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A 50 year old alcoholic has been having recurrent showed a 5cm solitary complex mass on spleen and
and frequent abdominal pain. He was diagnosed to was diagnosed to be a splenic abscess. Appropriate
have chronic pancreatitis and has a sclerotic duct treatment will be
and enlarged pancreatic head. The surgical A. Broad spectrum antibiotics
treatment of choice will be B. Percutaneous drainage of the complex mass
A. Duodenum preserving pancreatic head resection plus broad spectrum antibiotics
B. Puestow’s pancreaticojejenostomy C. Broad spectrum antibiotics plus splenectomy
C. Total pancreatectomy D. Exploratory laparotomy and drainage of the
D. 95% pancreatectomy abscess

2. A patient with chronic pancreatitis has been 7. A 34 year old female has history of melena,
complaining of abdominal fullness and had epistaxis, easy bruisability and ecchymosis, the
difficulty eating because of post-prandial pain, ct initial diagnosis made by the attending physician is
scan showed a 4cm pseudocyst at the back of the Idiopathic Thrombocytopenic Purpura. Which of
stomach. Recommended treatment will be the following is true regarding her condition?
A. Observation and periodic abdominal ultrasound A. It is caused by overproduction of IgM which
B. External drainage coats the platelets
C. Internal drainage B. Based on her clinical manifestation, her platelet
D. NPO and TPN for 4-6 weeks count must be at least 40,000/cu.mm
C. Spontaneous resolution is common in children
3. A 60 year old man with jaundice underwent D. Spleen is enlarged and best treated by
ERCP, the result showed diluted CBD and these is splenectomy
abrupt termination of the pancreatic duct(double
duct sign).Most likely diagnosis is 8. A 5 year old boy fell from his bicycle; his spleen
A. Chronic pancreatitis ruptured and has to undergo splenectomy. Which
B. Gallstone pancreatitis of the following is true regarding his condition?
C. CA of the pancreas A. The surgery must be postponed until he
D. Acute pancreatitis becomes older
B. He will no longer be infected with malaria after
4. An alcoholic 45 year old man has an acute splenectomy
pancreatitis, he has been in the hospital for 2 C. Meningococci is the most common organism
weeks and was improving but developed with high that may infect the patient after splenectomy
grade fever, tachycardia and abdominal distention. D. He must be vaccinated at least 2 weeks after
CT scan showed retroperitoneal air. Most likely splenectomy
diagnosis is
A. Pseudocyst of the pancreas 9. Which of the following is most sensitive test for
B. Pancreatic infection chronic pancreatitis?
C. Pancreatic abscess A. Pancreatic Polypeptide after a test meal
D. Infected Pseudocyst B. Bentiromide test
5. Which of the following initiated acute D. P-amylase determination
A. Impaired production of zymogen granules 10. A non-alcoholic 50 year old woman has a
B. Impaired protein and calcium synthesis honeycombed 3 cm mass at the head of the
C. Increased extrusion rate of zymogen granules pancreas that incidentally. You will advise the
D. Fusion of lysosomes and zymogen granules following except
A. Do EUS and sampling for presence of mucin
6. A 33 year old man with history of drug addiction B. Advise Whipple’s surgery
complained of left upper quadrant pain, high grade C. Do CEA determination
fever and tachycardia. CT scan of the abdomen D. Most likely it is benign
11. Which of the following statements is true 16. In order to prevent Overwhelming Post
regarding Thalassemia? splenectomy sepsis, the best thing to do for the ..
A. Splenectomy is the primary treatment A. Give prophylactic antibiotics
B. Diagnosis is by demonstrating Hyperchromic B. Annual vaccination
Macrocytic Anemia C. Vaccination 7 days after surgery
C. Part of the treatment is using D. Preserve splenic tissue as possible
D. B-Thallassemia patients are sym
17. A 43 year old man had been having episodes of
12. The following statements are true regarding watery diarrhea of 2 years duration. This was
Sickle Cell Anemia, except accompanied by epigastric pain, feeling bloated
A. It is due to mutation of adenine to thymine of and weight loss. The proton pump inhibitor he has
the B globin gene been taking seems to have no beneficial effet. The
B. The most common indication for splenectomy is diagnostic test that is best done will be
pain due to acute sequestration crises A. Serum gastrin determination
C. There is lack of deformability of RBC B. Esophagogastroduodenoscopy
D. Splenectomy will prevent the sickling of RBC C. Secretin provocative test
D. Maximal acid output determination
13. A 50 year old has been complaining of gnawing
epigastric pain, fatigue, irritability and 18. A serum gastrin level on the patient on the
diarrhea….Proton pump inhibitor and loperamide preceding number was 200pg/ml. The next logical
but seems not to respond well. EGD showed procedure to be done is to do
multiple ulcers in the…..duodenum. Serum calcium A. Secretin provocative test
is 13 mg/dl. The initial impression is Zollinger- B. Get the ratio of BAO to MAO
Ellison Syndrome. The following ….Except: C. Esophagogastroduodenoscopy
A. Ultrasound D. Re- test serum gastrin level
C.Octreotide Scintigraphy 19. This patient was eventually diagnosed to have
D. BAO/MAO Zollinger-Ellison syndrome. You expect the ratio of
his BAO to Mao to be
14. The above case was confirmed to be Zolinger- A. <80%
Ellison syndreome with MEN 1, the primary B. >30%
treatment ……… C. >60%
A. Enucleation of the tumor D. >40%
B. Selective Vagotomy
C. Parathyroidectomy 20. The best way to locate the lesion of the patient
D. Pancrea on the preceding number before surgery is to
request for
15. A 15 year old boy was brought to the hospital A. MRI
because of vomiting and abdominal pain. 2 weeks… B. Explore the Pasaro’s triangle
from his bike, the handle bar hitting his abdomen. C. CT scan with contrast
On examination, the boy is pale looking; D. Endoscopic Utrasound with Octreotide
the…Upper quadrant and positive Kher sign. Ct Scintiscan
scan showed a 15% subcapsular hematoma on
the… tachycardic. Best management will be to : MATCHING TYPE
A. Explore-lap, evacuation of hematoma, suturing 21. Marjolins ulcer
of the laceration 22. Level 4 malignant melanoma, neg. LN
B. Observation, Blood transfusion, CT scan 23. Locally recurrent lymphatic invading melanoma
monitoring of splenic injury 24. Level 2 ( <1mm) malignant melanoma
C. Explore lap
D. Explore lap
A. excision with 1cm margin 30. A 3 year old baby girl has 2 cm hemangioma on
B. Melphalan the left lower lip that seems to be rapidly growing
C. Excision with 2cm margin + sentinel LN biopsy in skin. The…is by
D. Excision with 1cm margin + Prophylactic LN A. Excision
dissection B. Laser surgery
C. Systemic prednisone

25. A bullous lesions affecting 8% of the body 31. A 35 year old female complained of flat, dull
surface erupted on a 5 year old few days after red lesion located along the cranial nerve V….Most
taking antibiotics for streptococcal infection of the likely diagnosis is
pharynx. Most likely diagnosis is A. Cavernous hemangioma
A. Steven Johnson syndrome B. Congenital nevus
B. TEN C. A-V malformation
C. SSSS D. Capillary malformation
D. Varicella Zoster
32. Involving the papillary-reticular dermis junction.
26. Based on your diagnosis on the preceding This melanoma is
number, you expect the following except: A. Clark level 1
A. cleavage plane is on the epidermal-dermal B. Clark level 2
junction C. Cark Level 3
B. there is sloughing of the respiratory tract D. Clark level 4
C. Defect is similar to 1st degree burns
D. Intestinal malabsorption 33. Best treatment for the melanoma discussed in
the preceding number is
27. Accepted treatment for the bullous lesion on A. Excision with 2cm margin + sentinel LN
the preceding cases are the ff. except dissection
A. Biologic dressing B. Excision with 1cm margin + sentinel LN
B. Correct fluid and electrolyte deficit dissection
C. Discontinue the antibiotic C. Excision with 3cm margin
D. Must continue the antibiotic to contain the D. Excision with 4cm margin + elective LN
bacteria dissection

28. A 65 year old patient presents with painless 1.5 34. A 23 year old female had an Open Reduction
cm ulcerating lesion on her right cheek. The lesion and Internal Fixation (ORIF) of an open fracture.
has been pres…. P.E. revealed no lymph node. The Incision site remained fresh x-ray of the involved
most likely diagnosis is limb showed osteomyositis. Most likely diagnosis is
A. pyogenic granuloma A. Hypertrophic scar
B. Melanoma B. Squamous cell carcinoma
C. Basal cell carcinoma C. Basal cell carcinoma
D. Squamous cell carcinoma
35. The best treatment for the above problem is
29. The standard treatment for ulcerating lesion of A. Excision with 1cm margin + prophylactic LN
the 65 year old patient mentioned on the dissection
preceding number is B. Excision with 4mm margin + LN dissection
A. excision with 2mm margin C. Excision with 1cm margin
B. MOH’s surgery D. Excision of the scar + intradermal injection of
C. Electrodessication Triamcinolone
D. Excision with 1cm margin
36. A 1 year old baby has an enlarging soft 42. A 29 year old presents with a 24-hour history of
compressible papular mass on the right abdominal pain and anorexia. He initially
cheek…birth. Most likely diagnosis is described… states the pain is severe in his right
A. Capillary Hemangioma lower quadrant. He is febrile and has a leukocytosis
B. Port wine stain with.. reveals tenderness of the right lower
C. Cavernous Hemangioma quadrant and guarding. The patient is taken to the
operating room… with the working diagnosis of
37. The best treatment of the above lesion is appendicitis. On laparoscopic evaluation, the
A. Systemic injection of prednisone appendix was normal… significantly inflamed.
B. Observation Which of the following is the most appropriate next
C. Excision step?
A. Schedule for laparotomy and Ileocecectomy
38. A 50 year old female has been complaining of B. Schedule for laparotomy and Right
stabbing pain on the pulp of her… nodule located Hemicolectomy
on subungal region of her right index finger. Most C. Schedule appendectomy
likely diagnosis is D. terminate the procedure and perform interval
A. Acra Lentiginous melanoma appendectomy in 6 weeks
B. Glomus Tumor E. Laparoscopic drain placement without
C. Benign appendectomy

39. A 5 year old boy with Pneumonia developed a 43. Which of the following is true about acute
necrotic lesion with thick..after being injected with appendicitis?
3rd gen cephalosphorin thru the IV fluids. The injury A. Impacted fecalith almost always lead to acute
is appendicitis
A. The antibiotic injected prevents the release of B. There is a predominance of gram (-) aerobes in
cytokines and growth factor an inlamed appendix
B. Pressure effect on closed space C. The most diagnostic of the classic PE signs is the
(+)Rovsing’s sign
40. A 10 year old boy was bitten by a stray dog on D. CT scan play a major role in the diagnosis of
his right leg. The wound is acute appendicitis in elderly
A. Copious irrigation, debridement, suturing and E. none
B. Copious irrigation, debridement and skin grafting 44. Administration of prophylactic antibiotics in
and antibiotics acute appendicitis is indicated towards which of
C. Copious irrigation, debridement, healing by the…
secondary intention and A. Prevent intraperitoneal infection
D. Copious irrigation, debridement, antibiotics and B. Prevent surgical site infection
suturing after 4-5 C. Prevent gangrene formation
D. Prevent perforation
41. Which of the following statements regarding E. Prevent sepsis
the anatomic location of the appendix is true?
A. The base of the appendix can always be found at 45. Considered to be a constant finding in adult
the continue of the ca.. patients with acute appendicitis
B. In the majority of the cases, this tip of the A. anorexia
appendix is found in the pelvis B. Nausea and vomiting
C. The appendix is often retrocecal and C. Mucosal guarding
extraperitoneal D. (+) Rovsing’s sign
D. The position of the tip of the appendix in
appendicitis does not determine the symptoms of 46. A 21 year old female was admitted because of
the.. right iliac pain of 12 hours duration. PE: abdom…
RLQ and hypogastric area. Rectal exam A. 24 hours
unremarkable. What is the appropriate initial B. 24- 48 hours
approach? C. 3-5 days
A. CT scan D. 7-10 days
B. Initiate antibiotics E. 10-14 days
C. Plain abdominal film
D. Pregnancy test 53. A 25 y/o female complains of severe pain in her
central lower abdomen of 4 hours… of thirst. Gyne
47. The lifetime risk of appendicitis in females: hx: LMP cannot be recalled with alleged
A. 10% contraceptives use. She is…fever. Her abdomen
B. 15% was marked and rebound tenderness. Some
C. 20% discoloration was…dx?
D. 25% A. Early appendicitis
E. 30% B. Ectopic pregnancy
C. Mittleschermz
48. In patients with ruptured appendicitis, the best
antibiotic combination is: 54. A 28 y/o female complains of sudden onset of
A. 1st gen cephalosphorin + metronidazole severe right sided abdominal pain and apparently
B. 2nd gen cephalosphorin + metronidazole cannot find a comfortable position to get relief
C. 3rd gen cephalosphorin + metronidazole from the pain. She has tenderness on the right side
D. 4th gen cephalosphorin + metronidazole of the abdomen with rigidity but no rebound. The
A. Acute AP
49. Which of the following statements regarding B. Acute Pyelonephritis
the clinicall course of appendicitis, is/are C. Penorated PUD
A. The typical history is one of vague abdominal
pain, followed by periumbilical pain 55. A 20 y/o female complains of sudden pain in
B. Nausea and vomiting usually precede the pain the pelvis and right iliac fossa…have normal
C. Gross hematuria and proteinuria are quite menses and her last mens was 15 days ago. She
common sometimes… The most likely diagnosis is…
D. Most patients……… A. Early appendicitis
E. A&B only B. Ectopic Pregnancy
C. Mittleschermz
50. A 35 y/o male consulted due to abdominal pain 56. The most common complication of acute
for the past 24 hours. Abdominal PE shows… appendicitis:
Rebound tenderness with muscle guarding at the A. Colo- cutaneous fistula
RLQ. CBC/ Urinalysis is normal. The… B. Liver Abscess
A. Schedule for immediate surgery C. Pyelophlebitis
B. Reevaluate abdomen after 4hours D.
C. Plain abdominal scout film
D. Repeat CBC/ Urinalysis after 4 hours 57. Special populations of people that may have
delayed diagnosis of
51. Differential diagnosis of acute appendicitis A. Very young patients
includes the following, except: B. Elderly Patients
A. Perforated peptic ulcers C. Patients with HIV infection
B. Meckel’s diverticulitis
C. PID 58. Which of the following modalities has the
D. highest sensitivity rate in the…
A. Abdominal scout film
52. Recommended duration of antibiotic coverage B. Oxaded compression USG
in non- perforated appendicitis: C. Enterocly..
63. True regarding clinical manifestations of
59. A 33 y/o female on her 3 trimester of peritonitis, EXCEPT:
pregnancy came- in with right…fever of 12 hours A. Expansion of intravascular volume by rapid
duration. The pain started with vague abdominal infusion of intravenous fluid (IVF) can augment
dis…examination there is very well localized cardiac…
tenderness of palpitation and… normal. CBC show B. As pulmonary edema progresses, protein rich
only mild leukocytosis . Urine and other fluid accumulates in the alveoli
investigation… C. Thrombocytopenia is peritonitis commonly
A. Conservative management is the option of occurs and suggests that disseminated
choice because 3rd… intravascular coagu…
B. Antacids should be given to rule out acid- peptic D. Initial bowel response in peritonitis is a
disease initial… transient hypermotility
C. Immediate appendectomy should be performed E. Peritonitis acts as a stimulus to many endocrine
otherwise co… organs
D. Diagnosis of acute appendicitis is highly unlikely
since pain… 64. True regarding the diagnosis of acute intra
E. Acute pyelitis of pregnancy and torsion of an abdominal infection, EXCEPT:
ovarian cyst.. diagnosis in pregnancy A. Radiologic picture mimics that if paralytic ileus
B. CT scan is required in the initial work- up of
60. Atypical presentation and difficulty of diagnosis acute peritonitis
is seen in… C. CT scan and ultrasound are very helpful in the
A. Pelvic diagnosis of intra abdominal abscess
B. Postileal D. Leukocyte count of >25, 000 or leucopenia of
C. Retrocecal <4000/mL3 are both associated with high mortality
D. Retroileal E. Air beneath the diaphragm may be noted on
chest x-ray if patient remains in an upright
61. Which of the following is / are TRUE regarding position..film is made
intra- abdominal abscess and peritonitis
A. Host defense mechanism continue anastomic 65. Spontaneous bacterial peritonitis, EXCEPT:
leakage to form an abscess A. Monomicrobial infection
B. A fistula forms when an abscess ruptures into B. More common in adults than in children
another hollow viscus C. Peritoneal tap is the most useful diagnostic test
C. If an abscess perforates in free peritoneal cavity, D. Diarrhea is usually seen in neonates
diffuse peritonitis results E. When the diagnosis is confirmed immediate
D. In peritonitis, the focus is sepsis is within the surgical intervention should be done
peritoneal cavity
E. All of the above 66. Tertiary peritonitis
A. Failure if autoregulation of normally activated
62. True regarding the peritoneal cavity, EXCEPT: host defense
A. The peritoneum is formed by a single layer of B. Autoagressive devastation of organ system
mesothelial cells functions
B. Peritoneal fluid has the same properties if lymph C. Clinical picture of sepsis without the presence of
C. Peritoneal fluid is secreted everywhere by the a focus of infection
peritoneal serosa D. On operation, no pathogens are present or only
D. Diaphragmatic motion, negative intrathoracic microorganisms of low- grade pathogenicity
pressure and positive intra-abdominal pressure E. All of the above
promotes peritoneal fluid and particles
E. The patency of diaphragmatic stomata may be 67. Intra- abdominal abscess:
altered by the respiratory cycle. A. May be seen with primary peritonitis
B. May be seen with secondary peritonitis
C. Better prognosis than diffuse peritonitis A. Poor patient condition preludes definitive
D. Abdominal CT is the most efficient diagnosis closure
E. All of the above B. Source of infection is not eliminated or
68. True regarding the management if intra- C. Uncontrolled hemorrhage managed by packing
abdominal abscess, EXCEPT: D. ALL?
A. Treatment of suspected intra- abdominal
abscess by antibiotic therapy without drainage 73. Which of the ff. statements about perforation
B. In later stages of an abscess, most antibiotics are peritonitis is NOT true:
ineffective A. Perforation from peptic ulcer presents acutely,
C. Percutaneous needle aspiration and closed that the patients…perforation occurred
catheter drainage is preferred to operative d… B. Typhoid perforation is usually seen in the first
D. Crystalloid solutions are the mainstay of fluid week of infection
volume resuscitation C. Carcinoma of the colon, if the ileocecal valve is
E. After percutaneous or open drainage of an competen… rupture of the cecum as ascending
abscess, the drains are left in place until… colon
D. In ruptured appendicitis, there is usually sudden
69. Which of the following is NOT an indication for deterioration in clinical status when diffuse…
open surgical drainage: E. Liver abscess can perforate and cause diffuse
A. Inability to safely drain percutaneously peritonitis
B. Presence of a pancreatic or carcinomatous
abscess 74. Earliest sign of peritonitis related to peritoneal
C. Association with a bowel fistula dialysis
D. Unilocular fluid collection A. Fever
B. Abdominal pain
70. True regarding the use if antibiotics in the C. Cloudy dialysis efficient
management if intra- abdominal abscess… D. Positive blood culture
A. It should e initiated before the percutaneuos or
operative drainage 75. Which of the following concerning peritoneal
B. IT should be guided by sensitivity studies response to injury is NOT TRUE:
obtained from previous intra-operative… treatment A. Non absorbed fibrin is invaded by fibroblasts
of antecedent abdominal infection between 5-10 days after injury, resulting to fibrous
C. It should always include the use if metronidazole B. Denuded peritoneum heals slowly over a course
or another drug with anti… if 5-7 days
D. It should continue until drains remain in place C. Adhesions form when peritoneal healing is
delayed or incomplete
71. Which of the following statements regarding D. With time, fibrous adhesions can become
open surgical drainage is/are TRUE: attenuated and may disappear
A. The presence of multiple, isolated, interloop E. Peritoneal healing occurs by ingrowth of
abscesses is an indication for… mesothelial cells from the edges of the defect
B. It is essential to obtain specimens of the abscess
content No. 76- 80 MATCHING TYPE: Match the types of
C. Abscess cavity should be thoroughly explored PERITONITIS with their corresponding clinical.
digitally and all loculations..residual space. A. Peritonitis following pancreatitis
D. Exploration & open drainage is undertaken B. Post- operative peritonitis
whenever the presence of CT & US. C. Perforation peritonitis
E. All of the above? D. Spontaneous primary peritonitis
E. Tuberculous peritonitis
72. Which of the following conditions would
indicate a staged abdominal repair?
E. 76. Stalavtite-like fibrinous messes hang from D. In distal small bowel obstruction, repetitive
parietal peritoneum on laparaoscopy vomiting does not prevent the…
E. Free peritoneal fluid in the peritoneal cavity
D. 77. Adult patients with ascites implies perforation of bowel.
B. 78. Anastomotic leakage 85. Radiographic finding of moderate gaseous
distention of entire small and large….
A. 79. Increased amylase or lipase in serum or urine A. Colonic obstruction with competent ileocecal
C. 80. Most common form of acute intra-abdominal B. Paracolic ileus
infection C. Complete small bowel obstruction
D. Partial small…
MULTIPLE CHOICE: E. Normal abdom….
81. Physical exam findings of a patient with
mechanical bowel obstruction, EXCEPT: 86. Which of the following abdominal signs will
A. Fever and Tachycardia most likely be positive in a patient…
B. Dehydration A. Carnett sign
C. Oliguria B. Forthergill sign
D. Completely silent abdomen is suggestive of C. Kistner Sign
paralytic ileus D. A & B only
E. Systemic sepsis or toxemia suggest presence of
gangrenous bowel 87. Coffee- bean sign on abdominal x-ray:
A. Fecal impaction
82. Which of the following will NOT cause B. Carcinoma of the colon
constipation: C. Ogilvie’s syndrome
A. Improper toilet training during childhood D.none?
B. Diet of highly refined foods
C. Weak abdominal muscles 88. Which of the following statements concerning
D. High fiber diet the diagnosis of the acute…
A. The patient with generalized peritonitis lies
83. Which of the following statements about motionless
gastrointestinal bleeding is INCORRECT: B. The abdomen becomes distended only in
A. Hematemesis may occur as a result of any patients with infracted b…
significant bleeding occurring at a… C. Corticosteroids do not affect the diagnosis of
B. Melena may persist for as long as 5 days after a acute abdominal distention…
significant gastrointestinal bleeding… D. Patients with paralytic ileus often have an area
C. Hematocrit is a reliable indicator of the degree of localized tenderness
of hemorrhage early in the setti… E. All of the above
D. Coffee ground vomitous is due to the gastric acid
effect on the blood that may 89. A 60 year old male patient develops sudden,
E. Azotemia often accompanied bleeding from severe, excruciating…
esophageal varices. A. Myocardial Infarction
B. Acute Appendicitis C. Perforated peptic ulcer
84. TRUE regarding abdominal distention in C. Perforated peptic ulcer
intestinal obstruction: D. Ruptured abdominal aneurysm
A. Gaseous distention if primarily from bacterial gas
production 90. The following statements concern the
B. The fluid component of abdominal distention is differential diagnosis of a…
from fluid sequestration with… A. A patient with acute abdominal pain persisting
C. Free peritoneal fluid seen in intestinal for more than
obstruction contributes significantly
B. The most reliable physical finding in acute B. It may be associated with malignancy
appendicitis.. C. It is a potential side effect of some drugs
C. Appendectomy is well- tolerated during D. It is mediated through the spinal reflexes
pregnancy E. It may be associated with inflammatory
D. Mesenteric adenitis may mimic acute abdominal pathology
appendicitis in child
E. When visceral pain becomes superseded by ***96. You were on duty at the ED when a 26 y/o
somatic pain female patient came in. She is at the midpoint of
her menstrual cycle and…. Has right lower
91. CASE: A 45 y/o woman had an apparently quadrant pain and tenderness, fever 39 degrees
uncomplicated… is 38.8 degrees Celsius, and her PR Celsius and two episodes of vomiting. WBC count:
is 110. The most likely cause is : 12500/mm3. Most likely diagnosis:
A. Urinary tract infection A. Acute appendicitis
B. Cholangitis B. Ruptured graafian follicle?
C. Wound infection C. Acute gastroenteritis
D. Pelvic inflammatory disease?
92. Concerning ileus, the following statements are E. Acute mesenteric lymphadenitis
true, EXCEPT:
A. Excessive surgical manipulation can cause ileus 97. The most frequent cause of upper
B. The stomach is the earliest to recover from … gastrointestinal bleeding is:
SMALL BOWEL DAPAT A. Esophageal varices
C. Oglivie’s syndrome is a form of adynamic ileus B. Gastritis
D. Small bowel obstruction and ileus can have sin… C. Angimata
E. Adynamic ileus is the most common type of il.. D. Peptic ulcer disease
E. Mallory- Weiss disease
93. All of the following findings seen in early
mechanical small bowel obstruction, EXCEPT: 98. The following statements are true regarding
A. Crampy abdominal pain that waxes and… strangulating obstruction, EXCEPT:
B. Abdominal distention A. A strangulating obstruction can progress to
C. Paucity or absence of colonic gas on abdominal infarction and gangrene in as little as 6 hours
plain films B. Ischemic bowel becomes edematous and infarcts
D. Absence of bowel sounds leading to gangrene and perforation
E. Hypovolemia C. Venous obstruction occurs first followed by
arterial occlusion
94. CASE: A 45 y/o woman comes to the ED D. Vovulus can cause strangulating obstruction
complaining of nausea and vomiting and absence E. Strangulation is more common in large bowel
of flatus or stool. She had a C-Section through a obstruction than in small bowel obstruction
low midline incision about 7 years ago. Which of
the following is the most likely causes of her 99. The localization of pain to the right lower
problem: quadrant, which often occurs in individuals who
A. Hernia have acute appendicitis is… of:
B. Adhesion A. Inflammation of parietal peritoneum
C. Tumor B. Distention of appendix
D. Congenital bands C. Vascular engorgement
E. Intra- abdominal abscess D. Perforation of appendix
E. Bowel infarction
95. The following statements concerning anorexia
are true, EXCEPT: 100. Murphy’s sign:
A. It precedes the onset of pain in acute A. The development of acute cholecystitis when
appendicitis the patient is least able to tolerate it
B. Right upper quadrant pain while the surgeon is
palpating and the patient is inspiring
C. Resistance to passive dorsiflexion of the foot
D. Arrest of inspiration while the surgeon is
palpating the right upper quadrant
E. A nontender palpable gallbladder

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