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169 Cards in this Set
- Front
- Back
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Select the correct statement regarding pancreas pseudocysts!
A. Pseudocysts rarely grow bigger than 5-6cm B. Pseudocysts are always connected to the Wirsungian duct C. Percutaneous drainage is not advised due to the high rate of recurrence D. Pseudocysts should always be treated surgically E. Pseudocysts are lined with granulation tissue |
Pseudocysts are lined with granulation tissue
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From the following substances which is produced in the islets of Langerhans?
A. Prostaglandin B. Glucagon C. Renin D. Pepsin |
Glucagon
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3. In general, which procedure is NOT approved for the treatment of a gallbladder cancer?
A. Cholecystectomy + pancreatic resection + lymphadenectomy B. Cholecystectomy + hepatic resection + lymphadenectomy C. Cholecystectomy alone D. Cholecystectomy + lymphadenectomy E. Biliary stenting |
Cholecystectomy + pancreatic resection + lymphadenectomy
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4. Which is the most common histological type of the gastric cancer?
A. Adenocarcinoma B. Lymphoma C. GIST D. Squamous cell carcinoma |
Adenocarcinoma
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.Which is NOT a damaging factor to the gastric mucosa related to the development of a peptic ulcer?
A. Alcohol B. Pepsin C. H. pylori D. Gastric acid E. Prostaglandins |
Prostaglandins
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6. From the following options which arteries provide the primary blood supply of the stomach?
A. Superior and inferior gastric arteries, left and right gastro-epiploic arteries B. Left and right gastric arteries, superior and inferior gastro-epiploic arteries C. Superior and inferior gastric arteries, superior and inferior gastro-epiploic arteries D. Left and right gastric arteries, left and right gastro-epiploic arteries |
Left and right gastric arteries, left and right gastro-epiploic arteries
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7. Which enzyme is produced in the pancreas in an inactive form?
A. Lipase B. Amylase C. Trypsin |
Trypsin
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Four days after an uneventful BillrothII gastric resection, a55-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. postoperative acute cholecystitis C. delayed rupture of a contused spleen D. acute pancreatitis E. wound infection |
duodenal stump leak
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Which of the following diseases is NOT associated with splenomegaly?
A. Lymphomas B. Sickle cell disease C. Portal hypertension D. Malaria |
Sickle cell disease
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Which statement is true for pancreatic cancer in general?
A. The majority of the tumors are located in the body of the pancreas B. Thanks to the modern oncologic treatment modalities, the average survival now exceeds 2 years even in unresectable cases C. Regarding histological types, 30% is ductal adenocarcinoma D. The traditional procedure for a resectable pancreatic head malignancy is the Whipple operation |
The traditional procedure for a resectable pancreatic head malignancy
is the Whipple operation |
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Please select the structures that surgeons dissect during anormal laparoscopic cholecystectomy.
A. Cystic artery and common bile duct B. Common bile duct and hepatic duct C. Cystic duct and cystic artery D. Cystic duct and common bile duct E. Right hepatic artery and cystic duct |
Cystic duct and cystic artery
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Which statement is true for acute pancreatitis?
A. ERCP is contraindicated in acute gallstone pancreatitis B. The most common causes are alcohol abuse and biliary tract disorders C. The basic pathomechanism is the bacterial digestion of the pancreatic tissue D. Surgery should be performed as early as possible in complicated pancreatitis |
The most common causes are alcohol abuse and biliary tract disorders
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From the following options select the scoring system currently used to help predict the severity of acute pancreatitis:
A. SAPS-II B. APACHE-II C. SIRS-I D. ASA |
APACHE-II
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From the following options which is the most typical complication of a cancer in the head of the pancreas?
A. Obstruction of the common bile duct B. Obstruction of the celiac trunk C. Obstruction of the hepatic duct D. Obstruction of the proximal ileum |
Obstruction of the common bile duct
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Partial gastric resection is indicated in the following case:
A. large peptic ulcer as a first line of treatment B. small antrum tumor with intestinal type Lauren classification C. small antrum tumor with diffuse type Lauren classification D. linitis plastica |
small antrum tumor with intestinal type Lauren classificatio
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Which of the following statement is NOT true for laparoscopic cholecystectomy when compared to an open procedure?
A. Requires shorter hospitalization time B. Postoperative pain is less severe C. Yields better cosmetic results D. Rate of complications is lower |
Rate of complications is lower
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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. Delayed open cholecystectomy with common bile duct exploration B. Urgent laparoscopic cholecystectomy followed by ERCP C. Immediate open cholecystectomy with common bile duct exploration D. Urgent ERCP followed by laparoscopic cholecystectomy E. Conservative treatment with antibiotics |
Urgent ERCP followed by laparoscopic cholecystectom
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Which of the following conditions presents an indication for hepatic resection?
A. Budd-Chiari syndrome B. Solitary liver metastasis C. Hepatitis C infection D. Hepatitis B infection E. Primary biliary cirrhosis |
Solitary liver metastasis
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Which is the most characteristic sign of gastric perforation in the first hour?
A. Sharp epigastric pain B. Sharp lower right quadrant pain C. Diarrhea D. Colic right upper quadrant pain E. Fever |
Sharp epigastric pain
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Which disease is treated by the Heller operation?
A. Achalasia of the cardia B. Esophageal carcinoma C. Hiatal hernia D. Crohn's disease E. Congenital megacolon |
Achalasia of the cardia
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Which of the following conditions Helicobacter pylori infection is NOT associated with?
A. Gastric ulcer B. Chronic gastritis C. Acute gastritis D. Gastric cancer E. Duodenal ulcer |
Acute gastritis
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From the following options which characteristics or studies can preoperatively distinguish a beign gastric
ulcer from a cancer? A. Clinical response to PPI treatment B. Multiple biopsies C. Acid secretory studies D. Diameter (more than 2 cm) |
Multiple biopsies
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Which condition is NOT associated with an increased risk of gastric cancer?
A. Atrophic chronic gastritis B. Helicobacter pylori infection C. Acute alcoholic gastritis D. Adenomatous gastric polyps |
Acute alcoholic gastritis
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Which of the following is the characteristic feature of the Mallory-Weiss syndrome?
A. Rupture of the gastric mucosa B. Rupture of the esophageal mucosa and the gastric mucosa in the region of the cardia C. Bleeding from a gastric polyp D. Mucosal rupture in the esophagus |
Rupture of the esophageal mucosa and the gastric mucosa in the region of the
cardia |
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The most frequent severe complication of a Roux-en-Y type gastric resection is:
A. dumping syndrome B. dehiscence of the ileal stump (anastomotic leakage) C. hemorrhage D. septic shock E. dehiscence of the duodenal stump (anastomotic leakage) |
dehiscence of the duodenal stump (anastomotic leakage)
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Regarding hepatic diseases, which statement is true?
A. When in doubt about the nature of a hepatic hemangioma, a percutaneous needle biopsy is recommended to confirm the diagnosis B. Focal nodular hyperplasia usually turns into a hepatic malignancy C. 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. The liver has 7 functional segments |
The liver has such a good regeneration potential that often as much as 75-80%
of the hepatic volume can be removed during surgery |
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The most prevalent cause of mortality due to a duodenal ulcer can be:
A. peritonitis resulting from acute perforation B. hemorrhage C. an untreatable disease D. an esophageal rupture associated with the regurgitation of the acidic gastric contents E. pyloric obstruction and inanition |
hemorrhage
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The treatment of choice for a symptomatic pancreatic abscess is:
A. pancreatic resection B. external drainage C. cystoenterostomy D. antibiotic therapy without drainage E. cystogastrostomy |
external drainage
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Select the condition which is most likely to be candidate for laparoscopic splenectomy:
A. splenic infiltration of pancreatic malignancy B. polycythemia vera C. portal hypertension D. thalassemia with significant splenomegaly E. Idiopathic Thrombocytopenic Purpura |
Idiopathic Thrombocytopenic Purpura
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All of the following factors cause acute pancreatitis, EXCEPT:
A. hypercalcemia associated with parathyroid dysfunction B. hyperlipidemia C. hemochromatosis D. alcohol E. biliary stones |
hemochromatosis
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Which of the following features reflect a poor prognosis in acute pancreatitis?
A. Reduced serum calcium level B. Hyperglycemia and glycosuria C. High surges of serum amylase levels D. Prolonged coagulation time E. High urinary amylase level |
Reduced serum calcium level
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What is the most severe possible complication of acute cholangitis?
A. Hepatic abscess B. Development of stones in the common bile duct C. Acute pancreatitis D. Duodenal perforation E. Prolonged jaundice |
Hepatic abscess
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The incidence of biliary stones is supposed to increase after which of the following operations?
A. Subtotal gastrectomy B. Resection of the jejunum C. Resection of a liver lobe D. Splenectomy E. Resection of the ileum |
Resection of the ileum
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Which of the following compounds is contraindicated following a liver resection?
A. Antibiotics B. Hypnotic analgesics C. Vitamin K D. Carbohydrates E. Albumin |
Hypnotic analgesics
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Characteristic features of thrombocytopenic purpura include all of the following, EXCEPT:
A. petechiae, ecchymoses or hemorrhages occur B. subnormal platelet count in peripheral blood C. the megakaryocyte count in the bone marrow is normal or increased D. significant splenomegaly is present E. it is more prevalent in females |
significant splenomegaly is present
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A splenectomy has a beneficial effect in all the following hemolytic conditions, EXCEPT:
A. hereditary elliptocytosis B. thalassemia C. hemolytic anemia due to glucose-6-phosphate deficiency D. hereditary spherocytosis E. sickle-cell disease |
hemolytic anemia due to glucose-6-phosphate deficiency
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Spontaneous rupture of the spleen may occur in all of the following conditions, EXCEPT:
A. portal hypertension B. infectious mononucleosis C. leukemia D. polycythemia vera E. malaria |
portal hypertension
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Gastric carcinoma develops most frequently in the region of the:
A. corpus B. cardia C. pyloric and antral region D. gastroesophageal junction E. fundus |
pyloric and antral region
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From the following options which CANNOT be used in the treatment of achalasia?
A. Balloon dilatation B. Self-expandable stent implantation C. Heller's myotomy D. Intraluminal cryotherapy |
Intraluminal cryotherapy
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All of the following procedures are appropriate for the treatment of verified choledocholithiasis ,EXCEPT:
A. transduodenal sphincteroplasty B. percutaneous extraction of biliary calculi using a Dormia-basket C. endoscopic papillotomy and extraction of biliary calculi D. choledochotomy and T-tube drainage |
percutaneous extraction of biliary calculi using a Dormia-baske
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Regarding the prognosis of gastric adenocarcinoma, which of the following statements is FALSE?
A. The intestinal histological type carries a better prognosis than the diffuse type B. The polypoid macroscopic type carries a better prognosis than the diffusely infiltrating type C. Length of survival is improved by chemotherapy and radiation therapy after curative resection D. Cure rates of 80 to 90 % are obtained for lesions confined to the mucosa |
Length of survival is improved by chemotherapy and radiation therapy after curative
resection |
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The pathologic lesion characteristic of the Mallory-Weiss syndrome is:
A. hemorrhage from a gastric polyp B. rupture of the gastric mucosa C. laceration of the mucosa at the gastroesophageal junction D. acute gastritis E. rupture of the esophagus |
laceration of the mucosa at the gastroesophageal junctio
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Which of the following disorders is associated with an elevated serum a-fetoprotein level?
A. Carcinoma of the gall bladder B. Carcinoma of the colon C. Carcinoma of the liver D. Carcinoma of the pancreas E. Crohn's disease |
Carcinoma of the liver
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Which of the following is the anatomic border between the left and right lobes of the liver?
A. The line connecting the fossa of the gall bladder and the fossa of the inferior vena cava B. The line connecting the falciform ligament and the inferior vena cava C. The line connecting the falciform ligament and the "bare area" 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 |
The line connecting the fossa of the gall bladder and the fossa of the inferior
vena cava |
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Which statement is NOT true for gastric cancer in general?
A. In linitis plastica only total gastrectomy is considered oncologically radical B. A CT scan helps to assess the infiltration of the surrounding organs/tissues C. The generally accepted complex treatment of gastric cancer is surgery, irradiation, chemotherapy and hormone therapy D. The most frequent signs are weight loss, abdominal pain, vomiting or bleeding |
The generally accepted complex treatment of gastric cancer is surgery, irradiation,
chemotherapy and hormone therapy |
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What is NOT considered a frequent complication after splenectomy?
A. Subphrenic abscess B. Bleeding C. Pulmonary embolisation D. Postsplenectomy fever |
Pulmonary embolisation
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Which operation is the most commonly accepted in acute necrotizing pancreatitis?
A. Cholecystectomy + drainage of the cystic duct B. Pancreatic resection + drainage C. Pancreatoduodenectomy D. Necrectomy + drainage |
Necrectomy + drainage
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What is NOT a typical symptom of in peptic ulcer disease?
A. Melena B. Fresh blood in the stool C. Bloating D. Nausea, vomiting E. Abdominal or epigastric pain |
Fresh blood in the stool
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The most severe complication after a Billroth-II gastric resection is:
A. thrombophlebitis B. dehiscence of the Roux-en-Y anastomosis C. dehiscence of the esophageal stump D. dehiscence of the duodenal stump E. hemorrhage |
dehiscence of the duodenal stump
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The land mark delineating the junction of the antral and fundic regions on the lesser curvature of the stomach is the:
A. Mayo-vein B. gastroduodenal artery C. gastroepiploic artery D. angular incisure E. left gastric artery |
angular incisure
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Stress ulcers have been observed in all of the following conditions, EXCEPT:
A. in central nervous system lesions B. after salicylate ingestion C. after alcohol ingestion D. after severe burns E. during penicillin administration |
during penicillin administration
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.A45-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 maybe, EXCEPT:
A. development of acute pancreatitis B. perforation of the transverse colon C. pulmonary embolism D. injury of the hepatic duct E. injury of the common bile duct |
pulmonary embolism
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All of the following are true for the pain associated with pancreatitis, EXCEPT:
A. unremitting (generalized) pain B. an abrupt onset C. diffuse mid-abdominal pain D. the pain radiates through to the back E. colic subcostal pain |
colic subcostal pain
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From the following options which is the most common type of weight reduction surgery?
A. Laparoscopic adjustable gastric banding B. Billroth-I resection with jejunal loop C. Laparoscopic adjustable esophageal banding D. Total gastrectomy with Roux-en-Y anastomosis E. Bilateral femoral amputation |
Laparoscopic adjustable esophageal banding
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Which of the following procedures is performed on the stomach?
A. Miles operation B. Choledochojejunostomy with Roux-en-Y anastomosis C. Wilson fundoplication D. Selective vagotomy |
Selective vagotomy
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Approximately what is the normal diameter of the common bile duct in adults?
A. 4-6mm B. 2-4mm C. 10-12mm D. 6-8mm E. 1-2mm |
6-8mm
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Which is not a typical complication of laparoscopic cholecystectomy?
A. Hematoma under the liver B. Postoperative bile leakage C. Dissection of the cystic duct D. Common bile duct lesion |
Dissection of the cystic duct
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Metabolic consequences of a gastric resection include:
A. iron-deficiency anemia B. steatorrhea C. calcium deficiency D. macrocytic anemia E. metabolic alkalosis |
macrocytic anemia
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All of the following statements are valid regarding gastric polyps, EXCEPT:
A. gastric polyps develop on atrophic gastric mucosa B. gastric polyps can develop as a feature of familial disease C. gastric polyps may develop first after puberty D. gastric polyps have a propensity for multiple occurrence E. gastric polyps are not expected to undergo malignant transformation |
gastric polyps are not expected to undergo malignant transformation
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Which vessel provides the blood supply of the pancreas?
A. Both B. Superior mesenteric artery C. Celiac trunk |
Both
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Which is the most common form of the gallbladder perforation?
A. Development of a cholecysto-phrenic fistula B. Free perforation with diffuse peritonitis C. Development of a cholecysto-enteric fistula D. Localized perforation with pericholecystic abscess |
Localized perforation with pericholecystic abscess
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Which is an absolute contraindication of laparoscopic cholecystectomy?
A. Gallbladder longer than 10cm B. Second trimester pregnancy C. Inability to tolerate general anesthesia D. Previous upper abdominal surgeries E. Old age |
Inability to tolerate general anesthesia
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What is the gold standard treatment of symptomatic cholelithiasis?
A. Open cholecystectomy B. Laparoscopic cholecystectomy C. Endoscopic retrograde cholangio-pancreatograpy D. Single-port cholecystectomy E. Shock wave lithotripsy |
Laparoscopic cholecystectomy
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In an operable pancreatic head malignancy which is considered the most successful operation?
A. Pancreatoduodenectomy B. Biliodigestive bypass C. Total pancreatectomy |
Pancreatoduodenectomy
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Which disease is characterized by a mid-abdominal, "beltlike" pain?
A. Gastric perforation B. Diverticulitis C. Pancreatitis D. Appendicitis E. Colonic cancer |
Pancreatitis
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What is the most common benign tumor of liver?
A. Hepatic metastasis from a benign colorectal lesion B. Hemangioma C. Hepatocellular cancer D. Focal sparing E. Focal nodular hyperplasia |
Hemangioma
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Select the indication(s) of parathyreoid surgery from the following options:
A. Symptomatic hypercalcaemia in all age groups B. Progressive reduction in bone density C. Hypercalcaemia in patients younger than 50 years D. Suspicion of malignant parathyroid disease E. Significantly reduced excretion of calcium in the urine |
Symptomatic hypercalcaemia in all age groups
Progressive reduction in bone density Hypercalcaemia in patients younger than 50 years Suspicion of malignant parathyroid disease |
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A thyroid storm (thyreotoxic crisis):
A. Propranolol administration is benefical as it antagonizes sympathic dominance B. Is usually treated by considerable doses of iodine C. Cortisone is a valuable drug in its therapy D. Can be induced by trauma, infection or acidosis |
A. Propranolol administration is benefical as it antagonizes sympathic dominance
B. Is usually treated by considerable doses of iodine C. Cortisone is a valuable drug in its therapy D. Can be induced by trauma, infection or acidosis |
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Characteristics of the papillary carcinoma of the thyroid are:
A. The frequency of development decreases with age B. It is dependent on the stimulatory effect of TSH C. Hematogenous metases are frequent in this type of cancer D. It can transform into the anaplastic form E. It features the slowest growth-rate among the malignancies of the thyroid gland |
-It is dependent on the stimulatory effect of TSH
-Hematogenous metases are frequent in this type of cancer -It can transform into the anaplastic form -It features the slowest growth-rate among the malignancies of the thyroid gland |
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A medullary carcinoma of the thyroid may be associated with:
A. Hyperparathyroidism B. Cushing's syndrome C. Pituitary adenomas D. Pheochromocytoma |
Hyperparathyroidism
Cushing's syndrome Pheochromocytoma |
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Which of the following statements are true for thyroid surgery in general?
A. After a total thyreoidectomy, life-long hormone supplementation is required B. The surgery is usually performed with the patient in a supine position C. In hyperthyreosis surgery is usually preceded by conditioning with iodine drops D. The standard approach is through a vertical Kocher incision |
-After a total thyreoidectomy, life-long hormone supplementation is required
-In hyperthyreosis surgery is usually preceded by conditioning with iodine drop |
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Select the most frequent signs of breast cancer:
A. Nipple discharge B. Skin ulceration C. Palpable mass D. Cyclic pain |
Nipple discharge
Skin ulceration Palpable mass |
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The postoperative treatment after a breast conserving resection due to invasive ductal cancer may include:
A. Oophorectomy B. Irradiation C. Hormonal therapy D. Sentinel node biopsy E. Chemotherapy |
Irradiation
Hormonal therapy Chemotherapy |
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A mammography is indicated:
A. For the drainage of a large breast cyst B. For the annual screening of females over 25 years of age C. For the assessment of a suspicious mass detected in patients with multiple cysts D. For monitoring the contralateral breast in females who have undergone unilateral mastectomy |
For monitoring the contralateral breast in females who have undergone unilateral mastectomy
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Paget's disease of the areola:
A. Is usually presents of an eczematous lesion B. Has much worse prognosis than breast cancer in general C. Is rare and comprises 1% of all breast cancers D. Is a primary cancer of the ducts |
-Is usually presents of an eczematous lesion
-Is rare and comprises 1% of all breast cancers -Is a primary cancer of the ducts |
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Bloody discharge from the nipple:
A. May result from injury of the breast B. May result from a ductal papilloma or carcinoma C. The standard treatment is radical mastectomy D. Is associated with malignant neoplasms in 10-30% of the cases |
-May result from injury of the breast
-May result from a ductal papilloma or carcinoma -Is associated with malignant neoplasms in 10-30% of the cases |
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Select the correct answers:
A. Phaeochromocytoma can lead to severe and abrupt hypotensive episodes B. Phaeochromocytoma is almost always malignant C. Phaeochromocytoma is a disease of the adrenal cortex D. Approximately 10% of all phaeochromocytomae is extra-adrenal E. Diagnosis of phaeochromocytoma can be made by a urine test for vanillylmandelic acid |
-Approximately 10% of all phaeochromocytomae is extra-adrenal
- Diagnosis of phaeochromocytoma can be made by a urine test for vanillylmandelic acid acid |
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Carcinoids of the processus vermiformis:
A. An extended right-sided hemicolectomy is the standard treatment B. Can mimic the signs of appendicitis C. Comprise 50% of all carcinoids developing in the gastrointestinal tract D. The carcinoid syndrome is uncommon |
-Can mimic the signs of appendicitis
-Comprise 50% of all carcinoids developing in the gastrointestinal tract -The carcinoid syndrome is uncommon |
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Clinical manifestations of the carcinoid syndrome include:
A. Right-sided heart disease B. Elevated blood pressure C. Diarrhea with cramping abdominal pain D. Bronchospasm with wheezing E. Flushing of the upper half of the body |
- Right-sided heart disease
-Diarrhea with cramping abdominal pain -Bronchospasm with wheezing -Flushing of the upper half of the body |
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Which is NOT a typical sign of Cushing's syndrome?
A. Muscle weakness B. Hypotension C. Central (truncal) obesity D. Purple striae E. Round “moon face” |
Hypotension
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Which anatomic structure is the most prone to injury during a thyroid surgery?
A. Esophagus B. Thyroid cartilage C. Recurrent laryngeal nerve D. Hypoglossal nerve |
Recurrent laryngeal nerve
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Which is the most frequent sign of breast cancer?
A. Pathologic fractures B. Skin ulceration C. Palpable mass D. Cyclic pain |
Palpable mass
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Which is NOT an indication of parathyreoid surgery from the following options?
A. Suspicion of malignant parathyroid disease B. Hypercalcaemia in patients younger than 50 years C. Significantly reduced excretion of calcium in the urine D. Symptomatic hypercalcaemia in all age groups E. Progressive reduction in bone density |
Significantly reduced excretion of calcium in the urine
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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. The standard operation for a T1N0 breast cancer is mastectomy with axillary lymph node dissection C. Radical surgery is indicated in most of the cases even in the presence of multiple distant metastases D. DCIS/LCIS can eventually turn into invasive breast cancer |
DCIS/LCIS can eventually turn into invasive breast cance
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Select the correct answer:
A. Phaeochromocytoma can lead to severe and abrupt hypotensive episodes B. Phaeochromocytoma is almost always malignant C. Phaeochromocytoma is a disease of the adrenal cortex D. Approximately 10% of all phaeochromocytomae is extra-adrenal |
Approximately 10% of all phaeochromocytomae is extra-adrena
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Regarding papillary thyroid carcinoma, which of the following statements is FALSE?
A. There is a high likelihood of occult multicentric disease B. It is the type of thyroid cancer most often associated with prior radiation exposure C. The presence of resectable lymph node metastases does not appear to worsen prognosis D. Papillary cancer is characterized by frequent hematogenous metastases |
Papillary cancer is characterized by frequent hematogenous metastases
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The most frequent cause of a palpable breast lump above 50 years is:
A. Benign breast change B. Abscess C. Cancer D. Cyst E. Fibroadenoma |
Cancer
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Which is the least frequent from the following types of thyroid cancer?
A. Medullary cancer B. Follicular cancer C. Anaplastic cancer D. Papillary cancer |
Anaplastic cancer
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From the following options which is true for Sentinel Node Biopsy in breast cancer?
A. Clinically detectable axillary lymph node enlargement requires Sentinel Node Biopsy B. The axillary dissection has to be performed even if the sentinel nodes were found to be tumor-free C. The sentinel node(s) can be identified using a radioactive tracer or special dye D. At least 5 lymph nodes has to be removed for correct histological sampling |
The sentinel node(s) can be identified using a radioactive tracer or special dye
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The incidence of which of the following cancer types has decreased over the last 40 years?
A. Bone marrow cancer B. Lung cancer C. Colon cancer D. Stomach cancer E. Breast cancer |
Stomach cancer
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What is the percentage of breast cancer among all the malignancies occurring in females?
A. 30% B. 10% C. 5% D. 25% E. 20% |
25%
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.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. there are no false positive results C. it is a particularly specific test in young females D. it is a painless procedure E. it can the detect the disease at an early stage |
it can the detect the disease at an early stage
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Which of the following therapies is recommended for breast cancer patients with extensive systemic metastases?
A. Simple mastectomy B. Chemo/radiotherapy C. Radical mastectomy D. Breast conserving surgery |
Chemo/radiotherapy
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The most prevalent histologic type of breast cancer is the:
A. invasive papillary carcinoma B. medullary carcinoma C. invasive lobular carcinoma D. invasive ductal carcinoma E. colloidal carcinoma |
invasive ductal carcinoma
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Breast cancer develops most frequently in which of the following regions of the breast?
A. The upper-lateral quadrant B. The lower-medial quadrant C. The subareolar region D. The upper-medial quadrant E. The lower-lateral quadrant |
The upper-lateral quadrant
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The risk of bilateral breast cancer is high when the primary lesion (having developed in the breast affected first) is:
A. invasive ductal cancer B. Paget's disease C. inflammatory carcinoma D. invasive lobular cancer |
invasive lobular cancer
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Acute mastitis is most prevalent at/in:
A. menopause B. pregnancy C. puberty D. breast feeding E. birth |
breast feeding
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A carcinoma of the thyroid gland:
A. develops in toxic adenomas B. is usually associated with hypothyroidism C. is generally characterized by normal thyroid function D. often causes hyperthyroidism E. only the metastases produce hormones |
is generally characterized by normal thyroid function
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Complications of hypoparathyroidism include:
A. hydronephrosis B. cataract formation and cerebral calcification C. adrenal insufficiency D. diabetes |
cataract formation and cerebral calcification
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Type-II multiplex endocrine neoplasia (MEN) consists of all the following, EXCEPT:
A. multiple neuromas B. pheochromocytoma C. parathyroid adenoma or hyperplasia D. pituitary neoplasms E. medullary carcinoma of the thyroid gland |
pituitary neoplasms
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The most reliable test in diagnosing a pheochromocytoma is:
A. the determination of basal plasma catecholamine levels B. the determination of plasma catecholamine levels following the injection of histamine C. a urinary vanillylmandelic acid determination D. the measurement of the 24-hour urinary metanephrine excretion rate E. the urinary catecholamines concentration |
the measurement of the 24-hour urinary metanephrine excretion rate
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In which of the following forms of primary hyperaldosteronism is the value of surgical therapy controversial?
A. Primary hyperaldosteronism due to adrenal hyperplasia B. Primary hyperaldosteronism of unknown origin C. Carcinoma of the adrenal cortex D. Solitary aldosterone producing adenoma E. Hyperaldosteronism sensitive to glucose administration |
Hyperaldosteronism sensitive to glucose administratio
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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. Subtotal lobectomy on the left side B. Total thyroidectomy with lymph node dissection C. Total thyroidectomy D. No surgery required, irradiation only E. Lobectomy on the left side |
Lobectomy on the left side
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The treatment of choice for Cushing's disease is:
A. irradiation of the pituitary gland B. a subtotal adrenalectomy C. a unilateral adrenalectomy D. a total adrenalectomy E. a hypophysectomy |
irradiation of the pituitary gland
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The most common type of congenital adrenal hyperplasia develops as a result of:
A. excessive ACTH release B. 11-hydroxylase enzyme deficiency C. 3-b-hydroxysteroid-dehydrogenase enzyme deficiency D. 17-hydroxylase enzyme deficiency E. 21-hydroxylase enzyme deficiency |
21-hydroxylase enzyme deficiency
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All of the following belong to skeletal changes occurring in hyperparathyroidism, EXCEPT:
A. osteopetrosis B. osteoporosis C. solitary or multilocular bone cysts D. pathologic fractures E. osteitis fibrosa cystica |
osteopetrosis
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The most prevalent type of thyroid cancer is:
A. papillary carcinoma B. follicular carcinoma C. anaplastic carcinoma D. medullary carcinoma E. secondary carcinoma |
papillary carcinoma
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The recommended therapy of intestinal carcinoid tumors is:
A. chemotherapy B. intestinal resection C. irradiation D. surgery followed by irradiation E. administration of serotonin antagonists |
intestinal resection
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Breast conserving surgery is contraindicated in the following cases:
A. If the axillary nodal status is positive B. Two or more primary tumors are present in separate quadrants of the breast C. Neo-adjuvant therapy was administered before surgery D. Patient is older than 70 years |
Two or more primary tumors are present in separate quadrants of the breas
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Type-II multiplex endocrine neoplasia (MEN) consists of all the following, EXCEPT:
A. multiple neuromas B. pheochromocytoma C. parathyroid adenoma or hyperplasia D. pituitary neoplasms E. medullary carcinoma of the thyroid gland |
pituitary neoplasms
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The most reliable test in diagnosing a pheochromocytoma is:
A. the determination of basal plasma catecholamine levels B. the determination of plasma catecholamine levels following the injection of histamine C. a urinary vanillylmandelic acid determination D. the measurement of the 24-hour urinary metanephrine excretion rate E. the urinary catecholamines concentration |
the measurement of the 24-hour urinary metanephrine excretion rate
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In which of the following forms of primary hyperaldosteronism is the value of surgical therapy controversial?
A. Primary hyperaldosteronism due to adrenal hyperplasia B. Primary hyperaldosteronism of unknown origin C. Carcinoma of the adrenal cortex D. Solitary aldosterone producing adenoma E. Hyperaldosteronism sensitive to glucose administration |
Hyperaldosteronism sensitive to glucose administratio
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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. Subtotal lobectomy on the left side B. Total thyroidectomy with lymph node dissection C. Total thyroidectomy D. No surgery required, irradiation only E. Lobectomy on the left side |
Lobectomy on the left side
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The treatment of choice for Cushing's disease is:
A. irradiation of the pituitary gland B. a subtotal adrenalectomy C. a unilateral adrenalectomy D. a total adrenalectomy E. a hypophysectomy |
irradiation of the pituitary gland
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The most common type of congenital adrenal hyperplasia develops as a result of:
A. excessive ACTH release B. 11-hydroxylase enzyme deficiency C. 3-b-hydroxysteroid-dehydrogenase enzyme deficiency D. 17-hydroxylase enzyme deficiency E. 21-hydroxylase enzyme deficiency |
21-hydroxylase enzyme deficiency
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All of the following belong to skeletal changes occurring in hyperparathyroidism, EXCEPT:
A. osteopetrosis B. osteoporosis C. solitary or multilocular bone cysts D. pathologic fractures E. osteitis fibrosa cystica |
osteopetrosis
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The most prevalent type of thyroid cancer is:
A. papillary carcinoma B. follicular carcinoma C. anaplastic carcinoma D. medullary carcinoma E. secondary carcinoma |
papillary carcinoma
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The recommended therapy of intestinal carcinoid tumors is:
A. chemotherapy B. intestinal resection C. irradiation D. surgery followed by irradiation E. administration of serotonin antagonists |
intestinal resection
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Breast conserving surgery is contraindicated in the following cases:
A. If the axillary nodal status is positive B. Two or more primary tumors are present in separate quadrants of the breast C. Neo-adjuvant therapy was administered before surgery D. Patient is older than 70 years |
Two or more primary tumors are present in separate quadrants of the breast
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All of the following substances are produced by functional carcinoid neoplasms, EXCEPT:
A. kallikrein and histamine B. ACTH C. serotonin D. 5-hydroxy-tryptophan E. parathormone |
parathormone
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What is the advantage of core biopsy over fine-needle aspiration biopsy (FNAB)?
A. Less painful for the patient B. It can be performed without radiological guidance C. The sensitivity and specificity is superior to FNAB, enables immunhistochemistry investigations D. The rate of complications is much lower |
The sensitivity and specificity is superior to FNAB, enables immunhistochemistry
investigations |
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From the following options which is true for Graves' disease?
A. The thyroid is usually not enlarged B. Treatment is multimodal and should always be started with subtotal or total thyroid resection C. The pathomechanism is the chronic stimulation of the thyroid follicles by autoantibodies D. Graves’ disease is the most common cause of hypothyroidism E. The pathomechanism is the chronic stimulation of the TSH receptors by autoantibodies |
The pathomechanism is the chronic stimulation of the TSH receptors by autoantibodies
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Which parameters are routinely checked for the evaluation of thyroid function?
A. sTSH, fT2, fT3 B. CRP, Hgb, Htc C. sTSH, fT3, fT4 D. TRAK, anti-TPO, anti-TG |
sTSH, fT3, fT4
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Regarding medullary thyroid cancer, which of the following statements is correct?
A. The serum calcitonin level is useful in the diagnosis and treatment B. The prognosis is approximately the same as that of the papillary cancer C. Medullary cancer almost always gives distant metastases D. It is derived from a dedifferentiated variant of the same cells that produce papillary and follicular cancers |
The serum calcitonin level is useful in the diagnosis and treatmen
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Which of the following studies CANNOT be used for the localization of a parathyroid adenoma?
A. Technetium-thallium scan B. CT C. Neck X-ray D. Ultrasonography |
Neck X-ray
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37. What is the lifetime risk of developing breast cancer in BRCA 1 or BRCA 2 positive cases?
A. 2-5% B. More than 50% C. 10-20% D. 20-50% E. 5-10% |
More than 50%
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What is the carcinoid syndrome?
A. Vomiting, nausea, skin rashes B. Bronchospasm, flushing, diarrhea, right sided heart failure C. Hypotension, nausea, diarrhea D. None of the above E. Bloating, hypertension, vomiting, skin rashes |
Bronchospasm, flushing, diarrhea, right sided heart failure
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Bone metastases rarely develop at which of the following sites?
A. Pelvis B. Bones distal to the knee or elbow C. Skull D. Long bones E. Vertebrae |
Bones distal to the knee or elbow
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The most common complications of a peptic ulcer are:
A. Jaundice B. Perforation C. Obstipation D. Bleeding |
-Perforation
-Bleeding |
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Common symptoms of gastric cancer are:
A. Anorexia, weight loss B. Jaundice C. Postprandial abdominal heaviness D. Vomiting |
-Anorexia, weight loss
-Postprandial abdominal heaviness -Vomiting |
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Which statement(s) is/are true about gastric cancer?
A. It is twice as common in women as in men B. Most of the patients diagnosed are operable C. Surgical resection is the only curative treatment D. H. pylori is an etiologic factor |
-Surgical resection is the only curative treatment
- H. pylori is an etiologic factor |
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Symptoms of acute calculous cholecystitis:
A. Right upper quadrant pain B. Stone(s) in the gallbladder on ultrasonography C. Fever and leukocytosis D. Obstipation |
-Right upper quadrant pain
-Stone(s) in the gallbladder on ultrasonography -Fever and leukocytosis |
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Common complications of acute cholelithiasis:
A. Development of hepatic malignancy B. Development of retroperitoneal abscess C. Development of pancreatitis D. Gallbladder perforation |
-Development of pancreatitis
-Gallbladder perforation |
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Main advantages of laparoscopic cholecystectomy:
A. Better cosmetic results B. Less pain than after the traditional cholecystectomy C. Need for expensive laparoscopic instruments D. Exploration of the abdominal cavity is easier |
-Better cosmetic results
-Less pain than after the traditional cholecystectomy |
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Choose the correct establishment(s) about the anatomy of the liver!
A. The common hepatic artery comes right from the abdominal aorta B. The portal vein is formed by the confluence of the splenic and superior mesenteric veins C. There are three major hepatic veins: left, right and middle D. The left lobe of the liver is bigger and contains more segments |
-The portal vein is formed by the confluence of the splenic and superior mesenteric
veins -There are three major hepatic veins: left, right and middle |
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Etiologic factors of primary liver cancer are:
A. Longstanding chronic cholelithiasis B. Cirrhosis from almost any cause (alcohol abuse, hemochromatosis, primary biliary cirrhosis, toxins) C. Metastasis of colorectal cancer D. Chronic hepatitis B and C virus infection |
- Longstanding chronic cholelithiasis
- Cirrhosis from almost any cause (alcohol abuse, hemochromatosis, primary biliary cirrhosis, toxins) |
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Potential treatment for metastatic neoplasms of the liver are:
A. Radiofrequency ablation B. Angiographic embolisatio C. Chemotherapy D. Hepatic resection |
-Radiofrequency ablation
-Angiographic embolisatio -Chemotherapy -Hepatic resection |
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Most common etiologic factors of acute pancreatitis are:
A. Cholelithiasis B. Colorectal malignancy C. Pulmonary disease D. Alcohol abuse |
-Cholelithiasis
-Alcohol abuse |
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Symptoms of acute pancreatitis:
A. Decreased or absent bowel sounds B. Severe epigastric or mid-abdominal pain C. Elevated serum and urinary amylase levels D. Nausea and vomiting |
- Decreased or absent bowel sounds
-Severe epigastric or mid-abdominal pain -Elevated serum and urinary amylase levels -Nausea and vomiting |
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True establishments about the prognosis of pancreatic adenocarcinoma are:
A. Overall 5-year survival is about 10 % B. Following a Whipple procedure, survival averages about 18 months C. If tumor cells extend to the margins of the resected specimen, long term survival is common D. The mean survival following palliative therapy is 7 months |
-Overall 5-year survival is about 10%
-Following a Whipple procedure, survival averages about 18 months - The mean survival following palliative therapy is 7 months |
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Disorders associated with secondary hypersplenism are:
A. Portal or splenic vein obstruction B. Myeloproliferative disorders C. Chronic hemolytic diseases D. Trauma |
-Portal or splenic vein obstruction
-Myeloproliferative disorders -Chronic hemolytic diseases |
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Indications for splenectomy are:
A. Gastric cancer B. GERD C. Primary splenic tumor D. Hereditary spherocytosis |
-Primary splenic tumor
-Hereditary spherocytosis |
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Disadvantages of laparoscopic surgery:
A. 2-Dimensional rendition on the screen B. Magnified image C. Loss of tactile information D. Expensive instruments |
-2-Dimensional rendition on the screen
-Loss of tactile information -Expensive instruments |
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Which two are among the most common laparoscopic operations?
A. Fabricius operation B. Cholecystectomy C. Inguinal hernia repair D. Splenectomy E. Kidney transplantation |
-Cholecystectomy
-Inguinal hernia repair |
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Which diseases are associated typically with a right lower quadrant abdominal pain?
A. Choledocholithiasis B. Diverticulitis C. Appendicitis D. Pancreatitis E. Right ovarian torsion |
-Appendicitis
-Right ovarian torsion |
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Choose the indirect signs of appendicitis!
A. Blumberg sign B. Psoas sign C. Horner sign D. Trotter sign E. Rovsing sign |
-Blumberg sign
-Psoas sign -Rovsing sign |
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Regarding the cause of a septic "chemical" peritonitis, which of the following statements are true?
A. In the absence of secondary infection, sterile bile does not irritate the peritoneum B. Barium produces peritonitis because of bacterial contamination associated with visceral perforations C. Endotoxic peritonitis cannot occur unless there is perforation of the bowel D. When bile gets into the abdominal cavity, it might eventually be contaminated by the gut flora E. Patients receiving H2 blockers have an increased risk for bacterial colonization of gastric contents |
- When bile gets into the abdominal cavity, it might eventually be contaminated
by the gut flora -Patients receiving H2 blockers have an increased risk for bacterial colonization of gastric contents |
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Concerning the clinical presentation of peritonitis, which of the following statements are true?
A. Peritonitis is usually associated with marked elevations of the white blood cell count B. Procalcitonin may be elevated in bacterial peritonitis C. Temperature elevation may be only minimal in infants and debilitated elderly patients D. Patients with peritonitis frequently shift position in order to relieve the pain E. High-pitched bowel sound become prominent as bowel wall edema leads to progressive compromise of the intestinal lumen |
- Procalcitonin may be elevated in bacterial peritonitis
- Temperature elevation may be only minimal in infants and debilitated elderly patients |
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The therapy of the initial phase of an acute diverticulitis includes:
A. Loop colostomy for mechanical decompression B. Intravenous fluid replacement C. Administration of systemic antibiotics D. Surgical resection of the affected part E. Liquid or low fiber diet |
- Intravenous fluid replacement
-Administration of systemic antibiotics -Liquid or low fiber diet |
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Surgical decompression of the dilated and distended bowels during surgery is beneficial because:
A. It facilitates closure of the abdominal wound B. It improves the circulation of the intestinal wall C. It removes toxins from the intestinal lumen D. It reduces the risk of a wound infection E. It reduces the risk of postoperative hernia formation |
-It facilitates closure of the abdominal wound
-It improves the circulation of the intestinal wall -It removes toxins from the intestinal lumen |
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Causes of extracellular hypovolemia developing in intestinal obstruction include:
A. Fluid sequestration in the intestinal wall B. Vomiting and the suction of gastric content through a nasogastric tube C. Fluid loss into the abdominal cavity D. Fluid sequestration in the lumen of the obstructed intestinal loops |
-Fluid sequestration in the intestinal wall
- Vomiting and the suction of gastric content through a nasogastric tubeHELYES / CORRECT - Fluid loss into the abdominal cavity -Fluid sequestration in the lumen of the obstructed intestinal loops |
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Typical radiographic signs of small bowel obstruction are:
A. Abnormal gas content in the small bowel B. Free air on the right side, under the diaphragm C. Absence of gas in the large bowel D. Multiple air-fluid levels |
-Abnormal gas content in the small bowel
- Absence of gas in the large bowel -Multiple air-fluid levels |
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The characteristic features of intestinal obstruction include:
A. Per rectal bleeding B. Vomiting C. No flatus is passed D. Distended abdomen E. Colicky abdominal pain |
-Vomiting
-No flatus is passed -Distended abdomen -Colicky abdominal pain |
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The treatment of paralytic ileus includes:
A. Early surgery B. Bowel decompression by a nasogastric tube C. Intravenous fluid replacement D. Bowel motility support |
-Bowel decompression by a nasogastric tube
-Intravenous fluid replacement -Bowel motility support |
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Which of the following statements are true for colorectal surgery?
A. Neoadjuvant chemoradiation is reserved for a locally advanced, low rectal cancer B. Worldwide overall 5-year survival is around 70% in colorectal cancer (all stages considered) C. Local excision may be adequate in early stage rectal cancer D. Laparoscopic techniques have minimal role in colorectal surgery |
-Neoadjuvant chemoradiation is reserved for a locally advanced, low rectal cancer
- Local excision may be adequate in early stage rectal cancer |
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What are the frequent spots of metastasis formation in rectal cancer?
A. Spleen B. Skin C. Bone D. Lung E. Liver |
-Bone
-Lung -Liver |
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Which of the following treatment modalities can be routinely used in the treatment of a Stage 3 colonic cancer (ascending colon)?
A. Chemotherapy B. Irradiation C. VEGF inhibitors D. Surgical resection E. TNF-alpha inhibitors |
-Chemotherapy
-VEGF inhibitors -Surgical resection |
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An increased risk of developing colorectal cancer has been PROVED in which of the following conditions?
A. Diet high in red meats B. Ulcerative colitis C. Prior cholecystectomy D. Diet high in fibers E. Familial Adenomatous Polyposis |
-Diet high in red meats
-Ulcerative colitis -Familial Adenomatous Polyposis |
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The therapeutic regimen in IBD may include the following drugs:
A. Antibiotics B. TNF-? inhibitors C. Immunosuppressants D. VEGF inhibitors E. Steroids |
-Antibiotics
-TNF-? inhibitors -Immunosuppressants - Steroids |
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Which of the following statements are true when comparing Crohn's disease to ulcerative colitis (UC)?
A. Perianal involvement is common in Crohn's and usually rare in UC B. Proctocolectomy is usually performed in Crohn's disease, but not in UC C. The risk of malignant transformation is higher in UC than in Crohn's D. Ulcerative colitis is more frequent than Crohn's disease E. The bowel infiltration is often transmural in UC and superficial in Crohn's |
-Perianal involvement is common in Crohn's and usually rare in UC
- The risk of malignant transformation is higher in UC than in Crohn's |
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Which of the following statements are true for surgery in Crohn's disease?
A. The recurrence rate after operation is around 10% B. Perirectal disease may respond to resection of diseased small bowel C. During a bowel resection in Crohn's disease, the surgeon should remove as large portion of the bowel as possible to prevent future recurrence D. The most common indications for operation are obstruction and abscesses E. The surgery is usually curative |
-Perirectal disease may respond to resection of diseased small bowel
-The most common indications for operation are obstruction and abscesses |
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Which is/are true about wound healing?
A. Secondary intention occurs in open wounds B. Most infected wounds and burns heal secondary C. Primary healing is simpler and requires less time D. Primary intention occurs when tissue is clearly incised |
- Secondary intention occurs in open wounds
-Most infected wounds and burns heal secondary -Primary healing is simpler and requires less time -Primary intention occurs when tissue is clearly incised |
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Possible methods for preventing surgical infections:
A. Surgical hand washing B. Surgery in a sterile operating room C. Use of LMWH D. Use of antibiotic prophylaxis |
-Surgical hand washing
-Surgery in a sterile operating room -Use of antibiotic prophylaxis |
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Symptoms of tetanus:
A. Spasms of the facial muscles B. Opisthotonos C. Diarrhea D. Happiness without a cause |
- Spasms of the facial muscles
-Opisthotonos |
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.Which of the following conditions for man absolute indication for a scheduled surgery?
A. Symptomatic gall stones B. Asymptomatic inguinal hernia C. Asymptomatic gall stones D. Gastroesophageal reflux disease E. Confirmed cancer of the ascending colon |
-Symptomatic gall stones
- Confirmed cancer of the ascending colon |
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Which of the following intervention are performed on with a diagnostic intent?
A. Submandibular lymph node biopsy B. Staging mediastinoscopy C. Breast augmentation D. Total colectomy in FAP |
-Submandibular lymph node biopsy
-Staging mediastinoscopy |
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Which is/are true statement(s) about inguinal hernias?
A. Inguinal hernias should always be repaired unless there are specific contraindications B. The complications of incarceration, obstruction and strangulation are greater threats than are the risks of operation C. The most common cause is the weakness of the posterior inguinal wall D. Successful repair requires that any correctable aggravating factors be identified and treated |
-Inguinal hernias should always be repaired unless there are specific contraindications
-The complications of incarceration, obstruction and strangulation are greater threats than are the risks of operation -The most common cause is the weakness of the posterior inguinal wall -Successful repair requires that any correctable aggravating factors be identified and treated |
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Operations for inguinal hernia repair are:
A. TAPP B. Miles operation C. Shouldice D. Lichtenstein operation |
- TAPP
-Shouldice L-ichtenstein operation |
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Possible etiologic factors for incisional hernia are:
A. Poor surgical technique B. Postoperative physical activity C. Length of the incision D. Postoperative wound infection |
Poor surgical technique
Postoperative physical activity Length of the incision Postoperative wound infection |
