‫يحرلا نمحرلا هللا مسب‬

‫م‬

Recall of Previous Selection Exams

(Surgical pass)

Prepared by:
Dr. Amjad Moin Alanqar

2023-1

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 2014
1-In haemorrhagic shock, Renin-Angiotensin-Aldosterone system is mainly stimulated:
Low effective circulating volume
2-All the following are causes of locked knee except:
Posterior cruciate ligament tear
3-A 55-year-old man with acute appendicitis, Final pathology reveals the presence of a 2-cm
carcinoid tumour:
Right hemicolectomy
4-Most common uterine tumour:
fibroid
5-Dislocation of the hip:
post most common
6-Absent distal peristalsis, elevated resting lower Oesophageal sphincter pressure with failure to
relax during deglutition:
Achalasia
7-Pilonidal sinus:
Shaving and local hygiene decreases the necessity for a surgical procedure.
8-To assess cardiac risk in patients with AAA:
Cardiac echography with dobutamine test.
9-In upper limb ischemia:
Color changes in the fingers is the commonest presentation
10-Wrist drop:
Radial nerve injury
11-A 54- year vehicle crash, A Foley catheter returns 450 ml of grossly bloody urine:
CT cystogram
12-Post splenectomy:
vaccination is not recommended after conservative management of grade IV splenic injury
13-Reperfusion syndrome after arterial embolectomy:
Is induced by metabolic acidosis and myoglobinuria.
14-Fasciotomy
clinical feeling
15-(SIRS) include the following except:
PCO2 < 32 mmHg
16-ABO matching of donor and recipient is unnecessary in the patient receiving : Platelets.

17-The most important radiographs used in evaluating an adult trauma patient are:

Lateral cervical spine, chest, pelvis.

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18-HELLP
Low Platelet
19-Pyrexia occurring 48 hours after an abdominal operation?
Chest infection.
20- Most common cause of bleeding after delivery:
atony
21-Intussusception in children:
Hydrostatic reduction
22-The diagnosis of acute appendicitis is most difficult to establish in:
Infants younger than 1 year.
23-Rectum and its relations is incorrect?
The upper 1/3 is entirely invested in peritoneum.
24-Femoral canal:
a dead space allowing distension of femoral vein during exercise
25-Definitive treatment of preeclampsia:
Delivery
26-SIADH:
increased urine sodium
27-Correct respiratory alkalosis in a patient on mechanical ventilation should be:
Decrease respiratory rate.
28-Adrenal insufficiency include:
Low sodium, high potassium, low glucose.
29-Crohn’s disease:
involve the small bowel only, the colon only, or both (as in ileocolitis)
30-Eclampsia most common occur:
within 48-hour post delivery
31-Structures can be found outside of the spermatic cord during a hernia repair?
direct hernia sac
32-Patient stop coumadin after treated from old DVT develop new DVT what’s the treatment:
Lifelong coumadin
33-Supracondylar fracture
interosseous ant median nerve

With my best wishes

‫بالتوفيق والنجاح‬

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 2015
1. Pre-operative cardiac risk except:
a. MI within 30 days
b. Supraventricular tachycardia
c. Decompensated heart failure
d. Aspirin

2. Anti-biotic before surgery except:

a. Antibiotic within 1 hour of incision.!!
b. If there is tourniquet you should inject drug before remove it
c. If the operation is long, you should repeat the antibiotic with short half-life.

3. Anatomy of pelvic floor except: may be prostate located directly on pelvic floor.
4. Innervation of pudendal nerve:
a. S2 S3 S4
b. S2S3
c. S1
d. L5

5. Burn and fluid: 40Kg 80% (4ml* 50%* 40Kg) + 2L =

a. 14.4 Ringer lactate
b. 19.9 glucose + ringer

6. About carpal tunnel syndrome: Tinel and funnel examination

7. Hypokalemia except:
a. Tetany
b. Abdominal distention
c. ECG change

8. DM in pregnancy complications except:

a. caput succedaneum
b. Macrosomia
c. IUFD
d. Preterm

9. Portal triad except: hepatic vein

10. About caput succedaneum: resolve spontaneously
11. Case about AAA
12. RA except: RF must be positive in all patient

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13. DVT+ chest pain+ tachycardia and tachypnea: PE
14. PE diagnostic = Angiography, Echo
15. Biophysical profile true: decrease score increase mortality
16. Testicular cancer except: spread to superficial LN
17. Needle stick unvaccinated HBV…. Give him vaccine
18. Craniopharyngioma: except!!
19. Induction of delivery breech baby except: First presentation during labor
20. Breast abnormal secretion: serosanguineous bloody
21. Treatment of hypernatremia complication. cerebral edema
22. Melanoma… superficial spread the most common type

23. About parotid pleomorphic adenoma

a. Treat by inoculation
b. Core biopsy
c. Rapid transform to malignancy

24. Vaginal Ph: 3.5 – 4.5

25. Co2 35-45
26. About aneurism: Berry is caused by hypercholesteremia

27. Breast feeding increase by:

a. Bed rest
b. Vitamins and minerals
c. A+B

28. On warfarin bleeding treat by: FFP

29. LP except: infection at the site
30. Physiological anemia in pregnancy the cause: increase plasma volume more than RBC size
31. True about kidney in pregnancy except: decrease renal plasma flow
32. Excretion of milk: oxytocin
33. Sheehan syndrome most important treatment: Cortisone
34. Addison: symptoms mimic Acute abdomen.
35. Trophoblast gestation follow up: B- HCG gonadotropin

36. The most common sign of trophoblast gestation:

a. Bleeding
b. Increase uterus size

37. The sign of very early sign of cervical cancer: symptomless

38. About EBV except: CMV more sore throat than EBV
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39. About shoulder dystocia
40. The most symptomatic fibroid… cervical
41. Contraindication to pregnancy: sever pulmonary HTN
42. Breast milk rich in … IgA immunoglobulin
43. Child and foreign body… bronchoscopy
44. Breast cancer true … DIC mirocalcification
45. About inguinal hernia true…. Vigorous reduction increase risk of strangulation
46. Anatomy of ischiorectal area….
47. Maternal mortality rate… 100.000 live birth

With my best wishes

‫بالتوفيق والنجاح‬

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 2016
1. Female baby at birth having bilateral breast enlargement: reassurance
2. We need ABO compatibility in all expect: platelet
3. About testicular cancer: seminoma is radiosensitive
4. Case of patient on coumadin, INR 3-4, going to emergent surgery, to correct coagulation we
give: FFP
5. All are risk factors for cervical cancer except: nulliparity
6. A case to calculate osmolality: in our case the answer was 384
7. MEN 2b all expect: hyperparathyroidism
8. Cisterna chyli present: posterior abd. aorta
9. During hernia repair structure not inside spermatic cord: direct hernia sac
10. Rectum all true except: upper third completely covered by peritoneum
11. Crohn’s can affect: can affect small bowel large bowel alone or both
12. Ulcerative colitis all expect: non caseating granuloma
13. About neck trauma: ipsilateral Horner may occur from carotid trauma
14. Most common symptom in ectopic pregnancy: abdominal pain
15. 8 wks. pregnant: CRL
16. DDH most effective diagnostic test: with US
17. Femoral canal: dead space to permit expansion of femoral vein
18. SIRS except: one of the criteria is wrong
19. About obstructive jaundice: fecal stercobilinogen reduced & urinary conjugated bilirubin is increased

20. In “catabolic” surgical patients, which of the following changes in body composition do not occur?
A. Lean body mass increases.
B. Total body water increases.
C. Adipose tissue decreases.
D. Body weight decreases.

21. Which of the following statements concerning the abdominal wall layers are correct, except:
The transversalis muscle is the most important layer of the abdominal wall in preventing hernias.
22. 52 y old female with 1-year amenorrhea: menopause
23. First Immunoglobulin to appear: IgM
24. Fever, eye swelling mostly in the left, bilateral nasal discharge, headache:
sinusitis or orbital cellulitis!!
25. All cause peptic ulcer expect: pernicious anemia or smoking or. H. pylori associated gastritis
26. Most common complication of breast feeding: purple mastitis or breast abscess or amenorrhea
27. Common cause of morbidity after trauma: obesity
28. Difficult to diagnose appendicitis in: infants less than 1year - all of the above
29. Indication for circumcision all except: UTI or phimosis

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30. Sun rays can disinfect by: ultraviolet rays??
31. Infection not transmitted vertically: (CMV)
32. Best indicator for good health in country: maternal mortality rate or none of the following
33. Disc L4-L5 lesion cause: no dorsiflexion of foot or sensation of small toes
34. Autoclaves disinfect all expect? gloves media
35. Drug impair kidney function? aminoglycoside, erythromycin, atenolol, all
36. Cause sensory neural hearing loss in children? gentamycin
37. Antenatal booking expects? Glucose – Hb – toxo.
38. About GDM? should start insulin, gtt is diagnostic
39. About bleeding: most diagnostic is colonoscopy
40. Which is Primary prevention: Screening of BP or stop smoking …
41. Pulsus alternans present in: cardiac tamponade or severe left ventricle failure
42. Not cause complete sterilization:
43. Not cause malabsorption:
44. Definitive treatment of severe preeclampsia is: delivery
45. Which drug can’t cross the placenta: heparin
46. Treatment of endometriosis except: estrogen
47. Occipitoposterior is: malposition
48. Most common cause of postpartum hemorrhage is: atony
49. Cause of high ESR except: osteoporosis
50. RA all are true except: RF is positive for all pt
51. Normal CO2: 35-45
52. All are used in the treatment of endometriosis except: estrogen
53. Blood transfusion metabolic disorder:
hypertension (overload), polyuria, hyperkalemia, hypothermia, hypocalcemia, DIC, acidosis

With my best wishes

‫بالتوفيق والنجاح‬

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 2018 – A
1- Which of the following drains in Lt renal vein?
a) Lt spermatic vein
b) Lt adrenal vein
c) All of the above
d) None of the above

2- The primary lymphatic drainage of the testes:

a) Aortocaval lymph nodes
b) Superficial inguinal lymph nodes
c) deep inguinal lymph nodes
d) renal
e) common iliac

3- All of the following are typical symptoms of BPH except:

a) Dysuria
b) Frequency
c) Urgency
d) Weak urine stream
e) Nocturia

4- If testicular artery ligated during surgery, the testis will receive collaterals from:
a) External pudendal, cremasteric, artery of the ductus deferens
b) Highly vascularized scrotum
c) External pudendal
d) None of the above

5- To distinguish between myoglobinuria/hemoglobinuria and True hematuria, you have to:

See RBCs in urine microscopically

6- The mainstay management of nasopharyngeal Ca:

a) Surgery
b) Surgery + chemotherapy
c) Surgery + radiotherapy
d) radiotherapy
e) None of the above

7- The position for endotracheal intubation:

a) Flexion of head + flexion of neck
b) Flexion of head + Extension of neck
c) Extension of head + Extension of neck
d) Extension of head + Flexion of neck
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8- Question about: abscess between tonsils and superior constrictor muscle: Quinsy abscess,

9- Indications for tracheostomy except:

a) Bilateral extensive lung consolidation
b) Acute Epiglottitis
c) Maxillofacial fracture

10- Complication of long-term use of nasal decongestant:

a) Vasomotor rhinitis
b) Allergic rhinitis
c) atrophic rhinitis?
d) rhinitis medicamentosa

11- The first line management for dry eye: Lubricants, anti-inflammatory, antibiotics

12- The wrong match:

a) Multiple sclerosis + scleritis (wrong: optic neuritis)
b) Sarcoidosis + uveitis
c) IBD + uveitis
d) RA + episcleritis& scleritis
e) None of the above

13- The following systemic diseases has external manifestation on eye (uveitis) except:
a) RA
b) SLE
c) IBD
d) Ischemic Heart disease
e) Sarcoidosis

14- The following muscles are supplied by 3rd cranial n. except:

a) Orbicularis Oculi
b) Superior rectal
c) Inferior rectal
d) Medial rectal
e) Inferior oblique

15- All cause bilateral eyelid swelling except:

a) chalazion
b) congestive heart failure

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16- Osgood Schlatter disease cause pain in:
a) Upper tibia
b) Patella
c) Lower tibia
d) Femur
e) Ankle

17- The following is contraindications for primary repair of flexor tendon injury except:
a) Old age pt …
b) Contaminated wound
c) None of the above

18- The best treatment for mid femur # without loss of the alignment (non displaced) in young pt:
a) Skeleton traction
b) Pins
c) Internal fixation
d) External fixation
e) Cylindrical cast

19- Nerve injury that causes Pointing index defect:

a) Median n. palsy
b) Ulnar n. palsy
c) Radial n. palsy
d) Median & Ulnar n. palsy
e) None

20- Not present in diabetic pt:

a) Dropped foot
b) Toe gangrene
c) 1st toe pole ulcer
d) Neuropathic ulcer
e) Joint deformity

21-True about osteosarcoma: radiologic finding (sunburst appearance)

22-Diagnostic test for tennis elbow: Tenderness elicited on lat. Epicondyle

23-Diagnostic sign of scaphoid fracture: local tenderness on the snuff box …

24-A case of a male teacher c/o lower back pain, when to need urgent referral to specialist (worst
presentation)? Perianal anesthesia??
25-Hematogenous osteomyelitis most frequently affect:
Diaphysis, epiphysis, metaphysis, flat bones, cuboidal bones.

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26-Drug used in sudden cardiac death: IV Epinephrine
27-Wrong about 1ry survey: assess breathing for 30 sec then start ventilation
28-Case: GCS 8
29-Another case: GCS 8
30-Pt with chest stab wound, stable, next step: Listen to his breath sounds
31-Pt in shock, distended neck veins, midline trachea, Dx: Pericardial Tamponade
32- Wrong about tension pneumothorax: tracheal deviation to the ipsilateral side
33- First step in pt. with tension pneumothorax Is:
needle decompression in 2nd intercostal space, Chest drains at 5th intercostal space at mid-axillary line
34-Not considered a diagnosis must be ruled out in primary survey: ATOM FC
Open pneumothorax, tension pneumothorax, rib fracture, flail chest
35-1st step in management of faciomaxillary fracture: ensure patent airway (tracheostomy)
36- Abdominal trauma, abdomen distended, next step: Do FAST
37- Trauma pt, which indicates poor prognosis:
low BP (70/50) 10 min before admission, depressed skull fracture

38-Hypovolemic shock: low cardiac output, low CVP, high PVR

39-Papillary thyroid cancer: Most common thyroid cancer in children
40-Case with Lt thyroid mass, FNA follicular, Rt lobe free, Mx: Diagnostic Lt Lobectomy
41-The least seen ECG changes in hypokalemia: 2nd & 3rd degree heart block, U wave, ST depression
42-Case, pt had Rt hemicolectomy, on Dextrose saline, now confused, most likely electrolyte
disturbance: Hyponatremia
43-Most commonly used tool to diagnose cholecystitis: Abdominal ultrasound
44-Case, inferolateral to pubic tubercle, medial to femoral vein, typical for: Femoral hernia
45-Case with two swellings: Pantaloon hernia
46-In hemorrhoid workup: If anemia present more evaluation for other Dx
47-Massive lower GI bleeding: Is frequently related to Rt colon
48-The following is caused by a single organism: 1ry peritonitis
49-Most reliable method to evaluate the nutritional status of pt: History of weight loss
50-The most likely one to need more maintenance fluid: young athlete
51-Surgical site infection by definition: Infection in wound site within 30 days of operation
52-Case with +ve rebound tenderness, free air in the peritoneum, next step:
No further investigation needed (perforated viscus directly to OR)

53-Case with signs of Intestinal obstruction and free air in the biliary tree, Dx: Gallstone ileus
54-Case, shock, pulse 120, stage: Grade 3 hemorrhagic shock
55-30 yrs. old female, Lt sided lower abdominal pain, next step: pregnancy test
56-Case of epidural hematoma, lucid interval, then GCS 5, next step: Endotracheal intubation

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57-Case 5 days post op complaining from difficulty in breathing, pain in Rt shoulder, fever, Dx:
Sub phrenic abscess
58-Breast, LCIS, true one: not considered premalignant lesion
59-True about Fibroadenoma: age (15-25)
60-Case with pneumaturia and UTI symptoms, Investigation: Cystoscopy (fistula)
61-Wrong about Necrotizing fasciitis: Initially there is mild or no pain & deep infection
62-The least Dx. To think about in RIF pain is: perforated peptic ulcer

63-Hoarseness of voice after thyroid surgery result from injury to:

a) External branch of superior laryngeal n.
b) Internal branch of superior laryngeal n.
c) Vagus n.

64- Accessory muscles of ventilation except: Teres major, teres minor, SCM, Abdominis rectus, diaphragm
65- Early sign of septic shock: delayed capillary refill time

66- Rectal examination in the gynecological practice:

a) Is useful in the diagnosis of enterocele
b) Is useful in suspected pelvic abscess
c) Is indicated in the assessment of carcinoma of the cervix
d) All of the above
e) None of the above

67- As regard the mechanism of labor, which of the following sequences is correct:
a) Descent, internal rotation, flexion
b) Engagement, flexion, descent
c) Engagement, internal rotation, descent
d) Engagement, descent, flexion
e) Descent, flexion, engagement

68- As regards breech presentation, all true except:

a) Incidence is 3.5%
b) Incidence is higher with post maturity
c) Lie is longitudinal.
d) The fetus presents by the podalic pole

69- The following are causes of breech presentation except:

a) Multiparity
b) Hydrocephalus
c) PET
d) Prematurity
e) Multiple pregnancy

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70- Complications of breech delivery is the following except:
a) Asphyxia
b) Shoulder dystocia
c) Rupture of abdominal organs
d) Brachial plexus injury
e) Fracture clavicle

71- Complications of ECV include the following except:

a) Premature labor
b) Liver injury
c) Premature rupture of the membranes
d) Knots of the cord
e) rupture uterus

72- Engagement means that the biparietal diameter is at station:

a) _2
b) _1
c) Zero
d) +1
e) +2

73- Nonengagement of the head in a multigravida late in pregnancy means that:

a) There is contraction of the pelvic inlet.
b) There is contraction of the med cavity
c) There is narrowing of the pubic arch
d) Usually, a normal situation
e) CS should be taken into consideration

74- Normal labor include the following except:

a) Vaginal delivery
b) Term baby
c) Multiple pregnancy
d) Alive fetus
e) Without complications to the fetus

75- The following hormones have a role in labor, all except:

a) Progesterone
b) Human placental lactogen
c) Estrogen
d) Fetal adrenal gland
e) Prostaglandins

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76- Caput succedaneum except:
a) A localized edema affecting the most dependent part of the fetal skull
b) It usually occurs in stillborn infants
c) It disappears shortly after birth
d) It means that labor was prolonged
e) It gives an idea about the attitude of the head

77- Fetal presentation is:

a) The lowermost part of the fetus which meets the pelvic brim
b) 96% Cephalic
c) 3.5% breech
d) Shoulder in .5%
e) 1/1500 face

78- Not true labor pains are:

a) Regular
b) Progressive
c) Relieved by sedation
d) Cause cervical dilatation
e) End with delivery of fetus and placenta

79- 30 yrs. old female with endometrial hyperplasia treatment of choice:

a) medroxyprogesterone
b) estrogens
c) danazol
d) GnRH analogues
e) all of the above

80- Abnormal Uterine bleeding (AUB) is defined by all of the following except:
a) Excessive Blood loss (>80 ml) during menses
b) Menstrual length less than 7 days
c) An interval of less than 21 days between the starts of successive menses
d) Irregular bleeding episodes between menses
e) Extended (>35 days) intervals between menses

81- The follicular phase of menstrual cycle is characterized by:

a) Endometrial proliferation.
b) Decreased estrogen
c) Progesterone dominance.
d) Fixed length of 8 days
e) Reduction in aromatase activity

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82- Which of the following is not a common site for endometriosis:
a) Bone
b) Ovaries
c) Uterosacral ligaments
d) Peritoneum
e) Oviduct

83- Bishop score includes all the following except:

a) Dilation of cervix.
b) Position of cervix
c) Presenting part of the fetus
d) Length of the cervix
e) Consistency of cervix

84- The second stage of labor:

a) separation of placenta
b) effacement of cervix
c) expulsion of placenta
d) dilation of cervix
e) expulsion of fetus

85- Most common cause of postmenopausal bleeding is:

a) Atrophic vaginitis
b) Endometrial cancer
c) Endometrial hyperplasia
d) Endometrial polyp
e) None of the above

86- Early deceleration is:

a) Associated with unengaged head
b) Associated usually with brain hypoxia
c) Decrease in the fetal beat that peaks after uterine contraction
d) Indication of c-section.
e) Results from increased vagal tone secondary to head Compression

87- First sign of puberty:

a) Budding of breasts.
b) Pubic hair
c) Menstruation
d) Growth changes
e) Changes in voice

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88- The most common cause of precocious puberty is:
a) Idiopathic
b) Gonad blastoma
c) Albright syndrome
d) Abnormal skull development
e) Granulosa cell tumor

89- Which of the following is known to be the commonest presentation in twins:

a) Breech, cephalic
b) Cephalic, breech
c) Cephalic, cephalic.
d) Breech, breech
e) Cephalic, transverse

90- With regards to contraception failure, the pearl index refers to:
a) Numbers of Pregnancies in years
b) Number of pregnancies in 1 woman-year
c) Number of pregnancies in 100 woman-year
d) Number of pregnancies in 100 woman-years over pregnancy losses
e) Number of Pregnancy losses in 100 woman-years

91- Cord prolapse is associated with one false:

a) Circumvallate placenta
b) Prematurity
c) High parity
d) Breech presentation
e) Multiple pregnancy

92- Uterine fibroids all true except:

a) Are the most common tumors found in women
b) Are more common in the black population
c) Are true encapsulated tumors
d) May be pedunculated
e) Are associated with sarcomatous change in less than 0.5 % of cases

93- Absolute contraindication to OCP, all EXCEPT:

a) smoking and over 35 years.
b) Family history of Breast cancer
c) Undiagnosed vaginal bleeding
d) Ischemic heart disease
e) DVT

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94- Which one of the following actions COCP has:
a) Reduce risk of endometrial cancer
b) Increase risk of ovarian cancer
c) Reduce risk of breast cancer
d) Reduce risk of cervical cancer
e) Worsen endometriosis

95- Associated with oligohydramnios: Renal agenesis

96- Normal FHR: 120- 160
97- True about menstrual cycle: granulosa produce hormones?!
98- Ovulation occurs as: LH surge
99- Mediolateral vs. median episiotomy: less extension
100- Not in PCOS: Wide carrying angle

With my best wishes

‫بالتوفيق والنجاح‬

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 2018 - B:
1. Surgical antibiotic prophylaxis is indicated:
A. In all emergency operations
B. For wounds classified as clean-contaminated
C. For wounds classified as contaminated
D. For wounds classified as dirty-infected
E. For all wounds

2. Morbid obesity is defined as:

A. 1.5 times ideal body weight
B. BMI > 40 kg/mg2
C.20% above ideal body weight for adolescents
D. A function of physical activity, comorbid conditions, and weight
E. Weight > 40 kg

[Link] of the following best prevents wound infection in open wound injury
[Link] IV antibiotics
b. Topical antibiotics
c. Chlorhexidine skin preparation
d. Wound vac
e. Wound debridement

[Link] Antibiotics
[Link] is considered bactericidal
b. Mechanism of action of quinolones is inhibition of RNA polymerase
c. Aminoglycosides inhibit 50S ribosome
d. Mechanism of action for metronidazole is oxygen radical production
e. Vancomycin inhibits DNA gyrase

[Link] is nitrogen balance positive?

A. In sepsis
B. During the first 3 days following surgery
C. During growth
D. While adrenocorticotropic hormone (ACTH) levels are high
E. Following bone fractures

[Link] sepsis is associated with ALL the following except

A. Increase cardiac output
B. Hyperkalemia
C. Hyperglycemia
D. Respiratory alkalosis
E. Confusion and irritability

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7. ALL the following patients require referral to a burn center except
A. A 25-year woman with 4% BSA second degree burns to the back of hand
B. A 25-year woman with 15% BSA second degree burns to her back
C. A 25-year man with 4% BSA second degree burns to his elbow
D. An 80-year man with 11% BSA second degree burns to his back
E. A 25-year man with 6% BSA third degree burns to his back

8. Which of the following is not a common cause of a small bowel obstruction in an adult?
A. Hernia
B. Tumor
C. Volvulus
D. Adhesions
E. Ileocolic intussusception

[Link] surgical resection (thyroidectomy) is first-line therapy for which one of the following?
A. Riedel thyroiditis (struma)
B. Toxic nodular goiter with marked compressive symptoms
C. Acute suppurative thyroiditis
D. Uncomplicated Graves’ disease (diffuse toxic goiter)
E. Hashimoto thyroiditis

10. Which of the following is not a common cause of inguinal hernia recurrence?
A. Excessive suture line tension
B. Failure to recognize an indirect hernia
C. Increased intra-abdominal pressure
D. Failure to a use tension-free or mesh repair
E. Poor collagen formation

11. Failure to recognize which of the following during repair of a sliding inguinal hernia is associated with
increased complications?
A. The colon usually constitutes part of the hernia sac.
B. Sliding hernias are usually direct hernias.
C. A separate incision is necessary for reduction.
D. Tension-free repair should be avoided.
E. High ligation of the sac is usually necessary.

12. Femoral hernias are:

A. The most common type of hernia in women
B. Usually bilateral
C. Strangulated in 15% to 20% of cases
D. More common on the left side
E. Associated with an inguinal hernia in >50% of patients
F.

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13. Which of the following statements is true regarding patients with rebound tenderness and free air seen
on plain radiographs?
A. Parenteral steroids are helpful in treating peritoneal inflammation.
B. CT scanning is important in surgical planning.
C. Narcotic analgesics are contraindicated because they may mask changes in the abdominal examination.
D. Abdominal ultrasound is superior to CT scanning in localizing an intra-abdominal abscess.
E. No further imaging studies are indicated

14. A common electrolyte abnormality seen at presentation with acute abdomen is:
A. Hyponatremia
B. Hypernatremia
C. Hypokalemia
D. Hyperchloremia
E. Hypermagnesemia

15. A 60-year-old man presents with an 8-hour history of severe diffuse abdominal pain with rebound tenderness.
His blood pressure is 96/60 mm Hg, pulse is 116 beats/min, and respiratory rate is 22/min. Oxygen saturation by
pulse oximetry is 93% on room air. Plain abdominal radiographs show subdiaphragmatic free air. The next step in
preparation for surgical intervention is:
A. CT scanning of the abdomen with intravenous contrast agent
B. Administration of 2 liters of isotonic crystalloid via peripheral IV
C. Placement of a central venous catheter for monitoring of central venous pressure
D. Endotracheal intubation
E. Broad-spectrum antibiotic administration

16. In the setting of abdominal pain, which of the following is not suggestive of abdominal catastrophe?
A. Pallor
B. Hypotension
C. Jaundice
D. Confusion
E. Diaphoresis

17. In evaluating patients with acute abdominal pain, the most effective tools for diagnosing
appendicitis are:
A. Computed tomography
B. Ultrasound
C. Complete blood cell count
D. History and physical examination

18. Perioperative antibiotic therapy for gangrenous appendicitis should be:

A. A single preoperative dose
B. Three doses (24 hours) of a single agent
C. Directed against gram-negative aerobes and anaerobes until resolution of fever and leukocytosis
D. None of the above

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19. A 1.5-cm carcinoid tumor located at the base of the appendix should be treated with:

A. Appendectomy
B. Right hemicolectomy
C. Subtotal colectomy
D. Chemotherapy alone

20. The most appropriate management of diverticulitis with an associated 3-cm pelvic abscess is:
A. Hartmann procedure
B. Sigmoid resection with primary anastomoses
C. Parenteral antibiotics
D. Percutaneous drainage

21. All of the following statements are true regarding acute anal fissures except:
A. They produce pain and bleeding with defecation.
B. Women typically have anterior fissures.
C. They result from sphincter hypertonia and mucosal ischemia.
D. They can be treated successfully with medical therapies.

22. Anorectal abscesses are infections that typically:

A. Originate within anal crypt glands in dentate line
B. Resolve completely without sequelae after incision and drainage
C. Form horseshoe extensions
D. Occur in patients who are immunocompromised
E. Can be treated early with antibiotics

23. A patient returns 5 days after cholecystectomy with right upper quadrant pain, normal liver
function test results, and fluid in the gallbladder fossa. A percutaneous drain is placed and shows
bile. The next appropriate step is:
A. Observation
B. Laparoscopic exploration
C. ERCP
D. PTC

24. The least problem that cause right lower abdominal pain in an 18 years female is

a. Ectopic pregnancy
b. Acute appendicitis
c. Ovarian torsion
d. Perforated peptic ulcer
e. Mittelschmerz

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25. Massive lower gastrointestinal hemorrhage
a. Rarely stops after resuscitation
b. Is caused by large bowel lesions only
c. can be most accurately localized by colonoscopy
d. Is frequently related to right colon lesions
e. Is most commonly caused by adenocarcinoma of the large intestine

26. A 30-year-old man presents to the ER following a high-speed motor vehicle accident. He has marked
abdominal distension, a pulse rate of 130 and a blood pressure of 80/50 mmHg. The most appropriate
initial investigation would be?
A. abdominal paracentesis
B. CAT scan of the abdomen
C. plain X-ray of the abdomen
D. FAST (focused abdominal sonography for trauma) scan

27. A patient arrives in the ER following motor vehicle accident with multiple injuries. Hypotension in this
patient is defined as systolic BP less than?
A) 50
B) 90
C) 110
D) 70

28. Which of the following is an indication for elective intubation in a patient with a normal voice, normal
oxygen saturation, and no respiratory distress?
A) Stab wound to the neck with mild swelling in the left lateral neck
B) Airway bleeding
C) Localized Right lateral subcutaneous emphysema
D) Bilateral mandibular fracture

29. The line of division between right and left lobes of liver is
a. the plane of falciform ligament
b. the plane connecting gall bladder fossa and inferior vena cava
c. the plane of ligamentum teres to inferior vena cava
d. at the caudate lobe
e. between segments two and four

30. A 25-years-old patient is brought to the emergency room following a motorcycle accident. His blood
pressure is 80/60 mm hg, pulse 160beats/min, respiratory rate, 40 breaths/min, labored. He has an
obvious open left femur fracture and is complaining vigorously of left chest pain and inability to get his
breath. He refuses to lie flat. Initial assessment would include all of the following EXCEPT:
a. auscultation of both lung fields
b. palpation of the position of the trachea
c. sending the patient for chest x-ray
d. looking to see if neck veins are distended
e. cardiac auscultation

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31. A gallbladder ruptured secondary to blunt an abdominal trauma should be treated by
a. serial CT and physical examinations
b. placement of a T- tube in the common duct, regardless of other treatment
c. cholecystectomy
d. cholecystostomy
e. Roux- en- Y cholecystojejunostomy

32. All of the following are common findings in the first 24 hours after inhalation injury with burn EXCEPT:
a. history of burn in an enclosed space.
b. hoarseness.
c. abnormal chest x-ray.
d. carbonaceous sputum.
e. bronchorrhea.

33. Which of the following should NOT be used to control the pain caused by fractured ribs:
a. morphine IV.
b. Demerol IM.
c. intercostals nerve blocks.
d. rib belts.
e. muscle relaxants.

34. All of the following findings suggest urethral injury EXCEPT:

a. blood at the external urethral meatus
b. scrotal hematoma
c. absence of a palpable prostate on rectal examination.
d. high – riding prostate on rectal examination.
e. blood in the rectal lumen

35. Which of the following findings suggests that shock in an injured patient may have a cause
other than hypovolemia:
a. hypotension
b. distended neck veins.
c. decreased skin temperature.
d. diminished pulse pressure.
e. falling central venous pressure

With my best wishes

‫بالتوفيق والنجاح‬

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 2018- C:
[Link] prolapse is associated with one false:
A. Circumvallate placenta
B. Prematurity
C. High parity
D. Breech presentation
E. Multiple pregnancy

[Link] regards breech presentation except:

A. Incidence is 3.5%.
B. Incidence is higher with post maturity.
C. Lie is longitudinal.
D. The fetus presents by the podalic pole

[Link] following are causes of breech presentation except:

A. Multiparity
B. Hydrocephalus
C. PET
D. Prematurity
E. Multiple pregnancy

[Link] of breech delivery are the following except:

A. Asphyxia
B. Shoulder dystocia
C. Rupture of abdominal organs
D. Brachial plexus injury
E. Fracture clavicle

[Link] of ECV include the following except:

A. Premature labor
B. Liver injury
C. Premature rupture of the membranes
D. Knots of the cord rupture uterus

[Link] means that the biparietal diameter is at station:

A. _2
B. _1
C. Zero
D. +1
E. +2

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[Link] of the head in a multigravida late in pregnancy means that:

A. There is contraction of the pelvic inlet.

B. There is contraction of the med cavity
C. There is narrowing of the pubic arch
D. Usually a normal situation
E. CS should be taken into consideration

[Link] labor include the following except:

A. Vaginal delivery
B. Term baby
C. Multiple pregnancy
D. Alive fetus
E. Without complications to the fetus

[Link] following hormones have a role in labor except:

A. Progesterone
B. Human placental lactogen
C. Estrogen
D. Fetal adrenal gland
E. Prostaglandins

[Link] succedaneum except:

A. A localized oedema affecting the most dependent part of the fetal skull
B. It usually occurs in stillborn infants
C. It disappears shortly after birth
D. It means that labor was prolonged
E. It gives an idea about the attitude of the head

[Link] presentation is except:

A. The lowermost part of the fetus which meets the pelvic brim
B. 96% Cephalic
C. 3.5% breech
D. Shoulder in .5%
E. 1/1500 face

[Link] labor pains are except:

A. Irregular
B. No dilatation
C. No effacement
D. Not relieved by analgesia
E. Not followed by labor

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13. A 30 yr. old female with endometrial hyperplasia treatment of choice:
A. medroxyprogesterone
B. estrogens
C. danazol
D. GNRH analogues
E. all of the above

[Link] Uterine bleeding (AUB) is defined by all of the following except?

A. Excessive Blood loss (>80 ml) during menses
B. Menstrual length less than 7 days
C. An interval of less than 21 days between the starts of successive menses
D. Irregular bleeding episodes between menses
E. Extended (>35 days) intervals between menses

[Link] follicular phase of menstrual cycle is characterized by:

A. Endometrial proliferation.
B. Decreased estrogen
C. Progesterone dominance.
D. Fixed length of 8 days
E. Reduction in aromatase activity

[Link] one of the following actions COCP has:

A. Reduce risk of endometrial cancer.

B. Increase risk of ovarian cancer.
C. Reduce risk of breast cancer
D. Reduce risk of cervical cancer.
E. Worsen endometriosis

[Link] of the following is not a common site for endometriosis:

A. Bone
B. Ovaries.
C. Uterosacral ligaments.
D. Peritoneum

[Link] score includes all the following except:

A. Dilation of cervix.
B. Position of cervix
C. Presenting part of the fetus
D. Length of the cervix
E. Consistency of cervix

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[Link] second stage of labor:
A. separation of placenta
B. effacement of cervix
C. expulsion of placenta
D. dilation of cervix
E. expulsion of fetus

[Link] common cause of postmenopausal bleeding is:

A. atrophic vaginitis
B. Endometrial cancer
C. Endometrial hyperplasia
D. Endometrial polyp
E. none of the above

[Link] contraindication to OCP, all except:

A. smoking and over 35 years.

B. Family history of Breast cancer
C. Undiagnosed vaginal bleeding
D. Ischemic heart disease
E. DVT

[Link] deceleration is:

A. Associated with unengaged head
B. Associated usually with brain hypoxia
C. Decrease in the fetal beat that peaks after uterine contraction
D. Indication of c-section.
E. Results from increased vagal tone secondary to head Compression

[Link] sign of puberty:

A. Budding of breasts.
B. Pubic hair
C. Menstruation
D. Growth changes
E. Changes in voice

[Link] order of cardinal movements in labor:

A. Engagement, internal rotation, flexion
B. Engagement, descend, flexion, internal rotation
C. Descend, engagement, flexion
D. Internal rotation, flexion, decent, engagement.
E. Engagement, flexion, internal rotation

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[Link] most common cause of precocious puberty is:
A. Idiopathic.
B. Gonad blastoma.
C. Albright syndrome.
D. Abnormal skull development.
E. Granulosa cell tumor

[Link] of the following is known to be the commonest presentation in twins:

A. Breech, cephalic
B. Cephalic, breech
C. Cephalic, cephalic.
D. Breech, breech
E. Cephalic, transverse

[Link]'s regards to contraception failure; the pearl index refers to:

A. Numbers of Pregnancies in years.
B. Number of pregnancies in 1 woman-year.
C. Number of pregnancies in 100 woman-year.
D. Number of pregnancies in 100 woman-years over pregnancy losses.
E. Number of Pregnancy losses in 100 woman-years

[Link] of long-term use of nasal decongestant?

A. Vasomotor rhinitis
B. Allergic rhinitis
C. Rhinitis medicamentosa

[Link], abscess between tonsils and superior constrictor m.

[Link] of voice after thyroidectomy:
A. External Superior LN
B. Internal Superior LN
Note: Rec. LN wasn’t an option

[Link] muscle of ventilation, all true except?

A. Tares major
B. Tares minor
C. abdominis rectus
D. diaphragm
E. SCM

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[Link] supply by oculomotor except? Orbicularis oculi
[Link] of 5%DW and 1/2NS for three days present with confusion and tonic, what ‘is the cause:
A. Hyper/hypo natremia
B. Hyper/hypo kalemia
C. Hypocalcemia

[Link] with hypokalemia, ecg is, except?

A. ST depression
B. U wave

[Link] the following cause uveitis except?

A. RA
B. Sarcoidosis
C. MS
D. UC

[Link] darning of right testis?

A. Superficial inguinal
B. Deep inguinal
C. Common iliac LN

[Link] the following drain to left renal vein?

A. Left adrenal vein?

B. Left spermatic vein?
C. All of the above?

[Link] with shock and distended neck vein and midline trachea, which one?
A. Cardiac tamponade
B. Tension Pneumothorax
C. Hemothorax

[Link] with sigmoid diverticula and present with UTI and Pneumaturia, which best diagnosis?
“Colo vesical fistula”
A. Ct
B. MRI
C. Cystoscope

[Link] 29 y with rebound tenderness in LIF, next step?

A. Urine pregnancy test
B. Abd U/S
C. AXR
D. Urine dipstick

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[Link], all the following except: pre-malignant

[Link] adenoma?
a. Is common in females between 15-25 years
b. Usually soft indiscreet lump
c. Malignant changes in 5 %
d. Arise from duct of breast
e. none of the above

[Link] Schlatter disease?

a. Upper tibia
b. Upper femur
c. Lower tibia
d. Patella

[Link] most consistent sign of a fracture of the carpal scaphoid is:

a. Wrist pain during attempted push-ups.
b. Diffuse swelling on the dorsum of the wrist.
c. Localized tenderness in the anatomic snuffbox.
d. Wrist popping on movement

[Link] with non-displaced femur shaft fracture, treatment?

A. ORIF
B. Percutaneous Pin

[Link] arrest? Epinephrine

[Link] coma scale → Direct and easy

[Link] coma scale →

different response, like one arm in flexion, other leg in extension, another arm localized to pain,
you have to calculate the best response in each of M, V, E

[Link] Elbow? tenderness on lateral epicondyle

[Link]:
A. sunburst sign due to involvement of soft tissue
B. exclusive in young adult
C. most common in epiphysis of long bone

[Link] carcinoma is treated by:

A. Antibiotics
B. Surgery
C. Radiotherapy
D. None of the above

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[Link] of the followings are the true anatomic axes for endotracheal intubation?
a) Flexion of the head and flexion of the neck
b) Extension of the head and extension of the neck
c) Flexion of the head and extension of the neck
d) Extension of the head and flexion of the neck
e) None

53.A single organism is usually the causative agent in:

A. pelvic inflammatory disease
B. perforated diverticulitis
C. acute cholecystitis
D. primary peritonitis
E. diabetic foot infection

[Link] with left acute subdural hematoma and GCS 9, which one is worst prognosis:
A. BP 90/70 for 10 min before hospital
B. Right epidural hematoma
C. Depressed skull fracture
D. 10% Pneumothorax

55. Patient with vomiting and abdominal pain and distention, U/S show air in biliary tree, most common cause:
a. Paralytic ileus
b. Gallbladder ileus

56. Patient treated for perforated appendix then two weeks came back with right tip of shoulder
pain. most common cause? Subphrenic abscess!!

[Link] CPR and ACLS guidelines:

[Link] underwent surgical ligation of testicular artery with preserve the blood supply to testis,
which is the source?
59. Compare to midline episiotomy, the mediolateral has? less extension!!
[Link] foot, present with all except:
a. Drop foot
b. Gangrene
c. Neuropathic ulcer
d. Joint deformity

[Link] of the following in primary survey except:

a. Tension Pneumothorax
b. Open Pneumothorax
c. Rib fracture
d. Flail chest
62. Ovulation occurs with? LH surge

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63. Meiosis about oocytes?
64. Which of the following is accurate about the workup of hemorrhoids?
A. Barium enema is routinely indicated for patients with suspected hemorrhoids
B. Histologic examination of hemorrhoidal tissue is routinely indicated
C. Proctoscopy may be used in place of anoscope in the assessment of internal hemorrhoids
E. The presence of anemia on laboratory testing should raise suspicion of an alternate diagnosis to hemorrhoids

65. Indication for tracheostomy except? consolidation of lung

66. Massive lower gastrointestinal hemorrhage:

A. Rarely stops after resuscitation
B. Is caused by large bowel lesions only
C. can be most accurately localized by colonoscopy
D. Is frequently related to right colon lesions
E. Is most commonly caused by adenocarcinoma of the large intestine
67. Early in septic shock: delay capillary refill

[Link] examination in the gynecological practice

A. Is useful in the diagnosis of enterocele
B. Is useful in suspected pelvic abscess
C. Is indicated in the assessment of carcinoma of the cervix
D. All of the above
E. None of the above

69. Stab wound in right anterior axillary line just above the costal margin 3 cm with 190/110 and
120 bpm, your next step?
a. CT abd and thorax
b. FAST
c. auscultation of chest
d. abd x-ray
e. abd U/S
70. Child with motor vehicle accident, loss of conscious for brief period, then transport to hospital conscious
oriented, then sudden LOC and GCS 5, next step?
a. endotracheal intubation
b. nasopharyngeal
c. oropharyngeal

[Link] baseline Heart rate of normal fetus at term is:

A. 80-100 bpm
B. 100-120 bpm
C. 120-160 bpm
D. 160-180 pbm
E. There is no baseline heart rate

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72. pantaloon hernia?

73. You are evaluating a 60‐year‐old woman who presents with a 3‐cm left thyroid nodule. Fine needle
biopsy is suggestive of follicular neoplasm. USG demonstrates a normal right thyroid lobe. What is
your recommendation for further treatment?
a. Repeat USG and biopsy in 6 months
b. Thyroid hormone suppression
c. Diagnostic left thyroid lobectomy
d. Total thyroidectomy
e. Total thyroidectomy and left modified radical neck dissection

74.A 33-year-old woman develops a reducible mass of the groin that is inferolateral to the pubic
tubercle and medial to the femoral vein. Which of the following is the most likely diagnosis?
a. Direct inguinal hernia
b. Femoral hernia
c. Incisional hernia
d. Indirect inguinal hernia
e. Umbilical hernia

75. The first priority in the management of facio-maxillary injuries is to:

a. Rule out fracture of the cervical spine.
b. Chest x-ray.
c. Ensure a patent airway
d. Stop the bleeding.
e. IV fluid resuscitation

[Link] osteomyelitis most frequently affects:

a. The diaphysis of long bones.
b. The epiphysis.
c. The metaphysis of long bones.
d. Flat bones.
e. Cuboidal bones

77. The least problem that cause right lower abdominal pain in an 18 years female is:
A. Ectopic pregnancy
B. Acute appendicitis
C. Ovarian torsion
D. Perforated peptic ulcer
E. Mittelschmerz

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78. Pointing index, injury in:
a. Ulnar
b. Median
c. Radial

79. Tension pneumothorax, which of the following true:

a. needle decompression in 2 ICS mid clavicular line
b. chest tube in 5 ICS mid axillary line

80. In polycystic ovarian syndrome, the following is not found in:

a. Wide carrying angle.
b. Hirsutism.
c. Obesity.
d. Raised LH.
e. None of the above

81. Highest maintenance fluid in:

a. 79 y lady with weight loss
b. 23 y athletic
c. 35 housewives
d. 55 obese office workers

82. Grade of hemorrhagic shock:

83. Regarding papillary thyroid cancer:
a. Account for 40% of thyroid cancer
b. Early blood spread
c. Commonest thyroid cancer in children
d. Common in endemic goiter areas
e. Multifocality is rare

84. Among patients who require nutritional resuscitation in an intensive care unit, the best evidence that
nutritional support is adequate is:
A. Urinary nitrogen excretion levels
B. Total serum protein level
C. Serum albumin level
D. Serum transferrin levels

85. BPH, all are symptoms except?

86. Repair rupture of tendon in all the following except:
87. About Necrotizing fasciitis, all true except?
88. Bilateral lid edema, all true except?

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89. Oligohydramnios is characteristically associated with (one true):

A. diabetes mellitus.
B. rhesus iso-immunization.
C. fetal renal agenesis.
D. hemangioma of the placenta.
E. fetal duodenal atresia

90. Red urine, how to differentiate between hemoglubemia and myoglubemia?

91. Back pain, worst presentation?
92. Dry eye. first line of treatment? antibiotics? Lubricants? Anti-inflammatory?
93. Surgical site infection. Definition:
90. All causes of uveitis except: ischemic heart disease

94. Hypovolemic shock is characterized by:

A. A low central venous pressure, high cardiac output, low peripheral resistance
B. A high central venous pressure, high cardiac output, high peripheral resistance
C. A low central venous pressure, low cardiac output, high peripheral resistance
D. A low central venous pressure, high cardiac output, high peripheral resistance E.
A high central venous pressure, low cardiac output, low peripheral resistance

[Link] tension pneumothorax the following signs are present except:

a. Hypoxia
b. Hyperresonance to percussion on the affected side
c. Tracheal deviation to the ipsilateral side
d. Distended neck veins
e. Tachycardia

97. The most commonly used imaging method for diagnosis of acute cholecystitis is:

a. CT of the abdomen.
b. ultrasonography of the gallbladder.
c. Oral Chol cystogram.
d. Radionuclide (HIDA) scan of the gallbladder
e. MRI

With my best wishes

‫بالتوفيق والنجاح‬

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 2019 - A
1- Hyphemia? Ant chamber, blunt trauma, DM, all of above.
2- All causes lid retraction except? Horner’s !!
3- Bilateral swelling of eye except?
4- Fracture of humerus shaft cause injury of? ulnar, radial, median.
5- Radial injury mostly with?
6- Bedridden patients can have all except?
7- With rickets you can see in x-ray except? narrow epiphysis
8- Bisphosphonate how its work? only on osteoclast
9- Good prognosis in cancer?
fusiform cancer, nasopharyngeal cancer, pharyngeal cancer, vocal cord cancer.
10- chronic tonsillitis, tonsilecular abscess, huge adenoid!
11- Hair follicle in ear? 1-boney part, 2- cartilaginous part.
12- Stridor after thyroid surgery? Bilateral!
13- Sensory neural hearing loss? both bone and air conduction
14- RTA case with 6th cervical injury?
15- A 3 months with 40C fever and raised palpable red spot rash in body Dx? meningococcemia
16- One week infant with melena Dx? Vit k def, hemophilia A, hemophilia B, necrotizing colitis.
17- Injury of urethra all true except?
high viding prostate, by PR prostate NOT felt, Rectum bleeding, urethral bleeding.
18- GFR rate increase in all except?
19- Case with increase Cr 4.6 + US mass comprising urethra best treatment is? stent, biopsy.
20- KUB all true except?
21- Regarding stones?
22- RTA except?
23- Hydatid form pregnancy best monitoring by?
24- Antenatal pregnancy book all except? CBC, Glucose, HBV, URINEANALYSIS.
25- Ectopic pregnancy you can find?
26- Semen collection in IVF by?
27- Best method treatment of hyperplasia with atypia?
28- Polyp cause bleeding? intramural, subserosa, …
29- Primary ovarian failure?
30- Endometriosis all true except?
31- post-partum preeclampsia one true?
32- MgSO4 all true except?
33- PROM treatment in (24-31) week except?

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 34- Increase risk for ovarian cancer except? breast cancer
35- Occipitoposterior is? position
36- All increase risk for cord prolapses except?
37- Most common complication with dystocia?
38- Norma with pregnancy except? vaginal
39- Uterine rupture most common symptom? CTG change
40- With preeclampsia except?
41- Cord prolapses? must CS
42- Celiac trunk:
1- left gastric
2- Right gastric
43- Anal anatomy:
44- Appendicitis Diagnosis? Mac Berny tenderness
45- 5 years surveillance in breast cancer depend on?
1- tumor size
2- pathology
3- L.N
46- Most common inguinal swelling in adult?
Inguinal hernia
47- 70 years old with pain and rectal bleeding
1- Ischemic colitis
2-Diverticulosis
3-Diverticulitis
4-Hemorrhoid
48- Painful bleeding? anal fissure
49- Acute A. Ischemia cause all except? muscle wasting
50- Multiple pus? carbuncle
51- Burn of Ant trunk rule of 9 ?18%
52- Case of RUQ+ fever + jaundice? cholangitis
53- Best method for dx of cholecystitis? u/s
54- Complication of acute pancreatitis except?
a. ARDS 2- DIC 3-Pseudocyst 4- cardiac insufficiency

55- Causes of hypercalcemia except? acute pancreatitis

56- All cause preoperative without peritonitis except? appendicular abscess.
57- Warfarin monitoring by? INR.

58- Warfarin antidote faster? FFP.

59- Hemorrhagic shock initial management? o2

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 60- Ankylosing spondylitis?

61- Increase COP in?

Hypovolemia, early septic, late septic, anaphylactic shock, neurogenic shock.
62-Anaphylactic shock? epinephrine
63-Septic shock?
64-Diabetic ulcer all true except? premalignant.

With my best wishes

‫بالتوفيق والنجاح‬

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 2019 - B
1. A postoperative patient with protracted vomiting is like to have :

A. Metabolic acidosis.
B. Respiratory acidosis.
C. Metabolic alkalosis.
D. Lactic acidosis.
E. Microcytic anemia.

2. Which of the following statements is true regarding patients with rebound tenderness and free
air seen on plain radiographs:
A. Parenteral steroids are helpful in treating peritoneal inflammation.
B. CT scanning is important in surgical planning.
C. Narcotic analgesics are contraindicated because they may mask changes in the abdominal examination.
D. Abdominal ultrasound is superior to CT scanning in localizing an intra-abdominal abscess.
E. No further imaging studies are indicated

3. An adult patient with both legs severely burned and his anterior trunk also burned has what
percentage total body burn:
A.45% .
B.54% .
C. 60% .
D.90% .
E. 74%

4. Incarceration of the antimesenteric portion of the bowel wall is referred to as which of the following:
A. Umbilical hernia.
B. Richter hernia.
C. Femoral hernia.
D. Indirect inguinal hernia.
E. Hiatal hernia.

5. An example of a pulsion diverticulum is :

A. Zenker diverticulum.
B. Traction mid-esophageal diverticulum.
C. True diverticulum.
D. Meckel diverticulum.
E. Esophageal leiomyoma
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6. A 47-year-old woman with recurrent bouts of acute cholecystitis is hospitalized on the medicine
service. Physical examination reveals right upper quadrant pain to palpation. Ultrasound reveals
evidence of pericholecystic fluid and gallstones. Which of the following laboratory studies is most
likely to be abnormal in this patient?
A. AST.
B. Lipase.
C. Amylase.
D. Bilirubin.
E. Alkaline phosphatase.

7. A 23-year-old woman driving her automobile is struck by another driver, the force of impact
causing her to strike the temporal area of the skull against the window. She develops a mild
headache but does not lose consciousness. Several hours later, she develops a severe headache
with nausea and vomiting. Which is the most likely diagnosis ?
A. Bacterial meningitis.
B. Berry aneurysm of the circle of Willis with rupture.
C. Epidural hematoma.
D. Subarachnoid hemorrhage.
E. Subdural hematoma.

8. A 52-year-old executive and heavy smoker tells you in the emergency room that he developed
sudden overwhelming epigastric pain at 8:15 AM. His skin feels clammy and he is tachycardic,
and his abdomen is rigid. The most likely diagnosis is:
A. Appendicitis.
B. Pelvic inflammatory disease.
C. Perforated peptic ulcer.
D. Acute cholecystitis.
E. Right lower lobe pneumonia

9. If one liter of 0.9% NaCl solution is given, what is the expected increase in plasma volume?

A1L
B 225 mL
C 275 mL
D 775 mL
E 1100 mL

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10. A 74-year-old woman reports that her left breast has been swollen and red for a couple of
months. She delayed seeking help because she has no pain or fever. Physical examination shows
classical “orange peel” appearance, but no discrete masses can be felt. This is most likely:
(A) Chronic cystic mastitis.
(B) Inflammatory cancer of the breast.
(C) Normal menopausal involutionary changes.
(D) Pyogenic breast abscess.
(E) Tuberculous or fungal breast abscess.

11. A 39-year-old woman discovers a lump on her lower neck that goes up and down with
swallowing. Physical examination discloses a 2-cm, firm mass in the right lobe of her thyroid
gland. She is otherwise asymptomatic. The appropriate course of action for this mass will best be
established by:
(A) Careful observation over the next few years.
(B) Fine-needle aspiration (FNA) cytology of the mass.
(C) Radionuclide scan of the thyroid gland.
(D) Response to suppression by exogenous thyroid medication. (E) Thyroid function tests (T4 and TSH).

12. A 46-year-old man involved in a motor accident arrives in the ER unconscious with multiple
facial fractures, brisk bleeding into his nose and mouth, and gurgles, irregular, and noisy
breathing. Several attempts at endotracheal intubation have failed because the blood obscures the
view and the nose does not have a lumen anymore. Five minutes have passed. It is time to do:
(A) Cricothyroidotomy.
(B) Emergency percutaneous tracheostomy over a light source.
(C) Emergency tracheostomy via a collar incision at the base of the neck.
(D) High-frequency ventilation by facial mask.
(E) Percutaneous needle insertion into the upper thyroid notch.

13. A 79-year-old man with atrial fibrillation develops an acute abdomen. When seen 3 days after
the onset of the abdominal pain, he has a silent abdomen with diffuse tenderness and mild
rebound. There is a trace of blood in the rectal exam. He looks quite sick, with acidosis and signs
of sepsis. The most likely diagnosis is:
(A) Acute pancreatitis.
(B) Mesenteric ischemia.
(C) Midgut volvulus.
(D) Perforated viscus.
(E) Primary bacterial peritonitis.

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14. A 17-year-old boy has been having right lower quadrant abdominal pain for 2 days. He says the pain
began at that location and has been gradually getting worse. On physical exam he has tenderness to deep
palpation and mild rebound on both the right lower quadrant and the left lower quadrant. His temperature
is 38°C, and his WBC is 8,500. He adds that he is terribly hungry, but his family is afraid to feed him. The
next step in management should be:
(A) Barium enema.
(B) CT scan of the abdomen.
(C) Emergency appendectomy.
(D) Lower GI endoscopy.
(E) Trial of antibiotic therapy.

15. After an explosion, many victims were presented with traumatic lower extremity Amputations. First
responders should control bleeding by what method, and after initial hospital resuscitation, shock should
be treated with what therapy?
(A) Direct pressure; whole blood.
(B) Direct pressure; packed red cells (RBCs).
(C) Tourniquets; whole fresh blood.
(D) Tourniquets; packed RBCs and fresh frozen plasma (FFP).
(E) Tourniquets; packed RBCs, FFP, and platelets in 1-1-1 ratio

16. A common electrolyte abnormality seen at presentation with acute abdomen is: A.

Hyponatremia
B. Hypernatremia
C. Hypokalemia
D. Hyperchloremia
E. Hypermagnesemia

17. In the setting of abdominal pain, which of the following is not suggestive of abdominal catastrophe?

A. Pallor
B. Hypotension
C. Jaundice
D. Confusion
E. Diaphoresis

18. Which of the following is not a common cause of a small bowel obstruction in an adult?

A. Hernia
B. Tumor
C. Volvulus
D. Adhesions
E. Ileocolic intussusception

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19. Morbid obesity is defined as:
A. 1.5 times ideal body weight
B. BMI > 40 kg/mg2
C. 20% above ideal body weight for adolescents
D. A function of physical activity, comorbid conditions, and weight
E. Weight > 40 kg

20. Which of the following best prevents wound infection in open wound injury

a. Prophylactic IV antibiotics
b. Topical antibiotics
c. Chlorhexidine skin preparation
d. Wound vac
e. Wound debridement

With my best wishes

‫بالتوفيق والنجاح‬

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 2020 - A
1- The greatest strength of wound achieved by: 6 weeks!!
2- Coagulation cascade activated start by: tissue factor 7
3- Not directly activate clot formation: ADP, epinephrine …
4- Michele’s diverticulum true except: simple Q
5- Which true about nephron: proximal C T mostly reabsorbed Na (as I recall)
6- Imaging study of choice for Legg-Calve-Perthes disease: MRI
7- All suggest urethral injury except: rectal bleeding
8- Which of the following most likely need urgent colectomy: cecal volvulus
9- Case about post op thyroidectomy c/o stridor
The most appropriate next step: open wound (remove stitch) immediately at bedside
10- Which is true about breast imaging study: MRI differentiate between breast scar and recurrent cancer
11- Most effective tool to dx appendicitis: Hx and PE (not any imaging study)
12- Stab injury to RT to sternum: P artery injury!
13- Gallows traction maneuver use for: femur shaft fracture in pediatrics
14- Q about physiology: Aquaporin receptor all true except: have NSAID receptor (as I remember)
15- Case about crash injury: most appropriate next step to protect renal: vigorous IV hydration
16- Case of picture diverticulitis: imaging study: CT
17- The most common symptom in hydatiform mole is: vaginal bleeding
18- Case of hydatiform mole > monitoring by: Gonadotropin titter
19- Mgso4 side effects in pregnancy all false except: fetal skeletal abnormality
20- All cause bilateral lid retraction except: Horner’s, chalazion …
21- Which of the following is histological pathognomonic of ectopic pregnancy?
22- The most common cause of hearing loss in pediatric age group: otitis media with effusion
23- Case of next step for endometrial hyperplasia with atypia:
24- All is primary ovarian failure except:
25- Q about (anatomy) lymphatic drainage of testis:
26- The most common site of fibroid to bleed: submucosal (not intramural)
27- Q about vertebral level which is true: umbilicus L3-4 vertebra
28- The most common electrolyte disturbance in acute abdomen:
hypokalemia (hyponatremia which is more true)
29- Most adhesions occur after: exploratory laparotomy
30- Physiology about creatinine clearance which is true:
31- Orbital cellulitis:
32- Bell’s palsy:
33- Endometriosis all true except:
34- Occipitoposterior consider as: Malposition

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35- Risk factor for nasopharyngeal cancer: EBV
36- PPH most common cause: uterine atony
37- Risk factor of ovarian cancer except:
38- Antenatal book include all except: HIV test
39- The most common presentation of uterine rupture is: abnormal fetal baseline tracing
40- Case about PROM remote from term all include in management except:
41- Q about duodenum anatomy:
42- Primary hyperaldosteronism lead to all of following except >> hyperkaliemia
43- NSAID: interstitial nephritis
44- Case scenario: elderly with pain + gross hematuria: passing stone
45- Case about thyroglossal duct cyst:
46- Massive bleeding definition except: 100 cc/min
47- All approved to decrease SSI except: body temp below 36
48- Case scenario of 70 yrs. anemic patient: suspected RT colon cancer
49- About 5Qs in Shock types and parameters detail: very important Topic in exam
50- Which foreign body need urgently to be removed from ear: battery
51- Malignant otitis media causative organism: pseudomonas aeruginosa
52- All are risk factor for otitis media in infants except: breast feeding
53- Case scenario about femur fracture which lead to symptoms of fat embolism.
54- Lachman test for: ACL
55- Case about septic arthritis (knee effusion) most appropriate next step: arthrocentesis
56- Case scenario about tennis elbow:
57- Differentiated between disc herniation from cauda equine:
58- Fracture of intertrochanteric neck of femur in 70 yrs. female: Austin moor!!
59- Q about CPR adrenalin shot which is false:
60- Q about burn Parkland formula calculation:
61- Q about Glass cow coma scale calculates:
62- prolapse (uterine – rectocele -cystocele)
63- Case scenario about osteoporosis hip fracture in elderly risky female after slipped:
64- Case scenario about classical presentation that suggest: anterior cruciate ligament tear
65- All regarding blood transfusion compatibility except:
66- All are advantages of minimally invasive surgery except:
67- Q about compartment syndrome which is true: pain out of proportion to clinical presentation
68- Q about function of peritoneum: rate of NS absorption!

With my best wishes

‫بالتوفيق والنجاح‬
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 2020 - B
1- Pain in the flaccid penis is usually due to:
A. peyrenic disease
B. bladder and urethral inflammation
C. priapism
D. calculi impacted in distal ureter
E. hydrocele

2- Where are melanoma in patient with dark skin most likely is:
A. Back
B. Arms
C. legs
D. palms soles and mucus membrane
E. face

3- What is the most common initial acid base abnormality seen in patient with a pulmonary embolism (PE)?
A. Respiratory alkaloses
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acid
E. Combined respiratory alkalosis and metabolic acidosis

4- What is the most common cause of an esophageal perforation?

A. Boerhaave's syndrome (spontaneous perforation)
B. Iatrogenic
C. Foreign body
D. Esophageal cancer
E. Trauma

5- A 20-year-old female who is 8 months pregnant presents with symptoms and signs of acute
cholecystitis and undergoes laparoscopic cholecystectomy uneventfully. However, she returns to
the emergency department on postoperative day 4 with acute-onset dyspnea and pleuritic chest
pain. A pulmonary embolism is subsequently diagnosed. What is the most likely source of the
thromboembolism?
A. The right common iliac vein
B. The left common iliac vein
C. The right popliteal vein
D. The night axillary vein
E. The left femoral vein

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6- In patients who present with acute pancreatitis, which factor is least likely to independent predict the
development of complications?
A. Age > 55 years
B. APACHE II score>8 points in the first 24 hours of admission
C. C-reactive protein 150 mg L. after 48 hours in hospital
D. Glasgow score > 3
E. Obesity

7- A 43-year-old previously well woman presents with pain, swelling and erythema in the anorectal area.
What is the most appropriate management?
A. CT of abdomen and pelvis
B. Examination under anesthesia and drainage of pus
C. Flexible sigmoidoscopy
D. Intravenous antibiotics
E. MRI of perineum

8- A 65-year-old man presents with left iliac fossa pain, pyrexia and raised white cell count 20
x1000 per mm3 and C-reactive protein of 200 mg/L What is the most appropriate investigation?
A. Abdominal X-ray
B. Barium enema
C. Colonoscopy
D. CT of abdomen and pelvis
E. Flexible sigmoidoscopy

9- Which of the following is not a definition of massive bleeding?

A. Blood loss of half the patient circulating volume in a 3-hour period
B. Blood loss of the patient circulating volume in a 24-hour period
C. Ongoing blood loss of 100 ml/min
D. Transfusion of 4 units of red cells in 4 hours with continued bleeding
E. Transfusion of 10 units of packed red cells in a 24-hour period

10- A 44-year-old woman falls from a significant height sustaining injuries to her head and
torso. Which of the following is a component of the secondary survey as per the advanced trauma
life support (ATLS) protocol?
A. Alert, voice, pain unresponsive assessment of neurological status
B. Control of hemorrhage
C. Focused assessment with sonography for trauma scan
D. Log roll including checking spinal integrity and anal tone
E. Respiratory rate

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11- A 70-year-old man presents with an acute onset of severe generalized abdominal pain wit
few clinical signs. Routine blood tests show raised inflammatory markers. What is the m likely
diagnosis?
A. Acute mesenteric ischemia
B. Acute pancreatitis
C. Diverticular disease
D. Perforated duodenal ulcer
E. Ruptured abdominal aortic aneurysm

12- Which one of the following clinical signs from the list below would you expect to see in
patient with cardiac tamponade?
A. Prominent first heart sound
B. Muffled heart sounds
C. Prominent second heart sound
D. Low jugular venous pressure
E. Hypertension

13- Which of the following is a Gram-negative bacterium?

A. Streptococcus pneumoniae
B. Neisseria meningitidis
C. Staphylococcus aureus
D. Streptococcus viridian’s
E. Clostridium botulinum

14- Which of the following is not a cause of lactic acidosis?

A. Pancreatitis
B. Excessive exercise
C. Pyloric stenosis
D. Septic shock
E. Biguanides

15- A 35-year-old butcher is admitted after stabbing himself with a knife inadvertently. His airway is
patent with normal breathing. His pulse is 110 beats/min, BP is 130/105 mmHg, and respiratory rate is 25
breaths/min. Assuming a body mass of 70 kg, what is the best estimated volume of blood lost ?
A. 400 ml.
B. 1000 mL.
C. 1800 mL.
D. 2500 mL
E. Impossible to say from given information

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16- Which of the following is not a syndrome associated with an increased risk of colonic adenocarcinoma?
A. Congenital hypertrophy of retinal pigment epithelium
B. Familial adenomatous polyposis coli
C. Hereditary non-polyposis colon cancer
D. Multiple endocrine neoplasia syndrome II
E. Gardner’s syndrome

17- The three phases of wound healing, in order, are:

A. Inflammation, proliferation, and maturation
B. Inflammation, proliferation, and contraction
C. Eschar formation, inflammation, and maturation
D. Fibrous exudate, granulation, and epithelialization
E. Coagulation, granulation, and epithelialization

18- A 45 years old man with a history of previous right hemicolectomy for Colon cancer present with
colicky Abd pain which has become constant over the last few hours, he has marked Abd distention and
has had only minimal vomiting, of a feculent his Abd is difficulty tender, Abdominal x-ray, shows multiple
air, fluid level with distention of some loops to greater than 3cm in diameter, The most likely diagnosis:
A. proximal small bowel obstructs
B. Distal small bowel obstructs
C. Acute appendicitis
D. Closed loop small bowel obstruct
E. Gastric outlet obstructs

19- Which of the following clinical situation can be associated with hypovolemic hyponatremia:
A. CHF
B. SlADH
C. Cirrhosis
D. Hypoglycemia
E. Gastrointestinal loss

20- The full in U.O.P associated with major, trauma may be caused by all of the following except:

A. hemorrhage.
B. a rise in ADH
C. a fall in adenosine activity
D. increase in the level of circulating Catecholamines
E. increase in corticosteroids output

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21- How much blood loss is necessary to first show hypotension
A. 10%
B. 20%
C. 25%
D. 30%
E. 40%

22- A 70 years old man presents with pallor and Breathlessness on exertion. He does not
complain of Abd pain. He has microcytic, hypochromic anemia which is the most problem cause:
A. Diverticulosis of the colon
B. peptic ulcer disease
C. Crohn’s disease
D. Ulcerative colitis
E. Carcinoma if the right colon.

23- Which of the following is the most common cause of bowel obstruction?
A. Small bowel ileus
B. Mechanical small bowel obstruction
C. Mechanical colonic obstruction
D. Acute colonic pseudo-obstruction
E. Gastric outlet obstruction

24- Which tissue is most sensitive to ischemia?

A. Muscle
B. Nerve
C. Skin
D. Fat
E. Bone

25- What is the most common serious complication of an end colostomy?

A. Bleeding
B. Skin breakdown
C. Parastomal hernia
D. Colonic perforation during irrigation
E. Stomal prolapse

26- Which of the following electrocardiographic changes is least likely to occur with hypokalemia?

A. ST segment depression
B. T-wave inversion
C. Second- or third-degree atrioventricular block
D. Premature ventricular complexes
E. U waves

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27- A normotensive bleeding patient is mildly anxious with a HR of 110 and an RR of 25. What class of
hemorrhagic shock is she in?
A. I
B. II
C. III
D. IV
E.V

28- Shock caused by a large tension pneumothorax is categorized as:

A. Trauma shock
B. Vasodilatory shock
C. Cardiogenic shock
D. Obstructive shock
E. Neurogenic shock

29- Which of the following is a cause of cardiogenic shock in a traumatic patient:

A. Hemothorax
B. Penetrating injury of the aorta
C. Air embolism
D…
E. All the above

30- Hepatic failure decrease synthesis of all the clotting factor except:
A. II
B. V
C. VIII
D. IX
E. VII

31- A 17 years old female presents after a motor vehicle Crash and is in hemorrhagic shock, a massive
transfusion protocol is triggered. What is the optimal rate in damage control resuscitation?
A.2 plasma 1 platelet 1 RBC
B. 1 plasma 1 platelet 1 RBC
C. 1 plasma 1PLT 3 RBC
D. 2 plasma 1 cryoprecipitate 1 RBC
E. 1 plasma 1 cryoprecipitate 1 RBC

32- Which of the following is true with regarding to burn injury :

A. Superficial partial thickness burn doesn’t have blistering
B. Full thickness 3rd degree burns can involve underlying fascia
C. Deep partial thickness burn has a loss of hair follicles
D. Deep partial thickness burns often heal spontaneously
E. Superficial partial thickness burn is not painful

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33- Which cells are responsible for the remodeling phase of wound healing:

A. Platelet
B. Myofibroblast
C. Neutrophil
D. Monocyte
E. Fibroblast

34- Which of the following statement regarding complication of central venous access is true:

A. The risk of catheter bloodstream infection is high in the subclavian site

B. Routine catheter exchange over a use all the risk infection
C. More than 3 attempt by the same operator increase the complications
D. Ultrasound guide lower complication cause during subclavian vein cannulation
E. The risk of catheter related thrombosis is not influenced by anatomic placement site

35- Regarding the most common cause of postpartum hemorrhage, one true:
A. Uterine atony

36- Endometrial hyperplasia one true :

A. Is a premalignant condition for endometrial cancer
B. Is typically found in patient aged 35-45
C. Is a common histological finding in patient of combined oral contraceptive COC

37- Subserous fibroid in nulliparous is removed by , one true :

A. abdominal myomectomy

38- Menorrhagia in adolescent is due to all of the following except :

A. immaturity of the hypothalamus pituitary ovarian axis
B. Von Willebrand disease and immunocompromised
C. The cyclic mostly ovulatory
D. Hypothyroidism can also lead to menorrhagia
E. Anatomical anomaly such as hemangioma or the av anomaly

39- Which of the following is true regarding bacterial vaginitis :

A. Is associated with a purulent, green discharge
B. Is associated with pre term labor
C. Is associated with vaginitis
D. Is associated with a cheesy smell
E. Is best treatment with vancomycin

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40- Ovarian neoplasm most commonly arise from which of the following cell:
A. Ovarian Epithelium
B. Ovarian serosa
C. Ovarian germ cell

41- The most common cause of postmenopausal bleeding is atrophic vaginitis and endometrial,
what is the third most common cause :
A. Cervical polyp
B. Endometrial carcinoma
C. Endometrial hyperplasia
D. Endometrial polyp
E. Exogenous estrogen

42- Regarding uterine fibroids, all true except:

A. Are the most common tumors found in women
B. Are more common in the black population
C. Are true encapsulated tumor’s
D. May be pedunculated
E. Are associated with sarcomatous change in less than 0.5% of ca

43- The uterine veins cuter the

A. Common iliac veins
B. Internal iliac veins
C. Interior veins cava
D. Femoral veins
E. External iliac veins

44- Which of the various walls of vagina are entirely covered with peritoneum
A. Antenor
B. Posterior
C. Lateral
D. A and B
E. A and C

45- The normal vaginal pH is

A. 2-3
B. 4-5
C. 6-7
D. 8-9
E. 10-11

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46- Endometrial polyps are:

A. Usually due to retained placental tissue

B. Always seen to reflect the cyclic changes of endometrium.
C. Often associated with malignancy in postmenopausal patient.
D. Frequently a cause of pyometra
E. Seen mostly in patients with birth control pills

47- The main cause of functional uterine bleeding is:

A. Myoma uteri
B. Cervical polyps
C. Endometritis
D. Persistent corpus luteum
E. Endometrial hyperplasia

48- Turner's syndrome does not include:

A. Growth retardation
B. Cubitus valgus
C. Webbed neck
D. Mature secondary sex organs
E. Ovarian dysgenesis

49- Regarding the cause of polyhydramnios all true except:

A. maternal diabetes
B. twin twins’ transfusion
C. impairment of fetal swelling
D. placental dysfunction
E. fetal gastrointestinal obstruction

50- Regarding the complication association with fetal growth restriction, all are true except:
A. birth asphyxia
B. hypoglycemia
C. meconium aspiration
D. sepsis
E. increase uterine artery resistant detect by doppler ultrasound

51- An (in situ) stage has not been effectively regard in which of the following:
A. ovarian cancer
B. endometrial cancer
C. cervical carcinoma
D. valvular carcinoma
E. vaginal carcinoma

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52- Which of the following true of obstetric hemorrhage:
A. it is the leading cause of maternal death worldwide
B. it is no longer a leading cause of maternal death in the United States
C. only 5% of maternal death in the United States are due obstetric hemorrhage
D. only 10% of maternal death in the United States are due obstetric hemorrhage
E. all of the above

53- In treating of uterine atony after delivery which of the following is true:
A. fundal massage should be performed
B. A 20 units of oxytocin bolus should be administrated intravenously
C. oxytocin diluted in a crystalloid solution with 200U should be administered Intravenously
D. a 40 unites oxytocin bolus should be administrated intravenously
E. all of the above

54- Cardiac disease that are known to lead to an increase maternal mortality included:
A. marfan syndrome
B. cardiomyopathy
C. pulmonary hypertension
D. all of the above
E. none of the above

55- Which anti-epileptic is associated with the highest risk of congenital malformation if taken in
the 1st trimester:
A. topiramate
B. lamotrigine
C. carbamazepine
D. phenytoin
E. sodium valproate

56- Which one of the following parameters does not increase during pregnancy :
A. blood volume
B. cardiac out put
C. red blood cell mass
D. central venous pressure
E. heart rate
57- The most common cause of precocious puberty is:
A. Idiopathic
B. Gonad blastoma
C. Albright syndrome
D. Abnormal skull development
E. Granulosa cell tumor

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58- The shortest distance between the sacral promontory and the symphysis pubis is called
which of the following?
A. Interspinous diameter
B. True conjugate
C. Diagonal conjugate
D. Obstetric conjugate
E. Anteroposterior diameter of midpelvis

59- A medical student asks you how to measure blood pressure, what maximum pressure should
you inflate the cuff to measure systolic blood pressure in pregnancy?
A. Always initially inflate to 200mmHg then deflate
B Patient's palpated diastolic blood pressure
C Patient's palpated systolic blood pressure
D. Patients palpated systolic blood pressure +20-30mmHg
E. Patients palpated systolic blood pressure + 5mmHg

60- A patient has a ventose delivery. Two days later she reports general malaise, fever and
feeling unwell. With sepsis, which is the first clinical sign to deteriorate, which can be
detected through the use of early warning scores?
A. Altered consciousness
B. Hypotension
C. Hypoxia
D. Tachycardia
E. Tachypnoea

61- What vitamin should women be advised during pregnancy and while breastfeeding?

A. Folic acid
B. Vitamin A
C. Vitamin C
D. Vitamin D
E. Vitamin K

62- Which of the following cardiac defects is more frequent:

A. Aortic stenosis
B. Pulmonic stenosis
C. Ventricular septal defects
D. Aortic coarctation
E. Hypoplastic left heart
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63- What is the usual method of diagnosing placental abruption?
A. Clinical diagnosis
B. D-dimer level
C. The Keilhauer–Betke
D. Transabdominal ultrasound
E. Transvaginal ultrasound

64- Regarding the fetal complication due to exposure to gentamycin, one true
A. Congenital heart disease
B. Ototoxicity
C. Cleft lip and palate
D. Limb reduction defects
E. Ventral septal defect

65- In the pregnant woman aged 35 years or over there is an increased incidence of all true except:
A. macrosomia
B. intrauterine growth restriction
C. Medical complications of pregnancy.
D. breech presentation
E. chromosomal abnormalities

66- Which of the following sonographic parameters is the most reliable for detection of macrosomia:
A. Head circumference
B. Abdominal circumference
C. Fermat length
D. humeral length
E. Crown rump length

67- Regarding the risk of pregnancy loss is higher in which of the following woman:

A. A with 2 or more prior pregnancy loss

B. B under the age of 35
C. C with prior live birth
D. D with one prior pregnancy loss
E. None of the above

68- Regarding the major risk factor for ectopic pregnancy, one true:

A. The use of an intrauterine contraceptive device

B. Previous PID
C. Cigarette smoking
D. Medically apportion
E. Salpingitis isthmica nodosa (SIN)

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69- Regarding the classic symptom’s triad of ectopic pregnancy, one true:
A. Amenorrhea irregular bleeding abdominal pain
B. Shock, uterine tenderness, and abdominal pain
C. Abdominal tenderness, pelvic tenderness, and irregular bleeding
D. Amenorrhea, shock, and uterine tenderness
E. Abdominal pain, shock, and vaginal bleeding

70- Regarding maternal medical complication that are increase in frequency in multifetal pregnancies
one true :
A. Anemia
B. Thrombophilia
C. Pneumonia
D. Appendicitis
E. Lower urinary tract infection

71- Common complication of septic arthritis of hip is:

A. Hypermobile joint
B. Necrosis of head and neck of femur
C. Persistent osteomyelitis of the femur
D. Coxa Vara
E. None of the above

72- Osgood Schlatter disease affects:

A. Lower tibia
B. Upper tibia
C. Distal femur
D. Proximal femur
E. Patella

73- Disc prolapse is common in:

1- L4, L5
2- L5, S1
3- T12, L1
4- S1, S2
5- T5, T6

74- Ganglion is most commonly seen over?

A. volar aspect of wrist
B. over forehead
C. dorsum of the tongue
D. sole of the foot
E. dorsal aspect of wrist

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75- Onion peel appearance on a ray is seen in?
A. osteosarcoma
B. Ewing’s sarcoma
C. osteoblastoma
D. osteochondroma
E. Metastatic bone disease

76- The following can cause osteoporosis except:

A. Hyperparathyroidism
B. steroids use
C. fluorosis
D. thyrotoxicosis
E. malnutrition

77- Bone growth is influenced maximally by?

A. Estrogen
B. Thyroxine
C. Testosterone
D. Insulin
E. growth hormone

78- Skeletal metastasis is common in:

A. cancer stomach
B. cancer pancreas
C. Hepatoma
D. cancer breast
E. brain tumors

79- Trendelenburg test is positive due to injury of which nerve?

A. inferior gluteal nerve
B. pudendal nerve
C. superior gluteal nerve
D. obturator nerve
E. E. femoral nerve

80- In a child with congenital hip dislocation, the legs are abducted with maintained w till a click is

heard. this test is known as?

A. Giliazzi's test
B. Telescope
C. Trendelenburg's sign
D. Ortolani's test
E. Thompson's test

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81- The middle turbinate?
A. is part of ethmoid bone
B. Is part of maxilla
C. Is a separate bone
D. It is only mucosal structure
E. It contains cartilage and bone covered with mucosa

82- Following are characteristics of discharge in unsafe chronic suppurative otitis media except?
A. Thick discharge
B. Scanty discharge
C. Odorless discharge
D. Blood-stained discharge
E. Purulent discharge

83- Which of the following is not a cause of hoarseness?

A. Carcinoma of right bronchus
B. Skull base tumor
C. Thyroidectomy
Hypothyroidism
D. Carcinoma of left bronchus

84- All are present in the medial wall of tympanic cavity except:
A. Oval window
B. Round window
C. Pyramid
D. Promontory
E. Tympanic part of facial nerve

85- ABR "Auditory Brain stem Response" is used in:

A. Test of hearing in malingering
B. Test of hearing in extracochlear lesion
C. Detection of acoustic neuroma
D. All of the above
E. a and b

86- Bilateral diffuse eyelid swelling may be caused by the following Except:

A. Acute Glomerulonephritis
B. Congestive heart failure.
C. Severe anemia.
D. Horner's Syndrome.

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87– In a major burns involving the head and upper body which of the following measures take the priority :
A. ABCDE
88- The common presentation of a Grawitz tumor (adenocarcinoma of the kidney ) is :
A. Low pain

89- Which of the following colonic disorders is not a precursor of colorectal cancer:

90- A middle-aged male with a past history of a cholecystectomy presents with small gut
abnormality the most likely cause is?
91- Fibroadenoma?
92- Splenic injury all are true except?
93- In patient receiving massive blood transfusion for active blood loss, which of the following is
correct ?
94- Advantages of epidural analgesia include?
95- Factors that decrease collagen syntheses include all of the following except?
96- The following statements is true concerning necrotizing fasciitis, except?
97- The following statement are true concerning the various type of shock except?

*2020-b repeat in other way:

1- Least one risk in acute pancreatitis Ranson’s criteria:
2- All of the following can cause Lactic acidosis except:
3- Causes of hypovolemic hyponatremia: SIADH
4- Rectum with peritoneum:
5- Common site of melanoma male in back female in legs.
6- Wound healing monocyte cell!
7- Hypotension due to blood loss 40%
8- Shock as general:
9- Acid base balance in PE: respiratory alkalosis
10- Most common cause of PE after surgery: Rt popliteal, Lt femoral, Rt common iliac.
11- Q about Fluid replacement:
12- Q about Burns:
13- Massive hemorrhage shock resuscitation:
1:1:1 ratio between packed RBCs, fresh frozen plasma, and platelets.
14- Becks triad:
15- 70 Y/O male sudden abdominal pain, fever, AAA
16- Secondary survey, FAST !! back roll
17- Tension pneumothorax cause shock obstructive!!
18- Furner gangrenes debridement s layers, triple AB, wide surgical debridement
19- Most common site of ganglion !! hand

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20- Most common cause of intestinal obstruction:
21- Hypokalemic ECG change:
RBBB, Rt axis deviation, S1Q3T3, ST (u wave, ventricular block, periventricular ST depression, t wave inversion)
22- Grade of hemorrhagic shock PR 110:
23- Complication of colectomy → parastomal hernia repeated
24- Most strong risk factor of breast cancer, FH !!, late menopause, late child bearing, late BF
25- Most common site of skeletal tumor Mets ??, breast, lung, prostate?
26- Gallows traction: femur fracture in child
27- Best substance used to calculate GFR
28- Endometrial hyperplasia, atypia, estrogen,
29- Functional uterine bleeding, anovulation
30- Polyhydramnios: DM. anencephaly, OA, omphalos (uterine dysfunction)
31- Submucous fibroid in nullipara: hysterectomy, laparoscopy
32- Carcinoma in situ except: ovarian!!
33- Vitamin give to pregnant in all trimester and during lactation K, E, A, D, folic acid
34- Ph of vagina (4-5)
35- Causes of Osteoporosis, biphosphate wrist, hip, vertebra
36- Cause of precocious puberty: repeated
37- Signs of ectopic pregnancy
38- Stages of normal labor (cardinal movement of labor)
39- Ovarian neoplasm cell in: ovarian epithelium repeated
40- Common cause of ectopic pregnancy PID
41- Turner syndrome and growth
42- Management of uterine atonia, message or oxytocin?
43- Most common cause of PPH?
44- Short diameter of intraspinal? repeated
45- All increase in pregnancy except CVP
46- Causes of menorrhagia except: ITP
47- Genital prolapse
48- Gram -ve bacteria: Neisseria meningitis
49- Liver not absorbed in disease: X, IX, VIII, II, VII
50- Transparent part of eyes (content) except? sclera, cornea, lines, vitreous
51- RA more than OA
52- Narrow sites of ureter: vesicle, vessels, pelvis
53- All cause of hoarseness except:
54- Middle ear: tympanic content
55- Rhabdomyolysis:

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56- Prophylactic drug in endocarditis pt:
57- Most common sited disk prolapses Disk herniation: L5-S1, L5-L4

58- Osgood Schlatter upper tibia repeated

59- Trendelenburg sigs for injury of which?? SPJ

60- Most common drug cause cleft lip? valproic acid

61- Gentamycin complication or SE? nephrotoxic, ototoxic

62- Hyphemia ?? repeated

63- Causes of led retraction

64- Orbital cellulitis
65- Causes of bell’s palsy
66- Epilepsy with convulsion
67- Most common cause of nasopharyngeal cancer? EBV

68- Otitis media:

69- Vagina with peritoneum:
70- NSAID with renal:

With the best wishes

‫بالتوفيق والنجاح‬

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 2020 - C
1- All of the following cause eyelid retraction except:
a. Orbital inflammation
b. Graves’ disease
c. Horner syndrome

2- Blunt trauma to the eye with anterior chamber bleeding called:

a. Hyphemia
3- All of the following is transparent except:
a. Lens
b. Cornea
c. Sclera
d. Vitreous

4- Question about orbital cellulitis:

5- Most of sodium is reabsorbed at:
a. Proximal convoluted tubule
b. Loop of Henle
c. Distal convoluted tubule

6- Which of the following initiates the coagulation cascade IN VIVO?

a. Factor XII
b. Thrombin
c. Tissue factor
d. Factor X
e. Prekallikrein **Factor XII is used to start coagulation cascades in laboratory studies (in vitro)

7- All of the following directly stimulate platelets aggregation except:

a. ATP
b. Collagen
c. Von will factor
d. IL6
e. IL1

8- Optimal wound strength occurs after:

a. 6th weeks

9- All of the following participate in sterility of operating room except:

a. Hand washing
b. Scrubbing
c. Cold temperature

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10-Cause of pseudomembranous colitis: clostridium difficile
11- Regarding duodenum all of the following true except:
a. Left gastric artery branches from celiac artery
b. Part of the duodenum is retroperitoneum
c. Ampulla of vater is formed by the union of the pancreatic duct and the common bile duct
d. Superior pancreaticoduodenal artery arises from superior mesenteric artery

12- Definition of massive bleeding, all correct except:

a. loss of one blood volume within a 24 hr period
b. blood loss > 150mL/min
c. 50% blood volume loss in 3 hours
d. All is correct

13- Burns in anterior chest and abdomen, circumferential of both arms, weight=75kg fluids
needed during first 8 hours? (4XTBSAXweight) / 2 = 5400 ml
14- Confused patient, open eye to verbal command but moves arms alone. Glasgow coma scale = 13

15- A patient presented to ER after a thyroid surgery complaining of difficulty of breathing and
stridor, on examination neck hematoma detected. Next step:
a. Incision at the operating room immediately
b. Incision at bedside immediately
c. Endotracheal intubation
d. Tracheostomy

16- True in hypovolemic shock:

a. Low CVP, Low CO, high peripheral resistance

17- Question about which the classification of hemorrhagic shock regarding the findings??

18- The most reliable tool to diagnose appendicitis:

a. Abdominal US
b. CT
c. History and physical examination

19- A 10 years old child presented with anterior neck mass movable with tongue protrusion. Dx:
a. Thyroglossal cyst
b. Cystic hygroma
c. Branchial cleft cyst

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20-Superior & inferior parathyroid artery arises from:
a. Inferior thyroid artery
b. External carotid artery
c. Internal carotid artery
21- Signs of urethral injury except:
a. high riding prostate
b. Rectal bleeding
c. urethral bleeding

22- Most common cause of gross hematuria: ureteric stone

23- Which is true about testis:
a. left testis drain in IVC
b. right testis drains in renal vein
c. one of 2 choices about lymphatic drainage??

24- Old woman presented to ER, her lower limb is external rotated and shortened. this is an example of:
a. pathological fracture
25- Patient has a femur fracture complaining of cough and dyspnea. Dx: Fat embolism
26- Baseball player complaining of unilateral elbow pain at the lateral side. Dx??

27- Trauma below knee, tibia is drawn anteriorly:

a. Anterior cruciate ligament injury
b. Posterior cruciate ligament injury
c. Medial meniscus tear

28- Which part is more susceptible to necrosis after scaphoid fracture?

a. Proximal
b. Distal

29- Early signs of compartment syndrome except:

a. Paresthesia
b. Pain
c. Pulseless

30- Question about Legg calve perthes disease:

31- Woman has a genuine stress urinary incontinence. Next step:

a. Urodynamic study
b. Cytometry

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32- All are prenatal booking tests except:
a. CBC
b. Urinalysis
c. HIV
d. Hepatitis B

33- Occipitoposterior is:

a. Malposition
b. Malattitude
c. Malpresentation

34- About fetal umbilical cord physiology, all are true except:
a. It contains two arteries and two veins

35- Question about degrees of a uterine prolapse:

36- Question about cord prolapse: urgent CS
37- Question about GTN: serial B-HCG

38- Most common cause of conductive hearing loss in children: a. Foreign body??
b. Wax impaction
c. Otitis media
d. Otitis externa

39- Risk factors of otitis media except:

a. Cleft palate
b. Straight Eustachian tube
c. Breast feeding

With my best wishes

‫بالتوفيق والنجاح‬

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 2021
1. Q about Fibroadenoma:
2. Q about Interspines ligament:
3. Q about Complex ostiomeatal:
4. Q about Papillae and minor calyces:
5. Reproductive technique: ART, Gift, ZIFT, PT??
6. All of the following can cause bilateral led retraction except Horner syndrome?
7. Bilateral eye swelling except: Horner, anemia, CHF, Horner!
8. Preeclampsia with liver: tenderness, and nystagmus, cholestasis?
9. Access for child 4yo: IO with emergency
10. Difficult intubation with then sedation and LMA?
11. Appropriate K for PH 7,8 and k 2,2 what is the??
12. Complex ostiomeatal Klippel-Feil syndrome?
13. Salter Harris classification of fracture:
14. Nerve damage effect of abduction of vocal cord:
15. Cardiac tamponade with pericardiocentesis,
16. Becks triad: without kussmaul breathing
17. Electrolyte disturbance cause acute abdomen: hypokalemia
18. Triad lethal death: acidosis hypothermia, hypotension ?? coagulopathy, hypocalcemia??
19. Antibiotic with operation: all emergency, all wounds, contaminated, clear contaminated
20. Laparoscopic contraindication: all except abdominal sepsis
21. Case of fall down from elevator cause of bilateral calcaneus fracture what is the Xray want to
do hip < knee, ankle, thoracic and lumber
22. CHD in infant diagnosed by history with examination and U/S
23. We must do aspiration for which joint to avoid avascular necrosis: hip, knee, ankle, shoulder
24. All of the following true about orbital cellulitis except:
25. Q about Sclera:
26. Hyphemia: anterior chamber bleeding, due to trauma, occur in diabetic pt, all of the above
27. Hypothesis of endometriosis
28. Functional uterine bleeding, endometriosis
29. Maternal mortality 100,000 live birth

With my best wishes

‫بالتوفيق والنجاح‬

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 important questions
[Link] shortest diameter is:
a. conjugate diameter
b. diagonal diameter
c. Interspinous diameter
d. all of above

2. Per vaginal exam is contraindicated in case of:

a. Cervical cancer
b. placenta previa
c. Abruptio placenta
d. uterine rupture

3. The following cancer is not have carcinoma in situ:

a. endometrial cancer
b. ovarian cancer
c. vaginal cancer
d. cervical cancer

4. Definition of Preeclampsia:
a. systolic hypertension more than 140 mmHg and diastolic hypertension more than 90 mmHg.
b. hypertension + pedal edema
c. hypertension + proteinuria
d. hypertension + eclampsia

5. Common presentation vesicular mole is:

A. Vaginal bleeding
b. Vaginal discharge
c. LAP
d. Dyspanurea

6. The treatment of Sheehan syndrome is:

a. Estrogen
b. progesterone
c. Cortisone
d. thyroid atom

7. After evacuation of vesicular mole, it should follow

a. Radiotherapy
b. Chemotherapy
c. hysterectomy
d. contraceptive pills

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8. The most common cause of ectopic pregnancy is:

a. congenital anomalies of uterus

b. Follicular salpingitis
c. Coagulation diseases
d. salipigopalsty

9. Clinical manifestation of sever preeclampsia include all the following except:

a. liver tenderness
b. severe headache
c. Nystagmus
d. epigastric pain

10. One is true about Cord prolapse:

a. may be reality detected during screening method in 3rd trimester of pregnancy
b. when it detects by PV during labor CS must be done
c. Frank presentation is commonly dangerous type of cord prolapse
d. CS delivery is contraindicated in IUFD

11. In management of PET. one is wrong:

Answer is: ACE drugs in treatment of choice in case preeclampsia

12. Pyometria in post menopause should be considered as she may had:

a. Endometriosis
b. PID
c. Asherman syndrome
d. Malignancy

13. About DUB, one is true:

[Link] defined as irregular menstrual vaginal bleeding
b. it defined as polymenorrhea
c. usually physical examination is unremarkable
d. D&C is mainly indicated in every woman less than 40 years

14. The most common cause of recurrent abortion is

a. genetic anomalies
b. uterine anomalies
c. hormone disease
d. pelvic congestion

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15. 40 years old female has history of IUCD, has serum pregnancy positive, which of the following
is high risk to develop it?
a. recurrent abortion
b. vesicular mole
c. Ectopic pregnancy
d. congenital abnormalities

16. Which of the following is not consider as antepartum hemorrhage?

a. Abruptio placenta
b. placental previa
c. undetermined cause
d. uterine rupture

17. The most common cause of PPH is:

a. uterine atony
b. retained placenta tissue
c. Coagulopathy
d. all of above

18. One of the following is true about physiological changes in pregnancy:

a. blood volume is increased about 100 %
b. increase vascular resistance 50 %
c. leukocytosis
d. decrease plasma renal follow

19. Obstetric complication of diabetic mother is all of following except:

a. IUFD
b. PTL
c. Macrosomia
d. PPH

20. About PET, one is true:

a. sever PET may persist after delivery of fetus
b. Eclampsia may occur up to 4 weeks after delivery
c. patient with sever PET, renal function test should not perform after delivery

21. As regard the mechanism of labor, which of the following sequences is correct:
a. Descent, internal rotation, flexion
b. Engagement, flexion, descent
c. Engagement, internal rotation, descent
d. Engagement, descent, flexion

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22. Maternal mortality refers to the number of maternal deaths that occur as the result of the
reproductive process per:
a. 1000 births
b. 10.000 births
c. 100.000 births
d. 10.000 live births

23. Ovulation in the human:

a. Is associated with a surge of luteinizing hormone.
b. Is characteristically followed by the development of secretory endometrium.
c. Is associated with an increase in motility of the fallopian tube.
d. Is associated with a sustained rise in basal body temperature.
e. Is followed by a rise in urinary pregnantriol.

24. The normal Vaginal PH is

a. 7-10
b. 3-4
c. 0-3
d. 6-8

25. Myoepithelial epithelial cell contraction can be achieved by:

A. prolactin
b. oxytocin
c. progesterone
d. estrogen

26. Viral infection of the cervix one true

A. Papilloma viruses are RNA viruses.
B. Human papilloma virus (HPV) types 16 and 18 are the RNA viruses most commonly associated with cervical cancer
C. Human papilloma virus infection can regress spontaneously
D. Viral infections involving the cervical epithelium are only manifested by dyskaryosis

27. All of the following are true in regards to vulvar Paget's disease with the EXCEPTION of
A. Presents as an erythematous, eczematoid lesion of the vulva
B. Most common in postmenopausal, Caucasian women
C. Presenting complaints of pruritus and vulvar soreness
D. Pathologic extent of disease corresponds well to the visual assessment of the lesion

28. Regarding the broad ligament, the following are true except
A Contains tissues of mesonephric origin
B has the fallopian tube in its upper free border
C has the ovarian artery in its lower attached border
D. has the ureter passing forward in its lower attached border

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29. Neck US is useful for giving possible find of:
a. multiplicity
b. Lymph node status
c. differentiation between malignant and benign
d. nodular size

30. The most common complication of pelvic fracture is:

a. hemorrhage
b. pelvic pain
c. urine retention
d. rectal tenesmus

31. DVT prevention is achieved by:

a. Calf compression during surgical operation
b. Elevation of bed floor.
c. both
d. Neither
32. According to Paget disease one is true:
a. usually presents with eczematous of nipple and areola
b. its precancerous lesion
c. mostly bilateral
d. usually treatment by simple mastectomy

33. One is incorrect about breast cancer:

a. usually has history of painful breast mass
b. often presents in upper outer quadrant
c. can be detected preoperatively by experience physicians 95 %
d. surgical operation is usually is treatment of choice

34. Blood-stained nipple discharge commonly associated with

a. breast ductal cancer
b. Ductal ectasia
c. Fibroadenoma
d. intraductal papilloma

35. All of the following are true about scaphoid fracture except:
a. usually presents by mechanism of outstretched hand
b. occurs usually by young age
c. the most common sign Localized tenderness in the anatomic snuffbox
d. Avascular necrosis is rare

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36. Median nerve compression syndrome in which the patient has motor weakness of the flexor
pollicis longus and the flexor digitorum profundu’s of the index finger without alteration in
sensibility is due to:
A. Compression of the median nerve at the elbow by the lacertus fibrosus.
B. Compression of the median nerve in the axilla.
C. Compression of the anterior interosseous nerve by the arcade of Frohse.
D. Compression of the anterior interosseous nerve by an aberrant accessory forearm muscle.

37. Auto-immune thyroiditis (Hashimoto’s disease):

A. Characteristically occurs in young females.
B. Often presents with hyperthyroidism.
C. Produces a soft diffuse enlargement of the thyroid gland.
D. Is associated with regional lymph node enlargement.

38. Recurrent Fanculosis is usually indicate:

a. DNS
b. DM
c. nasal polyp

39. Concerning to intestine obstruction. one is correct:

a. The majority of case is usually treat by mean of conservative method
b. In high bowel obstruction, vomiting occurs as earlier than abdomen pain
c. multiple gases in bowel present due to bacteria proliferation in bowel
d. loss of fluid and electrolyte is mainly produced by secondary abdomen distension

40. One is correct about rectal cancer:

a. Its squamous cell cancer
b. usually spread by lymphatic spread
c. more common in male
d. usually presents as painful rectal bleeding

41. Right colon cancer usually present with:

a. Anemia
b. Rectal bleeding
c. bowel obstruction

42. Concerning to cholangitis, one is incorrect:

a. present usually with fever, pain, jaundice
b. always presents with biliary tract disease
c. most common cause CBD stone

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43. According to ureteric stone:
a. usually presents with hemispherical shape
b. if it causes colicky pain, surgery is indicated
c. Neither
b. both

44. About cholecystitis all are incorrect except:

a. US is useful method for diagnosis

45. open chest trauma:

a. immediate thoracotomy
b. associated with mediastinal flap
c. usually connected with water seal
d. none of above

46. Most common cause of rectal bleeding in young adult patient is:
a. colonic can
b. angiodysplasia
c. diverticulitis
d. hemorrhoids

47. Common picture of chronic anal fissure:

a. rectal bleeding
b. painful defecation
c. pruritic of anus
d. anal discharge

48. Anal fissure:

a. mucosal ulcer in anal mucosa
b. usually in anterior
c. more common in male
d. the best treatment by medication

49. A 44-year-old man presents with painless rectal bleeding of 1 month's duration. He reports a
history of constipation. He works in heavy labor. For this patient, which of the following
statements regarding internal hemorrhoids is true?
a. Stapled hemorrhoidectomy should be done for grade 1 and 2 hemorrhoids

b. Internal hemorrhoids are located proximal to the dentate line and therefore are usually painless

c. A grade 1 internal hemorrhoid represents bleeding with prolapse

d. All of the above

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50. A 35-year-old man presents with severe acute abdominal pain of sudden onset. The pain
initially began in the upper abdomen and has now settled in the whole abdomen. On examination,
the abdomen was rigid. Chest X-Ray showed free gas under diaphragm. Which of the following is
the most appropriate course of management for this patient?
a. Observation
b. Urgent laparotomy
c. Nonurgent laparotomy
d. Laparoscopy

51. Regarding volvulus of the sigmoid colon, each of the following is true except:
a. likely results from redundant sigmoid colon with an elongated narrow mesocolon
b. there appears to be a congenital predisposition sigmoid volvulus.
c. diagnostic barium enema for sigmoid colon is essential
d. diagnostic x-ray for sigmoid volvulus shows a dilated loop of colon which points toward the right upper quadrant.

52. Benign prostatic hypertrophy:

a. Can readily be assessed on rectal examination.
b. Can be effectively treated with hormones.
c. Is most effectively treated by surgery.
d. Is a premalignant condition.

53. In deep venous thrombosis of the lower limb:

A. One of the most common sites of origin is the short saphenous vein.
B. One of the common sites of origin is in the iliofemoral segment.
C. The diagnosis can usually be made by clinical examination.
D. Tender swollen thrombosed veins are usually palpable.

54. The following are correct of acute painful of lower limb except:
a. acute ischemia
b. muscular tear
c. fracture of bone
c. DVT

55. Which of the following not need donor investigation during transfusion:
a. plasma
b. whole blood
c. packed RBC
d. platelet

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56. Following head injuries surgical intervention is usually required for:
A. Linear skull fractures.
B. Cerebral edema.
C. Depressed skull fractures.
d. all of above

57. Extradural hematomata:

A. Are usually arterial origin.
B. Have a characteristic concave appearance on CT scan C.
usually caused by posterior branch of middle meningeal artery.
D. All of above.

58. The characteristic signs of chronically raised intracranial pressure include:

a. Papilledema.
b. Epilepsy.
c. both.
d. neither

59. Patients with major burns:

A. Are in a negative nitrogen balance.
B. Have normal calorie requirements.
C. Do not generally become anemic.
D. Are resistant to septicemia

60. The dressing of a small burn should be:

A. Occlusive.
B. Non-absorptive.
C. Non-compressive.
D. Changed daily as a routine.

61. Which of the following statement is true concerning the management of chest trauma?
A. The majority of injuries to the chest require surgical intervention
B. The posterior lateral thoracotomy is the optimal approach for emergency thoracotomy
C. Either computed tomography or angiography are suitable methods for detecting aortic disruption
in a patient with an abnormal chest x-ray.
D. Persistent bleeding associated with a penetrating injury to the chest is often due to injury to an artery
of the systemic circulation

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62. Indications for Cesarean section during laparotomy for trauma include all except?
A. Maternal shock after 28 weeks gestation
B. Unstable thoracolumbar spinal injury
C. Mechanical limitation for maternal repair
D. Maternal death if estimated gestational age is at least 28 weeks

63. In head trauma patient after control of air way, the first diagnostic study
A. X-rays of the skull.
B. CT scan of the head.
C. X-rays of cervical spine
D. Carotid angiography.

64. he diagnosis of an inguinal hernia:

a. In infants often depends on the history given by its mother.
b. In the adult is most easily made with the patient in the sitting position.
c. Depends on the hernial sac or cough impulse being felt below the inguinal ligament.
d. Is supported by the presence of a trans illuminable scrotal swelling

65. Which of the following is sever type of pneumothorax?

a. spontaneous
b. closed
c. open
d. none of above

66. Which of the following concerning the Femoral sheath is false:

A. Contains the femoral artery
B. Contains lymph nodes
C. Contains the femoral canal
D. Contains femoral nerve

67. Which of the following are common cause of child bowel obstruction?
Hirschsprung's disease

68. Which of the following is not considered with Ranson’s criteria of acute pancreatitis?
a. serum LDH more than 350
b. serum of glucose level is high than 10 mmol
c. serum amylase more than 1000
d. level of WBC more than 20000

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69. The preferred operation for initial management of a thyroid nodule that is considered
suspicious for malignancy by FNAB is:
A. Excision.
B. Partial lobectomy.
C. Total lobectomy and isthmusectomy.
d. Total thyroidectomy.

70. The most common indication for operation in Crohn's disease of the colon is:
A. Obstruction.
B. Chronic debility.
C. Bleeding.
D. Perforation.

71. A 9-month-old boy presents with an acute scrotal swelling. The following diagnoses are likely:
a. Epididymitis
b. Torsion of the testicular appendage
c. orchitis
d. Irreducible inguinal hernia

With my best wishes

‫بالتوفيق والنجاح‬

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 2022-A
1- Urogenital Sinus (embryology):
a- prostate
b- vas deferens,
c- epididymis,
d- appendix testicle
2- Hypokalemic hypochloremic metabolic alkalosis:
hypertrophic pyloric stenosis
3- All of the following true except one:
a- insulin and glucose enter k inside cells,
b- spironolactone is k sparing diuretic,
c- KCL can be given bolus without dilution

4- Most metabolic rate:

a- burns,
b- sepsis

5- Source of energy after 5 days of fasting

: muscle.
6- Sepsis: hyperkaliemia, hypoglycemia…
7- Seronegative arthropathy except:
a- crohn,
b- ulcerative colitis,
c- psoriasis,
d- gout%

8- Thyroid orbitopathy except:

a- thyroid function test,
b- clinical,
c- US,
d- CT

9- Prolactin increased:
a- suckling,
b- decreased TRH,
c- milk let-down,
d- decreased during sleep,
e- Metoclopramide

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10- Corpus Luteum in Nonpregnant secrete: LH, Progesterone
11- Release of Anterior Pituitary Hormone: GnRH

12- Surgery in jaundiced patient increased except:

a- hepatorenal syndrome,
b- poor wound healing,
c- MI
d- coagulopathy,
e- infection

13- Most Common complication of LSCS (lower segment Caesarean section): hemorrhage

14- Complication of surgery with obese pt:

a- DVT
b- PE

15- Less in CS than vaginal:

a- postpartum Depression,
b- PPH,
c- Infection,
d- Amniotic fluid embolism

16- Stored blood deficient of factor:

a-2,
b-7,
c-9,
d-11

17- Immunosuppressive allogeneic transfusion because:

a- antibodies,
b- leukocytes,

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18- Case scenario: Extradural hemorrhage
19- Traumatic pneumothorax: definitive treatment is tube
20- Central venous line insertion: pneumothorax
21- Hypertonic saline: decrease cerebral odema
22- Ankle nerve supply: femoral nerve
23- Directly from aorta : ovarian artery
24- Testicular cancer to superficial and deep inguinal LNs:
25- Ovarian cancer to para-aortic LNs
26- Gynecology cancer treated mainly by radiotherapy : ovarian
27- Ovarian mass except : always malignant if associated with ascites .
28- hysterectomy of CIN:
a- Microinvasion
b- CIN 1
c- DM
d- Fibroid without menorrhea

29- Pudendal nerve :

a- S4-S5
b- S2-S4
30- disc prolapse : ankle jerk loss
31- submandibular area except : facial artery
32- branches of facial nerve in middle ear : chordae and stapedial
33- abruptio placentae except:
a- oligohydramnios
b- polyhydramnios
c- preeclampsia

34- class C drug except :

a- aspirin
b- cyclophosphamide
c- hydroxychloroquine
d- tacrolimus
35- hypovolemic hyponatremia
a- fistula
b- SIADH
c- CHF
d- Nephrotic
e- Liver failure

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 36- Citrate: bind to oxalate
37- In sepsis, most useful indicator: high lactate 5.4, Ph 7.28.
38- Renal colic in pregnant, initial test: renal US
39- RCC (renal cell carcinoma): size, histological type, grade, stage
40- Anaerobic bacteria except: resistant to carbapenem
41- Massive transfusion: 1:1:1 PRBC: FFP: PLT
42- True for secondary PPH: can be caused by infection

43- Endometriosis:
a- Fixed retroverted uterus
b- Superficial dyspareunia
c- Infertility ttt mostly by drug

44- Pelvic fracture: pelvic binder

45- Calcaneal fracture may be associated with: lumber fracture

46- Roth spots except:

a- Leukemia
b- IDA
c- Wald Enstrom macroglobulinemia
d- Endocarditis

47- Cricothyrotomy:
a- Percutaneous
b- Not use for less than 12
c- Tube less 4

48- Abdominal compartment syndrome: bladder pressure >35

49- Pressure ulcer for pressure 60mmhg after :

a- 1 hr
b- 4 Hrs.
c- 24 hrs.

50- Papilledema except :

a- Increased blind spot
b- Decrease visual acuity
c- Diminished papillary reflex.

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51- Not congenital infection:
a- hepatitis B,
b- CMV,
c- Varicella
d- CMV,
e- Parvovirus

52- Rubella: togavirus

53- Most common cause of heart disease in pregnant: rheumatic

54- Pethidine except:

a- increased APGAR score,
b- take 10-15 min to work

55- Most common nosocomial infection: pneumonia

56- Unfractionated heparin except: unfractionated heparin causes thrombocytopenia less than LMWH

57- Largest diameter of fetal skull: mento

58- 3rd stage of labor except: soft uterus

59- 3rd stage of labor: can use uterotonics

60- Hypertension in pregnancy can’t be given ergotamine

61- Cardioprotective postoperative:

a- b blockers,
b- ACE I,
c- DIURETICS
62- Mechanism of positive pressure ventilation CPAP in OSA (Obstructive sleep apnea):
a- pharyngeal muscle

63- Esophagus anatomy: at the end slightly anterior

64- Antiseptic of skin before surgery:

65- Fever first day post abd surgery: atelectasis

66- 3 days of hospitalization then surgery, hectic fever after 1day of surgery, you must check:
a- Lungs
b- IV lines
c- UTI

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67- Removal part of patella: comminuted fracture at lower pole

68- Neck femur fracture best solution:

a- Bipolar hemiarthroplasty
b- Total arthroplasty
c- Unipolar arthroplasty

69- Nerve injury with fracture shaft of humerus: axillary, radial

70- Most Common Cause of Premature Menopause: autoimmune

71- Primary dysmenorrhea 16 yrs, initial ttt: NSAID

72- Abortion except: congenital anomaly constitutes 5%,

73- Prevent the effect of corticosteroids on wound healing:

a- Vitamin C
b- Vit A
c- Copper
d- Vit D

74- One not part of biophysical profile: gestational weight

75- All of the following are true except one: ECF 80, intracellular K 98.

76- MODS:
77- HR 115, RR 25, normotensive: grade 2 hemorrhagic shock

78- GCS 8:
a- In coma
b- Oriented
c- Max 13
d- Minimum 0

79- Myasthenia gravis except:

a- Diplopia
b- Ptosis
c- Dysphagia
d- Afferent pupillary defect

80- Blastocyst: 5 days of fertilization

81- Most common cause complication of bicornuate uterus: pregnancy loss

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82- Inhibition of prolactin:
a- Estrogen and progesterone
b- Placental lactose
c- Inhibin

83- Allergic rhinitis except:

a- Watery or mucoid discharged
b- Sneezing
c- Antrochoanal polyp
d- Pale and bluish polyp

84- TVUS (transvaginal ultrasound) Detect Intrauterine Pregnancy if: BHCG > 1500
85- Ovarian Reserve at Birth: 100000
86- Ramsay Hunt syndrome except: Spontaneous resolution
87- Amniotic fluid max 900 mL at:
88- Osteoid osteoma (case scenario):
89- Q about diathermy:

With my best wishes

‫بالتوفيق والنجاح‬

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 2022- B
1- The most important cause of DVT is:
a- Heart failure
b- Contraceptive pills
c- Previous DVT
d- Postoperative
2- Secondary hemorrhage is usually due to:
a- Trauma
b- Slipped ligature
c- Infection
d- All of the above
3- In acute respiratory alkalosis, bicarbonate:
a- Increases
b- Decreases
c- Remains constant
d- Any of the above
4- Most common cause of water toxicity is:
a- Lactogenic
b- Compulsive water intake
c- Increase ADH
d- None of the above
5- The prodromal symptoms of tetanus include all of the following except:
a- Restlessness and sleeplessness
b- Rigidity or muscular twitching in the region of the wound
c- Stiffness and licking of the jaw muscles
d- High fever
e- Excessive swelling and salivation
6- Banked blood is deficient in all of the following except:
a- Platelets
b- White cells
c- Oxygen – carrying capacity of hob
d- Potassium
e- Anti-hemophilic globulin
7- The earliest sign of hypocalcemia is:
a- Carpopedal spasms
b- Positive chvostek's sign
c- Positive trousseau's sign
d- Tingling of fingers and circumoral region
e- Defective blood coagulation

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8- Peau d'orange is due to:
a- Skin metastases
b- Lymphatic obstruction
c- Thrombophlebitis
d- Any of the above
9- The following are true regarding hypoglossal cyst except:
a- Usually presents as midline neck swelling
b- Moy be confused with ectopic thyroid
c- Best treatment is follow up
d- Should be excised completely for fear of complication
10- The most common cause of goitrous hypothyroidism in adult is:
a- Graves' disease
b- Riedel thyroiditis
c- Hashimoto's disease
d- S Thyroiditis
11- The most common site of arterial embolism:
a- Common carotid artery
b- Brachial artery
c- Femoral artery
d- Popliteal artery
12- An abdominal aortic aneurysm is most often due to:
a- Trauma
b- Syphilis
c- Bacterial endocarditis
d- Atherosclerosis
e- Marfan syndrome
13- The following statement about the mallory-weiss syndrome are true accept:
a- Is due to mucosal tear along the gastroesophageal
b- Usually results from forceful retching or vomiting
c- Is often associated with alcohol abuse
d- Requires endoscopy for the diagnosis
e- Should be treated surgically
14- Metabolic complication of subtotal gastrectomy with billroth I or billroth II reconstruction
include the following except:
a- Hypothyroidism
b- Anemia
c- Reactive hypoglycemia
d- Dumping syndrome
e- Metabolic bone disease

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15- As regard presentation of acute pancreatitis all are correct except:
a- Symptoms or more evident than sings
b- Pain usually radial to hypogastrium
c- Hematemesis and or melena occur
d- Board like rigidity of abdomen, may occur
16- Which of the following statements is/are true about benign lesions of the liver:
a- Adenomas are true neoplasms with o predisposition for complications and should usually be resected
b- Focal nodular hyperplasia (FNH) is O neoplasm related to oral contraceptive pills and usually requires resection
c- Hemangiomas are the most common benign lesions of the liver that come to the surgeon's attention
d- Nodular regenerative hyperactive hyperplasia does not usually accompany cirrhosis
17- Mackles diverticulum most commonly presents by:
a- Gastrointestinal bleeding
b- Obstruction
c- Diverticulitis
d- Intermittent abdominal pain
18- Which of the following is a precancerous in the large bowel:
a- Diverticular disease
b- Bilhoziol colitis
c- peutz-jeghers syndrome
d- Gardner's syndrome
19- Multiple anal fissures are suggestive of:
a- Anal carcinoma
b- Cohn's disease
c- T.B
d- Ulcerative colitis
e- Any of the above
20- The treatment of choice in flail chest is
a- Tracheostomy
b- Intercostal nerve block
c- Adhesive stropping
d- Elevation of broken ribs with towel clips
e- Positive pressure ventilation

21- As regard lucid interval all are correct except:

a- Is a period of recovery from coma of concussion before proceeding to coma compression
b- Cause rapid deterioration after it
c- Is a common feature in epidural hematoma
d- Usually occurs with extradural hematoma

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22- In parklands formula the initial fluid replacement in 1st day is "
a- 5% glucose
b- Normal saline
c- Ringer lactate
d- Normal saline + ringer lactate
e- Blood + normal saline guided by hematocrit value
23- Signs of strangulation intestinal obstruction includes:
a- Nasogastric suction does not relief pain
b- Rebound tenderness
c- Leukocytosis
d- All of the above
24- Keloid are characterized by the following, except:
a- Consist of dense overgrowth of scar tissue
b- Develop after wounds, burns and vaccination marks
c- Are particularly common in Negroes and pregnant females
d- Occur most often on the face, neck, and front of the chest
e- May turn malignancy
25- An asymptomatic middle-aged woman is found to have s serum sodium level of 125mEq/l
after routine laparoscopy cholecystectomy. which of the following is the most appropriate
management strategy for this patient?
a- Administration of hypertonic saline solution
b- Administration of normal saline
c- Administration of sodium chloride tablets
d- Restriction of free water
e- Diuresis with furosemide
26- Medullary thyroid cancer: with calcitonin
27- The most common indication for intubation in trauma patient: altered mental status
28- Rhabdomyolysis: acute renal failure cause by myoglobin
29- Number of stages of anesthesia: 4
30- Meconium ileus most commonly occurs in: cystic fibrosis
31- Citrate: (bind to oxalate in urine, binds to calcium in urine)
32- About femoral hernia: strangulation mostly occur
33- About fluid: newborn has a greatest proportion of total fluid
34- About pyloric stenosis: usually presented by 3-5 week
35- Thrombin activate: V, VIII, X
36- Indication for emergent thoracotomy: fall in blood pressure with stab wound to chest

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37- Hazards of diathermy include all except:
a- Capacitive coupling,
b- Arrythmia,
c- Electrocution,
d- Expulsion of gas into bowel,
e- Damage to appendages
38- A male patient, post cholecystectomy, put in fluid contain (4% dextrose and .18 saline),
which of the following is correct about this fluid?
This type of fluid is inappropriate for this patient
39- Best way to administrate fluid in trauma patient with low blood pressure:
Two large bore cannulas in IV peripheral vein
40- type of cell mediated immunity: T-Cell
41- Which of the following is true about whole blood transfusion:
The whole blood has a risk for disease transmission than every single component of blood
42- Secondary PPH: may cause by infection
43- All of the following is true about ergot derivative except:
a- Act directly om myometrium,
b- Use for induction of labor,
c- As hemostasis in PPH,
d- None of the above
44- A 45 years old woman presents to the clinic complaining of post coital bleeding. she states
that it is similar to menstruation, the most common cause for her condition is:
a- Cervical polyp
b- Cervical ectopy
c- Cervical cancer
d- Nabothian cyst of the cervix
45- The most common organism cause PID: N. gonorrhea and chlamydia
46- The most risk factors for ectopic pregnancy: female with 3 times PID
47- Strawberry cervix occur in trichomonas vaginalis
48- All of the following symptoms occur is cervical ectropion except:
Dysmenorrhea
49- The aims of the 18-22 weeks anomaly scan include all except:
a- To locate the placenta
b- To determine the chronicity of a twin pregnancy
c- Assessment of amniotic fluid volume
d- To assess spine bifida
e- To identify fetal structural defects

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50- Oligohydramnios is associated with the following except: anencephaly
51- The following are risk factors for intrauterine growth restriction:
a- Multiple pregnancy
b- Aspirin use in pregnancy
c- Ant phospholipid syndrome
d- Fetal karyotype anomalies
52- Consequences of platelet abruption include all of the following except:
a- Hypovolemic shock
b- Fetal anemia
53- The following drugs have been shown to be effective in the treatment of the of preterm labor except:
a- Atosiban
b- Labetalol
c- Nifedipine
d- Indomethacin
54- Choose the option that is less common after caesarian delivery than after vaginal delivery :
a- Pulmonary embolism
b- Postpartum hemorrhage
c- Postnatal depression
d- Amniotic fluid embolism
e- Infection
55- Contraceptive implant release: progesterone
56- Not in active management of third stage of labor: manual removal of placenta
57- Physiological changes in pregnancy:
a- all TBG,
b- total Ft4 and total Ft3 increase
58- In first visit in pregnancy: gestational age, or urine analysis
59- The safest vaccine in pregnancy: rabies
60- Indication for anti D: in motor vehicle accident in RH negative mother
61- The most alternative for amniocentesis is: CVS
62- Which of the following is presentation in pregnancy:
a- transverse,
b- oblique,
c- face,
d- none of the above
63- Layer not incised in CS: external oblique
64- Oxytocin transmitted through: nerve axon

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65- A female patient with feature of turner syndrome: 45, x
66- Best day of menstrual cycle to take for LH and FSH is: 2-4 days
67- CEA is present in about % in epithelial ovarian tumor: 80%
68- 8 cm cystic ovarian mass in first trimester most likely to:
a- Torsion
b- Rupture
c- Calcification
69- All of the following pelvic structure support vagina except:
a- Perinea body
b- Pelvic diaphragm
c- Elevator ani muscle
d- Infundibulopelvic ligament
70- The first sign of amniotic fluid embolism is: dyspnea
71- Most common indication for leiomyoma resection: heavy bleeding
72- A female patient with dysuria (burning with urination), dyspareunia (painful intercourse), and
dribbling after voiding, most likely diagnosis: urethral diverticulum
73- All of the following occur in preeclampsia except: decrease deep tendon reflex
74- A 47 years old patient with heavy menstrual bleeding with intermenstrual bleeding, hg 11,1,
US normal, next step:
a- Coagulation profile
b- Endometrial biopsy
c- FSH
75- The cause of increase cardiac output in pregnancy: increase left ventricular stroke volume index
76- All of the following using in induction of labor except:
a- Oxytocin
b- Ergot
c- Prostaglandin
d- Rupture of membrane
77- The most important prognostic factor in RCC: tumor stage
78- Urogenital sinus give rise to: prostate
79- A case of 70 years old male with painless hematuria: bladder cancer
80- Bacterial without pyuria is suggestive for: colonization
81- Best initial test for renal colic in pregnancy: renal US
82- All of the following about orbital cellulitis is true except : the eye painless and freely mobile

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83- All of the following cause bilateral eyelid swelling except: Horner syndrome

84- All of the following cause proptosis except: Horner syndrome

85- Hyphema:

a- Means blood in anterior chamber

b- Common after blunt eye trauma
c- Can happen spontaneously in the diabetic patient
d- All of the following

86- The following are transparent except:

a- Cornea
b- Sclera
c- Crystalline lens

d- Vitreous humour

87- The most important investigation for Perthes disease: MRI

88- Lachman test with: anterior cruciate ligament tear

89- The most common cause of hematogenous osteomyelitis: staph aurous

90- Rotator cuff muscle includes all of the following except: teres major

91- A case with x ray showing narrowing space and osteophyte: osteoarthritis

92- A long case with supracondylar fracture with absent pulse, next step:

emergency operation as soon as possible

93- A case of septic arthritis, next step: arthrocentesis

94- Compartment syndrome: treated by fasciotomy

95- Compartment syndrome: suggestive when pain out of proportion

96- In compartment syndrome, except: when compartment pressure equal diastolic pressure

97- Case scenario about osteoporosis hip fracture in elderly risky female after slipped

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98- All of the following are related to ostiomeatal complex (OMC) except:

a- Bulla
b- Inferior turbinate
c- Maxillary sinus
d- Middle meatus
e- Uncinate process

99- 2nd lamellar present in: ethmoidal bullae

100- Parasympathetic fiber to submandibular gland through: facial nerve

With my best wishes

‫بالتوفيق والنجاح‬

...‫عش كل لحظة كأنها آخر لحظة يف حياتك‬

... ‫عش بحبك هلل سبحانه وتعاىل‬
...‫عش بالتطبع بأخالق الرسول عليه الصالة والسالم‬
...‫ عش بالحب والكفاح‬... ‫عش باإليمان واألمل‬
‫وقدر قيمة الحياة‬

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