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226 Cards in this Set

  • Front
  • Back
1. Select the correct statements regarding an open incisional hernia repair:
A Incisional hernias cannot develop after laparoscopic procedures
B The contents of the hernia sac must always be checked for signs of infarction
C Hernia repair with strong sutures yields equal results as the tension-free techniques
D During the Lichtenstein operation the mesh is fixed to the rectus sheath
(B)
2. The keloid:
A is less prevalent in blacks
B is an agglomeration of fibrous tissue
C has a tendency for malignant transformation
D is sensitive to antibiotic therapy
E develops in clean wounds
(B)
3. From the following famous physicians who was NOT a surgeon?
A Theodor Billroth
B Theodor Kocher
C Ignác Semmelweis
D William Halsted
E János Balassa
(C)
4. From the following options which is the most appropriate definition of tetanus?
A A medical condition characterized by a prolonged relaxation of smooth muscle fibers
B A medical condition characterized by a prolonged contraction of smooth muscle fibers
C A medical condition characterized by a prolonged contraction of skeletal muscle fibers
D A medical condition characterized by a prolonged relaxation of skeletal muscle fibers
(C)
5. Pilonidal sinuses frequently develop in:
A young adult males
B young adult females
C middle-aged patients
D elderly patients
(A)
6. Paronychia of the finger is best treated by which of the following types of incisions?

A Halfway between the unguicular margin and the pulp of the finger
B At a considerable distance from the distal unguicular margin
C Any incision that ensures adequate drainage from the phalanx
D A "J-shaped" incision at a 3 mm distance from the distal unguicular margin
E A wide "fishmouth" shaped incision
(D)
7. Bone metastases rarely develop at which of the following sites?
A Long bones
B Bones distal to the knee or elbow
C Skull
D Vertebrae
E Pelvis
(B)
8. In the case of clean, closed wounds, the most common source of a Staphylococcus
infection is:
A the ambient air of the operating theatre
B bedside instruments
C dust
D bedclothes
E bacterial flora of the patient or hospital personnel
(E)
9. The most efficient method for the prevention of a wound infection after the operation
of a perforated appendicitis:
A sprinkling the wound with sulphonamide powder
B drainage of the peritoneal cavity
C flushing the wound with antibiotic solutions
D rinsing the subcutaneous tissues with disinfectant solution
E none of the above
(D)
10. Mild infections of the hand can progress to potentially severe infections like:
A the skin of the hand is a particularly heavily contaminated area of the body
B the hand often sustains injury when it is infected
C there are numerous tendons with a poor blood supply and the maintenance of any
required immobilization is difficult
(C)
11. The commonly occurring paronychia of the fingers is caused by:
A frequent injury to the delicate skin of the fingers
B extremely heavy contamination of the skin of the hand
C excessive use and exposure of the hand and fingers during work
(A)
12. Which of the following diseases can be most likely transmitted by a blood transfusion?

A Serum hepatitis
B Lymphoblastic leukemia
C Myeloblastic leukemia
D Erythrocytosis
E Hodgkin's lymphoma
(A)
13. Among all the severe complications of blood transfusions, the most common problem
is:
A hemolytic reactions
B disease transmission
C circulatory overload
D hypokalemia
E alkalosis
(A)
14. The most common indication for renal transplantation is:
A hydronephrosis
B end-stage glomerulonephritis or pyelonephritis
C renal tuberculosis
D Wilms' tumor
E "staghorn stones"
(B)
15. The immunosuppressive drug that has vastly improved the results of organ
transplantation is:
A azathioprine (Imuran)
B pyrmidine derivatives
C corticosteroids
D cyclosporine A
E actinomycin D
(D)
16. What is the cause of a hyperacute rejection reaction ensuing after renal
transplantation?
A Circulating antibodies
B Increased cellular immunity
C Poor tissue perfusion
D Hematoma in the abdomen
E Intravascular antirenin deposition
(A)
17. Which one of the following options stands for a laparoscopic hernia repair surgery?

A TAP and TEPP
B TAPP and TEP
C Onlay or sublay eversion technique
D Lichtenstein and Shouldice operation
(B)
18. Which of the following facilitates collagen deposition during the process of wound
healing?
A Epithelial cells
B Endothelial cells
C Fibroblasts
D Capillary network
E None of the above
(C)
19. Case Study: A 23-year-old girl developed shaking chills, high-grade fever, and chest
pain after obtaining a 75 ml blood transfusion. Select the most likely cause of these
symptoms:
A a hemolytic transfusion reaction
B a pyrogenic reaction
C an infected blood product
D the presence of cold agglutinins
E citrate toxicity
(A)
20. All of the following factors contribute to the disruption of abdominal surgical wounds,
EXCEPT:
A surgical site infection
B frequent coughing
C hypoproteinemia
D anemia
E early mobilization
(E)
21. Generalized (diffuse) bleeding following surgical procedures may result from all of the
following, EXCEPT:
A a massive transfusion
B an undiagnosed coagulopathy
C sepsis
D insufficient closure of the wound
E fibrinolysis or defibrination
(D)
22. Indications for a liver transplantation in humans include all of the following,
EXCEPT:
A congenital biliary atresia
B primary neoplasms confined to the liver
C advanced liver cirrhosis
D biliary cirrhosis
E acute liver damage
(C)
23. Which of the following microorganisms is considered the pathogen of the
pseudomembranous colitis associated with antibiotic therapy?
A Bacteroides fragilis
B Staphylococcus species
C Clostridium perfringens
D Clostridium difficile
E Clostridium tertium
(D)
24. Which of the following statements is/are true for hernias in general?
A Femoral hernias are more common in males than in females
B The indirect inguinal hernia is the most common hernia in males
C Mesh implantation has no benefit in direct inguinal hernia
D Risk of incarceration is higher in hernias with a large orifice
(B)
25. Which of the following statements is true for Hesselbach’s triangle? )
A Defines the boundaries of a low lumbar hernia
B Defines the inguinal floor in the region of a direct inguinal hernia
C Is found in a single plane of the inguinal floor and is bounded by the superior
epigastric artery, inguinal ligament, and rectus sheath
D Is bounded medially by the inferior epigastric vessels
(B
26. What is the typical rate of recurrence after a Lichtenstein inguinal hernia repair?
A Under 2%
B Between 2-5%
C Between 5-10%
D Above 10%
(A)
27. When do we speak of Grade III hemorrhoids?
A The hemorrhoids do not prolapse
B The hemorrhoids prolapse upon defecation but spontaneously reduce
C The hemorrhoids prolapse upon defecation and must be reduced manually
D The hemorrhoids are prolapsed and cannot be manually reduced
(C)
28. Characteristics of the medieval medicine and surgery in Europe:
A Clerical blessing on autopsies
B High social status of surgeons
C Surgery practiced by barber surgeons
D Treatment was based on anatomical and physiological knowledge
(C)
29. From the following options which is characteristic to modern age surgery?
A Lack of general anesthesia limits the feasibility of major abdominal interventions
B Generally low degree of specialization
C Limited use of related resources (imaging techniques, laboratory tests, endoscopy)
D Research oriented, evidence based development of surgery
(D)
30. Which of the following operations CANNOT be used in the treatment of an inguinal
hernia?
A Bassini operation
B Shouldice operation
C Lichtenstein operation
D Mayo operation
E TAPP (transabdominal pre-peritoneal hernia repair)
(D)
197. Regarding papillary thyroid carcinoma, which of the following statements is
FALSE?
A The presence of resectable lymph node metastases does not appear to worsen
prognosis
B Papillary cancer is characterized by frequent hematogenous metastases
C It is the type of thyroid cancer most often associated with prior radiation exposure
D There is a high likelihood of occult multicentric disease
(B)
198. Select the correct answer:
A Phaeochromocytoma is almost always malignant
B Phaeochromocytoma is a disease of the adrenal cortex
C Approximately 10% of all phaeochromocytomae is extra-adrenal
D Phaeochromocytoma can lead to severe and abrupt hypotensive episodes
(C)
199. From the following options which is true for breast cancer?
A The incidence of early-stage breast cancer is decreasing since the establishment of a
nation-wide screening program
B DCIS/LCIS can eventually turn into invasive breast cancer
C The standard operation for a T1N0 breast cancer is mastectomy with axillary lymph
node dissection
D Radical surgery is indicated in most of the cases even in the presence of multiple
distant metastases
(B)
200. Which is NOT an indication of parathyreoid surgery from the following
options?
A Progressive reduction in bone density
B Hypercalcaemia in patients younger than 50 years
C Significantly reduced excretion of calcium in the urine
D Suspicion of malignant parathyroid disease
E Symptomatic hypercalcaemia in all age groups
(C)
201. Which is the most frequent sign of breast cancer?
A Palpable mass
B Cyclic pain
C Skin ulceration
D Pathologic fractures
(A)
202. Which anatomic structure is the most prone to injury during a thyroid surgery?
A Hypoglossal nerve
B Thyroid cartilage
C Recurrent laryngeal nerve
D Esophagus
(C)
203. Which is NOT a typical sign of Cushing’s syndrome?
A Round “moon face”
B Central (truncal) obesity
C Muscle weakness
D Purple striae
E Hypotension
(E)
204. All of the following are associated with the formation of aneurysms of the
descending aorta, EXCEPT:
A Marfan's syndrome
B injury
C syphilis
D atherosclerosis
(B)
205. The most severe complication of an abdominal aorta aneurysm is:
A rupture
B aortic valve insufficiency
C colon perforation
D compression of the urether
E compression of the portal vein
(A)
206. What is the most common cause of dissecting aneurysms of the thoracic aorta?

A Tricuspidal valve insufficiency
B Syphilis
C Degeneration of the tunica media
D Injury
E Coarctation of the aorta
(C)
207. Postthrombotic varicose veins develop as a result of:
A the insufficiency of the perforant veins
B the destruction of deep veins
C the destruction of superficial veins
D ileofemoral insufficiency
E obstruction of the great saphenous vein
(A)
208. All of the following are appropriate for the treatment of trophic ulcers after
venous thrombosis, EXCEPT:
A elevation of the leg
B compression dressing of varicose veins
C skin grafting
D removal of the saphenous vein
E venous bypass surgery
(E)
209. All of the following factors predispose to pulmonary embolism, EXCEPT:
A a sedentary lifestyle
B the presence of an underlying cardiac disease
C the presence of a neoplasm
D oral contraceptives
E a male gender
(E
210. The primary therapy for pulmonary embolism is:
A anticoagulant therapy
B ligation of the inferior vena cava
C thrombectomy
D pulmonary embolectomy
(A)
211. All of the following statements are valid regarding an aneurysm of the splenic
artery, EXCEPT:
A this is the least prevalent of the aneurysms developing on visceral arteries
B it is usually the consequence of degenerative changes in the tunica media of the
arterial wall
C it causes pain felt in the left hypochondrium and radiating to the left shoulder
D the calcified ring of the aneurysm may be visible on plain abdominal X-rays
E the risk of rupture is high during pregnancy
(A)
212. The treatment of choice for stenosis of the internal carotid artery is:
A eversion endarterectomy
B reversal endarterectomy
C bypass grafting
D ligation of the internal carotid artery
E administration of platelet aggregation inhibitors
(A)
213. The therapy of an arteriovenous fistula includes:
A excision of the fistula and restoration of the contiguity of the blood vessel
B ligation of the artery distal to the fistulae
C amputation of the extremity
D ligation of the vein distal to the fistulae
E drug therapy only
(A)
214. All of the following are trophic changes resulting from chronic ischemia,
EXCEPT:
A hair loss
B friable, opaque fingernails
C skin atrophy
D muscle atrophy
E osteoporosis
(E)
215. The most frequent cause of arterial occlusion is:
A embolism
B arteriosclerosis
C varicose veins
D all of the above
(B)
216. All of the following statements are valid regarding abdominal aortic
aneurysms, EXCEPT:
A most patients are asymptomatic; however the lesion can be detected by a routine
physical examination
B a pulsatile mass is palpated in the abdomen
C the diameter of the aneurysm is not related to the risk of rupture
D calcification of the aorta and large vessels is often visible on plain abdominal X-ray
E the abrupt onset of severe pain, radiating to the back and the hip indicates dissection or
rupture of the aneurysm
(C)
217. All of the following are characteristic features of Buerger's disease, EXCEPT:

A it is more prevalent in males
B the peak incidence occurs between 20 and 40 years of age
C it is rare in blacks
D it is closely associated with smoking
E it is an unusual form of atherosclerosis
(E)
218. All of the following may lead to the thoracic outlet syndrome, EXCEPT:
A a cervical rib
B the scalenic anticus syndrome
C costoclavicular compression
D Raynaud's disease
E a hyperabduction syndrome
(D)
219. The most common site of peripheral arteriosclerotic aneurysms is:
A the carotid artery
B the subclavian artery
C the femoral artery
D the popliteal artery
C the ulnar artery
(D)
220. A 65-year-old male patient passes tarry and loose stools (melena) 10 months
after an aorto-bifemoral bypass surgery. The most likely cause of this condition is:
A anastomotic leakage
B ulcerative colitis
C ischemic colitis
D an aortoduodenal fistula
(D)
221. Which methods is NOT appropriate for the diagnosis of deep-vein thrombosis?

A Phlebography
B Radioisotope labelled fibrinogen uptake test
C Doppler -ultrasonography
D Measurement of the venous flow-rate
E Impedance plethysmography
(D)
222. Select the correct statement:
A Intermittent claudication carries a high risk of limb loss within a year
B Intermittent claudication does not correlate with cardiovascular mortality
C Intermittent claudication should be treated with PTA regardless of the claudication
distance
D Intermittent claudication should be treated with best medical and/or surgical treatment
depending on the claudication distance
(D)
223. Find the false statement!
An angiogram was performed for left limb short distance claudication. Right limb is symptom
free. DSA shows an 80% short stenosis of the right common iliac vessel
A The symptom free narrowing should be angioplastied as a preventive measure
B In general: symptom free stenosis should not angioplastied
C Angioplasty is an operation with all the risks involved
D Angioplasty should be a clinical decision made by physician in charge preferably after
multidisciplinary discussion
(B)
224. Which is NOT a possible diagnostic modality for pulmonary embolism? (
A Chest X-Ray
B Perfusion/ventillation scintigraphy
C D-Dimer test
D Ankle/Brachial Index
D)
225. Choose the correct statement regarding Critical Limb Ischaemia:
A CLI is a relatively benign clinical entity with the worse outcome being minor
amputation
B CLI is a clinical entity with generalized symptoms and multiple cardiovascular co-
morbidities
C CLI usually requires conservative treatment only
D CLI is best treated with primary, major amputation
(B)
226. Surgical treatment of lower-limb varicosity includes the following steps:
(GSV: Great Saphenous Vein)
A Scalenotomy, phlebectomy, GSV ligation and stripping
B TEA, phlebectomy, GSV ligation and stripping, perforator ligation
C Saphenous bypass, phlebectomy, GSV ligation and stripping
D GSV ligation and stripping, phlebectomy, perforator ligation
E GSV stripping, phlebectomy, perforator ligation
(D)
167. Which of the following diseases is NOT associated with splenomegaly?
A Malaria
B Sickle cell disease
C Portal hypertension
D Spherocytosis
E Lymphomas
(B)
168. What does a T3N1Mx colorectal cancer stand for?
A Tumor infiltrates the subserosa, 1-3 positive lymph nodes, no information on distal
metastases
B Tumor infiltrates the submucosa, 1-3 positive lymph nodes, no information on distal
metastases
C Tumor infiltrates the subserosa, 4-6 positive lymph nodes, no information on distal
metastases
D Tumor infiltrates the pelvic wall, 1-3 positive lymph nodes, no information on distal
metastases
E Tumor infiltrates the subserosa, 1-3 positive lymph nodes, confirmed distal metastases
(A)
169. Which disease is associated typically with a left lower quadrant abdominal
pain?
A Choledocholithiasis
B Right ovarian torsion
C Appendicitis
D Diverticulitis
E Pancreatitis
(D)
170. Four days after an uneventful Billroth II gastric resection, a 55-year-old man
suddenly develops severe upper abdominal pain. On examination, his abdomen in
rigid and he has a fever. The probable diagnosis is:
A duodenal stump leak
B acute pancreatitis
C postoperative acute cholecystitis
D wound infection
E delayed rupture of a contused spleen
(A)
171. Which enzyme is produced in the pancreas in an inactive form?
A Trypsin
B Lipase
A Amylase
(A)
172. What is the abdominoperineal resection?
A Removal of the rectum and anus with the sphincter, creating a temporary ostomy
B Removal of the rectum and anus with the sphincter, creating a permanent ostomy
C Removal of the rectum and anus sparing the sphincter, creating a temporary ostomy
D Removal of the rectum and anus sparing the sphincter, creating a permanent ostomy
(B)
173. All of the following substances are produced by functional carcinoid
neoplasms, EXCEPT:
A serotonin
B 5-hydroxy-tryptophan
C kallikrein and histamine
D ACTH
E parathormone
(E)
174. Breast conserving surgery is contraindicated in the following cases:
A Two or more primary tumors are present in separate quadrants of the breast
B If the axillary nodal status is positive
C Neo-adjuvant therapy was administered before surgery
D Patient is older than 70 years
(A)
175. The recommended therapy of intestinal carcinoid tumors is:
A irradiation
B chemotherapy
C administration of serotonin antagonists
D surgery followed by irradiation
E intestinal resection
(E)
176. The most prevalent type of thyroid cancer is: (
A follicular carcinoma
B papillary carcinoma
C anaplastic carcinoma
D medullary carcinoma
E secondary carcinoma
B)
177. All of the following belong to skeletal changes occurring in
hyperparathyroidism, EXCEPT:
A osteitis fibrosa cystica
B osteopetrosis
C solitary or multilocular bone cysts
D pathologic fractures
E osteoporosis
(B)
178. The most common type of congenital adrenal hyperplasia develops as a result
of:
A 21-hydroxylase enzyme deficiency
B 11-hydroxylase enzyme deficiency
C 17-hydroxylase enzyme deficiency
D 3-b-hydroxysteroid-dehydrogenase enzyme deficiency
E excessive ACTH release
(A)
179. The treatment of choice for Cushing's disease is:
A a hypophysectomy
B irradiation of the pituitary gland
C a unilateral adrenalectomy
D a subtotal adrenalectomy
E a total adrenalectomy
(B)
180. What is the proper surgical treatment of an asymptomatic papillary thyroid
cancer – found incidentally - which is 5mm in diameter in the left lobe if there are no
enlarged lymph nodes:
A Total thyroidectomy
B Total thyroidectomy with lymph node dissection
C Lobectomy on the left side
D Subtotal lobectomy on the left side
E No surgery required, irradiation only
(C)
181. In which of the following forms of primary hyperaldosteronism is the value of
surgical therapy controversial?
A Solitary aldosterone producing adenoma
B Carcinoma of the adrenal cortex
C Primary hyperaldosteronism due to adrenal hyperplasia
D Hyperaldosteronism sensitive to glucose administration
E Primary hyperaldosteronism of unknown origin
(D)
182. The most reliable test in diagnosing a pheochromocytoma is:
A the measurement of the 24-hour urinary metanephrine excretion rate
B the urinary catecholamines concentration
C a urinary vanillylmandelic acid determination
D the determination of basal plasma catecholamine levels
E the determination of plasma catecholamine levels following the injection of histamine
(A)
183. Type-II multiplex endocrine neoplasia (MEN) consists of all the following,
EXCEPT:
A medullary carcinoma of the thyroid gland
B pituitary neoplasms
C pheochromocytoma
D parathyroid adenoma or hyperplasia
E multiple neuromas
(B)
184. Complications of hypoparathyroidism include:
A cataract formation and cerebral calcification
B diabetes
C adrenal insufficiency
D hydronephrosis
(A)
185. A carcinoma of the thyroid gland:
A often causes hyperthyroidism
B is usually associated with hypothyroidism
C is generally characterized by normal thyroid function
D only the metastases produce hormones
E develops in toxic adenomas
(C)
186. Acute mastitis is most prevalent at/in:
A birth
B puberty
C pregnancy
D breast feeding
E menopause
(D)
187. The risk of bilateral breast cancer is high when the primary lesion (having
developed in the breast affected first) is:
A DCIS
B inflammatory carcinoma
C invasive lobular cancer
D Paget's disease
E invasive ductal cancer
(C)
188. Breast cancer develops most frequently in which of the following regions of
the breast?
A The upper-medial quadrant
B The upper-lateral quadrant
C The subareolar region
D The lower-medial quadrant
E The lower-lateral quadrant
(B)
189. The most prevalent histologic type of breast cancer is the:
A invasive papillary carcinoma
B invasive ductal carcinoma
C medullary carcinoma
D colloidal carcinoma
E invasive lobular carcinoma
(B)
190. Which of the following therapies is recommended for breast cancer patients
with extensive systemic metastases?
A Chemo/radiotherapy
B Simple mastectomy
C Radical mastectomy
D Breast conserving surgery
(A)
191. Mammography is a particularly valuable method for the reduction of breast
cancer mortality, because:
A it does not frighten female patients away from being examined
B it can the detect the disease at an early stage
C there are no false positive results
D it is a painless procedure
E it is a particularly specific test in young females
(B)
192. What is the percentage of breast cancer among all the malignancies occurring
in females?
A 5%
B 10%
C 25%
D 20%
E 30%
(C)
193. The incidence of which of the following cancer types has decreased over the
last 40 years?
A Breast cancer
B Lung cancer
C Colon cancer
D Stomach cancer
E Bone marrow cancer
(D)
194. From the following options which is true for Sentinel Node Biopsy in breast
cancer?
A The sentinel node(s) can be identified using a radioactive tracer or special dye
B At least 5 lymph nodes has to be removed for correct histological sampling
C The axillary dissection has to be performed even if the sentinel nodes were found to be
tumor-free
D Clinically detectable axillary lymph node enlargement requires Sentinel Node Biopsy
(A)
195. Which is the least frequent from the following types of thyroid cancer?
A Papillary cancer
B Anaplastic cancer
C Follicular cancer
D Medullary cancer
(B)
196. The most frequent cause of a palpable breast lump above 50 years is:
A Abscess
B Benign breast change
C Cancer
D Cyst
E Fibroadenoma
(C)
31. Using of which anticoagulants requires close monitoring of the hemostatic
parameters?
A Aspirin
B Clopidogrel
C Ca-Heparin
D Low molecular weight heparin
(C)
32. Select the FALSE statement!
A Indirect inguinal hernia is the most common of the external abdominal wall hernias
B Incisional hernia can develop wherever there is a scar on the abdomen
C Obesity and liver cirrhosis can aggravate the development of umbilical hernias
D Reducible hernias require urgent operation within 12 hours
(D)
33. Select the diseases that pose an absolute indication for surgery.
A Obstructing colonic cancer
B Enlarged axillary lymph nodes
C Duodenal ulcer
D Large, symptomatic pancreatic pseudocyst
E Stones in the common bile duct causing jaundice
(A)
34. Which pathogen is the common cause of gas gangrene?
A Aspergillus
B Streptococcus
C Clostridium
D Pseudomonas
(C)
35. From the following options which factor does NOT impair the wound-healing
process?
A Chemotherapeutic drugs
B Anemia
C Jaundice
D Mobilization of the patient
(D)
36. The most significant advantage of the tension-free inguinal hernia repair over the
conventional techniques is:
A The rate of recurrence is lower
B The patient can leave the hospital sooner
C Yields better cosmetic results
D It’s cheaper than the Bassini operation
(A)
37. Which is NOT considered a wound healing complication?
A Dehiscence
B Seroma
C Primary wound healing
D Keloid formation
(C)
38. The most frequent cause of lung abscess is:
A the aspiration of infective material from the oral cavity or pharynx
B a blood-borne infection
C lymphatic spread from an infective focus
D a penetrating chest injury
E bronchogenic carcinoma
(A)
39. A lung abscess develops most frequently in the:
A left-upper lobe
B left-lower lobe
C lingular segment
D upper-dorsal segments of the right lung
E right-middle lobe
(D)
40. The chest x-ray of a 30-year-old patient with a simple rib fracture shows a 50%
pneumothorax. The first line of treatment should be:
A external fixation with adhesive tape
B the infiltration of the injured intercostal nerve with a local anesthetic
C coughing and respiratory exercises
D the administration of analgesics
E tube thoracostomy
(E)
41. A solitary mass in the lung of a middle-aged patient is most likely a:
A granuloma
B malignancy
C adenoma
D tuberculotic lesion
E secondary neoplasm
(A)
42. All of the following conditions are complications of empyema, EXCEPT: (
A bronchopleural fistula
B pleural adhesions
C pericarditis
D osteomyelitis
E circumscribed pneumonia
D)
43. The treatment of choice for hemothorax with an effusion of 500 cm3 or more is by:

A needle aspiration
B intercostal tube thoracostomy
C thoracotomy and ligation of the ruptured blood vessel
D supportive therapy with monitoring
E transfusion of fresh blood
(B)
44. The most frequent cause of thoracic empyema is:
A pneumonia of the ipsilateral lung
B the rupture of an emphysematous bleb
C a penetrating chest injury
D a subphrenic abscess
E ruptures of the thoracic segments of the esophagus
(A)
45. All of the following represent an indication for resection in pulmonary tuberculosis,
EXCEPT:
A an open cavity with positive sputum despite 3-6 months of therapy
B a negative sputum with destroyed segment residue
C a local infection caused by atypical acid-fast bacteria
D a new lesion with positive sputum
E tuberculotic bronchiectasis of the middle and lower lobes
D
46. All of the following statements are valid regarding lung cancer, EXCEPT:
A lung cancer is never symptom-free
B on X-ray it can occur as a coin lesion (round shadow) on the periphery of the lung
C hemoptysis is common in lung cancer
D a dry, distressing, unproductive cough may often be the only symptom of lung cancer
E a partial or complete airway obstruction may predispose to lung infection
(A)
47. All of the following are manifestations of the superior vena cava syndrome, EXCEPT:

A increased venous pressure
B edema of the head and neck
C enlarged veins which are visible on the anterior chest wall
D cyanosis
E dyspnea
(E)
48. All of the following are diagnostic signs of cardiac tamponade, EXCEPT:
A increased venous pressure
B shock
C a reduced cardiac output
D increased filling volume of the heart during diastole
E a reduced blood pressure
(D)
49. The 5-year survival of all lung cancer cases is not higher than:
A 10%
B 20%
C 30%
D 40%
E 50%
(A)
50. The most common malignancy of the bony chest wall is:
A solitary bone metastasis
B osteogenic sarcoma
C multiple myeloma
D Ewing's sarcoma
E chondrosarcoma
(E)
51. A possible etiologic factor in the development of pleural mesothelioma is:
A pneumoconiosis
B asbestosis
C anthracosis
D hereditary disposition
E peritoneal mesothelioma
(B)
52. Hemoptysis can result from all of the following, EXCEPT:
A bronchial carcinoma
B bronchial asthma
C bronchiectasia
D pulmonary infarction
E pulmonary tuberculosis
(B)
53. The most common cause of the superior vena cava syndrome is:
A a bronchial carcinoma arising from the upper-right lobe
B a neoplasm of the thymus
C thyroid cancer
D mediastinal fibrosis
E multinodular goiter
(A)
54. The therapy of choice for patients with tension pneumothorax associated with dyspnea
is:
A intravenous volume replacement
B administration of oxygen by mask
C immediate release of the air from the pleural cavity
D administration of analeptic drugs
E immediate intubation
(C)
55. Choose the most appropriate therapy of non-metastatic Non Small Cell Lung Cancer
from the following options.
A Lung resection with lymphadenectomy, adjuvant chemo and/or radiotherapy
B Chemo and radiotherapy
C Lung resection alone
D Wait-and-see strategy
(A)
56. What kind of operation is preferred in the treatment of pectus excavatum?
A Urgent thoraco-laparotomy
B Videothoracoscopic Nuss operation
C Reconstruction of the sternum with open operation
D Videothoracoscopic Nissen operation
(B)
57. What is the preferred operation for spontaneous pneumothorax?
A Thoracotomy and resection of the ruptured bulla and pleurodesis
B Peritoneal tube drainage
C Videothoracoscopic resection of the ruptured bulla and pleurodesis
D Videothoracoscopy and pleurodesis
(C)
58. Which operation can be performed in isolated pulmonary metastasis from colorectal
cancer?
A Subtotal pulmonectomy
B Lobectomy with lymphadenectomy
C Metastasectomy and/or tissue-sparing lung resection with lymphadenectomy
D Segmentectomy with lymphadenectomy
(C)
59. From the following options which is NOT a typical sign of a Zenker’s diverticulum?

A Dysphagia
B Regurgitation of undigested food
C Sharp pain when swallowing
D Gurgling sounds when swallowing
(C)
60. Which diagnostic modality CANNOT be used to assess the depth of malignant
infiltration in esophageal cancer?
A Endoscopy and biopsy
B CT scan
C Endosonography
D PET-CT
(A)
61. In hiatal hernia the most important examination to determine the type of the planned
fundoplication is:
A 24-hour Ph monitoring and manometry
B Barium swallow and 24-hour Ph monitoring
C Endoscopy
D Endoscopy and manometry
(A)
62. What is the therapy of lung metastases?
A Lobectomy
B Lobectomy with lymphadenectomy
C Metastasectomy and/or lung resection with lymphadenectomy
D Segmentectomy with lymphadenectomy
(C)
63. The treatment of malignant chest wall tumors is:
A excision
B radical resection
C radical resection with chest wall reconstruction
D radiotherapy
(C)
64. Which of the following conditions requires urgent surgery? )
A Paraesophageal hernia with erosion
B Paraesophageal hernia with incarceration
C Paraesophageal hernia with severe reflux
D Large symptomatic paraesophageal hernia
(B
65. What is the most common type of surgery in esophageal malignancies?
A Mucosal excision
B Total esophageal resection
C Segmental esophageal resection
D Subtotal esophageal resection
(D)
66. In an operable pancreatic head malignancy which is considered the most successful
operation?
A Pancreatoduodenectomy
B Total pancreatectomy
C Biliodigestive bypass
(A)
67. What is the gold standard treatment of symptomatic cholelithiasis?
A Open cholecystectomy
B Laparoscopic cholecystectomy
C Single-port cholecystectomy
D Endoscopic retrograde cholangio-pancreatograpy
E Shock wave lithotripsy
(B)
68. What percent of the small intestine can be removed without severe consequences on
digestive capacity and the subsequent risk of metabolic disorders? )
A 5%
B 10%
C 30%
D 70%
E 90%
(D
69. Which is an absolute contraindication of laparoscopic cholecystectomy?
A Previous upper abdominal surgeries
B Gallbladder longer than 10cm
C Old age
D Second trimester pregnancy
E Inability to tolerate general anesthesia
(E)
70. Which is the most common form of the gallbladder perforation?
A Localized perforation with pericholecystic abscess
B Free perforation with diffuse peritonitis
C Development of a cholecysto-enteric fistula
D Development of a cholecysto-phrenic fistula
(A)
71. Which vessel provides the blood supply of the pancreas?
A Celiac trunk
B Superior mesenteric artery
C Both
(C)
72. All of the following statements are valid regarding gastric polyps, EXCEPT:
A gastric polyps have a propensity for multiple occurrence
B gastric polyps develop on atrophic gastric mucosa
C gastric polyps may develop first after puberty
D gastric polyps can develop as a feature of familial disease
E gastric polyps are not expected to undergo malignant transformation
(E)
73. Metabolic consequences of a gastric resection include:
A macrocytic anemia
B iron-deficiency anemia
C metabolic alkalosis
D calcium deficiency
E steatorrhea
(A)
74. Intestinal diverticula develop most frequently in the:
A duodenum
B jejunum
C transverse colon
D descending colon
E sigmoid colon
(E)
75. Which is not a typical complication of laparoscopic cholecystectomy?
A Common bile duct lesion
B Dissection of the cystic duct
C Hematoma under the liver
D Postoperative bile leakage
(B)
76. Approximately what is the normal diameter of the common bile duct in adults?
A 1-2mm
B 2-4mm
C 4-6mm
D 6-8mm
E 10-12mm
(D)
77. Which of the following procedures are performed on the stomach?
A Selective vagotomy
B Choledochojejunostomy with Roux-en-Y anastomosis
C Miles operation
D Wilson fundoplication
(A)
78. From the following options which is the most common type of weight reduction
surgery?
A Bilateral femoral amputation
B Laparoscopic adjustable gastric banding
C Laparoscopic adjustable esophageal banding
D Total gastrectomy with Roux-en-Y anastomosis
E Billroth-I resection with jejunal loop
(C)
79. All of the following signs are present in mesenteric artery obstruction, EXCEPT:
A a sudden pain around the umbilicus
B the pain is disproportionally intense compared to the severity of physical signs
C an urge to defecate
D bloody stool
E bowel sounds reflecting permanently hyperactive peristalsis
(E)
80. All of the following are true for the pain associated with pancreatitis, EXCEPT:
A an abrupt onset
B diffuse mid-abdominal pain
C unremitting (generalized) pain
D the pain radiates through to the back
E colic subcostal pain
(E)
82. A 45-year-old female patient has undergone a laparoscopic cholecystectomy. Three
days following the procedure, she gradually develops signs of acute abdomen and has
fever. The possible cause may be, EXCEPT:
A injury of the common bile duct
B injury of the hepatic duct
C perforation of the transverse colon
D pulmonary embolism
E development of acute pancreatitis
(D)
83. Stress ulcers have been observed in all of the following conditions, EXCEPT:
A after severe burns
B in central nervous system lesions
C after alcohol ingestion
D after salicylate ingestion
E during penicillin administration
(E)
84. The landmark delineating the junction of the antral and fundic regions on the lesser
curvature of the stomach is the:
A angular incisure
B Mayo-vein
C left gastric artery
D gastroduodenal artery
E gastroepiploic artery
(A)
85. The most severe complication after a Billroth-II gastric resection is:
A thrombophlebitis
B dehiscence of the duodenal stump
C dehiscence of the esophageal stump
D dehiscence of the Roux-en-Y anastomosis
E hemorrhage
(B)
86. All of the following are extraintestinal manifestations of Crohn's disease, EXCEPT:

A erythema nodosum
B arthritis
C uveitis
D portal fibrosis
E an increased risk of malignant transformation
(E)
87. What is NOT a typical symptom of in peptic ulcer disease?
A Abdominal or epigastric pain
B Bloating
C Fresh blood in the stool
D Melena
E Nausea, vomiting
(C)
88. All of the following are intestinal complications of Crohn's disease, EXCEPT:
A perforation
B fistula formation
C rectal bleeding
D intestinal obstruction
E colonic polyposis
(E)
89. Which operation is the most commonly accepted in acute necrotizing pancreatitis?
A Cholecystectomy + drainage of the cystic duct
B Necrectomy + drainage
C Pancreatic resection + drainage
D Pancreatoduodenectomy
(B)
90. What is NOT considered a frequent complication after splenectomy?
A Subphrenic abscess
B Postsplenectomy fever
C Pulmonary embolisation
D Bleeding
(C)
91. Which statement is NOT true for gastric cancer in general?
A The most frequent signs are weight loss, abdominal pain, vomiting or bleeding
B In linitis plastica only total gastrectomy is considered oncologically radical
C A CT scan helps to assess the infiltration of the surrounding organs/tissues
D The generally accepted complex treatment of gastric cancer is surgery, irradiation,
chemotherapy and hormone therapy
(D)
92. In which disease is the "string sign" a characteristic feature?
A Ulcerative colitis
B Mesenteric infarction
C Volvulus of the sigmoid colon
D Crohn’s disease
E Rectal cancer
(D)
93. In Crohn's disease, the most frequent indication for surgery is:
A development of an intraabdominal fistula
B development of a perianal fistula
C an intra-abdominal mass
D stagnant bowel syndrome
E intestinal obstruction
(E)
94. Which of the following is the anatomic border between the left and right lobes of the
liver?
A The line connecting the falciform ligament and the inferior vena cava
B The line connecting the falciform ligament and the "bare area"
C The line connecting the fossa of the gall bladder and the fossa of the inferior vena cava
D The line connecting the fossa of the gall bladder and the "bare area"
E The line connecting the "ligamentum teres hepatis" and the inferior vena cava
(C)
95. Which of the following disorders is associated with an elevated serum a-fetoprotein
level?
A Carcinoma of the liver
B Carcinoma of the colon
C Crohn's disease
D Carcinoma of the pancreas
E Carcinoma of the gall bladder
(A)
96. The pathologic lesion characteristic of the Mallory-Weiss syndrome is: )
A rupture of the esophagus
B rupture of the gastric mucosa
C laceration of the mucosa at the gastroesophageal junction
D hemorrhage from a gastric polyp
E acute gastritis
(C
97. Regarding the prognosis of gastric adenocarcinoma, which of the following statements
is FALSE?
A The polypoid macroscopic type carries a better prognosis than the diffusely infiltrating
type
B The intestinal histological type carries a better prognosis than the diffuse type
C Cure rates of 80 to 90 % are obtained for lesions confined to the mucosa
D Length of survival is improved by chemotherapy and radiation therapy after curative
resection
(D)
98. All of the following procedures are appropriate for the treatment of verified
choledocholithiasis, EXCEPT:
A choledochotomy and T-tube drainage
B endoscopic papillotomy and extraction of biliary calculi
C transduodenal sphincteroplasty
D percutaneous extraction of biliary calculi using a Dormia-basket
(D)
99. From the following options which CANNOT be used in the treatment of achalasia?

A Intraluminal cryotherapy
B Balloon dilatation
C Heller’s myotomy
D Self-expandable stent implantation
(A)
100. Gastric carcinoma develops most frequently in the region of the:
A fundus
B cardia
B corpus
D pyloric and antral region
E gastroesophageal junction
(D)
101. In people over the age of 50, the incidence of colonic diverticula is
approximately:
A 0-5%
B 5-10%
C 10-20%
D 20-30%
E 30-40%
(E)
102. Which of the following disorders may cause paralytic ileus?
A Obstructing colonic cancer
B Annular pancreas
C Diffuse peritonitis
D Volvulus
E Intussusception/invagination
(C)
103. The most common factor in the etiology of acute appendicitis is:
A bacterial infection
B mechanical obstruction
C local circulatory insufficiency
D the role of chemical substances
E the lymphatic hyperplasia in the processus vermiformis
(B)
104. What is the least prevalent site for the development of intraperitoneal
abscesses?
A The pelvis
B The right subhepatic compartment
C The left subphrenic compartment
D The peritoneal sac
E The right subphrenic compartment
(D)
105. Spontaneous rupture of the spleen may occur in all of the following conditions,
EXCEPT:
A infectious mononucleosis
B malaria
C leukemia
D polycythemia vera
E portal hypertension
(E)
106. A splenectomy has a beneficial effect in all the following hemolytic conditions,
EXCEPT:
A hereditary spherocytosis
B hereditary elliptocytosis
C hemolytic anemia due to glucose-6-phosphate deficiency
D thalassemia
E sickle-cell disease
(C)
107. Characteristic features of thrombocytopenic purpura include all of the
following, EXCEPT:
A it is more prevalent in females
B petechiae, ecchymoses or hemorrhages occur
C significant splenomegaly is present
D subnormal platelet count in peripheral blood
E the megakaryocyte count in the bone marrow is normal or increased
(C)
108. All of the following are present in long-standing ulcerative colitis, EXCEPT:

A a shortening of the gut
B shrinkage and thickening of the mesentery
C enlarged masses comprised of lymph node conglomerates
D a dull, grayish mucosal surface
E perforation and abscesses along the mesenteric margin
(C)
109. Characteristic features of ischemic colitis are influenced by all of the following
factors, EXCEPT:
A the extent of vascular obstruction
B the duration of obstruction
C the patency of the collateral circulation
D the extent of bacterial invasion
E the intensity of the inflammation
(E)
110. All of the following are appropriate in the treatment of pseudomembranous
colitis, EXCEPT:
A discontinuing the causative antibiotic(s)
B the correction of electrolyte- and fluid losses
C metronidazole therapy
D vancomycin therapy
E corticosteroid therapy
(E)
111. Which of the following statements is the most appropriate following the
resection of a carcinoma of the descending colon?
A Abdominal US and colonoscopy repeated every 6 months
B Abdominal US and barium enema repeated every 6 months
C Monitoring of the serum CEA, US and colonoscopy at regular intervals
D Sulfasalazine (Salazopyrine) and prednisone therapy
E Checking the stool for occult bleeding every 3 months
(C)
112. All of the following drugs can induce gastrointestinal bleeding, EXCEPT:
A salicylates
B corticosteroids
C alcohol
D phenothiazines
E anticoagulants
(D)
113. The most common cause of a massive rectal bleeding is:
A a carcinoma of the descending colon
B colonic diverticulosis
C ulcerative colitis
D a carcinoma of the ascending colon
E stage-II hemorrhoids
(B)
114. Which of the following compounds is contraindicated following a liver
resection?
A Carbohydrates
B Albumin
C Vitamin K
D Hypnotic analgesics
E Antibiotics
(D)
115. The incidence of biliary stones is supposed to increase after which of the
following operations?
A Resection of a liver lobe
B Subtotal gastrectomy
C Splenectomy
D Resection of the jejunum
E Resection of the ileum
(E)
116. Mechanical ileus due to obstruction by a biliary stone develops most frequently
in the:
A duodenum
B jejunum
C ileum
D sigmoid colon
E anorectal junction
(C)
117. What is the most severe possible complication of acute cholangitis?
A Prolonged jaundice
B Development of stones in the common bile duct
C Acute pancreatitis
D Hepatic abscess
E Duodenal perforation
(D)
118. Which of the following features reflect a poor prognosis in acute pancreatitis?

A High surges of serum amylase levels
B Hyperglycemia and glycosuria
C High urinary amylase level
D Prolonged coagulation time
E Reduced serum calcium level
(E)
119. All of the following factors cause acute pancreatitis, EXCEPT:
A alcohol
B hypercalcemia associated with parathyroid dysfunction
C biliary stones
D hyperlipidemia
E hemochromatosis
(E)
120. The most appropriate surgical intervention for a rectal cancer located 3
centimeters above the anal verge is:
A anterior resection with primary anastomosis
B rectal resection with the "pull-through" procedure
C abdominoperineal resection of the rectum
D posterior resection
E two-stage resection
(C)
121. In which of the following conditions is a "drain-pipe" colon a characteristic
feature visible on X-ray taken after a barium enema?
A Amebiasis
B Ulcerative colitis
C Tuberculosis of the colon
D Granulomatous enteritis
E Familial polyposis
(B)
122. All of the following statements are true regarding thrombosed hemorrhoids,
EXCEPT:
A the abrupt appearance of a painful external bulge in the anal region
B the appearance of a tense, bluish, tender induration on the anal border
C an untreated lesion has a tendency to ulcerate and bleed
D hemorrhoids usually resolve within 24 hours
E prompt surgical decompression brings symptomatic relief
(D)
123. Which of the following procedures is appropriate for the definitive diagnosis of
congenital megacolon?
A Stool culture and parasitology
B Rectal biopsy
C Radiographic examination
D Pancreatic enzyme activity measurements from stool
E Sweat test
(B)
124. The operation of choice for congenital megacolon is:
A a colostomy
B an enterostomy
C a splanchnicectomy
D a total colectomy
E none of the above
(E)
125. From the following options which is true for Inflammatory Bowel Diseases?

A Severe rectal bleeding is more common in ulcerative colitis than in Crohn’s disease
B The exact pathomechanism of the disease is well established
C The typical age at the onset of the disease is around 60-70 years
D The most common symptoms are epigastric pain and vomiting
(A)
126. The most prevalent type of colorectal polyps is:
A villous polyp
B postinflammatory polyp
C tubular adenoma
D juvenile polyp
E hereditary multiple polyp
(C)
127. The anatomical border between the anus and the rectum is the:
A lateral hemorrhoidal groove
B interhemorrhoidal groove
C dentate line
D serrate line
E anorectal ring
(C)
128. From the following procedures which can be performed in a rectosigmoid
cancer causing incomplete obstruction?
A Resection with primary anastomosis
B Total colectomy with ileo-anal anastomosis
C Abdominoperineal resection
D Percutaneous bowel decompression
(A)
129. Colonic obstruction due to a sigmoid cancer is best treated by:
A a primary abdomino-perineal amputation
B decompression by colostomy only
C a primary anterior resection
D resection and temporary colostomy
E resection and permanent colostomy
(D)
130. Elevated CEA (carcinoembryonic antigen) levels have been observed in all of
the following conditions, EXCEPT:
A carcinoma of the pancreas
B breast cancer
C colonic cancer
D lung cancer
E myeloma
(E)
131. What is the role of postoperative irradiation in colonic cancer?
A Irradiation is not part of the routine therapeutic practice
B Irradiation should be used in lymph node positive cases
C Irradiation should be used in metastatic cases
D Irradiation should be used in every patent with inoperable cancer
(A)
132. What is the currently accepted surgical treatment of an anal fissure?
A Anterior resection
B Parks hemorrhoidectomy
C Anal dilatation
D Lateral internal sphincterotomy
(D)
133. Select the condition which is most likely to be candidate for laparoscopic
splenectomy:
A idiopathic Thrombocytopenic Purpura
B polycythemia Vera
C splenic infiltration of pancreatic malignancy
D thalassemia with significant splenomegaly
E portal hypertension
(A)
134. The treatment of choice for a symptomatic pancreatic abscess is:
A cystogastrostomy
B cystoenterostomy
C external drainage
D antibiotic therapy without drainage
E pancreatic resection
(C)
135. What is the Hartmann’s procedure?
A Two-staged bowel resection with the formation of a temporary ostomy
B Two-staged bowel resection with the formation of a definite ostomy
C Two-staged gastric resection with the formation of a definite gastrostomy
D Two-staged gastric resection with the formation of a temporary gastrostomy
E Two-staged esophageal resection with the formation of a temporary esophagostomy
(A)
136. The most prevalent cause of mortality due to a duodenal ulcer can be:
A hemorrhage
B peritonitis resulting from acute perforation
C pyloric obstruction and inanition
D an untreatable disease
E an esophageal rupture associated with the regurgitation of the acidic gastric contents
(A)
81. The most important sign of appendicitis is:
A right upper abdominal pain
B an elevated body temperature
C elevated inflammatory markers
D right lower abdominal quadrant pain
E diffuse mid-abdominal pain
(D)
137. Regarding hepatic diseases, which statement is true?
A The liver has 7 functional segments
B Focal nodular hyperplasia usually turns into a hepatic malignancy
C When in doubt about the nature of a hepatic hemangioma, a percutaneous needle
biopsy is recommended to confirm the diagnosis
D The liver has such a good regeneration potential that often as much as 75-80% of the
hepatic volume can be removed during surgery
(D)
138. The most frequent severe complication of a Roux-en-Y type gastric resection
is:
A dehiscence of the ileal stump (anastomotic leakage)
B dehiscence of the duodenal stump (anastomotic leakage)
C hemorrhage
D septic shock
E dumping syndrome
(B)
139. Which is the most reliable physical finding in acute appendicitis?
A Localized right lower quadrant tenderness
B Rebound tenderness
C Right lower quadrant hypesthesia
D Tenderness on rectal examination
E All of the above are equally reliable
(A)
140. Which of the following is the characteristic feature of the Mallory-Weiss
syndrome?
A Mucosal rupture in the esophagus
B Rupture of the gastric mucosa
C Rupture of the esophageal mucosa and the gastric mucosa in the region of the cardia
D Bleeding from a gastric polyp
(C)
141. All of the following statements are valid regarding perforated appendicitis,
EXCEPT:
A the incidence of this condition is higher in very young or old patients
B it is more prevalent among the poor
C in acute appendicitis, early antibiotic therapy prevents the perforation of the processus
vermiformix
D perforated appendicitis still carries significant mortality and morbidity rates
(C)
142. All of the following statements are valid regarding the development of cancer
in patients with ulcerative colitis, EXCEPT:
A the incidence of cancer increases proportionally to the duration of the disease
B the age of onset of ulcerative colitis determines the incidence of any associated cancer
C the malignant neoplasms develop from pseudopolyps
D the neoplasms are multiple, circumscribed and invasive
E the prognosis is poor
(C)
143. Villous adenomas (hairy polyps) of the rectum are best treated by:
A repeated rectosigmoidoscopies
B abdominoperineal resection
C local excision of the lesion
D infusion of electrolyte solutions
E drug therapy
(C)
144. Which condition is NOT associated with an increased risk of gastric cancer?

A Adenomatous gastric polyps
B Atrophic chronic gastritis
C Acute alcoholic gastritis
D Helicobacter pylori infection
(C)
145. From the following options which characteristics or studies can preoperatively
distinguish a benign gastric ulcer from a cancer?
A Diameter (more than 2 cm)
B Distance from the pylorus
C Acid secretory studies
D Multiple biopsies
E Clinical response to PPI treatment
(D)
146. An increased risk of developing colonic cancer is associated with the following
conditions, EXCEPT:
A Crohn’s disease
B Diet low in animal fat and protein
C Ulcerative colitis
D Familial polyposis
E Diabetes mellitus
(B)
147. In which of the following primary malignancies has the resection of hepatic
metastases the most pronounced effect on survival?
A Colorectal
B Breast
C Gastric
D Ovarian
E Pancreatic
(A)
148. Which of the following conditions Helicobacter pylori infection is NOT
associated with?
A Duodenal ulcer
B Gastric ulcer
C Chronic gastritis
D Gastric cancer
E Acute gastritis
(E)
149. Concerning the clinical presentation of peritonitis, which of the following
statements is true?
A Patients with peritonitis frequently shift position in order to relieve the pain
B High-pitched bowel sound become prominent as bowel wall edema leads to
progressive compromise of the intestinal lumen
C Peritonitis is always associated with marked elevations of the white blood cell count
D Temperature elevation may be only minimal in infants and debilitated elderly patients
E Before the diagnosis can be confirmed, there must be x-ray evidence of ileus and
obliteration of the psoas shadow
(D)
150. Which disease is treated by the Heller operation?
A Congenital megacolon
B Esophageal carcinoma
C Achalasia of the cardia
D Crohn’s disease
E Hiatal hernia
(C)
151. Regarding Crohn’s disease, which of the following statements is correct?
A It is characterized by transmural inflammation and skip lesions
B The long-term base therapy is based on administration of systemic steroids
C The disease involves the proximal ileum in the majority of the cases
D The risk for malignant transformation decreases over the course of disease
(A)
152. Which is the most characteristic sign of gastric perforation in the first hour?

A Fever
B Sharp epigastric pain
C Sharp lower right quadrant pain
D Colic right upper quadrant pain
E Diarrhea
(B)
153. Which of the following conditions presents an indication for hepatic resection?
)
A Hepatitis B infection
B Hepatitis C infection
C Solitary liver metastasis
D Primary biliary cirrhosis
E Budd-Chiari syndrome
(C
154. From the following treatment options which is the most appropriate for a
patient with suddenly developing jaundice, proven gallstones and no signs of acute
abdomen?
A Immediate open cholecystectomy with common bile duct exploration
B Urgent ERCP followed by laparoscopic cholecystectomy
C Delayed open cholecystectomy with common bile duct exploration
D Urgent laparoscopic cholecystectomy followed by ERCP
E Conservative treatment with antibiotics
(B)
155. Which of the following statement is NOT true for laparoscopic
cholecystectomy when compared to an open procedure?
A Yields better cosmetic results
B Rate of complications is lower
C Requires shorter hospitalization time
D Postoperative pain is less severe
(B)
156. Partial gastric resection is indicated in the following case:
A linitis plastica
B small antrum tumor with diffuse type Lauren classification
C small antrum tumor with intestinal type Lauren classification
D large peptic ulcer as a first line of treatment
(C)
157. From the following options which is the most typical complication of a cancer
in the head of the pancreas?
A Obstruction of the proximal ileum
B Obstruction of the common bile duct
C Obstruction of the hepatic duct
D Obstruction of the celiac trunk
(B)
158. Which one is the proper treatment in fecal peritonitis caused by a perforating
sigmoid tumor?
A Double-barrel colostomy
B Hartmann’s procedure
C Resection with primary anastomosis
D Right hemicolectomy
E Abdominoperineal resection
(B)
159. From the following options select the scoring system currently used to help
predict the severity of acute pancreatitis:
A APACHE-II
B SAPS-II
C ASA
D SIRS-I
(A)
160. From the following options which is the most frequent cause of mechanical
ileus?
A Large colonic polyp
B Parkinson’s disease
C Intussusception
D Obstructing tumor
E Gallstone ileus
(D)
161. Which one is NOT a sign of peritoneal irritation in appendicitis?
A Blumberg sign
B Rowsing sign
C Horner sign
D Psoas sign
(C)
162. Which is the proper treatment from the following options for a large cecal
tumor infiltrating the abdominal wall?
A Double-barrel sigmoidostomy
B Hartmann’s procedure
C Palliative resection with primary anastomosis
D Bilio-digestive bypass
E Abdominoperineal resection
(C)
163. Which statement is true for acute pancreatitis?
A The basic pathomechanism is the bacterial digestion of the pancreatic tissue
B Surgery should be performed as early as possible in complicated pancreatitis
C The most common causes are alcohol abuse and biliary tract disorders
D ERCP is contraindicated in acute gallstone pancreatitis
(C)
164. Please select the structures that surgeons dissect during a normal laparoscopic
cholecystectomy.
A Cystic duct and common bile duct
B Common bile duct and hepatic duct
C Right hepatic artery and cystic duct
D Cystic duct and cystic artery
E Cystic artery and common bile duct
(D)
165. Which of the following signs and symptoms is NOT characteristic to a
proximal mechanical ileus?
A Rectal bleeding
B Nausea and vomiting
C Abdominal pain
D Abdominal distension
(A)
166. Which statement is true for pancreatic cancer in general?
A Regarding histological types, 30% is ductal adenocarcinoma
B The majority of the tumors are located in the body of the pancreas
C The traditional procedure for a resectable pancreatic head malignancy is the Whipple
operation
D Thanks to the modern oncologic treatment modalities, the average survival now
exceeds 2 years even in unresectable cases
(C)