Wednesday, 29 January 2014

GENERAL SURGERY PART 1 MCQS

1. Tamoxifen in the treatment of breast cancer
a) 20 mg per day is as effective as higher doses
b) Treatment for longer than 5 years has been proven to be beneficial
c) Is only of benefit in patients with oestrogen receptor positive tumours
d) Doesnot reduces the risk of contralateral breast cancer 
e) Is not effective both postmenopausal women

2.Regarding Fibroadenomas all are true except;
a) Are benign monoclonal neoplasms
b) Most commonly present in late adolescence or the early 20s
c) Should be diagnosed by triple assessment
d) At least 30% reduce in size over a 2 year period
e) Can be safely managed conservatively

3. Familial adenomatous polyposis;
a) Is inherited as an autosomal recessive condition
b) Is characterised by polyp formation in late adulthood
c) Is associated with osteomas and epidermoid cysts in Gardener's Syndrome
d) Is due to a mutation on the short arm of chromosome 12
e) Can be screened for by fecal occult blood test

4. Regarding rectal cancer
a) It often arises in metaplastic polyps
b) The rectal cancer spreads mainly via blood stream
c) A cancer in the upper 1/3 of the rectum is appropriately managed by AP resection
d) Local recurrence of rectal cancer can be reduced a Total Mesorectal Excision
e) Chemotherapy is of proven benefit in Duke's A tumours

5. The following cause hypercalcaemia except:
a) Sarcoidosis
b) Primary hyperparathyroidism
c) Acute pancreatitis
d) Metastatic bronchial carcinoma
e) Milk-Alkali syndrome

6. Regarding malignant melanoma
a) The incidence is halving every 10 years
b) Superficial spreading melanoma is the commonest clinico-pathological type
c) Tumour thickness is not an important prognostic indicator
d) Regional lymphadenectomy provides survival benefit in patients with 'thick' tumours
e) Acral lentiginous tumours are usually found on the trunk and proximal limbs

7. Regarding oesophageal cancer  all are true except:
a) Squamous carcinomas predominate in the upper 2/3 of the oesophagus
b) Overall 5 year survival is greater than 50%
c) Tylosis genetically predisposes to the disease
d) 15% of adenocarcinomas are associated with Barrett's oesophagus
e) For palliation an Atkinson tube can be inserted endoscopically

8. Warfarin
a) Reduces the concentration of vitamin A dependent clotting factors
b) Has a half life of about 06 hours
c)Doesnot Crosses the placenta
d) Doses should be increased in liver disease
e) An INR of between 2.0 and 3.0 is appropriate in the treatment of DVT
9. Regarding anal fissures
a) 10% occur in the posterior midline
b) Multiple fissures suggest a diagnosis of rectal cancer
c) Only10% of acute fissures heal with the use of a bulking agent
d) Sphincterotomy has a success rate of over 90%
e) Sphincterotomy is associated with minor faecal incontinence in over 50% of patients
10. Regarding crystalloid solutions all are correct except:
a) Normal saline contains 154 mmol sodium and 154 mmol of chloride
b) 3 litres of dextrose saline in a day will provide 90 mmol of sodium
c) 2 grams of potassium chloride is equal to 57 mmol of the salt
d) Hartmann's solution contains calcium and bicarbonate
e) The daily maintenance potassium requirement of a 40 Kg woman is about 40 mmol
11. Solitary thyroid nodules
a) Are more prevalent in men
b) In the adult population more than 20% are malignant
c) More than 50% of scintigraphically cold nodules are malignant
d) The risk of a hot module being malignant is negligible
e) Should be surgically removed in all patients
12. The femoral canal
a) Lies lateral to the femoral vein
b) Has the pectineal ligament as its anterior border
c) Has the lacunar ligament as its lateral border
d) Has the inguinal ligament as its posterior border
e) Contains the lymph node of Cloquet
13. Intermittent claudication
a) Affects less than 1% of men over the age of 50 years
b) At 5 years 30% of claudicants will have progressed to an amputation
c) At 5 years 50% of claudicants will have died from ischaemic heart disease
d) Is usually associated with an ankle / brachial pressure index (ABPI) > 0.7
e) Is associated with a fall in the ABPI on exercise with delayed recovery

14. The pathology of ulcerative colitis
a) Shows full thickness inflammation
b) The rectum is almost always involved
c) 50% patients have terminal ileal disease
d) Enterocutaneous or intestinal fistulae are common
e) The serosa is usually involved

15. Infantile hypertrophic pyloric stenosis
a) Occurs with a male : female ratio of 1:1.
b) Sons of affected mothers have a 20% risk of developing the lesion
c) Invariably presents between six and eights months of age
d) Typically presents with bile stained projectile vomiting
e) Surgical treatment is by Heller's Cardiomyotomy

16. Phaeochromocytomas
a) Are neuroendocrine tumours of the adrenal cortex
b) Are malignant in 90% of cases
c) Occur as part of the MEN type I syndrome
d) Can be imaged with a meta-iodobenzylguanidine scan
e) Require only beta-blockade prior to surgery

17. Regarding Hydatid disease
a) Is due to Entamoeba histolytica
b) Man is a definitive host
c) The lung is the commonest site of infection
d) Can be diagnosed by the Casoni test
e) Is resistant to treatment by metronidazole

18. The following are features of thyrotoxicosis
a) Weight gain
b) Palpitations
c) Proximal myopathy
d) Increased skin pigmentation
e) Pretibial myxedema

19. Medullary carcinoma of the thyroid
a) Is a tumour of the follicular  cells
b) Produce thyroxine as the principle hormone
c) 10% of cases are sporadic
d) Can occur as part of the MEN type II syndrome
e) Subtotal  thyroidectomy is the surgical treatment of choice

20. The functions of a tracheostomy Includes all of the following except:
a) Bypass an upper airway obstruction
b) Decreases the anatomical dead space
c) Increase airway resistance
d) Protect against aspiration
e) Allow frequent airway suction

21. Regarding abdominal aortic aneurysms
a) They commonly  produce symptom before  they rupture
b) The risk of rupture increases with advancing age
c) Elective repair should have a 30-day mortality of less than 5%
d) Emergency repair has a 30-day mortality of less than 10%
e) The benefits of surgery for small (4.0-5.5 cm) is proven

22. Regarding colorectal carcinomas
a) About 10% present as surgical emergencies
b) Right-sided tumours often present with a change in bowel habit
c) 75% of tumours can be reached with a flexible sigmoidoscope
d) Over 20% of patients present with more than one primary tumour
e) A Duke's B tumour has nodal metastases

23. In patients with carotid artery disease
a) A bruit is a reliable sign of the degree of stenosis
b) Atheroma is most commonly seen in the external carotid artery
c) An embolic event often results in an ipsilateral hemiplegia
d) Prophylactic aspirin reduces the risk of a stroke
e) Surgery is of proven benefit in those with asymptomatic stenosis

24. Regarding acute limb ischaemia
a) Arterial occlusion has less dramatic effects in those with underling occlusive disease
b) Occurs more often in patients in sinus rhythm
c) Objective sensory loss doesnot requires urgent treatment
d) Fixed skin staining is an early sign
e) Intra-arterial thrombolysis is invariably successful with no morbidity

25. Regarding the use of laxatives
a) Ispaghula husk (e.g. Fybogel) is a bulk forming agent
b) Lactulose is a glucose polymer
c) Lactulose is hydrolysed by bacteria in the small intestine
d) Senna is a GI stimulant that acts within 30 minutes
e) Laxative abuse can lead to hyperkalaemia and colonic hypermotility

26. Regarding testicular tumours
a) They are the commonest malignancy in old men
b) Peak incidence for teratomas is seen at the age of 50 years
c) Seminomas are radiosensitive
d) Over 75% of Stage I teratomas are cured by chemotherapy
e) Chemotherapy rarely produces a cure in those with metastatic disease

27. Duct ectasia
a) If often associated with both viral and fungal infection
b) The incidence is reduced in smokers
c) May present with a green or watery nipple discharge
d) May present with nipple ulceration
e) Can be adequately treated with a microdochectomy


28. Regarding renal failure
a) Ureteric obstruction produces pre-renal renal failure
b) Pre-renal renal failure produces a high urinary sodium (>20 mmol/l)
c) Pre-renal renal failure produces a low urine osmolality
d) Non-steroidal anti-inflammatory drugs increase glomerular blood flow
e) Patients with an increased creatinine are at increased risk of postoperative renal failure

29.Regarding  Intussusception  all are true except:
a) Is most common in children from 6 to 12 years
b) Presents with colicky abdominal pain, rectal bleeding and an abdominal mass
c) 10% present with diarrhoea and vomiting suggestive of gastroenteritis
d) If no shock or peritonitis hydrostatic reduction can be attempted
e) A Meckel's diverticulum can induce an intussusception

30. Laparoscopic cholecystectomy
a) Is usually performed using a five port technique
b) The Veress needle is an 'open' technique for inducing the pneumoperitoneumc.
c) A supraumbilical abdominal scar is not a contraindication to laparoscopic    
    cholecystectomyd.
d) Dissection of Calot's triangle should be performed before the cystic duct is clipped
e) Most series report a conversion rate of over 20%

31. In obstructive jaundice
a) Urinary conjugated bilirubin is decreased
b) Serum unconjugated bilirubin is increased
c) Urinary urobilinogen is increased
d) Serum conjugated bilirubin is reduced
e) Faecal stercobilinogen is reduced

32. The following are clinical features of a large pulmonary embolism
a) Precordial chest pain
b) Haemoptysis
c) High fever
d) Bradycardia
e) Collapsed neck veins

33. Regarding the anatomy of the inguinal canal
a) The internal ring lies midway between the symphysis pubis and anterior superior iliac  spine
b) The internal ring lies medial to the inferior epigastric vessels
c) The Internal oblique aponeurosis forms the anterior boundary
d) The pectineal ligament forms the inferior boundary
e) The conjoint tendon forms the lateral part of the posterior wall

34. Regarding bladder tumours all statements are true except:
a) 90% are squamous carcinomas
b) Painless haematuria is the commonest presentation
c) Cigarette smoking is an important aetiological factor
d) 80% of tumours are superficial (i.e. no muscle invasion)
e) Superficial tumours are often well controlled by transurethral resection

35. Regarding ureteric calculi
a) Are most often composed of triple  phosphate
b) Less than 5% of those less than 5 mm in diameter pass spontaneously
c) Extracorporeal lithotripsy is useful for stones in the lower third of the ureter
d) About 30% of patients require open surgery to remove the stone
e) An obstructed ureter in the presence of infection is a surgical emergency

36. Cryptorchidism
a) Occurs in 20% of newborn boys
b) Risk of malignancy is not increased
c) Is associated with normal fertility
d) Laparoscopy is the best means of identifying an impalpable testis
e) Should be treated by orchidopexy at puberty

37. Regarding small bowel obstruction all are true except:
a)  Is most often due to an obstructed hernia
b) Causes colicky abdominal pain and vomiting
c) Abdominal distension is seen in all patients
d) All cases can be managed conservatively for the first 24 hours
e)  Rarely requires aggressive fluid resuscitation

38. Regarding bladder calculi,allare true except:
a) The incidence has fallen markedly in since the late 19th century
b) They may be totally asymptomatic
c) They are more prevalent in patients with chronic urinary sepsis
d) They are associated with squamous metaplasia of the bladder mucosa
e) They increase the risk of transitional cell carcinoma

39. Regarding gas gangrene
a) It is due to Clostridium botulinum infection
b) Clostridial species are gram-negative spore forming anaerobes
c) The clinical features are due to the release of protein endotoxin
d) Gas is invariably present in the muscle compartments
e) Anti gas gangrene serum is an essential part of treatment

40. Hodgkin's disease
a) Most commonly occurs in patients over 60 years of age
b) Usually presents as painful lymphadenopathy
c) The Pel-Epstein fever is a characteristic feature
d) Stage III disease is confined to one side of the diaphragm
e) Langhan`s giant cells are a diagnostic feature

41. The following are clinical features of Horner's syndrome
a) Miosis
b) Failure of abduction of the orbit
c) Proptosis
d) Increased sweating on the contralateral side of the forehead
e) Exophthalmos

42. Haemorrhage of over one litre will produce all of the followings except:
a) A reduction in renal blood flow
b) A decrease in platelet count
c) A fall in arterial pH
d) Increased fibrinolysis
e) A fall in body temperature

43.  Metastatic calcification is seen in
a) Hyperparathyroidism
b) Amyloidosis
c) Fat necrosis
d) Atheroma
e) Tuberculosis

Q44. Treatment of Choice for gastric varices is
a) Sclerotherapy
b) Band Ligation
c) Transjugular Intrahepatic Portosystemic Shunt
d) Application of cyanoacrylate glue
e) Shunt Surgery

45.  Best Investigation for diagnosing gastrojejunocolic fistula after Billroth II surgery is
a)  Barium Meal
b)  Barium swallow
c)  Barium Enema
d)  Colonoscopy
e)    CT Scan
46. All are precancerous for carcinoma colon except
a. crohn's disease
b. Bile acids
c. Fats
d. Carotene
e) Ulcerative colitis
47. Which of the following has the weakest association with Hepatocellular Carcinoma  
       (HCC)
a) Hepatitis B
b) Hepatitis C
c) oral contraceptives
d) Smoking
e)Aflatoxin
Q48.  Which is the most common cause of Hemobilia
a) Blunt Trauma Abdomen
b) Iatrogenic injury
c) Cholelithiasis
d) Hepatic artery aneyrysm
e) Cholangiocarcinoma
49. Which of the following is the least common position of appendix?
a) Retroileal
b) Retroceacal
c) Postileal
d) Pelvic
e)Paracecal
50. Most Common malignancy of appendix is?
a) Carcinoid Tumor
b) Adenocarcinoma
c) Squmaous Cell carcinoma
d) MIxed Cellularity
e)Lymphoma
51. What is not true as a differential diagnosis for appendicits in the elderly
a) Adenocarcinoma appendix
b) Diverticulitis
c) Pyelonephritis
d) Colitis
e)Ureteric colic
52. Most Common Cause of death in early acute Pancreatitis is
a) Renal Failure
b) Cardiac failure
c) Respiratory Failure
d) Uncontrolled Coagulopathy
e) Sepsis
53. All of the following have been used in management of  Acute Pancreatitis except
 a) Interleukin-10
 b_Gabexate
 c) Somatostatin
 d) Peritoneal dialysis
 e) Lexipafant
54. Nealon's classification is used for
   a)  Acute pancreatitis
   b) chronic pancreatitis
   c) pseudocyst pancreas
   d) alcoholic pancreatitis
   e) necrotising pancreatitis
55. Most common site for Carcinoma Pancreas is
a) Head
b) Body
c) Tail
d) Diffuse
e)Uncinate process
56. Endoscopic stone extraction from CBD is not possible  in all except?
a) Multiple CBD stones
b) Intrahepatic stones
c) Multiple Gallstones
d) Prior Gastrectomy
e)Duodenal diverticula
57. What is the management of choledochal cyst adherent to portal vein?
a) Excision and Roux en y hepaticojejunostomy
b)Internal drainage into roux en y jejunal limb
c) Hepatic lobectomy
d) The internal lining of the cyst can be excised, leaving the external portion of the cyst   wall intact.
e) Marsupialization
58. The most common cystic disease of the spleen is
a) Hydatic cyst of spleen
b) Pseudo cyst of the spleen
c) Columnar lined cyst of spleen
d) Cystic lymphangioma
e) Dermoid cyst
59. OPSI is commonest in splenectomy done for
a) Thalassemia
b) Trauma
c) Hereditary Spherocytosis
d) ITP
e) Sickle cell disease
60. Which of the following is not true regarding wandering spleen?
a) The spleen is attached to a long vascular pedicle without the usual mesenteric  
     attachments.
b) Torsion and infarction of the spleen are common complications
c) There is congenital atresia of the dorsal mesogastrium in children
d) Splenectomy is required in all cases
e) May present as acute abdomen
61. Treatment for bleeding duodenal diverticulum is
a) Diverticulectomy
b) Diverticulopexy
c) Diverticulization
d) Subtotal diverticulectomy
e) Gastro-jejunostomy
62. Which of the following does not appear to cause early dumping
a) Serotonin
b) Bradykinin
c) Neurotensin
d) Secretin
e)Enteroglucagon
63. Which is false for GIST (Gastro intestinal stromal tumor)  of stomach
a) It is the same as leiomyoma and leomyosarcoma as described previously.
b) origin is from mucosa from the interstitial cells of Cajal
c) Associated with C-Kit Mutation
d) Imatinab is a new effective drug for adjuvant therapy
e)Detection of KIT protein distiguishes GIST from smooth muscle tumors
64. Most important investigation for Dysphagia in 60 year old is
a) Upper GI Endoscopy                 
b) CT Thorax
c) Barium meal X-ray 
d) MRI Scan
e) Laproscopy 
65. Maximum potassium concentration is seen in
a)            Saliva
b)            Gastric secretions
c)            Jejunum
d)            Bile
e)            Colon                                            
66. Which of the following muscles do not form the posterior relation of breast?
a) Pectoralis major
b) Serratus Anterior
c) Rectus Abdominis
d) Lattismus Dorsi
e) Pectoralis minor
67. Minimum number of lymph nodes to be dissected in Axillary sampling in brest     conservation surgery is
a) 2
b) 3
c) 4
d) 5
e) 10
68. Which of the following is a contraindication for breast conserving surgery (BCT)?
a) Small lump to breast ratio
b) Central breast tumor mass
c) Breast Tumor size less than 5 cm
d) Young age
e) Old age
69. Which of the following is not an indication for admission in a case of burns
a) Full thickness burns more than 5% of total body surface area (TBSA)
b) Partial thickness burns more than 10% in adults
c) Partial thickness burns more than 10% in children
d) Inhalationsl burns
e) Electrical burns
70. Which is the site for escharotomies in extremities for deep burns?
a) Anterior aspect
b) Posterior Aspect of the limb
c) Medial or lateral aspect of limb
d) It can be anywhere
e)None of the above
71. The most common Vein to be involved in Extrahepatic portal hypertension in chronic pancreatitis is
a) Portal vein
b) Splenic vein
c) Superior mesenteric vein
d) Inferior mesenteric vein
e) Inferior vena cava
72. Which one is a definite urgent indication of thoracotomy:
a)Bilateral hemothorax
b)Tension pneumothorax containing more than 1.5 litres of air
c)Flail chest with more than 10 ribs fracture
d)Ahemothorax draining more than 200ml per hour
e)All of the above
73. Which one of the following is false regarding hernias:
a) Inguinal hernia is superomedial to pubic tubercle
b) Femoral hernia is inferolateral to pubic tubercle
c) Men are more likely to have inguinal hernia than females
d) Men are more likely to have femoral hernia than females
e) Inguinal hernia are more common in females
74. A lesion typically found on legs in diabetics
a) Erythema nodosum
b) Necrobiosis lipoidica
c) Erythema  ab igne
d) Pyoderma gangrenosum
e) Erythema multiforme
75. Which one of the following is incorrect regarding ulcerative colitis?
a) Smoking is protective
b) Predominantly involves large bowel
c) Can present with erythema nodosum
d) A COBBLE –STONE appearance is seen on colonoscopy
e) Acute episodes are treated by i/v steroids and azothiaprine
76.  Which ONE of the following is NOT an absorbable suture?
a) Catgut
b) polyglyconate
c) PDS (Polydioxanone)
d) Silk
e) Vicryl (Polyglactins.
77. Adequate minimum urine output in a 70kg man during resuscitation is
a)            35 ml/hr
b)         20 ml/hr
c)            50 ml/hr
d)            45 ml /hr
e)            60 ml/hr
78. Which of the following is true for basal cell carcinoma?
a)            metastases to lymph node is rare
b)            common at non-sun exposed area
c)            UV light is not a cause
d)            morpheous type is easily treated
e)            treatment of choice is radiotherapy
79.  A 28 year old lady complains of painful defecation associated with fresh per-rectal bleed. Possible diagnosis to consider:
a)            hiradenitis suppurativa
b)            dermoid cyst
c)            pilonidal sinus
d)            anal fissure
e)            pruritis ani
80. Haemorrhoids
a)            are commonly believed to be venous malformation
b)            require surgical excision if small and symptomatic
c)            commonly present with painful bleeding and perianal swelling
d)            may undergo malignant metaplasia in those with chronic prolapse
e)            pruritis ani
81. The Thyroid gland:
a)         Is derived from the third and fourth pharyngeal pouches
b)         Isthmus overlies the 5th and 6th tracheal rings normally
c)         Embryologically, descends along the thyroglossal tract
d)         Is supplied by the superior thyroid branch of the internal carotid artery
e)         Is supplied by the inferior thyroid branch of the external carotid artery
82. A nodule in the thyroid gland:
a)         May be a presentation of multinodular goitre
b)         Is unlikely to be a cyst if painful
c)         Should not be investigated with needle cytology
d)         Usually requires excision
e)         Will require radio-isotope scanning to help distinguish between a benign and a malignant nodule.
83. A multinodular goitre:
a)         Is more common in patients who are iodine deficient
b)         Is not preceded by a diffuse goitre in early adult life
c)         Often becomes neoplastic
d)         May be effectively treated with thyroid hormone
e)         Always needs surgical treatment
84. Autoimmune thyroiditis (Hashimoto’s disease):
a)         Characteristically occurs in young females
b)         Always presents with hyperthyroidism
c)         Produces a nodular enlargement of the thyroid gland
d)         Is associated with regional lymph node enlargement
e)         Is associated with raised serum levels of thyroid antibodies
85. Thyroid cancer:
a)         Frequently produces multinodular enlargement of the gland
b)         May well be diagnosed by thyroid scan
c)         Causes a hard nodule in the gland
d)         Often produces a bruit over the gland
e)         Should be suspected if there is vocal cord palsy
86. Papillary carcinoma of the thyroid:
a)         May follow radiation exposure in childhood
b)         Is a rapidly-growing tumour
c)         Doesnot metastasizes to lymph nodes
d)         Is often a localized tumour
e)         Is rarely cured by surgery
87. Follicular carcinoma of the thyroid:
a)         Is more common in males
b)         Is more common below the age of 30 years
c)         Usually metastasizes to lymph nodes
d)         Is associated with a relatively good prognosis in old age
e)         Is best treated by total thyroidectomy
88. Undifferentiated (anaplastic) carcinoma of the thyroid:
a)         Is more common in females
b)         Is less common above the age of 60 years
c)         Is often thyroid stimulating hormone (TSH) dependent
d)         Often exhibits independent thyroid hormone production
e)         Is usually preceded by a long-standing goitre
89. The surgical treatment of differentiated thyroid cancer:
a)Should be by total thyroidectomy in the potentially curable patient
b)Should include a frozen section histological examination of the tumour
c)Should include block dissection of the neighbouring lymph nodes whetheror not they appear to contain tumour
d)Is most successful in anaplastic cancer
e)Should be preceded by a therapeutic dose of I131
90. Recurrent thyroid cancer can effectively be treated by all except:
a)         High doses of I131
b)         High doses of thyroid hormone
c)         External irradiation
d)         Chemotherapy
e)         Further surgery
91. Which of the following is not true for Hashimoto thyroiditis?
a)         It is an autoimmune disease caused by CD4 cells with specificity to thyroid antigens
b)         commonly presents as hypothyroidism
c)         Surgery is required in almost all cases
d)         Hashimoto thyroiditis can progress to lymphoma of thyroid
e)         Primary treatment is thyroxine
92. In which of the following conditions anti thyroid antibody may not be elevated?
a)         Hashimoto thyroiditis
b)         Grave's disease
c)         Multinodular goitre
d)         Lymphoma of thyroid
e)         None of the above
93. What is the most common composition of renal stones?
a)         Uric acid stones
b)         struvite
c)         calcium oxalate
d)         Magnesium
e)         Xanthine
94. The most common cause of stone formation is?
a)    metabolic abnormalities
b)    urological abnormalities
c)    infection
d)    Immobilization
e)    Vitamin A deficiency

95. In the ED what is a value for defining hematuria?
a)    Any RBCs/hpf
b)    2 RBCs/hpf
c)    4 RBCs/hpf
d)    5 RBCs/hpf
e)    10RBCs/hpf
96. In the treatment of a 3 year old boy with a UTI,  the strongest indication for admission?
a)         Localized myalgias
b)         Maculopapular rash
c)         Marked fever
d)         Mucoid Diarrhea
e)         Persistent Vomiting
97. Which of the following statements regarding imaging techniques for evaluation of
      suspected kidney stones is correct?
a)         CT scanning poses risk of nephrotoxic contrast
b)         CT scanning provides little data about the adjacent intrabdominal structures
c)         Intravenous pyelogram is highly sensitive but does not provide information on renal function
d)         Plain radiography is highly specific
e)         Ultrasonography is the preferred modality for pregnant pts but might not identify stones smaller than 5mm
98. A 13 year old boy is brought to the ER for sudden onset of groin pain. On
      examination his right testicle is swollen, raised, and tender. Which of the following   
     statements regarding this pts condition is correct?
a)         CT of the affected are is the imaging study of choice
b)         Duplex ultrasonography provides little useful anatomic information
c)         Positive creamasteric reflex confirms the diagnosis
d)         Relief of pain with elevation reliably differentiates this condition from  
            epididymitis
e)         The bell clapper deformity predisposes pts to this condition
99. What is the most common symptom of localized prostate ca.?
a)         Hematuria
b)         Urinary sx’s -- frequency,nocturia
c)         Bony pain
d)         No symptoms
e)         Retention of urine
100.Which one is an absolute contraindication of suprapubic catheterization:
a)         Lower urinary tract infection
b)         Cancer of urinary bladder
c)         Bladder calculi
d)         Interstitial cystitis


e)         Palpable urinary bladder

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