MCQ

Dr:- Ashraf .I. Obaid

1.
2.
3.
4.

Which?
The most common -------is
Regarding
All of the following are true about neurogenic
shock except:
5. The following --------------------- except :
6. Heparin
7. Which of the following is false:

Which hypersensitivity reaction is associated with a tuberculin reaction?

1.Type I: immediate
2.Type II: cytotoxic
3.Type III: immune complex
4.Type IV: cell mediated
The most common location for a gastric ulcer is
1. Fundus
2. Greater curvature
3. Cardia
4. Body
5. Antrum
1.Regarding the management of major trauma
1.Deaths follow a trimodal distribution
2.Cardiac tamponade is characterised by raised BP, low
JVP and muffled heart sounds
3. Assessment of uncomplicated limb fractures should
occur during the primary survey
4. Deterioration of the casualty during the primary survey
should lead to the secondary survey
5.All are false

Which hypersensitivity reaction is associated with a tuberculin reaction?

1.Type I: immediate
2.Type II: cytotoxic
3.Type III: immune complex
4.Type IV: cell mediated
The most common location for a gastric ulcer is
1. Fundus
2. Greater curvature
3. Cardia
4. Body
5. Antrum
1.Regarding the management of major trauma
1.Deaths follow a trimodal distribution
2.Cardiac tamponade is characterised by raised BP, low
JVP and muffled heart sounds
3. Assessment of uncomplicated limb fractures should
occur during the primary survey
4. Deterioration of the casualty during the primary survey
should lead to the secondary survey
5.All are false

All of the following are true about neurogenic shock except:

a. There is a decrease in systemic vascular resistance and an increase in
venous capacitance.
b. Tachycardia or bradycardia may be observed, along with hypotension.
c. The use of an alpha agonist such as phenylephrine is the mainstay of
treatment.
d. Severe head injury, spinal cord injury, and high spinal anesthesia may
all cause neurogenic shock.
The following cause hypercalcaemia except :
a. Sarcoidosis
b. Primary hyperparathyroidism
c. Acute pancreatitis
d. Metastatic bronchial carcinoma
e. Milk-Alkali syndrome
For a 40-kg baby the maintenance daily fluid requirement is approximately
which of the following?
a. 1100 ml
b. 1250 ml
c. 1550 ml
d. 1700 ml
e. 2000 ml

All of the following are true about neurogenic shock except:

a. There is a decrease in systemic vascular resistance and an increase in
venous capacitance.
b. Tachycardia or bradycardia may be observed, along with hypotension.
c. The use of an alpha agonist such as phenylephrine is the mainstay of
treatment.
d. Severe head injury, spinal cord injury, and high spinal anesthesia may
all cause neurogenic shock.
The following cause hypercalcaemia except :
a. Sarcoidosis
b. Primary hyperparathyroidism
c. Acute pancreatitis
d. Metastatic bronchial carcinoma
e. Milk-Alkali syndrome
For a 40-kg baby the maintenance daily fluid requirement is approximately
which of the following?
a. 1100 ml
b. 1250 ml
c. 1550 ml
d. 1700 ml
e. 2000 ml

. Infantile hypertrophic pyloric stenosis

a. Occurs with a male: female ratio of 4:1.
b. Presents between six and eight months of age
c. Typically presents with bile stained projectile vomiting
d. Surgical treatment is by Heller's Cardiomyotomy
e. all are false
. Which of the following do you consider to be the most important clinical sign
in acute appendicitis,
a. Abdominal tenderness around the umbilicus
b. Abdominal tenderness in the RIF
c. Tenderness over McBurneys point
d. Rovsings sign positive
e. Suprapubic tenderness
Heparin
a. Acts as an anti-platelet
b. Acts as an anti-thromboplastin
c. Acts as an antithrombin
d. All of the above
e. None of the above

. Infantile hypertrophic pyloric stenosis

a. Occurs with a male: female ratio of 4:1.
b. Presents between six and eight months of age
c. Typically presents with bile stained projectile vomiting
d. Surgical treatment is by Heller's Cardiomyotomy
e. all are false
. Which of the following do you consider to be the most important clinical sign
in acute appendicitis,
a. Abdominal tenderness around the umbilicus
b. Abdominal tenderness in the RIF
c. Tenderness over McBurneys point
d. Rovsings sign positive
e. Suprapubic tenderness
Heparin
a. Acts as an anti-platelet
b. Acts as an anti-thromboplastin
c. Acts as an antithrombin
d. All of the above
e. None of the above

10. All of the following are mechanisms of urinary calculi formation except,
a. Hypoparathyroidism
b. Prolonged recumbency
c. Infection with urea-splitting organisms
d. Foreign body
e. Urinary tract obstruction
11. Which of the following are not found in peritonitis?
a. Patient is lying still
b. Guarding
c. Rebound tenderness
d. Hyperactive bowel sounds
e. Rigid abdomen
12-Which one of the following suggest a diagnosis of Hirschsprung's disease?
a. A contrast-study showing dilatation of the aganglionic bowel
segment.
b. Early presentation with vomiting.
c. Neonatal large bowel obstruction.
d. Presentation after 1 year of age.
e. Red current jelly stools.

10. All of the following are mechanisms of urinary calculi formation except,
a. Hypoparathyroidism
b. Prolonged recumbency
c. Infection with urea-splitting organisms
d. Foreign body
e. Urinary tract obstruction
11. Which of the following are not found in peritonitis?
a. Patient is lying still
b. Guarding
c. Rebound tenderness
d. Hyperactive bowel sounds
e. Rigid abdomen
12-Which one of the following suggest a diagnosis of Hirschsprung's disease?
a. A contrast-study showing dilatation of the aganglionic bowel
segment.
b. Early presentation with vomiting.
c. Neonatal large bowel obstruction.
d. Presentation after 1 year of age.
e. Red current jelly stools.

A.The aortic valve is tricuspid.

B.The ascending aorta is entirely outside the pericardial sac.
C.The left atrial appendage is identified readily by transthoracic
echocardiography.
D.The pulmonary trunk lies anterior to the ascending aorta.
E.The right atrium is posterior to the left atrium.
14-Which of the following is true concerning Scaphoid fractures?
A.Rarely occur in young adults
B.when complicated by avascular necrosis the proximal pole is usually
affected
C.should be treated by bone grafting and internal fixation even if
undisplaced
D.wrist fractures are uncommon
E.anteriorposterior and lateral radiographs reveal most fractures
15-Which of the following statements is true of upper limb nerve injuries?
A.Injury to the median nerve results in a wrist drop
B.Injury to the radial nerve results in loss of sensation over the palmar
aspect of the index finger
C.Injury to the median nerve results in loss of sensation in the anatomical
snuffbox
D.Injury to the ulnar nerve results in a claw hand
E.Injury to the ulnar nerve results in loss of sensation over the thumb

A.The aortic valve is tricuspid.

B.The ascending aorta is entirely outside the pericardial sac.
C.The left atrial appendage is identified readily by transthoracic
echocardiography.
D.The pulmonary trunk lies anterior to the ascending aorta.
E.The right atrium is posterior to the left atrium.
14-Which of the following is true concerning Scaphoid fractures?
A.Rarely occur in young adults
B.when complicated by avascular necrosis the proximal pole is usually
affected
C.should be treated by bone grafting and internal fixation even if
undisplaced
D.wrist fractures are uncommon
E.anteriorposterior and lateral radiographs reveal most fractures
15-Which of the following statements is true of upper limb nerve injuries?
A.Injury to the median nerve results in a wrist drop
B.Injury to the radial nerve results in loss of sensation over the palmar
aspect of the index finger
C.Injury to the median nerve results in loss of sensation in the anatomical
snuffbox
D.Injury to the ulnar nerve results in a claw hand
E.Injury to the ulnar nerve results in loss of sensation over the thumb

16- Regarding intravenous solutions:

a. Normal saline contains 180mmol/l of sodium
b. Ringer's lactate solutions is designed for intracellular fluid
replacement
c. Sodium bicarbonate 8.4% is a hyperosmolar solution
d. Normal saline with added potassium is appropriate therapy to
correct a respiratory alkalosis
e. All are True
17-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
e. Contains the femoral vein
18-The following is true of the spleen:
a. Is the largest lymphoid organ in the body
b. Lies obliquely between the seventh and tenth rib
c. The lower pole extends beyond the mid-axillary line
d. Is usually palpable when normal
e. Usually measures 16cm in maximum length when healthy

16- Regarding intravenous solutions:

a. Normal saline contains 180mmol/l of sodium
b. Ringer's lactate solutions is designed for intracellular fluid
replacement
c. Sodium bicarbonate 8.4% is a hyperosmolar solution
d. Normal saline with added potassium is appropriate therapy to
correct a respiratory alkalosis
e. All are True
17-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
e. Contains the femoral vein
18-The following is true of the spleen:
a. Is the largest lymphoid organ in the body
b. Lies obliquely between the seventh and tenth rib
c. The lower pole extends beyond the mid-axillary line
d. Is usually palpable when normal
e. Usually measures 16cm in maximum length when healthy

19-Breast cancer risk is increased in association with the following factors

except:
a. Nulliparity
b. Immediately after pregnancy
c. Early menarche
d. Early age at first pregnancy
e. Late menopause
20-In 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
21- The most common hernia in females is:
a. Femoral hernia.
b. Direct inguinal hernia.
c. Indirect inguinal hernia.
d. Obturator hernia.
e. Umbilical hernia.

19-Breast cancer risk is increased in association with the following factors

except:
a. Nulliparity
b. Immediately after pregnancy
c. Early menarche
d. Early age at first pregnancy
e. Late menopause
20-In 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
21- The most common hernia in females is:
a. Femoral hernia.
b. Direct inguinal hernia.
c. Indirect inguinal hernia.
d. Obturator hernia.
e. Umbilical hernia.

22-. The most helpful diagnostic radiographic procedure in small bowel

obstruction is:
a. CT of the abdomen.
b. Contrast study of the intestine.
c. Supine and erect x-rays of the abdomen.
d. Ultrasonography of the abdomen.
e. MRI Abdomen
23- In role of nine extent of burn if entire trunk is burned it will be equal to:
a. 9% body surface area.
b. 18% body surface area.
c. 36% body surface area.
d. 27% body surface area.
e. 45% body surface area.
24-. If torsion of the testicle is suspected, surgical exploration:
Can be delayed 24 hours and limited to the affected side.
Can be delayed but should include the asymptomatic side.
Should be immediate and limited to the affected side.
Should be immediate and include the asymptomatic side.

22-. The most helpful diagnostic radiographic procedure in small bowel

obstruction is:
a. CT of the abdomen.
b. Contrast study of the intestine.
c. Supine and erect x-rays of the abdomen.
d. Ultrasonography of the abdomen.
e. MRI Abdomen
23- In role of nine extent of burn if entire trunk is burned it will be equal to:
a. 9% body surface area.
b. 18% body surface area.
c. 36% body surface area.
d. 27% body surface area.
e. 45% body surface area.
24-. If torsion of the testicle is suspected, surgical exploration:
Can be delayed 24 hours and limited to the affected side.
Can be delayed but should include the asymptomatic side.
Should be immediate and limited to the affected side.
Should be immediate and include the asymptomatic side.

25- Hyperthyroidism can be caused by all of the following except:

a. Graves' disease.
b. Plummer's disease.
c. Struma ovarii.
d. Hashimoto's disease.
e. Medullary carcinoma of the thyroid.
26- A 9 month old boy presents with an acute scrotal swelling. The following
diagnoses are likely:
a. Epididymitis
b. Orchitis
c. Torsion of the testicular appendage
d. Irreducible inguinal hernia
e. Acute idiopathic scrotal oedema
27. The evaluation of a comatose patient with a head injury begins with:
a.The cardiovascular system.
b. Pupillary reflexes.
c. Establishment of an airway.
d. Computed tomography (CT) of the brain
e .insertion of Intravenous canula

25- Hyperthyroidism can be caused by all of the following except:

a. Graves' disease.
b. Plummer's disease.
c. Struma ovarii.
d. Hashimoto's disease.
e. Medullary carcinoma of the thyroid.
26- A 9 month old boy presents with an acute scrotal swelling. The following
diagnoses are likely:
a. Epididymitis
b. Orchitis
c. Torsion of the testicular appendage
d. Irreducible inguinal hernia
e. Acute idiopathic scrotal oedema
27. The evaluation of a comatose patient with a head injury begins with:
a.The cardiovascular system.
b. Pupillary reflexes.
c. Establishment of an airway.
d. Computed tomography (CT) of the brain
e .insertion of Intravenous canula

28. The following is an indication for thoracotomy in chest injury,

a. Cardiac tamponade
b. Uncontrolled pulmonary air leakage
c. Perforation of thoracic esophagus
d. Blood loss of 200ml/hr for 2-3 hrs via chest tube
e. All of the above
29. Regarding Gallstones all of the following are true except:a. Prevalence increases with advancing age
b. 30% of gallstones are radio-opaque
c. Cholesterol stones result from a change in solubility of bile
constituents
d. Biliary infection, stasis and changes in gallbladder function
can precipitate stone formation
e. Gram-negative organisms are the most common isolated
30.In obstructive jaundice:
a. Urinary conjugated bilirubin is increased
b. Serum unconjugated bilirubin is increased
c. Urinary urobilinogen increased
d. Serum conjugated bilirubin is reduced
e. Faecal stercobilinogen is increased

28. The following is an indication for thoracotomy in chest injury,

a. Cardiac tamponade
b. Uncontrolled pulmonary air leakage
c. Perforation of thoracic esophagus
d. Blood loss of 200ml/hr for 2-3 hrs via chest tube
e. All of the above
29. Regarding Gallstones all of the following are true except:a. Prevalence increases with advancing age
b. 30% of gallstones are radio-opaque
c. Cholesterol stones result from a change in solubility of bile
constituents
d. Biliary infection, stasis and changes in gallbladder function
can precipitate stone formation
e. Gram-negative organisms are the most common isolated
30.In obstructive jaundice:
a. Urinary conjugated bilirubin is increased
b. Serum unconjugated bilirubin is increased
c. Urinary urobilinogen increased
d. Serum conjugated bilirubin is reduced
e. Faecal stercobilinogen is increased