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Why?
Radial nerve runs in spiral groove of humeral shaft.
Clinical clue:
1. Wrist drop
2. Loss of finger extension
3. Sensory loss on dorsum of hand
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Shaft of humerus fracture → Radial nerve
When?
1. Direct trauma to arm
2. Fall on flexed elbow
3. Road traffic accident
4. Adults
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Why?
Axillary nerve winds around the surgical neck of humerus.
Clinical clue:
1. Loss of shoulder abduction (15–90°)
2. Flattened deltoid
3. Loss of sensation over “regimental badge area”
Wind = يلتف
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Surgical neck fracture → Axillary nerve
When?
1. Fall on shoulder
2. Direct blow to shoulder
3. Common in elderly (osteoporosis)
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1. Surgical neck fracture → Axillary nerve.
2. Shaft fracture → Radial nerve
3. Supracondylar fracture (child) → Median nerve.
4. Medial epicondyle fracture → Ulnar nerve.
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Fall on flexed elbow
Direct trauma to arm
This causes fracture of the shaft of humerus
➡️ Radial nerve is injured
(because it is tightly wrapped around the shaft in the spiral groove)
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A child sustains a supracondylar fracture of the humerus. Which nerve is most likely to be injured?
A. Ulnar nerve
B. Radial nerve
C. Median nerve
D. Musculocutaneous nerve
A patient presents with clay-colored (pale) stool. This is most likely due to:
A. Hemolytic anemia
B. Obstructed bile duct
C. Pancreatitis
D. Gastroenteritis
E. Peptic ulcer
Which enzyme is most commonly elevated in gallbladder disease (e.g., cholecystitis, cholestasis)?
A. AST (Aspartate aminotransferase)
B. ALT (Alanine aminotransferase)
C. ALP (Alkaline phosphatase)
D. Amylase
A patient presents with a board-like abdomen and air under the diaphragm on X-ray. The primary concern is:
A. Gastroenteritis
B. Acute pancreatitis
C. Perforated peptic ulcer
D. Acute cholecystitis
All of the following are true about femoral hernia EXCEPT:
A. Lies lateral to the femoral vein
B. Occurs more commonly in females than males
C. On examination, it is below and lateral to the pubic tubercle
D. The femoral canal contains the lymph node of Cloquet
E. More likely to be irreducible on presentation
Which is the most helpful diagnostic imaging for suspected intestinal obstruction?
A. CT abdomen
B. Erect & supine abdominal X-ray
C. Ultrasound (USS)
D. MRI abdomen
The appearance of “peau d’orange” on the breast indicates:
A. Benign fibrocystic changes
B. Breast abscess
C. Inflammatory breast carcinoma
D. Mastitis
Paget disease of the breast typically presents as:
A. Painful breast lump
B. Nipple eczematous changes with underlying carcinoma
C. Bilateral nipple discharge
D. Peau d’orange without nipple involvement
Which anesthetic agent causes hypotension and increased systemic vascular resistance?
A. Midazolam
B. Ketamine
C. Propofol
D. Etomidate
Hematochezia is most commonly caused by:
A. Peptic ulcer disease
B. Esophageal varices
C. Hemorrhoids
D. Gastritis
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14. In unilateral Clift -lip, the following statements are true EXCEPT that it:
A. Affects the upper lip only.
B. May be partial or complete.
C. Is always associated with nasal deformity
D. Produces no serious speech defects.
21. Hashimoto disease may present by:
A. Thyrotoxicosis.
B. Myxedemo
C.Goiter.
D. Any of the above.
29. The triple assessment of breast masses :
A. Clinical examination, imaging, and biopsy
B. Mammogram, ultrasound, and MRI
C. Physical exam, blood tests, and imaging
D. Biopsy, blood tests, and imaging .
38. What complication can arise from untreated appendicitis :
A. Perforation
B. Abscess formation
C. Sepsis
D. All of the above
43. Causes of massive splenomegaly include the following EXCEPT:
A. ITP
B. Myeloid leukemia
C. Thalassemia major
D. Amyloidosis
53. Renal Calculi infection: associated with proteus
A. Triple Phosphate
B. Uric Acid
C. Xanthine
D. Calcium Oxalate
57. A 61-years-old male patient smoker working in printing industry prese with painless hematuria of 6 mo3 duration. Urinalysis shows full fiel RBCs, no pus cells and other eleme urine were normal. The most diagnosis is:
A. Begnin prostatic hyperplasia
B. Prostatic carcinoma.
C. Chronic cystitis.
D. Urinary bladder tumors.
58. The symptoms of benign prostatic hypertrophy (BPH) include:
A. Nocturnal frequency.
B. Hesitancy.
C. Weak flow of urine
D. All of the above.
59. The following statements about varicocele are true EXCEPT:
A. It is more ommon on the right
B. It can present as a late sign of carcinoma
C. It has bag of worm like feeling
D. It can lead to infertility
60. Which of the following urinary calculi is radiolucent?
A. Calcium oxalate.
B. Pure uric acid.
C. Cystine stone..
D. Calcium carbonate stone
62. What is the most common location for ureteral stones to cause obstruction?
A. Renal pelvis
B. Ureteropelvic junction
C. Mid-ureter
D. Ureterovesical junction
Which of the following statements regarding thyroid neoplasms is CORRECT?
A. Papillary carcinoma is the least common thyroid malignancy.
B. Thyroid carcinoma affects men more commonly than women.
C. Follicular carcinoma occurs mainly in childhood.
D. Medullary carcinoma arises from parafollicular C-cells.
E. Anaplastic carcinoma is the most common thyroid malignancy.
Which of the following conditions is a risk factor for uric acid stones?
A. Hyperparathyroidism
B. Gout
C. Chronic urinary tract infection
D. Renal tubular acidosis
Patient presents with dysuria, urinary frequency, urgency, and suprapubic pain
What is the most likely diagnosis?
A. Acute pyelonephritis
B. Urethritis
C. Cystitis
D. Renal calculi
48. Which condition is characterized "currant jelly" stools in children ?
A. Intussusception
B. Appendicitis
C. Volvulus
D. Gastroenteritis
68-year-old man presents to the emergency department with sudden inability to pass urine. He reports lower abdominal discomfort and a feeling of bladder fullness.
What is the most likely diagnosis?
A. Acute urinary retention
B. Chronic urine retention
C. Kidney stone obstruction
D. Neurogenic bladder
Which of the following does NOT typically occur in pheochromocytoma?
A. Hypertension
B. Palpitations
C. Sweating
D. Diarrhea
Which is the best initial investigation to diagnose primary hypothyroidism?
A. TSH
B. T4
C.T3
D. Anti-thyroid peroxidase antibodies
Early complication of supracondylar fracture of the humerus:
a) Volkmann’s ischemic contracture
b) Cubitus valgus
c) Cubitus varus
d) Injury to the brachial artery
e) None of the above
Fracture of ulna + dislocation of superior radioulnar joint:
a) Bennell
b) Galeazzi
c) Colles
d) Monteggia
e) Salter-Harris
Fracture of ulna + dislocation of superior radioulnar joint:
a) Bennell
b) Galeazzi
c) Colles
d) Monteggia
e) Salter-Harris
Which nerve is most at risk in fracture of shaft of humerus?
a. Median nerve
b. Radial nerve
c. Posterior interosseous nerve
d. Ulnar nerve
e. Ascending circumflex brachial nerve
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Body Mass Index (BMI) is best defined as:
A. A measure of body fat percentage
B. A measure of muscle mass
C. A ratio of weight to height squared
D. A measure of waist circumference
Which sign indicates possible splenic rupture in trauma patients?
A. Kehr’s sign
B. Murphy’s sign
C. McBurney’s sign
D. Cullen’s sign
15. A 65 female complains regurgitation of undigested food, few hours after meal, she also have progressive difficulty in swallowing, weight loss and swelling in the neck. What is your diagnosis:
A. Achalasia.
B. Ca esophagus.
C. Pharyngeal pouch.
D. Diffuse esophageal spasm.
Regarding complications of fracture healing, which of the following definitions are CORRECT?
A. Malunion is healing of a fracture in an abnormal position with angulation, rotation, or shortening.
B. Delayed union is a fracture that takes longer than the expected time to heal but eventually shows progressive signs of healing.
C. Nonunion is failure of a fracture to unite after an adequate period of time with no evidence of progressive healing.
D. All of the above
What does “intermittent claudication” signify in a surgical history?
A. Chronic respiratory disease
B. Ischemic leg pain during exertion
C. Neurological deficit
D. Gastrointestinal discomfort
Trendelenburg’s sign indicates:
a) Injury to posterior cruciate ligament
b) Radiculopathy of S1
c) Weakness of hip gluteal abductors
d) Fracture of radial head
e) Tear of rotator cuff of shoulder
Which of the following tests is most specific for ACL injury?
a. Anterior drawer test
b. Posterior drawer test
c. Varus stress test
d. Lachman’s test
e. Both a and d
A patient presents with sudden severe flank pain radiating to the groin and hematuria. Initial suspicion should be:
A. Renal stone disease
B. Pyelonephritis
C. Bladder cancer
D. Urinary tract infection
A Colles fracture typically occurs at which location:
A. Distal radius –
B. Proximal humerus
C. Femoral neck
D. Tibial plateau
Ewing sarcoma affecting the humerus is characterized by:
A. Is a metastasis from carcinoma of the thyroid
B. Looks like cut onion layers on X-ray
C. Has a soap-bubble appearance on X-ray
D. Displays sun-ray spicules on X-ray
Bennett’s fracture is:
A. Reversed Colles’ fracture
B. Fracture of the scaphoid bone in the wrist
C. Fracture of the radial styloid process
D. Fracture-dislocation of the base of the first metacarpal
Which of the following describes Dupuytren’s contracture?
A. Subcutaneous fibrosis of palmar fascia
B. Progressive cord-like thickening of palmar fascia
C. Progressive flexion deformity of the fingers
D. All of the above
A 43-year-old man had a previous wrist injury. The ulnar nerve was severed. Which of the following findings is consistent with this injury?
A. Claw hand involving the ring and little fingers
B. Atrophy of the thenar muscles
C. Absent sensation in the index finger
D. Inability to flex the distal phalanx of the index finger
In assessing knee joint effusion, which test is commonly used?
A. Patellar tap test
B. Trendelenburg test
C. FABER test
D. Thomas test
2) Visceral pain is typically:
A. Well localized
B. Sharp
C. Mediated via spinal nerves
D. Perceived to be in the midline
4) A normal adult resting heart rate typically falls within which range?
A. 60-70 beats per minute
B 60-100 beats per minute
C. 100-120 beats per minute
D. 120-140 beats pet minute
5) Where is the dorsalis pedis pulse halluces longus typically palpated?
A Medial to the tendon of extensor
B. Lateral to the tendon of extensor halluces longus
C. Posterior to the medial malleolus
D. Posterior to the lateral malleolus
9. A Body Mass Index (BMI) of 25-to-29.9 kg/m² is classified as:
A. Underweight
B. Normal weight
C. Overweight
D. Obese
13. Keloid scars are characterized by the vaccination marks. following, EXCEPT:
A. Develop after wounds, burns and vaccination marks.
B. Are particularly common in negroes and pregnant females.
C. Occur most often on the face, neck and front of the chest.
D May turn malignant.
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امتحان الجزئي دفعة 48 قروب B ناقص 6MCQs بس
An everted edge is characteristic of which type of ulcer:
A. Tuberculous ulcer
B. Rodent ulcer
C. Syphilitic ulcer
D. Malignant ulcer
A 45-year-old man presents with sudden severe epigastric pain radiating to the back, vomiting, and no hematemesis. History of chronic alcohol use. What is the most likely diagnosis?
A) Acute appendicitis
B) Acute pancreatitis
C) Peptic ulcer perforation
D) Cholecystitis
E) Small bowel obstruction
Perthes’ disease – all are true EXCEPT:
A. Usually presents before 10 years of age
B. Is due to avascular necrosis of the distal femoral epiphysis
C. Is more common in boys
D. X-ray may show capital femoral epiphysis smaller, denser, flatter
E. May require surgical containment with subtrochanteric osteotomy
A painless, soft, subcutaneous, fluctuant lump over the scapular region that demonstrates a “slip sign” is most likely:
A. Lipoma
B. Leiomyoma
C. Neurofibroma
D. Fibrosarcoma
A smooth, well-defined scalp swelling attached to skin with a visible punctum is most likely:
A. Sebaceous cyst –
B. Dermoid cyst
C. Lipoma
D. Neurofibroma
10. Parotid duct opens into mouth opposite:
A. Upper third molar tooth
B Upper second molar tooth
C. Lower first molar tooth
D. Lower second molar tooth
55.A 12 year old boy experiences sudden severe pain in the right testis. On palpation there is exquisite tenderness. The most likely diagnosis is:
A. Spontaneous hemorrhage
B Testicular torsion
C. Strangulated hernia
D. Epidydimitis
Direct inguinal hernia comes out through:
a. External inguinal ring.
b. Internal inguinal ring.
c. Hesselbach’s triangle.
d. None of the above.
The most serious complication of a hernia is:
A. Irreducibility
B. Inflammation
C. Obstruction
D. Strangulation
E. Incarceration
During scrotal swelling examination, the fluctuation test is negative in:
A. Testicular tumor
B. Hydrocele
C. Epididymal cyst
D. Spermatocele
Which of the following testicular swellings does NOT usually give a positive transillumination test?
A. Hematocele
B. Hydrocele
C. Epididymal cyst
D. Cystic hygroma
Which laboratory test can help diagnose prostate cancer?
A. Serum creatinine
B. Prostate-Specific Antigen (PSA) level
C. Blood urea nitrogen (BUN)
D. Carcino-embryonic antigen (CEA)
Symptoms/signs commonly associated with increased intracranial pressure include:
A. Nausea and vomiting
B. Bradycardia
C. Confusion
D. All of the above
All are signs of hypocalcemia EXCEPT:
A. Chvostek’s sign
B. Trousseau’s sign
C. Troisier’s sign
D. Circumoral numbness
The retrograde purpose of endoscopic retrograde cholangio-pancreatography (ERCP) is:
A. To diagnose pancreatic tumors
B. To diagnose and treat bile duct obstructions
C. To assess liver function
D. To perform biopsy of pancreas
The “string sign” on imaging is most commonly associated with:
A. Crohn’s disease
B. Ulcerative colitis
C. Diverticulitis
D. Appendicitis
Swelling in one leg often suggests:
A. Renal failure
B. Deep vein thrombosis
C. Heart failure.
D. Chronic liver disease
A pulsatile abdominal mass is most likely due to:
A. Intestinal obstruction
B. Aortic aneurysm.
C. Appendicular mass
D. Splenomegaly
Regarding groin hernias, the occlusion test is positive in:
A. Direct inguinal hernia
B. Indirect inguinal hernia
C. Femoral hernia
D. All of the above
All of the following may cause a palpable right iliac fossa mass EXCEPT:
A. Ulcerative colitis
B. Tuberculosis
C. Appendicular mass
D. Ovarian cancer
Charcot’s triad is:
A. Fever, abdominal pain, jaundice
B. Fever, vomiting, jaundice
C. Fever, jaundice, abdominal distension
D. Fever, diarrhea, jaundice
Which of the following factors increases the risk of developing breast cancer?
A. Early menopause
B. Late menarche
C. Nulliparity
D. Breastfeeding
A 10-year-old girl presents with a small midline neck swelling that moves upward on protrusion of the tongue. The most likely diagnosis is:
A. Thyroglossal cyst
B. Branchial cyst
C. Thyroid nodule
D. Submental lymph node
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Why different nerves are injured?
👉 Because mechanism of trauma determines direction of fracture displacement.
👉 Direction of displacement determines which nerve lies in the line of injury.
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Children → fall on outstretched hand (extended elbow).
Adults → fall on flexed elbow or direct trauma.
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