-year-old female presents with a history of acute appendicitis treated conservatively. She now has a recurrent mass in the right iliac fossa. What is the most appropriate next step in management?
A) Immediate appendicectomy
B) Observation with interval appendicectomy
C) Antibiotics and analgesics
D) Drainage of the mass
Answer: B) Observation with interval appendicectomy
6. A 50-year-old male presents with a history of acute appendicitis and now has a palpable, tender mass in the right iliac fossa. Ultrasound confirms the presence of fluid. What is the most likely diagnosis?
A) Appendicular mass
B) Appendicular abscess
C) Mucocele of the appendix
D) Carcinoid tumour
Answer: B) Appendicular abscess
7. A 35-year-old female presents with a history of acute appendicitis and now has a large, non-tender mass in the right iliac fossa. There is no evidence of infection. What is the most likely diagnosis?
A) Appendicular mass
B) Appendicular abscess
C) Mucocele of the appendix
D) Carcinoid tumour
Answer: C) Mucocele of the appendix
8. A 20-year-old male presents with a history of acute appendicitis and now has a palpable mass in the right iliac fossa. Biopsy reveals a carcinoid tumour. What is the most appropriate treatment?
A) Appendicectomy
B) Right hemicolectomy
C) Observation
D) Chemotherapy
Answer: A) Appendicectomy
9. A 45-year-old male presents with a history of acute appendicitis and now has a palpable mass in the right iliac fossa. Biopsy reveals a mucinous cystadenocarcinoma. What is the most appropriate treatment?
A) Appendicectomy
B) Right hemicolectomy
C) Observation
D) Chemotherapy
Answer: B) Right hemicolectomy
10. A 55-year-old female presents with a history of acute appendicitis and now has a palpable mass in the right iliac fossa. Biopsy reveals a mucinous cystadenoma. What is the most appropriate treatment?
A) Appendicectomy
B) Right hemicolectomy
C) Observation
D) Chemotherapy
Answer: A) Appendicectomy | 128 |
| 14 | Appendix MCQS
1. What is the most common position of the vermiform appendix?
A) Retrocaecal
B) Pelvic
C) Subserosal
D) Preileal
Answer: A) Retrocaecal
2. Which of the following is the most common cause of obstruction leading to acute appendicitis?
A) Faecoliths
B) Stricture
C) Foreign body
D) Adhesions
Answer: A) Faecoliths
3. What is the earliest symptom of acute appendicitis?
A) Pain
B) Vomiting
C) Fever
D) Diarrhea
Answer: A) Pain
4. Which of the following is a sign of acute appendicitis where pain is elicited in the right iliac fossa when the left iliac fossa is pressed?
A) Rovsing’s sign
B) Psoas test
C) Obturator test
D) McBurney’s point tenderness
Answer: A) Rovsing’s sign
5. What is the commonest organism found in acute appendicitis?
A) E. coli
B) Enterococci
C) Streptococci
D) Cl. welchii
Answer: A) E. coli
6. Which of the following is a rare cause of appendicitis in children under the age of two?
A) Viral infection
B) Bacterial infection
C) Faecoliths
D) Dietary factors
Answer: A) Viral infection
7. What is the typical presentation of pain in appendicitis during pregnancy?
A) Higher and more lateral
B) Lower and more medial
C) Centralized around the umbilicus
D) Diffuse abdominal pain
Answer: A) Higher and more lateral
8. What is the treatment of choice for acute appendicitis?
A) Antibiotics
B) Appendicectomy
C) Conservative management
D) Interval appendicectomy
Answer: B) Appendicectomy
9. What is the commonest type of neoplasm found in the appendix?
A) Cystic neoplasms
B) Carcinoid tumour
C) Mucinous cystadenocarcinoma
D) Primary adenocarcinoma
Answer: B) Carcinoid tumour
10. What is the recommended management for an appendicular mass?
A) Immediate surgery
B) Conservative management with interval appendicectomy
C) Antibiotics only
D) No treatment needed
Answer: B) Conservative management with interval appendicectomy
11. What is the most common complication of acute appendicitis?
A) Perforation
B) Peritonitis
C) Portal pyaemia
D) Pseudomyxoma peritonei
Answer: A) Perforation
12. What is the recommended time frame for interval appendicectomy after an appendicular abscess?
A) 6 weeks to 3 months
B) 3 to 6 months
C) 1 to 2 years
D) Immediately after the abscess is drained
Answer: A) 6 weeks to 3 months
13. What is the typical size of a carcinoid tumour in the appendix?
A) Less than 1 cm
B) 1 to 2 cm
C) More than 2 cm
D) Variable, no typical size
Answer: A) Less than 1 cm
14. What is the recommended treatment for a mucocele of the appendix?
A) Observation
B) Appendicectomy
C) Antibiotics
D) Drainage
Answer: B) Appendicectomy
15. What is the typical five-year survival rate for patients with mucinous type adenocarcinoma of the appendix?
A) 100%
B) 70%
C) 40%
D) 5%
Answer: B) 70% | 123 |
| 15 | 🛑🛑Skin🛑🛑☝️ | 129 |
| 16 | Skin MCQS Cases
1. A 35-year-old male presents with a raised, reddish lesion on his ear lobe that extends beyond the margin of a previous wound. The lesion has been growing over the past few months. What is the most likely diagnosis?
A) Hypertrophic scar
B) Keloid scar
C) Pyogenic granuloma
D) Dermoid cyst
Answer: B) Keloid scar
2. A 60-year-old female with a history of diabetes mellitus and prolonged bed rest due to a recent hip fracture develops a red, painful area over her sacrum that progresses to a shallow abrasion. What is the stage of this pressure sore?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Answer: B) Stage 2
3. A 40-year-old male with a history of neurofibromatosis presents with multiple benign tumors on his skin. Which of the following is NOT a common complication of his condition?
A) Pressure effect
B) Sarcomatous transformation
C) Intra-abdominal obstruction
D) Renal failure
Answer: D) Renal failure
4. A 25-year-old female with a history of frequent sunburns and a family history of skin cancer presents with a well-defined, pearly-edged lesion with central ulceration on her cheek. What is the most likely diagnosis?
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Malignant melanoma
D) Kaposi's sarcoma
Answer: A) Basal cell carcinoma
5. A 50-year-old male with a history of smoking and previous radiotherapy for head and neck cancer presents with a rapidly growing, painless lesion on his scalp that is prone to bleeding. What is the most likely diagnosis?
A) Pyogenic granuloma
B) Dermoid cyst
C) Neurofibroma
D) Squamous cell carcinoma
Answer: A) Pyogenic granuloma
6. A 65-year-old female with a history of prolonged immobility due to a stroke develops a deep ulcer over her ischial tuberosity with extensive soft tissue loss and muscle necrosis. What is the stage of this pressure sore?
A) Stage 1
B) Stage 2
C) Stage 3
D) Stage 4
Answer: D) Stage 4
7. A 40-year-old male with a history of HIV presents with multiple purple lesions on his legs. What is the most likely diagnosis?
A) Kaposi's sarcoma
B) Malignant melanoma
C) Basal cell carcinoma
D) Squamous cell carcinoma
Answer: A) Kaposi's sarcoma
8. A 20-year-old female with a history of frequent sun exposure presents with a pigmented lesion on her arm that has irregular borders and is changing in size and color. What is the most likely diagnosis?
A) Malignant melanoma
B) Basal cell carcinoma
C) Squamous cell carcinoma
D) Pyogenic granuloma
Answer: A) Malignant melanoma
9. A 55-year-old male with a history of heavy smoking and sun exposure presents with a firm, irregular lesion on his forehead that has been slowly growing over the past year. What is the most likely diagnosis?
A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Malignant melanoma
D) Dermoid cyst
Answer: B) Squamous cell carcinoma
10. A 30-year-old female with a history of a recent surgical scar on her abdomen presents with a raised, red lesion confined to the wound margin that has not regressed over several months. What is the most likely diagnosis?
A) Hypertrophic scar
B) Keloid scar
C) Pyogenic granuloma
D) Dermoid cyst
Answer: A) Hypertrophic scar | 171 |
| 17 | 18. What is the treatment for Kaposi's sarcoma?
A) Radiotherapy
B) Chemotherapy
C) Surgical excision
D) Both A and B
Answer: D) Both A and B
19. Which of the following is NOT a staging system for malignant melanoma?
A) Clarks staging
B) Breslow staging
C) TNM staging
D) AJCC staging
Answer: C) TNM staging
20. What is the treatment for malignant melanoma?
A) Surgical excision
B) Palliative treatment with interferon Alfa
C) Radiotherapy
D) Both A and B
Answer: D) Both A and B | 112 |
| 18 | Skin MCQS
1. Which of the following is NOT a type of wound that is prone to keloid or hypertrophic scar formation?
A) Infected wounds
B) Trauma
C) Burns
D) Tension over the sternum
E) Wounds in the abdomen
Answer: E) Wounds in the abdomen
2. What is the main difference between hypertrophic scars and keloid scars in terms of appearance?
A) Hypertrophic scars are confined to the wound margin, while keloid scars extend beyond the wound margin.
B) Hypertrophic scars are more common in black and Hispanic races, while keloid scars are not.
C) Hypertrophic scars have a normal rate of collagen synthesis, while keloid scars have an increased rate of synthesis and breakdown.
D) Hypertrophic scars are associated with hypoxia, while keloid scars are not.
Answer: A) Hypertrophic scars are confined to the wound margin, while keloid scars extend beyond the wound margin.
3. Which of the following is NOT a common site for pressure sores?
A) Sacrum
B) Greater trochanter
C) Heel
D) Lateral malleolus
E) Ankle
Answer: E) Ankle
4. What is a common risk factor for developing pressure sores?
A) Immobility
B) Prolonged bed rest
C) Conditions that slow wound healing
D) All of the above
Answer: D) All of the above
5. What is the treatment of choice for papilloma (skin tags)?
A) Surgical excision
B) Laser therapy
C) Topical ointments
D) Radiotherapy
Answer: A) Surgical excision
6. Pyogenic granuloma is a type of:
A) Benign tumor
B) Malignant tumor
C) Infection
D) Inflammatory condition
Answer: A) Benign tumor
7. What is the treatment for dermoid cysts?
A) Complete surgical excision
B) Non-surgical treatment with ointments
C) Laser therapy
D) Radiotherapy
Answer: A) Complete surgical excision
8. Neurofibroma is associated with which condition?
A) Neurofibromatosis
B) Basal cell carcinoma
C) Kaposi's sarcoma
D) Malignant melanoma
Answer: A) Neurofibromatosis
9. Which of the following is NOT a type of Kaposi's sarcoma?
A) Classic Kaposi's sarcoma
B) AIDS-associated Kaposi's sarcoma
C) Endemic Kaposi's sarcoma
D) Transplantation-associated Kaposi's sarcoma
E) Malignant Kaposi's sarcoma
Answer: E) Malignant Kaposi's sarcoma
10. What is the most common predictor of risk for malignant melanoma?
A) Presence of naevi
B) Sunlight exposure
C) Family history
D) Previous history of skin lesions
Answer: A) Presence of naevi
11. Which of the following is NOT a risk factor for squamous cell carcinoma?
A) Congenital xeroderma pigmentosum
B) Sunlight exposure
C) Ionizing radiation
D) Family history of melanoma
Answer: D) Family history of melanoma
12. What is the treatment for basal cell carcinoma?
A) Surgical excision with 5 mm margins
B) Radiotherapy
C) Chemotherapy
D) Both A and B
Answer: D) Both A and B
13. Which of the following is the most common type of malignant melanoma?
A) Superficial spreading melanoma
B) Nodular melanoma
C) Lentigo maligna
D) Acral lentiginous melanoma
Answer: A) Superficial spreading melanoma
14. What is the treatment for keloid and hypertrophic scars?
A) Non-surgical treatment with silicon gel sheets
B) Intralesional steroid injections
C) Surgical treatment with excision and Z-plasty
D) All of the above
Answer: D) All of the above
15. Which of the following is NOT a common site for dermoid cysts?
A) Medial end of eyebrows
B) Midline of the nose
C) Midline of the neck
D) Lateral malleolus
Answer: D) Lateral malleolus
16. What is the treatment for pyogenic granuloma?
A) Surgical excision
B) Silver nitrate application
C) Diathermy
D) Both B and C
Answer: D) Both B and C
17. Which of the following is NOT a complication of neurofibromatosis?
A) Pressure effect
B) Deafness
C) Sarcomatous transformation
D) Intra-abdominal obstruction
Answer: B) Deafness | 108 |
| 19 | 🛑🛑Thyroid🛑🛑☝️☝️ | 103 |
| 20 | Thyroid MCQS
1. What is the most common type of thyroid cancer?
A) Medullary thyroid cancer
B) Anaplastic thyroid cancer
C) Papillary thyroid cancer
D) Follicular thyroid cancer
Answer: C) Papillary thyroid cancer
2. Which of the following is a characteristic feature of papillary thyroid cancer (PTC)?
A) Complex papillary architecture
B) Abundant altered mitochondria
C) Arises from parafollicular C cells
D) Indistinguishable from follicular adenomas
Answer: A) Complex papillary architecture
3. What percentage of thyroid tumors does follicular thyroid cancer (FTC) account for?
A) 5%
B) 10%
C) 20%
D) 80%
Answer: B) 10%
4. Which of the following is a risk factor for the development of FTC?
A) Iodine excess
B) Iodine deficiency
C) Presence of psammoma bodies
D) Male sex
Answer: B) Iodine deficiency
5. What is the prognosis for patients with FTC in terms of 10-year survival rate?
A) Around 50%
B) Around 75%
C) Around 85%
D) Around 100%
Answer: C) Around 85%
6. Hurthle cell cancer (HCC) is a variant of which type of thyroid cancer?
A) Papillary thyroid cancer
B) Medullary thyroid cancer
C) Follicular thyroid cancer
D) Anaplastic thyroid cancer
Answer: C) Follicular thyroid cancer
7. What is the incidence of lymph node metastases in patients with HCC?
A) Around 5%
B) Around 10%
C) Around 20%
D) Around 50%
Answer: C) Around 20%
8. Medullary thyroid cancer (MTC) arises from which cells of the thyroid gland?
A) Follicular epithelial cells
B) Parafollicular C cells
C) Hurthle cells
D) Stromal cells
Answer: B) Parafollicular C cells
9. What is the overall 10-year survival rate for patients with MTC?
A) Around 50%
B) Around 75%
C) Around 85%
D) Around 100%
Answer: B) Around 75%
10. Which of the following is not a poor prognostic factor for MTC?
A) Age >40 years at presentation
B) Female sex
C) Extrathyroidal spread
D) Nodal involvement
Answer: B) Female sex
11. What is the standard operation for MTC in the absence of lymph node metastases?
A) Total thyroidectomy and central compartment neck node dissection
B) Unilateral lobectomy and isthmectomy
C) External beam radiotherapy
D) Chemotherapy
Answer: A) Total thyroidectomy and central compartment neck node dissection
12. Which of the following is not a recommended treatment for low-risk patients with DTC?
A) Total thyroidectomy
B) Unilateral lobectomy and isthmectomy
C) Radioactive iodine
D) External beam radiotherapy
Answer: D) External beam radiotherapy
13. What is the primary treatment for most patients with DTC?
A) Thyroidectomy
B) Chemotherapy
C) Immunotherapy
D) Hormone therapy
Answer: A) Thyroidectomy
14. Which of the following is a highly aggressive form of thyroid cancer?
A) Papillary thyroid cancer
B) Follicular thyroid cancer
C) Medullary thyroid cancer
D) Anaplastic thyroid cancer
Answer: D) Anaplastic thyroid cancer
15. What is the female to male ratio for thyroid lymphoma?
A) 1:1
B) 2:1
C) 3:1
D) 4:1
Answer: C) 3:1 | 107 |
