Pediatric Surgery Samplex

1. Ectopic testis maybe located: B. When there is abdominal distention

A. Proximal to the internal ring C. In the right lower quadrant
B. At the external ring D. In the presence of peritonitis
C. Along the inguinal canal
D. At the supera-pubic area 11. In the event that the hypertrophied pylorus can not be palpated,
ultrasound is performed to look for
2. Surgical correction of Malrotation includes the followhng, EXCEPT: A. ‘string sign’
A. Straightening of the duodeno-jejunal junction B. Visible gastric waves on the abdominal wall
B. Fixation of the cecum to the right lower quadrant of the C. Pyloric canel length or =/>1.6 cm and muscle thickness of =/>
abdomen 0.4 cm
C. Release of the Ladd’s bands D. Delayed gastric emptying time
D. Widening of the mesenteric pedicle
12. The reason behind Malrotation is
3. The reason for acid base imbalance in persistent non-bilious A. Rapid increase of the midgut in-utero
vomiting is B. Non-rotation of the duodeno-jejunal and ileo-cecal
A. Increase loss of bicarbonate junctions
B. Loss of HCL C. Evisceration of the midgut out of the coelornic cavity
C. Renal absorption of Hydrogen ion D. Non-rotation of the superior mesenteric vessels
D. Increase plasma potassium
13. A pathognornonic finding in hypertrophic pyloric stenosis is
4. Persistent non-bilious vomiting may occur in A. palpable epigastric olive-shaped mass
A. Duodenal atresia B. Elongated pyloric canal in ulteosound
B. Jejunal atresia C. UGIS “string sign”
C. Ileal atresia D. X- roy “single bubble”
D. Colonic atresia
14. In a newborn that has bilious vomiting but no abdominal distention,
5. Barium enema in a newborn with persistent bilious vomiting and the scout film of the abdomen will probably reveal
abdominal enlargement will reveal any of the following, EXCEPT: A. “single bubble sign”
A. High-lying cecum B. Step-ladder appearance
B. Microcolon C. “double bobble sign”
C. Contracted rectum and distended sigmoid D. Multiple air – fluid level
D. Small left colon
15. The most number of gonglion cells con be found in this plexus
6. Orchidopexy will prevent the following complications, EXCEPT A. Henle’s
A. Infertility B. Solar
B. Trauma C. Meissner’s
C. Torsion D. Auerbach’s
D. Malignancy
16. The usual profile of a baby with intussusception
7. The reasons for the characteristic bloody discharge in A. Beyond 1 year of age
intussusception include the following, EXCEPT B. Solar
A. Drawing in of the mesentery into the intussuscipions C. Healthy-looking
B. Obturator hernia D. Youngest of the siblings
C. Perforation of the bowel
D. Congestion of the intussuscipions 17. An enlarged painless scrotum without an inguinal bulge is least
8. A reducible bulge on the grain of a female child is probably likely:
A. Obturator hernia A. Intrauterine testicular torsion
B. Femoral hernia B. Testicular tumor
C. Indirect inguinal hernia C. Indirect inguinal gernia
D. Direct inguinal hernia D. Hydrocoele

9. The standard surgical correction of Hypertrophic pyloric stenosis is 18. Rectal ganglion cells are most abundant in the area between
A. Pyloric canal dilation A. Submucoma and basement membrane
B. Gastro-duodenal bypass B. Serosa and longitudinal muscle
C. Pyloric resection with gastro-duodenal anastomosis C. Mucosa and submucosa
D. Incision of the sero-muscular layer of the pylorus D. Longitudinal and circular muscles

10. Sausage-shaped mass in Intussusception will be appreciated 19. Persistent non-bilious vomiting may result in
A. Early in the course of the disease A. Hypochloremic hyperkalemic metabolic alkalosis
 B. Hyperchloremic hyperkalemic metabolic acidosis D. Manual reduction without sedation
C. Hyperchloremic hypokalemic metabolic acidosis 29. Treatment of choice for intussusception with abdominal tenderness
D. Hypochloremic hypokalemic metabolic alkalosis and guarding
A. Pneumatic reduction
20. A baby with no anal opening will not develop abdominal distention B. Saline reduction
if he has the following EXCEPT C. Barium reduction
A. Esophageal atresia D. Manual operative reduction
B. Duodenal atresia
C. Ileal atresia 30. Management of inguinal hernia in children
D. Malrotation A. Repair of the inguinal floor
21. Barium enema in a boby with persistent bilious vomiting but without B. Repair of the internal ring
abdominal distention will reveal C. High ligation of the sac
A. High-lying cecum D. All
B. Microcolon
C. Transition zone 31. Abdominal distention with bilious vomiting is found in
D. Saumtooth appearance A. Incarcented inguinal
22. A body with persistent bilious vomiting without abdominal B. Malrotation
distention has C. Annular pancreas
A. Ileal atresia D. Duodenal atresia
B. Hypertrophic pyloric stenosis
C. Malrotation 32. Upper GI series findings in Malrotation EXCEPT
D. Hirschsprung’s disease A. Presence of barium in the stomach after 24 hours
B. Cecum is located in the epigastric area
23. Trans-anal rectal biopsy is performed at C. Plind poush at the duodenum
A. Posterior rectal wall D. Duodeno-jejunal junction lies on the right side
B. Lateral rectal wall
C. The dentate line 33. Gastroesophageal reflus in the newborn
D. 2 cm distal to the dentate line A. Is pathologic
B. Persists beyond infancy
24. Clinical presentations of Hypertrophic pyloric stenosis include C. Is less common in neurologically impaired babies
A. Vomiting starts immediately after birth D. Is responsive to positioning and formuia changes
B. Palpable oliver-shaped mass in the presence of gastric
dilatation 34. Aganglionesis is found in the
C. Vomitus in bilious A. Dilated segment of bowel
D. Usually malnourished B. Contracted segment of bowel
C. Proximal transition zone
25. True of cryptorchidism D. Proximal to the dilated bowel
A. Orchidopexy is recommended at 2 years of age and
younger 35. The form of duodenal atresia with incomplete obstraction
B. Testis is present at birth, then subsequently disappears A. Intra-luminal membrane with small perforation
C. Testis can be manunlly manipulated down into the scrotum B. Cord-like structure between the two duodenal segments
D. Has equal density and size as that of the normal testis C. Complete discontinuity
D. “Windsock” deformity
26. In a neonate with persistent bilious vomiting without abdominal
distention, the expected radiologic finding is 36. Early connection of erypambidism minimizes these complications
• “Coiled-spring appearance” EXCEPT
• “Cork-screw” • Infertility
• Appearance “String sign” • Torsion
• “Dance’s sign” • Malignancy
• Trauma
27. Hydrocoele, in contrast with inguinal hernia
• Is reducible 37. Expected radiologic finding in Hypertrophic pyloric stenosis,
• Requires an operation regardless of age EXCEPT
• Has different etiology • Pyloric canal length of =/> 1.6 cm and muscle thickness of =/> 0A
• Does not have an inguinal bulge 츠
• Presence of barium in the stomach after 24 hours
28. Initial treatment of incarcerated hernia without peritonitis • “String sign”
A. Emergency operation • “Single babble sign”
B. Sedation
C. Observation 38. An indirect inguinal hernia should be
 • Operated once diagnosed
• Observed during infancy
• Diagnosed with ultrasound
• Manage with repair of the inguinal floor

39. The pathophysiology of duodenal atresia is

• Intra-uterine vascular accident
• Non-union of foregut and midgut
• Failure of intraiuminal vacuolization
• Abnormal rotation of the duodeno-jejunal junction

40. Bloody stool and vomiting is compatible with

• Amoebiasis
• Meckel’a diverticulum
• Strangulated inguinal hernia
• Rectal polyp

41-50 A. Omphalocoele B. Gastroschisis C. Both D. None

of above
___B_41. Intestinal atresia
___D_42. Malrotation
___A_43. Trisomy
___A_44. underdeveloped abdominal cavity
___A_45. Beckwith-Wideman Syndrome
___A_46. Pentalogy of Cantrell
___A_47. Cloacal extrophy
___D 48. Bowel perforation
___B_49. Erythematous, edematous bowels
___C_50. Liver evisceration